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Doctorat
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2022
Ethiopian food-based dietary guidelines : development, evaluation, and adherence monitoring
Titre : Ethiopian food-based dietary guidelines : development, evaluation, and adherence monitoring
Auteur : Bekele, Tesfaye Hailu.
Université de soutenance : Wageningen University & Research.
Grade : Doctor of Philosophy PhD 2022
Résumé partiel
Food-based dietary guidelines (FBDG) promote and maintain healthy eating in a population by providing country-specific guidance. However, many African countries like Ethiopia do not have FBDG. This thesis described the development and evaluation of Ethiopia’s FBDG and healthy eating index (Et-HEI). The methodological framework for developing Ethiopian FBDG and a healthy eating index is described as a three-phase process. A multidisciplinary technical working group was established to develop FBDG for the general population above two years of age. Priority diet-related public health problems and risk factors and a systematic review of dietary patterns related to the identified priority health outcomes following a multi-step process. we reviewed systematic reviews and developed dietary recommendations for the Ethiopian FBDG. Systematic reviews were eligible if they investigated the impact of foods, food groups, diet, or dietary patterns on nutritional status (protein-energy, vitamin A, zinc, calcium, folate), cardiovascular diseases (CVD), or type 2 diabetes mellitus (T2DM). The results showed that not many studies on the impact of diet on protein-energy malnutrition or micronutrient deficiencies were published. Consumption of 30-90g of whole grains daily reduces the risk of CVD and T2DM. Consumption of 15-35g of nuts and seeds per day increases antioxidant levels such as vitamin E and A and lowers CVD and blood sugar levels. Pulse consumption of 50-150g per day or four servings (400g) per week reduces the incidence of CVD and T2DM. Milk and dairy foods are good sources of calcium and help improve bone mineral density among adults and children. Processed meat intake to less than 50 grams daily and eating more fish reduce CVD risk. Sugar consumption should be less than 5-10% of total energy daily to lower the risk of obesity, CVD, and T2DM. the association of saturated fatty acids with CVD and T2DM is inconclusive. CVD and T2DM risks are reduced by consuming 200-300 grams of vegetables and fruits daily. Plant-based diets lower the risk of CVD and T2DM and reduce micronutrient bioavailability. We studied the acceptability, cultural appropriateness, consumers’ understanding, and practicality of the Ethiopian FBDG’s messages, tips, and food graphics using focus group discussions and key informant interviews.
Mots Clés : dietary guidelines ; healthy diets ; public health ; food ; nutritional status ; consumer attitudes ; cultural factors ; education ; gender ; fasting ; cost
Page publiée le 22 mai 2023