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- Volume 29, Issue 1, 2016
South African Journal of Clinical Nutrition - Volume 29, Issue 1, 2016
Volumes & issues
Volume 29, Issue 1, 2016
Source: South African Journal of Clinical Nutrition 29, pp 4 –6 (2016)More Less
The debate and the evidence in the literature on the importance of the type of fat in the diet continues to elicit interest, and hopefully better understanding. Opperman et al addressed the suggestion made in The Real Meal Revolution that seed oils are toxic, high in trans fat and genetically modified in this issue of the SAJCN. The authors concluded in their findings that South African seed oils, i.e. sunflower oil, olive oil and canola oil are of good quality and safe for human consumption, based on their fatty acid composition, i.e. trans-fatty acid content, peroxide and conjugated diene levels. They further concluded that oil crops are not genetically modified.
Source: South African Journal of Clinical Nutrition 29, pp 7 –11 (2016)More Less
Objectives: A diet that is high in fat and low in carbohydrates is advocated in the recently published The Real Meal Revolution. A suggestion was made in this publication that seed oils are toxic. The authors stated that available seed oils on the South African market were high in trans-fatty acid (TFA), as well as being genetically modified, and thus should be avoided. We compared three oils, i.e. canola, sunflower and olive oil, against internationally accepted standards, to determine the quality of these oils using gaschromatographic analysis, to determine whether or not there was any foundation to the statement pertaining to the toxicity of South African seed oils. Reported parameters included the fatty acid profile, TFA content, peroxide level and conjugated diene (CD) content.
Design: Samples were purchased from local retail stores. Two independent researchers de-identified the oils, and stored them in numbered containers under nitrogen until commencement of the analysis. Hence, a blind sample of oils was received.
Outcome measures: Twelve (n = 12) olive oil, 15 (n = 15) canola oil and 7 (n = 7) sunflower oil samples were subjected to analysis. CD and peroxide levels were conducted spectrophotometrically, and fatty acid content determined by gas liquid chromatography.
Results: The total TFA content of the three types of sampled oils was below 0.5%, and the peroxide (meq O2/kg) and CD levels (µmol/g) were within allowable limits, as described in the Codex Standard for Named Vegetable Oils, as well as previous publications.
Conclusion: The results demonstrated that the South African seed oils included in this analysis contained a negligible amount of TFA, adhered to international recommendations with respect to fatty acid content, and were well within the safe range for oxidation products. Therefore, the statement that South African seed oils are toxic is inaccurate, unscientific and without merit.
Source: South African Journal of Clinical Nutrition 29, pp 13 –21 (2016)More Less
Current global mortality from noncommunicable diseases (NCDs) remains unacceptably high and is increasing. A major reduction in the burden of NCDs should come from population-wide interventions, including the promotion of a healthy diet through the provision of adequate nutrition information on food labels. However, in order for this type of intervention to be successful, it is important to have a better understanding of the consumer. This review focuses on the need for food and nutrition labelling (the section of information on a food label that specifically declares nutrient content) within the context of NCDs, as well as consumer nutrition label use, and understanding and the impact of nutrition labelling on purchasing behaviour. It provides a summary of the latest global nutrition labelling trends, the current situation in South Africa and the way forward. Consumer knowledge, use and understanding of nutrition labelling has been investigated extensively in the international literature. However, the majority of these investigations were conducted in developed countries. Therefore, additional research on the impact of nutrition labelling in developing countries is necessary, and should be a priority. There have been many developments in South Africa in terms of food and nutrition labelling in the last decade. Although the food industry, health professionals and consumers face many changes, challenges and opportunities with regard to food, and specifically to nutrition labelling, this is also the ideal time to promote the use and understanding of nutrition information on labels by health professionals to consumers.
Consumption and wastage of home-fortified maize flour products in northern Malawi : original researchSource: South African Journal of Clinical Nutrition 29, pp 23 –26 (2016)More Less
Objective: The objective of the study was to determine the amount of home-fortified maize flour products consumed and wasted by women aged 15-49 years, and children aged ≤ 5 years. Design: This was a descriptive cross-sectional study.
Setting: The study took place in Ekwendeni, a home fortification project area in Mzimba District, Northern Region, Malawi.
Subjects: The study subjects were members of a random sample of 205 households practising home fortification.
Outcome measures: The study's outcome measures included weighing fortified nsima, a thick maize flour-based porridge which was consumed, and its leftovers, using a kitchen scale. Using systematic random sampling, fortified maize flour and nsima samples were collected from households for energy, iron, zinc and vitamin A analysis. The data were analysed using descriptive statistics.
Results: The food intake and plate waste of fortified food products pertaining to 94 children (49% male and 51% female) and 173 women wasanalysed. Predominantly, nsima (55%) was the main food product made from fortified maize flour. Other foods were porridge and chigumu, whole maize flour-based bread. Overall, the daily average consumption of fortified foods (nsima, porridge and chigumu) was 332 g/day for children, and 1011 g/day for women. Plate waste accounted for 25% of the food served to the children, and 12% served to the women. Discarding fortified nsima resulted in a 23% loss of energy and micronutrients in the children, and a 11.2% loss in the women.
Conclusion: Commonly consumed home-fortified maize flour products were nsima, porridge and chigumu. The plate waste of the fortified foods, primarily nsima, resulted in considerable loss of energy and micronutrients, especially in the children. Home-fortification interventions should include nutrition messages on food budgeting to minimise food and nutrient losses in women and children in northern Malawi.
Moderate malnutrition in children aged five years and younger in South Africa : are wasting or stunting being treated? : original researchSource: South African Journal of Clinical Nutrition 29, pp 27 –31 (2016)More Less
Objectives: The objective of the study was to describe wasting and stunting in children aged 12-60 months, admitted to targeted supplementary feeding programmes for the treatment of moderate acute malnutrition (MAM) in South Africa.
Design: A cross-sectional, descriptive study was performed.
Subjects and setting: Children with MAM, managed as outpatients at primary healthcare facilities in three provinces, were included in the study conducted between September 2012 and August 2013. Outcome measures: Weight, height and mid-upper-arm circumference (MUAC) measurements were collected to classify the children as moderately or severely stunted or wasted.
Results: Of the total sample (n = 225), 13% (n = 30) were diagnosed as wasted, 58% (n = 131) as stunted, and 21% (n = 47) as both wasted and stunted. MUAC was significantly associated with wasting. However, an association was not found between MUAC and stunting. Of the sample, 32% (n = 72) presented with severe stunting, and 29% (n = 65) with moderate wasting. Food insecurity was associated with wasting, but not with stunting.
Conclusion: A low weight-for-age z-score resulted more from stunting than from wasting in this study. Severe stunting presented as a greater health concern than moderate wasting. Without scrutinising wasting and stunting, healthcare professionals may remain unaware of the drivers of underweight for age in children treated at South African primary healthcare facilities. Following this study's outcomes, the sensitivity of MUAC in screening for moderate malnutrition in South African settings with a high prevalence of stunting is questionable. It is recommended that current nutritional interventions are revisited to explore the efficacy of treating children with wasting, stunting or both.
Consuming the daily recommended amounts of dairy products would reduce the prevalence of inadequate micronutrient intakes in the United States : diet modelling study based on NHANES 2007-2010 : original researchSource: South African Journal of Clinical Nutrition 29, pp 32 –41 (2016)More Less
Background: A large portion of Americans are not meeting the Dietary Reference Intakes (DRI) for several essential vitamins and minerals due to poor dietary choices. Dairy products are a key source of many of the nutrients that are under consumed, but children and adults do not consume the recommended amounts from this food group. This study modelled the impact of meeting daily recommended amounts of dairy products on population-based nutrient intakes.
Methods: Two-day 24-h dietary recalls collected from participants ≥2 years (n = 8944) from the 2007-2010 What We Eat in America, National Health and Nutrition Examination Survey (NHANES) were analysed. Databases available from the WWEIA/NHANES and the United States Department of Agriculture (USDA) were used to determine nutrient, food group, and dietary supplement intakes. Modelling was performed by adding the necessary number of dairy servings, using the dairy composite designed by USDA, to each participant's diet to meet the dairy recommendations outlined by the 2010 Dietary Guidelines for Americans. All analyses included sample weights to account for the NHANES survey design.
Results: The majority of children 4 years and older (67.4-88.8 %) and nearly all adults (99.0-99.6 %) fall below the recommended 2.5-3 daily servings of dairy products. Increasing dairy consumption to recommended amounts would result in a significant reduction in the percent of adults with calcium, magnesium, and vitamin A intakes below the Estimated Average Requirement (EAR) when considering food intake alone (0-2.0 vs. 9.9-91.1 %; 17.3-75.0 vs. 44.7-88.5 %; 0.1-15.1 vs. 15.3-48.0 %, respectively), as well as food and dietary supplement intake. Minimal, but significant, improvements were observed for the percent of people below the EAR for vitamin D (91.7-99.9 vs. 91.8-99.9 %), and little change was achieved for the large percentage of people below the Adequate Intake for potassium.
Conclusions: Increasing dairy food consumption to recommended amounts is one practical dietary change that could significantly improve the population's adequacy for certain vitamins and minerals that are currently under-consumed, as well as have a positive impact on health.
Author Lize RossouwSource: South African Journal of Clinical Nutrition 29, pp 42 –46 (2016)More Less
Necrotising enterocolitis (NEC) is the most common gastrointestinal disease in preterm neonates. The aetiology of NEC remains poorly understood. Proposed preventive strategies include the provision of breast milk as an enteral feed, monitoring the advancement of feeds and modulating the gut microbiome by providing probiotics. Some patients who present with NEC require surgical intervention for the resection of a necrotic bowel which may result in short bowel syndrome (SBS). SBS may also result from congenital defects or disease-associated loss of absorption, and is characterised by the inability to maintain protein, energy, fluid, electrolyte or micronutrient balance when on a conventionally accepted, normal diet. The clinical course and nutritional management of a preterm infant with SBS is described in this case study. New developments in the prevention of NEC are briefly discussed. Relevant evidence with regard to nutritional management is reviewed, and practical aspects of the management discussed.
Source: South African Journal of Clinical Nutrition 29 (2016)More Less
Past presidents of SASPEN, Prof Demetre Labadarios, Prof Renee Blaauw and Mrs Janicke Visser, have been recognised by being awarded honorary membership to the society. This is a small token of appreciation for their tremendous work in establishing SASPEN, and their dedication to advancing the stance of the dietetic profession in South Africa. SASPEN is privileged to have you as members.