- A-Z Publications
- South African Journal of Clinical Nutrition
- Previous Issues
- Volume 26, Issue 3, 2013
South African Journal of Clinical Nutrition - Volume 26, Issue 3, 2013
Volumes & issues
Volume 26, Issue 3, 2013
Author Demetre LabadariosSource: South African Journal of Clinical Nutrition 26 (2013)More Less
The current issue of the SAJCN reflects on three significant elements in the growth of nutrition in the country. Firstly, a new Chief Directorate: Health Promotion and Nutrition has been created in the national Department of Health. Chief Director, Ms Moeng Mahlangu, writes: "The primary healthcare reengineering process has already laid a strong foundation for improving the health of South Africans through the involvement of communities, and the need to implement evidence-based interventions to guide programming is of paramount importance". The SAJCN congratulates Ms Moeng Mahlangu, and offers its support to the Chief Directorate's future challenges of addressing national priorities for the further development of Nutrition and Dietetics in the country, as well as improving the nutritional status of the nation.
Source: South African Journal of Clinical Nutrition 26, pp 100 –102 (2013)More Less
This South African Journal of Clinical Nutrition (SAJCN) issue comes at a time when childhood obesity is attracting considerable attention in the country. South Africa is a middle-income country and regarded as being in the final stage of nutrition transition. Thus, while successive national surveys in South Africa have shown some decrease in the prevalence of undernutrition, particularly underweight, in children, the prevalence of chronic overnourishment (overweight and obesity) is growing progressively and is a public health concern. This was highlighted in the recently released report of the 2012 South African National Health and Nutrition Examination Survey (NHANES-1), which concluded that "interventions are needed to address the dual problems of chronic undernutrition (stunting) and the rapidly rising trend of overweight and obesity in children in South Africa".
Would an increase in vegetable and fruit intake help to reduce the burden of nutrition-related disease in South Africa? An umbrella review of the evidence : review articleAuthor C. NaudeSource: South African Journal of Clinical Nutrition 26, pp 104 –114 (2013)More Less
Evidence indicates that increased vegetable and fruit intake improves health. The intake of vegetables and fruit in South Africa is much lower than recommended. When considering the promotion of greater vegetable and fruit intake in South Africa, it is necessary to view the available evidence on the relationship between vegetable and fruit intake and disease risk reduction through a South African lens. This will help to determine whether or not interventions to optimise vegetable and fruit intake would contribute to reducing the burden of nutrition-related disease in South Africa. The aim of this umbrella review was to compile the best available evidence from multiple reviews and scientific reports on the link between vegetable and fruit intake and the nutrition-related burden-of-disease profile in South Africa. Vegetable and fruit intake has been associated with prevalent nutrition-related problems in South Africa, including vitamin A status and adiposity in children; and cancer, cardiovascular disease, type 2 diabetes and adiposity in adults. Reviewed evidence from systematic reviews and scientific reports has suggested that increasing vegetable and fruit intake in South Africa could potentially contribute to reducing the burden of nutrition-related conditions in this country. Increasing vegetable and fruit intake in preschool children could improve their vitamin A nutriture. Enhancing vegetable and fruit intake in adults could contribute to reducing the risk of certain prevalent cancers (lung and gastrointestinal) and cardiovascular disease (coronary heart disease, ischaemic heart disease and cerebrovascular accidents). It should be kept in mind that the methodological quality of the included systematic reviews ranged from low to high (AMSTAR), and most reviews did not assess the scientific quality of the included studies. This evidence supports the need to promote greater vegetable and fruit intake in South Africa.
An investigation into utilising gestational body mass index as a screening tool for adverse birth outcomes and maternal morbidities in a group of pregnant women in Khayelitsha : original researchSource: South African Journal of Clinical Nutrition 26, pp 116 –122 (2013)More Less
Objective : The aim of this study was to investigate the ability of the gestational body mass index (BMI) method to screen for adverse birth outcomes and maternal morbidities.
Design : This was a substudy of a randomised controlled trial, the Philani Mentor Mothers' study.
Setting and subjects : The Philani Mentor Mothers' study took place in a peri-urban settlement, Khayelitsha, between 2009 and 2010. Pregnant women living in the area in 2009-2010 were recruited for the study.
Outcome measures : Maternal anthropometry (height and weight) and gestational weeks were obtained at baseline to calculate the gestational BMI, which is maternal BMI adjusted for gestational age. Participants were classified into four gestational BMI categories: underweight, normal, overweight and obese. Birth outcomes and maternal morbidities were obtained from clinic cards after the births.
Results : Pregnant women were recruited into the study (n = 1 058). Significant differences were found between the different gestational BMI categories and the following birth outcomes: maternal (p-value = 0.019) infant hospital stay (p-value = 0.03), infants staying for over 24 hours in hospital (p-value = 0.001), delivery mode (p-value = 0.001), birthweight (p-value = 0.006), birth length (p-value = 0.007), birth head circumference (p-value = 0.007) and pregnancy-induced hypertension (p-value = 0.001).
Conclusion : To the best of our knowledge, this is the first study that has used the gestational BMI method in a peri-urban South African pregnant population. Based on the findings that this method is able to identify unfavourable birth outcomes, it is recommended that it is implemented as a pilot study in selected rural, peri-urban and urban primary health clinics, and that its ease and effectiveness as a screening tool is evaluated. Appropriate medical and nutritional advice can then be given to pregnant women to improve both their own and their infants' birth-related outcomes and maternal morbidities.
The influence of socio-demographic factors on the nutritional status of children in the Stellenbosch area, Western Cape : original researchSource: South African Journal of Clinical Nutrition 26, pp 124 –131 (2013)More Less
Objectives : To determine the prevalence of overweight and obesity, as well as socio-demographic risk factors associated with childhood overweight and obesity in the Stellenbosch area, Western Cape province.
Design : A cross-sectional, comparison study was conducted.
Setting and subjects : A representative group of 638 children (aged 6-13 years) attending three randomly selected Stellenbosch primary schools. An additional school was selected for the pilot study. In the screening (first) phase, children were weighed and measured to calculate body mass index using international obesity task force guidelines to determine the prevalence of overweight and obesity. For the comparison (second) phase of the study, only 24 overweight and obese children and 21 children of normal weight (comparison group) (n = 45) were included.
Outcome measures : Socio-demographic and eating behaviour data were collected using a structured questionnaire and compared between the overweight and obese group and the comparison group (normal weight) to identify associated risk factors.
Results : The prevalence of overweight and obesity was 13%, of which 9% (n = 57) were overweight and 4% (n = 27) obese in the screening phase. In the comparison phase, socio-economic factors, such as maternal employment hours (p-value = 0.0462); family characteristics, such as the number of children in the household (p-value = 0.0231); and time spent participating in sport (p-value = 0.0450); were significantly associated with overweight or obesity.
Conclusion : Preventative initiatives should proactively promote healthy eating behaviour and physical activity in children at an early age, based on previous research, particularly in girls. Involving families and schools in these initiatives is recommended, as well as a national childhood obesity monitoring system to identify children at risk, and tracking childhood obesity trends to guide evidence-based interventions to tackle this growing public health issue.
Adaptation of the RenalSmart® web-based application for the dietary management of patients with diabetic nephropathy : original researchSource: South African Journal of Clinical Nutrition 26, pp 132 –140 (2013)More Less
Objectives : The aim of this study was to develop and test a web-based application for the dietary management of patients with diabetic nephropathy.
Design : Observational descriptive study.
Settings and subjects : RenalSmart® is a web-based application used to assist dietitians in clinical practice, from tertiary to primary care, to manage patients with chronic renal failure. The application was adapted and enhanced to include functions for the nutritional assessment of a patient with diabetic nephropathy, the formulation of a dietary prescription and the development of a meal plan and sample menu. It includes a graphical display of anthropometric and biochemical measurements. Quality assurance testing was undertaken throughout the development process by the project team in a pilot study involving generalist dietitians and dietitians who specialise in diabetic and renal nutrition. Non-random purposive sampling, including snowball sampling, was used to recruit them.
Outcome measures : The application was finally tested for accuracy and acceptability by registered dietitians in South Africa.
Results : Thirty-seven dietitians completed the final testing of the application. The mean age of the respondents was 33 years. Thirty-five per cent resided in the Western Cape. The overall acceptability of the application was rated as good to excellent by 81% of respondents. There was a significant difference between dietitians who usually consulted renal patients, compared to those who did not, in their rating of the accuracy of the data-saving function (p-value = 0.02) and the fluid requirements (p-value = 0.03). In this regard, the former group of dietitians was dissatisfied with these functions.
Conclusion : The web-based application developed in this study was rated as accurate and acceptable by the majority of respondents. Identified problem areas were addressed in the final version.
Knowledge and perceptions of nursing staff on the new Road to Health Booklet growth charts in primary healthcare clinics in the Tygerberg subdistrict of the Cape Town metropole district : original researchSource: South African Journal of Clinical Nutrition 26, pp 141 –146 (2013)More Less
Objectives : The objectives of the study were to assess the perceptions of nursing staff on the Road to Health Booklet (RTHB), to assess their knowledge of the RTHB growth charts, and to determine whether the level of knowledge was acceptable for successful utilisation of the RTHB growth charts.
Design : A cross-sectional descriptive survey.
Setting : Twelve primary healthcare clinics in the Tygerberg subdistrict.
Subjects : Nursing staff who were going to work with the RTHB on a daily basis.
Outcomes measures : The knowledge and perceptions of the nursing staff on the new RTHB were measured using a self-administered questionnaire.
Results : The study highlighted that the majority of the nursing staff did not possess sufficient knowledge to successfully utilise the RTHB. The mean score percentage for the total 12 knowledge questions was 55%. Less than a third (n = 13) of participants could correctly interpret the cut-off value for mid-upper-arm circumference. Only 38% and 52% correctly knew that -2 standard deviation for weight-for-age and weight-for-length represents underweight and wasting, respectively. Fifty-five per cent could correctly interpret the growth faltering graph. Forty-three per cent of participants felt the change to the RTHB was unnecessary, and 55% thought that mothers or caregivers would not easily understand the RTHB. More than half (n = 22) of the participants said that they had adequate knowledge to work with the RTHB, while the rest reported that they did not.
Conclusion : The RTHB has the potential to decrease the prevalence of malnutrition in children. However, to achieve this, effective usage and understanding of the RTHB is critical.
Overweight, obesity and underweight in nurses in Vhembe and Capricorn districts, Limpopo : short reportSource: South African Journal of Clinical Nutrition 26, pp 147 –149 (2013)More Less
Background : In South Africa, anecdotal evidence concerning the prevalence of overweight and obesity in nurses is alarming, but no scientific studies have confirmed this notion. This study aimed to determine the prevalence of underweight, overweight and obesity in black nurses practising in South Africa.
Method : A cross-sectional study involving 153 nurses, aged 19-50 years and older, was undertaken in the Vhembe and Capricorn districts, Limpopo province. Height and weight were measured to determine body mass index (BMI) and physical activity was assessed by report. The World Health Organization criteria determined the BMI categories.
Results : The mean BMI of the nurses was 31.7 ± 18.1 kg/m2. The prevalence of underweight, overweight, obesity and extreme obesity in the nurses was 2%, 27.5%, 44.4% and 7.2%, respectively. The prevalence of overweight and obesity increased with age, peaking at ages 30-39 for overweight, and over 50 years of age for obesity. Among the males nurses, the prevalence of underweight, overweight, obesity and extreme obesity were 2%, 30.6%, 36.7% and 6.1%, respectively. Corresponding figures for the female nurses were 1.9%, 26%, 48.1% and 7.7%, respectively.
Conclusion : The study revealed a high prevalence of overweight and obesity in nurses in the Vhembe and Capricorn districts, a rate that is comparable with that of the general population in South Africa. Future studies are needed to identify risk factors for the prevalence of overweight and obesity in nurses.
The acceptability and intake of lipid-based pastes as a food supplement in a South African context : short reportSource: South African Journal of Clinical Nutrition 26, pp 150 –151 (2013)More Less
This descriptive study included 103 children aged 12-60 months, 39 older children and 291 adults, and was performed to assess the sensory acceptability of a lipid-based food supplement. Lipid-based pastes were found to be highly acceptable, although concern exists regarding the recommended portion sizes, especially for young children with poor appetite.
Source: South African Journal of Clinical Nutrition 26, pp 152 –155 (2013)More Less
A chylothorax can be defined as a leakage of chylous fluid from an abnormal or damaged thoracic duct or a main branch thereof, after an injury or obstruction in the pleural cavity. Management of a chylothorax includes surgical and conservative medical treatment that includes medical nutrition therapy. However, there is no clear evidence yet as to whether enteral nutrition or parenteral nutrition is the preferred nutrition support option for medical nutrition therapy.
Source: South African Journal of Clinical Nutrition 26 (2013)More Less
Prof Carin Napier was re-elected as chairperson of the Eastern branch of Nutrition Society of South Africa (NSSA) for 2013-2014. Lenore Spies is the treasurer; Christine Broadhurst, the secretary; and Thobe Dlamuka, Heleen Grobbelaar, Christelle Crickmore and Justine Casey, the other committee members.
Source: South African Journal of Clinical Nutrition 26 (2013)More Less
The new BSc Dietetics programme commenced at the Nelson Mandela Metropolitan University (NMMU) in Port Elizabeth in February 2013 with an intake of first-year students. The initial intake of students derived mainly from the Eastern Cape. Some of the students have already obtained BSc degrees in other fields, while others matriculated last year. Three students from America, and one from Sweden, are also following the nutrition modules of the programme.
Source: South African Journal of Clinical Nutrition 26 (2013)More Less
For several years, there has been an ongoing discussion on the need to place Nutrition and Dietetics on a more senior level within the Department's of Health's management structure. This would enable the current Directorate of Nutrition to attain more direct representation with regard to the many and significant priorities in Nutrition and Dietetics in the country.