Pub Date : 2022-02-16DOI: 10.1080/16070658.2022.2033470
CR Erasmus, T. Pillay, M. Siwela
Background: Complementary foods are required to be given timeously, in adequate amounts, prepared safely and must be nutritious. Caregivers play a vital role in ensuring that the complementary feeding transition and beyond happens optimally to achieve normal growth and development in their children. Objective: The aim was to explore what factors influenced the primary caregivers’ choices during the complementary feeding transition period. Methods: A cross-sectional qualitative study was conducted using focus-group discussions and interviews with caregivers of children enrolled in the Optimal Child Growth and Development (OrCHID) study, which included participants from the Mother and Child in Environment (MACE) cohort and SONKE mother and child cohort. Results: During the analysis of the focus-group discussions (FGDs) and interviews, nine themes were identified including: (i) starting complementary feeding; (ii) food choices; (iii) family meals; (iv) food preparation methods; (v) meal composition; (vi) texture; (vii) education source; (viii) food source; and (ix) nutrition knowledge. These themes and the key concepts associated with them were categorised into timing and transition, meal preparation, and knowledge and choices. Conclusion: The caregivers relied largely on advice from family members who advised on their customs and cultural belief systems, which then impacted when the caregivers started complementary foods, food choices, texture, meal composition and transition to family meals. The caregivers sourced complementary foods based on accessibility, convenience and affordability. The caregivers described having a responsive feeding style, where their decisions were influenced by their sensitivity to how their child was responding emotionally and/or physically to the foods they were receiving. Keywords: focus group discussion, complementary feeding practices, caregivers
{"title":"Factors affecting the choices made by primary caregivers during the complementary feeding transition period, KwaZulu-Natal, South Africa","authors":"CR Erasmus, T. Pillay, M. Siwela","doi":"10.1080/16070658.2022.2033470","DOIUrl":"https://doi.org/10.1080/16070658.2022.2033470","url":null,"abstract":"Background: Complementary foods are required to be given timeously, in adequate amounts, prepared safely and must be nutritious. Caregivers play a vital role in ensuring that the complementary feeding transition and beyond happens optimally to achieve normal growth and development in their children. Objective: The aim was to explore what factors influenced the primary caregivers’ choices during the complementary feeding transition period. Methods: A cross-sectional qualitative study was conducted using focus-group discussions and interviews with caregivers of children enrolled in the Optimal Child Growth and Development (OrCHID) study, which included participants from the Mother and Child in Environment (MACE) cohort and SONKE mother and child cohort. Results: During the analysis of the focus-group discussions (FGDs) and interviews, nine themes were identified including: (i) starting complementary feeding; (ii) food choices; (iii) family meals; (iv) food preparation methods; (v) meal composition; (vi) texture; (vii) education source; (viii) food source; and (ix) nutrition knowledge. These themes and the key concepts associated with them were categorised into timing and transition, meal preparation, and knowledge and choices. Conclusion: The caregivers relied largely on advice from family members who advised on their customs and cultural belief systems, which then impacted when the caregivers started complementary foods, food choices, texture, meal composition and transition to family meals. The caregivers sourced complementary foods based on accessibility, convenience and affordability. The caregivers described having a responsive feeding style, where their decisions were influenced by their sensitivity to how their child was responding emotionally and/or physically to the foods they were receiving. Keywords: focus group discussion, complementary feeding practices, caregivers","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43029966","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 : 2022-02-02DOI: 10.1080/16070658.2021.2018788
Zarina Ebrahim, G. Glorieux, M. Moosa, R. Blaauw
Background: Traditional chronic kidney disease (CKD) dietary advice is challenging with many restrictions, consequently adherence to the CKD diet is low. Recent literature has proposed less restrictive dietary guidelines in CKD to improve dietary adherence and outcomes; however, limited evidence of its implementation exists. Objectives: This study (trial number: PACTR202002892187265) investigated the effect of simplified dietary advice on nutritional outcomes and adherence after four weeks of dietary advice. Design: A before-and-after study was conducted. Outcome measures: Sociodemographic, clinical and biochemical information was collected and anthropometric measurements performed on Stage 3–5 CKD participants attending a pre-dialysis clinic. Uremic toxins were quantified by UPLC/fluorescence detection. Dietary intake was assessed using a quantified food frequency questionnaire (QFFQ). Participants were educated by the study dietitian on simplified dietary advice using an infographic. A diet-adherence score sheet monitored adherence. All outcomes were measured at baseline and four weeks after the diet was advised. IBM SPSS® version 27 was used for statistical analysis. Results: Fifty-nine participants, mean age 41.0 ± 11.6 years, completed the study. After four weeks, significant improvements were found in body mass index (p < 0.006), waist circumference (p < 0.001), mid-upper arm circumference (P < 0.001), serum total cholesterol (p < 0.045), serum triglycerides (p < 0.017), energy (p < 0.001), protein (p< 0.001) and most dietary intake variables. Overweight and obesity prevalence was high at 68%. Uremic toxin concentrations remained stable. Dietary adherence was 88.6%. Conclusion: The simplified dietary advice suggests improved nutritional outcomes in CKD patients who were predominantly overweight and obese, without compromising kidney function. This study highlights the importance and feasibility of simplified nutrition education in CKD.
{"title":"Effect of simplified dietary advice on nutritional status and uremic toxins in chronic kidney disease participants","authors":"Zarina Ebrahim, G. Glorieux, M. Moosa, R. Blaauw","doi":"10.1080/16070658.2021.2018788","DOIUrl":"https://doi.org/10.1080/16070658.2021.2018788","url":null,"abstract":"Background: Traditional chronic kidney disease (CKD) dietary advice is challenging with many restrictions, consequently adherence to the CKD diet is low. Recent literature has proposed less restrictive dietary guidelines in CKD to improve dietary adherence and outcomes; however, limited evidence of its implementation exists. Objectives: This study (trial number: PACTR202002892187265) investigated the effect of simplified dietary advice on nutritional outcomes and adherence after four weeks of dietary advice. Design: A before-and-after study was conducted. Outcome measures: Sociodemographic, clinical and biochemical information was collected and anthropometric measurements performed on Stage 3–5 CKD participants attending a pre-dialysis clinic. Uremic toxins were quantified by UPLC/fluorescence detection. Dietary intake was assessed using a quantified food frequency questionnaire (QFFQ). Participants were educated by the study dietitian on simplified dietary advice using an infographic. A diet-adherence score sheet monitored adherence. All outcomes were measured at baseline and four weeks after the diet was advised. IBM SPSS® version 27 was used for statistical analysis. Results: Fifty-nine participants, mean age 41.0 ± 11.6 years, completed the study. After four weeks, significant improvements were found in body mass index (p < 0.006), waist circumference (p < 0.001), mid-upper arm circumference (P < 0.001), serum total cholesterol (p < 0.045), serum triglycerides (p < 0.017), energy (p < 0.001), protein (p< 0.001) and most dietary intake variables. Overweight and obesity prevalence was high at 68%. Uremic toxin concentrations remained stable. Dietary adherence was 88.6%. Conclusion: The simplified dietary advice suggests improved nutritional outcomes in CKD patients who were predominantly overweight and obese, without compromising kidney function. This study highlights the importance and feasibility of simplified nutrition education in CKD.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2022-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45586472","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 : 2021-12-16DOI: 10.1080/16070658.2021.2003148
CJ Grobler, W. Oldewage-Theron, J. Chalwe
Objectives: The aim of this study was to assess the effect of vitamins B12, B6 and folate supplementation at >100% Recommended Dietary Allowances (RDA) for six months on serum homocysteine (Hcy) levels of an elderly urbanised black South African community. Design: An experimental, non-equivalent control group intervention study design was used in a 104 purposively selected sample. Two groups were compared: hyperhomocysteinaemic (hyperHcy) (n = 61) and normo-homocysteinaemic (normoHcy) (n = 43). Setting: Elders attending a day-care centre in Sharpeville, Gauteng, South Africa. Subjects: All subjects were equivalent in age (> 60 years), race (black) and unemployed/pensioner. Outcome measures: The following parameters were determined at baseline and after the six-month supplementation: serum Hcy, vitamins B6, B12 and folate levels, red cell count, mean cell volume, haemoglobin, haematocrit and the nutritional intake of vitamin B6, B12 and folate. Results: A very high incidence (66.36%) of hyperhomocysteinaemia was present in the sample. The mean ± standard deviation (SD) serum Hcy level in hyperhomocysteinaemic individuals decreased statistically significantly from 25.00 ± 8.00 umol/l to 18.80 ± 12.00 umol/l after the intervention. The number of respondents with an increased Hcy level decreased from 100% (baseline) to 67% after the intervention. Conclusions: It is concluded that supplementation of vitamins B6, B12 and folate is an effective Hcy-lowering approach to reduce hyperhomocysteinaemia in an elderly population, and thereby reduce their risk of cardiovascular disease (CVD). Summary The supplementation had a beneficial effect on the respondents’ serum vitamin B6 as well as their haemopoiesis (decreased macrocytosis).
{"title":"The effect of vitamins B12, B6 and folate supplementation on homocysteine metabolism in a low-income, urbanised, black elderly community in South Africa","authors":"CJ Grobler, W. Oldewage-Theron, J. Chalwe","doi":"10.1080/16070658.2021.2003148","DOIUrl":"https://doi.org/10.1080/16070658.2021.2003148","url":null,"abstract":"Objectives: The aim of this study was to assess the effect of vitamins B12, B6 and folate supplementation at >100% Recommended Dietary Allowances (RDA) for six months on serum homocysteine (Hcy) levels of an elderly urbanised black South African community. Design: An experimental, non-equivalent control group intervention study design was used in a 104 purposively selected sample. Two groups were compared: hyperhomocysteinaemic (hyperHcy) (n = 61) and normo-homocysteinaemic (normoHcy) (n = 43). Setting: Elders attending a day-care centre in Sharpeville, Gauteng, South Africa. Subjects: All subjects were equivalent in age (> 60 years), race (black) and unemployed/pensioner. Outcome measures: The following parameters were determined at baseline and after the six-month supplementation: serum Hcy, vitamins B6, B12 and folate levels, red cell count, mean cell volume, haemoglobin, haematocrit and the nutritional intake of vitamin B6, B12 and folate. Results: A very high incidence (66.36%) of hyperhomocysteinaemia was present in the sample. The mean ± standard deviation (SD) serum Hcy level in hyperhomocysteinaemic individuals decreased statistically significantly from 25.00 ± 8.00 umol/l to 18.80 ± 12.00 umol/l after the intervention. The number of respondents with an increased Hcy level decreased from 100% (baseline) to 67% after the intervention. Conclusions: It is concluded that supplementation of vitamins B6, B12 and folate is an effective Hcy-lowering approach to reduce hyperhomocysteinaemia in an elderly population, and thereby reduce their risk of cardiovascular disease (CVD). Summary The supplementation had a beneficial effect on the respondents’ serum vitamin B6 as well as their haemopoiesis (decreased macrocytosis).","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45916509","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 : 2021-12-02DOI: 10.1080/16070658.2021.2003058
Siphiwe N. Dlamini, Gudani Mukoma, S. Norris
Objectives: This study aimed to: (i) determine the proportion of fast-food restaurants that provide nutritional information, (ii) describe the nutritional information of similar food items and meal combinations across the fast-food restaurants, (iii) and use a graphical labelling system to describe these data. Methods: Thirty-one of the biggest fast-food restaurants in South Africa were included to estimate the proportion of those that provided nutritional information on their websites/outlets. Energy, protein, fat, carbohydrate, salt and sugar nutrient compositions were compared for similar food items (burger or pizza), and a meal combination that included burger/pizza, medium-size fried chips and a sugar-sweetened beverage. The UK Traffic Light labelling system was used to compare fat, salt and sugar across restaurants. Results: Only 58% of the restaurants provided some form of nutritional information. While all burgers were high in protein, some were also high in fat, salt and sugar, as indicated by percentages of the nutritional reference ranges above 30%. Similarly, this was the case for pizzas. All meal combinations particularly exceeded the total recommended energy, carbohydrates, sugar and salt content, and most also exceeded the recommended fat content. Conclusions: Consumption of popular South African fast foods may disproportionally contribute to the daily intakes of total energy, fat, salt and sugar, especially when consumed as combination meals including fried chips and sugar-sweetened beverages. Recommendations: Consumers should limit their fast-food intake and avoid eating meal combinations. The South African Government’s commitment to curb the rise of non-communicable diseases should consider regulations that mandate nutritional labelling of fast foods, to assist consumers in making informed dietary choices.
{"title":"Should fast-food nutritional labelling in South Africa be mandatory?","authors":"Siphiwe N. Dlamini, Gudani Mukoma, S. Norris","doi":"10.1080/16070658.2021.2003058","DOIUrl":"https://doi.org/10.1080/16070658.2021.2003058","url":null,"abstract":"Objectives: This study aimed to: (i) determine the proportion of fast-food restaurants that provide nutritional information, (ii) describe the nutritional information of similar food items and meal combinations across the fast-food restaurants, (iii) and use a graphical labelling system to describe these data. Methods: Thirty-one of the biggest fast-food restaurants in South Africa were included to estimate the proportion of those that provided nutritional information on their websites/outlets. Energy, protein, fat, carbohydrate, salt and sugar nutrient compositions were compared for similar food items (burger or pizza), and a meal combination that included burger/pizza, medium-size fried chips and a sugar-sweetened beverage. The UK Traffic Light labelling system was used to compare fat, salt and sugar across restaurants. Results: Only 58% of the restaurants provided some form of nutritional information. While all burgers were high in protein, some were also high in fat, salt and sugar, as indicated by percentages of the nutritional reference ranges above 30%. Similarly, this was the case for pizzas. All meal combinations particularly exceeded the total recommended energy, carbohydrates, sugar and salt content, and most also exceeded the recommended fat content. Conclusions: Consumption of popular South African fast foods may disproportionally contribute to the daily intakes of total energy, fat, salt and sugar, especially when consumed as combination meals including fried chips and sugar-sweetened beverages. Recommendations: Consumers should limit their fast-food intake and avoid eating meal combinations. The South African Government’s commitment to curb the rise of non-communicable diseases should consider regulations that mandate nutritional labelling of fast foods, to assist consumers in making informed dietary choices.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44163914","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 : 2021-11-24DOI: 10.1080/16070658.2021.2001928
Nosiphiwo Mandla, C. Mackay, S. Mda
Introduction: Severe acute malnutrition (SAM) is an important global and national public health concern. It contributes to under-five mortality but is also largely a preventable disease. Objective: This study aimed to assess the prevalence of and mortality associated with SAM. Design: A retrospective review of hospital files was conducted. Setting: Dora Nginza Hospital, Eastern Cape, South Africa was the site of the study. Subjects: The study included children from 6 to 59 months of age admitted to the paediatric ward between January 1, 2018 and December 31, 2018. Children with chronic disease were excluded. Ethics approval was granted by Walter Sisulu University (053/2019). Outcome measures: Anthropometric, co-morbid and outcomes data were retrieved and analysed. Results: A total of 1 296 children were included in the study, 93 with SAM. The prevalence of SAM was 7.2%. Children with SAM had a median age of 16 months (IQR 11–25). Gender distribution was 52 (56%) females and 41 (44%) males. The inpatient mortality rate for children with SAM was 6.5%. Children with SAM were at significantly increased risk of mortality (RR 5.97, 95% CI 3.1–11.6, p-value < 0.0005). Three factors were significantly associated with mortality: nutritional oedema, sepsis, and hypokalaemia. Conclusion: The prevalence of SAM at Dora Nginza Hospital is high, and children with SAM are at significantly increased risk of mortality. Specific risk factors for mortality include sepsis, urinary tract infection, nutritional oedema and hypokalaemia. Modifiable factors associated with SAM and SAM-related mortality need to be targeted urgently to improve outcomes.
{"title":"Prevalence of severe acute malnutrition and its effect on under-five mortality at a regional hospital in South Africa","authors":"Nosiphiwo Mandla, C. Mackay, S. Mda","doi":"10.1080/16070658.2021.2001928","DOIUrl":"https://doi.org/10.1080/16070658.2021.2001928","url":null,"abstract":"Introduction: Severe acute malnutrition (SAM) is an important global and national public health concern. It contributes to under-five mortality but is also largely a preventable disease. Objective: This study aimed to assess the prevalence of and mortality associated with SAM. Design: A retrospective review of hospital files was conducted. Setting: Dora Nginza Hospital, Eastern Cape, South Africa was the site of the study. Subjects: The study included children from 6 to 59 months of age admitted to the paediatric ward between January 1, 2018 and December 31, 2018. Children with chronic disease were excluded. Ethics approval was granted by Walter Sisulu University (053/2019). Outcome measures: Anthropometric, co-morbid and outcomes data were retrieved and analysed. Results: A total of 1 296 children were included in the study, 93 with SAM. The prevalence of SAM was 7.2%. Children with SAM had a median age of 16 months (IQR 11–25). Gender distribution was 52 (56%) females and 41 (44%) males. The inpatient mortality rate for children with SAM was 6.5%. Children with SAM were at significantly increased risk of mortality (RR 5.97, 95% CI 3.1–11.6, p-value < 0.0005). Three factors were significantly associated with mortality: nutritional oedema, sepsis, and hypokalaemia. Conclusion: The prevalence of SAM at Dora Nginza Hospital is high, and children with SAM are at significantly increased risk of mortality. Specific risk factors for mortality include sepsis, urinary tract infection, nutritional oedema and hypokalaemia. Modifiable factors associated with SAM and SAM-related mortality need to be targeted urgently to improve outcomes.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48295484","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 : 2021-11-19DOI: 10.1080/16070658.2021.1999050
Nikki L Verwey, J. Jordaan, F. Wenhold
Objective: A survey was undertaken to evaluate and compare dietary intakes of first- and third-year female dietetics students. Design: This was a cross-sectional survey. Setting: The University of Pretoria (UP) was the site of the survey. Population: The study encompassed first- (2012–2015) and third- (2012–2017) year female dietetics students (N = 368). Outcome: Dietary intake data from multiple-day weighed food records were analysed on nutrient, food group and meal and snacking pattern levels. Results: Recorded energy intakes of participants (n = 105 first years, n = 166 third years; response rate: 73.6%) were below Estimated Energy Requirements. Across year groups, intakes exceeded and fell below the Acceptable Macronutrient Distribution Range for fat and carbohydrates respectively; however, third years consumed cereals, grains and starchy vegetables more often. Over 50% of first and third years exceeded Estimated Average Requirements of respectively 3 and 6 of 10 tested micronutrients. Third years recorded higher (all p < 0.001) intakes of protein, magnesium, calcium, zinc and vitamin A than first years. Similarly, their Nutrient Adequacy Ratios were higher (all p < 0.001) for magnesium, calcium and vitamins A, B6 and B12. Average Mean Adequacy Ratios were 70% (first years) and 77% (third years). The year groups differed in terms of food group intake. The number of daily eating occasions decreased over weekends for first and third year students, yet intakes of energy (p < 0.05) and fat (p < 0.001) were higher over weekends. Conclusions: Amidst likely under-recording and/or under-eating, UP female dietetics students’ intakes of some micronutrients may be low. Recorded intakes of third years exceeded those of first years. Recorded nutrient intake improved from the first to the third year of the study in dietetics students.
{"title":"Dietary intake of first- and third-year female dietetics students at a South African university","authors":"Nikki L Verwey, J. Jordaan, F. Wenhold","doi":"10.1080/16070658.2021.1999050","DOIUrl":"https://doi.org/10.1080/16070658.2021.1999050","url":null,"abstract":"Objective: A survey was undertaken to evaluate and compare dietary intakes of first- and third-year female dietetics students. Design: This was a cross-sectional survey. Setting: The University of Pretoria (UP) was the site of the survey. Population: The study encompassed first- (2012–2015) and third- (2012–2017) year female dietetics students (N = 368). Outcome: Dietary intake data from multiple-day weighed food records were analysed on nutrient, food group and meal and snacking pattern levels. Results: Recorded energy intakes of participants (n = 105 first years, n = 166 third years; response rate: 73.6%) were below Estimated Energy Requirements. Across year groups, intakes exceeded and fell below the Acceptable Macronutrient Distribution Range for fat and carbohydrates respectively; however, third years consumed cereals, grains and starchy vegetables more often. Over 50% of first and third years exceeded Estimated Average Requirements of respectively 3 and 6 of 10 tested micronutrients. Third years recorded higher (all p < 0.001) intakes of protein, magnesium, calcium, zinc and vitamin A than first years. Similarly, their Nutrient Adequacy Ratios were higher (all p < 0.001) for magnesium, calcium and vitamins A, B6 and B12. Average Mean Adequacy Ratios were 70% (first years) and 77% (third years). The year groups differed in terms of food group intake. The number of daily eating occasions decreased over weekends for first and third year students, yet intakes of energy (p < 0.05) and fat (p < 0.001) were higher over weekends. Conclusions: Amidst likely under-recording and/or under-eating, UP female dietetics students’ intakes of some micronutrients may be low. Recorded intakes of third years exceeded those of first years. Recorded nutrient intake improved from the first to the third year of the study in dietetics students.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45476084","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 : 2021-11-19DOI: 10.1080/16070658.2021.1996754
M. Marais, E. Lessing, T. Frank
Objectives: To assess whether the right to adequate food (RtF) is realised by children and primary caregivers and what actions are required to fully realise this right. Design: A cross-sectional, descriptive study was undertaken using a mixed-methods approach. Setting and subjects: Rural and urban primary caregivers of children (one to five years old) were recruited if they had resided in the Blue Crane Route (Eastern Cape) for at least six months. Purposefully selected key informants (KIs) involved in nutrition and food security, health or governance participated in in-depth interviews. Outcome measures: Primary caregivers responded to interviewer-administered questionnaires (IAQ) (N = 161), which investigated various indicators supporting the realisation of the RtF. Statistical analysis of quantitative data examined relationships between urban and rural participants. Significance was considered at p < 0.05. In-depth interviews with key informants (KIs) examined the perceptions of 11 prominent community leaders. Qualitative data were coded deductively and common themes identified. Results: Based on the IAQ, half (51%) of the caregivers had experienced risk of, or food insecurity in the past month. Common themes indicative of suboptimal realisation of the RtF included insufficient employment opportunities, inadequate policies and programme implementation, and inadequate agrarian practices, while the child support grant partially supported the realisation of the RtF. Caregivers felt disempowered by a sense of inability to realise the right themselves without government assistance but KIs suggested that caregivers needed to take responsibility. Conclusion: The RtF of children and their caregivers is not fully realised in the Blue Crane Route. Concerted, multidisciplinary approaches using a rights-based approach to implement policies and programmes are needed, together with the empowerment of the community with necessary skills and resources to further the realisation of the RtF.
{"title":"Assessment of the realisation of the right to adequate food in the Blue Crane Route (Eastern Cape, South Africa)","authors":"M. Marais, E. Lessing, T. Frank","doi":"10.1080/16070658.2021.1996754","DOIUrl":"https://doi.org/10.1080/16070658.2021.1996754","url":null,"abstract":"Objectives: To assess whether the right to adequate food (RtF) is realised by children and primary caregivers and what actions are required to fully realise this right. Design: A cross-sectional, descriptive study was undertaken using a mixed-methods approach. Setting and subjects: Rural and urban primary caregivers of children (one to five years old) were recruited if they had resided in the Blue Crane Route (Eastern Cape) for at least six months. Purposefully selected key informants (KIs) involved in nutrition and food security, health or governance participated in in-depth interviews. Outcome measures: Primary caregivers responded to interviewer-administered questionnaires (IAQ) (N = 161), which investigated various indicators supporting the realisation of the RtF. Statistical analysis of quantitative data examined relationships between urban and rural participants. Significance was considered at p < 0.05. In-depth interviews with key informants (KIs) examined the perceptions of 11 prominent community leaders. Qualitative data were coded deductively and common themes identified. Results: Based on the IAQ, half (51%) of the caregivers had experienced risk of, or food insecurity in the past month. Common themes indicative of suboptimal realisation of the RtF included insufficient employment opportunities, inadequate policies and programme implementation, and inadequate agrarian practices, while the child support grant partially supported the realisation of the RtF. Caregivers felt disempowered by a sense of inability to realise the right themselves without government assistance but KIs suggested that caregivers needed to take responsibility. Conclusion: The RtF of children and their caregivers is not fully realised in the Blue Crane Route. Concerted, multidisciplinary approaches using a rights-based approach to implement policies and programmes are needed, together with the empowerment of the community with necessary skills and resources to further the realisation of the RtF.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43232972","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 : 2021-11-16DOI: 10.1080/16070658.2021.1997267
M. Theron, S. O'Halloran
Objectives: This study aimed to determine the energy and protein content of meals served and consumed by hospitalised patients compared with their needs, to assess patients’ food satisfaction and investigate associations with energy and protein intake. Design: This was an exploratory quantitative cross-sectional study. Setting: Three public hospitals within the Cape Town metropole were recruited; a central hospital (945 beds), large district hospital (372 beds) and a medium district hospital (172 beds). Subjects: Adult inpatients 18+ years admitted to medical or surgical wards, on a non-therapeutic/normal hospital diet were recruited by purposive sampling method between 2018 and 2019. Outcomes measures: Each participant’s weight and height were measured to calculate body mass index (BMI) and to determine energy/protein requirements. The Acute Care Hospital Foodservice Patient Satisfaction Questionnaire was administered. Meals were weighed before and after consumption to calculate energy and protein intake per patient/day. Results: A total of 128 patients (males = 71) participated. Total protein served did not meet patient requirements in any of the hospitals. Consumed energy and protein were significantly below requirements in all hospitals (p < 0.002). Perceived food quality (r = 0.38, p = 0.039) and staff/service issues (r = 0.39; p = 0.035) were significantly positively correlated with protein intake, while appetite correlated positively (r = 0.42, p = 0.006; r = 0.41, p = 0.008) and length of stay (LOS) correlated negatively (r = −0.46, p = 0.002; r = −0.42, p = 0.008) with energy and protein intake, respectively. Conclusion: Energy and protein served was significantly lower than participants’ requirements in all three hospitals and none achieved the official ration scale amounts. Nearly 40% reported having a normal appetite and did not receive additional food from family or friends, which may lead to hospital-acquired malnutrition and increased hospital length of stay (LOS). Improved hospital food quality, quantity, mealtimes and staff training should be a focus to improve patient energy and protein intake.
{"title":"Patients in public hospitals received insufficient food to meet daily protein and energy requirements: Cape Town Metropole, South Africa","authors":"M. Theron, S. O'Halloran","doi":"10.1080/16070658.2021.1997267","DOIUrl":"https://doi.org/10.1080/16070658.2021.1997267","url":null,"abstract":"Objectives:\u0000 This study aimed to determine the energy and protein content of meals served and consumed by hospitalised patients compared with their needs, to assess patients’ food satisfaction and investigate associations with energy and protein intake. \u0000 Design:\u0000 This was an exploratory quantitative cross-sectional study. \u0000 Setting:\u0000 Three public hospitals within the Cape Town metropole were recruited; a central hospital (945 beds), large district hospital (372 beds) and a medium district hospital (172 beds). \u0000 Subjects:\u0000 Adult inpatients 18+ years admitted to medical or surgical wards, on a non-therapeutic/normal hospital diet were recruited by purposive sampling method between 2018 and 2019. \u0000 Outcomes measures:\u0000 Each participant’s weight and height were measured to calculate body mass index (BMI) and to determine energy/protein requirements. The Acute Care Hospital Foodservice Patient Satisfaction Questionnaire was administered. Meals were weighed before and after consumption to calculate energy and protein intake per patient/day. \u0000 Results:\u0000 A total of 128 patients (males = 71) participated. Total protein served did not meet patient requirements in any of the hospitals. Consumed energy and protein were significantly below requirements in all hospitals (p < 0.002). Perceived food quality (r = 0.38, p = 0.039) and staff/service issues (r = 0.39; p = 0.035) were significantly positively correlated with protein intake, while appetite correlated positively (r = 0.42, p = 0.006; r = 0.41, p = 0.008) and length of stay (LOS) correlated negatively (r = −0.46, p = 0.002; r = −0.42, p = 0.008) with energy and protein intake, respectively. \u0000 Conclusion:\u0000 Energy and protein served was significantly lower than participants’ requirements in all three hospitals and none achieved the official ration scale amounts. Nearly 40% reported having a normal appetite and did not receive additional food from family or friends, which may lead to hospital-acquired malnutrition and increased hospital length of stay (LOS). Improved hospital food quality, quantity, mealtimes and staff training should be a focus to improve patient energy and protein intake.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45959392","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 : 2021-11-08DOI: 10.1080/16070658.2021.1991674
T. Hutton, A. Gresse
Objective: This study aimed to assess the objective understanding of five front-of-pack label formats, namely the Reference Intake, Multiple Traffic Light label, Nutri-Score, health endorsement logo and warning label, among consumers in Nelson Mandela Bay, South Africa. Design: This was a cross-sectional, exploratory study. Setting: Interviewer-administered surveys were conducted at 12 randomly selected food retail outlets in an urban setting. Subjects: A total of 359 adult participants were included in this study. Outcome measures: Objective understanding was measured by asking participants to rank food products according to their nutritional quality, using the displayed front-of-pack label. Results: The type of front-of-pack label significantly influenced ranking ability (p < 0.00001). All the evaluative front-of-pack labels significantly improved the participants’ ability to identify healthier food products compared with the no-label control. The reductive Reference Intake, however, showed no significant impact on consumer understanding. Conclusion: Evaluative front-of-pack labels significantly improved the participants’ ability to identify healthier food products, when compared with the Reference Intake and no-label control. Future research should test the objective understanding of culturally diverse groups in South Africa, particularly among rural populations.
{"title":"Objective understanding of five front-of-pack labels among consumers in Nelson Mandela Bay, South Africa","authors":"T. Hutton, A. Gresse","doi":"10.1080/16070658.2021.1991674","DOIUrl":"https://doi.org/10.1080/16070658.2021.1991674","url":null,"abstract":"Objective: This study aimed to assess the objective understanding of five front-of-pack label formats, namely the Reference Intake, Multiple Traffic Light label, Nutri-Score, health endorsement logo and warning label, among consumers in Nelson Mandela Bay, South Africa. Design: This was a cross-sectional, exploratory study. Setting: Interviewer-administered surveys were conducted at 12 randomly selected food retail outlets in an urban setting. Subjects: A total of 359 adult participants were included in this study. Outcome measures: Objective understanding was measured by asking participants to rank food products according to their nutritional quality, using the displayed front-of-pack label. Results: The type of front-of-pack label significantly influenced ranking ability (p < 0.00001). All the evaluative front-of-pack labels significantly improved the participants’ ability to identify healthier food products compared with the no-label control. The reductive Reference Intake, however, showed no significant impact on consumer understanding. Conclusion: Evaluative front-of-pack labels significantly improved the participants’ ability to identify healthier food products, when compared with the Reference Intake and no-label control. Future research should test the objective understanding of culturally diverse groups in South Africa, particularly among rural populations.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46335809","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 : 2021-11-06DOI: 10.1080/16070658.2021.1994109
T. Turk, A. Poonawala, S. Shulman, P. Sepoloane
Objectives: This study was undertaken to identify stakeholder needs and wants in relation to an Infant and Young Child Feeding, Social and Behaviour Change Communication (SBCC) strategy for the 16 Southern African Development Community (SADC) member states during Covid-19 lockdowns and travel restrictions. Design: A rapid-assessment mixed-methods approach using qualitative and quantitative studies was adopted. Secondary data sources supported in-field findings. Setting/Subjects: Qualitative approaches included 17 key informant interviews from 7 SADC member states. Quantitative methods of an online survey elicited feedback from 61 participants from 11 SADC member states. Outcome measures: More strategic, best practice, infant and young child feeding SBCC programmes are recommended in SADC. Results: Programme challenges included increased demands on health systems from Covid-19, poor attitudes and beliefs toward IYCF behaviours, the dual burden of undernutrition and overnutrition, and financial and human resource capacity challenges to implement and evaluate SBCC campaigns at scale. Opportunities were also identified for improved detection, better meeting IYCF nutritional needs from locally sourced foods, training and capacity building for greater engagement of front-line field staff, effective policy development to support parent-friendly hospitals and workplaces, and improved regional integration. Conclusions: The needs assessment demonstrated that priority programme planning can continue while the health sector deals with a pandemic threat. The adaptation to virtual support provided a variety of learnings for research designs, data collection and analysis, albeit over an extended timeframe of six months. A number of innovative approaches were identified in the resultant SBCC strategy for SADC along with opportunities for regional efficiencies in adapting existing, best practice SBCC creative and programming approaches.
{"title":"Assessing infant and young child feeding priorities to inform the development of a nutrition social and behaviour change communication (SBCC) strategy during a pandemic threat","authors":"T. Turk, A. Poonawala, S. Shulman, P. Sepoloane","doi":"10.1080/16070658.2021.1994109","DOIUrl":"https://doi.org/10.1080/16070658.2021.1994109","url":null,"abstract":"Objectives: This study was undertaken to identify stakeholder needs and wants in relation to an Infant and Young Child Feeding, Social and Behaviour Change Communication (SBCC) strategy for the 16 Southern African Development Community (SADC) member states during Covid-19 lockdowns and travel restrictions. Design: A rapid-assessment mixed-methods approach using qualitative and quantitative studies was adopted. Secondary data sources supported in-field findings. Setting/Subjects: Qualitative approaches included 17 key informant interviews from 7 SADC member states. Quantitative methods of an online survey elicited feedback from 61 participants from 11 SADC member states. Outcome measures: More strategic, best practice, infant and young child feeding SBCC programmes are recommended in SADC. Results: Programme challenges included increased demands on health systems from Covid-19, poor attitudes and beliefs toward IYCF behaviours, the dual burden of undernutrition and overnutrition, and financial and human resource capacity challenges to implement and evaluate SBCC campaigns at scale. Opportunities were also identified for improved detection, better meeting IYCF nutritional needs from locally sourced foods, training and capacity building for greater engagement of front-line field staff, effective policy development to support parent-friendly hospitals and workplaces, and improved regional integration. Conclusions: The needs assessment demonstrated that priority programme planning can continue while the health sector deals with a pandemic threat. The adaptation to virtual support provided a variety of learnings for research designs, data collection and analysis, albeit over an extended timeframe of six months. A number of innovative approaches were identified in the resultant SBCC strategy for SADC along with opportunities for regional efficiencies in adapting existing, best practice SBCC creative and programming approaches.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42529214","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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