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- Volume 27, Issue 2, 2014
South African Journal of Clinical Nutrition - Volume 27, Issue 2, 2014
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Volume 27, Issue 2, 2014
Author Demetre LabadariosSource: South African Journal of Clinical Nutrition 27 (2014)More Less
The International Labour Organization's Social Protection Report 2014/2015 highlights the important contribution which social protection makes in addressing poverty and inequality, as well as in supporting growth and development. It also acknowledges the global improvement in accessing social protection, especially in middle-income countries, and identifies the lack of effective social security systems in some countries as a risk to further improvement. The report provides updates on social protection for children and families, adults and the elderly, as well as universal health coverage, and draws attention to challenges that need to be addressed, if improved access is to be achieved.
The role of human milk oligosaccharides in preventing necrotising enterocolitis and human immunodeficiency virus transmission : reviewSource: South African Journal of Clinical Nutrition 27, pp 51 –55 (2014)More Less
The heavy burden of maternal human immunodeficiency virus (HIV) infection has resulted in a high prevalence of premature births, with an associated increase in the incidence of necrotising enterocolitis (NEC). NEC is a life-threatening inflammatory disease of the gastrointestinal tract that predominantly occurs in preterm infants. Human milk oligosaccharides (HMOs) are carbohydrate compounds which have been shown to have health-promoting effects through their bifidogenic and antiadhesive properties. There is a reduced incidence of NEC in infants who receive human milk, compared to those receiving infant formula. It is suggested that the oligosaccharides found within human milk may act as specific substrates in assisting the growth of selected beneficial bacteria, called probiotics. Probiotics are live microbial food ingredients which have been shown to have health-promoting effects. Lactobacillus rhamnosus GG and Bifidobacterium infantis have been used as probiotics to reduce the incidence of NEC. Furthermore, HMOs have been associated with protection against postnatal HIV transmission. HMOs may hold key responsibility for the prevention of NEC, and possibly the transmission of HIV, to infants in resource-limited settings and in a developing country, such as South Africa, where HIV plays a major role in the outcomes of preterm neonates.
Determinants of obesity and perception of weight in hypertensive patients in rural South Africa : original researchSource: South African Journal of Clinical Nutrition 27, pp 56 –62 (2014)More Less
Objective : The objective of the study was to identify factors associated with being overweight or obese, and perceptions of weight by hypertensive patients living in rural South Africa.
Design : This was a nested cross-sectional study.
Setting : The setting was primary healthcare clinics close to Manguzi Hospital, KwaZulu-Natal.
Subjects : Subjects were 109 males and 391 females, prescribed at least one antihypertensive medication aged ≥ 18 years.
Outcome measures : The primary outcome measure was body mass index (BMI) ≥ 25 kg/m2. The secondary outcome measure was recognition of being overweight by those with a BMI ≥ 25 kg/m2.
Results : The mean age was 58 years. Three hundred and ninety-one (78%) participants were female, and the majority had never been to school or had attended primary school only. Three hundred and eleven (62%) participants were overweight or obese, with a BMI ≥ 25 kg/m2. Factors associated with being overweight or obese included having high cholesterol [adjusted odds ratio (OR) 10.62, 95% confidence interval (CI): 1.22-92.4, p-value 0.032], and having never smoked (adjusted OR 3.22, 95% CI: 1.38-7.52, p-value 0.007. Human immunodeficiency virus (HIV) was associated with a lower risk of being overweight or obese (adjusted OR 0.52 for BMI ≥ 25, 95% CI: 0.31-0.89, p-value < 0.0001). Only 12% of participants who were overweight or obese perceived that they were overweight. Participants with a BMI ≥ 25 kg/m2 were most likely to recognise they were overweight if they had high cholesterol, diabetes or HIV.
Conclusion : Almost two thirds of participants were overweight or obese, and of these, only 12% perceived that they were overweight. Educating patients about obesity, particularly when they have other cardiovascular risk factors such as hypertension, is of public health importance.
WHO 2010 infant feeding guidelines in resource-limited settings : attitudes of human immunodeficiency virus-infected women and other role players in Kampala, Uganda : original researchSource: South African Journal of Clinical Nutrition 27, pp 63 –68 (2014)More Less
Objective : The objective of the study was to describe the attitudes of human immunodeficiency virus (HIV)-infected women and other role players towards the World Health Organization (WHO) 2010 infant feeding guidelines.
Design : This was formative evaluation research, carried out from September-November 2011.
Setting : The study was conducted at Mulago Hospital, Kampala, Uganda.
Subjects : Focus group discussions (FGDs) were held among five groups: HIV-infected pregnant women (9), HIV-infected postpartum mothers (10), HIV-infected peers (10), male partners (10), family members of the pregnant women (10) and key informants (12).
Outcome measures : Descriptive data were collected through FGDs and key informant interviews.
Results : With the exception of male partners, the majority of FGD participants and key informants who were health workers held a positive attitude towards exclusive breastfeeding. The introduction of complementary foods at six months while HIV-infected lactating mother continued to breastfeed was supported by all of the health workers, but by only a minority of participants from each focus group discussion. The majority of FGD participants and the health workers were in favour of an HIV-infected lactating mother taking antiretroviral (ARV) drugs during the breastfeeding period, rather than the infant.
Conclusion : Three conclusions can be drawn from this study. Firstly, general attitudes towards the WHO 2010 infant feeding guidelines on exclusive breastfeeding were positive. Secondly, there were still fears about an HIV-infected mother introducing complementary foods at six months while continuing to breastfeed. Thirdly, all of the FGD participants and the majority of the health workers recommended that the mother should take ARV drugs in the lactating period.
Factors associated with central overweight and obesity in students attending the University for Development Studies in Tamale, Ghana : a cross-sectional study : original researchSource: South African Journal of Clinical Nutrition 27, pp 69 –74 (2014)More Less
Objectives : This study assessed the prevalence of central overweight and obesity in students of the University for Development Studies in Tamale, Ghana. Lifestyle factors associated with central overweight and obesity were also investigated in this study population.
Design : A cross-sectional study design was employed.
Setting : School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana.
Subjects : A sample of 552 students was randomly selected to participate.
Method : Waist and hip circumference was measured with appropriate tools and computed into a waist-to-hip ratio (WHR). Demographic and socio-cultural factors, such as age, sex, smoking status and coffee and alcohol consumption, were recorded. Physical activity was assessed using the World Health Organization Global Physical Activity Questionnaire.
Results : Generally, 29.3% of the participants had a normal WHR (44.1% males, 3.0% females). 60.9% (55.9% males, 69.7% females) were centrally overweight and 9.8% (0.0% males, 27.3% females) centrally obese. Age and smoking status were not associated with central overweight and obesity. Being female was significantly associated with a higher prevalence of central obesity. The prevalence of central obesity was 13.9% in non-coffee drinkers, 6.7% in coffee drinkers, 11% in non-alcohol drinkers and 0% in alcohol drinkers. Almost 95% of centrally obese participants engaged in light or moderate physical activity, and 5.6% in vigorous physical activity (p-value < 0.0001). Conversely, 55% of normal weight participants engaged in light or moderate physical activity and 44% in vigorous physical activity (p-value 0.0008).
Conclusion : Physical activity, female gender, alcohol and coffee consumption were associated with central obesity.
Author L. VeldsmanSource: South African Journal of Clinical Nutrition 27, pp 75 –79 (2014)More Less
A 34-year-old man with no significant past medical history was admitted to hospital on 16 February, with a three-day history of right lower quadrant pain, followed by nausea and vomiting. On physical examination, he appeared to be dehydrated (dry mucous membranes) with low-grade pyrexia [38°C, tachycardia (102 beats per minute)], mild abdominal distension, reduced bowel sounds and maximal tenderness at McBurneys's point.
Source: South African Journal of Clinical Nutrition 27, pp 80 –81 (2014)More Less
I read with great interest the excellent article by Oldewage-Theron and Egal.
Their key finding was that despite eating a diet of 71% carbohydrate to 20% fat to 9% protein, that approaches the macronutrient proportions advocated as healthy by South African dietary experts, 34% of women in a peri-urban Vaal region had dyslipidaemia. Eighty-two per cent of the women with dyslipidaemia were obese, whereas 53% of the women without dyslipaemia were also overweight. More than 35% from both groups were hypertensive. The rates for diabetes were not reported.
Author Claire Julsing-StrydomSource: South African Journal of Clinical Nutrition 27, pp 82 –84 (2014)More Less
Prof. Sylvia Escott-Stump visited South Africa this year to present at the Nutritional Solutions CNE event in April 2014. A special interview was arranged to share her knowledge regarding various topics associated with obesity, the very complex condition.
The cause of obesity is multifactorial and it is truly impossible to pinpoint a single cause. The contributing factors must be taken into account when managing obesity and the management thereof should focus on the person as an individual and address the person's medical history and nutritional status. According to Sylvia Escott-Stump, key contributing factors for the development of obesity include lifestyle (poor diet, skipping meals, a lack of sleep, drinking sugar-sweetened drinks in excess, drinking too much alcohol, snacking, a lack of exercise, and poor choices at social events); psychosocial (depression, stress, anxiety, binge eating or overeating; inadequate income which may lead to an imbalanced intake of nutrients); biomedical (genetics, metabolism and perinatal factors); and other factors such as medication use (e.g. prednisone or cortisone); a reduced mobility for some reason (an injury or amputation); and inflammatory processes.