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- Volume 20, Issue 1, 2007
South African Journal of Clinical Nutrition - Volume 20, Issue 1, 2007
Volumes & issues
Volume 20, Issue 1, 2007
Author Annatjie SmithSource: South African Journal of Clinical Nutrition 20, pp 4 –5 (2007)More Less
Children, who are the future of any country, need to be afforded the best opportunity for growth and development as well as the best possible nutrition options. Feeding is a shared social activity and is important for health and wellbeing. Individuals with developmental disabilities are known to be at increased nutritional risk. As such, feeding difficulties early in life should be regarded as clear warning signs from the point of view of disease prevention, and should also prompt the mother to seek expert advice from a health professional.
Source: South African Journal of Clinical Nutrition 20, pp 6 –14 (2007)More Less
Objectives. To assess the nutritional status of disabled schoolchildren using anthropometric measures and dietary intake, and to compare estimated energy expenditure with energy intake and body weight.
Design. A descriptive, cross-sectional survey was undertaken.
Setting. The study was conducted at three Bloemfontein schools for disabled children (Tswellang: physically disabled, Pholoho: mentally disabled, Martie du Plessis: both mentally and physically disabled).
Subjects. Subjects included a random selection of 145 boys and girls aged 8 - 15 years.
Outcome measures. Standard methods were used to determine height, demi-span, knee-height, weight, mid-upper arm circumference and triceps skinfolds. A 24-hour recall combined with a food frequency questionnaire and 7-day weighed food record were used to determine usual dietary intake of day scholars and hostel scholars respectively. Resting energy expenditure (REE) was calculated for each child using Shöfield equations. Total energy expenditure (TEE) was calculated by multiplying the appropriate physical activity level (PAL) factor by REE.
Results. The high prevalence of stunting (weight-for-height < -2 standard deviations (SD)) (Tswellang 47.7%, Pholoho 37.3%), and underweight (weight-for-age < -2 SD) (Tswellang 29.8%, Pholoho 18.7%) was a matter of concern. Although median energy intake was slightly lower than the recommended intakes, median protein intake tended to be adequate, while micronutrient intake was low. Median energy intake determined by the 24-hour recall tended to be lower (Pholoho -769 kJ) or nearly the same (Tswellang 327 kJ) as the calculated TEE (PAL 1.2 - 1.8).
Conclusion. Nutrient density and texture of the children's diet should be monitored to improve nutritional status. In future studies more accurate methods should be used to determine energy intake and expenditure.
Breastfeeding, complementary feeding and nutritional status of 6 - 12-month-old infants in rural KwaZulu-NatalSource: South African Journal of Clinical Nutrition 20, pp 16 –24 (2007)More Less
Objective. To determine breastfeeding, complementary feeding and nutritional status of 6 - 12-month-old rural infants.
Study design. A cross-sectional survey was done. Breastfeeding and complementary feeding practices were determined by questionnaire; an unquantified food frequency questionnaire was used to determine usual food intake. Biochemical assessment of nutritional status included determination of haemoglobin, serum retinol, ferritin and zinc concentrations. Body length and weight were measured.
Setting/subjects. Subjects included 505 infants aged 6 - 12 months living in the Valley of a Thousand Hills, a rural area in KwaZulu-Natal.
Results. Breastfeeding had been initiated in the case of 96% of the infants. Milk feeds at the time of the survey included breastmilk alone (58%), breastmilk plus bottle feeds (23%), and bottle feeds alone (18%). Formula feeds were either dilute (54%) or concentrated (14%). First solid foods given were maizemeal porridge (55%), infant cereals (32%), and ready-to-eat bottled baby foods (9%). Various energy-rich foods were added to the porridge for most of the infants. Biochemical data showed that 20% of infants had serum retinol levels < 20 µg/dl, 67% had serum ferritin levels < 12 µg/l, 49% had haemoglobin levels < 11 g/dl, and 32% had serum zinc levels < 60 µg/dl. Anthropometric data showed that 16% were stunted and 6% were underweight.
Conclusion. Inappropriate feeding practices and micronutrient deficiencies should be addressed. This can be done through the community health worker programme, provided that the community health workers have adequate knowledge of infant nutrition.
Source: South African Journal of Clinical Nutrition 20, pp 28 –36 (2007)More Less
Background. Poor nutritional status in HIV / AIDS patients can affect immune function profoundly, leading to faster disease progression and earlier death.
Objective. To determine the micronutrient intake of HIV-infected women in Mangaung.
Design and setting. A cross-sectional study was undertaken in Mangaung, Bloemfontein, Free State.
Subjects and methods. A representative group of 500 pre-menopausal women (25 - 44 years) was randomly selected to participate in the study. Micronutrient intake was determined using a Quantitative Food Frequency Questionnaire (QFFQ). Median micronutrient intakes were compared with the Recommended Dietary Allowance (RDA) or Adequate Intake (AI) values. The prevalence of women with intakes ≤ 67% of the RDA or AI was calculated. Median micronutrient intakes were compared between HIV-infected and uninfected women using non-parametric 95% confidence intervals (CIs) and the Mann-Whitney test.
Results. Sixty-one per cent of women in the younger age group (25 - 34 years) and 38% of older women (35 - 44 years) were HIV-infected. Between 46.6% and 70.7% of all women consumed ≤ 67% of the RDA or AI for calcium, total iron, selenium, folate and vitamin C. At least 25% of HIV-infected women did not meet either the RDA or the AI for vitamins A, D and E. Younger HIV-infected women had significantly higher intakes of calcium (p = 0.046), phosphorus (p = 0.04), potassium (p = 0.04), vitamin B12 (p = 0.01), vitamin D (p = 0.03) and vitamin E (p = 0.04) than their HIV-uninfected counterparts. Older HIV-infected women had significantly lower intakes of haem iron (p = 0.03), non-haem iron (p = 0.04) and selenium (p = 0.04) than their HIV-uninfected counterparts.
Conclusions. Insufficient micronutrient intakes are common in both HIV-infected and uninfected women. A well-balanced diet and micronutrient supplementation seem warranted to ensure optimal health and survival, particularly in HIV-infected women.
Source: South African Journal of Clinical Nutrition 20, pp 39 –44 (2007)More Less
The study aimed to determine whether knee height would be a more appropriate surrogate measurement than armspan in determining height and body mass index (BMI) in a group of South African older people (≥ 60 years). A random sample of adults (older than 18 years) who attended selected clinics or who lived in selected old-age homes in the Western Cape volunteered to participate in the study. Subjects were divided into a study group of older people (≥ 60 years of age, N = 1 233) and a comparative group of younger adults (18 - 59 years, N = 1 038). Armspan, knee height, standing height and weight were measured using standardised techniques. The standing height measurements were significantly different between the two groups (p = 0.0001), with a mean for adults of 1.61 m (standard deviation (SD) 0.09) compared with that of older peole (1.57 m (SD 0.09)). Mean standing height decreased with age. Knee-height measurements were not significantly different between the two groups, but when used to calculate height, the adults were significantly taller (p = 0.0001), with a mean height of 1.67 m (SD 0.06) compared with that of the older people (1.59 m (SD 0.08)). Mean armspan also decreased with age, and derived standing height was significantly different (p = 0.0001) between the two groups, with adults being taller (1.67 m (SD 0.11)) than the older people (1.63 m (SD 0.11)). In this study group, the knee-height measurements were more closely related to the standing height than the armspan. The BMI calculated from armspan-derived height tended to classify the older people towards underweight. Knee-height measurement would appear to be a more accurate and appropriate method to determine height in older people in South Africa.
Source: South African Journal of Clinical Nutrition 20 (2007)More Less
Dietetics is a uniquely diverse profession with practices in therapy, in the community and in food service management. It is because of the diversity of our training and the phenomenal change in the practice of dietetics that continued communication and learning are necessary. I would like to first congratulate all dietitians on being able to substantiate their participation in continued professional development to the HPCSA. The HPCSA CPD audit was undertaken in 2006. Of the 592 forms that were submitted to the HPCSA, 94% of dietitians were found to be compliant.