Assessment of Nutrition and Dietary Practices Among Patients with Gastrointestinal Symptomatology at Kenyatta National Hospital, Kenya

Abstract

Gastrointestinal Symptoms (GIS) represents a range of disorders with unclear pathophysiology, presenting symptoms such as abdominal pain, ulcers, cramps, constipation, nausea, and vomiting. The disease is linked to multiple factors, including genetics, environment, infections, immune dysfunction, and altered gut microbiota. The rising incidence of GIS globally—affecting over 6.8 million individuals—is attributed to increased urbanization, industrialization, and consumption of processed foods. Sub-Saharan Africa, despite reporting an increase in GIS cases, has limited published studies on the condition, highlighting the need for localized research. The study investigated the dietary habits, nutritional status, and food choices of patients with GIS attending Kenyatta National Hospital (KNH). This study assessed 200 randomly selected GIS patients diagnosed by 2023. It aimed to determine their socio-demographic characteristics, dietary patterns, the influence of food choices on disease progression, and their nutritional status. Findings indicated that females (57%) were more affected than males, though gender did not show a statistically significant association with GIS (p=0.76). The majority (40%) were aged above 34 years, and most patients (72.5%) lived in urban areas. Socio-economic factors such as marital status, education, and income had significant associations with GIS (p<0.05). Over 45% of respondents were well-educated and self-employed, and 22.4% reported a history of cigarette smoking. Dietary analysis revealed that 87% of respondents used sugar in beverages, and 87.9% preferred home-cooked meals, with only 8.1% eating in hotels. The most common foods reported to trigger GIS included beans (76.6%), spicy foods (14.1%), chapatti (13.8%), soft drinks (5.8%), and oranges (4.1%). Similarly, intolerable foods identified were legumes (28.9%), chapatti (10.4%), milk (5.8%), and oranges (5.2%). Foods that brought relief included cabbage (23.3%), potatoes (10.75%), milk (8.3%), and carrots (6.2%). Nutrient intake assessment showed excessive consumption of macronutrients compared to recommended daily allowances (RDAs): carbohydrates (154%), protein (193%), energy (127%), and fiber (211%). Consequently, 69% of participants were overweight or obese (BMI ≥26.38 kg/m²), though none were morbidly obese or underweight. Regression analysis showed a significant relationship between BMI and calorie intake (p=0.003), while the relationship between BMI and food frequency was not significant (p=0.680), contrary to most prior research. The study recommends that GIS patients regularly consult nutritionists to receive updated dietary guidance, control portion sizes to reduce excess macronutrient intake, and engage in at least 30 minutes of exercise daily. Weight reduction and careful food selection, avoiding foods that aggravate symptoms, are essential. Additionally, the Ministry of Health (MOH) should develop dietary prescriptions for GIS patients and integrate GIS management strategies into national health policy guidelines.