Virginia Research Day 2021

Medical Student Research Cl inical

Bowling, Sean, OMS II; Meacham, Susan, PhD, RD; Erazo, Xiomara, MD; Vaquedano, Ivin, MS; Christianson, Ryan, M; Rafie, Carlin, PhD, RD; Van Mullekom, Jennifer, PhD; Sutphin Dean, PhD Corresponding author: sbowling@vt.vcom.edu 04 Combatting Micronutrient Deficiencies in Honduras Through Culturally Appropriate Food Recommendations: Short-Term Medical Missions Students as Agents of Change

Via College of Osteopathic Medicine–Virginia Campus

Context: Students on short term medical missions (STMM) providing information on culturally appropriate food recommendations can help combat micronutrient deficiencies, a public health concern in developing countries such as Honduras. Nutrition education can be challenging when women in health disparity areas experience overweight and obesity, and paradoxically, their children experience malnutrition in the form of stunting. Both women and children may also be at increased risk for micronutrient deficiencies, due to low dietary intakes of iron, vitamin A and zinc. Objective: To assess consumption of common foods by adult Honduran women to inform future patient education efforts during mission trips to improve nutritional status. Methods: Women visiting the James Moody Adams health clinic at the Baxter Institute in Tegucigalpa, Honduras volunteered to participate in an approved multi-country, multiphase observational study. Descriptive characteristics of subjects were obtained and their responses to a food frequency questionnaire (FFQ) assessed to determine changes in food consumption behaviors before and after a nutrition education intervention. The FFQ listed 35 common

foods and/or beverages with response choices ranked least (1) to most (6) often consumed during a day or week. Results: Participants completing pre-test assessments and the nutrition education intervention (n=107) had mean ± standard deviation measures for BMI = 30.6 ± 6.5; waist circumference = 36.0 ± 5.4; weekly family incomes, in United States dollar equivalents = $31.9 ± 26.5; most equitably distributed by age between 21 to 50 years of age, most reported less than one hour of physical activity daily. Those returning to complete post-test FFQs (n=71, 66%) reported reductions in consumption of proteins, p=0.00; grains, p=0.00; fruits, p=0.00; dairy, p=0.00; unhealthy sweet and salty snacks, p=0.00. No change was observed in the consumption of vegetables, p= 0.11; corn, p=0.27. Conclusion: A brief nutrition education intervention provided by health professionals was effective in this cohort of adult Honduran women. Food consumption behaviors reflected reduced consumption of foods, such as unhealthy snacks without reducing vegetable consumption. STMM have the capacity to reduce micronutrient deficiencies by providing nutrition education to large numbers of patients recommending

culturally appropriate foods high in iron, vitamin A, and zinc. This can be done by performing nutrition screenings, promoting provider-patient conversations, and distributing credible education materials to reinforce the message that ‘nutrition is prevention’. Study conclusions support the creation and implementation of nutrition education modules for medical mission trip participants, suggesting pre-trip preparations to convey, with a script and brochures, the importance of nutrition as prevention for non- communicable and communicable diseases.

This study was funded in part by the VCOM REAP Seed Grant.

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