Development and testing of food based dietary guidelines for individuals above five years of age the case of the Lake Victoria Region, Kenya

Abstract

Globally, suboptimal diets are noted as responsible for more deaths than any other risk among adults aged 25 years or older. Dietary analysis found that the leading dietary risk factors for mortality were diets high in sodium, and low in whole grains, fruits, vegetables, nuts, seeds, and ω-3 fatty acids. Further, the poor in developing countries including Kenya suffer from hunger, consumption of food inadequate in micronutrients, and the emergence of overnutrition. Similar challenges are experienced in the Lake Victoria region, Kenya. As a basis to educate the community on healthy eating, earlier research in the region recommended the development of food-based dietary guidelines (FBDGs). This research used descriptive qualitative design to develop and consumer-test FBDGs for the Lowlands in the Lake Victoria region. As recommended by FAO and WHO (1998), both policy makers and consumers were involved in the development of FBDGs. Kisumu and Homa Bay Counties were purposively selected for this study. In a series of three workshops, a 30-member panel drawn from nutrition and nutrition-related fields drafted 11 preliminary FBDGs. Using a focus group discussions (FGD) guide, a total of 72 FGDs each consisting of 8-12 community members were conducted to consumer-test the preliminary guidelines for clarity of words and perception. The FGD was conducted among primary and high school learners and among adult males and females within the community. The FGD proceedings were recorded, transcribed, translated, and coded based on themes. The thematic analysis was carried out with the aid of NVivo8 (QSR International Pty Ltd Version 8, 2008). Feedback from the FGD was used to reword the final draft consisting of 12 guidelines. The guidelines were generally perceived as promoting dietary intake on the basis of the ‗balanced diet‘ principle. However, the ‗balanced diet‘ concept in the region was understood to mean the consumption of meals consisting of three nutrients; carbohydrates, proteins and vitamin. Further, some concepts such as ‗three regular meals‘,‗snacks‘ ‗food variety‘ ‗healthy and physically active lifestyle‘ were not easily understood. Food insecurity, inadequate nutrition knowledge, patriarchy in choices of foods to grow, emerged as challenges likely to impede the implementation of FBDGs in the lowlands of Lake Victoria region. The adoption of the FBDGs in the region will depend on access to adequate economic resources and food availability to community members.