Institut für Ernährungswissenschaften

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Anemia among Syrian refugee children aged 6 to 23 months living in Greater Beirut, Lebanon, including the Voices of Mothers’ and Local Healthcare Staff: A mixed-methods study
(2023) Jeremias, Theresa; Abou-Rizk, Joana; Burgard, Leonie; Entenmann, Isa; Nasreddine, Lara; Jomaa, Lamis; Hwalla, Nahla; Frank, Jan; Scherbaum, Veronika
Globally, the prevalence of anemia among children during the period of complementary feeding is high. A cross-sectional, mixed-methods study was conducted to examine the main determinants of anemia among Syrian refugee children aged 6 to 23 months (n = 215) and to illuminate the knowledge, attitudes and perceptions of their mothers and Lebanese healthcare staff on its causes and available treatment options. 42% of the children and 20% of their mothers were anemic. Determinants of child anemia were the mother having anemia or not knowing that fish/seafood is a source of iron; the child having been acutely ill the last two weeks or receiving cow’s milk, but not consuming iron-rich infant formula, added fats/oils, or fruits in the previous 24 hours. Several Syrian mothers knew some causes of anemia and named dizziness as a leading symptom but did not mention flesh foods as a key source of heme iron. They reported financial constraints in accessing iron-rich foods and supplements. Lebanese doctors largely gave appropriate dietary advice and prescribed iron supplements as treatment. Multisectoral interventions are needed that combine medical and financial support with nutrition counseling for mothers to reduce the high burden of anemia among young children living in a multiple crises situation.
Anthropometrics, hemoglobin status and dietary micronutrient intake among Tanzanian and Mozambican pigeon pea farmers
(2022) Eleraky, Laila; Issa, Ramula; Maciel, Sónia; Mbwana, Hadijah; Rybak, Constance; Frank, Jan; Stuetz, Wolfgang
Inadequate consumption of micronutrient-dense and protein-rich foods such as vegetables, legumes and meat is an important contributing cause for anemia and deficiencies of vitamin A and iron in rural communities of Tanzania and Mozambique. A cross-sectional study was conducted to assess the nutritional status (anthropometrics and hemoglobin) and diets in particular micronutrient intake of female and male pigeon pea farmers from Lindi, Tanzania, and Gurué, the Zambézia province of Mozambique. A total of 1526 farmers (669 from Tanzania, 857 from Mozambique) were studied, of whom 16% were overweight and 35% were anemic. The highest prevalence of overweight and anemia, at 35% and 48%, was observed in Tanzanian and Mozambican women, respectively. Overall, only a small proportion of women and men reached the recommended daily dietary intake of vitamin A (10%), iron (51%) and zinc (44%). Multiple regression models revealed that dark green leafy vegetables (DGLVs) highly predicted vitamin A intake, whereas legumes in Tanzania and starchy plants in Mozambique were actually the dominant sources of vitamin A. Cereals covered over half of the iron and the zinc intake in both countries. An increased consumption of micronutrient-rich DGLVs and legumes, while reducing the high amounts of refined maize or polished rice, is suggested to counteract the high prevalence of anemia and overweight among smallholder farmers in East and South Eastern Africa.
Infant feeding practices, nutrition, and associated health factors during the first six months of life among Syrian refugees in Greater Beirut, Lebanon: A mixed methods study
(2022) Abou-Rizk, Joana; Jeremias, Theresa; Nasreddine, Lara; Jomaa, Lamis; Hwalla, Nahla; Frank, Jan; Scherbaum, Veronika
The objective was to describe infant feeding practices, nutrition and related health aspects of infants under six months among Syrian refugees in Greater Beirut, Lebanon. A cross-sectional study was conducted among Syrian refugee mothers with infants under six months in July–October 2018 (N = 114). Additionally, eleven focus group discussions were conducted to explore supportive factors and barriers associated with early breastfeeding practices. The prevalence of pre-lacteal feeding was high (62.5%), whereas early initiation of breastfeeding was low (31%), and exclusive breastfeeding very low (24.6%). One-fifth of the infants were anemic (20.5%) and 9.6% were wasted. A significantly higher proportion of non-exclusively breastfed infants had a fever and took medicines than those who were exclusively breastfed. Supporting factors of adequate infant feeding practices comprised knowledge on maternal nutrition and exclusive breastfeeding, along with receiving support from healthcare professionals and family members. Identified barriers included preterm delivery, pre-lacteal feeding, an at-risk waist circumference and moderate to severe depression among mothers, bottle feeding, early introduction of food, maternal health reasons, breastmilk substitutes’ distribution, and misinformation offered by mothers-in-law. To address sub-optimal feeding practices documented among Syrian refugees, awareness on proper breastfeeding practices, maternal nutrition, and psychosocial support should be provided to mothers and family members alike.
Nutrition-related knowledge, attitudes, practices, and anemia status of lactating mothers in Bukavu, Democratic Republic of the Congo - A cross-sectional analysis
(2024) Beitze, Damaris Elisabeth; Kavira Malengera, Céline; Barhwamire Kabesha, Theophile; Scherbaum, Veronika
Maternal nutrition is impacted by personal and environmental factors including dietary intake, knowledge, food availability, and affordability. This cross-sectional analysis aimed to evaluate nutrition-related knowledge, attitudes, practices, and associations with hemoglobin concentration among lactating mothers in the Bukavu region, Democratic Republic of the Congo. In 444 lactating mothers, nutrition-related knowledge and practice were assessed by questionnaires and translated into knowledge and practice scores ranging from 0 to 1, attitudes and drivers of food choice were assessed, the Dietary Diversity Score (DDS) was assessed with 24 h dietary recalls in a potential range from 0 to 10, and hemoglobin (Hb) was measured in mothers and their infants. Anemia prevalence was 28.2% among mothers and 74.3% among infants aged 3–8 months. Nutritional knowledge and practice were limited (the median total knowledge score was 0.39, median DDS was 3.0). While there were slight positive correlations between knowledge and maternal Hb, DDS did not significantly correlate with either knowledge or Hb. Although half of the mothers stated a perception about their own susceptibility to anemia or vitamin A deficiency (56.4%, 47.4%), less than half of those could justify their estimation (40.9%, 44.2%). Taste (68.1%), appearance (42.5%), availability (29.0%), and health effects (25.6%) were important drivers of food choice. In conclusion, interventions on the different influencing factors including nutrition education strategies are needed.
Uncovering the relationship between selenium status, age, health, and dietary habits: Insights from a large population study including nonagenarian offspring from the MARK-AGE project
(2023) Giacconi, Robertina; Piacenza, Francesco; Aversano, Valentina; Zampieri, Michele; Bürkle, Alexander; Villanueva, María Moreno; Dollé, Martijn E.T.; Jansen, Eugène; Grune, Tilman; Gonos, Efstathios S.; Franceschi, Claudio; Capri, Miriam; Weinberger, Birgit; Sikora, Ewa; Toussaint, Olivier; Debacq-Chainiaux, Florence; Stuetz, Wolfgang; Slagboom, Pieternella Eline; Bernhardt, Jürgen; Fernández-Sánchez, Maria Luisa; Provinciali, Mauro; Malavolta, Marco
An inadequate selenium (Se) status can accelerate the aging process, increasing the vulnerability to age-related diseases. The study aimed to investigate plasma Se and Se species in a large population, including 2200 older adults from the general population (RASIG), 514 nonagenarian offspring (GO), and 293 GO Spouses (SGO). Plasma Se levels in women exhibit an inverted U-shaped pattern, increasing with age until the post-menopausal period and then declining. Conversely, men exhibit a linear decline in plasma Se levels with age. Subjects from Finland had the highest plasma Se values, while those from Poland had the lowest ones. Plasma Se was influenced by fish and vitamin consumption, but there were no significant differences between RASIG, GO, and SGO. Plasma Se was positively associated with albumin, HDL, total cholesterol, fibrinogen, and triglycerides and negatively associated with homocysteine. Fractionation analysis showed that Se distribution among plasma selenoproteins is affected by age, glucometabolic and inflammatory factors, and being GO or SGO. These findings show that sex-specific, nutritional, and inflammatory factors play a crucial role in the regulation of Se plasma levels throughout the aging process and that the shared environment of GO and SGO plays a role in their distinctive Se fractionation.
Walnut oil reduces Aβ levels and increases neurite length in a cellular model of early Alzheimer disease
(2022) Esselun, Carsten; Dieter, Fabian; Sus, Nadine; Frank, Jan; Eckert, Gunter P.
Mitochondria are the cells’ main source of energy. Mitochondrial dysfunction represents a key hallmark of aging and is linked to the development of Alzheimer’s disease (AD). Maintaining mitochondrial function might contribute to healthy aging and the prevention of AD. The Mediterranean diet, including walnuts, seems to prevent age-related neurodegeneration. Walnuts are a rich source of α-linolenic acid (ALA), an essential n3-fatty acid and the precursor for n3-long-chain polyunsaturated fatty acids (n3-PUFA), which might potentially improve mitochondrial function. (2) Methods: We tested whether a lipophilic walnut extract (WE) affects mitochondrial function and other parameters in human SH-SY5Y cells transfected with the neuronal amyloid precursor protein (APP695). Walnut lipids were extracted using a Soxhlet Extraction System and analyzed using GC/MS and HPLC/FD. Adenosine triphosphate (ATP) concentrations were quantified under basal conditions in cell culture, as well as after rotenone-induced stress. Neurite outgrowth was investigated, as well as membrane integrity, cellular reactive oxygen species, cellular peroxidase activity, and citrate synthase activity. Beta-amyloid (Aβ) was quantified using homogenous time-resolved fluorescence. (3) Results: The main constituents of WE are linoleic acid, oleic acid, α-linolenic acid, and γ- and δ-tocopherol. Basal ATP levels following rotenone treatment, as well as citrate synthase activity, were increased after WE treatment. WE significantly increased cellular reactive oxygen species but lowered peroxidase activity. Membrane integrity was not affected. Furthermore, WE treatment reduced Aβ1–40 and stimulated neurite growth. (4) Conclusions: WE might increase ATP production after induction of mitochondrial biogenesis. Decreased Aβ1–40 formation and enhanced ATP levels might enhance neurite growth, making WE a potential agent to enhance neuronal function and to prevent the development of AD. In this sense, WE could be a promising agent for the prevention of AD.

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