Food Crop Diversity, Women's Income-Earning Activities, and Distance to Markets in Relation to Maternal Dietary Quality in Tanzania.

Autor:	Madzorera I; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA., Blakstad MM; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA., Bellows AL; Department of International Health (Human Nutrition), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Canavan CR; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA., Mosha D; Ifakara Health Institute, Dar es Salaam, Tanzania., Bromage S; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA., Noor RA; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA., Webb P; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA., Ghosh S; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA., Kinabo J; Department of Food Science Technology, Nutrition and Consumer Sciences, Sokoine University of Agriculture, Morogoro, Tanzania., Masanja H; Ifakara Health Institute, Dar es Salaam, Tanzania., Fawzi WW; Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA.; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	The Journal of nutrition [J Nutr] 2021 Jan 04; Vol. 151 (1), pp. 186-196.
DOI:	10.1093/jn/nxaa329
Abstrakt:	Background: Women's dietary diversity and quality are limited in low- and middle-income countries (LMICs). Nutrition-sensitive interventions that promote food crop diversity and women's access to income could improve diets and address the double burden of malnutrition in LMICs. Objectives: We examined the associations among food crop diversity and women's income-earning activities with women's diet quality, as well as effect modification by access to markets, in the context of small-holder food production in rural Tanzania. Methods: Data from a cross-sectional study of 880 women from Rufiji, Tanzania, were analyzed. Women's dietary intake was assessed using a food frequency questionnaire. The prime diet quality score (PDQS; 21 food groups; range, 0-42), a unique diet-quality metric for women that captures the healthy and unhealthy aspects of diet, was computed. Generalized estimating equation linear models were used to evaluate the associations of food crop diversity and women's income-earning activities with PDQS, while controlling for socio-economic factors. Results: Maternal overweight (24.3%) and obesity (13.1%) were high. The median PDQS was 19 (IQR, 17-21). Households produced 2.0 food crops (SD ± 1.0) yearly. Food crop diversity was positively associated with PDQS (P < 0.001), but the association was strengthened by proximity to markets (P for interaction = 0.02). For women living close (<1.1 km) to markets, producing 1 additional food crop was associated with a 0.67 (95% CI, 0.22-1.12) increase in PDQS, versus a 0.40 (95% CI, 0.24-0.57) increase for women living farther away. The PDQS increased with women's salaried employment (estimate, 0.96; 95% CI, 0.26-1.67). Conclusions: Household food production may interact with access to markets for sales and purchases, while nonfarm income also improves women's diet quality in rural Tanzania. Programs to improve women's diet quality should consider improving market access and women's access to income (source of empowerment), in addition to diversifying production. (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Society for Nutrition.)
Databáze:	MEDLINE
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