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- South African Journal of Clinical Nutrition
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- Volume 22, Issue 1, 2009
South African Journal of Clinical Nutrition - Volume 22, Issue 1, 2009
Volumes & issues
Volume 22, Issue 1, 2009
Promotion, protection and support of exclusive breast-feeding (EBF) - how to change a normative behaviour into a reality? : editorialAuthor J.N. MatjiSource: South African Journal of Clinical Nutrition 22, pp 6 –7 (2009)More Less
Author A. PrinsSource: South African Journal of Clinical Nutrition 22, pp 9 –15 (2009)More Less
The incidence of burn injuries is on the increase in Africa due to migration to urban areas and the development of slum areas, but there is a paucity of such data on the African continent. The South African Medical Research Council has indicated that 3.2% of the South African population is burned annually, with 50% of individuals who suffer burns being younger than 20 years. The Red Cross Children's Hospital admits 650 to 900 children with burn injuries annually.
Burn injury, the most severe type of injury from a metabolic point of view, is characterised by the most profound alterations in basal metabolic rate and urinary nitrogen excretion. In addition, requirements for and / or metabolism of macro- and micronutrients are altered or increased. The major improvement in burn survival can be attributed to many factors, one being the development and implementation of improved methods of nutritional support that optimise host defences, enhance wound healing and support the metabolic response to stress. The greatest threats to survival from burns are still infection / sepsis, with burn wound sepsis and nosocomial pneumonia, including ventilator-associated pneumonia (VAP), being the leading causes of death. Effective medical nutrition therapy in patients with burn injuries requires an understanding of the physiologic and metabolic alterations that accompany the burn injury, alterations in the immune system and the role of reactive oxygen species (ROS).
Knowledge, attitudes and practices regarding iodine among patients with hyperthyroidism in the Free State, South Africa : original researchSource: South African Journal of Clinical Nutrition 22, pp 18 –21 (2009)More Less
Objectives: To gather baseline information on the knowledge, attitudes and practices regarding iodine and iodised salt among patients with hyperthyroidism in the Free State.
Subjects and Setting: The study was part of a large cohort study that included the first 96 patients aged 13 years or older diagnosed with hyperthyroidism and referred to Universitas Academic Hospital in Bloemfontein, South Africa during 2005.
Methods: The patients were interviewed in their language using a structured validated questionnaire. Descriptive statistics were used for data analysis.
Results: The majority of the patients (86.9%) did not know what iodine was. Similarly, a higher percentage of patients (76.7%) were unaware of the most important or main source of iodine in the food of South Africans. Regarding knowledge of the most important harmful effect on the health of children if they did not get enough iodine, almost all of the patients (89.1%) did not know what it was. Ninety-five per cent of salt was obtained from the local shops, and only 36.1% of the patients read the labelling on the package during purchase. A very small proportion of patients (1.6%) stored salt in closed containers and away from sunlight, while about half of them (49.2%) stored salt in open containers without lids, 36.1% stored it in rigid plastic containers with holes at the top, and 13.1% stored it in the open plastic bags in which the salt was bought.
Conclusions: Patients with hyperthyroidism lacked knowledge of iodine, as well as of the storage of iodised salt, and this could have contributed to the persisting endemic goitre reported in previous studies. An aggressive awareness programme, targeting policy makers and the public, is recommended to ensure sustainable elimination of iodine deficiency disorders in South Africa.
The metabolic profiles of HIV-infected and non-infected women in Mangaung, South Africa : original researchSource: South African Journal of Clinical Nutrition 22, pp 23 –28 (2009)More Less
Objective: To determine the biochemical nutritional status of HIV-infected women in Mangaung.
Setting: The community of Mangaung, Free State, South Africa.
Subjects: A representative group of 500 black women (25-44 years) was selected randomly to participate.
Outcome measures: Biochemical analyses were performed for total lymphocytes, serum protein, serum albumin, plasma fibrinogen, serum insulin, serum glucose, serum triglycerides and serum cholesterol using standard methodology. Values were compared to standard references, and between HIV-infected and HIV-uninfected women.
Results: After screening for eligibility, 488 women qualified. Sixty-one per cent of the younger women (25-34 years) and 38% of the older women (35-44 years) were HIV-infected. HIV-infected women had significantly lower median blood values for total lymphocytes (p = 0.0001 and p = 0.02 for younger and older group respectively) and serum albumin (p = 0.0001 for both age groups), but significantly higher median concentrations of serum protein (p = 0.0001 for both age groups) than uninfected women. Plasma fibrinogen and serum insulin concentrations were significantly lower in HIV-infected younger women than in their uninfected counterparts (p = 0.002 for both parameters). Older HIV-infected women had significantly lower total serum cholesterol values (p = 0.01) than older HIV-uninfected women. Serum glucose and serum triglycerides did not differ significantly between HIV-infected and HIV-uninfected women.
Conclusions: The results indicate a possible impact of HIV infection on serum protein and serum albumin, which may adversely affect biochemical nutritional status and the course of HIV progression. Future research into the causes and possible treatment of metabolic changes in women in this community should be prioritised.
Development of a Malian food exchange system based on local foods and dishes for the assessment of nutrient and food intake in type 2 diabetic subjects : original researchSource: South African Journal of Clinical Nutrition 22, pp 31 –35 (2009)More Less
Objective: To develop exchange lists for the assessment of food and nutrient intakes for people with diabetes in Mali.
Design: Based on North American exchange lists, a Malian food exchange system was developed using food composition tables for Mali. Dietary intakes were assessed by two 48-hour dietary recalls. Daily numbers of exchanges were determined for the whole sample and for each gender. Energy and macronutrient intakes obtained by a software-based nutritional analysis of the dietary recalls were compared with the average energy and nutrient values calculated with the exchange lists.
Setting: Centre National de Lutte contre le Diabète.
Subjects: Seventeen male and 40 female adults with type 2 diabetes.
Results: The analysis of food recalls using the Malian exchange system showed that subjects consumed the following numbers of exchanges per day: 2.6 ± 1.5 meat and substitutes, 0.5 ± 0.8 legumes, 0.7 ± 1.2 milk, 8.0 ± 4.1 fat, 8.3 ± 3.0 starch, 1.5 ± 0.9 vegetables, 0.2 ± 0.5 fruit, and 0.0 ± 0.2 sugar-added foods, totalling 1 854 ± 648 kcal, 260 ± 92 g carbohydrate, 56 ± 23 g protein and 63 ± 31 g fat. These results concerning energy and macronutrients did not differ significantly from those obtained from the nutritional analysis of food recalls with software using data from the Food Composition Table for Mali. Compared to women, men consumed significantly larger numbers of exchanges of meat and substitutes, fat, starch, and fruit. No significant differences were found for the intakes of legumes, milk, vegetables and sugar-added foods.
Conclusions: This study allowed the development of Malian food exchange lists and demonstrated their usefulness for the description of the dietary pattern and energy and macronutrient intakes of male and female Malian type 2 diabetic patients.
Factors influencing high socio-economic class mothers' decision regarding formula-feeding practices in the Cape Metropole : original researchSource: South African Journal of Clinical Nutrition 22, pp 37 –44 (2009)More Less
The aims of the study were to identify the reasons why high socio-economic class women in the Cape Metropole decide not to breast-feed; to evaluate whether the type and volume of infant formula selected by the mother was appropriate for her infant's current age and to identify the factors that influence the decision-making process when deciding which infant formula to feed her infant.
An observational descriptive study with consecutive sampling was utilised. Data of 55 mothers with infants aged 0 to 6 months that were not currently breast-fed was captured in day care centres and private clinics situated in the Cape Metropole. Data was collected by means of a self-administered questionnaire available in Afrikaans and English.
The majority of mothers (80%) decided only after the birth of their infant to rather opt for formula feeding. Evident factors that were identified as barriers to breast-feeding include a lack of knowledge and experience (38%) as well as a lack of facilities at public places (75%) and at work (71%) to breast-feed. Perceived benefits of infant formula included that the father could help with the workload (67%) and does not feel left out (38%), the mother knows what volume of milk is received (84%) and the convenience if the mother is working (64%). The mothers were overall not concerned about possible side-effects of breast-feeding and did not feel that their breasts were physically not of optimal physiology to breast-feed.
One of the greatest challenges to support, protect and promote breast-feeding is to ensure that information sources give scientifically correct information to the uninformed or information-seeking mother in a standardised and positive manner.
Author Rene SmalbergerSource: South African Journal of Clinical Nutrition 22 (2009)More Less
I would like to wish you and your families a prosperous 2009. May this year be a year of fulfillment in all areas of your life. May we as dietitians not see the challenges as obstacles, but may we find creative ways of overcoming society's obstacles, and make a significant difference in each of our community's nutrition.