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- Volume 23, Issue 4, 2010
South African Journal of Clinical Nutrition - Volume 23, Issue 4, 2010
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Volume 23, Issue 4, 2010
Source: South African Journal of Clinical Nutrition 23 (2010)More Less
Author Demetre LabadariosSource: South African Journal of Clinical Nutrition 23 (2010)More Less
In my message in June 2009, I concluded, in reference to higher education, with the hope that "the road ahead, exciting and promising as it seems to be, needs to be mapped with great care and wisdom, if the 'bubble' is not to burst". For a number of different reasons today, higher education internationally is characterised by events which include violent student demonstrations against the rise in tuition fees (promising to make higher education unaffordable to the majority) and limitations on student visas and jobs. There are also desperate and gloomy predictions that a third of universities face closure in the United Kingdom.
Author J.H. DownsSource: South African Journal of Clinical Nutrition 23, pp 177 –178 (2010)More Less
It is disappointing that, despite South Africa having the highest prevalence of HIV infection in the world, very few studies regarding the impact of nutritional interventions (more specifically, nutritional supplementation) on people living with HIV/AIDS (PLWHA) on antiretroviral therapy (ARV) have been published. The study published in this edition of the SAJCN, which was conducted in 2007 in five clinics in the Northern Cape Province to assess the nutritional status and the impact of nutritional supplementation, sought to address the paucity of data in the South African context regarding this subject.
Author S.B. CassimSource: South African Journal of Clinical Nutrition 23, pp 181 –185 (2010)More Less
The prevalence of overweight and obesity, particularly in children, raises serious attention to its causes and possible interventions. Food marketing to children has in recent years come under scrutiny as one of the putative factors responsible for the rising rates of obesity among children. This article addresses the global evidence base on the issue and explores policy interventions practised in the more developed world as well as the local challenges in dealing with the issue in South Africa. South African policymakers have a wide range of policy options based on international practice in committing to the health and well-being of its children.
Increased mining activities in the eastern Democratic Republic of Congo : an opportunity to improve the nutritional status of children under five-years-old : original researchSource: South African Journal of Clinical Nutrition 23, pp 186 –190 (2010)More Less
Introduction: Household poverty and poor access to health and other social amenities are key drivers of malnutrition and poor child health in most low-resources settings. The Democratic Republic of Congo (DRC), in the backdrop of past instability, experiences a host of socioeconomic factors that effectively result in malnutrition among under-five children - despite immense natural resources. Recent stability and enormous mineral resource wealth has attracted mining companies to invest in the eastern provinces of the country, presenting an opportunity to improve the nutritional and overall health status of children in the region. We therefore sought to describe the prevalence of malnutrition in the region, cognisant of these developments.
Methods: Seven hundred and sixty-two under-five children from 420 households in two districts in the eastern DRC were assessed in this survey. We calculated their malnutrition indicators and made comparisons between semi-urban and rural children; taking semi-urban as a good proxy for populations within the coverage of mining activities. For each indicator, all children whose appropriate parameters were available were included in the evaluation with a plausible z-score.
Results: An estimated 21.5% (95% confidence interval [CI]: 18.5-24.5) of the children assessed were found to be underweight, with 6.8% being severely underweight. However, the prevalence of wasting among these children was estimated at 5.8% (95% CI: 4.1%-7.6%), which was lower than the national average of 16%. Of significance, the age groups six to 11 and 12 to 23 months were found to be more wasted compared to other age categories. Within the six- to 11-months age category, rural children fared better than their semi-urban counterparts at 5% (95% CI: 0%-13%) and 14.6% (95% CI: 13.6%-25.6%) respectively.
Conclusion: We conclude that malnutrition among under-five children is a significant problem in the eastern DRC. Business investment in the region offers real opportunities to comprehensively address these pressing challenges that face communities. Businesses keen to address malnutrition need to be cognisant of the prevalence of the problem and its contextual drivers, particularly on the socio-economic front, to be able to conceptualise appropriate responses.
Breastfeeding pattern, anthropometry and health status of infants attending child welfare clinics of a teaching hospital in Nigeria : original researchSource: South African Journal of Clinical Nutrition 23, pp 191 –196 (2010)More Less
Objective: To determine the breastfeeding pattern and its relationship with the physical growth and health status of infants aged 0-24 weeks.
Design and setting: A prospective cohort study was carried out at three comprehensive health centres of Nnamdi Azikiwe University Teaching Hospital, Anambra State (Nigeria) from September 2006 to June 2007. The feeding pattern, body weight, length and morbidity of 228 infants were assessed at birth, 6, 10, 14, 20 and 24 weeks when they visited the child welfare clinics for routine immunisations or on appointment. The infants were recruited from the immunisation registers by a systematic random sampling method. Based on their current feeding pattern during the period under study, infants were classified into exclusive breastfeeding (EBF) and non-exclusive breastfeeding (non-EBF) groups. Data analysis was carried out using SPSS and Epi Info statistical computer software. A probability value (p-value) of less than 0.05 was considered statistically significant.
Results: The EBF rate declined progressively from 64.9% at birth to 37.3% at 24 weeks of age. Maternal older age, multiparity and delivery at a government health facility were positively associated with higher rates of EBF (p < 0.05). Only 110 (48.2%) babies were put to the breast immediately (≤ 1 hour) after delivery. The numbers that received colostrum and prelacteal feed were 118 (82.5%) and 59 (25.9%), respectively. On-demand breastfeeding was more popular than timed feeding (95.5% vs 7.5%; p < 0.05). At 24 weeks of age EBF males and females achieved a better and more rapid growth in weight and length compared to those in the non-EBF group (p = 0.000). Episodes of diarrhoea and fever were significantly associated with non-EBF (p = 0.000).
Conclusion: The study revealed that EBF had a positive effect on the physical growth and health status of infants, but the rate of EBF was low. It is suggested that activities that promote appropriate breastfeeding practices should be targeted at mothers and locations in which poor breastfeeding practices exist.
Nutritional status of HIV-infected adults on antiretroviral therapy and the impact of nutritional supplementation in the Northern Cape Province, South Africa : original researchSource: South African Journal of Clinical Nutrition 23, pp 197 –201 (2010)More Less
Objectives: The study aimed to describe the nutritional status and determine the impact of current nutrition intervention strategies on weight changes in adult HIV-infected patients on antiretroviral (ARV) therapy.
Design: A descriptive, prospective trial was performed.
Setting: The investigation was conducted at ARV roll-out centres in Kimberley, Upington, Kuruman, Prieska and Springbok in the Northern Cape Province of South Africa.
Subjects: Adult HIV-infected patients receiving ARV therapy were included in the study.
Outcome measures: Each participant's body mass index (BMI) was determined before and after a four-month intervention period of nutritional supplementation with an instant, enriched maize product.
Results: Data from 98 patients (mean age 39.7 years; standard deviation 8.9 years) were assessed. Prior to intervention, the median BMI was 20 kg/m2 (range 12.6-29.7 kg/m2); the patients from Kuruman had a greater incidence of underweight compared to the other towns, with a median BMI of 17.9 kg/m2. Of the 87 patients assessed during the final week, 49.4% experienced weight gain and 40.2% lost weight. Eighteen (20.7%) patients gained more than 5% of their baseline weight, which was significant. Only eight (9.2%) patients lost more than 5% of their baseline weight. Twenty-two patients who presented with a BMI < 18.5 kg/m2 at baseline had a median weight gain of 1.13 kg during the intervention period, while the group with a BMI > 18.5 kg/m2 presented with no change in median weight.
Conclusions: Nutritional supplementation, provided according to provincial policy and combined with ARVs, nutritionally benefitted about half of the patients in the ARV programme in the Northern Cape.
Risk factors of poor anthropometric status in children under five years of age living in rural districts of the Eastern Cape and KwaZulu-Natal provinces, South Africa : original researchSource: South African Journal of Clinical Nutrition 23, pp 202 –207 (2010)More Less
Objectives: Factors associated with children's anthropometric status were determined.
Design: Secondary analysis was done using data from a cross-sectional survey including children under five years of age (n = 2 485) and their mothers in rural districts of the Eastern Cape and KwaZulu-Natal provinces, South Africa.
Methods: Data generated by questionnaire and anthropometric indices were used to construct a logistic regression model, taking into account hierarchical relationships of risk factors to determine the odds of a child being stunted, underweight or overweight. Statistical significance was set at p < 0.05.
Results: Factors associated with stunting were child of male gender (odds ratio (OR) = 1.233), the mother's perception that child was not growing well (OR = 1.346), household receiving no food handouts (OR = 0.719) and mother not making important household decisions (OR = 0.760). Underweight was associated with child of male gender (OR = 1.432), low maternal education (OR = 1.720), mother's perception that child was not growing well (OR = 2.526), any current breastfeeding (children < 24 months: OR = 2.022), and prior gastrointestinal symptoms (OR = 1.527). Factors associated with child overweight were the household not having a regular source of income (OR = 1.473), low maternal education (OR = 0.595) and mother's perception that child is not growing well (OR = 0.361).
Conclusion: Boys were more likely to be stunted and/or underweight. Children of mothers with less than five years schooling were more likely to be underweight. A regular source of household income was associated with child overweight/obesity.
Source: South African Journal of Clinical Nutrition 23 (2010)More Less
The Fourth African Nutritional Epidemiology Conference (ANEC IV) was held in Nairobi, Kenya, 4-8 October 2010. The theme for the conference was Nutrition and Food Security: Successes and Emerging Challenges. A highlight was the presentation of the 2010 EV McCollum International Lectureship in Nutrition, by the American Society of Nutrition, to Professor Andrew Prentice at the conference. The title of the acceptance lecture by professor Prentice was Trials and tribulations: unexpected outcomes from micronutrient interventions, and the need for more mechanistic research. Other keynote speakers included Professors Alan Jackson, David Thurnham, Ken Brown, Charlotte Neumann, Suzanne Filteau, Regina Moench-Pfanner, Anna Lartey and Adelheid Onyango.