Masters Degrees (Dietetics And Human Nutrition)

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Anthropometric status and dietary habits of registered nurses, enrolled nurses and enrolled nursing auxilliaries workng at a private hospital in Pietermaritzburg, KwaZulu-Natal.
(2021) Yegambaram, Leah Bianca.; Pillay, Kirthee.
The prevalence of overweight and obesity has been increasing over the years, particularly in South Africa (SA). A major contributor to this is poor lifestyle choices such as unhealthy diets and sedentary lifestyles. The rise in overweight and obesity is alarming as both are major risk factors for non-communicable diseases (NCDs). Overweight and obesity are also becoming more prevalent among healthcare professionals, specifically nurses. However, nurses are expected to lead by example and should be role models to the patients they care for. Nurses are the backbone of healthcare facilities and being overweight or obese impacts both on themselves and on their patients. Factors contributing to overweight and obesity among nurses include consuming meals late, eating during stressful periods, low physical activity levels and working shifts. Aim: This study aimed to investigate the anthropometric status and dietary habits of registered nurses (RNs), enrolled nurses (ENs) and enrolled nursing auxiliaries (ENAs) working at a private hospital in Pietermaritzburg (PMB), KwaZulu-Natal (KZN). Objectives: (i) to determine the anthropometric status of RNs, ENs and ENAs working at a private hospital in PMB, KZN; (ii) to determine the dietary habits of RNs, ENs and ENAs working at a private hospital in PMB, KZN; (iii) to determine the factors contributing to the anthropometric status and dietary habits of RNs, ENs and ENAs working at a private hospital in PMB, KZN; (iv) to determine the prevalence of NCDs among RNs, ENs and ENAs working at a private hospital in PMB, KZN. Method: A cross-sectional descriptive study was conducted on RNs, ENs and ENAs working at a private hospital in PMB, KZN. A self-administered questionnaire was developed to obtain data on demographic characteristics, lifestyle factors, body image and weight and eating habits. Anthropometric status was determined using selected anthropometric indices including weight, height, body mass index (BMI) and waist circumference (WC). Dietary habits was assessed using a food frequency questionnaire (FFQ) and a single 24-hour recall. The 24-hour recall was analysed using the Medical Research Council (MRC) Food Finder software programme version 1.0. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 22. Results: The study sample consisted of 130 nurses; 40.8% (n=53) were RNs, 36.9% (n=48) were ENs, 2.3% (n=3) were midwives, 19.2% (n=25) were ENAs and one was a clinical nurse specialist in the neonatal intensive care unit (NICU). A significant number of the participants were either overweight (25.4%; n=33) or obese class I (29.2%; n=38) (p<0.0005). Most participants did not smoke (82.3%; n=107) or consume alcohol (59.2%; n=77). Only 50% (n=65) of participants exercised. A significant number (63.1%; n=82) indicated that they were not satisfied with their body shape/size and did not feel that they were at a healthy body weight (60%; n=78). The majority of participants underestimated their BMI using the Stunkard figure rating scale (76.9%; n=100). The majority of participants stated they had tried to lose weight before (64.6%; n=84). The most common weight loss methods were cutting down on fast foods/takeaways (67.9%; n=57) (p=0.001) and exercising (63.1%; n=53). A significant number of nurses agreed that they were role models to their patients (70.8%; n=92) and believed it was important for a nurse to have an ideal body weight (92.3%; n=120). The majority of participants skipped meals (83.8%; n=109) with the only significantly skipped meal being breakfast (63.3%; n=69). A significant number of participants prepared their own meals at home (84.6%; n=110). Participants significantly agreed that time [M (mean)=3.98; p<0.0005], cost (M=3.26; p=0.021), emotions/stress (M=3.61; p<0.0005) and convenience (M=3.38; p<0.0005) were factors that influenced their meal choices. There was significant agreement that a lack of time to prepare meals (M=3.69; p<0.0005), lack of time to eat at work (M=4.04; p<0.0005), emotions/stress (M=3.30; p<0.0010) and healthy food not being available to buy at work (M=3.22; p<0.0036), were factors preventing nurses from eating healthily. The most common food item bought at the hospital cafeteria was pies (21.5%; n=17). Fruit (52.3%; n=68), sweets (34.6%; n=45) and sugar-sweetened soft drinks (32.3%; n=42) were consumed at least once a day. The mean BMI for females (33.6 kg/m2) was significantly higher than that for males (28.1 kg/m2) (p=0.043). Most male participants had a WC above 94 cm (63.6%; n=7), while the majority of females (88.2%; n=105) had a WC above 80 cm. The mean BMI for non-smokers (BMI=33.8 kg/m2) was significantly higher than that of smokers (29.6 kg/m2) (p=0.030). A higher BMI was associated with less snacking. The mean BMI for those who skipped supper (36.3 kg/m2) was significantly higher than for those who ate supper (32.0 kg/m2) (p=0.013). The mean BMI for those who skipped meals (33.8 kg/m2) was significantly higher than for those who did not skip meals (29.6 kg/m2) (p=0.005). The FFQ showed that the starches most frequently consumed were brown and white bread/rolls, white rice, phutu (crumbly maize meal porridge) and potatoes without skin. Sweets, chips (crisps), biscuits and chocolates were also frequently eaten. In the meat, poultry, fish, eggs and meat substitutes group, eggs, processed meats and chicken cuts with skin were frequently (n=65) of participants exercised. A significant number (63.1%; n=82) indicated that they were not satisfied with their body shape/size and did not feel that they were at a healthy body weight (60%; n=78). The majority of participants underestimated their BMI using the Stunkard figure rating scale (76.9%; n=100). The majority of participants stated they had tried to lose weight before (64.6%; n=84). The most common weight loss methods were cutting down on fast foods/takeaways (67.9%; n=57) (p=0.001) and exercising (63.1%; n=53). A significant number of nurses agreed that they were role models to their patients (70.8%; n=92) and believed it was important for a nurse to have an ideal body weight (92.3%; n=120). The majority of participants skipped meals (83.8%; n=109) with the only significantly skipped meal being breakfast (63.3%; n=69). A significant number of participants prepared their own meals at home (84.6%; n=110). Participants significantly agreed that time [M (mean)=3.98; p<0.0005], cost (M=3.26; p=0.021), emotions/stress (M=3.61; p<0.0005) and convenience (M=3.38; p<0.0005) were factors that influenced their meal choices. There was significant agreement that a lack of time to prepare meals (M=3.69; p<0.0005), lack of time to eat at work (M=4.04; p<0.0005), emotions/stress (M=3.30; p<0.0010) and healthy food not being available to buy at work (M=3.22; p<0.0036), were factors preventing nurses from eating healthily. The most common food item bought at the hospital cafeteria was pies (21.5%; n=17). Fruit (52.3%; n=68), sweets (34.6%; n=45) and sugar-sweetened soft drinks (32.3%; n=42) were consumed at least once a day. The mean BMI for females (33.6 kg/m2) was significantly higher than that for males (28.1 kg/m2) (p=0.043). Most male participants had a WC above 94 cm (63.6%; n=7), while the majority of females (88.2%; n=105) had a WC above 80 cm. The mean BMI for non-smokers (BMI=33.8 kg/m2) was significantly higher than that of smokers (29.6 kg/m2) (p=0.030). A higher BMI was associated with less snacking. The mean BMI for those who skipped supper (36.3 kg/m2) was significantly higher than for those who ate supper (32.0 kg/m2) (p=0.013). The mean BMI for those who skipped meals (33.8 kg/m2) was significantly higher than for those who did not skip meals (29.6 kg/m2) (p=0.005). The FFQ showed that the starches most frequently consumed were brown and white bread/rolls, white rice, phutu (crumbly maize meal porridge) and potatoes without skin. Sweets, chips (crisps), biscuits and chocolates were also frequently eaten. In the meat, poultry, fish, eggs and meat substitutes group, eggs, processed meats and chicken cuts with skin were frequently consumed. The fruit and vegetables most frequently consumed were non-starchy vegetables, fresh fruit and fruit juice. Full cream milk, sunflower oil, tub/soft margarine and cheddar cheese were the dairy and fats eaten most often. Tea and water were consumed more often than sugar-sweetened beverages. Overall, the most frequently consumed foods were full cream milk, sunflower oil, tea, white sugar, fresh fruit, brown sugar, brown bread/rolls, tub/soft margarine, sweets and white bread/rolls. Conclusion: There was a high prevalence of overweight and obesity among the participants. According to WC, the majority of nurses had an increased risk for metabolic complications. However, most participants were not diagnosed with a NCD. Factors associated with a high BMI included being female, not smoking, skipping meals, skipping supper, less snacking and cost of meals. Nurses consumed both healthy and unhealthy foods. Overall, there was a higher intake of carbohydrates and protein and a lower intake of dietary fibre. Despite the many hours that they spend caring for patients, nurses should also pay attention to their own health and well-being. Nurses should be supported in their efforts to achieve and maintain a healthy weight and lead a healthy lifestyle.
The effect of Lactobacillus reuteri supplementation on anthropometric measurements, lung function and lung infections in a cystic fibrosis population in KwaZulu-Natal.
(2007) Read, Amanda Jane Price.; Maunder, Eleni Maria Winifred.
BACKGROUND: Cystic fibrosis (CF) patients grow poorly and tend to be malnourished. They frequently suffer from lung infections necessitating the repeated use of antibiotics. AIM: This study was conducted to determine whether supplementation with a probiotic Lactobacillus reuteri (L. reuteri) could reduce the incidence and duration of lung infections, and whether this would impact on their anthropometric data. The secondary purpose was to compare the nutritional status of the CF patients attending CF clinics in Kwazulu-Natal (KZN) with CF patients attending CF clinics in Cape Town (CT). METHODS: Twenty three CF patients 6-31 years of age from 2 CF clinics in Kwazulu-Natal started the study although only 16 patients completed it. The study was a randomized, double blind, placebo controlled crossover trial with six months on placebo and six months on probiotic. Weight, height, mid arm circumference (MAC), triceps skin fold thickness (TSF), forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured, sputum collected and a symptom diary completed over the 12 month period. Anthropometric data of CF patients attending CF clinics in CT was obtained from the publication by Westwood & Saitowitz (1999). RESULTS: Compliance with taking the L. reuteri was poor. Most took only 50% of the required daily dose. Probiotic supplementation showed a slight (non significant) trend to improve FEV1 and FVC, while no significant difference could be seen in the number and duration of the lung infections. Sputum analysis showed a non significant trend towards the probiotic reducing the number of bacteria in the sputum. There was a significant reduction of symptoms for fever, running nose, sore throat and ear ache while on placebo. There was a significant increase in weight gained off probiotic compared to the probiotic period. The changes in height, weight for age (WFA) percentiles, height for age (HFA) percentiles, WFA and HFA Z-scores, percentage expected weight for age and percentage expected height for age all showed no difference whether on or off probiotic. Over half the CF children in the KZN clinics were underweight for their actual height compared to one third in the CT clinics with a higher number of subjects below the 5th percentile for MAC and TSF readings compared to CT. CONCLUSION: Due to a small sample size and poor compliance no firm conclusions could be drawn. However a slight (non significant) improvement could be seen in favour of the probiotic for FEV1, FVC, and sputum analysis. Although all other findings were not significantly different it would be of benefit to carry out further investigation with improved compliance with the probiotic to see if the parameters set out above could be improved. The KZN and CT CF groups were comparable and the nutritional status of CF patients on KZN was well below that of the CT CF clinics and further monitoring would need to be carried out.
Incidence of malnutrition as measured using specific anthropometric and biochemical parameters and its relationship with chemotoxicity in children with nephroblastoma admitted to Inkosi Albert Luthuli Central Hospital between 2004-2012.
(2016) Draper, Kelly Sue.; Pillay, Kirthee.; Wiles, Nicola Laurelle.
Introduction: The prevalence of malnutrition in children with cancer in developing countries is reported to be as high as 69%. Malnutrition is worse in developing countries as the diagnosis of cancer may be delayed due to poor access to health care. The assessment of the nutritional status of paediatric oncology patients on admission to hospital is crucial as nutritional status is known to influence treatment and clinical outcomes. Several studies suggest that concurrent malnutrition and cancer in children leads to reduced chemotherapy delivery due to impaired tolerance and increased toxicity. The influence of malnutrition on the prevalence, frequency and duration of chemotoxicity in South African children with nephroblastoma has not been well researched. Aim: This study aimed to determine the incidence of malnutrition as measured using specific anthropometric and biochemical parameters and its relationship with chemotoxicity in children with nephroblastoma admitted to IALCH between 2004-2012. Objectives: a) To determine the incidence of malnutrition as measured using specific anthropometric and biochemical parameters in children with nephroblastoma admitted to IALCH between 2004-2012. b) To determine the influence of malnutrition as measured using specific anthropometric and biochemical parameters on the prevalence of chemotoxicity. c) To determine the influence of malnutrition as measured using specific anthropometric and biochemical parameters on the frequency and duration of chemotoxicity Methods: Seventy-seven children between the ages of 1-12 years diagnosed with nephroblastoma and admitted to IALCH between 2004 and 2012 were studied prospectively. Nutritional assessment took place before treatment was started and included weight, height, mid upper arm circumference (MUAC), triceps skinfold thickness (TSFT) and serum albumin. The administration of Neupogen® was used as a surrogate for haemotoxicity and the frequency and duration of its use was recorded. Results: When patients were classified by weight for age (WFA), height for age (HFA), weight for height (WFH) and body mass index (BMI) for age, malnutrition was seen in 37.5%, 39.5%, 28.4% and 30.3% of patients respectively. When the parameters MUAC and TSFT were used the prevalence of malnutrition was 56% and 52.7% respectively. There was a significant relationship between the prevalence of toxicity and MUAC. The mean frequency and duration of chemotoxicity was significantly higher in those defined as malnourished using MUAC. Frequency and duration of chemotoxicity were positively correlated. Serum albumin, when used alone, showed that 86% of the cohort had a normal nutritional status. Conclusions: Nutritional assessment in children with solid tumours should include MUAC, TSFT as well as weight and height. This is because the use of weight and height alone could underestimate the prevalence of malnutrition. Children with nephroblastoma who have malnutrition according to their MUAC are more likely to experience more frequent and longer periods of chemotoxicity. Serum albumin should not be used in isolation to identify malnutrition.

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Browsing Masters Degrees (Dietetics And Human Nutrition) by Subject "Anthropometry."