Browsing by Author "Wellard, Kate"

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    A food‐based approach could improve dietary adequacy for 12–23‐month‐old Eastern Ugandan children
    (John Wiley & Sons Ltd., 2022) Kimere, C. Njeri; Nambooze, Joweria; Lim, Haeun; Bulungu, L.S. Andrea; Wellard, Kate; Ferguson, L. Elaine.
    Little is known about dietary adequacy, for young Ugandan children, or context‐ specific food choices to improve it. This study estimated the percentage of breastfed 12–23‐month‐old rural Eastern Ugandan children (n = 114) at risk of inadequate intakes of 12 nutrients; and identified realistic food choices for improving it. In this cross‐sectional survey, dietary (weighed food records), anthropometric and socioeconomic data were collected. The percentages of children at risk of inadequate nutrient intakes were estimated, assuming 541 g/day of breast milk was consumed. The median nutrient densities of their complementary feeding diets were also compared with desired levels. Linear programming analyses were used to identify ‘problem nutrients’ (where requirements will be difficult to meet given dietary practices) and model food choices to improve dietary adequacy. Overall, 21.2% of children were stunted and 3.8% were wasted. A high percentage (>45%) of children were at risk of inadequate intakes, for nine of the 12 nutrients assessed, and dietary nutrient densities were below desired levels for seven of the 12 nutrients. Iron, calcium, thiamine and niacin were ‘problem nutrients’. Through careful selection of foods, modelling indicates that population level dietary adequacy can be achieved for eight of the 12 nutrients modelled. These choices include cows' milk, legumes, green leafy vegetables, sweet potatoes and fruits. Overall results suggest these high percentages of children at risk of inadequate nutrient intakes can be reduced through behaviour change interventions, although additional interventions may be required to ensure population‐level dietary adequacy for iron, thiamine and niacin. KEYWORDS: dietary adequacy, food choice, food‐based recommendations, nutrients, nutrition, Uganda, young children
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    Validation of a life-logging wearable camera method and the 24-h diet recall method for assessing maternal and child dietary diversity
    (Cambridge University Press, 2021-06) Bulungu, L. S. Andrea; Palla, Luigi; Priebe, Jan; Forsythe, Lora; Katic, Pamela; Varley, Gwen; Galinda, D. Bernice; Nakimuli, Sarah; Nambooze, Joweria; Wellard, Kate; Ferguson, L. Elaine
    Accurate and timely data are essential for identifying populations at risk for under nutrition due to poor-quality diets, for implementing appropriate interventions and for evaluating change. Life-logging wearable cameras (LLWC) have been used to prospectively capture food/beverage consumed by adults in high-income countries. This study aimed to evaluate the concurrent criterion validity, for assessing maternal and child dietary diversity scores (DDS), of a LLWC-based image-assisted recall (IAR) and 24-h recall (24HR). Direct observation was the criterion method. Food/beverage consumption of rural Eastern Ugandan mothers and their 12–23-month-old child (n 211) was assessed, for the same day for each method, and the IAR and 24HR DDS were compared with the weighed food record DDS using the Bland–Altman limits of agreement (LOA) method of analysis and Cohen’s κ. The relative bias was low for the 24HR (–0•1801 for mothers; –0•1358 for children) and the IAR (0•1227 for mothers; 0•1104 for children), but the LOA were wide (–1•6615 to 1•3012 and –1•6883 to 1•4167 for mothers and children via 24HR, respectively;–2•1322 to 1•8868 and –1•7130 to 1•4921 for mothers and children via IAR, respectively). Cohen’s κ, for DDS via 24HR and IAR, was 0•68 and 0•59, respectively, for mothers, and 0•60 and 0•59, respectively, for children. Both the 24HR and IAR provide an accurate estimate of median dietary diversity, for mothers and their young child, but non-differential measurement error would attenuate associations between DDS and outcomes, thereby under-estimating the true associations between DDS – where estimated via 24HR or IAR – and outcomes measured. Key words: Validation studies: Diet assessment: Wearable cameras: Bland–Altman method
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    Validation of an automated wearable camera‐based image‐assisted recall method and the 24‐hour recall method for assessing women’s time allocation in a nutritionally vulnerable population:
    (MDPI Open Access Journals, 2022) Bulungu, L. S. Andrea; Palla, Luigi; Priebe, Jan; Forsythe, Lora; Katic, Pamela; Varley, Gwen; Galinda, D. Bernice; Nakimuli, Sarah; Nambooze, Joweria; Wellard, Kate; Ferguson, L. Elaine
    Accurate data are essential for investigating relationships between maternal time‐use patterns and nutritional outcomes. The 24 h recall (24HR) has traditionally been used to collect time‐use data, however, automated wearable cameras (AWCs) with an image‐assisted recall (IAR) may reduce recall bias. This study aimed to evaluate their concurrent criterion validity for assessing women’s time use in rural Eastern Ugandan. Women’s (n = 211) time allocations estimated via the AWC‐IAR and 24HR methods were compared with direct observation (criterion method) using the Bland–Altman limits of agreement (LOA) method of analysis and Cronbach’s coefficient alpha (time allocation) or Cohen’s κ (concurrent activities). Systematic bias varied from 1 min (domestic chores) to 226 min (caregiving) for 24HR and 1 min (own production) to 109 min (socializing) for AWC‐IAR. The LOAs were within 2 h for employment, own production, and self‐care for 24HR and AWC‐IAR but exceeded 11 h (24HR) and 9 h (AWC‐IAR) for caregiving and socializing. The LOAs were within four concurrent activities for 24HR (−1.1 to 3.7) and AWC‐IAR (−3.2 to 3.2). Cronbach’s alpha for time allocation ranged from 0.1728 (socializing) to 0.8056 (own production) for 24HR and 0.2270 (socializing) to 0.7938 (own production) for AWC‐IAR. For assessing women’s time allocations at the population level, the 24HR and AWC‐IAR methods are accurate and reliable for employment, own production, and domestic chores but poor for caregiving and socializing. The results of this study suggest the need to revisit previously published research investigating the associations between women’s time allocations and nutrition outcomes. Keywords: Validation studies; time use; methodology; wearable camera; measurement error; care practices; maternal time