Assessment of Nutritional Status and Dietary Pattern of Rural and Urban Retirees in Selected Communities of South-West Nigeria

Research Article

Assessment of Nutritional Status and Dietary Pattern of Rural and Urban Retirees in Selected Communities of South-West Nigeria

  • Obisesan, D. O 1
  • Alaka, F. A 2
  • Odunayo, A. A 1
  • Aanu-Bakare, G. O 1

*Corresponding Author: Akinjide Akinsola, 1Helen Keller International, Nutrition Department, Yaoundé, Cameroon.

Citation: Obisesan, D. O., Alaka, F. A., Odunayo, A. A. & Aanu-Bakare, G. O, (2024), Assessment of Nutritional Status and Dietary Pattern of Rural and Urban Retirees in Selected Communities of South-West Nigeria, J. Nutrition and Food Processing, 7(11); DOI:10.31579/2637-8914/253

Copyright: © 2024, Akinjide Akinsola. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 17 July 2024 | Accepted: 02 September 2024 | Published: 12 September 2024

Keywords: anthropometric indices; food intake; nutritional status; quality of life; retirees

Abstract

The study assessed nutritional status and dietary pattern of rural and urban retirees in selected communities in South-West Nigeria. Four research questions were raised to guide the study and two hypotheses were formulated and tested at 0.05 level of significance. The study adopted a descriptive survey design with 420 respondents. Three instruments were used for the study which is laboratory analysis, structured questionnaire and measurement of anthropometric indices. The instrument was validated by experts while its reliability test was done using Pearson Product-Moment Correlation which yielded a co-efficient of 0.83. Frequency, Percentage, Mean and Standard Deviation were used to answer research questions while Pearson Correlation Coefficient was used to test the hypothesis. The results of the study showed that level of food intake was high but low in quality, more than half of the retirees are at a high nutritional health risk, the nutritional status was normal for male retirees and risky for female. Furthermore, the relationship between food intake and nutritional status is insignificant for rural retirees but, low, negative and significant for rural and urban retirees in selected community in South-West Nigeria. The study recommended, among others, that proper attention should be given to retirees’ food intake to reduce the observed prevalence of nutrient deficit in order to improve their quality of life

1.Introduction

There are different opinions on when ‘old age’ begins which depends on the selection criteria, the starting point for old age in Nigeria and international circle has been set at 60 years. A retiree is often an elderly person advanced in age beyond middle age; old age consists of ages nearing or surpassing the average life span of human being and thus heading towards the end of human life cycle. They are those who have retired from the public sector or any paid position and are 60 years of age or older, they are also known as retirees or senior citizen (Babineau et al., 2018). Research have shown that nutrition in one early age goes a long way to affect one’s nutritional status and health-wise in the old age. Nutritional requirements in the elderly remain about the same, but their energy needs decrease. This means that older people should consciously select foods with a high nutritional value (Shahar, 2017). These are foods that are high in vitamins, minerals and fibre like whole grain products, legumes, fruit and vegetables. Rich energy source foods such as oils, butter, cold cuts, whole-milk products, baked goods and candy should be eaten sparingly because they contain a lot of calories in the form of sugar and fat which can contribute to obesity just as in younger years, attention must be given in old age to maintain a healthy body weight. Energy consumption is also raised by regular exercise, and this has a beneficial effect on weight. People who exercise regular can also eat more, and this makes it easier to meet daily vitamin, mineral, and trace requirements (Dunne & Dahl, 2017).

Physical activity has the benefit of preventing muscle deterioration, promoting mental equilibrium, and warding of the disease of civilization in elderly person/retirees (King et al., 2017). Everyday physical exercise can be added to, or substituted for, sports like bicycling, gym work-outs, strength training, or walking. Use the stairs instead of the elevator or escalator, go shopping on foot, take an afternoon walk through the path or by the lake, take a walk with the dog (or your neighbor’s) and the likes. Outdoor exercise builds up vitamin D from the sunshine which, along with calcium, influences bone density. Hunger and thirst as well as the senses of taste and smell can decrease in older people. It may be helpful to have outside reference points and signals for guidance (time of day, members of the household and the likes). Eating and drinking should therefore be planned. It is useful to develop an eating pattern in which several small meals are spread out over the day. The sensation of thirst can also diminish; the body’s signals for lack of fluids get weaker with age (Firdaus, 2015). The old people should drink at least 105 litres (3pints) of liquid a day, the volume of liquid drinks should be increased in case of greater fluid loss (e.g. heavy sweating, vomiting, diarrhea, etc.) coffee, black tea and alcoholic drinks do not count since they draw fluid from the body. These problems can be dealt with by balanced nutrition, eating fibre-rich foods such as whole-grain products (at least one portion a day) and fruits and vegetables and by drinking at least 105 litres (3pints) of liquids. 

Proper chewing promotes digestion (Babar et al., 2022). The digestive tract is less burdened if several small meals a day are consumed, while digestive disorder such as bloating and feelings of fullness will occur less often. Exercise and abdominal massage could keep the intestines moving (Fanelli & Stevenhagen, 2018). The best formula for a healthy old age is an active lifestyle with regular bodily exercise, an abundance of social interaction and a balanced varied (Higuera, 2019). Thus, in a nation like Nigeria where the economy is in a decline, diet-related illnesses are unavoidable, it became obvious that elderly people's eating habits and nutritional status must be determined in order to implementing interventions because the effects on the health of retirees in rural and urban regions may be severe. Therefore, the objective of the research was to use senior citizens in South-West Nigeria's rural and urban residents to assess food intake and nutritional status while four research questions were raised to guide the study and one hypothesis was tested at 0.05 level of significant.

1.1.  Research Questions

The following research questions were used to guide the study;

  1. What is the health status of rural and urban retirees in selected communities of South-West Nigeria?
  2. What is the nutritional status of rural and urban retirees in selected communities of South-West Nigeria?
  3. Is there any difference between the food intake, health and nutritional status of male and female among the rural and urban retirees in selected communities of South-West Nigeria;
  4. Is there any correlation between food intake, health and nutritional status of rural and urban retirees in selected communities of South-West Nigeria?

1.2.  Objectives of the study

The general purpose of the study is to assess the nutritional status and dietary pattern of rural and urban retirees in selected communities of south-west Nigeria while its specific objectives are; 

  1. Determine the health status of rural and urban retirees in selected communities of South-West Nigeria;
  2. Investigate the nutritional status of rural and urban retirees in selected communities of South-West Nigeria;
  3. Examine the difference between the food intake, health and nutritional status of male and female among the rural and urban retirees in selected communities of South-West Nigeria;
  4. Find out if there is any correlation among food intake, health and nutritional status of the rural and urban retirees in selected communities of South-West Nigeria.

1.3.  Hypotheses

  1. Ho: β = q   There is no significant difference between the food intake of rural and urban retirees in selected communities of South-West Nigeria.
  2. Ho: β = q  There is no significant different between the food intake, health and nutritional status of male and female among the rural and urban retirees in selected communities of South-West Nigeria

2. Research design

The research design used was descriptive research design which was mainly used to elicit information on the assessment of nutritional status and dietary pattern of rural and urban retirees in selected communities in South-West of about 2,385,053 elderly/retirees in South-West Nigeria (National Bureau of Statistics, NBS, 2023).

2.1. Population and sampling techniques

Multi-stage sampling techniques were employed for the study. The first stage was the selection of four (i.e 0.02%) of the retirees in each states in the geo-political zone. The four states were purposively selected for manageability. The selected states are (Ekiti, Lagos, Ogun and Osun). This was followed by random selection of (0.02%) in each of the four states whereby each state was divided into rural local governments and also urban local governments while each selected local government, there were randomly selection of towns and villages as well as communities and wards. In each wardpurposive election of retirees was taking place for about (0.02%) which amount the total of four hundred (420) retirees used for the study.

2.2. Instrument for data collection

A structured questionnaire was used for data collection which consists of two sections (A and B). Section A elicit information on the samples consisting of 5 (demographical profile) terms with18-items. Section B was a pre-format recorded of 24-hour dietary recall and nutritional intake of the elderly based on their age, height, and weight was taken using a bathroom scale and height meter. These measurements were used to determine stunting, underweight and wasting of the respondents which were done during observation for weeks before their daily intake (24hr- recall method) for laboratory analysis in order to determine their daily food intake when compared to food composition standard/textbook.

2.3. Validation and reliability of the instrument

The ascertain of content and face validity of the instrument was done by giving out the questionnaire to experts in the field of nutritionists who are also experienced in research which help to eliminate all forms of bias and irrelevant items from the questionnaire. The suggested areas of modification were affected by the researchers. The reliability of the instrument was established by using the test-retest method. Forty respondents of twenty females and twenty males per each state was randomly selected from four different rural and urban areas in Ondo and Oyo States that are not parts of the states used for the study. A re-administration of the same instrument was done after two weeks using the same group of respondents. The total scores for each testing period were computed and Pearson Product Moment Correlation (PPMC) was used to determine the agreement between the two scores. A reliability test “r” 0.78 was accepted to make the structured questionnaire highly reliable.

2.4. Data collection and analysis

The administration, collection of the questionnaire and body measurement of was done with the help of two research assistants. Four hundred and twenty copies of the questionnaire were randomly distributed to the respondents and all were recovered back. Data generated through the questionnaire was analyses using percentages, mean and standard deviation. The food intake of the rural and urban retirees was compared with Food and Agriculture Organization standards. The hypothesis was tested at 0.05 level of significant while laboratory results were expressed as mean of triplicate analyses.

3. Results and discussion

3.1. Proximate Composition of 24-hr recall food intake of the retirees

There was no significant differences (p<0>

 Lagos StateOgun StateEkiti StateOsun State

Parameter 

      (%)

Oluwole

(Urban)

Isele

(Rural)

Lafenwa

(Urban)

Ilugun

(Rural)

Ado-Ekiti

(Urban)

Ayegbaju 

(Rural)

Akarabata 

(Urban)

Gbogan 

(Rural)

Moisture content8.53 ± 0.23b8.54 ± 0.11b8.19 ± 0.30a8.04 ± 0.21a8.64 ± 0.13b8.64 ± 0.22b8.33 ± 0.15ab8.28 ± 0.23a
Crude protein6.87 ± 0.21c6.75 ± 0.17c5.56 ± 0.01a6.25 ± 0.26b6.21 ± 0.20b6.43 ± 0.11bc6.57 ± 0.08bc6.08 ± 0.21b
Crude fat5.57 ± 0.03b5.28 ± 0.20a5.59 ± 0.11b5.09 ± 0.07a6.04 ± 0.16c5.77 ± 0.03bc5.31 ± 0.01a5.42 ± 0.14a
Crude fiber2.34 ± 0.08bc2.46 ± 0.11c2.25 ± 0.05bc2.08 ± 0.13 b2.74 ± 0.09d2.04 ± 0.06b2.19 ± 0.11ab1.69 ± 0.23a
Total ash3.80 ± 0.00ab3.92 ± 0.14b3.46 ± 0.07a3.41 ± 0.00a3.91 ± 0.04b3.86 ± 0.01ab3.81 ± 0.03ab3.57 ± 0.05a
CHO72.94 ± 0.05a73.03 ± 0.43ab74.15 ± 0.27c75.13 ± 0.52cd72.46 ± 0.16a73.26 ± 0.29ab73.79 ± 0.41ab74.96 ± 0.39cd
Energy, KJ/g387.48 ± 1.05b384.91 ± 0.96a390.75 ± 0.93c389.75 ± 1.00bc387.67 ± 0.91b389.30 ± 0.88bc 387.62 ± 0.87b391.54 ± 1.01c

Values are means ± SD of triplicate determinations while values with different superscript within the same row are significantly different @ p<0>

Tables 1: Proximate Composition of 24-hr recall food intake of the retirees

3.2 Mineral profiles of 24-hr recall food intake of the retirees

Statistical differences were observed at alpha p<0>

 Lagos StateOgun StateEkiti StateOsun State

Parameter 

 (100mg/g)

Oluwole

(Urban)

Isele

(Rural)

Lafenwa

(Urban)

Ilugun

(Rural)

Ado-Ekiti

(Urban)

Ayegbaju 

(Rural)

Akarabata 

(Urban)

Gbogan 

(Rural)

Calcium1.86 ± 0.00a2.48 ± 0.11bc1.79 ± 0.07a1.84 ± 0.03a2.31 ± 0.00b2.33 ± 0.06b2.08 ± 0.13ab2.01 ± 0.10ab
Cupper2.46 ± 0.00b2.61 ± 0.21c1.96 ± 0.18a1.96 ± 0.11a2.19 ± 0.08ab2.56 ± 0.31b1.96 ± 0.08a1.97 ± 0.04a
Iron2.51 ± 0.11b2.64 ± 0.04b2.01 ± 0.05ab1.99 ± 0.00a2.23 ± 0.10ab2.50 ± 0.16b2.00 ± 0.32ab1.99 ± 0.00a
Magnesium26.87 ± 1.04c20.50 ± 0.88ab26.37 ± 0.36c19.85 ± 0.21ab22.36 ± 0.15b18.70 ± 0.28a22.18 ± 0.15b18.37 ± 0.00a
Potassium191.52 ± 1.63d177.96 ± 0.93b191.02 ± 1.59d177.33 ± 0.34b184.28 ± 1.71c161.51 ± 0.38a184.55 ± 1.69c161.18 ± 0.47a
Sodium11.97 ± 0.30b10.61 ± 0.26a11.91 ± 0.18b10.32 ± 0.21a12.96 ± 0.86c11.60 ± 0.52b13.18 ± 0.84d11.82 ± 0.61b
Zinc 2.51 ± 0.22b2.67 ± 0.18bc2.00 ± 0.00ab1.98 ± 0.07a2.18 ± 0.00ab2.39 ± 0.00b1.99 ± 0.15a1.95 ± 0.13a
          Mean 34.25 ± 0.47d31.35 ± 0.37bc33.87 ± 0.35cd30.75 ± 0.14b32.09 ± 0.24c28.80 ± 0.24a32.58 ± 0.48c28.47± 0.19a

Values are means ± SD of triplicate determinations while values with different superscript within the same row are significantly different @ p<0>

Tables 2: Mineral Profiles of 24-hr recall food intake of the retirees

3.3. Vitamins Content of 24-hr recall food intake of the retirees

Likewise, the vitamins contents followed the same trends of mineral profiles determined. Significant differences (p<0> 

Parameter 

(100mg/g)

Lagos StateOgun StateEkiti StateOsun State
 

Oluwole

(Urban)

Isele

(Rural)

Lafenwa

(Urban)

Ilugun

(Rural)

Ado-Ekiti

(Urban)

Ayegbaju 

(Rural)

Akarabata 

(Urban)

Gbogan 

(Rural)

Vitamin A70.52 ± 0.68d69.92 ± 0.35d83.04 ± 1.23ef80.99 ± 0.53e50.18 ± 0.22cd38.91 ± 0.27a49.52 ± 0.14c43.42 ± 0.11b
Vitamin B13.55 ± 0.13c2.95 ± 0.07b3.53 ± 0.06c1.98 ± 0.14a3.55 ± 0.33c3.42 ± 0.18c2.90 ± 0.22b2.92 ± 0.19b
Vitamin B23.54 ± 0.11cd2.94 ± 0.20bc3.50 ± 0.19cd1.94 ± 0.15a3.94 ± 0.21d3.41 ± 0.26c2.88 ± 0.30b2.91 ± 0.13b
Vitamin C13.01 ± 0.72cd12.41 ± 0.08cd13.36 ± 0.54c11.24 ± 0.36b9.98 ± 0.17a15.58 ± 0.19d9.33 ± 0.35a15.34 ± 0.27d
Vitamin K4.48 ± 0.18de3.88 ± 0.29c4.18 ± 0.15d2.63 ± 0.11a4.08 ± 0.11d3.57 ± 0.33bc3.44 ± 0.19bc3.07 ± 0.12b
         Mean19.02 ± 0.36cd18.42 ± 0.20c21.53 ± 0.43d19.75 ± 0.26cd14.36 ± 0.21b12.97 ± 0.25a13.82 ± 0.24ab13.49 ± 0.16ab

Values are means ± SD of triplicate determinations while values with different superscript within the same row are significantly different @ p<0>

Tables 3: Vitamins Content of 24-hr recall food intake of the retirees

3.4. Mean and standard deviation of health of retirees in south-west Nigeria

Table 4 shows the descriptive data with respect to the nutritional health of retirees in South-West Nigeria. Total respondents are 420, the  minimum value is 0.00, while the maximum was 12.00. Though they have a mean of 8.83 ± 2.61 Standard Deviation, the mean value when compared with the standard as prescribed is above the mean of 6.00.This implies that averagely, the retirees are having a high nutritional health risk.

VariableNMin Max Mean Std. DevRemarks
 Health Status4200.0012.008.832.61High Health Risky

Table 4: Mean and standard deviation of health of retirees in south-west Nigeria

3.5. Mean and standard deviation of nutritional status of retirees in south-west Nigeria

Table 5 shows the descriptive data with respect to the nutritional status of retirees in South-West Nigeria. Total respondents’ N = 420 comprising 214 male retirees and 206 female retirees. The mean value for the males is 0.806 while it was 0.804 for the females. Comparing these values with the criteria, it is interpreted as “Normal” for male and “Risky” for the female retirees.

SexNMin Max Mean Std. DevRemarks
Male2040.6490.9070.8060.059Normal
Female2160.6330.9020.8040.058Risky

Table 5: Mean and standard deviation of nutritional status of retirees in south-west Nigeria

3.6. Hypothesis I: There is no significant difference in the food intake of retirees in rural and urban areas in South-West Nigeria

Table 6 shows the test of difference in the food intake of rural and urban retirees in South-West Nigeria. From the table, the number of rural retirees’ respondents is 94 while the urban retirees are 146 and their mean values are 49.85 and 50.93 while standard deviations are 5.99 and 4.95 respectively. The t-value of -1.518 is not significant, because, the p-value (0.130) is greater than alpha level. Therefore, the null hypothesis is retained. This implies that irrespective of whether the retirees are in rural or urban areas the level of food intake is the same. The result of data analysis in response to hypothesis one indicated that there is no significant difference in the food intake of male and female retirees in South-West Nigeria. Hence, the null hypothesis is retained, implying that irrespective of whether the retirees is male and female the level of food intake is the same. This could be as a result of decrease in calorie intake which are associated with a series of symptoms such as loss of taste bud, tooth, sore gum, ailment of diseases and many others, irrespective of their gender. In a similar study, Sanford (2017) highlighted that nearly 20-30% of elderly individuals suffer from anorexia which is a major contributor of frailty among both male and female. Study by Theou et al. (2015) found that 12 - 28 % elderly people are frail, with the highest prevalence among women than men whereas Campitelli et al. (2018) found frailty to be prevalent among 19 - 44 % of the elderly population both male and female. The decline in calorie intake is associated with numerous factors which aggravate the geriatric syndrome of anorexia.

LocationNMeanStd. Dev.Dft-valuep-value (Sig. 2-tailed)
Rural9449.855.99238-1.5180.130
Urban14650.934.95   

α = 0.05; p >0.05 Not Significant

Table 6: Independent samples t-test of difference in food intake of rural and urban retirees in south-west Nigeria

3.7. Hypothesis II: There is no significant relationship between food intake, health and nutritional status of retirees in South-West Nigeria.

Table 7 shows the Pearson’s coefficient of correlation among food intake, health and nutritional status. From the table the correlation coefficients (r) between “Food Intake” and “Health” is 0.154 this value is positive but low, however, the value is significant. The correlation coefficient between “Food Intake” and “Nutritional Status,” is - 0.065 which is negative, low and insignificant, as well as this between “Nutritional Status” and “Health” (- 0.074). The null hypothesis is rejected as far as the food intake and health of the retirees are concerned. This implies that increase in food intake corresponds to increase in health among retirees in South-West Nigeria. The answer to hypothesis showed that there is a significant positive and low relationship between food intake and health, but the relationship is a negative, low and insignificant between food intake and nutritional status, as well as between nutritional status and health. This could be because of good knowledge of food nutrient constitute to appropriate health as well as good nutritional status. Improved food intake has been shown to correlate positively with improved health among retirees (Getahun et al., 2016). The authors explained that good diet is essential to health promotion and to chronic disease management among these people. Aguila (2018) also posited that improved food intake is a necessary focus for public health and policy in tackling chronic disease and in supporting well-being and healthy life through old age. Therefore, food intake and healthy living can simultaneously be improved upon through good knowledge of food and nutrition and active dietary behavior.

N = 420Food intakeHealth Nutritional Status
Food intakePearson Correlation1  
Sig. (2-tailed)   
Health StatusPearson Correlation0.154*1 
Sig. (2-tailed)0.017  
Nutritional StatusPearson Correlation-0.065-0.0741
Sig. (2-tailed)0.3130.253 
* = Correlation is significant at the 0.05 level (2-tailed).

Table 7: Correlation matrix of food intake, nutritional health and nutritional status of retirees in south west Nigeria

4. Conclusion

The findings of this study showed that the retirees have high level of nutritional knowledge and food availability. This afforded them the opportunity to be able to choose the right food at the right and appropriate time. However, the level of food intake was found to be low which mean their nutritional health and status risk will be high. Finally, increase in food intake of the retirees corresponds to increase in their low nutritional health.

4.1. Recommendations

Based on the findings of this study, the following recommendations were made;

  1. More food should be made available in the locality either rural or urban areas for easy accessibility for the retirees to maintain good nutritional health and improve their nutritional status. Moreover, individuals should diversify their diet and engage in enough physical activity to help halt the rising prevalence of overweight and obesity among older adults which can lead to untimely death.
  2. There is the need for nutritionists and other stakeholders to engage in active aging interventions to improve the nutritional status and quality of life of elders at the community settings at large.
  3. Nutritionists and Dieticians should raise nutrition awareness among the older age group and the government structures since interventions to correct the nutritional status of elders are strongly required for a functionally active, good nutritional health and better quality of life. 

Acknowledgement

We acknowledge and appreciate The Tertiary Education Trust Fund (TETFUND) of Nigeria through Institution Based Research Grant (IBRG) and Federal College of Education (Special), Oyo authorities for funding the project in the selected states of south-west households, Nigeria. Moreover, we are highly indebted to the research assistants that were used for this study.

References

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Dr Suramya Dhamija

Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.

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Bruno Chauffert

I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!

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Baheci Selen

"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".

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Jesus Simal-Gandara

I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.

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Douglas Miyazaki

We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.

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Dr Griffith

I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.

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Dr Tong Ming Liu

I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.

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Husain Taha Radhi

I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.

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S Munshi

Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.

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Tania Munoz

“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.

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George Varvatsoulias

Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.

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Rui Tao

Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.

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Khurram Arshad

Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.

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Gomez Barriga Maria Dolores

The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.

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Lin Shaw Chin

Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.

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Maria Dolores Gomez Barriga

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.

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Dr Maria Dolores Gomez Barriga

Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.

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Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.

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Dr Marcelo Flavio Gomes Jardim Filho

Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”

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Zsuzsanna Bene

Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner

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Dr Susan Weiner