Dietetics And Human Nutrition

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The accuracy of arm-associated height estimation methods compared to true height in a multi-racial group of young South African adults.
(2015) Lahner, Christen Renée.; Kassier, Susanna Maria.; Veldman, Frederick Johannes.
Background: Stretch stature is the gold standard for measuring true height, but when this is not possible height estimation methods are used. To date, only two South African studies regarding height estimation techniques have been published. Objective: To investigate the accuracy of arm-associated height estimation methods used for the calculation of true height compared to stretch stature in young South African adults. Design: A cross-sectional descriptive design was employed. Setting: Pietermaritzburg, Westville and Durban, KwaZulu-Natal, South Africa, 2015. Subjects: Convenience sample (N=900) aged 18 to 24 years, which included an equal number of subjects from both genders (n=150 per gender) stratified across race (White, Black and Indian). Results: Highly significant differences exist between genders (p<0.001), where males had larger stretch statures and arm-associated measurements than females (p<0.001). Highly significant differences exist between race groups (p<0.001), where whites had significantly different stretch statures as well as different armassociated measurements compared to Blacks and Indians. Some similarities were found between race groups, especially between Blacks and Indians. Arm-associated height estimation methods can be used as estimates of true height in accordance with the following study findings: (i) among Black African males, the World Health Organisation (WHO)-adjusted equation would seem to be the most appropriate, followed by demi-span male equation; (ii) among Black African females, the demispan female equation would seem to be the most appropriate, followed by total armspan; (iii) among Caucasian males, the total armspan would seem to be the most appropriate, followed by half-armspanx2; (iv) among Caucasian females, the total armspan would seem to be the most appropriate, followed by half-armspanx2; (v) among Indian males, the demi-span male equation would seem to be the most appropriate, followed by the WHO-adjusted equation; and (vi) among Indian females, the WHO-adjusted equation would seem to be the most appropriate, followed by demi-span female equation. Discussion:. The anthropometric variation between genders and race groups was linked to the exposure to secular growth conditions, which influences a subject's physiological ability to achieve their maximal height. The Vitruvius theory was proposed where total armspan potentially represents a subject's maximal height, and the ability for them to reach that height is dependent on exposure to consistent ambient secular growth conditions during the window period and beyond. Conclusion: In conclusion, this study's findings provides a baseline for future height studies to be conducted on the South African population, where each anthropometric method should be validated for each race and gender.
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.
Assessment of mothers and preschool-age children's food and nutrition security status: a cross-sectional case study of North central zone, Nigeria.
(2023) Omachi, Bosede Alice.; Van Onselen, Annette.; Kolanisi, Unathi.
Child and maternal nutrition are essential to any country's food and nutrition security, encompassing all the components of maternal and child growth, well-being, development, and productivity, as contained in the modified UNICEF 2020 conceptual framework on determinants of maternal and child nutrition. According to the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC), preschool children are regarded as being between 3 and 5 years old. This period entails intensive cognitive development in children, where developmental milestones that help shape their personality, interpersonal relationships, and thinking patterns are fostered; hence, the need to consume healthy meals following the recommended minimum dietary diversity requirements of at least five to eight food groups per day for children is a bedrock for positive health outcomes. The prevalence of nutrition-related maternal and child morbidity has continued to increase in recent times across many low- and middle-income countries (LMICs) owing to several complex multifactorial and interrelated determinants. The complexity and interconnectedness of the determinants of maternal and child nutrition in developing countries, such as Nigeria, are yet to be well conceptualised and have become a public health issue due to the emerging triple burden of malnutrition (TBM) and the prevalence of diet-related non-communicable diseases ravaging the nation. Therefore, this study assessed the food and nutrition security status of mothers and their preschoolers in North Central Nigeria. A cross-sectional descriptive design and a multi-stage sampling technique were used to recruit 450 mother-child pairs (preschool children aged 3-5 years) across the North South senatorial district in Niger State, North Central Nigeria. Sociodemographic information and biodata of mothers and their preschoolers were collected using semi-structured questionnaires. Feeding patterns of mother-child pairs were assessed using a qualitative food frequency questionnaire based on 24-hour and 7-day dietary recall. The dietary diversity of households, mothers, and children was assessed using the Household Dietary Diversity Score (HDDS), Minimum Dietary Diversity Score for Children (MDD_C), and Minimum Dietary Diversity Score for women of reproductive age (MDD_W), respectively, as recommended by the Food and Agriculture Organization (FAO), Family Health International (FHI) and World Health Organization (WHO). The Household Food Insecurity Access Scale (HFIAS) was used to assess the food insecurity status of the participants. Anthropometric indices of the preschoolers were assessed based on weight-for-age, height-for-age, and weight-for-height indicators, while maternal anthropometry was assessed using body mass index (BMI) and waist/hip ratio. Maternal nutrition knowledge was assessed using a Likert-type scale. Retrieved information was analysed using SPSS version 28. Descriptive statistics are presented in tables and charts, while regression models were used for inferential statistics, with statistical significance being considered at a 95% confidence interval with a p-value of < 0.05. The study was conducted in two phases: the first phase considered an in-depth narrative literature review that evaluated the food and nutrition security status of preschool children in North Central, Nigeria, as well as the food insecurity and vulnerability of the food environment among Nigerian mothers. This study explored the literature using a qualitative approach and an overview of online sources, peer-reviewed articles, books, and other publications and relevant reports from official websites to investigate the concept of the food environment, food acquisition and utilisation complexities among Nigerian women, and the prevalence of food and nutrition insecurity and its determinants among preschool children. This review found that the global prevalence of the Triple Burden of Malnutrition (TBM) is alarming, especially among developing nations, affecting more women than men. Food acquisition and utilisation are important determinants of women’s food and nutritional security status. Full but empty plates have continued to be a dilemma among women from countries undergoing urbanisation and nutrition transitioning; hence, poor nutrient intake has been reported to account for the high risk of maternal morbidity and mortality related to nutritional causes in most developing countries, such as Nigeria. This revealed that the interconnectedness of the food environment to food acquisition and utilisation in addressing food insecurity and malnutrition as an innovative concept is yet to be well understood and explored in many studies across Nigeria. It also elucidates the drivers of poor dietary diversity, meal quality, and food consumption patterns among preschool children and possible health outcomes of compromised feeding patterns and the risk of non-communicable diseases and malnutrition among the study participants. In addition, the review also focused on the drivers of the food environment, food acquisition, nutrient utilisation, and the prevalence of TBM among women across the six geopolitical zones in the country. The high prevalence of malnutrition and diet-related noncommunicable diseases in this study accounts for the high maternal and child morbidity and mortality rates, especially in many rural and poor households across the nation, thus becoming a significant public health concern. Some factors found to significantly impact food utilisation among women were food literacy, poverty, insurgence, lack of support systems, seasonality, and family size. To mitigate these challenges, efforts should be geared towards improving both the community and consumer food environments, thus ensuring the consumption of nutrientdense meals for optimal health outcomes and well-being, especially among women and preschool children living in rural areas, urban slums, and low-income households across the six geopolitical zones of the nation and among other developing nations experiencing food and nutrition insecurity around the world. The second phase was the experimental section and was divided into two parts: the first part explored the socioeconomic status, household food security status using the HFIAS and the feeding patterns of the preschool children using the qualitative 24 hour and 7-day dietary recall. Dietary diversity was assessed using the MDD_C, while the anthropometric indicators for under-five children were used to categorise the children into stunting, wasting, underweight, and normal weight. The results showed that the majority (76.4%) of the preschool children were from rural communities; more than half (51.8%) of the children were from mothers who had only Islamic education (no formal education), and only a few (1.2%) of the children were born to single mothers. Almost all (95.6%) of the children were from Islamic religious homes, and the majority (71.6%) of the mothers were unemployed, while 83.8% of the monthly household income was below N18,000 ($40), which is far below the national minimum income range of N36,000. Most (73.6%) of the children were from male-headed households. The predominant ethnic group was Nupe (68.4%), whereas the least dominant was Gwari (<1%). Most (98.8%) of the preschool children were from food-insecure households, and almost half (42.4% and 40.2%) of the preschool children were either moderately food insecure or severely food insecure, respectively. The severity of food insecurity increased with parity, and its prevalence was higher among children from multiparous and grand multiparous households. The most consumed food group among preschoolers was cereal-based food products, while the least consumed food groups were fruits and vegetables. This study also showed that over half (60.0%) of the preschoolers did not meet the minimum dietary diversity score (MDD_C) recommended for their age. The anthropometric indices of the preschool children showed that half (50.0%) of the children were stunted (height-for-age), 21.0% had wasting (weight-forheight), and 29.0% were underweight (22.2% were severely underweight) (weight-for-age). The logistic regression model showed that the socioeconomic status of mothers, such as education, income, religion, occupation, employment status, means of waste disposal, source of potable water (water suitable for human consumption), and water treatment methods, were associated with the household food insecurity status of the children and were associated with inadequacy in children’s MDD (p < 0.05). The second part of the experiment explored the contribution of maternal nutrition literacy to the nutritional status of mothers in Niger State, North Central Nigeria. The results showed that the majority (63.8%) of the mothers were between 26 and 35 years old. More than half (51.6%) of the mothers did not know what a balanced diet was based on the definitions provided in the questionnaire. Social media or online information was the most explored source of nutritional information among mothers (36.4 %). Fifty-four per cent of the mothers indicated that their nutrition literacy had no positive impact on their dietary quality. The food consumption pattern showed that fruits/vegetables, and dairy products were the least consumed food groups among the mothers (7.1% and 9.1%, respectively). More than half (57.6%) of the mothers were within the normal BMI range, and the mean waist/hip ratio was 0.82 ± 0.08. The regression model showed that place of residence, occupation, source of potable water, and method of waste disposal were significantly associated with adequacy of maternal minimum dietary diversity. Although nutrition knowledge has been reported to influence dietary quality among mothers, this study showed that other intrinsic factors besides nutrition knowledge significantly impacted the dietary quality and nutritional status of mothers in the study area. Therefore, to optimise health outcomes among mothers, stakeholders at all levels must implement programs and policies that address issues such as insurgence, inflation, climate change, disparity in wealth distribution, and seasonal vulnerability. In conclusion, the prevalence of food and nutrition insecurity was high among the participants due to poor socioeconomic status and poor food environment, thereby compromising the meal quality and consumption frequency of mothers and their preschoolers. Most mothers adopted the consumption of ultra-processed foods and beverages as coping strategies to salvage the impact of hunger and starvation, thereby predisposing them to the risk of TBM and NCDs among mothers and their preschool children. To mitigate these challenges, efforts should be geared towards addressing the determinants of food and nutrition insecurity with a multidimensional approach at the grassroots level and involving all stakeholders and policymakers, to enable a sustainable food system through nutrition-sensitive agriculture at the household and community level. Draught resistant and improved variety crops should be used to mitigate climate change impact on food access and affordability and thus, enhance adequate consumption of nutrient-dense meals for optimal health outcomes among the participants and across most food insecure developing nations. IQOQA Ukudla kwezingane nomama kuyisibikezelo sanoma yisiphi isimo sokungavikeleki kokudla ezweni, ifood and nutrition insecurity status (FNIS). Ukuvela komthwalo ophindwe kathathu wokungondleki, itriple burden of malnutrition (TBM); ukusabalala kwezifo ezingatheleleki ezihlobene nokudla kanye nokufa phakathi kwabesimame nezingane zasenkulisa eNigeria kuyinto ekhathaza kakhulu impilo yomphakathi. Lolu cwaningo luhlole isimo sokuphepha kokudla nokudla kwabesimame nezingane zasenkulisa eNorth Central Nigeria. Kwasetshenziswa inqubo yokusampula yezigaba eziningi ukuqasha amabhangqa anga-450 omama nezingane kulo lonke elaseNiger State, eNigeria. Imibuzo ehlelekile kanye nezingxoxo zeqembu lokugxila zasetshenziselwa ukubuyisa ulwazi ngesociodemographic, ibiodata, iphethini yokudla, ukudla kwasendlini isimo sokuphepha, ulwazi lokudla kwabesimame, ukuhlukahluka okuncane kokudla, kanye nezinkomba ze-anthropometric zabomama / abanakekeli kanye nezingane zabo zasenkulisa. Imininingwane eyatholakala yahlaziywa ngokusebenzisa i-SPSS version 28, futhi ukubaluleka kwezibalo kwabekwa kumaphesenti angama-95 kwesikhawu sokuzethemba kanye ne-p-value < 0.05. Lolu cwaningo luveze ukuthi amaphesenti angama-76.4 womama nezingane zabo zasenkulisa bavela emiphakathini yasemaphandleni, kanti amaphesenti angama-83.8% emali abayithola emakhaya ngenyanga ingaphansi kuka-N18 000 ($40). Iningi (98.8%) labahlanganyeli babevela emakhaya angenakudla, futhi cishe isigamu (42.4% no-40.2%) sasinokudla ngokulinganisela okungaphephile noma okungaphephile kakhulu, ngokulandelana. Amaphesenti angamashumi ayisithupha (60.0%) ezinganeni zasenkulisa azizange zihlangabezane nokuhlukahluka okuncane kokudla (MDD_C). Iphethini yokusetshenziswa kokudla kwabahlanganyeli yabonisa ukuthi izithelo / imifino (7.1%) kanye nemikhiqizo yobisi (9.1%) kwakungamaqembu okudla angadliwa kakhulu, kanti ukudla okunesitashi (53.1%) kwakuyikona okungamaqembu okudla okudliwayo. Iningi lomama (57.6%) babengaphakathi kwebanga elijwayelekile le-BMI, kanti amaphesenti angama-50.0 ezingane zaphazamiseka. Amaphesenti angamashumi amahlanu nane (54%) omama babenolwazi oluphansi lokudla okunomsoco. Kwakukhona ukuhlangana okuqinile phakathi kwesimo sezenhlalo nezomnotho somama / abanakekeli kanye nesimo sokungavikeleki kokudla kwasendlini, izinkomba ze-anthropometric kanye nokwanela kwe-MDD yabahlanganyeli (p < 0.05). Ngakho-ke, kumele kuhlolwe izindlela eziningi zokubhekana nesimo sokungavikeleki kokudla nokudla phakathi kwalaba bantu abasengozini.
An assessment of the effect of a peanut based ready-to-use nutritional supplement on HIV positive adults on antiretroviral therapy, attending the 1000 Hills Community Helpers Centre, Durban, KwaZulu-Natal.
(2014) Ncwane, Mphilonhle Vuyani Sibongeleni.; Veldman, Frederick Johannes.
Introduction: The aim of this study was to assess the nutritional effect of a peanut based ready-to-use food supplement (RUSF) [Sibusiso®] on HIV positive adults on antiretroviral therapy (ART). Objectives: (1) To determine whether the BMI of HIV positive adults on ART supplemented with RUSF was improved after a three months supplementation period. (2) To determine the most predominant self reported disease symptoms experienced by HIV positive adults on ART at baseline assessment. (3) To determine whether predominant disease symptoms experienced by HIV positive adults in ART improved after supplementation with Sibusiso® RUSF. (4) To determine whether appetite, meal consumption and energy levels improved among HIV positive adults on ART supplemented with Sibusiso® RUSF. (5) To determine if there was any observed changes in body fat distribution in HIV positive adults on ART after being supplemented with Sibusiso® RUSF. Materials and methods: This is a non randomised descriptive study whereby data was collected using a cross-sectional method. It included 50 HIV positive adults (between 20 and 78 years of age) on antiretroviral therapy, attending the 1000 hills community helpers’ centre, Durban, KwaZulu-Natal. A monitoring tool was used to collect data on anthropometrical measurements (weight and height), disease symptoms experienced, disease conditions identified by the researcher/research assistants, level of appetite, meal frequency consumption and energy for each subject for a period of three consecutive months. Twenty participants were interviewed to assess the body fat distribution after using the supplement using a self reporting method. Results and discussions: Study findings suggest that supplementation with RUSF for at least three months has a potential to gradually improve weight gain among HIV-positive adults on ART. The most self reported predominant disease symptom experienced before supplementation was fever, followed by nausea and persistent diarrhoea. This was in keeping with the results from other studies. After supplementation, there was a significant improvement in fever and gastroenteritis and steady but statistically significant decline in vomiting. However there was non-significant improvement in nausea and no change in persistent diarrhoea. RUSF in this study was also found to exert a beneficial effect on appetite, meal consumption and energy levels of participants. The study showed that short-term supplementation with RUSF is highly unlikely to result in lipodystrophy. Conclusion: The administration of the nutrition supplement Sibusiso® RUSF for at least three months, in conjunction with the use of ART, was found to improve nutritional status in HIV patients under the controlled condition. Sibusiso® RUSF was able to improve the episode of fever which was most dominant disease symptom at baseline while improving gastroenteritis and vomiting. However it did not have an impact on reducing the episodes of nausea and persistent diarrhoea. Sibusiso® RUSF was also able to improve appetite, meal consumption and energy of participants after a three month period.
An assessment of the quality and acceptance of a ready-to-use supplement, Sibusiso, by human immunodeficiency virus and human immunodeficiency virus/tuberculosis treated patients in KwaZulu-Natal.
(2013) Mabaso, Prudence Bongekile.; Siwela, Muthulisi.; Pillay, Kirthee.; Amonsou, Eric Oscar.; Veldman, Frederick Johannes.
Introduction: Malnutrition is a health issue directly and indirectly contributing towards high rates of morbidity and mortality globally, particularly in developing countries. South Africa (SA) is faced with a double burden of diseases with a high prevalence of both under and over nutrition. The high prevalence of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) in SA worsens undernutrition. HIV/AIDS increases nutrient requirements and inadequate food intake results in malnutrition. Nutrition support through food supplementation is important to combat the high prevalence of malnutrition in sub-Saharan African countries including South Africa. Thus, a groundnut-soya based supplementary paste, Sibusiso, has been produced. However, its nutritional composition and acceptability have not been studied. Objectives: (i) To determine the nutritional composition and physical properties of a ready-to-use supplement, Sibusiso, (ii) To determine the sensory acceptability of Sibusiso among healthy subjects; and sensory acceptability and perceptions of Sibusiso by subjects treated for HIV and HIV/TB. Materials and methods: The nutritional composition, colour and texture of Sibusiso and a commercial peanut butter (control) were analysed following standard procedures. A cross-sectional consumer acceptability test was done using a 5-point facial hedonic scale (healthy control group, n = 68; HIV, n = 88 and HIV-TB co-infection treated, n = 51). A total of six focus group discussion sessions (HIV subjects = 4 sessions and HIV/TB co-infected subjects = 2 sessions) were also conducted. Results and discussions: The protein content of Sibusiso (16 g/100 g) was almost half that of the commercial peanut butter (control), (25 g/100 g). However, Sibusiso contained 1.4 times more ash (4 g/100 g) and almost twice as much carbohydrate (40 g/100 g) compared to the commercial peanut butter (22 g/100 g). The fat (40 g/100 g) and energy (2 624 kJ/ 100 g) content of Sibusiso was not substantially different from that of the commercial peanut butter which was 43 g/100 g and 2 852 kJ/100 g, respectively. The lysine content of Sibusiso (58 mg/g) was about 1.7 times higher than that of the commercial peanut butter. The methionine (11 mg/g) and histidine (35 mg/g) content of Sibusiso was almost twice that of the commercial peanut butter, respectively. The nutrient content of Sibusiso was either similar or slightly more than that of other ready-to-use supplements such as Plumpy’nut®. Sibusiso met the FAO/WHO/UNU recommendations for essential amino acids. The consumption of 50 g of Sibusiso per day may provide approximately 35% of the Estimated Energy Requirements (EER) and 30% of the Recommended Dietary Allowance (RDA) for protein for adults. Sibusiso was brown in colour, similar to the commercial peanut butter. Its textural attributes were found similar to that of the commercial peanut butter but harder and stickier. The acceptability of Sibusiso was significantly associated (p ≤ 0.05) with the health status of consumers. Overall, Sibusiso was liked by 94% of HIV and HIV/TB individuals (mean score: 4) compared to 85% for the healthy group (control). More than 90% of the HIV/TB and HIV treated individuals liked the taste compared to the control group (86%, mean score: 4). The colour and mouthful were rated 'good' by more than 80% of the HIV and HIV/TB group, mean score: 3, with only 68% among the healthy group, mean score: 4.1. Conclusion: Sibusiso is a good source of nutrients and was found to be acceptable to HIV and HIV/TB treated consumers. It may be effective in alleviating disease-related malnutrition among vulnerable individuals such as those infected by HIV and HIV/TB.
The attitude toward and the prescription of a low carbohydrate, high fat diet by KwaZulu-Natal clinical dieticians.
(2015) Joyner, Stephanie Alexandra.; Wiles, Nicola Laurelle.; Kassier, Susanna Maria.
Aim: To determine the attitude toward and the prescription of a low carbohydrate, high fat (LCHF) diet by KwaZulu-Natal clinical dieticians working in government or private practice. Objectives: The study set out to determine the following objectives: (i) dieticians’ attitudes toward a LCHF diet, (ii) the prescription of this diet in practice and concerns regarding the diet; (iii) to determine if there is a relationship between the socio-demographic characteristics, areas of work and professional interest as well as research involvement of dieticians and the prescription of a LCHF diet in practice; and to (iv) assess whether dieticians would be willing to adapt their practice methods and attitude after hearing a presentation on the LCHF diet. Method: The email addresses for 155 clinical dieticians, working in either government or private practice, were obtained from a data base. The dieticians were emailed a link to a four-part online questionnaire regarding their area of work, main professional interests, practice methods, prescription or non-prescription of a LCHF diet and research involvement. Results: The response rate to the questionnaire was 58% (n=90). The majority of the subjects were female (n=87, 97%) and had qualified at the University of KwaZulu-Natal (n=67, 74%). Patients with non-communicable diseases were the most common condition counselled by the subjects (71.3%). The latter was also the main area of interest for subjects in private practice. Upon analysis of the section pertaining to research involvement, it was found that the majority of subjects scored poorly in the questions related to the most basic of research involvement skills, with an average score of 40%. Overall, there was a negative attitude toward the prescription of the LCHF diet. Only 17% (n=15) of the subjects had prescribed the LCHF diet in practice and it had been prescribed rarely. The most common condition that the diet was prescribed for was weight loss. Subjects working in private practice were more likely to prescribe a LCHF diet for their patients compared to those working in government. More than 80% of the sample reported that they had never prescribed the diet. The most common reason provided was that it was felt there was a lack of supportive evidence for its use. Discussion: The finding that private practicing dieticians are more likely to prescribe a LCHF diet to patients may be because this type of patient is more likely to be able to afford and sustain a LCHF diet compared to the type of patients seen by subjects working in the government sector. These patients are also more likely to be aware of the LCHF diet compared to government health patients. Very few deiticians prescribed a LCHF diet; this may be a reflection of the dieticians practicing evidence evidence-based nutrition and/or it could be related to harm-avoidance. The very low level of research involvement and skill observed in the study is a concern and should be used as a basis for further investigation. Conclusion and recommendations: The low score obtained by subjects in basic research involvement could be interpreted that more emphasis should be placed on this area in undergraduate training and in the continuing professional development of qualified dieticians. More studies need to be done on the long-term safety and efficacy of a LCHF diet for the prevention and management of NCDs. Dietetic authorities should consider a country-wide advertising campaign to encourage the public to consult a Registered Dietician before following a LCHF diet
Awareness, attitudes and response to the sugar-sweetened beverage tax among consumers in Pietermaritzburg, KwaZulu-Natal.
(2019) Baijnath, Nikita.; Pillay, Kirthee.
Introduction: Obesity and overweight have been identified as serious health problems both globally and in South Africa. One of the contributing factors to this epidemic is the consumption of sugar-sweetened beverages (SSBs), high in sugar and energy. Sugar-sweetened beverages are defined as: ‘beverages that contain added caloric sweeteners such as sucrose, high fructose corn syrup or fruit juice concentrates’ and include soft drinks, fruit drinks, sports/energy drinks, vitamin water drinks, sweetened ice tea and lemonade. The South African Minister of Finance implemented the sugar-sweetened beverage (SSB) tax on 01 April 2018, as part of a multidisciplinary strategy to alleviate the obesity problem. The tax is calculated according to the direct proportion of added sugar at 2.1 cents per gram of sugar that exceeds 4 g per 100 ml, resulting in an approximate 20% increase in the price of SSBs. Given that the SSB tax is relatively new in South Africa, there is a need to assess the awareness, attitudes and responses of South African consumers to the tax. Aim: This study aimed to assess the awareness, attitudes and response to the sugar-sweetened beverage tax among consumers in Pietermaritzburg, KwaZulu-Natal. Objectives: (i) To determine if consumers in Pietermaritzburg, KwaZulu-Natal are aware of the SSB tax (ii) To determine the demographic characteristics of consumers who are aware of the SSB tax in Pietermaritzburg, KwaZulu-Natal (iii) To determine the attitudes of consumers in Pietermaritzburg, KwaZulu-Natal towards the SSB tax (iv) To determine the response of consumers in Pietermaritzburg, KwaZulu-Natal to the SSB tax, in terms of purchasing behaviour. Methods: An observational cross-sectional study was conducted at seven shopping centres in Pietermaritzburg, using a self-administered questionnaire, developed for this study. The questionnaire was used to gather data on demographic characteristics, awareness and response to the SSB tax. Data was analysed using the IBM Statistical Package for Social Science (SPSS) version 23.0. Results: The participants were mostly 18-30 year old Indian or African consumers, with a low income and in possession of a matric certificate or tertiary qualification. A significant number of consumers were aware of the South African SSB tax (58.1%; n=229), however, almost half did not know when it was implemented (47.6%; n=109). Indian and white consumers were significantly more aware of the SSB tax compared to African consumers (p<0.0005). In addition, awareness increased according to income level (more than R40 000 per month) and age (31-50 year olds) (p<0.0005). The consumers were divided in their attitudes towards the SSB tax. Nearly equal amounts of participants were in agreement (35.8%; n=141) or disagreement (37.0%; n=146) with the SSB tax. Furthermore, many believed that it would benefit the country in terms of the economy or health (43.6%; n=100). However, some felt that they could not afford the tax (21.8%; n=50) or felt that the money would go to the government and not benefit the public (12.7%; n=29). Many also believed that the South African economy would be negatively affected in terms of job losses (41.1%; n=162). However, there was neither significant agreement nor significant disagreement that the SSB tax would reduce obesity or consumption rates of SSBs. In addition, many indicated that the government should not interfere with the beverage choices of South Africans (41.9%; n=165). About half of the participants stated that they would make healthier beverage choices, following the implementation of the SSB tax (53.6%; n=211). Moreover, half of the consumers indicated that they would opt for water (50.8%; n=200). Other common alternatives included 100% fruit juice (49.2%; n=194) and milk and milk products (30.2%; n=119). Finally, most participants suggested that they would like the government to help reduce the prevalence of obesity by supporting an increase in nutrition education (27.3%; n=68) and physical activity (22.5%; n=56). Conclusion: This study aimed to assess the awareness, attitudes and response to the SSB tax among consumers in Pietermaritzburg, KwaZulu-Natal. The majority of the consumers were aware of the South African SSB tax; however, almost half did not know when it was implemented. Indian and White consumers, between the ages of 31 and 50 years old, earning more than R40 000 per month, were the most aware of the South African SSB tax. Half of the consumers were in favour of the SSB tax and felt that it would improve health. The same number also indicated that they would choose water as an alternative, if SSBs were no longer affordable to them, followed by 100% fruit juice and milk and milk products. The differences in attitudes towards the SSB tax show that there is a need for consumers to know more about the SSB tax. Hence, more awareness campaigns are required. Future research should investigate the impact of the SSB tax on health, obesity rates and the economy.
Body mass index, body image and possible factors related to weight loss practices of female undergraduate students on the Pietermaritzburg campus, University of Kwazulu-Natal.
(2019) Lubisi, Zethembiso Desiree; Kassier, Susanna Maria.; Mkhwanazi, Blessing Nkazimulo.
South Africa is undergoing epidemiological transition, characterized by an increasing prevalence of obesity, especially among women. Among those 15 to 24 years of age, the prevalence of overweight and obesity at 40.9% is cause for concern, as it is associated with the development of non-communicable diseases of lifestyle. However, 18.1% of women in the above age category, indicated that they are unhappy with their current weight. Body image is related to an individual’s perception of the attractiveness of their own body, and has an impact on actual weight and weight management practices. Body image dissatisfaction refers to the negative perceptions and feelings a person has about their body and can be affected by factors such as body shape and appearance, body weight gain attitudes, and cultural norms regarding an ideal body size. In this respect, university students are of particular interest, as they are known to experience a number of stressors during the transition from secondary- to tertiary education that contributes to unhealthy eating habits, a decreased level of physical activity and subsequent weight gain. Objectives To determine the Body Mass Index (BMI), body image and factors related to weight loss practices among female undergraduate students on the Pietermaritzburg (PMB) campus of the University of KwaZulu-Natal (UKZN). Methods A cross sectional descriptive survey of conveniently sampled female undergraduate students on the PMB campus (N=316), UKZN was conducted. Weight and height were measured by trained fieldworkers for the calculation of BMI. Data was collected by means of a self-administered questionnaire to determine the socio-demographic characteristics, physical activity level, nutrition knowledge, body perceptions, weight management practices and dietary diversity of study participants. Results The majority of participants (86.7%), were black African and registered for study within the College of Agriculture, Engineering and Science (45.6 %). The mean age of the study sample was 20 ± 2 years. Participants mainly resided in private accommodation (44.3%), followed by 38.6% living in university residences. The majority (72.7%) were funded by the National Student Financial Aid Scheme (NSFAS). Participants who prepared their own meals, did so 3.7 ± 2.3 times per week, with 84.3% reporting that they prepared their own meals most days of the week. Most consumed take-aways (91.1%), with 61.2% doing so on a weekly basis. Nearly half (48.1%) of the participants had a normal BMI, followed by 19% being overweight. Furthermore, 13.3% were classified as obese class I, while 12.6% were classified as obese class II. Only 4.4% were underweight, while 2.5% were classified as obese class III. The majority (46.8%) could be classified as being moderately physically active, followed by those with a low level of physical activity at 38.6%. Only 14.6% were classified as having a high level of physical activity. A nutrition knowledge score of ≥ 50% was achieved by 63.8% of participants, followed by a third (34.3%) who had a score of less than 50%. The most noteworthy findings were that participants were not aware that starchy foods should form the basis of most meals, and that drinking boiled water does not facilitate weight loss. An assessment of participant weight management practices, revealed that 59.1% weighed themselves, with 61.0% reporting that they do so monthly. Despite the fact that the majority of participants (70.0%) classified their current body weight as normal, 56.4% had attempted weight loss. Of those who had not attempted weight loss, the majority (37.5%) indicated that the reason for not attempting weight loss, was that they were satisfied with their body weight, followed by 35% indicating that they perceived their body weight as normal. The majority of participants who attempted weight loss, resorted to healthy weight loss practices (50.9%), followed by 42.0% who made use of a combination of healthy and unhealthy weight loss practices. In terms of body image perceptions, the difference between perceived (“feel”) and ideal body size was calculated, rendering a Feel Ideal Index (FID) score of 0.4 ± 1.33, indicating that participants desired to be thinner. The majority of participants (45.0%) had a medium dietary diversity as was indicated by the consumption of 6 to 11 food groups, followed by more than a third of participants (35.6%) having a high dietary diversity score due to the consumption of more than 11 food groups. One out of five participants (19.4%) consumed diets that lacked diversity. Conclusion Body image perception and level of body image satisfaction were the most important determinants of whether participants engaged in weight management practices. This was illustrated by participants who had never attempted weight loss, indicating that the reason why they have never attempted weight loss was because they “perceived their current body weight to be normal” and that they are “satisfied with current weight”. An increase in BMI was positively associated with an increase in body image dissatisfaction (BID), resulting in overweight and obese participants attempting to lose weight. It was also noted that a larger proportion of participants indicated that they have attempted weight loss, and did so using healthy weight loss practices such as exercise, diet and reduced portion sizes. Participants desired body sizes that were thinner than their perceived current body size. This was illustrated by a positive mean FID index score of 0.4 ± 1.33. Although those with a high BMI desired a large body size, it was thinner than what they perceived themselves to be. Furthermore, participants living in university residences and private accommodation, had a higher BMI than those who lived at home. Those with a higher physical activity level (PAL), weighed themselves more often when compared to those who were less active. This may suggests that participants were engaged in physical activity to improve appearance. However, it could also be an indicator that participants were physically active for the promotion of health, general wellbeing and for social reasons. Significant relationships between nutrition knowledge score and BMI, as well as dietary diversity score were not documented. However, participants with a good nutrition knowledge score perceived their current weight to be lower than those with a poor nutrition knowledge score.
Breakfast consumption and the relationship to to socio-demographic and lifestyle factors of undergraduate students in the School of Health Sciences at the University of KwaZulu-Natal.
(2017) Seedat, Raeesa.; Pillay, Kirthee.
Introduction: Breakfast is commonly regarded as the most important meal of the day. The consumption of breakfast has been linked to various health benefits, and is widely acknowledged in available literature. There is improved nutrient intake in those who consume breakfast compared to those who skip breakfast. Consumption of breakfast leads to positive health behaviour, improved stress management, feeling energetic and making less unhealthy snack choices. On the other hand, neglecting breakfast can have negative implications, such as fatigue and decreased concentration. Furthermore, skipping breakfast is positively correlated with obesity risk. The high prevalence of overweight and obesity in South Africa could be linked to poor breakfast consumption habits and requires further investigation. Several studies have illustrated a high prevalence of breakfast skipping amongst the university student population worldwide, due to affordability and time management. It could be assumed that students studying towards qualifications in health sciences would be more inclined towards regular breakfast consumption, as part of a healthy lifestyle; however, further research is required to investigate this. Due to the paucity of data amongst South African university health science students, this study aimed to investigate breakfast consumption and the relationship to socio-demographic and lifestyle factors of undergraduate students in the School of Health Sciences, at the University of KwaZulu-Natal (UKZN). Aim: To investigate breakfast consumption and the relationship to socio-demographic and lifestyle factors of undergraduate students in the School of Health Sciences at UKZN. Objectives: • To investigate breakfast consumption and the factors that influence breakfast consumption in undergraduate students in the School of Health Sciences at UKZN. • To determine the socio-demographic and lifestyle profile of undergraduate students in the School of Health Sciences at UKZN. • To determine if there was a correlation between breakfast consumption, socio-demographic profile, lifestyle indicators and Body Mass Index (BMI) among undergraduate students in the School of Health Sciences at UKZN. Methods: A cross-sectional, descriptive study was conducted on undergraduate students in the School of Health Sciences at UKZN, based at the Westville campus. A self-administered questionnaire consisting mainly of close-ended questions was used to collect data. Weight and height measurements were taken and used to calculate BMI. Results: Most participants were between 19 to 20 years of age, were females, lived at the university residence and were in their first year of study. Most reported their health status to be good or fair, did not smoke or consume alcohol and were physically active. Breakfast was consumed by 82.1% (n=284), however, only 50.5% (n=143) consumed it daily. Breakfast consumption was associated with lower levels of fatigue and higher levels of alertness. Ready to eat or instant breakfast cereals, tea or coffee, eggs and leftovers were popular breakfast choices. Reasons for consuming breakfast included: to satisfy hunger, for energy, to be alert, prevent fatigue and for health reasons. Breakfast was skipped due to a lack of time and a lack of appetite. A significant number of those who did not eat breakfast were in their third year of study, were smokers and consumed fast foods or take-away foods frequently. Daily breakfast intake was found among a significant proportion of Indian and white participants, those who lived at home and those whose parents or family were responsible for purchasing groceries. This study found no relationship between breakfast consumption and BMI. Conclusion: The majority of students at the School of Health Sciences at UKZN consumed breakfast; however, not all consumed it regularly. Breakfast was consumed to achieve satiety, provide energy, be alert, prevent fatigue and for health reasons. Barriers to breakfast consumption included a lack of time and a lack of appetite. There was no relationship between breakfast consumption and BMI. Given its health and nutritional benefits, regular breakfast consumption should be encouraged among university students.
Caregiver and child acceptability of a provitamin A carotenoid, iron and zinc rich complementary food prepared from common bean and pumpkin in Uganda.
(2020) Buzigi, Edward.; Siwela, Muthulisi.; Pillay, Kirthee.
Vitamin A deficiency (VAD), iron deficiency (ID), and zinc deficiency (ZnD) are the three leading micronutrient deficiencies causing morbidity and mortality among children under five years in developing countries, including Uganda. A high prevalence of VAD, ID and ZnD among children in developing countries begins during the period of complementary feeding, which is between the ages of six to 24 months. This is the period when children are fed complementary foods (CFs) prepared from vitamin A, iron, and zinc deficient staple tubers and cereals. To combat VAD, ID, and ZnD, the World Health Organization (WHO) recommends that CFs be diversified with vitamin A, iron and zinc rich food sources, such as animal source foods (ASFs), food supplements and commercially fortified foods. However, ASFs, commercially fortified foods and food supplements are either unaffordable or inaccessible to rural Ugandan caregivers. Therefore, the aim of this study was to prepare a complementary food (CF) rich in provitamin A carotenoids (PVACs), iron and zinc using locally available common bean and pumpkin and to test the acceptability of the CF among caregivers and their children in rural Uganda. The study objectives were to: (i) select one common bean landrace superior in iron and zinc, and one pumpkin landrace superior in PVACs from a variety of local landraces available in the local market; (ii) evaluate the effect of home cooking methods on provitamin A carotenoid (PVAC) retention in the selected pumpkin (superior in PVACs), and iron and zinc retention in the selected common bean (superior in iron and zinc); (iii) assess child acceptability of an innovative CF- a common bean pumpkin blend (BPB) prepared with common bean (superior in iron and zinc) and pumpkin (superior in PVACs); (iv) assess caregiver perceptions and acceptability of the innovative CF (BPB). The study was conducted in rural Kyankwanzi district, Uganda, East Africa. Cross-sectional and randomised control trial designs were used in this study for the consumer acceptability investigations; and a controlled laboratory experiment for the nutrient retention investigation. Three pumpkin landraces on the local market of the study area were screened for PVACs, whilst five common bean landraces also on the local market were screened for iron and zinc content. Iron and zinc content were determined by flame atomic absorption spectrometry (FAAS), whilst PVAC content was determined by high performance liquid chromatography (HPLC). True retention of iron, zinc and PVAC was determined after expert caregivers cooked pumpkin by either boiling or steaming, whilst the common bean was cooked by either boiling with or without prior soaking. Caregivers prepared the test CF and the control according to the consistency (thickness or thinness) fit for child consumption based on the child’s age and stage of development. The test CF (BPB) was prepared by mixing and blending two parts of cooked pumpkin and one part of cooked common bean, whilst the control CF, pumpkin puree (PP) was prepared by mashing one part of cooked pumpkin. Seventy children, aged 6 to 24 months participated in the child acceptability randomised crossover study. In the current study, the CFs test food (BPB) and control (PP) were considered acceptable if the child consumed at least 50 g and more of the 100 g of the CF offered. Mean duration for intake of the CFs and vitamin A, iron and zinc intake were calculated. A paired t-test was used to determine whether there were significant differences in the amount, duration, and micronutrient intake between the BPB and PP. Further, 70 caregivers (whose children participated in the child acceptability study) participated in the caregiver acceptability study. A cross-sectional sensory evaluation study design was used to assess caregiver perceptions and acceptability of the study CFs. Sensory attributes (taste, colour, aroma, texture and general acceptability) of the BPB and PP were rated using a five-point facial hedonic scale (1=very bad, 2=bad, 3=neutral, 4=good, 5=very good). Focus group discussions (FGDs) were also conducted to assess caregiver perceptions about using the BPB as a CF. A chi-square (X2) test was used to detect the proportionate difference for each sensory attribute between BPB and PP, whilst focus group discussions (FGDs) data was analysed by thematic analysis. A p value of 0.05 was considered statistically significant. For objective one (first investigation), β-carotene content in Sweet cream (1 704 μg/100 g) was significantly higher compared to Dulu (1 333 μg/100 g) and Sun fish (1041 μg/100 g) (p<0.0001). The α- carotene content of Sweet cream was significantly lower (46 μg/100 g, p<0.0001) compared to Dulu (77.3 μg/100 g) and Sun fish (79.3 μg/100 g). However, the total retinol activity equivalent (RAE) was highest in Sweet cream (143.9 μg/100 g), compared to Dulu (115.4 μg/100 g) and Sun fish (90.1 μg/100 g). Iron content was highest in Obwelu (7.75 mg/100g), compared to Masavu (6.95 mg/100 g), Nambale (6.55 mg/100g), Kanyebwa (7.15 mg/100 g) and Obwayelo (6.5 mg/100 g). Obwelu had significantly higher iron concentrations than Obwayelo (p<0.05). Zinc content was highest in Obwelu (3.05 mg/100 g), but was not significantly different (p >0.05) compared to the other common bean landraces of Masavu (2.95 mg/100 g), Nambale (2.35 mg/100 g), Kanyebwa (2.9 mg/100 g) and Obwayelo (3.0 mg/100 g). The findings of the first investigation suggested that Sweet cream was superior in PVAC content compared to the other pumpkin landraces, whilst Obwelu was superior in iron and zinc content compared to the other common bean landraces. Therefore, Sweet cream and Obwelu were selected for use in the preparation of a CF rich in PVACs, iron and zinc. For objective two (second investigation), β-carotene, α-carotene, and total provitamin A content in raw pumpkin was 1704 μg/100 g, 46 μg/100 g and 1437 μg/100 g, respectively. Either boiling or steaming pumpkin resulted in over 100% retention of PVACs and total provitamin A. Iron and zinc retention in soaked boiled common bean was 92.2% and 91.3%, respectively. Boiling common bean without soaking resulted in 88.4% and 75.6% retention of iron and zinc, respectively. The findings of the second investigation suggested that there was a high retention of PVACs in pumpkin, Sweet cream after boiling or steaming, and a high retention of iron and zinc in common bean, Obwelu after boiling with prior soaking. For objective three (third investigation), the mean amount of BPB (53.9 g) and the control (PP) (54.4 g) consumed by children was high, but not significantly different from each other (p>0.05). The mean duration for child consumption of BPB was 20.6 minutes and 20.3 minutes for the control and the durations for child consumption were not significantly different from each other (p<0.05). The mean child intake of vitamin A was significantly higher (p<0.05) from the control (PP) (152.5 μgRAE) compared to the test food (BPB) (100.9 μgRAE). The mean iron intake was significantly higher (p<0.05) from BPB (1.1 mg) compared to the control (0.3 mg). Furthermore, zinc intake was significantly higher (p<0.00001) from the (0.58 mg), compared to control (0.13 mg). For objective four (fourth investigation), between 64% and 96% of the caregivers rated both BPB and PP as acceptable (good to very good) for all the sensory attributes. There was no significant difference (p>0.05) in caregiver acceptability for all sensory attributes between BPB and PP (p>0.05). Caregivers had positive perceptions about the taste, texture, aroma, and colour of the BPB. Caregivers were keen to know the specific varieties of common bean and pumpkin used to formulate the PVAC, iron and zinc rich BPB. Findings from this study suggest that a complementary food, BPB, rich in PVACs, iron and zinc prepared from locally available common bean, Obwelu and pumpkin, Sweet cream was acceptable to caregivers and their children who were in the age range of complementary feeding in Uganda. To contribute towards combating child VAD, ID and ZnD, policy makers in Uganda, such as the district nutrition coordination teams should support and promote the cultivation and utilisation of common bean, Obwelu and pumpkin, Sweet cream as major ingredients of CFs. The use of BPB as a CF should not replace other existing nutrition interventions such as micronutrient supplementation, commercial fortification, biofortification programmes and the use of ASFs that aim to combat micronutrient deficiencies during the period of complementary feeding. However, the use of BPB as a CF should be a complementary strategy to these existing nutrition interventions. Future studies should investigate the effect of BPB intake on the vitamin A, iron and zinc status of children.
A comparative analysis of the nutrition status, nutrition knowledge and food frequency of adolescents attending an urban versus a peri-urban school in Hilton, KwaZulu-Natal.
(2014) Audain, Keiron Arthur.; Veldman, Frederick Johannes.
Adolescence is an important stage in human development. Optimum nutrition is crucial during this period, as additional nutrient requirements are needed to promote growth and maturation. With the nutrition transition in low-to-middle-income countries (LMICs), adolescents are increasingly exposed to energy-dense, nutrient poor foods; however it is not entirely clear the impact of socioeconomic status, in particular household food insecurity, on the consumption frequency of these foods. The impact nutrition knowledge may have on the dietary choices adolescents make is also unclear. Poor food choices among adolescents can contribute towards overweight/obesity and stunting, leading to the susceptibility to both communicable and non-communicable diseases (NCDs) in adulthood. The objective of this study was to determine the prevalence of overweight/obesity and stunting among South African adolescents from different socioeconomic backgrounds, in relation to their nutrition knowledge, household food insecurity status, and frequency of food consumption. The study consisted of a cross-sectional descriptive survey conducted among learners from a high-income, private urban school and a low-income, government peri-urban school in Hilton, KwaZulu-Natal. A total of 98 grade nine to eleven learners from the urban school and 111 grade nine to eleven learners from the peri-urban school volunteered to participate (N= 209). Nutritional status was determined by anthropometric measurements that included weight, height and MUAC. Subsequently BMI was calculated. Nutrition knowledge and food frequency were determined via non-quantified nutrition knowledge and food frequency questionnaires. A socio-demographic questionnaire (SDQ) was used to collect information on parental level of education and employment status. Household food security was determined using the Household Food Insecurity Access Scale (HFIAS). A higher prevalence of overweight and obesity was observed among urban learners compared to their peri-urban counterparts, however only for the boys as peri-urban girls had a notable prevalence of overweight and obesity compared to urban girls. Stunting was present among peri-urban learners but virtually absent in their urban counterparts, which was indicative of a double-burden of overweight/obesity and stunting within the peri-urban group. Peri-urban learners had parents with lower education and employment levels compared to urban learners. Adolescents with mothers that were educated up to tertiary level were associated with a higher nutrition knowledge scores (NKS). Urban learners had a higher mean NKS than peri-urban learners; however it did not necessarily reflect healthier food choices, as urban learners had a high consumption frequency of fatty red and processed meat, white bread and fizzy drinks. Peri-urban learners reported a higher preference for deep-fried, high-fat snacks such as vetkoeks and samosas; which may be related to the high levels of household food insecurity that was noted. Among grade ten peri-urban learners, 50% reported having no food to eat of any kind in the household, with 5% reporting that it occurred often. Poor dietary habits among adolescents in general were observed in this study; although food sources varied between urban and peri-urban learners possibly due to differences in cost and availability of food items. A lower SES was an underlying factor for the consumption of energy-dense foods among peri-urban learners; while a higher SES was associated with the consumption of more expensive fatty foods among urban learners. Thus, the risk of malnutrition (overweight/obesity and stunting) and subsequent disease susceptibility is present in both groups as a result.
A comparison between the excess fluid to be removed in chronic haemodialysis patients, estimated by HD unit staff versus the multiple frequency BIA measurement.
(2015) Downs, Jane H.; Veldman, Frederick Johannes.; Kassier, Susanna Maria.
Abstract in PDF file.
Comparison of body mass index, eating behaviour and eating attitude between dietetic- and non-dietetic female undergraduate students at a South African University.
(2016) Barnard, Jendri Elizabeth.; Veldman, Frederick Johannes.; Kassier, Susanna Maria.
Abstract available in PDF file.
Comparison of indicators of household food insecurity using data from the 1999 national food consumption survey.
(2006) Sayed, Nazeeia.; Maunder, Eleni Maria Winifred.
Information on the present situation of household food insecurity in South Africa is fragmented. There is no comprehensive study comparing different indicators of household food security. Better information on the household food security situation in South Africa would permit relevant policy formulation and better decision-making on the allocation of limited resources. The availability of a national dataset, the first South African National Food Consumption Survey data (1999) , provided the opportunity to investigate some of the issues raised above, and to contribute to knowledge on the measurement of household food security. The aim of this study was to use the data from the 1999 National Food Consumption Survey (NFCS) to : • Determine and compare the prevalence of household food insecurity using different indicators of household food security ; • Determine the overlap of households identified as food insecure by the different indicators (i.e. how many of the same households are identified as food insecure); and to • Investigate whether there was any correlation between the indicators selected . The indicators of household food security selected were: household income, household hunger experienced, and using the index child: energy and vitamin A intake (from 24 Hour Recall (24HR) and Quantified Food Frequency data), dietary diversity (from 24HR data) and anthropometric indicators stunting and underweight. The cut offs to determine food insecure household were those used in the NFCS and the cut off for dietary diversity was exploratory. The main results of the study were as follows : • The prevalence estimates of household food insecurity ranged from 10% (underweight indicator) to 70% (low income indicator). Rural areas consistently had a higher prevalence of household food insecurity than urban areas . The Free State and Northern Cape provinces had higher levels of household food insecurity, with the Western Cape and Gauteng the lower levels of household food insecurity . • Quantified Food Frequency (QFF) data yielded lower prevalence of household food insecurity estimates than 24 hour recall (24HR) data. Household food insecurity as determined by low vitamin A intakes was higher than that determined by low energy intakes for both the 24HR and QFF data . • There was little overlap with the indicators (9-52%), indicating that the same households were not being identified by the different indicators. Low dietary diversity, low income, 24HR low vitamin A intake and hunger had higher overlaps with the other indicators. Only 12 of 2826 households (0.4%) were classified by all nine indicators as food insecure. • The dataset revealed a number of statistically significant correlations. Overall , low dietary diversity, low income, 24HR low energy intake and hunger had the stronger correlations with the other indicators. Food security is a complex, multi-dimensional concept, and from the findings of this study there was clearly no single best indicator of household food insecurity status. Overall , the five better performing indicators (higher overlaps and correlations) were : low income, 24 hour recall low energy intake, 24 hour recall low vitamin A intake, low dietary diversity and hunger; this merits their use over the other selected indicators in this study. The indicator selected should be appropriate for the purpose it is being used for, e.g. estimating prevalence of food insecurity versus monitoring the long term impact of an intervention. There are other important criteria in the selection of an indicator. Income data on a national scale has the advantage of being available annually in South Africa, and this saves time and money. The 24HR vitamin A intake and 24HR energy intake indicators has as its main draw back the skill and time needed to collect and analyse the information, which increases cost and decreases sustainability. Dietary diversity and hunger have the advantage of being simple to understand, and quicker and easier to administer and analyse. It is suggested that a national food security monitoring system in South Africa uses more than one indicator, namely : 1) household income from already existing national data, 2) the potential for including a hunger questionnaire in the census should be explored, and 3) when further researched and validated, dietary diversity could also be used in national surveys.
Current dietary practice of South African dietitians in the treatment symptomatic uncomplicated diverticular disease.
(2017) March, Tanya.; Biggs, Chara.
Introduction: There is a global rise in diverticular disease (DD) in Westernized countries although the prevalence in South Africa (SA) is unknown. This has a significant effect, not only on the quality of life but also economically as the requirement for surgical interventions and hospital admissions have increased, putting additional pressure on healthcare systems. Dietary approaches to the treatment of DD differ and are contradictory. The traditional restrictive low fiber diet approach recommends the avoidance of insoluble fiber including nuts, seeds, popcorn and corn while the International Current Consensus Guidelines (ICCG) from a number of countries such as Italy, Poland, Denmark, America, Great Britain, advocate a liberal unrestricted high fiber diet (HFD). Although the ICCG have concluded that the consumption of nuts, seeds and popcorn does not appear to exacerbate DD symptoms and complications, there has been anecdotal evidence that their inclusion may worsen symptoms and provoke attacks in some patients suffering with symptomatic uncomplicated DD (SUDD). There are also conflicting views as to whether fiber supplementation is necessary in SUDD. Aim: The aim was to determine dietary treatment methods used by registered dietitians (RDs) practicing in SA when treating SUDD and to determine their beliefs regarding the ICCG for SUDD, trigger foods and the use of fiber, prebiotic and probiotic supplements. Methods: Snowball sampling was used in this quantitative descriptive study to identify 155 RDs in SA who treated SUDD. The RDs completed a closed and open-ended self-administered questionnaire. Results: Diverticular disease was treated by 75% of dietitians in the private sector compared to 25% in the government sector. A third of the dietitians treated less than five patients per year and a third treated two or more patients per month. Their approach to treatment was not significantly different. A significant portion (77%) disagreed with the ICCG and 79% identified foods (including seeds, nuts, pips, wheat, popcorn and fruits), which they believed triggered symptoms. None supplemented with bran and only 1.3% recommended insoluble fiber. Supplementation with prebiotics was considered least beneficial (20%) compared to 74% who routinely prescribed probiotics. The main probiotic species prescribed were Lactobacillus acidophilus, Bifidobacterium lactis, Bifidobacterium longum, Bifidobacterium bifidum, Lactobacillus casei, Lactobacillus rhamnosous, Lactobacillus plantarum and Streptococcus thermophiles. Only 7%, however, prescribed an evidence based strain. Many RDs (74%) felt that patients responded well to their treatment with significant improvement in symptoms and had a decreased relapse rate. Conclusion: The majority of dietitians practicing in SA do not support the ICCG advocating a liberal, unrestricted HFD as the appropriate dietary approach for the treatment of SUDD. An individual treatment approach for each patient was reported throughout the study. Practice regarding the use of prebiotics and probiotics was not evidence-based.
The current infant feeding practices and related factors of Indian and Zulu mothers with 0-9 month old infants attending well baby clinics in Durban-North.
(2017) Mkhize, Zanele Prudence.; Kassier, Susanna Maria.; Veldman, Frederick Johannes.
Background: Currently there are no studies that have been conducted regarding infant feeding practices for Indian mothers neither comparing Indian mothers with other race in South Africa. Thus, this may be the first study and further research may be conducted. Objective: The objective of the study was to determine and compare the infant feeding practices and factors influencing these practices of Indian and Zulu mothers with 0-9 month’s old infants attending well-baby clinics in Durban-North of the Ethekwini District, KwaZulu-Natal. Design: A descriptive cross-sectional survey of mothers was performed. Subjects and setting: Four hundred and fifty participants (50%) Indian and (50%) Zulu mothers with infants aged 0-9 months attending Tongaat community health centre, Verulam and Trenance Park Clinics were included in the study conducted between August and October 2016. Outcome measures: A data collection tool included four indicators: (1) socio-demographic characteristics; (2) infant feeding practices (3) mother’s knowledge, attitude, perception and beliefs regarding infant feeding as well as (4) resources that could influence infant feeding practices) which were measured and compared using Chi-square test and independent samples t-test. Results: High prevalence of breastfeeding immediately after delivery was reported by both groups of Indian (95.5%) and Zulu (90.1%) mothers. However, there was a statistically significant difference between race and food/liquids given to infants before six months of age. The exclusive breastfeeding rate was (37.8%) for Indian infants and (64%) for Zulu infants, by the age of six months. The majority of mothers on both groups decided on their own to feed infants other foods and/ or liquids. For Indian mothers, returning back to work was the main reason to feed infants something other than breast milk, whereas the Zulu mothers reported to feel that their infants were hungry. Overall, clinical staff were the predominant source of infant feeding information. Conclusion: This study confirmed that breastfeeding is a universal infant feeding practice. However, there are challenges that influence the practice of appropriate infant feeding.
The current infant feeding practices and related factors of Zulu mothers with 0-6 month old infants attending PMTCT and non-PMTCT clinics in central Durban, KwaZulu-Natal : an exploratory study.
(2005) Kassier, Susanna Maria.; Maunder, Eleni Maria Winifred.
Abstract: Introduction: Exclusive breastfeeding for the first six months of an infant's life is recommended worldwide. In 1998 the South African Demographic and Health Survey (SADHS) showed that only 10% of mothers exclusively breastfeed at three months. As the HIV virus is transmissible via breast milk, UNAIDS (2002) recommends that women in developing countries should be given a choice of feeding method after being counselled on the risks and benefits of breast feeding versus formula feeding. As a result, the Prevention of Mother-to-Child Transmission (PMTCT) programme was launched in KwaZulu-Natal with the aim of providing interventions to prevent Mother-to-Child Transmission of the HIV virus. However, research has shown that infant feeding practices are influenced by numerous factors. Ultimately mothers will feed their infants in a manner they feel comfortable with, even if it is not always the most appropriate choice. Aim: The aim of this study was to determine and compare current infant feeding practices and some of the factors that influenced these practices among Zulu mothers with 0 - 6 month old infants attending PMTCT and non-PMTCT clinics in Central Durban, KwaZulu-Natal. Methodology: A cross-sectional, descriptive survey was conducted amongst 150 mothers sampled from three non-PMTCT clinics and 150 mothers sampled from three PMTCT clinics. Systematic random sampling of mothers attending the two types of clinics was used to ensure an equal number of mothers· with infants aged 0 - < 6 weeks, 6 - < 14 weeks and 14 weeks to 6 months. The number of mothers interviewed per clinic was determined proportionate to clinic size. Interviews were conducted in Zulu by trained fieldworkers according to a structured interview schedule consisting of 87 open- and closed-ended questions. Summary of most important findings and conclusion: Overall, one quarter of the mothers attending non-PMTCT and one third of mothers at PMTCT clinics were practising exclusive breastfeeding at the time of the survey. The general trend was that mothers attending PMTCT clinics were more inclined than those attending non-PMTCT clinics to breastfeed their infants exclusively (34% versus 24% respectively) or to formula feed (16,7% versus 12,7% respectively). Furthermore, there was a significant decline in exclusive breastfeeding and predominant breastfeeding with increasing infant age in both clinic groups. The opposite held true for mixed feeding and formula feeding in that infants were more inclined to mixed feeding or formula feeding with increasing infant age. In both clinic groups, exclusive breastfeeding was the method of choice in the 0 - < 6 week age category, while a preference for mixed feeding was shown in the 6 - < 14 week category. This trend persisted in the 14 week - < 6 month age category, especially in the non-PMTCT clinics, while there was a small but pronounced increase in formula feeding amongst PMTCT mothers. Although these findings can be explained as a result of implementing the PMTCT programme, the positive trends observed in non-PMTCT clinics serve as an indicator that the Integrated Nutrition Programme (INP) and Baby Friendly Hospital initiative have also had an impact on the feeding choices mothers make. Despite the limited duration of the PMTCT programme at the time of the study, indicators of the impact of the intervention include that a lower percentage of PMTCT mothers introduced foods and/or liquids in addition to breast milk to their infants before six months of age compared to non-PMTCT mothers. Furthermore, more mothers attending PMTCT clinics were shown how to breastfeed and were more likely to have received information about formula feeding. Despite these indicators of a positive impact of the PMTCT programme, the mean age for introducing liquids and/or solids in addition to breast milk was about six weeks and the incidence of this practice was very high for both groups. The similar incidence of formula feeding observed between the two clinic groups suggests the presence of constraints to safe infant feeding choices among mothers attending PMTCT clinics. As observed, infant feeding practices were still not ideal in either of the two clinic groups. However, the high level of antenatal clinic attendance documented for both groups serves as evidence that, if opportunities for providing mothers with appropriate infant feeding advice are utilized optimally, the antenatal clinic could serve as an ideal medium through which infant feeding education can take place, especially as the clinic-based nursing staff were cited as the most important source of infant feeding information by both groups of mothers in the antenatal and postnatal phases. The documented infant feeding practices should be interpreted against the backdrop of factors such as socio-demographic characteristics of the mothers, availability of resources such as social support from peers and significant others and reigning infant feeding beliefs that could influence infant feeding decisions. Predictors of exclusive breastfeeding in PMTCT and non-PMTCT clinics were determined by means of multivariate logistic regression analysis. Significant values were obtained for both clinic groups in terms of the infant not having received liquids in addition to breast milk. No additional predictors were found amongst mothers attending non-PMTCT clinics, however predictors amongst mothers attending PMTCT clinics included whether the mother had not visited the clinic since the infant's birth, whether she practiced demand feeding and whether she was experiencing stress at the time of the study. The limited number of predictors of exclusive breastfeeding documented in this study, especially among non-PMTCT mothers may be explained by the fact that infant feeding behaviour is multifactorial by nature and the interaction between factors that influence feeding choice is strong.
Determining the general - and sports-related nutrition knowledge of male adolescent rugby union players attending a secondary, urban government boy's school in Pietermaritzburg, KwaZulu-Natal.
(2014) Stegen, Bridgitte.; Kassier, Susanna Maria.
Walsh, Cartwright, Corish, Sugrue & Wood-Martin (2011) suggest that the need for sound nutritional knowledge regarding both general concepts that pertain to healthy eating habits as well as the dietary principles that should be met for optimal sports performance, is of vital importance. According to Strachan (2009), adolescent sportsrelated nutrition knowledge is an area of great concern and in need of investigation, especially amongst local adolescent rugby players. Rugby is a high contact sport and the popularity of rugby union-related matches has considerably increased on a global scale (Griffiths 2012; Walsh et al 2011; Quarrie, Alsop, Waller, Bird, Marshall & Chalmers 2001). Unfortunately, Webb & Beckford (2013) and Burkhart (2010) recognize that there is limited published research available where an investigation into the general- and sports-related nutrition knowledge of adolescent athletes was conducted. This study aims to determine the general- and sports-related nutrition knowledge of male adolescent rugby players attending a boys only secondary, urban government school in Pietermaritzburg, KwaZulu-Natal. A cross-sectional study was conducted on adolescent rugby players (N= 110) at a local urban, government school in Pietermaritzburg (mean age =15.22 ± 1.430). The players were requested to complete a nutrition knowledge questionnaire developed initially by Whati (2005) for urban South African adolescents. For the purpose of this study the questionnaire was adjusted in accordance with the study objectives using peer-reviewed journals. The results showed that urban, government-level adolescent rugby players have an adequate general- and sports-related nutrition knowledge but lacked knowledge in the field of carbohydrates, understanding of what a well- balanced diet and healthy eating entails as well as the intake and role of protein. Parents and the media were selected as the two major sources of this information. More than half the participants admitted to using a nutritional supplement 3-4 times a week. There was no statistically significant trend in the improvement of knowledge from the under 14 to the open age groups, perhaps emphasizing the lack of sound nutrition education. Several statistically significant trends regarding nutrition practices, such as iii supplement use, were seen when comparing the open age group to the non-open age category; however the nutrition knowledge showed no statistically significant difference. The results of this study correlate to similar published studies regarding nutrition knowledge of adolescent athletes. Due to the lack of locally published research concerning the nutrition knowledge of adolescent rugby players this study forms a reference point to the importance of determining the nutrition knowledge of adolescent athletes in order to understand the need for nutrition knowledge education.
Determining the relationship between added sugar intake and body mass index (BMI) among undergraduate students between the ages of 18-25 years studying at the University of KwaZulu-Natal, Pietermaritzburg campus.
(2016) Nakhooda, Ra’eesah Ismail.; Wiles, Nicola Laurelle.
Chronic diseases of lifestyle are a major contributor towards the increased incidence of mortality and morbidity among individuals worldwide. In conjunction with this, dietary and lifestyle modifications have contributed towards the overweight and obesity problem. Recent but not conclusive evidence has suggested that the consumption of added sugars, particularly from sugar sweetened beverages (SSBs) could be the driving force behind this problem. University students are vulnerable to these dietary and lifestyle changes as they are exposed to a new environment in which independent food choices have to be made. Unfortunately the influence of the food environment often results in poor dietary habits. Determining the relationship between added sugar intake and body mass index (BMI) among undergraduate students between the ages of 18-25 years studying at the University of KwaZulu-Natal (UKZN), Pietermaritzburg campus. To determine: the demographic characteristics of the students such as age, gender, race and place of residence; the BMI of the students; the dietary intake of added sugar from foods and beverages among the students; the association between the dietary intake of added sugar and the students’ BMI; the consumption and consumption patterns of sugar sweetened beverages; the influence of demographic characteristics on the dietary intake of added sugars and the factors that influence the intake of SSBs. A cross sectional study was conducted on 387 undergraduate students between the ages of 18-25 years attending UKZN, Pietermaritzburg. Non-probability sampling was used to recruit the students. A three part questionnaire was used to gather information on anthropometric measurements, demographic characteristics, and a 24 hour dietary recall and a Food Frequency Questionnaire (FFQ) was used to assess the added sugar intake among the subjects. The study population consisted of 33.1% male subjects and 66.9% female subjects. Most of the subjects were from the Black African race group (90.4%), followed by the Indian (7%), Coloured (2.1%) and White (0.5%) race group. A vast majority of the subjects lived away from home (76.7%). A significant number of the subjects were within the normal BMI classification (64.9%) and the mean BMI of the subjects was 23.5kgm2. The prevalence of overweight and obesity was higher among the female (22% and 11.5%) than male subjects (13.3% and 2.4%) and more male subjects were within the normal BMI category (77.3%). Significant differences were observed between the subjects BMI and the consumption of some food and beverage items listed in the FFQ. Subjects with a higher BMI consumed flavoured milks less often, and consumed a greater amount of ice cream and a smaller amount of hard boiled sweets. The frequency of consumption of the foods and beverages that contained added sugar was significantly higher among the female subjects, and the male subjects consumed significantly greater amounts of these foods and beverages. Differences were observed in the consumption of added sugars across the genders, races and place of residence. Subjects that lived at home and that were Indian and female consumed most of the food and beverage categories that contained added sugars more frequently. Taste and price significantly influenced the students’ consumption of SSBs. The most frequent place of purchase and consumption of SSBs as reported by the subjects were supermarkets and on campus respectively. Most of the subjects were within the normal BMI classification. Approximately one third of the subjects were overweight or obese, however there were more overweight subjects. The prevalence of overweight and obesity was higher among the female subjects. The subjects’ diet lacked variety, and the frequency of consumption of added sugars from the various food and beverage categories was relatively high among the sample population. Differences with regards to the consumption of added sugars were observed across the categories of gender, race and place of residence. Factors such as taste and price greatly influenced the students’ consumption of SSBs. Although significant differences between BMI and the intake of some sugar containing foods and beverages existed, this aspect requires further exploration among university students. The poor dietary habits among the university students as well as the prevalence of overweight and obesity among this population group, highlight the fact that there is a great need for strategies to be implemented in order to promote healthier dietary and lifestyle habits among young adults.
Developing and assessing the appropriateness of the preliminary food-based dietary guidelines for South Africans.
(2002) Love, Penelope Valmai.; Maunder, Eleni Maria Winifred.; Green, Jannette Maryann.; Ross, Fiona.
Aim. The aim of this study was to document and provide a critical analysis of the South African Food-Based Dietary Guidelines (FBDGs) development process, and to assess the appropriateness of the proposed South African FBDGs. To achieve this aim, specific study objectives included the following : (1) To document and critically analyse the South African FBDGs process in relation to the 10-step development process recommended by the FAO/WHO. (2) To assess the appropriateness of the proposed South African FBDGs in terms of consumer comprehension (perceptions, general understanding and specific interpretations), and application of the guidelines (ability to apply the guidelines when planning a typical day' s meals for their families). (3) To assess the compatibility of the proposed South Africa FBDGs in terms of food categorisation as perceived by consumers, and as depicted in the food guides that are commonly used. Methodology. An extensive literature review on the development of international dietary guidelines, the emergence of FBDGs and the FAO/WHO FBDGs process, together with documentation of the South African FBDGs process, was used to critically analyse the process used for developing the proposed South African FBDGs. Focus group discussions (n=15) and structured individual interviews (n=230) were held in ten magisterial districts within KwaZulu Natal (KZN), randomly selected according to settlement strata (rural, urban informal, urban formal) and ethnicity (Black, Indian, White) to reflect the KZN population. Participants were women with no formal nutrition training, who made the food purchasing and preparation decisions in the household. A total of 103 women participated in the focus group discussions and 230 women in the structured individual interviews. Results. The process followed by the SA FBDG Work Group has ensured that the proposed South African FBDGs are country-specific in that each FBDG is evidence-based and relates to specific nutrition-related public health concerns of South Africans. Except for the "Eat healthier snacks" FBDG, participants understood and interpreted the FBDGs as intended by health professionals, and could construct a day's meals to reflect the FBDGs. Only two other FBDGs were identified as confusing in terms of terminology used, namely, "legumes" and "foods from animals". By rewording these guidelines the FBDGs would be highly compatible in terms of personal food categorisation. Use of food guides was low, mainly due to a lack of knowledge about how to use them. In terms of food categorisation as depicted by the reportedly most commonly used food guides (3- and 5- Food Group Guides), these food guides are incompatible with the proposed FBDGs. Conclusions. Within the South African context, the FAO/WHO FBDGs development process was feasible and practical to implement. However, to ensure sustainability of the South African FBDGs process, it is strongly recommended that the Department of Health appoint a representative scientific committee specifically for the purpose of reviewing and reformulating the South African FBDGs. Results indicate that a single set of FBDGs can be appropriate for all South Africans provided that certain guidelines are reworded as suggested; and that all the guidelines are accompanied by explanatory information citing commonly consumed foods/drinks as well as practical examples of how to apply the guidelines in light of perceived barriers. In terms of the appropriateness of food guides commonly used in South Africa, there is a need to either move away from the concept of food groups and/or to develop a new South African food guide that is compatible with the proposed FBDGs.

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