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- Volume 22, Issue 2, 2009
South African Journal of Clinical Nutrition - Volume 22, Issue 2, 2009
Volumes & issues
Volume 22, Issue 2, 2009
Source: South African Journal of Clinical Nutrition 22 (2009)More Less
In the "bubble" era we all leave in we have experienced the bursting of the ".com", "property market" and the "global economy" bubbles. Indeed, we have experienced the consequences of these events, with the full impact of some of these bubbles still to be felt by our society at large.
A perspective on the inappropriate infant feeding practices observed among KwaZulu-Natal mothers : professional expectations clash with human nature's realities : editorialSource: South African Journal of Clinical Nutrition 22, pp 56 –57 (2009)More Less
In sum, the solution framework proposed by Ghuman et al confirms our quixotic penchant for tilting at the windmill of adherence to exclusive breast-feeding. Rather than relying on a single champion on the battlefield against MTCT, a broad phalanx of actors, taking actions backed by evidence of efficacy, will finally shore up the weaknesses of human nature in confronting the passage of the HIV to the generation being born daily in KwaZulu-Natal and across sub-Saharan Africa.
Use of the South African Food Composition Database System (SAFOODS) and its products in assessing dietary intake data : part II : invited reviewSource: South African Journal of Clinical Nutrition 22, pp 59 –67 (2009)More Less
A number of dietary research methodologies are available for the collection of quantitative dietary intake data. The methods most often used in South Africa include the 24-hour dietary recall, the quantitative food frequency questionnaire, and the dietary intake record. To quantify dietary intake, the information typically required includes the energy and nutrient composition of foods commonly consumed in South Africa. The South African Food Composition Database System (SAFOODS) and its products, e.g. the printed tables and software program FoodFinder3, provide the researcher with the tools to convert food intake data into energy and nutrient(s) intake. FoodFinder3 can be used for the nutrient analysis of the data. It also enables the user to export the data to MS Excel for further analysis and for importing the data into other statistical packages. Coding for the type and quantity of food consumed is required however before the data can be electronically analysed. The Food Quantities Manual of the Medical Research Council provides the necessary information for the conversion of food intake data recorded in household measures into grams of food. To ensure that the quality of the dataset is high, several steps have to be undertaken before statistical analysis and reporting of the data can take place. Appropriate statistical methods are required for the analysis of the data as nutrient intake data are often skewed. Using a standardised protocol, validated questionnaires and the South African Food Composition Database (SAFOOD) for the analysis of dietary intake data could make the pooling of data from small scale or regional studies possible. This may impart an impression of energy and nutrient intake at the national level, and could, at least in part, compensate for the absence of regular national surveys.
What factors determine the use of the nutrition information on the food label when female consumers from Pietermaritzburg select and purchase fat spreads? : original researchSource: South African Journal of Clinical Nutrition 22, pp 69 –73 (2009)More Less
Objectives: This study set out to determine the following in relation to the nutrition information on the food labels of selected fat spreads: the demographic profile of female consumers using the food label, reasons for food label use and whether the use of the food label leads to the purchase of the selected fat spreads.
Methods: One hundred and fifty women aged 25 to 45 years were chosen using an accidental, non-probability sample of consumers shopping at selected supermarkets in Pietermaritzburg. Consenting subjects were presented with a questionnaire to determine their demographic characteristics as well as their reasons for purchasing the selected fat spreads. Descriptive statistics and principal component analyses were used to analyse the results of this study.
Results: Fifty-five per cent (n = 82) of this study sample reported using the nutrition information label to assist with their purchases and 68% (n = 102) found the nutrition information important when purchasing a new product.
Conclusions: The female consumer most likely to use the nutrition information on the food label had a tertiary education; was a primary food purchaser; lived with other people; had more money per month to spend on food; and was conscious of choosing the healthier option. Principal component analysis revealed that the purchase of a selected fat spread was influenced by a number of variables reflecting health awareness, the selected fat spread's marketing, presentation and popularity, and familiarity with and cost awareness of the selected fat spread.
Infant feeding practices in a high HIV prevalence rural district of KwaZulu-Natal, South Africa : original researchSource: South African Journal of Clinical Nutrition 22, pp 74 –79 (2009)More Less
Aim: To describe infant feeding practices at birth and at 14 weeks post-partum in the Ugu-North Health District, KwaZulu-Natal, South Africa.
Methods: A prospective, cohort study design was used. Mothers who delivered over a one-month period were interviewed at birth and 14 weeks later.
Results: Initially, 168 mothers were interviewed within 24 hours of delivery, of whom 117 (70%) were contactable at 14 weeks post-partum. The vast majority (96%) initiated breast-feeding at birth. At birth, less than one-third (55/168 [32.7%]) of mothers declared an intention to both breast and formula (mix) feed in the next 14 weeks, but by the 14th week post-partum over three-quarters (89/117 [76.1%]) actually practised mixed feeding. At 14 weeks, the prevalence of exclusive breast-feeding was 18%: 52% of infants were offered water and 73% solids. The majority (20/23 [87%]) of HIV infected mothers chose to breastfeed their infants at birth. Nevertheless, they were significantly more likely to formula feed their infants compared to HIV negative mothers (3/23 [13.0%] vs 2/145 [1.4%], OR 10.73, 95% CI 1.34 - 99.16, p = 0.02). By 14 weeks, only 11% of HIV positive mothers were still exclusively breast-feeding, while almost two-thirds (12/19 [63%]) practised mixed feeding. This change was mainly ascribed to their need to return to school (40%) or to work (20%).
Conclusions: Most infants were fed inappropriately by 14 weeks of age. The failure to maintain exclusive breast-feeding, despite high initiation rates, is of greatest concern. Routine prevention of mother-to-child transmission of HIV services was ineffective in influencing mothers to follow any feeding regimen exclusively.
Osmolality of modified enteral tube feeds for adults in hospitals across the Western Cape Province : original researchSource: South African Journal of Clinical Nutrition 22, pp 81 –87 (2009)More Less
Objectives: The first aim of this study was to determine the incidence of use, reasons for use, and procedures / recipes followed in modifying enteral tube feeds (ETFs) for adults in state and private hospitals across the Western Cape Province (WCP), South Africa (baseline data). The second aim was to determine the osmolality of the modified ETFs used by these hospitals (osmolality data).
Design: A descriptive cross-sectional study.
Setting and subjects: The study was conducted in January / February 2007. The baseline data was collected by means of a coded questionnaire sent to all state and private hospitals in the WCP (n = 111), excluding all children's hospitals. The osmolality data was obtained by means of freeze-point depression of the modified ETF recipes obtained from the participating hospitals.
Results: A total response rate of 94% was obtained. Of the participating hospitals (n = 104), 48% were state (n = 50) and 52% were private hospitals (n = 54). Sixty-two per cent of hospitals (n = 64) made use of ETFs, with 25% modifying their feeds (n = 16). Twelve recipes were obtained for the osmolality testing. Eight recipes (66%) were significantly lower (p < 0.001), two (16%) were significantly higher (p < 0.001) and two of the recipes did not differ from the standard enteral product. Eight recipes (66%) had a significantly higher average osmolality (p < 0.001) than that of body fluid. The concentrated ETF recipe (1.43 kcal/ml) had the highest osmolality (707 mOsm/kg/H20).
Conclusions: Modular ETFs had lower average osmolality than those of the semi-modular and the standard enteral products, and of body fluid (300 mOsm/kg/H20).
The risk of developing malnutrition in people living with HIV / AIDS : observations from six support groups in Botswana : original researchAuthor M.S. NnyepiSource: South African Journal of Clinical Nutrition 22, pp 89 –93 (2009)More Less
Objectives: The objectives of this study were 1) to determine the proportion of people living with HIV / AIDS (PLWHA) at risk of developing malnutrition, 2) to determine the prevalence of malnutrition (BMI < 18.5 kg/m2), and 3) to describe the dietary intake and other nutrition parameters of PLWHA with membership in support groups.
Design: Descriptive cross-sectional study.
Setting: Six support groups in Gaborone and neighbouring locations.
Subjects: Consenting, free-living HIV-positive adults 20 to 50 years of age with membership in support groups for PLWHA.
Outcome measures: The subjects' risk of developing malnutrition was established using a modified subjective global assessment (SGA) screening tool. Subjects with an SGA score ≥ 4 were classified as being at high risk of developing malnutrition.
Results: From 145 PLWHA screened, 47.5% (n = 69) were found to be at high risk of developing malnutrition (SGA score ≥ 4) and 28.5% (n = 41) were malnourished (BMI < 18.5 kg/m2). In the sample with SGA scores ≥ 4, 52.2% (n = 35) presented with a BMI < 18.5 kg/ m2. These two groups also reported more unintentional weight loss, gastrointestinal symptoms, and other conditions commonly associated with a high risk of developing malnutrition. PLWHA with membership in support groups also had low educational attainment and high unemployment rates. A total of 47% of subjects with an SGA score ≥ 4 needed food assistance.
Conclusions: Almost 50% of PLWHA with membership in support groups for PLWHA are at risk of developing malnutrition, while about 30% have a BMI < 18.5kg/m2. Nutrition screening can also help to identify those PLWHA with a BMI > 18.5 kg/m2 who are still at high risk of developing malnutrition. Timely nutrition interventions can therefore be instituted in order to prevent deterioration in nutritional status.
Dietary intake and metabolic control of children aged six to ten with type 1 diabetes mellitus in KwaZulu-Natal : original researchSource: South African Journal of Clinical Nutrition 22, pp 95 –98 (2009)More Less
Objectives: The objective of this study was to assess the dietary intake and metabolic control of children with type 1 diabetes.
Design: A cross-sectional observational study was carried out.
Subjects: A total of 30 subjects whose ages ranged from six to ten years were included in the study.
Setting: The study was conducted at the Paediatric Diabetic Clinics at Grey's Hospital, Pietermaritzburg and Inkosi Albert Luthuli Central Hospital (IALCH), Durban, in KwaZulu-Natal. Outcome measures: Dietary intake was assessed using a three-day dietary record. Metabolic control was assessed using glycosylated haemoglobin (HbA1c).
Results: The mean percentage contributions of macronutrients to total energy as determined by the three-day dietary records were as follows: carbohydrate - 52%; added sucrose - 2%; protein - 16%; fat - 32%. The mean intakes were similar to the recommendations of the International Society for Pediatric and Adolescent Diabetes (ISPAD) Consensus Guidelines (2002). Micronutrient intake was generally adequate. The mean latest glycosylated haemoglobin (HbA1c) for the sample as at the time of the study was 9.7%. Five of the thirty subjects had HbA1c values that were within the recommended levels for children with type 1 diabetes.
Conclusions: The macronutrient intake in this sample was found to be similar to the ISPAD Consensus Guidelines (2002) while micronutrient intake was adequate in most cases. Overall the sample had poor metabolic control.
Author Duduzile MthuliSource: South African Journal of Clinical Nutrition 22 (2009)More Less
The ADSA executive committee's term of office will end at the end of June. This committee has served for three years from July 2006 till June 2009. Let's look back at the highlights of this committee's term of office. ADSA membership has increased from 1 138 to 1 202 during the term of office.