Human Nutrition
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- ItemAbnormal eating attitudes and weight loss behaviours of girls attending a "traditional" Jewish high school in Johannesburg : an examination of teachers' awareness(Stellenbosch : University of Stellenbosch, 2011-03) Notelovitz, Talia; Visser, J.; Szabo, C. P.; Fredericks, N.; Harvey, J.; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Human Nutrition.ENGLISH ABSTRACT: Background: Eating disorders are an important cause of morbidity and mortality in adolescent and young adult women. There is some evidence that Eating disorders may be more common in Jewish females than in their non-Jewish counterparts. Individuals with abnormal attitudes as defined by the Eating Attitudes Test (26-Item version) (EAT-26) are at increased risk of developing an eating disorder. School teachers are required to take an active role in the currently favoured ecological approach to the prevention of eating disorders. Objectives: The current study sought to determine the prevalence of abnormal eating attitudes and weight loss behaviours in a Jewish female adolescent sample and to investigate school teachers’ awareness of these factors and their attitudes towards a school programme to address these. Methods: A cross-sectional study of girls in grades 8 to 11 and teachers of both genders was undertaken at a “traditional” Jewish high school in Johannesburg, South Africa. A questionnaire consisting of the EAT-26 and a modified section of the United States Youth Risk Behaviour Survey (YRBS) was completed by pupils. A questionnaire developed by the researcher for the study was completed by teachers. Results: Two hundred and twenty pupils (response rate 84.3%) and 38 teachers (52.1%) participated. Twenty percent of pupils (n=43) had EAT-26 scores greater than or equal to 20 and 30.2% were found to require clinical evaluation for a potential eating disorder Thirty two point seven percent (n=72) of girls considered themselves to be overweight. Sixty four percent (n=139) were trying to lose weight at the time of the study and 19.1% (n=42) had engaged in one or more extreme methods of weight loss (fasting, purging or non-prescribed medication) in the past 12 months. Most teachers (81.6%, n=29) underestimated the proportion of girls requiring clinical evaluation and 71.1% (n=27) underestimated the extent of current weight loss attempts. Almost all (97.3%, n=37) the teachers recognised the need to address disordered eating attitudes and patterns in the school but only 34.2% (n=13) viewed the school as the appropriate place, would be prepared to participate and would give up class time. Conclusions: This is the first study to document the presence of abnormal eating attitudes among Jewish adolescent females in South Africa. The prevalence fell within the upper end of the range of rates reported in studies of adolescent girls in South Africa and abroad. Dieting and attempts at weight loss are common in this population and are also in keeping with the findings from international studies. This is the first study to measure teachers’ awareness of the eating attitudes and weight loss behaviours of girls attending the school at which they teach. The teachers participating in this study were not fully aware of the extent to which eating-related issues affect female pupils. Over and above this, there appears to be a resistance to facilitating and participating in a school programme addressing these issues. A qualitative exploration of this could yield valuable insights.
- ItemAbnormal eating attitudes and weight-loss behaviour of adolescent girls attending a “traditional” Jewish high school in Johannesburg, South Africa(MedPharm Publications, 2014-07) Visser, Janicke; Notelovitz, Talia; Szabo, Christopher P.; Fredericks, NicoletteObjectives: This study aimed to determine the prevalence of abnormal eating attitudes and weight-loss behaviour in female Jewish adolescents. Teachers’ awareness of these factors and their attitudes towards a school programme to address these were also investigated. Design: A cross-sectional study was conducted. Subjects and setting: Female learners in grades 8-11 (n = 220), attending a “traditional” Jewish high school in Johannesburg were included. Teachers (n = 38) at the relevant school were also recruited. Outcome measures: A questionnaire consisting of the 26-item version of the Eating Attitudes Test (EAT-26) and a modified section of the USA Youth Risk Behavior Survey was completed by learners. Teachers completed a questionnaire designed by the researchers. Results: Twenty per cent of the learners (n = 43) achieved EAT-26 scores ≥ 20, suggestive of a possible eating disorder, while 30.2% (n = 65) required clinical evaluation for a potential eating disorder. Thirty-three per cent (n = 72) of the adolescent girls considered themselves to be overweight, while 64% (n = 139) were trying to lose weight at the time of the study. 19.1% (n = 42) had engaged in one or more extreme methods of weight loss in the past 12 months. Most teachers (81.6%, n = 29) underestimated the proportion of adolescent girls requiring clinical evaluation and 71.1% (n = 27) underestimated the extent of current weight-loss attempts. Almost all of the teachers (97.3%, n = 37) recognised the need to address disordered eating attitudes. However, only 34.2% of the teachers (n = 13) viewed the school as the appropriate place in which to do this, and were also prepared to participate in the programme and sacrifice class time. Conclusion: To date, no published South African literature documents the presence of abnormal eating attitudes in Jewish adolescent females in South Africa. The prevalence fell within the upper end of rates reported in studies on adolescent girls in South Africa and abroad. Teachers who participated in this study were not fully aware of the extent to which eating-related issues affected female learners. A qualitative exploration thereof could yield valuable insights.
- ItemAchievements and challenges of facilities implementing human milk banks in the KwaZulu-Natal province, South Africa(Stellenbosch : Stellenbosch University, 2021-03) Kadir, Zaheeda; Daniels, Lynette; Boatemaa, Sandra; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY: Purpose: Human milk banks (HMB) (as a supporting mechanism) have a role to play in providing support to vulnerable infants to survive and thrive in the clinical setting. Human milk is better tolerated as it tends to reduce the length of stay in hospital and late onset sepsis, and decreases the risk of necrotising enterocolitis (NEC). With very few milk banks initiated and those that have been initiated struggling for sustainability, this research in the African context should assist in creating awareness of the importance of human milk banks (HMBs). The aim of the study was to analyse the activities of all human milk banks in KZN and to establish challenges and achievements between 2016 and 2019. Study Design: A longitudinal review study, with an analytical component, was conducted. Quarterly and annual reports from HMB in the KZN between 2016 and 2019 were used. Quantitative analysis on the performance indicators reported in the HMB reports and thematic analysis of achievements and challenges using the World Health Organization (WHO) system building blocks were used. Findings: A total of 91 reports were used in this study. New Donors increased from 264 in 2016 to 1 870 in 2019. A specialised facility was cited as having the largest number of infants receiving donor human milk, from 43 in 2016 to 194 in 2019. The amount of pasteurised milk transferred to other facilities was highest in 2016. The main achievement cited by the HMB reports was the increase in number of donors at district, regional, tertiary and specialised levels. The main challenge cited by the HMB reports was the lack of skilled HMB health workers. Conclusion: This study examined the activities of all human milk banks in KZN and established the challenges and achievements between 2016 and 2019. The various achievements such as acceptance of mothers donating human milk, assistance to other facilities that do not have an established HMB, and challenges such as lack of trained skilled staff, lack of consumables and non-functional equipment, should be considered. A national core model for implementation of HMB in South Africa will assist with a more standardised implementation of the HMB.
- ItemAcidified infant formula explained(Medpharm Publications, 2013) Labuschagne, Irene; Van Niekerk, Evette; Lombard, Martani J.The development of effective methods to prevent acute gastroenteritis is an important goal for infant health. Exclusive breastfeeding and postponement of complementary foods until the age of six months is recommended for healthy infants. However, at times, infant formula is required. Various types are commercially available. Acidified cow’s milk formula has been found to prevent the growth of pathogenic bacteria and concurring diarrhoeal disease.
- ItemThe adaptation of an appropriate screening tool for the early detection of malnutrition in individuals with intellectual disability (ID) in a psychiatric hospital in North West Province (South Africa)(Stellenbosch : Stellenbosch University, 2012-12) Nel, Maretha; Marais, Maritha; Potgieter, Sunita; Nel, D. G.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Nutrition.ENGLISH ABSTRACT: Background: Considering the myriad of risk factors causing nutritional deficiency, as well as the prevalence of malnutrition and feeding problems experienced by individuals with intellectual disability (ID), early detection and diagnosis of malnutrition in this population group is essential. Objectives: The main aim and objectives of the study were to determine the degree of malnutrition and body composition in individuals with ID living in a psychiatric hospital (North West Province, South Africa), to determine which degree of ID was more prone to malnutrition, to investigate the different risk factors for malnutrition in this group of individuals, and to use this data to adapt an existing screening tool used to facilitate the easier identification of malnutrition. Methodology: An observational descriptive cross-sectional study, with an analytical component, was conducted. The study consisted of two phases. During the first phase, measurements were taken of individuals with ID to determine body composition and nutritional status. During the second phase, said data, as well as other factors influencing the nutritional status of individuals with ID, were used to adapt an existing screening tool to allow for easier identification of malnutrition in the study population. The adapted screening tool was tested by nursing staff. Results: The anthropometric measurements of 244 individuals with ID were determined. The overall anthropometrical status indicated that half of the study population (52,1%, n=127) had a normal nutritional status, that 38,1% (n=93) was undernourished or at risk of becoming undernourished, and that 10,0% (n=24) was either at risk of becoming or was overnourished . Men were more prone to being undernourished or at risk of becoming undernourished (48,0%, n=73), compared to women (21,7%, n=20). Although no significant difference was found in anthropometrical status across the four severities of ID (Pearson Chi-square test (ρ=0,15)), individuals with mild ID were more likely to become obese (19,4%, n=6), and individuals with profound ID were more prone to being underweight (57,1%, n=8). It was found that 41,8% (n=102) of the total study population had a waist circumference (WC) above the normal values. A significant difference was found between increased WC and severity of ID (Pearson Chi-square test (ρ=0,00)). Other risk factors that can influence nutritional status in said population included medical conditions such as hypertension (13,0%, n=32) and epilepsy (EP) (46,0%, n=112), as well as polypharmacy (71,7%, n=175). An existing malnutrition screening tool for the population with ID was adapted by means of the addition of prevalent factors (WC measurements, presence of EP and use of medications), as well as through adaptation of the scoring system. Conclusion: Using anthropometric measurements and indices for body composition, a high prevalence of malnutrition was identified in the study population of individuals with ID. The adapted screening tool was more sensitive than the original tool in identifying individuals who were at risk of malnutrition, or who were already malnourished in this study population. The research undertaken in this respect can help health care professionals to be more aware of the interaction between the severity of ID and malnutrition.
- ItemAdaptation of the RenalSmart web-based application for the dietary management of patients with diabetic nephropathy(Medpharm Publications, 2013) Esau, Nazeema; Koen, Nelene; Herselman, Marietjie G.ENGLISH SUMMARY : Objectives: The aim of this study was to develop and test a web-based application for the dietary management of patients with diabetic nephropathy. Design: Observational descriptive study. Settings and subjects: RenalSmart® is a web-based application used to assist dietitians in clinical practice, from tertiary to primary care, to manage patients with chronic renal failure. The application was adapted and enhanced to include functions for the nutritional assessment of a patient with diabetic nephropathy, the formulation of a dietary prescription and the development of a meal plan and sample menu. It includes a graphical display of anthropometric and biochemical measurements. Quality assurance testing was undertaken throughout the development process by the project team in a pilot study involving generalist dietitians and dietitians who specialise in diabetic and renal nutrition. Nonrandom purposive sampling, including snowball sampling, was used to recruit them. Outcome measures: The application was finally tested for accuracy and acceptability by registered dietitians in South Africa. Results: Thirty-seven dietitians completed the final testing of the application. The mean age of the respondents was 33 years. Thirty-five per cent resided in the Western Cape. The overall acceptability of the application was rated as good to excellent by 81% of respondents. There was a significant difference between dietitians who usually consulted renal patients, compared to those who did not, in their rating of the accuracy of the data-saving function (p-value = 0.02) and the fluid requirements (p-value = 0.03). In this regard, the former group of dietitians was dissatisfied with these functions. Conclusion: The web-based application developed in this study was rated as accurate and acceptable by the majority of respondents. Identified problem areas were addressed in the final version.
- ItemAnaemia in South Africa: the past, the present and the future(Health and Medical Publishing Group, 2013) Visser, Janicke; Herselman, MarietjieDespite some modest improvements described recently, anaemia remains a significant global public health concern affecting both developed and developing countries. It affects a quarter of the global population, including 293-million (47%) children who are younger than five years of age. A prevalence of 42% and 30% has been described in pregnant and non-pregnant women, respectively. Children and women of reproductive age are at high risk, partly because of physiological vulnerability, followed by the elderly. Africa and Asia are the most heavily affected regions, accounting for 85% of the absolute anaemia burden in high-risk groups. According to the World Health Organization global database on anaemia (1993-2005), this haematological disorder was considered to be a moderate public health problem at the time in South African preschool children, pregnant women and non-pregnant women of reproductive age.
- ItemAnthropometric status in children aged 6-36 months, born from intended and unintended pregnancies in vulnerable communities from the Western Cape Province(Stellenbosch : Stellenbosch University, 2019-04) Holm, Adri; Du Plessis, Lisanne; Skinner, Donald; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY : South Africa has a high rate of unintended pregnancies among vulnerable women. There is a growing body of evidence that shows the importance of the first 1000 days of life (namely, from conception to 2 years old). This time period in the life cycle provides a crucial window of opportunity for proper nutrition, which could improve overall health, cognitive capacity and academic performance, leading to improved health and socio-economic circumstances on an individual and national scale in South Africa. Improving the quality of women’s and girls’ pre-conception nutritional intake, as well as their intake during the period of pregnancy, could boost progressive maternal and child health and development outcomes. This cross-sectional study measured the pregnancy intention of mothers (n=72), aged 15 to 43 years old, retrospectively to analyse the impact thereof on their child’s current nutritional status in two vulnerable peri-urban communities in the Western Cape. Other determinants of health and its effects on children’s nutritional status were also investigated. From the sample population, 39% (n=28) of the pregnancies were categorised as “Unplanned”, 46% (n=33) as “Ambivalent” and only 15% (n=11) as “Planned”. Infants born from ambivalent pregnancy intention had a slightly lower birth weight than those of unplanned and planned pregnancy intention. Pregnancy intention and the current anthropometric status of the child were not associated [CI: -1.86 to 1.86]. A non-linear association was found between the ages of the sample population and their anthropometric status. Children aged 12 to 28 months were more prone to malnutrition.Women receiving their main income from the Child Support Grant had a significantly lower pregnancy intention than those women receiving their main income from either family or the child’s father (Prob > F =0.0038). No literature was previously available on whether there is a link between the high rate of unintended pregnancies in vulnerable communities in South Africa, and malnutrition in young children born from such pregnancies. This research concludes that unintended pregnancies did not contribute to malnutrition in the studied vulnerable peri-urban communities. Hence, even though many of the pregnancies were unintended, it seems as if most of the mothers found a way to care for the child. Improving nutritional quality and the emotional wellbeing of all women of childbearing potential, therefore, presents a key opportunity to improve future generations’ health and mitigate the risk of adverse long-term economic outcomes. Future mothers should be empowered to make decisions in the best interest of their children, regardless of whether the pregnancies were planned or unplanned.
- ItemThe anthropometric, vitamin A and iron status of pre-school children in the Western and Northern Cape Provinces(Stellenbosch : Stellenbosch University, 1998-11) Blaauw, Renee; Labadarios, D.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Human Nutrition.ENGLISH ABSTRACT: Vitamin A deficiency (VAD) and anaemia are major nutritional disorders worldwide, including Africa . It has been estimated that ½ million children go blind annually due to vitamin A deficiency, whereas anaemia affects approximately a quarter of the world's population. Furthermore, protein energy malnutrition (PEM) is known to be responsible for 55 % of childhood deaths worldwide. n view of these relationships, the aims of this study were to establish the anthropometric, vitamin A and iron status of pre-school children in the Western Cape (as part of a national survey), as well as to identify major factors contributing to poor status.
- ItemAn anti-inflammatory approach to the dietary management of multiple sclerosis : a condensed review(Co-published by Medpharm Publications and Taylor & Francis, 2017) Labuschagne, I. L.; Blaauw, ReneeMultiple sclerosis (MS) is a chronic, inflammatory, neurodegenerative demyelinating disease of the central nervous system (CNS). Inflammation is increased by high-energy Western-style diets, typically high in salt, animal fat, red meat, sugar-sweetened drinks and fried food, and low in fibre, as well as lack of physical exercise. An anti-inflammatory dietary regimen, with or without administration of dietary supplements, supporting the general trend towards an amelioration of inflammatory status, should be considered. Understanding the role of gut microbiota in health and disease can lay the foundation to treat chronic diseases by modifying the composition of gut microbiota through lifestyle choices, including dietary habits and possibly probiotic supplementation. Evidence from experimental, epidemiologic and clinical studies supports the potential association between poor vitamin D status and the risk of developing MS, as well as an adverse disease course. Correcting vitamin D status seems plausible in patients with MS
- ItemAntioxidant intake in paediatric oncology patients(Stellenbosch : Stellenbosch University, 2011-12) Slegtenhorst, Sonja; Visser, Janicke; Meyer, Rosan; Stellenbosch University. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Human Nutrition.ENGLISH ABSTRACT: Background: The role of antioxidants and adequate nutrition in the prevention and course of cancer treatment is globally recognised in nullifying the effects of free radicals and increasing the nutritional status of children during treatment. Objective: To investigate whether children with cancer meet their Dietary Reference Values and Safe Intakes for antioxidants, energy and protein. Design: Single centre prospective study. Setting: Children were recruited from the East of England Primary Treatment Centre using convenience sampling over 8 months. Forty-two children and adolescents diagnosed with a Solid tumour, Lymphoma or Leukaemia were eligible for data analysis (n=20 male; n=22 female). Method: Data was collected with an Estimated Food Record (EFR) in the 1st (EFR1) and 3rd month (EFR2) post-diagnosis. In the week following EFR completion, parents and/or children were contacted to complete four non-consecutive days of 24-hr food recalls. Data was categorised into diet alone, diet + food supplement (FS), tube feeding (tube) or diet + multi-vitamin-mineral supplementation (VMS). Malnutrition was determined by weight-for-age z-scores. Nutrient intake was compared to the Recommended Nutrient Intake (RNI), the Estimated Average Requirements (EAR) and the Lower Recommended Nutrient Intake (LRNI). Result: The sample consisted of 33% (n=14) diagnosed with Leukaemia, 24% (n=10) with Lymphoma and 43% (n=18) with Solid tumours. Sixty seven percent (n=28) underwent chemotherapy and 33% (n=14) a combination of therapies. Significant correlations were seen between the assessment tools in the diet alone category for both months for; vitamins A, C, E, selenium and protein and for EFR1 for zinc and energy. In both months greater numbers of children achieved ≥100% of requirements for diet + VMS (EFR 1; p<0.05; EFR2 p<0.05) than for other feeding modes. Vitamin C achieved the highest intakes compared to the RNI at 773% (EFR1) and 829% (EFR2). Intakes above 200% of the RNI were seen for vitamins A, C, E, selenium and zinc. No significant differences were seen between modes of feeding in either month for selenium or zinc. Vitamin A (EFR1≤ 100% diet alone p<0.05) and zinc (EFR1≤ 100% diet alone p=0.02) met the least of the LRNI in the 1st month compared to other antioxidants. No statistical significant difference was observed between the number of children attaining their EAR’s between the 3 modes of feeding in the 1st month and 3rd month. In the 1st month 27% (n=8) of participants consumed vitamin and/or mineral supplements, 18% in the 3rd month (n=4). In the 1st month 5% (n=2) of children were moderately malnourished and 10% (n=4) in 3rd month. Conversely in the 1st month 3% (n=1) were overweight and 3% (n=1) obese; the leukaemia group predominant. Conclusion: The research tools showed good correlation. Children using vitamin and/or mineral supplements mostly achieved their RNI’s compared to other feeding modes. Across feeding modes some children achieved antioxidant intakes above 200% RNI. LRNI’s on diet alone were not achieved for vitamin A and zinc. The study showed Leukaemics as having a higher prevalence of obesity. More research is required to determine the clinical implications of these findings.
- ItemApplication of evidence on probiotics, prebiotics and synbiotics by food industry : a descriptive study(London : Biomed Central, 2014-10) Mugambi, Mary N.; Young, Taryn; Blaauw, Renee; Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Human Nutrition.ENGLISH ABSTRACT: This study assessed how the food industry applies the knowledge and evidence gained from synbiotics, probiotics or prebiotics research in infants, on the general paediatric population. This study also explored: what happens after the clinical trials using infant formula are completed, data is published or remains unpublished; the effectiveness and type of medium the formula manufacturers use to educate consumers on probiotic, prebiotic or synbiotic infant formula. Findings: This was a descriptive study (a survey) that used a structured questionnaire. All listed companies that manufacture and / or market food products with added probiotics, prebiotics or synbiotics for infants were identified and invited to participate. People responsible for research and development were invited to participate in the survey. A letter of invitation was sent to selected participants and if they expressed willingness to take part in the study, a questionnaire with a written consent form was sent. Descriptive statistics and associations between categorical variables were to be tested using a Chi-square test, a p < 0.05 was statistically significant. A total of 25 major infant formulas, baby food manufacturers were identified, invited to participate in the survey. No company was willing to participate in the survey for different reasons: failure to take any action 5 (20%), decision to participate indefinitely delayed 2 (8%), sensitivity of requested information 3 (12%), company does not conduct clinical trials 1 (4%), company declined without further information 4 (16%), erroneous contact information 6 (24%), refusal by receptionists to forward telephone calls to appropriate staff 3 (12%), language barrier 3 (12%), company no longer agrees to market research 1 (4%). Conclusion: Due to a poor response rate in this study, no conclusion could be drawn on how the food industry applies evidence gained through probiotics, prebiotics or synbiotics research on infants for the benefit of the general paediatric population. More information and greater transparency is needed from the infant formula manufacturers on how they apply the evidence gained from the research on probiotics, prebiotics and synbiotics on infants
- ItemAre the attitudes and practices of foodservice managers, catering personnel and students contributing to excessive food wastage at Stellenbosch University?(Co-published by Medpharm Publications, NISC (Pty) Ltd and Taylor & Francis Group, 2017) Marais, M. L.; Smit, Y.; Koen, N.; Lotze, E.Objective: The aim was to investigate factors contributing to food wastage by Stellenbosch University (SU) students in selected residences, and to determine the attitudes and practices of students and catering personnel impacting on food waste and a sustainable environment. Design: Cross-sectional, descriptive study. Setting: Stellenbosch University, Western Cape. Subjects: Six foodservice managers, 63 catering personnel and 517 students participated in the study. Outcome measures: A weighed-food wastage study was conducted at seven selected residences during lunch and supper on three non-consecutive weekdays. Food service managers (FSMs) and catering personnel completed interviewer-administered questionnaires, while SU students completed an electronic survey. Results: Ninety percent of students preferred the standard menu options, despite a relatively high average plate waste of 16.9%. More production waste was generated during lunch than supper. The male residence generated more plate waste. Even though students requested larger servings of vegetables, the wastage of these items was high. Factors contributing to wastage were the booking system, menus and serving style, meal plan stipulating the serving of dessert and serving of a large starch portion. All FSMs and 88.5% catering personnel considered it important to reduce food wastage to a minimum. Conclusion: Education of catering personnel and students regarding food waste reduction measures is crucial. A representative forum including students, catering companies and faculty management should be involved when seeking solutions to reduce food wastage and improve communication. By implementing these strategies, a university-wide culture of sustainability with a focus on food waste reduction can be developed and nurtured.
- ItemAspects of body image perception of preadolescent girls of different ethnic groups in Northeastern Johannesburg, South Africa(Stellenbosch : University of Stellenbosch, 2010-12) Bruk, Lila; Labadarios, Demetre; Herselman, Marietjie; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Human Nutrition.ENGLISH ABSTRACT: Background: Poor body image perception and body dissatisfaction has been found to be a risk factor for eating disorders. Studies have found that signs of distorted body image perception and body dissatisfaction can be detected in children as young as 8 or 9 years old. Aim: The current study served to assess the extent of this problem in Northeastern Johannesburg, South Africa, in order to allow for the necessary intervention steps (e.g. development of school-based programmes) to deal with this problem to be put in place. Method: The study was a cross-sectional analytical study with a descriptive component. Two hundred and four girls (81.37% Black, 15.20% White and 3.43% Coloured or Indian) aged between 96 and 119 months in primary schools in Northeastern Johannesburg were selected for this study using systematic random sampling. They were required to complete a questionnaire about their body image perception and weight control behaviours, as well as undergo anthropometric measurements (i.e. weight and height). Results: This study found that the subjects placed much importance on being thin, with subjects stating that they thought if a girl was thin she would be more popular (63.96%), have better self esteem (69.63%), be more attractive (69.11%), be more feminine (73.80%) and be healthier (66.84%). When asked to identify the girl from a silhouette drawing that most resembled themselves, 45.00% of the subjects were able to accurately identify which girl’s size most resembled their own, whereas 48.50% saw themselves as thinner than they are and 6.50% saw themselves as fatter than they are. In addition, the majority of subjects (69.61%) said that they were very happy with their weight and the majority (74.88%) classified it as “just right.” However, despite these findings, there was still significant body dissatisfaction evident in the group with 50.25% of the subjects wanting to be thinner, 28.57% wanting to be fatter and only 21.18% not wanting to be thinner or fatter than they currently are. Of the subjects participating in the study, 50.98% had tried to lose weight in the past and 28.71% had tried to gain weight. Also, various factors (i.e. media, cultural, family and peer influences), were shown to have a significant influence on the subjects’ body image perception. Other factors such as socioeconomic status and physical activity level had no significant link with the subjects’ body image perception. Conclusion: There is a significant problem with poor body image perception and resultant weight control behaviours in this age group. Clearly, there is a need for body image improvement programmes to be put in place in primary schools so as to prevent preadolescent girls from moving towards a lifetime of suffering with body dissatisfaction or, even worse, developing a life-threatening eating disorder.
- ItemAspects of knowledge, attitudes and practices of medical practitioners on obesity and weight management in three urban centres in Kenya(Stellenbosch : University of Stellenbosch, 2005-12) Ojwang, Alice AChieng; Labadarios, D.; Visser, J.; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Human Nutrition.Objectives: To determine aspects of knowledge, attitudes and practices of Medical Practitioners on obesity and weight management in three urban centres in Kenya. Research methods and procedures: A cross sectional survey of a randomly selected sample of 485 Medical Practitioners (MPs) from three urban centres in Kenya namely Nairobi, Mombasa and Kisumu was carried out. Four hundred and thirty (89% response) questionnaires were fully completed and returned. Data was gathered on the demographics of the study population; knowledge of nutrition and obesity; awareness of obesity as a health problem assessment, management (diet, exercise and pharmacology) and practices regarding obesity as well as if and how the MPs would like their knowledge of obesity improved.
- ItemAspects of nutritional knowledge, attitudes and practices of nurses working at the surgical division at the Kenyatta National Hospital, Kenya(Stellenbosch : University of Stellenbosch, 2006-12) Kobe, Judith A; Labadarios, D.; Marais, D.; Nel, D. G.; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Human Nutrition.INTRODUCTION: Adequate nutrition is required for patients to improve and maintain their health. Nurses are in one of the best positions to ensure adequate nutrition because of their holistic caring role. The aim of the study was to determine aspects of the current nutritional knowledge, attitudes and practices of registered nurses towards nutritional management of patients. RESEARCH METHODS: This was a descriptive and observational study. One hundred and one out of 160 Kenyan registered nurses working at the surgical division at Kenyatta National Hospital in Nairobi, Kenya successfully completed the study representing a 63% response rate. The 47-item validated questionnaire consisted of 9 socio-demographic questions, 13 questions on nutrition knowledge, 13 questions on attitude and 12 questions on nurses’ practices. RESULTS: The general performance of the registered nurses on the selected aspects of knowledge, attitudes and practices was overall poor. They contradicted themselves on their beliefs in relation to their practices. They did not know their primary role in nutrition care, neither did they know the role played by dietitians/nutritionists and doctors. Twenty-six percent of the registered nurses strongly agreed that it was the nurses’ responsibility to assess the nutritional status of patients compared to 72% who strongly agreed it was the dietitians’/nutritionists’ responsibility and 24% who strongly agreed it was the doctors' responsibility. Eighty-two percent reported that they would refer patients to a dietitian/nutritionist, 18% that they would discuss diet options with the patients, while none of the registered nurses would consult the doctor if they felt that the patient was not receiving adequate nutrition. Seventy-five percent of them suggested that nutritional care of patients could be improved by adopting a multidisciplinary approach and 18% by catering staff feeding the patients. Only 28% reported that nutritional issues were included in ward rounds. Although 72% of the registered nurses reported that it was important to weigh patients on admission, only 43% reported actually weighing patients, of which 59% weighed patients for medication purposes and only 18% weighed patients for nutritional status assessment. The overall nutritional knowledge score was graded as average (57%). The poorest scores were noted for knowledge on clinical nutrition questions (14%) and the highest scores for knowledge on basic nutrition questions (91%). CONCLUSION: Although the nurses regarded nutritional care of patients as important, their practices seemed to contradict their attitudes. Considering the responsibility the nurses are entrusted with regarding patient nutritional care, their current knowledge, attitudes and practices towards nutritional care is a cause for concern. The results of this study provide a basis for continuous nutrition education, well-designed protocols for nutritional status assessment by registered nurses and efforts directed towards improved clinical practice.
- ItemAspects of the involvement, confidence and knowledge of South African registered dietitians regarding genetics and nutritional genomics(Stellenbosch : University of Stellenbosch, 2011-03) Oosthuizen, Lizalet; Du Plessis, L. M.; Naude, C. E.; Nel, D. G.; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Human Nutrition.ENGLISH ABSTRACT: Introduction: Nutritional genomics is a new and emerging field aimed at investigating the complex interactions between genetics and diet and the joint influence this has on disease prevention and health promotion. Research is accelerating at a rapid pace and although still in its infancy, it is important for registered dietitians (RDs) to be knowledgeable and keep abreast of these developments as it promises to revolutionize dietetic practice. International studies have demonstrated low confidence and involvement as well as poor knowledge of both genetics and nutritional genomics amongst RDs. To date no similar studies have been conducted amongst South African (SA) RDs. Methods: A cross-sectional descriptive study was conducted using a national survey of 1881 dietitians registered with the Health Professions Council of South Africa (HPCSA). Data was collected using an existing and validated questionnaire as developed for use in a similar study amongst RDs in the United Kingdom (UK). The self-administered questionnaire consisted of 4 sections to assess the following aspects: i) involvement and confidence in activities relating to genetics and nutritional genomics ii) knowledge of genetics and nutritional genomics iii) factors associated with knowledge and iv) demographic information. The main method of questionnaire distribution was via email (70%) using the Association of Dietetics in South Africa (ADSA) distribution service and questionnaires were posted to those RDs not registered with ADSA (30%). Results: The response rate was 15.2% (n = 279). Results showed low involvement in activities relating to genetics (n = 47, 17%) and nutritional genomics (n = 72, 25.8%). The majority of respondents indicated low confidence in performing activities relating to genetics (n = 161, 58.7%) and nutritional genomics (n = 148, 53.8%). However, a significant positive association was found between involvement and confidence for all activities (p < 0.001). The mean total knowledge score was 48.5 (±19%) and considered as low, with the mean genetics score of 58.5 (± 24%) being significantly higher than the nutritional genomics score of 31.9 (±23%), p < 0.001. Those respondents who reported involvement in discussing the genetic basis of a disease (p = 0.02); providing guidance to patients with genetic disorders (p = 0.01); providing training or education on human genetics (p = 0.01) and discussing with patients how diet may interact with genes to influence risk (p = 0.03) also had higher total knowledge scores. Factors associated with knowledge were greater genetics content in university studies (p < 0.001); higher qualification (p = 0.01); participating in related continuous professional development (CPD) activities (p <0.001) and considering genetics of greater importance to dietetic practice (p = 0.03). Conclusions: The results of this study indicate that there is overall low involvement, confidence and knowledge of genetics and nutritional genomics amongst SA RDs and this compares well with international studies. Recommendations therefore include the development of a competency framework for genetics and nutritional genomics for undergraduate dietetic education as well as CPD activities in order to provide the driving force for the development of this field in SA.
- ItemAssessing the effect of fluctuating food prices on the accessibility to nutritious foods by households in Senqu municipality in the Eastern Cape(Stellenbosch : Stellenbosch University, 2021-12) Webber, Sheree; Mbhenyane, Xikombiso Gertrude; van Rooyen, Carl Johan; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY: Food insecurity is a problem that faces the individual, household, community and nation. To achieve sufficient food security, the four aspects of food security need to be achieved simultaneously. These aspects are availability of the food, access to the food, utilisation of the food once accessed, and stability of the supply to food. Studies have shown that South Africa has enough food available for the population, but not everyone has sufficient access to this food. Climate change, oil prices, transport costs and food prices all play important roles in achieving sufficient access to food security. Food prices have increased in South Africa and this will have an impact on whether access to sufficient food that promotes a healthy diet will be achieved. The study’s objectives included determining the food items affected by the price fluctuations during 2019-2020, determining the purchasing practices of the households and how they are affected by price fluctuations, determining the food preferences based on the Food Based Dietary Guidelines (FBDGs), and evaluating the effect of price fluctuations, purchasing practices and food preferences on nutritional adequacy. The study design used was an observational, descriptive cross-sectional design, and the data collected was quantitative. The data was collected using a questionnaire that was administered to the participants by fieldworkers. The food groups used in the questions were based on the (FBDGs), South African National Health and Nutrition Examination Survey (SANHNES), the National Agricultural Marketing Council (NAMC)l and the Bureau for Food and Agricultural Policy (BFAP) reports. The questionnaire had a section for the Household Food Security Survey Module (HFSSM) and Household Food Insecurity Access Scale (HFIAS). Ethics approval for the study was obtained from the Stellenbosch University on the 25 September 2020 for data collection to take place in November 2020. Most households bought more starchy foods and less meat due to the fluctuating food prices of items. Households did not consume enough protein from animal sources to ensure a healthy balanced diet. It is recommended to ensure that education and support are given to grow the proper food gardens to promote a more varied diet. It is also recommended to educate consumers about more affordable foods the increase dietary diversity, like legumes as a protein source and traditional vegetables as well as the increased consumption of different forms of milk.
- ItemAssessing the extent and effectiveness of diabetes self-management education in public health care institutions in Harare, Zimbabwe(Stellenbosch : Stellenbosch University, 2016-12) Nkomani, Sanele; Blaauw, Renee; Rusakaniko, Simba; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY : Introduction: Nutrition focused diabetes self-management education (DSME) provided by a dietitian or diabetes educator considerably improves glycaemic control, reduces the rate of complications, and reduces costs. Little is known about the effectiveness of DSME interventions, despite the rising prevalence of type 2 diabetes (T2DM) in Harare. This study therefore aimed to assess the extent to which existing DSME interventions improve nutrition focused knowledge, attitudes and practices (KAP). Secondly, health facility resoures to support effective DSME were assessed. Methods: A cross sectional survey design was used to determine nutrition focused diabetes KAP for 156 participants with T2DM attending eight public health facilities within the Harare metropole. The final sample size detected an effect size of 0.4 between two groups perceived to differ with regard to DSME received, i.e. central hospital outpatient clinic attendees and city health clinic attendess. Two (out of two) central hospital clinics in Harare were selected and six city health clinics (representing six of nine health districts in Harare) were selected using a multiple stage sampling strategy. Participants were divided equally between the two groups. Mean KAP scores from a reseacher designed questionnaire were compared between clinic groups, consultation with a dietitian and a diabetes educator. Nineteen health professionals involved in diabetes management at the sampled facilities also completed a self assessment on the primary care resources available to deliver quality DSME at their respective clinics. Results: The majority of participants (90.3%, n=139) reported recieving DSME, while fewer had consulted a dietitian (49.0%, n=76) or diabetes educator (52.0%, n=80). Dietitian (χ2=10.61,p=0.01) and diabetes educator (χ2=12.31,p=0.00) led interventions occurred more frequently at central hospitals. Participants showed better knowledge (p<0.01), and attitudes (p<0.00) for other self-care behaviours compared to nutrition knowledge (p<0.01). Significantly higher levels of knowledge were observed for central hospital clinic atendees (p=0.00), consultation with a dietitian (p<0.01) or diabetes educator (p=0.00). However, no differences were observed in attitudes for clinic group (p=0.10), consultation with a dietitian (p=0.30) or diabetes educator (p=0.19). Only those that had consulted a dietitian reported better adherence to dietary guidelines (p=0.00) and physical activity (p=0.02) self-care behaviours. Over half of the health professionals (57.9%, n=19) and (68.4%, n=19) scored resources for patient and organisational support respectively as inconsistent and limited. Health professionals from city health clinics rated their patient (p<0.01) and organisational (p<0.01) support capacity higher than health professionals from central hospital clinics. Conclusion: DSME intervention occurs more frequently at central hospitals, although no evidence of structured DSME programmes exists. Only dietitian led interventions significantly improved both knowledge and practices, highlighting a need to scale up dietetic intervention, particularly in city health clinics were very little DSME occurs. Health professional perceived resources for DSME to be inadequate and inconsistent, revealing the need for improved training of health professonals involved in diabetes management.
- ItemAssessing the knowledge and perceptions of medical students from the Western Cape, South Africa, regarding the Millennium Development Goals(Medpharm Publications, 2012) Yeatman, Toni-Lee; Koen, N.; De Ridder, L.; Fenn, B.; Wormsbacher, L.; Daniels, L.Background: Health science students are key players in implementing the Millennium Development Goals (MDG). Knowledge and understanding at university level is essential to achieve the goals by 2015. The primary objective of this study was to assess the knowledge and perceptions of fifth-year medical students at Stellenbosch University and the University of Cape Town regarding the MDG. The secondary objectives were to determine the degree to which students are involved in awareness campaigns and implementation of the MDG, and to assess students’ perceptions regarding the need for the MDG in South Africa. Method: This observational, descriptive, cross-sectional study collected quantitative data. A census was carried out. All participants completed a self-administered questionnaire. Results: Of the 176 participants, 61.14% said they had previously heard or read about the MDG. Forty per cent had heard about the MDG through awareness campaigns. More than half (54.86%) claimed to know what the MDG were, but could not name all of the goals. Participants identified a mean of three out of eight MDG correctly. The majority of students considered MDG implementation in South Africa important but ineffective (69.85%), and 85.82% believed that the MDG would not be achieved on time. Conclusion: It was found that fifth-year medical students in the Western Cape were not adequately informed about the MDG and their importance in South Africa. However, their perceptions were positive, in that the majority agreed that the implementation of the MDG in South Africa is important and that more needs to be done in creating awareness about the goals.