Pub Date : 2022-11-29DOI: 10.1080/16070658.2022.2147663
H. Spies, M. Frey, B. Karstens
Background The most common cause of haemodynamic instability (a disturbance of the forces involved in circulating blood through the body) in the critically ill patient is a state of shock, whether it is hypovolaemic, cardiogenic or distributive (septic, anaphylactic or neurogenic) shock. Although the causes of the state of shock differ, the result is the same: decrease in cardiac output and insufficient tissue perfusion; hence haemodynamic instability. Interventions, including fluid therapy and the administration of vasoactive substances like vasopressors (increase in the vascular tone) and inotropic substances (increase in myocardial contraction) to restore homeostasis (haemodynamic stability), are of critical importance to prevent further deterioration.
{"title":"Nutrition and vasoactive substances in the critically ill patient","authors":"H. Spies, M. Frey, B. Karstens","doi":"10.1080/16070658.2022.2147663","DOIUrl":"https://doi.org/10.1080/16070658.2022.2147663","url":null,"abstract":"Background The most common cause of haemodynamic instability (a disturbance of the forces involved in circulating blood through the body) in the critically ill patient is a state of shock, whether it is hypovolaemic, cardiogenic or distributive (septic, anaphylactic or neurogenic) shock. Although the causes of the state of shock differ, the result is the same: decrease in cardiac output and insufficient tissue perfusion; hence haemodynamic instability. Interventions, including fluid therapy and the administration of vasoactive substances like vasopressors (increase in the vascular tone) and inotropic substances (increase in myocardial contraction) to restore homeostasis (haemodynamic stability), are of critical importance to prevent further deterioration.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"35 1","pages":"177 - 182"},"PeriodicalIF":1.1,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46875445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-29DOI: 10.1080/16070658.2022.2147660
R. Blaauw
Data on the prevalence of malnutrition amongst adult hospitalised patients globally range between 23–55%. South African data is scarce but tend to be on the higher end of the range. A study from the Eastern Cape province reported a prevalence of 48.2%, using the MUST (Malnutrition Universal Screening Tool) high-risk group. Using the Nutrition Risk Screening2002 tool to identify participants at-risk of malnutrition, a prevalence of 53.7% were reported for three academic hospitals in South Africa. A recent study from Gauteng province reported a malnutrition prevalence of 56.8%, using the Global Leadership Initiative on Malnutrition (GLIM) criteria. As malnutrition is associated with longer length of hospital stay, more complications, increased re-admissions and greater mortality, early identification and appropriate management of malnutrition is crucial.
{"title":"Importance of hospital food supply to manage malnutrition","authors":"R. Blaauw","doi":"10.1080/16070658.2022.2147660","DOIUrl":"https://doi.org/10.1080/16070658.2022.2147660","url":null,"abstract":"Data on the prevalence of malnutrition amongst adult hospitalised patients globally range between 23–55%. South African data is scarce but tend to be on the higher end of the range. A study from the Eastern Cape province reported a prevalence of 48.2%, using the MUST (Malnutrition Universal Screening Tool) high-risk group. Using the Nutrition Risk Screening2002 tool to identify participants at-risk of malnutrition, a prevalence of 53.7% were reported for three academic hospitals in South Africa. A recent study from Gauteng province reported a malnutrition prevalence of 56.8%, using the Global Leadership Initiative on Malnutrition (GLIM) criteria. As malnutrition is associated with longer length of hospital stay, more complications, increased re-admissions and greater mortality, early identification and appropriate management of malnutrition is crucial.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":" ","pages":"i - ii"},"PeriodicalIF":1.1,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45907756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-27DOI: 10.1080/16070658.2022.2148909
Samson Udho, Joyce Nankumbi, Mariam Namutebi, D. Mukunya, G. Ndeezi, J. Tumwine
Background: Anaemia in pregnancy is associated with poor maternal and foetal outcomes. Nonetheless, there is a paucity of recent literature on the predictors of anaemia during pregnancy in the context of northern Uganda, a region emerging out of decades of war. A study was undertaken to determine the prevalence and factors associated with anaemia among pregnant women in northern Uganda. Methods: In this cross-sectional study, 320 pregnant women seeking care at Lira Regional Referral Hospital were consecutively enrolled. Data were collected using a structured interviewer-administered questionnaire. Data collected included: demographic, obstetric, nutritional and dietary characteristics of study participants. Data analysis consisted of descriptive statistics, cross-tabulations and logistic regression with 95% confidence and a p-value of < 0.05 as significant using STATA version 14. Results: The mean age of the women was 25.3 ± 5.6 years while their mean gestational age was 25.4 ± 7.8 weeks. The overall prevalence of anaemia (Hb < 11 g/dl in the first and third trimesters and less than 10.5 g/dl in the second trimester) was 24.7%. Iron deficiency was prevalent in half of the women (50%) with anaemia. Factors independently associated with anaemia included taking antimalarial prophylaxis (AOR 0.44; 95% CI 0.19, 0.99) and consumption of legumes and cereals more than twice in the previous week (AOR 0.46; 95% CI 0.24, 0.89). Conclusion: One-quarter of pregnant women in this study population based in northern Uganda were anaemic. There is a need to strengthen interventions to control anaemia during pregnancy, particularly the intake of antimalarial prophylaxis and consumption of iron-rich locally available foods.
{"title":"Prevalence of anaemia in pregnancy and associated factors in northern Uganda: a cross-sectional study","authors":"Samson Udho, Joyce Nankumbi, Mariam Namutebi, D. Mukunya, G. Ndeezi, J. Tumwine","doi":"10.1080/16070658.2022.2148909","DOIUrl":"https://doi.org/10.1080/16070658.2022.2148909","url":null,"abstract":"Background: Anaemia in pregnancy is associated with poor maternal and foetal outcomes. Nonetheless, there is a paucity of recent literature on the predictors of anaemia during pregnancy in the context of northern Uganda, a region emerging out of decades of war. A study was undertaken to determine the prevalence and factors associated with anaemia among pregnant women in northern Uganda. Methods: In this cross-sectional study, 320 pregnant women seeking care at Lira Regional Referral Hospital were consecutively enrolled. Data were collected using a structured interviewer-administered questionnaire. Data collected included: demographic, obstetric, nutritional and dietary characteristics of study participants. Data analysis consisted of descriptive statistics, cross-tabulations and logistic regression with 95% confidence and a p-value of < 0.05 as significant using STATA version 14. Results: The mean age of the women was 25.3 ± 5.6 years while their mean gestational age was 25.4 ± 7.8 weeks. The overall prevalence of anaemia (Hb < 11 g/dl in the first and third trimesters and less than 10.5 g/dl in the second trimester) was 24.7%. Iron deficiency was prevalent in half of the women (50%) with anaemia. Factors independently associated with anaemia included taking antimalarial prophylaxis (AOR 0.44; 95% CI 0.19, 0.99) and consumption of legumes and cereals more than twice in the previous week (AOR 0.46; 95% CI 0.24, 0.89). Conclusion: One-quarter of pregnant women in this study population based in northern Uganda were anaemic. There is a need to strengthen interventions to control anaemia during pregnancy, particularly the intake of antimalarial prophylaxis and consumption of iron-rich locally available foods.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"1 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49204588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-15DOI: 10.1080/16070658.2022.2140498
Tshegofatso Betty Mohlala, S. Mathunjwa, Heather Legodi, M. Mataboge
Objective: The study aimed to explore and describe the infant feeding experiences of mothers of children aged 3 to 24 months, living in two selected informal settlements in Tshwane, South Africa. Design: This exploratory qualitative study gathered data via six focus-group discussions (FGDs). These were facilitated using a semi-structured questionnaire guide with probes. Data were then transcribed, coded and thematically analysed. Setting: The study was conducted in the two selected informal settlements in the west of Tshwane, South Africa. Subjects: Biological mothers (n = 28) of infants and young children aged 3 to 24 months, living in the selected informal settlements participated. The mothers had to be living with their child with some responsibility for their daily care and feeding. Results: Three themes with six sub-themes were identified following thematic analysis. First was the mothers’ experience of infant feeding, which included their interpretations and practices of exclusive breastfeeding and complementary feeding. Second, mothers received infant feeding support from their elders based on common beliefs. The support received from healthcare workers was sometimes perceived negatively. However, healthcare workers based at healthcare facilities were important sources of exclusive breastfeeding and complementary feeding information. Third were the setting-related factors that negatively affected the mothers’ ability to access nutritious food for themselves and their infants. These included household food insecurity, plus environmental and household factors affecting food storage and preparation. Conclusion: Mothers experienced several challenging circumstances affecting their infant feeding efforts. These findings highlight the need to strengthen targeted infant feeding counselling and support for mothers living in resource-constrained environments.
{"title":"Exploring the infant feeding experiences of mothers living in selected Tshwane informal settlements: a qualitative study","authors":"Tshegofatso Betty Mohlala, S. Mathunjwa, Heather Legodi, M. Mataboge","doi":"10.1080/16070658.2022.2140498","DOIUrl":"https://doi.org/10.1080/16070658.2022.2140498","url":null,"abstract":"Objective: The study aimed to explore and describe the infant feeding experiences of mothers of children aged 3 to 24 months, living in two selected informal settlements in Tshwane, South Africa. Design: This exploratory qualitative study gathered data via six focus-group discussions (FGDs). These were facilitated using a semi-structured questionnaire guide with probes. Data were then transcribed, coded and thematically analysed. Setting: The study was conducted in the two selected informal settlements in the west of Tshwane, South Africa. Subjects: Biological mothers (n = 28) of infants and young children aged 3 to 24 months, living in the selected informal settlements participated. The mothers had to be living with their child with some responsibility for their daily care and feeding. Results: Three themes with six sub-themes were identified following thematic analysis. First was the mothers’ experience of infant feeding, which included their interpretations and practices of exclusive breastfeeding and complementary feeding. Second, mothers received infant feeding support from their elders based on common beliefs. The support received from healthcare workers was sometimes perceived negatively. However, healthcare workers based at healthcare facilities were important sources of exclusive breastfeeding and complementary feeding information. Third were the setting-related factors that negatively affected the mothers’ ability to access nutritious food for themselves and their infants. These included household food insecurity, plus environmental and household factors affecting food storage and preparation. Conclusion: Mothers experienced several challenging circumstances affecting their infant feeding efforts. These findings highlight the need to strengthen targeted infant feeding counselling and support for mothers living in resource-constrained environments.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"36 1","pages":"118 - 125"},"PeriodicalIF":1.1,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42229544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-12DOI: 10.1080/16070658.2022.2135186
C. Chin, M. Wicks, M. Feyasa, N. Koen
Introduction: Food and nutrition labelling is an effective tool to address diet-related non-communicable diseases (NCDs), in which nutrition education plays an integral role. Objectives: To investigate South African dietitians’ understanding, perspectives and practices of food and nutrition labelling as a nutrition education tool. Design: A quantitative descriptive cross-sectional study was conducted. Setting: A nationwide survey was undertaken of dietitians from all sectors of practice. Subjects: Dietitians registered with the Health Professions Council of South Africa (HPCSA) (n = 137). Outcome measures: A self-administered electronic survey was used for data collection. Results: Awareness of labelling regulations was high (86.9%); however, confidence in knowledge of regulations was lacking (53.3%), as well as knowledge regarding food-labelling regulations (R146) (52.6%). More than half (57.7%) regarded labels as relevant to their daily work and 51.8% used labels frequently, varying use depending on client needs. For education purposes, the nutrition information table (75.2%), client-specific nutrients (70.0%) and health endorsement logos (HELs) (59.2%) were most frequently used. Product healthiness was mainly evaluated using the cooking method (86.1%), level of processing (67.9%) and product category (63.5%). Least used aspects were origin/certification claims (39.4%) and animal husbandry (34.3%). Highly rated aspects included belief in label efficacy (88.3%), accuracy (81.8%), a positive attitude (87.6%) and relevance (80.2%). Conclusion: To promote optimal use of labelling as a nutrition education tool, standardisation, trustworthiness and continuing education should be addressed. Furthermore, the urgent promulgation of the draft food labelling regulations will address existing barriers to label use.
{"title":"Food and nutrition labelling as a nutrition education tool: understanding, perspectives and practices of South African dietitians.","authors":"C. Chin, M. Wicks, M. Feyasa, N. Koen","doi":"10.1080/16070658.2022.2135186","DOIUrl":"https://doi.org/10.1080/16070658.2022.2135186","url":null,"abstract":"Introduction: Food and nutrition labelling is an effective tool to address diet-related non-communicable diseases (NCDs), in which nutrition education plays an integral role. Objectives: To investigate South African dietitians’ understanding, perspectives and practices of food and nutrition labelling as a nutrition education tool. Design: A quantitative descriptive cross-sectional study was conducted. Setting: A nationwide survey was undertaken of dietitians from all sectors of practice. Subjects: Dietitians registered with the Health Professions Council of South Africa (HPCSA) (n = 137). Outcome measures: A self-administered electronic survey was used for data collection. Results: Awareness of labelling regulations was high (86.9%); however, confidence in knowledge of regulations was lacking (53.3%), as well as knowledge regarding food-labelling regulations (R146) (52.6%). More than half (57.7%) regarded labels as relevant to their daily work and 51.8% used labels frequently, varying use depending on client needs. For education purposes, the nutrition information table (75.2%), client-specific nutrients (70.0%) and health endorsement logos (HELs) (59.2%) were most frequently used. Product healthiness was mainly evaluated using the cooking method (86.1%), level of processing (67.9%) and product category (63.5%). Least used aspects were origin/certification claims (39.4%) and animal husbandry (34.3%). Highly rated aspects included belief in label efficacy (88.3%), accuracy (81.8%), a positive attitude (87.6%) and relevance (80.2%). Conclusion: To promote optimal use of labelling as a nutrition education tool, standardisation, trustworthiness and continuing education should be addressed. Furthermore, the urgent promulgation of the draft food labelling regulations will address existing barriers to label use.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"36 1","pages":"108 - 117"},"PeriodicalIF":1.1,"publicationDate":"2022-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41439087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-09DOI: 10.1080/16070658.2022.2114408
A. van Heerden, Ş. Kolozali, S. Norris
Background: Continuous monitoring of glucose (CGM) via subcutaneous patch is an accurate self-monitoring tool of blood glucose, but also introduces a range of additional benefits such as real-time feedback. While its value among pregnant women with gestational diabetes mellitus (GDM) is established in high-income countries, little is known about the feasibility and acceptability among pregnant women without GDM in low-resource settings in low- and middle-income countries. Objectives: This study aims to assess the feasibility and acceptability of CGM with pregnant mothers in South Africa and to explore the value of a collected data set for GDM prevention. Methods: Ten women between 12 and 18 weeks pregnant were recruited from the antenatal clinic at Chris Hani Baragwanath Academic Hospital into a prospective mixed-methods pilot study. Demographic and anthropometric data, HbA1c and a lipid panel were collected. Women then wore two consecutive Freestyle Libre 2 patches for a total of 28 days. In-depth interviews were undertaken with all 10 women on study exit to explore themes of acceptability and the use of technology during pregnancy. Thematic analysis was performed on the qualitative data while exploratory data-analysis techniques were applied to the CGM data. Results: Pregnant women (n = 10) had a mean (SD) age of 29.81 years (4.39), with most being unemployed (8), unmarried (8) and without a tertiary degree (7). Analysis suggests that fear of use was greater than the actual discomfort experienced during use of the CGM patch. The main barrier to use was the patch falling off and women being uncomfortable to reapply it. This was borne out by all 10 women wearing the first patch for at least 12 of the 14 days, but only 4 managing the same with patch two – primarily applied by themselves at home. Women expressed support for the use of technology during pregnancy, especially as it related to feeling that their pregnancy was being monitored and that they were being supported. Conclusion: In this pilot study, women overwhelmingly found the wearing of a CGM patch during pregnancy to be acceptable. Feasibility was reasonable with most data being successfully retrieved from the devices over a two-week period. Longer use was found to have additional challenges. The use of CGM patches appear to be a possible candidate for inclusion in GDM prevention or behavioural interventions during pregnancy in South Africa.
{"title":"Feasibility and acceptability of continuous at-home glucose monitoring during pregnancy: a mixed-methods pilot study","authors":"A. van Heerden, Ş. Kolozali, S. Norris","doi":"10.1080/16070658.2022.2114408","DOIUrl":"https://doi.org/10.1080/16070658.2022.2114408","url":null,"abstract":"Background: Continuous monitoring of glucose (CGM) via subcutaneous patch is an accurate self-monitoring tool of blood glucose, but also introduces a range of additional benefits such as real-time feedback. While its value among pregnant women with gestational diabetes mellitus (GDM) is established in high-income countries, little is known about the feasibility and acceptability among pregnant women without GDM in low-resource settings in low- and middle-income countries. Objectives: This study aims to assess the feasibility and acceptability of CGM with pregnant mothers in South Africa and to explore the value of a collected data set for GDM prevention. Methods: Ten women between 12 and 18 weeks pregnant were recruited from the antenatal clinic at Chris Hani Baragwanath Academic Hospital into a prospective mixed-methods pilot study. Demographic and anthropometric data, HbA1c and a lipid panel were collected. Women then wore two consecutive Freestyle Libre 2 patches for a total of 28 days. In-depth interviews were undertaken with all 10 women on study exit to explore themes of acceptability and the use of technology during pregnancy. Thematic analysis was performed on the qualitative data while exploratory data-analysis techniques were applied to the CGM data. Results: Pregnant women (n = 10) had a mean (SD) age of 29.81 years (4.39), with most being unemployed (8), unmarried (8) and without a tertiary degree (7). Analysis suggests that fear of use was greater than the actual discomfort experienced during use of the CGM patch. The main barrier to use was the patch falling off and women being uncomfortable to reapply it. This was borne out by all 10 women wearing the first patch for at least 12 of the 14 days, but only 4 managing the same with patch two – primarily applied by themselves at home. Women expressed support for the use of technology during pregnancy, especially as it related to feeling that their pregnancy was being monitored and that they were being supported. Conclusion: In this pilot study, women overwhelmingly found the wearing of a CGM patch during pregnancy to be acceptable. Feasibility was reasonable with most data being successfully retrieved from the devices over a two-week period. Longer use was found to have additional challenges. The use of CGM patches appear to be a possible candidate for inclusion in GDM prevention or behavioural interventions during pregnancy in South Africa.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"36 1","pages":"100 - 107"},"PeriodicalIF":1.1,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47749809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-09DOI: 10.1080/16070658.2022.2114405
T. Mabesa, S. Knight, N. Nkwanyana
Introduction: Malnutrition is an increasing public health challenge in low- and middle-income countries. Growth Monitoring and Promotion (GMP) is a United Nations International Children’s Emergency Fund (UNICEF) strategy to combat malnutrition. This study aimed to measure factors associated with knowledge and practices of GMP in caregivers of children from birth to 24 months referred to Inkosi Albert Luthuli Central Hospital (IALCH) from health facilities in KwaZulu-Natal (KZN) during 2018. Methods: An observational, analytic cross-sectional study design was used. The study sample comprised 383 caregivers of these children. Data were obtained from interviewer-administered questionnaires. Results: Most caregivers (n = 201, 52%) were between the ages of 21 and 30 years; 95% (n = 360) had more than primary education. Most (n = 341, 89%) caregivers presented the Road-to-Health Card (RTHC) for assessment, but only 7.6% (n = 26) were complete. Most caregivers (n = 281, 73%) had an excellent overall knowledge of how an RTHC contributes to GMP. However, only 38 (10%) had the skill to interpret all four of the test growth charts. There was a statistically significant association (p < 0.05) between some caregivers’ variables and their knowledge of the RTHC. Conclusion: Despite having good theoretical knowledge concerning the information in the RTHCs, most caregivers could not correctly interpret the growth charts. The education of caregivers and health workers on the importance of appropriate use of the RTHC for GMP is recommended.
{"title":"Completeness of the road-to-health card and factors affecting knowledge and practices of growth monitoring and promotion in caregivers of young children in KwaZulu-Natal","authors":"T. Mabesa, S. Knight, N. Nkwanyana","doi":"10.1080/16070658.2022.2114405","DOIUrl":"https://doi.org/10.1080/16070658.2022.2114405","url":null,"abstract":"Introduction: Malnutrition is an increasing public health challenge in low- and middle-income countries. Growth Monitoring and Promotion (GMP) is a United Nations International Children’s Emergency Fund (UNICEF) strategy to combat malnutrition. This study aimed to measure factors associated with knowledge and practices of GMP in caregivers of children from birth to 24 months referred to Inkosi Albert Luthuli Central Hospital (IALCH) from health facilities in KwaZulu-Natal (KZN) during 2018. Methods: An observational, analytic cross-sectional study design was used. The study sample comprised 383 caregivers of these children. Data were obtained from interviewer-administered questionnaires. Results: Most caregivers (n = 201, 52%) were between the ages of 21 and 30 years; 95% (n = 360) had more than primary education. Most (n = 341, 89%) caregivers presented the Road-to-Health Card (RTHC) for assessment, but only 7.6% (n = 26) were complete. Most caregivers (n = 281, 73%) had an excellent overall knowledge of how an RTHC contributes to GMP. However, only 38 (10%) had the skill to interpret all four of the test growth charts. There was a statistically significant association (p < 0.05) between some caregivers’ variables and their knowledge of the RTHC. Conclusion: Despite having good theoretical knowledge concerning the information in the RTHCs, most caregivers could not correctly interpret the growth charts. The education of caregivers and health workers on the importance of appropriate use of the RTHC for GMP is recommended.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"36 1","pages":"84 - 92"},"PeriodicalIF":1.1,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41615234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-06DOI: 10.1080/16070658.2022.2114406
Hanel Duvenage, G. Gericke, Jane W. Muchiri
Objective: To describe the dietary intake and its quality of patients with poorly controlled type 2 diabetes mellitus (T2DM) by assessing the dietary variety (DVS), dietary diversity (DDS), nutrient adequacy ratio (NAR) and mean nutrient adequacy ratio (MAR). Design: This was a descriptive, cross-sectional study. Setting: Diabetes outpatient clinic at a tertiary hospital in Tshwane district, Gauteng province, South Africa. Subjects: Adults, aged 40–70 years, with poorly controlled T2DM (HbA1c ≥ 8%). Outcome measures: Dietary intake data were obtained through two, multi-pass, 24-hour recalls. Individual food items were used to determine the DVS and DDS. The SAMRC FoodFinder III software was used to analyse the macro- and micronutrients, from which the NAR and MAR scores were determined. Descriptive statistics were used to analyse the data. Results: Seventy-seven patients (60 females) participated. Their mean age was 57.2 (±6.6) years. The DDS was adequate at 4.99 (out of a possible 7 food groups); however, the DVS was low (16%) as well as the consumption of vegetables, fruits and legumes. Mean NAR scores indicated insufficient energy intake. Intakes of vitamin D, calcium, folate and iron were below 50% of the recommended daily intake. MAR scores indicated unsatisfactory micronutrient intake at 0.63 (ideal ≥ 1). Conclusions: In this tertiary healthcare setting, T2DM patients with poor glycaemic control had sub-optimal dietary quality. Interventions such as nutrition education programmes that provide simple and factual information on the benefits of healthy eating and practical ways of achieving healthy diets among people with T2DM are needed.
{"title":"Diet quality of adults with poorly controlled type 2 diabetes mellitus at a tertiary hospital outpatient clinic in Tshwane District, South Africa","authors":"Hanel Duvenage, G. Gericke, Jane W. Muchiri","doi":"10.1080/16070658.2022.2114406","DOIUrl":"https://doi.org/10.1080/16070658.2022.2114406","url":null,"abstract":"Objective: To describe the dietary intake and its quality of patients with poorly controlled type 2 diabetes mellitus (T2DM) by assessing the dietary variety (DVS), dietary diversity (DDS), nutrient adequacy ratio (NAR) and mean nutrient adequacy ratio (MAR). Design: This was a descriptive, cross-sectional study. Setting: Diabetes outpatient clinic at a tertiary hospital in Tshwane district, Gauteng province, South Africa. Subjects: Adults, aged 40–70 years, with poorly controlled T2DM (HbA1c ≥ 8%). Outcome measures: Dietary intake data were obtained through two, multi-pass, 24-hour recalls. Individual food items were used to determine the DVS and DDS. The SAMRC FoodFinder III software was used to analyse the macro- and micronutrients, from which the NAR and MAR scores were determined. Descriptive statistics were used to analyse the data. Results: Seventy-seven patients (60 females) participated. Their mean age was 57.2 (±6.6) years. The DDS was adequate at 4.99 (out of a possible 7 food groups); however, the DVS was low (16%) as well as the consumption of vegetables, fruits and legumes. Mean NAR scores indicated insufficient energy intake. Intakes of vitamin D, calcium, folate and iron were below 50% of the recommended daily intake. MAR scores indicated unsatisfactory micronutrient intake at 0.63 (ideal ≥ 1). Conclusions: In this tertiary healthcare setting, T2DM patients with poor glycaemic control had sub-optimal dietary quality. Interventions such as nutrition education programmes that provide simple and factual information on the benefits of healthy eating and practical ways of achieving healthy diets among people with T2DM are needed.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"36 1","pages":"93 - 99"},"PeriodicalIF":1.1,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49451450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-06DOI: 10.1080/16070658.2022.2114404
B. Saayman, A. Millar, E. van Niekerk
Objectives: To describe the impact of nutritional interventions on the outcomes of children with short bowel syndrome (SBS). Design: This was a retrospective descriptive observational review where data were obtained from the patient’s medical records. Subjects and setting: Children with SBS between the ages of 0 and 24 months who obtained this diagnosis between January 2005 and December 2015 at a tertiary paediatric hospital in Cape Town were investigated. Results: There were 46 patients (62% male, 38% female) included in the study. The median duration of parenteral nutrition (PN) support was one month (0.6, 2.2 months), after which 83% of patients were weaned from PN. Enteral nutrition was commenced in 96% of patients, with the majority (n = 36; 82%) starting on day six (±6; range 1–29 days) postoperatively and 80% of patients attaining full feeds at median 1.2 months (0.2, 36 months). Patients displayed a mean weight and length gain of 15 g/day (±4; range 19–92 g) and 2 cm/month (±1.4; range 0.25–4 cm) respectively. The main complications were PN-associated cholestasis (n = 17), fat malabsorption (n = 13) and vitamin D deficiency/insufficiency (n = 5). Conclusion: This study showed that early initiation of PN support was attained, and that most patients were able to achieve enteral autonomy.
{"title":"Nutritional interventions and outcomes of children with short bowel syndrome in a tertiary hospital setting in South Africa","authors":"B. Saayman, A. Millar, E. van Niekerk","doi":"10.1080/16070658.2022.2114404","DOIUrl":"https://doi.org/10.1080/16070658.2022.2114404","url":null,"abstract":"Objectives: To describe the impact of nutritional interventions on the outcomes of children with short bowel syndrome (SBS). Design: This was a retrospective descriptive observational review where data were obtained from the patient’s medical records. Subjects and setting: Children with SBS between the ages of 0 and 24 months who obtained this diagnosis between January 2005 and December 2015 at a tertiary paediatric hospital in Cape Town were investigated. Results: There were 46 patients (62% male, 38% female) included in the study. The median duration of parenteral nutrition (PN) support was one month (0.6, 2.2 months), after which 83% of patients were weaned from PN. Enteral nutrition was commenced in 96% of patients, with the majority (n = 36; 82%) starting on day six (±6; range 1–29 days) postoperatively and 80% of patients attaining full feeds at median 1.2 months (0.2, 36 months). Patients displayed a mean weight and length gain of 15 g/day (±4; range 19–92 g) and 2 cm/month (±1.4; range 0.25–4 cm) respectively. The main complications were PN-associated cholestasis (n = 17), fat malabsorption (n = 13) and vitamin D deficiency/insufficiency (n = 5). Conclusion: This study showed that early initiation of PN support was attained, and that most patients were able to achieve enteral autonomy.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"36 1","pages":"76 - 83"},"PeriodicalIF":1.1,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48906011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-31DOI: 10.1080/16070658.2022.2105492
N. Wiles
Ultra-processed foods (UPFs) are “ formulations of food sub-stances often modified by chemical processes and then assembled into ready-to-consume hyper-palatable food and drink products using flavours, colours, emulsifiers and a myriad of other cosmetic additives ” . 1 Advances in food manu-facturing technology have resulted in UPFs that not only have an extended shelf-life but more have greater desir-able organoleptic properties. These products have popularity worldwide they are “ ready-to-consume ” or “ ready-to-heat ” them very convenient to consumers. They are readily available, cheap and easy to access. trade and
{"title":"The battle against ultra-processed food consumption in a post-COVID-19 era","authors":"N. Wiles","doi":"10.1080/16070658.2022.2105492","DOIUrl":"https://doi.org/10.1080/16070658.2022.2105492","url":null,"abstract":"Ultra-processed foods (UPFs) are “ formulations of food sub-stances often modified by chemical processes and then assembled into ready-to-consume hyper-palatable food and drink products using flavours, colours, emulsifiers and a myriad of other cosmetic additives ” . 1 Advances in food manu-facturing technology have resulted in UPFs that not only have an extended shelf-life but more have greater desir-able organoleptic properties. These products have popularity worldwide they are “ ready-to-consume ” or “ ready-to-heat ” them very convenient to consumers. They are readily available, cheap and easy to access. trade and","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":" ","pages":"i - ii"},"PeriodicalIF":1.1,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43475003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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