Acceptability of the use of cereal and legume combination (beans and maize) among students

Protein-energy malnutrition (PEM) is a significant public health issue, particularly among people in developing regions with limited dietary diversity. Socio-economic factors, poor eating habits, and restricted access to quality protein sources contribute to nutritional deficiencies. These deficiencies can impair cognitive function, academic performance, and overall health. Addressing PEM through cost-effective and locally available dietary solutions is essential for improving students’ well-being.

A promising approach to addressing PEM is the combination of cereals and legumes, specifically maize and beans. Maize is a carbohydrate-rich staple but lacks lysine, an essential amino acid (Food and Agriculture Organization [FAO], 2013). Conversely, beans are a good source of lysine but are deficient in methionine, which maize provides in sufficient amounts (Gibson, 2014). Together, these foods form a complete protein, enhancing dietary quality and overall nutrition.

This study examines the acceptability of maize and beans as a dietary intervention for managing PEM among students. While these foods are common in Nigerian households, their effectiveness in addressing malnutrition has not been fully explored. Understanding students’ perceptions and willingness to adopt this diet is vital for promoting sustainable nutritional solutions (Oniang’o & Mutuku, 2016).

Using qualitative and quantitative methods, the study will assess students’ dietary habits and factors influencing food choices. It will also explore barriers to adopting this diet and recommend strategies for integrating maize and beans into school feeding programs (Bouis & Saltzman, 2017). Findings will provide insights for policymakers and nutritionists to implement effective dietary interventions, ultimately improving student health and academic performance.

This study is significant as it provides insights into the prevalence of protein-energy malnutrition among students and evaluates the effectiveness of using maize and beans as a dietary intervention. The findings will be valuable to nutritionists, policymakers, and educational institutions in developing strategies to combat malnutrition among students. By identifying the factors influencing dietary choices, this study will contribute to the design of awareness programs that promote healthy eating habits. Additionally, it will provide a foundation for further research on sustainable and affordable nutritional solutions that can be implemented in other institutions facing similar challenges.

Concept of Protein-Energy Malnutrition (PEM)

Protein-energy malnutrition (PEM) is a severe form of malnutrition that arises due to inadequate intake of protein and energy. It remains a prevalent issue in developing nations, affecting children, adolescents, and young adults who lack access to a balanced diet (World Health Organization [WHO], 2020). According to WHO, malnutrition is responsible for nearly half of all deaths in children under five years old, and its effects can persist into adulthood, impacting cognitive abilities, immune function, and overall well-being (WHO, 2021). The interplay between protein and energy intake is critical, as a deficiency in one often leads to deficiencies in the other, exacerbating malnutrition (Black, Victora, Walker & Bhutta, 2017).

PEM can be classified into two major types: kwashiorkor and marasmus. Kwashiorkor results from severe protein deficiency and is characterized by edema, skin lesions, and fatty liver, while marasmus occurs due to overall energy deficiency, leading to extreme wasting and stunted growth (Smith, Haddad & Fawzi, 2019). Kwashiorkor tends to occur in children who consume adequate calories but insufficient protein, often resulting in symptoms such as swelling, irritability, and skin changes. In contrast, marasmus results from prolonged inadequate intake of both energy and protein, causing severe muscle wasting, loss of fat stores, and an emaciated appearance (Gibson, 2014). Research indicates that both conditions significantly compromise immune function, increasing susceptibility to infectiousdiseases such as pneumonia and diarrhea, which further exacerbate mortality rates (Golden, 2016).

In many developing countries, students suffer from PEM due to economic hardship, poor dietary habits, and limited knowledge about proper nutrition (FAO, 2018). A study conducted by Olaniyi and Adeyemi (2021) in Nigeria found that 40% of college students exhibited signs of malnutrition due to poor dietary diversity and financial limitations. The consequences of PEM are far-reaching, affecting cognitive function, immune response, and physical development. Cognitive impairment due to PEM has been linked to poor academic performance, reduced concentration, and increased susceptibility to illnesses, further worsening students’ educational outcomes (Muller & Krawinkel, 2020). A study conducted by Grantham-McGregor, Cheung, Cueto, Glewwe, Richter and Strupp (2018) demonstrated that malnourished children often experience long-term educational setbacks due to stunted brain development, ultimately affecting their future economic potential.

Further studies have also shown that PEM is not just limited to children but affects adolescents and young adults, particularly in university settings where financial limitations and dietary habits play a crucial role in nutritional status. According to a study by Nnyepi, Gobotswang and Mburu (2021), university students in Botswana experienced significant levels of malnutrition due to inadequate intake of nutrient-rich foods. Similarly, a report by Kaur, Singh and Gill (2019) found that Indian college students consuming high-carbohydrate, low-protein diets exhibited signs of PEM, impacting their academic performance and physical health. Addressing these issues requires interventions such as better meal planning, policy adjustments, and increased awareness about affordable, nutritious food options.

Importance of Cereal-Legume Combination in Nutrition

The combination of cereals and legumes has been widely recognized as a practical strategy for improving protein intake in low-resource settings (FAO, 2015). Cereals such as maize are rich in carbohydrates and energy but lack lysine, an essential amino acid. Legumes like beans provide lysine but are deficient in methionine, an amino acid available in cereals. When consumed together, maize and beans form a complete protein source, providing all essential amino acids required for growth and development (Michaelsen et al., 2017).

Research has demonstrated the effectiveness of cereal-legume combinations in combating PEM. For instance, a study conducted by Bouis and Saltzman (2017) found that school children who consumed maize and bean meals regularly showed improved nutritional status and cognitive function. Another study by Onyeka, Okoro and Nwankwo (2021) in rural Nigeria reported that children who incorporated maize-bean meals into their diets had higher growth rates and reduced incidences of stunting. A meta-analysis conducted by Beal, Massiot, Arsenault, Smith and Hijmans (2021) concluded that increasing dietary diversity through the incorporation of legumes in staple foods significantly reduces malnutrition rates across various age groups. The affordability and accessibility of these foods make them viable options for students facing food insecurity.

Moreover, an assessment of dietary patterns in sub-Saharan Africa by Amodu, Sanni and Aluko (2020) highlighted that indigenous knowledge on food combinations plays a crucial role in dietary choices. Promoting cereal-legume combinations through culturally accepted food preparation methods can increase their acceptability and consumption. Studies have also shown that fortifying maize and bean meals with additional micronutrients such as iron and zinc can further enhance their nutritional benefits, reducing the risk of anemia and other deficiencies common in resource-limited settings (Stevens, Watt, Brimbecombe & Judd, 2020).

Additionally, studies by Ghosh, Das and Gupta (2022) found that students who regularly consumed a cereal-legume combination had improved gut microbiota, which contributed to better nutrient absorption and overall digestive health. The study emphasized that dietary interventions should consider the importance of gut health in maximizing nutrient uptake from foods. Similarly, research conducted by Martin, Armstrong and Rodriguez (2021) highlighted that a balanced intake of legumes and cereals significantly reduced inflammation markers in the body, improving long-term health outcomes in malnourished individuals.

Acceptability of Maize and Beans in Student Diets

The success of any nutritional intervention depends on its acceptability among the target population. Previous studies suggest that socio-economic status, cultural preferences, and taste influence students’ willingness to adopt maize and beans as staple foods (Oniang’o & Mutuku, 2016). The texture, flavor, and cooking methods of maize and beans affect their desirability among students.

A study conducted in Nigeria by Okeke, Njoku and Anene (2020) revealed that students often prefer high-energy, processed foods over traditional diets due to modern lifestyle changes and taste preferences. Processed and fast foods are frequently marketed to young adults, making them more appealing despite their poor nutritional value (Ajayi & Omole, 2021). However, nutrition education and awareness campaigns can improve the acceptability of maize and beans by highlighting their benefits in preventing PEM (Adepoju, Bello & Akinwale 2018). A study by Obinna, Okechukwu and Adeyemi (2021) showed that students who were educated on the benefits of legume-based meals reported an increased willingness to consume maize and beans. Understanding students’ perceptions and barriers to adopting this dietary practice is crucial in designing effective nutritional interventions. Additionally,sensory evaluations have indicated that modifying preparation methods to enhance flavor and texture can increase consumption rates among young people (Dlamini, Moyo & Ncube, 2022).

Factors Influencing Dietary Choices

Dietary choices among students are shaped by various socio-economic and environmental factors. These factors include economic constraints, cultural food practices, availability of food, and personal preferences (Adebayo, Adeyemi & Olaniyi, 2019). Economic factors play a significant role in determining the types of foods students consume. A study by Olaniyi and Adeyemi (2021) found that students from low-income backgrounds rely heavily on inexpensive, carbohydrate-dense foods, leading to poor dietary diversity.

Cultural factors also influence food selection, as some communities perceive beans as a food for the poor, reducing its acceptability (Akinyele, 2017). In some African societies, maize-based meals are more commonly consumed, while legumes are reserved for specific occasions or socioeconomic classes (Oni, Lawal & Adebisi 2019). Another determinant of food choices is knowledge about nutrition. Many students lack awareness of the health benefits of a balanced diet, leading to unhealthy eating habits. Implementing nutrition education programs in schools can help address these misconceptions and encourage healthier food choices (WHO, 2021).

Recommendations for Promoting Maize and Beans as a Cost-Effective and Sustainable Dietary Intervention for Managing PEM Among Students

The combination of maize and beans offers a nutritionally balanced, affordable, and locally available solution for addressing Protein-Energy Malnutrition (PEM) among students, particularly in low-resource settings. However, for this dietary intervention to be successfully adopted, multiple strategies must be implemented to overcome economic, cultural, and behavioral barriers. The following recommendations will facilitate the widespread acceptance and sustained consumption of maize and beans as a viable solution for PEM.

Nutrition Education and Awareness Campaigns

A major barrier to adopting maize and beans in students’ diets is the lack of awareness about its nutritional benefits (Adepoju et al., 2018; WHO, 2021). Many students perceive maize and beans as basic or inferior foods, leading them to prefer processed or high-energy diets with poor nutritional value (Oniang’o & Mutuku, 2016). To address this:

• Educational Programs: Schools should incorporate nutrition education into their curriculum, emphasizing the benefits of maize-bean combinations in providing complete proteins, improving cognitive function, and enhancing overall health (Muller & Krawinkel, 2020).
• Workshops and Seminars: Organizing nutrition workshops led by dietitians and health professionals can increase students’ knowledge and motivation to adopt healthier food choices (WHO, 2021).
• Information Campaigns: Posters, social media campaigns, and student-led advocacy groups can be used to dispel myths about maize and beans and highlight their cost-effectiveness and health benefits (Ajayi & Omole, 2021).

Improving the Taste, Variety, and Preparation Methods

Students’ taste preferences and cooking methods significantly impact their willingness to consume maize and beans regularly (Dlamini et al., 2022; Okeke et al., 2020). To enhance acceptability:

• Diversified Recipes: Introducing creative recipes such as maize and bean porridge, spiced bean soups, maize-bean patties, or fortified maize meals can make the diet more appealing (Oniang’o & Mutuku, 2016).
• Sensory Testing and Modifications: Conducting sensory evaluations to determine the most preferred texture and flavor combinations among students can guide improvements in meal preparation (Dlamini et al., 2022).
• Training in Meal Preparation: Schools can provide students with hands-on cooking demonstrations to teach them how to prepare maize and beans in tasty, convenient, and time-efficient ways (Adepoju et al., 2018).

Integrating Maize and Beans into School Feeding Programs

School feeding programs present an effective and structured way to ensure students consume balanced diets regularly (Bouis & Saltzman, 2017). Governments, institutions, and policymakers should:

• Develop Subsidized Meal Plans: Schools should incorporate fortified maize and beans into cafeteria meal plans at low or subsidized costs to encourage mass consumption (FAO, 2018).
• Government and NGO Partnerships: Collaborations with organizations such as WHO, FAO, and local food agencies can help provide funding and resources for sustainable school feeding programs (Black et al., 2017).
• Homegrown School Feeding Initiatives: Encouraging local farmers to supply maize and beans to schools ensures affordability, supports local agriculture, and promotes food security (Amodu et al., 2020).

Addressing Economic Barriers Through Subsidies and Incentives

Economic constraints often limit students’ access to nutritious foods (Olaniyi & Adeyemi, 2021). Governments and institutions can promote affordability by:

• Providing Food Subsidies: Subsidizing maize and beans for students from low-income backgrounds can encourage regular consumption without financial strain (Adebayo et al., 2019).
• Student Food Support Programs: Establishing food banks within schools where students can receive free or discounted maize and beans can enhance food security (FAO, 2018).
• Encouraging Household Consumption: Policymakers can promote household-level adoption by educating families on the cost-effectiveness of maize and beans in preventing malnutrition (Gibson, 2014).

Community and Cultural Engagement for Long-Term Adoption

Cultural beliefs and traditions strongly influence food choices (Akinyele, 2017; Oni et al., 2019). To ensure acceptance and long-term adherence to this intervention:

• Cultural Food Adaptation: Maize and beans should be incorporated into traditional meals that align with students’ cultural preferences (Amodu et al., 2020).
• Community Involvement: Engaging parents, local food vendors, and school administrators in discussions about maize and beans can foster social support and wider acceptance (Okeke et al., 2020).
• Media and Influencer Engagement: Working with local influencers, chefs, and health advocates can help change negative perceptions of maize and beans (Ajayi & Omole, 2021).

Strengthening Policy Support for Sustainable Implementation

For maize and beans to be a long-term solution for PEM, supportive government policies and institutional frameworks must be in place. This includes:

• National Nutrition Policies: Governments should integrate cereal-legume combinations into national dietary guidelines to promote widespread adoption (WHO, 2021).
• Research and Development: More studies should be conducted on the bioavailability of nutrients in maize and beans to further improve their nutritional composition and fortification strategies (Stevens et al., 2020).
• Monitoring and Evaluation: Implementing nutrition tracking systems in schools can help monitor PEM trends and evaluate the impact of maize-bean interventions (Black et al., 2017).

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