Background: Women are at risk of undernutrition due to biological, socio-economic, and cultural factors. Undernourished women have higher risk of poor obstetric outcomes. We aimed to determine the prevalence and factors associated with undernutrition among women of reproductive age in Uganda.Methods: We used Uganda Demographic and Health Survey (UDHS) 2016 data of 4640 women aged 20 to 49 years excluding pregnant and post-menopausal women. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. We used multivariable logistic regression to determine factors associated with underweight and stunting among 20 to 49 year old women in Uganda.Results: The prevalence of underweight and stunting were 6.9% (318/4640) and 1.3% (58/4640) respectively. Women who belonged to the poorest wealth quintile (Adjusted Odds Ratio (AOR) 3.60, 95% CI 1.85–7.00) were more likely to be underweight compared to those who belonged to the richest wealth quintile. Women residing in rural areas were less likely to be underweight (AOR 0.63, 95%CI 0.41–0.96) compared to women in urban areas. Women in Western (AOR 0.30, 95% CI 0.20–0.44), Eastern (AOR 0.42, 95% CI 0.28–0.63) and Central regions (AOR 0.42, 95% CI 0.25–0.72) were less likely to be underweight compared to those in the Northern region. Women belonging to Central (AOR 4.37, 95% CI 1.44–13.20) and Western (AOR 4.77, 95% CI 1.28–17.78) regions were more likely to be stunted compared to those in the Northern region.Conclusion: The present study showed wealth index, place of residence and region to be associated with undernutrition among 20 to 49 year old women in Uganda. There is need to address socio-economic determinants of maternal undernutrition mainly poverty and regional inequalities.

Consumers are increasingly encouraged to reduce meat and dairy consumption. However, few meta-analyses of randomized controlled trials (RCTs) on the effect of reducing meat and/or dairy on (absolute) protein intake, anthropometric values, and body composition are available. The aim of this systematic review and meta-analysis was to evaluate the effect of reducing meat and/or dairy consumption on (absolute) protein intake, anthropometric values, and body composition in adults aged ≥ 45 years. The MEDLINE, Cochrane CENTRAL, Embase, ClinicalTrials.gov, and International Clinical Trials Registry Platform databases were searched up to November 24, 2021. Randomized controlled trials reporting protein intake, anthropometric values, and body composition were included. Data were pooled using random-effects models and expressed as the mean difference (MD) with 95%CI. Heterogeneity was assessed and quantified using Cochran’s Q and I² statistics. In total, 19 RCTs with a median duration of 12 weeks (range, 4–24 weeks) and a total enrollment of 1475 participants were included. Participants who consumed meat- and/or dairy-reduced diets had a significantly lower protein intake than those who consumed control diets (9 RCTs; MD, −14 g/d; 95%CI, −20 to −8; I² = 81%). Reducing meat and/or dairy consumption had no significant effect on body weight (14 RCTs; MD, −1.2 kg; 95%CI, −3 to 0.7; I² = 12%), body mass index (13 RCTs; MD, −0.3 kg/m²; 95%CI, −1 to 0.4; I² = 34%), waist circumference (9 RCTs; MD, −0.5 cm; 95%CI, −2.1 to 1.1; I² = 26%), amount of body fat (8 RCTs; MD, −1.0 kg; 95%CI, −3.0 to 1.0; I² = 48%), or lean body mass (9 RCTs; MD, −0.4 kg; 95%CI, −1.5 to 0.7; I² = 0%). Reduction of meat and/or dairy appears to reduce protein intake. There is no evidence of a significant impact on anthropometric values or body composition. More long-term intervention studies with defined amounts of meat and dairy are needed to investigate the long-term effects on nutrient intakes and health outcomes. PROSPERO registration no. CRD42020207325.

Background: The global population is increasingly aging, imposing a substantial burden on social and healthcare systems as aging is associated with gradual muscle wasting and functional decline. Consumption of protein-rich foods, such as livestock-based meat, providing high-quality proteins can prevent muscle wasting and related functional decline in older adults. However, there is a lack of data on the older adults’ perceptions about meat consumption, particularly in Sub-Saharan Africa. Objective: To explore the perceptions about dietary meat consumption among older adults in Gasabo district, Kigali, Rwanda. Methods: We conducted a descriptive qualitative study, using focus group discussions. A total of eight FGDs, lasting between 55 and 80 min, were conducted with gender-mixed groups, including 31 men and 33 women aged ≥ 55 years old. Eight older adults participated in each FGD session, and all discussions were conducted in the local language (Kinyarwanda) using a pre-designed interview guide. The discussions were audio-recorded and transcribed verbatim and translated into English. The transcript was inductively analyzed using thematic analytical process. Results: Three themes were identified from the data, predominantly related to motives and barriers of meat consumption. The motives of meat consumption included improved quality and taste of the diet, improving own health, and having a social function. Barriers of meat consumption were perceived to be related to health risks, sustainability concerns (depletion of resources), and religious beliefs. Lastly, it was widely perceived that meat was unavailable and economically inaccessible, thus meat consumption was perceived to be associated with improved wealth. Conclusion: The findings revealed a low and declining meat consumption among older adults due to poverty. Improving financial capacity or strategic public health work to improve protein consumption in the elderly is necessary to meet nutritional needs and facilitate healthy aging.

Older people are at high risk of protein deficiency, which accelerates the age-related loss of muscle mass. However, there is a paucity of data on the consumption of protein-rich animal-sourced foods and their relationship with dietary intake and muscle mass of older adults in low- and middle-income countries. Therefore, this study assessed ASF consumption and its associations with protein intake and muscle mass of older adults. A cross-sectional study was conducted among community-dwelling older adults in the Gasabo district, Rwanda. Dietary intake was estimated using two non-consecutive 24-h recalls. A structured questionnaire was used to collect data on socio-demographic characteristics. Inverse propensity score weighting was employed to assess the association between animal-source food (ASF) consumption and protein intake and muscle mass. Slightly more than half (56%, n = 189) of the older adults consumed ASFs. In adjusted models, ASF consumption was positively associated with protein intake (ATE: 9.6 g/d; CI, 6.8 to 12.4) and muscle mass (ATE: 1.7 kg; CI, 0.0 to 3.4). The results also showed that adding one and two or more ASFs to the diet was proportionally associated with an increase in protein intake (ATE: 4.7 g/d; 95% CI, 0.2 to 9.3 and ATE: 13.9 g/d; 95% CI, 5.9 to 22.0, respectively), but not with muscle mass (ATE: 1.2 kg; 95% CI − 1.4 to 3.9 and ATE: 1.4 kg; 95% CI − 0.6 to 9.6, respectively). The consumption of ASFs was generally low among community-dwelling older adults. However, older adults who consumed ASFs had improved protein intake and muscle mass compared with those who consumed plant-based diets. Large and prospective studies, extending beyond urban settings, are needed to identify factors that can be targeted to improve ASF consumption and overall dietary intake among older adults in Rwanda.

Background: Sub-Saharan Africa is facing a dietary transition with both undernutrition and rising rates of non-communicable diseases. Adopting the reference diet proposed by the EAT-Lancet Commission can reduce both the environmental burden and improve health outcomes. However, whether this diet provides micronutrient adequacy in older adults in low-income settings has not been investigated. This study examines adherence to the EAT-Lancet diet and its association with micronutrient intake among older adults in the Gasabo district, Kigali, Rwanda. Methods: This cross-sectional study involved 334 older adults aged 55–93 years from Kigali, Rwanda. Dietary intake was assessed using two non-consecutive 24-h recalls, and socio-demographic data were collected through interviews. Adherence to the EAT-Lancet diet was evaluated using a 42-point index based on food group consumption and micronutrient intake was analyzed in relation to adherence tertiles. Multivariable regression models, adjusted for age, sex, and energy intake, were used to assess associations between diet adherence and micronutrient intake. Results: The EAT-Lancet adherence score ranged from 13 to 36, with a mean of 24. Higher adherence was associated with increased consumption of whole grains, vegetables, fish, and nuts, while red meat, dairy, and poultry intake declined. Adherence was positively associated with energy intake and intake of retinol-equivalents, thiamine, niacin, folate, vitamins B12 and D, calcium, phosphorus, magnesium, iron, and zinc. When adjusting for energy intake, the association with zinc and potassium became non-significant and the association with riboflavin became negative. Conclusion: Higher adherence to the EAT-Lancet diet was associated with higher intake of energy and several micronutrients important for healthy aging in this population of predominantly older, poor adults in Kigali. However, the potential for nutrient gaps, particularly in riboflavin, highlights the need for context-specific dietary adaptations to ensure nutritional adequacy in older populations in Rwanda.