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- Volume 19, Issue 2, 2006
South African Journal of Clinical Nutrition - Volume 19, Issue 2, 2006
Volumes & issues
Volume 19, Issue 2, 2006
Source: South African Journal of Clinical Nutrition 19 (2006)More Less
South African eating patterns have shifted from undernutrition to overnutrition in the last 40 years, with increases in the average per capita intake of calories by about 300 kilocalories or 12%, from 2 603 kilocalories per day in 1962 to 2 921 kilocalories in 2001, as well as in the amounts of fat (from 61.2 g to 79 g), proteins (from 68.4 g to 75.1 g) and carbohydrates (from 445 g to 478 g).
Community health workers can play an important role in the prevention and control of non-communicable diseases in poor communitiesAuthor H. Salome KrugerSource: South African Journal of Clinical Nutrition 19, pp 52 –54 (2006)More Less
Countries in transition, such as South Africa, are particularly affected by the increased prevalence of obesity across all economic levels and age groups. Shifts in dietary intake and physical activity patterns to higher fat intake and inactivity are thought to be contributing factors. Prevention and treatment of obesity is therefore necessary to prevent the development of non-communicable diseases (NCDs). Such interventions should be based on education, behaviour change, community participation and local action. In this regard, adequately resourced prevention and intervention programmes should be planned, monitored and evaluated properly.
Source: South African Journal of Clinical Nutrition 19, pp 56 –62 (2006)More Less
Background. Community health workers (CHWs) are lay people trained to assist with health care in their communities. This study took place at two sites in Khayelitsha, a township in the Cape Peninsula, from 2000 to 2002.
Objectives. To describe the process of developing an intervention programme for primary prevention of noncommunicable diseases (NCDs) in general and cardiovascular disease in particular, targeting CHWs.
Method. Forty-four CHWs were assigned to either an intervention or a control group. The intervention group, living in Site C, received training on lifestyle modification with emphasis on healthy eating and physical activity, while the control group, living in Site B, did not receive any training until a year later. The process was undertaken in four stages. Stage 1 involved assessment of the CHWs' risk factors by obtaining anthropometric measurements. CHWs were interviewed and focus group discussions were held on the socio-cultural factors associated with body weight and body image, and barriers to physical activity. Stage 2 involved developing and implementing a training programme for primary prevention of NCDs among CHWs. Stage 3, conducted at Site C, involved a situational assessment of available resources in the community for promoting healthy lifestyles. The fourth and final stage involved the implementation of community interventions by the CHWs.
Results. A large percentage of CHWs were overweight and obese, and therefore at risk for NCDs. They had misconceptions about causes and treatment of these diseases, and also lacked knowledge on nutrition and the risk of high fat intake. Easy access to cheap unhealthy food, rather than fresh fruit and vegetables, limited their ability to make healthy food choices. The findings from stage 1 led to a community participatory intervention.
Conclusions. Developing community-targeted interventions for NCDs can be achieved by involving CHWs at the initial stage and utilising a multifaceted approach. Education of community members and CHWs does not guarantee behaviour modification. Unless the environment encourages healthy living, NCDs will continue to be a burden in the poor populations of South Africa.
Foods and beverages that make significant contributions to macro- and micronutrient intakes of children in South Africa - do they meet the food-based dietary guidelines?Source: South African Journal of Clinical Nutrition 19, pp 66 –76 (2006)More Less
Objective. The aim of this study was to determine which foods and beverages contribute most (≥ 5% of total) to energy, macronutrient and micronutrient intakes of South African children aged 12 - 108 months. It was also our intention to evaluate the dietary content according to the Food-Based Dietary Guidelines (FBDGs) (2001) for South Africans aged 7 years and older. Low energy and micronutrient intakes are widespread in South Africa and it is important to examine which foods are currently contributing to nutrient intake in order to make appropriate suggestions regarding dietary improvements.
Methods. The National Food Consumption Survey was undertaken in 1999 on a representative sample of children aged 12 - 108 months (N = 2 818). Dietary intake of each participant was determined by means of a 24-hour recall undertaken with the primary caregiver of the child. Dietary aids were used to assist in the determination of portion sizes of foods and drinks consumed. The FoodFinder database was used to determine the dietary composition of the dietary intake according to local food tables. Statistical analyses involved calculating the percentage contribution of different food items towards total intake of each specific nutrient.
Results. Only a few food items contributed significantly to the intakes of many nutrients. Maize porridge and bread contributed 27% and 14.8% to total energy, 19.1% and 15.7% to protein and 40% and 17.2% to carbohydrate intake, respectively. In terms of micronutrients, maize porridge and bread contributed 10.9% and 15.6% to iron, 14.9% and 16.9% to zinc, 9.8% and 19.5% to niacin and 37.6% and 15.6% to thiamin intake. In terms of the FBDGs, guidelines not being met were those aimed at improving variety of foods eaten, increasing fruit and vegetable intake, increasing legume intake, and eating more animal foods. Ones that were being met were making starches the basis of most meals, and using fats sparingly.
Conclusion. Maize and bread contributed significantly to macronutrients and most micronutrients, with the exception of calcium. Food fortification of these items will increase these values significantly. The diet of children in South Africa (12 - 108 months) in 1999 was found to have little variety, was low in fat and animal foods, particularly dairy foods, and contained a low intake of legumes, fruit and vegetables.
Source: South African Journal of Clinical Nutrition 19, pp 80 –85 (2006)More Less
Objectives. To explore and describe eating attitudes in early pubertal 11-year-old black and white South African girls in an urban environment undergoing transition.
Design. The study was designed as a cross-sectional baseline initiative within a longitudinal study.
Subjects. Two hundred and two subjects were randomly selected; 54 were white and 148 black.
Methods. Subjects completed questionnaires, and anthropometric measurements were taken.
Outcome measures. Variables included body mass index (BMI), eating attitudes (EAT score), dietary intake, socio-economic status, pubertal status and level of physical activity.
Results. As expected, the prevalence rate of abnormal eating attitudes in this group of girls was low (1%). No significant ethnic differences were found in the total EAT scores. White participants displayed greater oral control, while their black peers displayed greater tendencies toward dieting (p = 0.05). Girls who scored higher on the dieting subscale had a larger body size and were more inactive than low dieting scorers (p = 0.05). A relationship between body size measurements and dietary intake was found only in black girls. Traditionally a larger figure is accepted in black culture. However our data suggest a move away from this, indicating acculturation, as awareness of increased body size significantly influenced dieting attitudes. However, scores were within the normal range.
Conclusions. There is early evidence suggesting the impact of societal transition on young black girls with regard to eating attitudes. Black girls in this age group are adopting Western ideals of beauty and thinness.
Potential health risks of folic acid supplementation of 5 mg per day during pregnancy : correspondenceSource: South African Journal of Clinical Nutrition 19 (2006)More Less
To the Editor: We would like to express our concern regarding current prescriptions for folic acid supplementation for pregnant women in state hospitals. The current practice is that these women are advised to take a supplement containing 5 mg folic acid daily, which is over 10 times the recommended daily allowance (RDA) for pregnant women, i.e. 400 µg per day from supplements, and 5 times higher than the upper tolerable limit of 1 mg per day.
Source: South African Journal of Clinical Nutrition 19 (2006)More Less
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