South African Journal of Clinical Nutrition - latest Issue
Volumes & issues
Volume 29, Issue 4, 2016
Author Demetre LabadariosSource: South African Journal of Clinical Nutrition 29, pp 3 –3 (2016)More Less
The end of 2016 coincides with the transfer of the SAJCN to the Taylor and Francis manuscript management platform (Editorial Manager) for the submission of new manuscripts. The SAJCN will, therefore, be available via the Taylor and Francis website as of early in 2017 (https://www.editorialmanager.com/sajcn).
Value of antioxidant capacity as relevant assessment tool for “health benefits” of fruit - understated or inflated?Source: South African Journal of Clinical Nutrition 29, pp 4 –6 (2016)More Less
Consumption of fruit and vegetables is considered to be an inherent part of a healthy diet, but more so since plant antioxidants, and in particular polyphenols, have been linked through in vivo and epidemiological studies with positive health outcomes. As a result, polyphenols have been elevated to “lifespan essentials”, because scientific evidence indicated that they are needed by humans to achieve a full lifespan by reducing the risk of a range of chronic diseases. No Dietary Reference Intake values exist for polyphenols, however, it has been suggested that their target intake value should be based on the total polyphenol content provided by the “5-a-day” portions of fruit and vegetables recommendation by the World Health Organisation.
An unusual case of Wernicke’s encephalopathy - thiamin deficiency in advanced gastric adenocarcinomaSource: South African Journal of Clinical Nutrition 29, pp 33 –37 (2016)More Less
Wernicke’s encephalopathy (WE) is a neurological syndrome most commonly found in patients suffering from alcohol abuse. It is less frequently diagnosed in non-alcoholic patients. In non-alcoholic patients WE might develop due to the exclusion of upper portions of the gastrointestinal tract (e.g. after gastrectomy, gastrojejunostomy, gastric bypass surgery) or secondary to intractable vomiting, inadequate dietary intake or malabsorption. Other described conditions in which WE may develop include HIV/AIDS, several types of malignancy (inoperable gastric cancer, leukaemia and lymphoma), prolonged periods of malnutrition (anorexia), hyperemesis gravidarum, thyroid conditions, post organ transplant as well as patients receiving dialysis and long-term dependency on parenteral nutrition (PN).
Source: South African Journal of Clinical Nutrition 29, pp 133 –138 (2016) http://dx.doi.org/10.1080/16070658.2016.1219468More Less
Objective: The objective of this study was to analyse the dispensing patterns of vitamins (Anatomical Therapeutic Chemical (ATC) group A11) over a one-year period in a group of community pharmacies in South Africa.
Design and setting: A retrospective drug utilisation study was conducted on community pharmacy electronic dispensing records in South Africa recorded in 2013.
Outcome measures: All products for ATC subgroup A11 were extracted and analysed.
Results: A total of 164 233 vitamin products were dispensed to 84 805 patients (62.64% female patients). Males received on average 2.09 (SD = 2.63) vitamin products per year, compared to 1.84 (SD = 2.13) products for females. Ergocalciferol (A11CC01) was the most often dispensed (37.48% of all vitamin products), followed by plain Vitamin B-complex products (A11EA00) accounting for 32.77%. Ergocalciferol (vitamin D2) is only available on prescription (50 000 IU tablets or 50 000 IU/ml oily drops) in South Africa. Tablets were the preferred dosage form (62.84% of products). Most injections were for Vitamin B1 or Vitamin B combination products.
Conclusion: Ergocalciferol and injectable vitamins have recently been rescheduled to prescription-only; it is probable that this has impacted on the usage of these products. It is important to monitor future vitamin supplementation behaviour in community pharmacies since pharmacies are selling many of these products and pharmacists can, by counselling patients, determine the reasons for the use of these products. Furthermore, should dietitians and nutritionists choose to work with this captive audience, supplementation patterns can be monitored to develop and implement appropriate awareness campaigns. Further studies to explore these baseline results are recommended.
Author Ilse TruterSource: South African Journal of Clinical Nutrition 29, pp 139 –144 (2016) http://dx.doi.org/10.1080/16070658.2016.1217643More Less
Objectives: The aim of the study was to investigate the dispensing patterns of prescription-only antiobesity preparations in South Africa (classified as Anatomical Therapeutic Chemical (ATC) group A08).
Design: Retrospective, cross-sectional drug utilisation study using electronic dispensing records.
Setting: Private sector community or retail pharmacies in South Africa.
Subjects: Patients who received one or more antiobesity medications in ATC group A08 in 2013.
Outcome measures: Number of patients by age and gender, prescribing frequency and cost of antiobesity prescriptions, and trends observed.
Results: A total of 27 703 patients were prescribed 52 555 products for antiobesity medication during 2013. The average age of patients was 41.71 (SD = 11.37) years, with male patients older than female patients (46.09 and 40.02 years, respectively). More females (72.19%) were dispensed antiobesity products, and females received their prescriptions at a younger average age than male patients. Five active ingredients were dispensed. Phentermine was prescribed the most, accounting for 92.44% of all the antiobesity prescriptions, followed by orlistat (6.08%), phendimetrazine (1.36%), D-norpseudoephedrine (0.06%) and diethylpropion (0.05%). Most patients (79.44%) received only short-term therapy (one or two prescriptions for an antiobesity product during the year). A small percentage (0.30%) of young patients (18 years and younger) received antiobesity products, despite the fact that the safety of these products in children has not been proven.
Conclusions: Most antiobesity preparations were prescribed to females. Phentermine was the most commonly dispensed active ingredient, followed by orlistat. Further studies on patient outcomes and the cost-effectiveness of these products should be conducted.
Colon cancer and the consumption of red and processed meat : an association that is medium, rare or well done?Author S.M. KassierSource: South African Journal of Clinical Nutrition 29, pp 145 –149 (2016) http://dx.doi.org/10.1080/16070658.2016.1217645More Less
In 2015, the International Agency for Research on Cancer (IARC) indicated that red meat is a probable cause of colon cancer, while processed meat was classified as carcinogenic. The 2010 indicators of lifetime risk for developing colorectal cancer among South African (SA) males and females was 1:114 and 1:182 respectively, while its prevalence as a newly diagnosed cancer was seventh for males and sixth for females. SA consumers have increased their meat expenditure over the past decade as a result of class mobility. This has resulted in an increase in the proportion of middle-class consumers. Although the consumption of red meat has increased, it has been surpassed by chicken. Due to a lack of national food consumption data regarding processed meat, it is not clear what local consumption trends are. The 2015 Consumer Price Index (CPI) documented a significant urban food price increase for chicken, cheaper cuts of beef and polony. However, when comparing urban food prices, a processed meat like polony is 27% cheaper per kilogram than whole chicken. Hence it is possible that the relative affordability of processed meat could contribute to its consumption among many South Africans (SAs) and in so doing, could contribute to colon cancer risk. In relation to the above, it is important for future SA public health recommendations to take cognisance of the World Cancer Research Fund and American Institute for Cancer Research recommendations of limiting red meat consumption to less than 500 g/week and avoiding processed meat.
South African indigenous fruits – underutilized resource for boosting daily antioxidant intake among local indigent populations?Source: South African Journal of Clinical Nutrition 29, pp 150 –156 (2016) http://dx.doi.org/10.1080/16070658.2016.1219470More Less
Consuming more than seven portions of fruit and vegetables daily substantially lowers the risk of mortality from any cause, yet many South Africans living below the poverty line have a very low or even zero intake of fruit and vegetables. Advice on the importance of consuming a healthy, and at the same time affordable diet needs to be provided by suggesting alternatives among indigenous plants that are nutritionally superior to “exotic” fruits. But to what extent could antioxidant intake be boosted through the ingestion of selected indigenous fruits? Ten indigenous South African fruits were evaluated for their antioxidant activity and compared with blueberry and cranberry. An Antioxidant Potency Composite Index was drawn up based on the results of three equally weighted assays, namely Total Phenolic Content (FCR), Trolox Equivalent Antioxidant Capacity (TEAC) and Total Antioxidant Capacity (H-ORACFL+L-ORACFL). The antioxidant potency rankings obtained were as follows: wild plum > wild olive > colpoon > blueberry > christmas berry > crossberry > waterberry > cranberry > tortoise berry > bietou > num-num > sour fig. Blueberry and cranberry ranked 5th and 9th, respectively. It was shown that by introducing servings of as little as 25 g of wild plum, waterberry, num num or sour fig into the diet, the daily antioxidant intake can be boosted to within an acceptable range to support health. All of these freely available fruits are known and have been traditionally used by rural communities in South Africa.
Source: South African Journal of Clinical Nutrition 29, pp 157 –164 (2016) http://dx.doi.org/10.1080/16070658.2016.1217646More Less
Human milk is the preferred feed for preterm infants, yet it may need to be fortified for optimal growth and development. Standard fortification of human milk seldom meets the recommended intake of protein, leading to inadequate post-natal growth. This article aims to critically review different human milk fortification strategies with a focus on in-hospital growth of premature infants in resource-limited settings. Super, adjustable and target fortification are compared to standard fortification. Different growth outcome parameters limit comparability of findings, but super fortification and adjustable fortification present opportunities to explore. More uniform growth outcome assessment is recommended. Practical implementation and cost-effectiveness in the local setting need to be investigated.
Nutrition-related cancer prevention knowledge of undergraduate students at the University of Ibadan, NigeriaSource: South African Journal of Clinical Nutrition 29, pp 165 –171 (2016) http://dx.doi.org/10.1080/16070658.2016.1217648More Less
Objective: This study assessed the nutrition-related cancer prevention knowledge and dietary pattern of undergraduate students.
Design: A cross-sectional study design was employed.
Setting: The University of Ibadan campus, Ibadan, Oyo state, Nigeria.
Participants: A systematic random sampling of 367 undergraduate students was done.
Method: A pretested self-administered questionnaire assessed the nutrition-related cancer prevention knowledge of the participants based on WCRF/AICR guidelines. A food frequency questionnaire was used to evaluate the dietary pattern. Weight, height, waist and hip circumferences, body mass index and waist:hip ratio were measured and computed based on standard procedures.
Results: Less than half (49%) had good nutrition-related knowledge of cancer prevention. About 30.0–40.0% frequently consumed legumes/nuts, vegetables and fruits respectively. About 75.0% frequently consumed processed cereals and grains (white rice, white bread and noodles). Above 20.0% were overweight, while 3.8% were obese. Less than 75.0% had low risk of abdominal obesity while 25.5% had high risk of abdominal obesity. Nutrition knowledge of cancer prevention was associated with the frequency of consumption of processed cereals and grains (χ2 = 13.724; p= 0.000), legumes/nuts (χ2 = 17.268; p = 0.000), meat (χ2= 22.972; p = 0.000), fish χ2 = 23.017; p = 0.000), pastry snacks (χ2 = 36.159; p = 0.000) and sugary drinks (χ2= 6.432; p = 0.011). There was no significant difference in knowledge of cancer prevention and the frequency of consumption of roots and tubers, milk, vegetables, and fruits. A higher risk of abdominal obesity was associated with infrequent consumption of legumes/nuts (χ2= 7.001, p = 0.008) in the males, and with vegetables (χ2= 6.771, p = 0.009) and fruits (χ2= 4.205, p = 0.040) intakes in the females.
Conclusion: Nutrition-related knowledge of cancer prevention was low, and the respondents also had a poor dietary pattern. The high risk of abdominal obesity may be a pointer to the larger young adult population, emphasising a need for targeted intervention.
Source: South African Journal of Clinical Nutrition 29, pp 172 –173 (2016) http://dx.doi.org/10.1080/16070658.2016.1217649More Less
Despite the numerous interventions for the amelioration of socio-economic status and food security in Africa, the output still does not show any significant effect, leaving people to wonder if it will ever be possible to eradicate poverty and malnutrition in that part of the world. Malnutrition can effectively be eradicated but it will all depend on the strategies put in place as well as the monitoring systems, coordination and resources available for their proper functioning. In Cameroon, the situation keeps deteriorating with an estimated 229 000 cases of malnourished children (34% being severe cases) noted at the start of 2015, compared to 186 000 cases noted in 2014 (29% being severe cases). It was also noted that 8 out of 10 cases of malnutrition came from the North and Far North regions of Cameroon with more than half of the remainder coming from the East region of the country.