Lupine Publishers | In-Depth Review of Caregivers’ Nutrition Education effects, on Complementary Feeding Practices in Nigeria

 Lupine Publishers | Scholarly Journal of Food and Nutrition

Abstract

This study is an in-depth finding of the effect of nutrition education on caregivers’ complementary feeding practices. The WHO recommendations for optimal complementary feeding are based on continued breastfeeding, early introduction of solid or soft diet, minimum meal frequency (MMF) and minimum dietary diversity (MDD) in terms of food groups. Improved knowledge on adequate complementary feeding could positively affect the attitude of caregivers towards complementary feeding practices. Meanwhile, effect of demographic and socio-economic status was also reviewed. Materials used for this study are secondary data from archived materials and existing literature on effects of nutrition education on complementary feeding in Nigeria and other developing. The study showed that reports on complementary feeding practices in developing countries are rated inadequate, with inappropriate early introduction of complementary feeding. Complementary feeding was either introduced too early or too late with thin and low iron rich and vitamin A rich diet. Study revealed poor practices of Minimum Meal Frequency (MMF) and Minimum Dietary Diversity (MDD). Force feeding overrides responsive feeding which attracts other complicated health issues among the infants. The final summary showed that nutrition education will be an effective tool to solve the problem of inadequacy in complementary feeding practices.

Introduction

The knowledge, attitude and practices of complementary feeding among caregivers in the developing countries have been rated poor [1]. Caregivers’ nutrition education on complementary feeding is an effective tool to improve the complementary feeding practices. Other factors affecting the complementary feeding as revealed by researchers are socio-demographic and socio-economic status of the caregivers. The effects of nutrition education on knowledge, attitude and complementary feeding practices of the caregivers and the nutritional status of infants revealed by existing literature are discussed in this chapter. Infants feeding practices reports available in some West African nations showed poor practices of MAD by caregivers in Ghana (13%) and in Benin Republic (9%) [2]. The report of the Nigerian National Demographic and Health Survey [3] indicated that only 11% of the breastfed infants received complementary foods from at least four food groups. Globally, about 45% of infants less than 6 months of age were exclusively breastfed (EBF), with 42% in sub-Sahara Africa and 29% for West and Central African countries. In Nigeria, EBF rate is at 17%, which implies that 83% have had untimely introduction of complementary feeding [1]. In the developing countries, malnutrition has been proved to be responsible for over 41% of the deaths among children 6 to 24 months of age [4,5] revealed that under nutrition of protein and energy-giving foods contributed to 45% of death, among children less than five years of age in evidence-based research carried out in 34 countries in the world. The global strategy for infants and young child feeding was based on the significance of nutrition in the early months and years of life [6]. These strategies include monitoring, assessing and promoting adequate infant nutrition, breastfeeding, feeding behavior, national health programs and infants feeding guidelines. In order to achieve adequate infant feeding practices in the developing nations, the global strategies must be followed.

Research objectives are

a) To ascertain the relationship between caregiver’s nutrition education on caregivers’ complementary feeding knowledge, attitudes and practices

b) To identify relative findings on effects of nutrition education on caregivers’ complementary feeding knowledge, attitudes and practices

c) To establish the on effects of caregivers’ nutrition education on infant’s nutrition status

Research Methods

Secondary data from existing literatures on effects of nutrition education on complementary feeding knowledge, attitude and practices as well as the infant’s nutrition status was used to make compilations on these findings.

Demographic and socio-economic factors influencing caregivers complementary feeding practices:

Demographic and socio-economic status of caregivers is one of the major factors associated with poor complementary feeding practices of caregivers and nutrition status of infants in developing countries [7]. Maternal age, educational level and the household’s income have been reported as factors associated with the complementary feeding knowledge, attitudes and practices among the caregivers. The caregivers’ age and low education level attainment have been revealed to influence complementary feeding practices in countries such as India [8]. In Nepal, indicated that mothers of infants aged 6-23 months working outside the home were less likely to practice optimal complementary feeding that meet the recommended dietary diversity. Also, [9] revealed that mothers that worked 8 hours outside their homes were unable to meet the recommended dietary diversity and meal frequency for infants in Nigeria. This was associated with limited time they had with their children. [10] revealed that food restrictions due to cultural belief as well as economic status of mothers were contributing factors to inappropriate feeding practices among mothers in Cross River State, Nigeria. In Moretele District in South Africa, [11] showed that adherence to cultural practices affects mothers’ attitude to complementary feeding practices. Households with lower wealth index were found to be the more likely to have inappropriate complementary feeding practices in India, Bangladesh, Nepal, Pakistan and Sri Lanka [12]. There was a significant association found between caregivers’ socio-economic status and infant feeding practices in Nekemte, Ethiopia. The study showed that caregivers in the low socio-economic strata practiced sub-optima complementary feeding [13]. The effects of economic status on nutrition status of children have also been illustrated by researchers. In Ondo State, [14] discovered low intake of energy dense food and protein containing food among children whose mother were living in rural communities of Ondo state. The author stated further that the mothers were of low socioeconomic status. This corroborates the research of [15] on effect of low socio-economic status of rural market women in owo Local Government of Ondo State on the nutrition status of their infants. The study reported a positive correlation between low economic status of the market women and the feeding practices as well as the nutritional status of the children. Research has proved that caregivers required skilled support to adequately feed their infants despite the limitations which could be caused by socio-economic and demographic status of the caregivers [16]. Nutrition education is an effective way of improving complementary feeding practices among mothers as [17] reported that poor feeding practices are not necessarily due to lack of high quality of foods at the household but lack of infants’ feeding knowledge by the caregivers.

Complementary feeding knowledge, attitude and practices:

Knowledge is the understanding of any given topic [18]. In this study, knowledge referred to the ability to understand specified aspects of complementary feeding practices. Attitudes are emotions, motivations and perceptive as well as cognitive beliefs that could either positively or negatively influence the caregivers’ complementary feeding attitudes [18-20]. Caregivers complementary feeding attitudes or infant’ feeding behavior is influenced by his/her emotional, motivational and perceptional as well as thoughts [20]. Attitudes have the ability to influence the future behavior of the caregivers’ knowledge and could explain the reason why caregivers adopt complementary feeding practices and no other alternatives [21]. The terms attitude, beliefs and perceptions are interchangeable. In this study, “practices” is an observable action of a caregiver that could affect his/her infants’ nutrition, such as eating, feeding, water treatment, cooking and foods selection for the infants. Practice and behavior are terms used interchangeable, though practice has a connotation of longstanding or commonly practiced behavior [22].

Effect of nutrition education on caregivers’ complementary feeding knowledge:

Knowledge on complementary feeding by the caregivers has been revealed by [11] to be limited in African countries. A Nigerian study showed that knowledge on benefit of continued breastfeeding along complementary feeding till the infant’s age 24 months is low [23]. A descriptive study on maternal knowledge on complementary feeding in India, established that 75% of caregivers had average knowledge on appropriate consistency and safe preservation of infant’s meal [24]. The circumstances are similar to Nigeria, Ondo State in particular. According to [25], only 30% of the caregivers have adequate knowledge of complementary feeding in Nigeria. In Ondo State, it is reported that 70% of the caregivers used sorghum majorly as complementary foods [15]. The role of nutrition education on caregivers feeding knowledge cannot be underrated. The [16] stated that inadequate knowledge on appropriate complementary feeding is a determinant of malnutrition among the infants in the developing countries. The effect of organized and well-planned nutrition education on complementary feeding knowledge have been proved by researchers [26] reported that 88% of caregivers in North Shan State and Karachi State Republic of the Union of Myanmar were able to plan infants’ meals from more than four food groups after nutrition education on the infants feeding knowledge [27] showed that nutrition education to improve maternal complementary feeding knowledge significantly impacts on knowledge of meal preparation for children in Uganda. The authors stated that 71% of caregivers who received nutrition education intervention had improved knowledge in complementary feeding and were able to improve in infants feeding frequency. Furthermore, Nutrition education and counseling on infants feeding improved the complementary feeding knowledge of caregivers significantly by 1.5 points in a study conducted in the Philippines. Ondo State, Nigeria still suffers a setback in adequate complementary feeding as there is lack or low knowledge of complementary feeding [15]. The author reported that caregivers in Ondo State had low knowledge on food diversification. Intervention programs which involve the caregivers and Community Health Extension Workers have been confirmed to be limited in Ondo State thereby causing a research gap on complementary feeding knowledge in Ondo State, Nigeria consistency. The study of [15] was a cross-sectional study to determine the situation of feeding practices and factors affecting the feeding practices of the infants. In Nigeria, only 3.7% of households have access to an improved water resources located on premises, free of E-coli and available when needed [28]. The report showed that diarrhea is prevalent due to poor access to portable drinking water. Caregivers knowledge to improved access to portable water was low as 63.4% of caregivers used unprotected well in Biye community in Kaduna, Nigeria [29] the author stated further that water boiling method is the cheapest way to achieve portable water for the infants in the community.

Effect of nutrition education on caregivers’ complementary feeding attitudes:

The UNICEF [17] suggested that reduction of child mortality can be achieved when IYCF awareness is improved. The poor complementary feeding attitudes have been linked with communities’ beliefs and mothers’ perceptions [30]. Showed that socio-cultural belief has a strong influence on infants feeding and determines optimal infants feeding practices; breastfeeding and complementary feeding in Kakamega County, Kenya. In Zambia, majority stopped breastfeeding before the appropriate time because they believed that breast milk was not enough, and that the child had lost interest in breastfeeding described how Mexican mothers in a cross-sectional survey mostly fed their children liquid and semi liquid foods with few vegetables, meats and legumes. The author stated that Mexican mothers took this decision due to their perspective on the consistency of the food for infants, that is, soft or solid foods are detrimental to infants’ health [31] confirmed that, despite the economic status and educational attainments of mothers, they exhibit poor attitude to complementary feeding in Shabelle Zone of Somalia due to influence of the cultural belief. Feeding thin consistency feeds in small amounts and food restriction due to cultural beliefs are common in Nigeria [32, 33] revealed that scientific knowledge on infant feeding practices would improve complementary feeding attitude among mothers in Republic of Kosovar. Meanwhile, the author’s opinion was in contrast to [34] who revealed that despite the nutritional education on importance of consumption of pulses to children’s wellbeing in Southern Ethiopia, there was no significant difference between attitudes of mothers who received the training and attitudes of mothers in the control group due to cultural belief on effect of pulses on children [35] experienced low acceptability of blended complementary food with pulses in Ethiopia. This study put into consideration the fact that cultural beliefs may be influencing caregivers’ attitude and therefore focused on other beneficial food items in the study area to improve caregivers’ attitude on complementary feeding [36]. Showed that despite the knowledge of complementary feeding among mothers in Lagos State, Nigeria, the mothers had the poor attitude towards timely introduction of complementary feeding as majority of the caregivers introduced complementary feeding too early or too late. The author stated that this was prevalent among working mothers. The intervention of nutrition education and counseling was proved to improve mothers’ attitude towards complementary feeding [37] revealed that caregivers had change in attitudes towards responsive feeding and their infants’ nutrient intake was higher compared to the control group. Most studies conducted both in Ondo State and in other locations in Nigeria were descriptive and cross-sectional studies, leaving research gaps on effect of nutrition education on complementary feeding attitudes in the area [23] conducted a cross-sectional survey in Nigeria on factors affecting breastfeeding practices. This was a cross sectional study which identified poor practices of breastfeeding but could not profound solution through an intervention [25] conducted a study in Lagos, Nigeria on factors associated with inadequate complementary feeding. Also, [14] carried out a study on complementary feeding in Ondo State, Nigeria on effect of socio-economic status on infant feeding. The above two studies were cross-sectional studies on factors associated with inadequate complementary feeding in Nigeria. The studies of [25,14] were unable to improve the complementary feeding attitudes of the caregivers in the study areas because they were cross-sectional studies and not an interventional study. The above two studies had little or no effect on the participants, although they could be included by Nigerian government’s program for policy framework. The study of [38] and [39] was designed to assess complementary feeding practices among caregivers and there was no intervention on complementary feeding practices in these studies. There is limited literature on the effect of nutrition education on maternal attitudes towards complementary feeding.

Effect of nutrition education on caregivers’ complementary feeding practices:

A report by UNICEF showed that complementary feeding practices are globally poor [2]. In Ireland, only 36% of infants had timely initiation of solid and semi solid foods. According to [40], only 1.8% of caregivers in Uganda fed infants with protein containing food products, especially meat during the period of complementary feeding [41] stated that only 28% of caregivers in Ghana were able to feed their infants 2-3 times daily with adequate complementary meals. The level of inadequate complementary feeding in Nigeria is worse than that of Ghana as only 11% of exclusively breastfed infants receive complementary meals from four food groups and only 7% of the non-exclusive breastfed infants were fed with adequate complementary feeding in Nigeria. These show the poor practices of complementary feeding among caregivers in the region. United States Agency for International Development [42] in an assessment of infant and young child feeding practices in Nigeria affirmed that there are challenges to improve on complementary feeding behaviors among caregivers with infants. However, the author indicated that with well-trained health workers, coordinated and targeted messaging to caregivers and influencing groups in the communities, there will be a great deal of progress towards increasing optimal infant and young child feeding practices in Nigeria. To corroborate the above, [38] and [39] observed that nutrition education intervention among caregivers in Nigeria will improve the caregivers’ complementary feeding practices [43] discovered that nutrition education on complementary feeding carried out by 30 several studies in developing countries showed statistical evidences of improved complementary feeding practices of mothers. Therefore, the study recommended nutrition education among mothers to improve complementary feeding practices. The study of [29] on improved hygiene practices among caregivers showed that 79.6% caregivers boiled their drinking water in Biye community, Kaduna, Nigeria. Interventions that improved complementary feeding practices among caregivers were carried out in some part of the world such as Cambodia, Zimbabwe, Mali and Ghana with different degrees of success. In Bangladesh, [44] revealed that breastfeeding counseling improved exclusive breastfeeding among mothers. The author revealed that when mothers received counseling on exclusive breastfeeding, they practiced it until 135 days while the control group practiced exclusive breastfeeding for 75 days. This improvement achieved was due to interventional research by the researcher. Another instance was the successful report of FAO [20] in a program titled “Promoting improved complementary feeding” in Cambodia. The program was based on counseling, training and cooking demonstration. This program was carried out by conducting home visits to assist households who were encountering challenges in adopting the improved complementary feeding and the caregivers were trained with improved recipe. The program was recorded to be a success as the caregivers had improved knowledge, attitude and complementary feeding practices. However, a similar nutrition education program which trained the caregivers on improving complementary feeding in Zimbabwe proved unsuccessful due to inadequate monitoring system and lack of trained personnel for continuity [27] stated that women who receive nutrition education on complementary feeding were able to prepare complementary diet from over four food groups, compared to their attitude towards dietary diversity before the nutrition education. The success report of Cambodia nutrition education and training program was particularly based on the current caregivers with infants at the time of the program in the study area. The program did not plan for the sustainability of the program on subsequent caregivers; as there were no community-based personnel that were involved to receive the training [20]. Also, in Zimbabwe, the nutrition program to promote adequate complementary feeding practices was unsuccessful due to lack of trained personnel educating caregivers to continue with the programs among the caregivers. There has been limited documentation of complementary feeding on nutrition education targeted at the caregivers as well as health personnel within the health care system who deals with maternal and child’s health in Ondo State. Surveys on infants’ feeding practices available were mainly on cross-sectional survey of the situation and no known intervention was found.

Effect of caregivers’ nutrition education on nutrition status of infants

The National Demographic and Health Survey carried out by revealed that 43% of children less than five years of age in rural areas of Nigeria were stunted and 29% of Nigerian children were underweight and too thin for age. In Ondo State, 26% of children less than five years were stunted while 43% were underweight [45]. Inadequacy in complementary feeding practices can result to malnutrition in children during the complementary feeding period [46]. Declared the period of complementary feeding as a period of windows of opportunity for growth flattering. Revealed that there were suboptimal complementary feeding practices among mothers studied in different geographical area in Nigeria which leads to growth flattering of infants in the area. Interventions that can bring about improvement in the nutrition status of infants could be achieved by nutrition education [5] revealed that weight and height increased among children 6-24 months of age after maternal nutrition education on complementary feeding in Sri Lanka and Tanzania. Concluded that nutrition education intervention was successful in reducing malnutrition in Pakistan as 36% malnourished children progressed to normal nutrition status [47] showed that there was an increase in weight (350g) and length (0.66cm) among the infants of caregivers in intervention group that received complementary feeding nutrition education in Karachi, Pakistan [48] stated that pooled-effect sizes from three recent systematic reviews suggested a modest nutrition education but there was a significant effect of the types of complementary feeding interventions on weight and length gain [49] revealed the effectiveness of nutrition education as a tool to improve mothers’ knowledge and complementary feeding practices which improved the nutrition status of the infants. The author reported in a postprogram comparison research carried out among mothers in Uganda. Mother who participated in the program had significant improvement on complementary feeding practices which in turn had positive impact on the nutrition status of their infants. In Nigeria there is limited literature on benefit of nutrition education on nutrition status of the infants. The above interventional studies on nutrition education on complementary feeding were carried out to determine the effect of the intervention on complementary feeding practices as well as the effects on the nutritional status of the infants.

Discussion

The literatures reviewed for this study showed that the complementary feeding knowledge, attitude and practices among the caregivers is inadequate, and this affects the nutrition status of infants. The caregivers especially in the developing countries such as Nigeria and some African nations have limited or low knowledge of appropriate complementary feeding practices. The caregivers’ complementary feeding practices are not in line with the WHO recommended guidelines for infants feeding. The knowledge on the appropriate time of introducing complementary feeding among the caregivers was established. Majority of the caregivers had knowledge on timely introduction of complementary feeding (6 months), although not all of them. It means that some introduced early while some introduced it late. This is similar to the report of [47]. The author reported that in Karachi, Pakistan 17% of the mothers lacked knowledge of appropriate time of introducing complementary feeding and 83% had good knowledge. Although, [13] revealed that 44.2% of mothers in Nekemte, Ethiopia lacked knowledge on rightful time of introducing complementary feeding. The literature reviewed further showed that the attitudes of the caregivers towards complementary feeding were influenced by the culture and the belief of the caregivers as an individual and the communities. It is an established fact that nutrition education would be an effective means of improving complementary feeding practices among caregivers on; timely introduction of complementary feeding, soft/solid food consistency, good hygiene practices, food diversification, consumption of iron rich foods and minimum acceptable diet. Effect of caregivers’ belief on dietary diversity as indicated by [30] revealed that mothers’ attitude towards infants feeding played a significant role in food they fed the children in Kakamega County, Kenya [34] reported that mothers’ negative attitude towards pulses in feeding the infants was the factor preventing mothers to diversify complementary foods with pulses in Southern Ethiopia but the knowledge of the caregivers in the intervention group was improved on dietary diversity after nutrition education. According to [50] knowledge either directly contributes to attitude formation or indirectly affects attitudes. Complementary feeding practices by caregivers globally were rated poor [16]. The author stated further that the situation does not exclude the caregivers in the developed world; it is a global problem [16]. The effect of poor complementary feeding practices on the infants’ wellbeing has been identified and determined to be, increase in morbidity and mortality rate [16]. Survival rate of infants before their first birthday has been associated with feeding practices of the caregivers [51]. Intervention on complementary feeding practices rated the second to reduce mortality rate in infancy. It has been shown that infant and young child feeding is a key area to improve child survival, promote healthy growth and development [52].

Acknowledgement

The researchers acknowledge TETFUND and Rufus Giwa Polytechnic, Owo, Ondo State.

Conflict of interest

The researchers declare no conflict of interest regarding this study.

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Lupine Publishers | Do Low Carb Diets Cause Heart Disease or Cancer?

 Lupine Publ;ishers | Scholarly Journal of Food and Nutrition

Keywords

Keywords: Fmtvdm; lowcarb; heart disease; cancer; atkins; pritikin

Introduction

It is well recognized that coronary artery disease and cancer are the result of inflammatory changes, which occur within the tissues of the body - specifically the walls of the coronary arteries (CAD) and within the specific organ (e.g. breast, colon) tissue in question [1-3] – and not the blood. Despite this obvious difference between blood and tissue, medical studies looking at the impact of diets and drugs have primarily utilized changes in qualitative or at best semi-quantitative imaging [4-6], weight and blood tests to monitor presumed changes in heart disease and cancer. However, changes in heart disease and cancer cannot be measured through the mere use of blood tests alone, since these blood tests merely tell us what is happening within the blood and not what is happening in the tissues of the body proper [7,8] – hence, the persistent debate about the consequences of different diets or drugs, and the potential risk for CAD and cancer [9-14] – and the persistent doubt and confusion by the public and media [15-18]. Frankly, if I hadn’t spent more than three decades working out some of the details and limitations in our knowledge and published studies - based upon what I read in the lay press - I would be just as confused [19-25].

Case example in point - consequence or coincidence?

A middle-aged man with chest discomfort, had per his report, been following a LowCarb diet for six months. His already borderline elevated total blood cholesterol level prior to beginning the LowCarb diet had increased by almost 100 mg/dl or 2.59 mmol/l after being on the diet. His physician ordered a coronary artery calcium (CAC) study, shown in Figure 1, which revealed no evidence of calcification (Table 1). The absence of measurable calcium on a CAC study does not eliminate CAD [1], although, elevated numbers – which are semi-quantitative, can be helpful. In this instance they were not. Following persistent angina chest pain, a coronary arteriogram (cardiac catheterization), shown in Figure 2, was performed reportedly revealing a 99% narrowing of the proximal part of the patients left anterior descending (LAD) coronary artery. This was treated with stent placement. The real question here isn’t does he have CAD – which he still has despite having stents because having a stent doesn’t mean you are now free of CAD, only that you are receiving continued treatment for the CAD – but WHY? Clearly the answer is that he has inflammation within the wall of his LAD. But the more fundamental question is why did this inflammation occur and was the LowCarb diet, which he reported following, the cause of that inflammation or was it merely a coincidence?.

 

Discussion

Beyond the obvious information from the patients case, including his reported history of changing his diet, the already borderline elevated blood cholesterol level which reportedly increased further on the LowCarb diet and the CAC study, which failed to detect CAD because, after all, CAC studies only detect calcium – which when present is a good indicator of something going on but the absence of which as seen in this case does not eliminate the question of CAD – the question then becomes, Did the LowCarb diet produce the patients CAD and angina [19,20]? It is unlikely that in six-months he went from pristine arteries to an almost totally occluded LAD – although as previously documented using Positron Emission Tomography (PET) this could have happened [26]. Notwithstanding this possibility, we simply have no prior information about the state of health of this gentleman’s coronary arteries prior to this original cardiac catheterization. Was this the same amount of narrowing that was present prior to the dietary change? Is this worse or better than what existed before? While we now know that Dr. Robert Atkins died with CAD and reportedly had stents placed for treatment years before his death - it is not known whether the Atkins diet was the cause of his CAD. Perhaps it was coincidental, perhaps his heart disease would have been worse without the diet, perhaps it was the cause or perhaps the diet had no effect at all. We also know that Nathan Pritikin died with leukemia and followed the Pritikin vegetarian diet. While much attention has been paid to reports that Pritikin had heart disease diagnosed earlier in life, which was reportedly absent at the time of his death – we truly don’t know if the original diagnosis of heart disease was accurate, or not. Perhaps he never had heart disease and simple didn’t develop it over time following his diet. The bigger question – one I never hear raised – is What role, if any; did his diet play in his leukemia? Was it the cause, or would he have died earlier had he not been following his diet? Or perhaps the Pritikin diet had no effect on the leukemia.

Despite all the social media, advertising, marketing, Google searches, tweeting, blogs, Facebook postings, and bickering, we will never know the answer to how these diets affected the overall health of - or the role, if any, they played in - Atkins heart disease or Pritikin’s cancer. Anyone who tells you otherwise is probably trying to sell you something. It is one thing to say there is a correlation and something else altogether to say there is causation [27]. What we do know is inflammation is the cause of heart disease and the early changes associated with cancer [1]. This inflammation is caused by a host of factors, which play different roles in different individuals, based upon their genetic response to environmental factors – environmental factors, which include inter alia diet, lifestyle, medications, and smoking. We also know that merely taking blood samples to look for cholesterol levels, or C-reactive protein, or homocysteine, or anything else is ersatz and is not going to tell us what is happening to the coronary arteries themselves or to tissue (e.g. breast) undergoing an environmental barrage on its way to becoming cancer [7,8]. If we as physicians are going to talk to our patients, or publish papers in medical journals, or talk to the media – so the media can write second hand stories, which someone else will write third hand stories about – then we need to get our facts straight and to do that will require that we objectively measure [28] what we are talking about. Until then, we are only doing everyone a disservice by pretending we know exactly what these diets are doing to people. If we are right, then we have just been lucky. If we are wrong – then we are potentially violating our Hippocratic Oath, “Primum non nocere”.

Conclusion

Before we continue to tell people which diets are safe, which are harmful, and which may have no impact on heart disease or cancer, we should first objectively measure the true effect these diets have on the arteries of the heart and the potential areas of the body, where we are concerned about the risk of cancer occurring. Then and only then will we be able to have an intelligent objective conversation with our patients about diets and their causative role in heart disease and cancer.

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Lupine Publishers | How Beneficial are Statins and PCSK9-Inhibitors?

 Lupine Publishers | Scholarly Journal of Food and Nutrition

 

Abstract

Everyday people take their cars into the mechanic to be worked on. Sometimes it’s for routine maintenance, other times it’s because a warning light has come on or something just doesn’t feel or sound right when the car is running. People frequently visit their doctors for the same reason. Either something just doesn’t feel right – perhaps an unusual ache or pain, sometimes that pain is in your chest - or one of your blood tests (warning lights) came back in an abnormal range. Your doctor will frequently run blood tests looking for a problem, much like the mechanic will check the oil in your engine. Except the auto mechanic shuts the car off to run his tests; something your doctor doesn’t have the luxury of doing. You can infer a lot by looking at the engine oil, or getting a blood test. But you can only infer something is going on. Neither the engine oil nor the blood test tells you what the problem actually is – only hopefully where to look for the answer to the problem When people get their cholesterol levels checked, it’s usually because they’re worried about their heart – even though cholesterol by itself doesn’t cause heart disease (Figure 1) – inflammation does. To begin with you should also know there is more than one type of cholesterol in your body.

The combination of these various types of cholesterol, when put together, are called your total cholesterol (TC). It’s the sum of your good (HDL) and bad (LDL) cholesterol, along with the fats (triglycerides) in your blood, which are either made in your liver (very low density lipoprotein cholesterol; VLDL) or consumed (fats and chylomicrons) by you in the foods you eat. Another type of cholesterol is called intermediate density lipoprotein cholesterol (IDL), because it is intermediate in density, compared with the other types, and when compared with the other types of cholesterol IDL is composed almost equally of cholesterol and fat.

TC = HDL + LDL + VLDL/5 + Chylomicrons + IDL

You probably already realize this, but you do need cholesterol for your body to work. You need cholesterol for your cells to grow and maintain themselves and you need cholesterol for hormones, for the lining of the axons of nerves in your body – including your brain. You really don’t need to worry about eating it because your liver is designed to make it. In fact, most people only absorb about 10% of the cholesterol they eat, which means for most people, they are absorbing somewhere between 25 and 50 mg each day from the food they eat. If you had to depend upon that, you would probably either die or become seriously ill. Fortunately you don’t need to depend upon what you absorb from the foods you eat, because your liver will make around 1000 mg each day – 20 to 40 times the amount you get from your diet – as long as you don’t have liver disease. One of the interesting characteristics of carnivores is that their livers don’t make cholesterol to meet their needs, so carnivores have to consume cholesterol from the foods they eat to survive.

All this begs the question, if we need cholesterol, why do so many doctors say cholesterol is bad for you? The answer is both simpler and much more complex (Figure 1), than many people think. Most foods that are high in cholesterol are also high in saturated fat and it is this saturated fat, once oxidized, which is a primary, although not only, cause of inflammation, within the walls of the arteries of the heart that produces coronary artery (CAD)/heart disease [1,2], angina and death.

Increased dietary saturated fat intake not only increases the amount of cholesterol made by your liver, but it can also reduce the ability of cells in your body to remove the LDL cholesterol (Figures 1 & 3) from the blood, by interfering with the LDL receptors themselves–i.e., the part of your cells responsible for recognizing cholesterol and removing it from the blood for use by the body. Just like insulin receptors, which respond to increased levels of glucose (sugar) in the blood stream, so too do the LDL receptors, respond to increased levels of LDL cholesterol. However, there is no actual relationship between measured changes in blood tests like cholesterol and measured changes in CAD [3], when physiologically measured [4], as shown in (Figure 2) [2]. These changes cannot be measured using mere coronary arteriograms [5]-the basis for most if not all of the clinical data supporting the use of cholesterol lowering medicines - as coronary arteriograms neither measure the ability of the coronary arteries to respond to increased demand for coronary blood flow, nor the inflammation within the walls of the arteries themselves. This is an extremely important point and one that is frequently overlooked, given that up to 70% of all myocardial infarctions (heart attacks) occur in people whose arteries have less than 30% narrowing of the lumen – the area where the blood flows - and it is only this lumen narrowing, which coronary arteriograms can evaluate.

What types of foods raise your cholesterol levels?

While there are many studies which reveal that many different types of diets may initially show improvements in weight loss and blood cholesterol levels, most (not all) people would agree that there are three basic types of foods, which have been associated with increased cholesterol levels. These include:

a. Saturated Fat

b. Trans Fats, and

c. Highly refined, processed foods.

An increased consumption of any, or a combination of these, can be associated with increased cholesterol levels, increased insulin resistance, increased LDL receptor resistance, and increased weightobesity. Consequently resulting in heart disease, strokes, diabetes and a variety of other diseases. One of the common themes running through medicine and social media is the belief, that medicines can solve your problems or at least ameliorate them, thereby shifting the burden of responsibility. Something Big Pharma and Big Food are all too happy to accept, as this shift in responsibility results in profits for these corporations. Clearly you don’t solve what you put in your mouth by putting something else in your mouth–including medications or more of another type of food. You solve the problem by not putting the first problem in your mouth.

While the approach of putting more food or medications in your mouth is lucrative for Big Food and Big Pharma, it has been disastrous for everyone else. Let’s be very clear here-there has not been a shift in genetics in the last 100 years. Evolutionary mutations don’t work that way and such changes when they do occur, provide a survival benefit or they become extinguished. As Figure 4 shows [6], there is little, if any, survival benefit from this increased expenditure of healthcare monies being thrown at the problem and no appreciable increased life expectancy. One of, if not the, major health care expenditure currently confronting us, is the cost of prescription medications; with statins, PCSK9-inhibitors and diabetes medications leading the way. Before we address how these medications work, lets first look at the issue of cholesterol itself.

How much cholesterol is too much?

People unfortunately have a tendency to think of things in black and white, true false, right wrong - absolutes. For decades physicians have talked about levels of cholesterol that we want to keep your blood cholesterol below to reduce your risk of heart disease. The truth is that there is no absolute value, which is safe for everyone. What may be safe for you may kill someone else and vice-versa.

In the 1980’s and 1990’s, the first author was a member of the American Heart Association - Physician Cholesterol Education Faculty, and we used to tell people that total cholesterol levels should be kept below 150 milligrams/deciliter (mg/dl or %) or 3.879 mmol/l (millimole per liter) in standard international (SI) units. The use of this number was somewhat arbitrary as 50% (half) of all people who have heart attacks, have total cholesterol levels less than 150 mg/dl. At the same time, other people with higher cholesterol levels do not have heart attacks. There are a number of reasons for this including the differences in genetic handling of cholesterol levels, the other factors involved in the inflammatory process (Figure 1) and our sheer lack of real data about tissue levels of cholesterol and CAD where the real problem lies, versus blood levels of cholesterol and CAD.

The important take away point is that oxidized cholesterol builds up in the walls of the arteries of the heart and elsewhere, interfering with the ability of these arteries of the heart to do their job and the result, which isn’t measured by looking at the cholesterol in the blood, is a heart attack, stroke, loss of limb, etc. Cholesterol flowing through the blood stream without depositing is not actually causing an issue, at least not while flowing freely through the blood.

The cholesterol causing heart disease isn’t the cholesterol floating around in your blood stream to be sampled by your doctor

Only about 7% of your total BODY cholesterol is found in your BLOOD. The remaining 93%, which we don’t measure, is stored inside the cells of your body. Within the cells, the cholesterol is being used for cell growth, repair and to make hormones along with other substances needed by your body. It is also here where cholesterol is undergoing oxidation and participating in the inflammation within the walls of your arteries - where the real problem exists. When too much cholesterol is stored in the walls of your arteries, and oxidized, inflammation will occur (Figure 1) and these arteries will not be able to do their job. When that happens, you can have a heart attack, stroke, need kidney dialysis or lose a limb. It will just depend upon which artery is being damaged. The smaller the artery the sooner the damage is likely to occur and be noticed.

LDL receptor resistance is just as important, if not more so, than Insulin resistance (Figures 1 & 3)

A lot of people are talking about insulin resistance - the reason why many people ultimately develop diabetes. When you have more sugar than the cells of your body need, the cells protect themselves by becoming less responsive to the insulin. Less responsive = insulin resistance.

The same thing happens with cholesterol. Most, but not all, of your cholesterol is taken up for use by the cells of your body via LDL cholesterol receptors. Just like the insulin receptors for glucose (sugar), when the cells in your body don’t need more cholesterol, the LDL cholesterol receptors become less response (Figure 3). Less responsive = LDL resistance. When these LDL receptors become less responsive, the LDL cholesterol remains in your blood stream longer, where with time it becomes damaged (oxidized). This oxidized cholesterol can enter the walls of the arteries which supply blood to your brain, heart, kidneys, liver; in other words, everywhere. Once inside the walls of your arteries, this oxidized cholesterol - which is an inflammatory irritant to the artery - is taken up or consumed (phagocytized) by a special type of cell, called a macrophage.

Macrophages are specialized cells intended to protect your body. They are part of your defensive immune system designed to fight disease and foreign invaders. By consuming the oxidized cholesterol, the damaged cholesterol is removed from the wall of the arteries. Unfortunately, this results in the death of these macrophages, which have died in defense of your body; thus beginning an inflammatory build up within the walls of your artery, which we call atherosclerosis - or coronary artery (heart) disease.

This inflammatory buildup within the walls of arteries interferes with the ability of the coronary arteries to relax and carry more blood flow to the heart when needed [4,5]. This is atherosclerosis and it is not seen by conventional cardiology tests. Coronary arteriograms with their limitations and reliability problems [5], do not see this buildup within the walls of the artery. Coronary calcium (CAC) scoring, which looks for the presence of calcium – which may or may not be present (Figure 1) - only sees calcium (if present) but tells us nothing about the ability of the arteries to increase their blood flow when needed.

Both arteriograms and CAC scoring are merely anatomic tests. They are limited to seeing a narrowing or calcium, but their failure to see something and their inability to tell you what the arteries are capable of doing [4], provide us limited information. Up to eightyfive percent of people will have a heart attack due to the rupture of this built up inflammatory material, inflammation, which began years earlier within the walls of the arteries. As such the use of coronary arteriograms and CAC scores for assessing the impact of cholesterol lowering drugs is extremely limited and should be cautiously considered.

How do the cholesterol lowering drugs work?

Ninety-three (93) percent of the low-density lipoprotein (LDL) cholesterol in your body, the cholesterol we call the bad cholesterol - because it is this cholesterol, which eventually causes most of the harm to the arteries of your body once oxidized, causing heart attacks, strokes and other major medical problems – is actually in the cells of your body and not the blood stream. It is in the cells of your body, where this LDL is needed – where it is actually being used for cell growth, repair, hormone production, et cetera, where it cannot be measured. However, even too much of a good thing, can be a problem.

This 93% of your body’s cholesterol isn’t measured by sampling your blood for cholesterol. This cholesterol is inside the cells and cannot be measured, at least without taking biopsies (pieces) of your muscles, heart, brain, liver, et cetera. To get this LDL inside your cells to be used requires, as we have mentioned, a special receptor that recognizes the LDL - just like there are insulin receptors that recognize insulin to bring glucose into the cells.

Many of the drugs physicians use to lower your cholesterol, work either by slowing down how much cholesterol your liver makes (that 1000 mg per day) or they work by trying to increase how much LDL cholesterol is taken up from the blood, into the cells of your body. Just because you lower the amount of LDL in your blood, doesn’t mean you are reducing the amount of LDL in your body. In fact if you’re removing it from the blood and putting it inside the cells, you’re clearly not removing it from the body. The consequence of this is an increase in the amount of cholesterol within the cells of the body proper. When those cells are within the walls of the coronary arteries, inflammation can worsen promoting CAD. Coronary arteriograms and CAC scores are not going to see this.

The main drugs for slowing the production of cholesterol by your liver are HMG Co-A reductase inhibitors - affectionately called statins. This is the slowest step in the production of cholesterol by your liver. There is ample evidence that these drugs interfere with co-enzyme Q 10, needed for normal cellular function. There is also unpublished data, showing that damage to muscles, resulting from the use of statins is much higher than previously thought, with studies showing muscle damage even when blood tests for that muscle damage are not elevated.

Another older group of drugs, included here for purpose of being complete, are the bile acid sequestrants. These drugs work inside your gastrointestinal (GI) tract, where they combine with the cholesterol in the bile secreted through your liver and gallbladder to help digest fats you have eaten. By binding with the cholesterol in your bile, the cholesterol is removed from your body when you evacuate your bowels. Thus these drugs actually lower the total body cholesterol burden.

A relatively new group of drugs are the PCSK9 inhibitors. These drugs are antibodies to proprotein convertase subtilisin kexin9 (PCSK9). PCSK9 removes LDL receptors from your liver as part of the naturally occurring clean up (recycling) sequence. The function of PCSK9 is to reduce the number of LDL receptors your liver has, which will reduce the amount of LDL your liver can remove from your blood. Block this with a PCSK9 inhibitor, and the LDL receptors remain in place, resulting in more LDL being removed from your blood by your liver; thereby lowering your blood LDL cholesterol, while increasing your liver LDL cholesterol.

Finally, we have Niacin - also known as vitamin B3. Niacin increases your good (HDL) cholesterol, which you can also do by exercising, not smoking if you are a smoker and reduce the fats and refined foods in your diet. Again, not putting the first thing in your mouth.

HDL is a scavenger mechanism. By removing LDL from other parts of the body, HDL can reduce the level of LDL in your blood - but not your body. HDL merely moves the cholesterol around from one place to another, to be dealt with another day. In some instances, HDL can actually harm your body. If the HDL is dysfunctional, which happens either due to genetics or when you have diabetes, inflammation or oxidative stress, this same HDL that was once thought to be only helpful, can actually be pro-inflammatory and cause atherosclerotic heart disease.

Conclusion

The focus of using cholesterol lowering medications, is to lower blood cholesterol levels. However, as we have seen, the real harm occurs within the cells of the body and in particular within the walls of the arteries, where inflammatory plaques result from a combination of factors (Figure 1), including but not limited to oxidized LDL cholesterol. By actually lowering the serum LDL levels, many of these drugs work by increasing the uptake of LDL into the cells of the body proper.

The proposed benefit of these medications, are based upon the lowering of blood LDL cholesterol levels, and reported changes in coronary arteriograms. However, the lack of correlation between changes in blood cholesterol levels and changes in measured physiologic CAD [3] - by simply removing the LDL cholesterol from the blood and placing it into the cells of the body where oxidation may occur – raise significant questions as to the real cost benefit ratios of these drugs.

Given these limitations, it would appear that greater emphasis should be placed on lowering total body cholesterol burden, either through the use of medications which actually lower LDL body cholesterol levels, or through dietary and lifestyle changes which limit the oxidative impact of LDL cholesterol in addition to the other components (Figure 1) responsible for inflammatory coronary artery disease.

Acknowledgment

FMTVDM is issued to the first author. The “Inflammation and Heart Disease” theory was developed by the first author. All figures reproduced with the expressed consent of the first author.

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Lupine Publishers | Autism and Food Selectivity- Mini Review

 Lupine Publishers | Scholarly Journal of Food and Nutrition

Introduction

The label “autism” has become one of the most important linguistic and conceptual creations in medical and psychological nomenclature, and has two names linked to pioneering studies: Austrian pediatrician Hans Asperger and Austrian psychiatrist Leo Kanner. Seventy years have passed since the publication of Asperger’s text on autism (1944), Kanner’s article (1943) had been known since its publication. Asperger was totally ignored until 1976 when English psychiatrist Lorna Wing published an article summarizing the work [1]. Kanner (1943), who first described and named early childhood autism, believed it was a distinct entity to be clearly distinguished from mental retardation, but there are many people who would argue that the two cannot be separated [2].

Autism and Asperger’s syndrome [3-5] are best known among invasive developmental disorders (PDD), a family of conditions marked by the early onset of delays and deviations in the development of social, communicative and cognitive skills. too many skills [6]. The first reports were made in 1943 by Leo Kanner, who first described 11 cases of what he called autistic affective contact disorders [7] as a condition with very specific behavioral characteristics, such as: disturbances of affective relationships. with the environment, extreme autistic loneliness, inability to use language for communication, presence of good cognitive potentialities, apparently normal physical appearance, ritualistic behaviors, early onset and predominant incidence in males.

Knickerbocker proposed that oral sensitivity, which is common in children with ASD, may be another example of a sensory system that is not only hyperresponsive to oral input, but also has a deficit in the modulation capacity of a varied sensory information input [8].

Oral hyperresponsiveness is more common in children with ASD than in children with typical development. Children with oral hyperresponsiveness are described as picky eaters, eat few vegetables and fruits, refuse to eat the same meal as their family, refuse to try and have aversion to certain tastes, textures and smells, do not like foods with low temperatures. or tall [9]. Parents of children with ASD often report that their children have a very restricted diet, with limited and limited food selection and acceptance and may be restricted to five foods [10].

In several of the studies analyzed by the authors, reports of food-based refusal of food have been identified, and difficulties in ingesting certain food textures have been attributed to changes in sensory processing or may be indicative of oro-motor difficulties, as well., sensory or oromotor changes may contribute to food refusal, with difficulty in chewing food or tolerating texture mix [11].

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Lupine Publishes | Poultry Meat

 Lupine Publishers | Trends in Ophthalmology Open Access Journal 

Introduction

Chicken meat and its products are important for human diet in all over the world because they contribute to solve the global food problems and provide the well-known protein, fat, essential amino acids, minerals, vitamins and other nutrients and they also have a milder flavor which is more readily complemented with flavoring and sauces. Environmental pollution by heavy metals is considered as one of the most serious problems in the world over the last few decades. Emissions of heavy metals to the environment occur via a wide range of pathways, including air, water and soil, threatening the animal and human health and quality of the environment. Heavy metal toxicity could be present in different ways depending on its route of ingestion, its chemical form, dose, tissue affinity, age and sex, as well as whether exposure is acute or chronic and. Nowadays, poultry feed is produced from various raw materials such as fish by-products that can transfer heavy metals to poultry feed in undesirable levels following collecting them from contaminated waters, that may lead to increase of trace metals in chicken and chicken products with a serious threat because of their toxicity, bioaccumulation and biomagnifications in the food chain.

The main heavy metals of concern are lead, cadmium, copper, mercury and arsenic which at even low concentrations pose serious health hazard to primary and secondary consumers due to bio magnifications. The effects of metals and metalloids are partly due to the direct inhibition of enzymatic systems and, also to the indirect alteration of the essential metal ion equilibrium. Majority of the known metals and metalloids are very toxic to living organisms and even those considered as essential can be toxic if present in excess. Moreover, owing to their toxicity persistence and tendency to accumulate, heavy metals when occurring in higher concentrations, become severe toxic for human being and all living organisms through alteration of physiological activities and biochemical parameters in blood and tissues, and through defects in cellular uptake mechanisms in the mammalian liver and kidney, inhibiting hepatic and renal sulfate / bicarbonate transporter causing sulfaturia.

Lead is an accumulative poison; it has hematological effect due to the inhibition of hemoglobin synthesis and shortening life span of circulating erythrocytes resulting in anemia. It has a toxic and damage effects leading to reduction of the cognitive development and intellectual performance in children; increase blood pressure; damage of the brain and kidneys; cardiovascular and reproductive diseases in adults.

Cadmium is used extensively in the mining and electroplating industries and found in fertilizes and fungicides. It is a very toxic heavy metal, which accumulates inside the body particularly kidneys and chronic exposure may induce heart diseases, anemia, skeletal weakness, depressed immune system response, kidney and liver diseases; cancer and death.

Copper is an essential element for man and animals. It is required for normal biological activity of several enzymes and it added to poultry diets with manganese and zinc (premix) to enhance their weight gain and disease prevention. Meanwhile, ingestion of excessive doses of copper may lead to adverse health problems, such as severe nausea, bloody diarrhea, hypotension, liver and kidney damage.

Arsenic is a metalloid that occurs in inorganic and organic forms and is found in the environment, both naturally occurring and as a result of human activity. The inorganic forms of arsenic are more toxic than organic ones. However, so far, most of the data regarding arsenic occurrence in food, gathered under the official control of foodstuff, is still reported as total arsenic, without differentiating the various types of arsenic in the diet. It has a toxic effects includes decrease in hemoglobin, packed cell volume, erythrocytic count and total leukocytic counts, heterophils and lymphocytes.

The presence of the residual agro-chemicals in foods is detrimental to human health and the accumulation of foreign chemicals such as lead, arsenic, cadmium, copper and mercury in human system has been linked to immune-suppression, hypersensitivity to chemical agents, liver and kidney damage, breast cancer, reduce sperm count and infertility, respiratory distress DNA alteration and death in extreme cases. Considering the fact that chicken meat and its products can contain some toxic heavy metals and therefore exposure to the toxic trace metals will be gained through consumption of these products, the accurate determination of them has been focused by researchers in last decades, worldwide.

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Lupine Publishers | Net Revenue Determination of Beans Marketers in Imo State, Nigeria

 Lupine publishers |  Scholarly Journal of Food and Nutrition\

Abstract

The study is on net revenue determination of beans marketers in Imo state, Nigeria. Specifically, it examines the socioeconomic characteristics of the respondents, determines the factors influencing the selling price and marketing margin of beans and identifies the marketing constraint for beans in the study area. Purposive and simple random sampling techniques were employed to select eighteen (18) wholesalers and forty-eight (48) retailers. Descriptive statistics and multiple regression models were used to analyze the data collected. Results showed that majority of the beans traders were males, within the age range of 41-50 years, well educated, have high marketing experience, married and belong to trade/cooperative association. The regression analysis shows that the purchase price of beans favored the selling price of wholesale and retail marketing however it has negative effect on variables such on their marketing margins and seasonality. The constraints to beans marketing in the study area are problem of insurgency (91.94%), high transportation cost (95.16%) and high purchase price (87.10%).The results suggest that policies that could impact on transportation and insurgencies in the north should be adopted to ameliorate the challenges of Bean marketers.

Keywords: Net Revenue; Determination; Beans (Cowpea); Marketers; Nigeria

JEL Classification: D41, L10, Q13

Introduction

Beans are third most popular food after rice and cassava in Nigeria, grown throughout sub-Saharan Africa commonly in the dry savanna regions of West Africa. A warm climate and drought tolerant crop grown throughout the tropics particularly in the semi-arid and low rainfall regions [1], it is a pulse with high protein content, affordable and also a staple food crop. Its forage is used in animal feed especially during dry season when animal feed is scarce and demand for feed is very high. Beans play a key role in the diet of rural and urban dwellers especially the poor and vulnerable group as an affordable source of protein and a substitute for animal protein. This is in line with Ayinde and Adejobi [2], who reported that beans provide the most affordable protein supplement to the urban and rural poor. This is as a result of its ability to serve in different forms such as Moimoi, Akara (bean cake) etc. it can also be cooked alongside with other cereals and tubers such as rice, maize, yam, plantain etc. which is very affordable and helps to reduce high rate of starchy food consumption in the developing countries. In Nigeria Beans production is appreciating, having its major producing states in the north. Singh et al. [3] as reported by [4] revealed that Nigeria is the major producer and consumer of beans in the world with production estimate of 1.7million metric tons from about 4million hectares. Futuless et al. [5] also reported that about 14million hectares are under beans cultivation with about 5million of the total being in Nigeria. In 2013 it was revealed that Nigeria produces an average of 2.5 million metric tons of beans [6]. The high production rate of beans in Nigeria can be attributed to high population growth, poverty and the demand for low-cost food. According to Nathan et al. [7] the economic importance of beans in Nigeria is on the increase particularly in the southern states where its demand is increasingly high due to population growth. This is as a result of its aptitude in boosting their protein intake thereby covering the gap created by insufficient supply of animal protein in the diets of many households [8]. However, beans production in Nigeria has declined in the past few years as a result of insurgency in the northern region of the country which is the main producer of beans, it is reported that most of the beans consumed in Nigeria is imported from neighboring countries such as Niger republic and Burkina Faso (African agricultural technology foundation [9]. Beans have emerged with the potentiality of bridging the protein-carbohydrate imbalance prevailing in Nigeria through its wide range of acceptability and its nutritional value which aims towards sustainability and food and nutrition security Thus, improving the revenue generation of both the producers and the marketers. However, Gieri et al. [4] reported that some of the major problems associated with beans production and marketing is inadequate capital, pest and disease, poor logistics marketing outlets and management difficulties which have adverse effect on their net revenue [10]. Also, according to Bakoji [11] farmers socioeconomic factors such as farm size, level of education, years of farming experience, institutional and technological factors influence their net revenue on beans production and marketing activities [12,13]. Despite this limitations on beans production, there is a rapid population growth with increasing demand for staple food crops therefore there is a need to make advancements in coping with the challenges surrounding beans production and marketing in order to meet the demand for food to achieve food sufficiency and eradicate malnutrition in the study area. This study aims to examine net revenue determination of beans marketers in Imo state, Nigeria. Specifically; it intends to achieve the following

a) Examine the socioeconomic characteristics of beans marketers

b) Determine the factors influencing the net revenue of beans marketers in the study area.

c) Identify the marketing constraints for beans marketers in the study area.

Methodology

This study was conducted in Imo State. The state lies in the south east geopolitical zone of Nigeria with Owerri as its capital and largest city. The State also lies within latitudes 40451N and 70151N, and longitude 60501E and 70251E with an area of around 5,100sq.km. Imo State is composed of three Agricultural zones, namely; Owerri, Okigwe and Orlu and it is subdivided into 27 Local Government Areas (LGAs). The State has a total population of 3,934,899 persons with a population density that varies from 230 persons per square kilometer in the densely populated areas [14]. Agriculture is assumed to be one of the major sources of income of most occupants of the area though they are largely civil servants. Purposive and random sampling techniques were used in selecting the respondents. A main market from the three agricultural zones namely owerri, okigwe and orlu was purposively selected due to high concentration of marketing activities in these markets. One rural local government area was randomly selected from each of the three agricultural zones. A major market was selected from the three rural LGAs. Thus, three urban and three rural markets making a total of six markets were randomly selected for the study. Six beans wholesalers and six retailers were selected from the three urban markets and from the rural market; ten beans retailers were randomly selected. This gives 18 wholesalers and 48 retailers (18 urban and 30 rural retailers) and a total of 66 respondents for the study. Data for this study were collected from primary source and was obtained using a well-structured questionnaire. Data collected were analyzed using descriptive statistics and multiple regression techniques.

Results and Conclusion

Source: Field survey data, 2019

The result of the socioeconomics of beans marketers as shown in the Table 1 above discloses that majority of beans marketers were male (Tables 2 & 3). This points to the fact that it is a strenuous business, which often requires activities such loading and off-loading, movement of product from the long distance of production to areas of sale may be a challenge to the female counterparts. It further shows that the marketers have a mean age of 46 which indicates that majority of them are active and energetic enough to carry out the work associated with transferring beans from one place to another. The educational attainment of the marketers shows that majority of the marketers spent 13-18 years in school, which implies that the marketers has gained a high level of education and are innovative enough to maximize the limited resources and generate profit. The table further highlights that majority of the bean’s marketers have marketing experience range from 21-30 years, this implies that the marketers have been in the marketing business for a reasonable number of years and have acquired experience and skills needed to cope with the complexities of marketing. Majority of the marketers were married and belongs to trade/cooperative association, this implies that they may have availability of labor and access to credit, extension/business strategist which will boost their marketing activities. The estimated functions were evaluated in terms of the statistical significance and coefficient of magnitude. Using the coefficient of multiple determinations (R~) and (F) value coefficient which defines the magnitude of t-values and based on a priori expectation. The regression result of factors influencing wholesaler's selling price of Beans as presented. Based on these statistical and economic criteria, the Linear functional form was selected as the lead equation since it has the highest significant of coefficient of R at 0.7737 indicated by F-value of 5.8594.

***Sig@ 1%; **sig@ 5%, *sig@ 10%, + Lead equation. Source: Computed Results 2019

This implies that 77.37% variability in selling price was explained by the variables considered in the model, while the remaining 22.63% was unexplained which could be attributed to errors and omitted variables. The F-statistics value of 5.8594 was significant which implies that the model is the best fit for the expression and an indication of overall significance of the regression. Out of the seven independent variables, three variables namely purchase price (X¹), marketing cost (X²) and seasonality (X³) were statistically significant at 5% level of probability. The regression result of the factors influencing the retailer's selling price for beans in the Table 3 above shows the four functional forms, and based on the values of R~, F-statistics and the a priori expectation, the exponential function was chosen as the lead equation as it has the highest significant R2 as indicated by F-statistics (9.6281). Results show that the coefficient of multiple determinations (R~) was 0.6647.This implies that 68.78% of the variability in retailer's selling price was explained by the exogenous variables included in the model while the remaining 33.53% was unexplained variables attributed to omitted variables captured by the error term. The F-statistics value of 5.8594 (p<0.00) was significant implied the model is best fit for the expression and an indication of overall significance of the regression. Results show that the purchase price (X¹), number of buyers (X⁴) and market location (7) were statistically significant at 5% respectively. This implies that purchase price, number of buyers and market location significantly affects the retailers selling price of beans.

***sig at 1%; ** sig at 5%, * sig at 10% + Lead Equation Source: Computed Results, 2019

Factors Influencing the Marketing Margins for Beans

Table 4 shows the regression result of the factors influencing the wholesaler's marketing margins for beans in the study area. It shows the four functional forms, and based on the values of R~, l: -statistics and the a priori expectation, the double log function was chosen as the lead equation. Results showed that the coefficient of multiple determinations (R~) was 0.7441. This implies that 74.41% of the variability in wholesaler's marketing margins was explained by the independent variables included in the regression model, while the remaining 25.59% was unexplained due to omitted variables in the model as captured by the errors term of the regression model. The F-statistics value of 2.6166 (p<0.01) was significant implied the model is best fit for the expression and an indication of overall significance of the regression. Results show that the purchase price (X¹), transportation cost (X³), handling cost (X⁵) and seasonality (X¹⁰) were statistically significant at 5% which implies that the marketing margin of the beans marketers are greatly influenced by the impact of purchase price, transportation cost, handling cost and seasonality nature of beans. The above results in Table 5 shows the regression result of the factors influencing the retailer's marketing margins for beans in the study area. It shows the four functional forms and based on the values of R and F-statistics the linear function was chosen as the lead equation. Results showed that the coefficient of multiple determinations (R) was 0.8401.

*** Significant at 1%; ** significant at 5%, ^significant at 10% + Lead equation Source: Computed Results, 2019.

***significant at 1%; ** significant at 5%, *significant at 10% + = Lead equation Source: Computed Results, 2019.

Results of the Factor Influencing Retailer’s Marketing Margins for Beans

This implies that 84.01% of the variability in retailer's marketing margins was explained by the included variables in the model, while the remaining 15.99% was unexplained and could be attributed to omitted variables in the regression which are captured as error term. The F-statistics value of 1.6282 (p<0.00) was significant implied the model is best fit for the expression and an indication of overall significance of the regression results show that the (X¹), (X⁷), (X⁸) and (X⁹) were significant at 5% which means that purchase price, market charges, level of education and household size have tremendous impact on the retailers marketing margins. Results in Table 6, indicates that the insurgencies in the northern part of country, high transportation cost to and from the major purchase sources and high purchase price are the constraints militating against efficient marketing of beans in the area. The high prices of beans may be due the unrest experienced from point of production. High price could equally be as resulting in low yields and consequently scarcity. NPC [15] linked the high prices to the sale of beans to urban markets thus decreasing supply in source markets, and hence results in high prices. Abate also confirmed that prices for beans are generally higher in a season especially in the months between January and April [16,17].

*Major constraints. Source: Field Survey Data, 2019.

Conclusion

The study shows that the beans marketers were mostly men with majority on wholesaling than in retailing, still in their youthful age and are energetic to carry out their marketing activities efficiently. Purchase price of beans favored the selling price of wholesalers and retail marketing however; it is a major disincentive to their marketing margins and marketing costs particularly during bumper period when the selling price is lower than purchase price. Seasonality of beans has a negative effect on wholesalers selling price and marketing margins during harvest periods when sellers’ price is at the lowest and distinctive to wholesale marketing. High marketing charges and handling costs have negative impact on the marketing margins on both traders. Problem of insurgencies from the north is the major constraint faced by beans marketers in the study area

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