Publications by authors named "Laar A"

Due to complex interactions, changes in any one area of food systems are likely to impact-and possibly depend on-changes in other areas. Here we present the first annual monitoring update of the indicator framework proposed by the Food Systems Countdown Initiative, with new qualitative analysis elucidating interactions across indicators. Since 2000, we find that 20 of 42 indicators with time series have been trending in a desirable direction, indicating modest positive change.

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Diet quality is influenced by multiple individual factors, but their relative strength and importance remain unclear. We investigate the associations between five domains of individual factors (economic, cognitive, aspirational, situational and consumer behaviour) and diet intake of adolescents in Accra, Ghana. A cross-sectional survey among Junior High School (JHS) students (n = 409, mean age 14.

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Background: In Ghana, several qualitative studies have explored users' perspectives on conventional sources of sexual and reproductive health (SRH) information and factors which influence provision of and access in rural settings. However, there is a dearth of qualitative studies on healthcare provider (HCP) perspectives on factors that deter access to conventional sources of SRH information among young people in rural Ghana and innovative ways for addressing barriers. This study explored perspectives on barriers to traditional sources of SRH information and services and innovative ways of using mHealth technologies for addressing provision and access challenges among young people in rural Ghana.

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Article Synopsis
  • The review explored young people's experiences and perceptions of using mobile health (mHealth) platforms for sexual and reproductive health (SRH) information and services in low- and middle-income countries (LMICs), particularly in rural areas.
  • It involved a qualitative synthesis of 26 studies published between 2000 and 2023, assessing the methodological quality using GRADE and CERQual frameworks, which favored texting and voice messaging for their convenience, privacy, and affordability.
  • Major challenges identified included limited network and electricity access, high costs of mobile devices and credit, and socio-cultural barriers affecting usage of these platforms.
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Background: Abdominal pain after bariatric surgery (BS) is not uncommon. A number of patients require reoperation. Limited studies have investigated the outcome of reoperations for abdominal pain after BS.

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Objective: To assess the availability and marketing of ultra-processed foods (UPF) in modern retail food outlets (supermarkets and minimarts) in Kenya and associated factors.

Design: This cross-sectional study was conducted in Kenya from August 2021 to October 2021. Variables included the geographic location and the socio-economic status (SES) levels, the food items displayed for sale and advertised in the stores, and locations in the stores such as the entrance.

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Objective: This review aimed to (i) synthesise evidence of the impact of publicly procured school meals programmes on nutritional outcomes of children/adolescents (5-18 years) in sub-Saharan Africa and (ii) identify challenges and facilitators to implementing effective school meals programmes.

Design: Mixed-methods systematic review ( 7 databases). Nutritional outcomes assessed were anthropometrics (underweight, stunting, wasting, overweight/obesity), micronutrient deficiencies, food consumed and food environment.

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Background: The Ghana School Feeding Programme (GSFP) provides public primary school pupils with a free daily meal. Each meal is expected to follow set menus, providing 30% of children's' (6-12 years) energy requirements. This study assessed the nutritional quality and diversity of planned and provided GSFP meals, engaging school caterers to identify how meal quality in the Greater Accra Region could be enhanced.

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Nutrient profiling (NP) models that assess nutrient density of foods can help remedy micronutrient deficiencies. We used NP methods to identify the most nutrient-rich foods in the 2019 FAO/INFOODS Western Africa Food Composition Table (WAFCT). The WAFCT had complete data for 909 foods.

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Background: In 2023, the first evidence-based classification for recurrent weight gain (RWG) after metabolic and bariatric surgery was introduced. It uses early and late follow-up weight loss benchmarks based on standard deviations (SD) of percentage total weight loss(%TWL) results from the large Dutch Audit for Treatment of Obesity (DATO) registry (n > 18,000). We aimed to validate this classification and confirm its clinical relevance with an external cohort.

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Background: Bariatric surgery is an effective treatment option for obesity and provides long-term weight loss and positive effects on metabolism, but the underlying mechanisms are poorly understood. Alterations in bile acid metabolism have been suggested as a potential contributing factor, but comprehensive studies in humans are lacking.

Methods: In this study, we analysed the postprandial responses of bile acids, C4 and FGF19 in plasma, and excretion of bile acids in faeces, before and after bariatric surgery in patients (n = 38; 74% females) with obesity with or without type 2 diabetes from the BARIA cohort.

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Street foods are one of the highest contributors to foodborne illness in most developing economies around the world. In Ghana, diarrhoeal diseases, which are usually food or waterborne, are among the top ten causes of death. Most street food safety risks are avoidable when all food safety regulations are complied with.

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Background: People with a chronic condition such as Parkinson's disease (PD) struggle with acceptance and finding meaning in life. Consciousness coaching could be a valuable addition in addressing these issues.

Objective: We aim to evaluate the user experiences and potential effectiveness of consciousness coaching for people with PD (PwPD).

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Introduction: Nutrition is a very important element of a comprehensive care for people living with HIV/AIDS (PLHIV), especially in resource-constrained settings where malnutrition and food insecurity are common. Dietary diversity is a useful indication of nutritional adequacy (diet quality) in people of all ages. An optimally diverse diet strengthens the body's immune system.

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Obesity is associated with low-grade inflammation and insulin resistance (IR). The contribution of adipose tissue (AT) and hepatic inflammation to IR remains unclear. We conducted a study across three cohorts to investigate this relationship.

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Purpose: Chronic pain and obesity often co-occur, negatively affecting one another and psychological wellbeing. Pain and psychological wellbeing improve after bariatric metabolic surgery (BMS), however, it is unknown whether psychological wellbeing improves differently after weight loss between patients with and without chronic pain. We investigated whether weight loss is associated with greater psychological wellbeing and functioning change after BMS, comparing patients with and without preoperative pain syndromes.

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This study assessed challenges faced by researchers with the informed consent process (ICP). In-depth interviews were used to explore challenges encountered by Investigators, Research assistants, Institutional Review Board members and other stakeholders. An electronic questionnaire was also distributed, consisting of Likert-scale responses to questions on adherence to the ICP, which were derived from the Helsinki Declaration and an informed consent checklist of the US Department of Health and Human Research (HSS).

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Numerous research methodologies have been used to examine food environments. Existing reviews synthesizing food environment measures have examined a limited number of domains or settings and none have specifically targeted Canada. This rapid review aimed to 1) map research methodologies and measures that have been used to assess food environments; 2) examine what food environment dimensions and equity related-factors have been assessed; and 3) identify research gaps and priorities to guide future research.

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Background: Glycemic control is an important goal of bariatric surgery in patients with type 2 diabetes mellitus (T2DM) and obesity. The laparoscopic one-anastomosis gastric bypass (OAGB) has potential metabolic benefits over the laparoscopic Roux-en-Y gastric bypass (RYGB). Aim of this study is to examine whether RYGB or OAGB grants better glycemic control 12 months post-surgery.

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Article Synopsis
  • The analysis introduces a food system indicator framework and monitoring architecture to assess food system changes related to global development and sustainability goals, focusing on five key themes: diets and health, environmental impact, livelihoods and equity, governance, and resilience.
  • A total of 50 indicators were developed through a consultative process, ensuring coverage for each theme, which serves as a baseline for evaluating global food systems.
  • While every country shows positive outcomes in certain areas, no country excels across all domains, indicating room for improvement towards achieving healthy, sustainable, and equitable food systems by 2030.
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Amidst high burden of infectious diseases, undernutrition and micronutrient deficiencies, non-communicable diseases (NCDs) are predicted to become the leading cause of death in Ghana by 2030. NCDs are driven, to a large extent, by unhealthy food environments. Concerned, the Ghana Ministry of Health (MOH) has since 2012 sought to garner the support of all to address this challenge.

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Objective: This study assessed stakeholder readiness to address unhealthy food and beverage marketing and availability in/around Public Basic Schools (for children 4-15 years) in Greater Accra Region, the highly urbanised administrative capital of Ghana.

Design: The community readiness model was used to conduct in-depth mixed methods interviews with stakeholders. Using predefined anchored rating statements, quantitative readiness scores ranging from 1 to 9 were generated.

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Background: Abdominal pain after bariatric surgery (BS) is frequently observed. Despite numerous diagnostic tests, the cause of abdominal pain is not always found.

Objectives: To quantify type and number of diagnostic tests performed in patients with abdominal pain after BS and evaluate the burden and their yield in the diagnostic process.

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