There are urgent calls for the transformation of agriculture and food systems to address human and planetary health issues. Nutrition-sensitive agriculture and agroecology promise interconnected solutions to these challenges, but evidence of their impact has been limited. In a cluster-randomized trial (NCT02761876), we examined whether a nutrition-sensitive agroecology intervention in rural Tanzania could improve children's dietary diversity. Secondary outcomes were food insecurity and child anthropometry. We also posited that such an intervention would improve sustainable agricultural practices (e.g., agrobiodiversity, intercropping), women's empowerment (e.g., participation in decision making, time use), and women's well-being (e.g., dietary diversity, depression). Food-insecure smallholder farmers with children aged <1 y from 20 villages in Singida, Tanzania, were invited to participate. Villages were paired and publicly randomized; control villages received the intervention after 2 y. One man and 1 woman “mentor farmer” were elected from each intervention village to lead their peers in agroecological learning on topics including legume intensification, nutrition, and women's empowerment. Impact was estimated using longitudinal difference-in-differences fixed-effects regression analyses. A total of 591 households (intervention: n = 296; control: n = 295) were enrolled; 90.0% were retained to study end. After 2 growing seasons, the intervention improved children's dietary diversity score by 0.57 food groups (out of 7; P < 0.01), and the percentage of children achieving minimum dietary diversity (≥4 food groups) increased by 9.9 percentage points during the postharvest season. The intervention significantly reduced household food insecurity but had no significant impact on child anthropometry. The intervention also improved a range of sustainable agriculture, women's empowerment, and women's well-being outcomes. The magnitude of the intervention's impacts was similar to or larger than that of other nutrition-sensitive interventions that provided more substantial inputs but were not agroecologically focused. These data suggest the untapped potential for nutrition-sensitive agroecological approaches to achieve human health while promoting sustainable agricultural practices.

African nightshade (ANS) is among many underexploited and neglected indigenous vegetables. This study assessed the effect of lactic acid fermentation (LAF) on nutritional and sensory quality in Solanum villosum (Sv) and Solanum scabrum (Ss). Spontaneously fermented (SF) and controlled fermented (CF) conditions using Lactobacillus plantarum LP90 and Leuconostoc mesenteroides LM58 were employed for 15 days and 120 h. From the fermented pickles, relish products were prepared using cooking oil and a variety of spices. The relish products were subjected to a consumer acceptability test. Results show a significant drop in pH to <3.5, increasing titratable acidity (TTA) to around 0.6 after 120 h and 15 days of CF and SF, respectively. LAF resulted in a 2.6–5 and 1.6–4.8‐fold significant rise in β‐carotene in pickles and their relish products. All pickles and relish products exhibited a significant decrease (p < .05) in vitamin C by 88.33%–95.90%. LAF significantly reduced total phenolic (26%– 43%) and Chlorophyll (16.45%–39.25%). On the other hand, LAF showed improvement in minerals content (P, Ca, Fe, and Zn) and reduction of tannin (76.27%–92.88%) and oxalate (77.33%–90%) levels. LAF relish products were highly preferred by the consumers, with S. villosum controlled fermented relish (SvCFR) leading. All fermented relishes were stable at ambient (27°C) and refrigeration (4°C) temperatures after 6 months of storage. Generally, LAF is an effective method for ANS preservation, with improved nutritional quality and safety. LAF can therefore be recommended to small‐scale farmers, processors, and households for ANS preservation. Ultimately, this method enhances the nutrition and sensory quality, safety, and livelihood.

Hyperglycemia in pregnancy is a medical condition resulting from either pre-existing diabetes or insulin resistance developed during pregnancy. This study aimed to determine the prevalence of hyperglycemia in pregnancy and influence of body fat percentage and other determinants on developing hyperglycemia in pregnancy among women in Arusha District, Tanzania. A cross–sectional study was conducted between March and December 2018 at selected health facilities in Arusha District involving 468 pregnant women who were not known to have diabetes before pregnancy. Blood glucose was tested by Gluco-Plus™ using the World Health Organization criteria at fasting and 2 h after consuming 75 g of glucose dissolved in 300 ml of water. Body fat was measured using a bioelectric impedance analyzer, mid-upper arm circumference using a regulated tape, weight using SECA™, blood pressure using a GT-868UF Geratherm™ machine, and height using a stadiometer. Demographic and maternal characteristics were collected through face to face interviews using a structured questionnaire. The participants’ mean age was 28 years (SD ± 6), mid-upper arm circumference 27 cm (SD ± 3.7), body fat 33.72% (SD ± 7.2) and pre-pregnancy body mass index 25.6 kg/m2 (SD ± 5.5). One-third of participants had mid-upper arm circumferences ≥28 cm with 25% being overweight and 22.7% obese before pregnancy. Prevalence of hyperglycemia in pregnancy was 16.2% (n = 76) of which 13% had gestational diabetes and 3.2% diabetes in pregnancy. Hyperglycemia in pregnancy was significantly associated with body fat percentage (AOR 1.33; 95% CI: 1.22–1.44), family history of Type 2 diabetes mellitus (AOR 6.95, 95% CI: 3.11–15.55), previous delivery of babies ≥4 kg (AOR 2.3, 95% CI: 1.00–5.28), mid-upper arm circumference ≥ 28 cm (AOR 1.2, 95% CI: 1.09–1.32), and Type 2 diabetes mellitus symptoms (AOR 2.83, 95% CI: 1.53–6.92). The prevalence of hyperglycemia in pregnancy was high, particularly among women with history of delivering ≥4-kg babies, increased body fat, mid-upper arm circumference, symptoms and/or family history of Type 2 diabetes mellitus. These findings identify opportunities to further explore the utility of body fat percentage and other determinants for rapid screening and management of hyperglycemia in pregnancy.

Background: Aflatoxin, produced by Aspergillus flavus and Aspergillus parasiticus fungi, contaminates a broad range of crops such as maize, nuts, and cotton. Aflatoxin exposure causes growth failure, immune suppression, and liver cancer. While several systematic reviews have assessed the link between aflatoxin exposure and growth development in humans, there is a lack of reviews on the associations between aflatoxin exposure and micronutrient levels/status. This review addresses that gap by compiling studies on the association between aflatoxin exposure and micronutrient levels/status in humans. Methods: A comprehensive search of the SCOPUS, PUBMED, EMBASE, and Web of Science databases was conducted, focusing on studies published between 2003 and 2023. Only English-language studies using urine, blood, serum, or plasma biomarkers were included to assess the exposure and outcomes. The risk of bias in these studies was evaluated using the Academy of Nutrition and Dietetics Quality Criteria for human studies. Results: Ten observational studies were included in the systematic review, which collectively reported the association between aflatoxin exposure and haemoglobin, zinc, and vitamin A, E, and C levels. This review suggests that aflatoxin exposure is associated with micronutrient deficiencies, such as anaemia (low haemoglobin levels (<11 g/dL)) in pregnant women and vitamin A deficiency in adults and children. Conclusions: This review highlights the link between aflatoxin exposure and micronutrient deficiencies, emphasizing the need for aflatoxin mitigation within micronutrient interventions. Future studies should focus on longitudinal and interventional research to establish causal relationships and assess the effectiveness of mitigation strategies. Additionally, further research is needed to explore the interaction between aflatoxin exposure and other potential confounding factors such as dietary patterns, socioeconomic status, and genetic predisposition.

Purpose: This study aims at determining the risk of physical inactivity and sedentary behaviors on overweight and obesity among primary school children aged 10–13 years in Tanzania. Design/methodology/approach: A case-control study was conducted from January to March 2020 involving 69 overweight/obese children as cases and 138 normal weight children as controls. Cases were identified as having body mass index-for-age ≥ +1 standard deviation (SD) and controls as those having BMI-for-age range between −2 SD to <+1 SD. A validated questionnaire was used for data collection on daily physical activities and sedentary behavior types, frequency duration and activity score. An independent sample t-test was used to compare means of activity score between cases and controls. Binary logistic regression was used to predict risk factors for overweight/obesity. Findings: Risk factors for overweight/obesity were listening to music and/or radio for >2 h/week (OR 2.7, 95% CI 1.2–6.1) and walking for exercise 2 h/week (OR 0.14, 95% CI 0.03–0.7) was a protective factor against overweight/obesity. Controls had a significantly higher mean score of being active during lunch breaks compared to cases (p = 0.012). Cases had higher weight, height and percentage body fat than controls (p < 0.001). The home environment provided more avenues for physical activity than the school environment. Originality/value: To the best of the authors’ knowledge, this is original research work and the first case-control study to predict physical activity and sedentary behaviors as risk factors for overweight and obesity in Tanzanian school children.

Screening for gestational diabetes mellitus in Tanzania is challenged by limited resources. Therefore, this study aimed to develop a simple method for identification of women at risk of gestational diabetes mellitus in Arusha urban, Tanzania. This study used data from a cross sectional study, that was conducted between March and December 2018 in Arusha District involving 468 pregnant women who were not known to have diabetes before pregnancy. Urine glucose was tested using urine multistics and blood glucose levels by Gluco-Plus™ and diagnosed in accordance with the World Health Organization’s criteria. Anthropometrics were measured using standard procedures and maternal characteristics were collected through face-to-face interviews using a questionnaire with structured questions. Univariate analysis assessed individual variables association with gestational diabetes mellitus where variables with p-value of < 0.05 were included in multivariable analysis and predictors with p-value < 0.1 remained in the final model. Each variable was scored based on its estimated coefficients and risk scores were calculated by multiplying the corresponding coefficients by ten to get integers. The model’s performance was assessed using c-statistic. Data were analyzed using Statistical Package for Social Science™. The risk score included body fat ≥ 38%, delivery to macrosomic babies, mid-upper arm circumference ≥ 28 cm, and family history of type 2 diabetes mellitus. The score correctly identified 98% of women with gestational diabetes with an area under the receiver operating characteristic curve of 0.97 (95% CI 0.96–0.99, p < 0.001), sensitivity of 0.98, and specificity of 0.46. The developed screening tool is highly sensitive and correctly differentiates women with and without gestational diabetes mellitus in a Tanzanian sub-population.