Browsing by Author "Lokangaka A"

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    Junk food use and neurodevelopmental and growth outcomes in infants in low-resource settings.
    (2024) Chiwila MK; Krebs NF; Manasyan A; Chomba E; Mwenechanya M; Mazariegos M; Sami N; Pasha O; Tshefu A; Lokangaka A; Goldenberg RL; Bose CL; Koso-Thomas M; Goco N; Do BT; McClure EM; Hambidge KM; Westcott JE; Carlo WA; School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo.; University of Colorado School of Medicine, Aurora, CO, United States.; Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States.; Department of Obstetrics and Gynecology, Columbia University, New York, NY, United States.; Department of Pediatrics, University of North Carolina, Chapel Hill, NC, United States.; Eunice Kennedy Shiver National Institute of Child Health and Human Development, Bethesda, MD, United States.; Global Network, University Teaching Hospital, Lusaka, Zambia.; Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.; Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala.; Research Triangle Institute International, Durham, NC, United States.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    INTRODUCTION: Feeding infants a sub-optimal diet deprives them of critical nutrients for their physical and cognitive development. The objective of this study is to describe the intake of foods of low nutritional value (junk foods) and identify the association with growth and developmental outcomes in infants up to 18 months in low-resource settings. METHODS: This is a secondary analysis of data from an iron-rich complementary foods (meat versus fortified cereal) randomized clinical trial on nutrition conducted in low-resource settings in four low- and middle-income countries (Democratic Republic of the Congo, Guatemala, Pakistan, and Zambia). Mothers in both study arms received nutritional messages on the importance of exclusive breastfeeding up to 6 months with continued breastfeeding up to at least 12 months. This study was designed to identify the socio-demographic predictors of feeding infants' complementary foods of low nutritional value (junk foods) and to assess the associations between prevalence of junk food use with neurodevelopment (assessed with the Bayley Scales of Infant Development II) and growth at 18 months. RESULTS: 1,231 infants were enrolled, and 1,062 (86%) completed the study. Junk food feeding was more common in Guatemala, Pakistan, and Zambia than in the Democratic Republic of Congo. 7% of the infants were fed junk foods at 6 months which increased to 70% at 12 months. Non-exclusive breastfeeding at 6 months, higher maternal body mass index, more years of maternal and paternal education, and higher socioeconomic status were associated with feeding junk food. Prevalence of junk foods use was not associated with adverse neurodevelopmental or growth outcomes. CONCLUSION: The frequency of consumption of junk food was high in these low-resource settings but was not associated with adverse neurodevelopment or growth over the study period.
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    Theory-driven process evaluation of a complementary feeding trial in four countries.
    (2014-Apr) Newman JE; Garces A; Mazariegos M; Michael Hambidge K; Manasyan A; Tshefu A; Lokangaka A; Sami N; Carlo WA; Bose CL; Pasha O; Goco N; Chomba E; Goldenberg RL; Wright LL; Koso-Thomas M; Krebs NF; Statistics and Epidemiology, RTI International, Research Triangle Park, NC 27709, USA, Multidisciplinary Health Institute, Francisco Marroquin University, Guatemala City 01011, Guatemala, Institute for Nutrition of Central America and Panama, Guatemala City 01011, Guatemala, Department of Pediatrics, Section of Nutrition, University of Colorado Denver, Aurora, CO 80045, USA, Centre for Infectious Disease Research in Zambia, Lusaka 34681, Zambia, Kinshasa School of Public Health, Kinshasa, Democratic Republic of Congo, Department of Community Health Science and Family Medicine, Aga Khan University Medical College, Karachi 74800, Pakistan, Department of Pediatrics/Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL 35233, USA, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA, University Teaching Hospital, Lusaka 34681, Zambia, Obstetrics and Gynecology, Columbia University, New York, NY 10027, USA and Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD 20852, USA.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    We conducted a theory-driven process evaluation of a cluster randomized controlled trial comparing two types of complementary feeding (meat versus fortified cereal) on infant growth in Guatemala, Pakistan, Zambia and the Democratic Republic of Congo. We examined process evaluation indicators for the entire study cohort (N = 1236) using chi-square tests to examine differences between treatment groups. We administered exit interviews to 219 caregivers and 45 intervention staff to explore why caregivers may or may not have performed suggested infant feeding behaviors. Multivariate regression analysis was used to determine the relationship between caregiver scores and infant linear growth velocity. As message recall increased, irrespective of treatment group, linear growth velocity increased when controlling for other factors (P < 0.05), emphasizing the importance of study messages. Our detailed process evaluation revealed few differences between treatment groups, giving us confidence that the main trial's lack of effect to reverse the progression of stunting cannot be explained by differences between groups or inconsistencies in protocol implementation. These findings add to an emerging body of literature suggesting limited impact on stunting of interventions initiated during the period of complementary feeding in impoverished environments. The early onset and steady progression support the provision of earlier and comprehensive interventions.