title: Promotion of Orange-Fleshed Sweet Potato Increased Vitamin A Intakes and Reduced the Odds of Low Retinol-Binding Protein among Postpartum Kenyan Women.
abstract: Background:Orange-fleshed sweet potato (OFSP) improves vitamin A (VA) status of young children; research with pregnant and lactating women is limited.Objective:We examined the effectiveness of the Mama SASHA (Sweetpotato Action for Security and Health in Africa) program to improve nutrition knowledge, diets, and nutritional status of pregnant and lactating women (PLW) in Western Kenya.Methods:Eight health facilities were allocated to the Mama SASHA intervention or comparison arms. PLW in intervention facilities received enhanced nutrition counseling at health clinics, were linked with community-based maternal support groups, and received vouchers for OFSP vine cuttings. Control PLW received clinic-based nutrition counseling only. A total of 505 women in early and midpregnancy, attending their first antenatal care visit, and with no previous engagement in project activities were enrolled from the 8 facilities. Nutrition and health-seeking knowledge, food security, dietary patterns, and anthropometric measurements were collected at 4 time points at ≤9 mo postpartum. VA intakes were assessed with multipass 24-h recalls in a subsample of 206 mothers at 8-10 mo postpartum. VA status was assessed by using serum retinol-binding protein (RBP). Impacts were estimated with multilevel mixed models adjusted for clustering and differences at enrollment.Results:At enrollment, 22.9% of women had RBP <1.17 μmol/L. By 9 mo postpartum, intervention women had significantly higher intakes of VA [adjusted difference = 297.0 retinol activity equivalent (RAE) units; 95% CI: 82, 513 RAE units;P= 0.01;n= 206], greater consumption of VA-rich fruit and vegetables in the previous 7 d (difference-in-difference estimate: 0.40 d; 95% CI: 0.23, 0.56 d;P< 0.01), and a 45% reduction in the odds of RBP <1.17 μmol/L (OR: 0.55; 95% CI: 0.33, 0.92;P= 0.01).Conclusion:Promotion of OFSP to PLW through health services is a feasible strategy to improve women's nutrition knowledge, VA intakes, and maternal RBP.
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA; awebb3@emory.edu.
authors.forename: Amy Webb
authors.initials: AW
authors.lastname: Girard
authors.affiliation: International Potato Center, Nairobi, Kenya.
authors.forename: Frederick
authors.identifier: 0000-0003-4212-5816
authors.initials: F
authors.lastname: Grant
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Watkinson
authors.affiliation: International Potato Center, Nairobi, Kenya.
authors.forename: Haile Selassie
authors.initials: HS
authors.lastname: Okuku
authors.affiliation: International Potato Center, Nairobi, Kenya.
authors.forename: Rose
authors.initials: R
authors.lastname: Wanjala
authors.affiliation: Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; and.
authors.forename: Donald
authors.initials: D
authors.lastname: Cole
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA.
authors.forename: Carol
authors.initials: C
authors.lastname: Levin
authors.affiliation: International Potato Center, Nairobi, Kenya.
authors.forename: Jan
authors.initials: J
authors.lastname: Low
mesh_terms: D000328:Adult; D005247:Feeding Behavior; D005260:Female; D006268:Health Facilities; D006293:Health Promotion / Q000379:methods / Q000592:standards*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D027723:Ipomoea batatas / Q000737:chemistry*; D007630:Kenya / Q000453:epidemiology; D007774:Lactation; D008297:Male; D008427:Maternal Health Services; D009752:Nutritional Status; D035281:Plant Tubers; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D015397:Program Evaluation; D012177:Retinol-Binding Proteins / Q000172:deficiency / Q000378:metabolism*; D014801:Vitamin A / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology; D014802:Vitamin A Deficiency / Q000097:blood / Q000178:diet therapy / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D012177:Retinol-Binding Proteins; D014801:Vitamin A
keywords: Kenya; agriculture; maternal nutrition; orange-fleshed sweet potato; vitamin A