The intake and quality of breakfast consumption in adolescents attending public secondary schools in the North West province, South Africa

Objectives: The objectives of the study were to determine the proportion and quality of breakfast intake in adolescents, and to determine the effect of breakfast intake and quality on overall diet quality.Design: A cross-sectional quantitative study design was used.Setting: The setting was seven public secondary schools in Potchefstroom and the surrounding areas in North West province.Subjects: The subjects were randomly selected adolescents in grades 9-11 (n = 244).Outcome measures: A self-administered demographic questionnaire was completed by the adolescents. Single 24-hour recall, using the four-stage multiple-pass method, was conducted to obtain information on breakfast and dietary intake for the day. Breakfast quality was measured by applying a breakfast quality score. The Diet Quality Index Revised was used to assess the quality of the overall diet. Spearman’s rank correlation coefficient was employed to assess an association between the continuous variables. The chi-square or Fisher’s exact test was utilised to assess an association between the categorical variables.Results: The proportion of breakfast intake and skipping was 81% and 19%, respectively. The mean breakfast quality score was moderate (3.1). No significant difference was shown in the diet quality score for the breakfast eaters and skippers. The breakfast quality score was marginally associated with calcium intake (p-value < 0.0001, r = 0.418), phosphorous intake (p-value < 0.0001, r = 0.378) and total diversity score (p-value < 0.0001, r = 0.369).Conclusion: The proportion of breakfast skipping, moderate quality of the breakfast consumed and trend of improved nutrient intake with improved breakfast quality highlights the need for breakfast education and intervention as part of the Integrated School Health Policy.Keywords: adolescent, breakfast, breakfast quality, diet quality, adolescenc

Low rates of exclusive breastfeeding are still evident in four South African provinces

Objectives: Breastfeeding is one of the primary strategies used to enhance infant nutrition and improving child survival worldwide. The intention of globally increasing the rate of exclusive breastfeeding (EBF) to at least 50% of infants in the first six months of life was stated in the 2014 International Conference on Nutrition Rome Declaration on Nutrition and the Post-2015 Development Agenda. This study aimed to explore the infant-feeding practices of mothers and caregivers of infants aged ≤ 6 months in four provinces in South Africa.Setting and subjects: This cross-sectional study was conducted in four provinces in South Africa. In total, 40 health facilities were randomly selected in the four provinces and visited, including metropolitan and non-metropolitan health facilities over the geographical area of the provinces. The sample size comprised mothers and/or caregivers of babies aged ≤ 6 months.Design: Fixed-format interviews were used in this cross-sectional study on 580 mothers and/or caregivers. The mothers completed 24-hour recall based on the Food and Agriculture Organization of the United Nations dietary diversity list, consisting of 12 different food groups, to assess dietary intake and diversity.Results: The EBF rate for infants up to the age of six months was 12%. Mothers who delivered full-term babies were most likely to initiate breastfeeding within the first hour of delivery. More than a third of the mothers had ceased breastfeeding by one month (40%, n = 23). The introduction of complementary food took place in 17% of infants during this first month. The minimum standards of dietary diversity were met by one infant only. Different reasons found to influence mothers’ feeding practices included needing to return to work (29%) or their studies (12%), the mothers’ health status (25%), and perceptions of an “insufficient” milk supply (13%).Conclusion: Therefore, new strategies should address these gaps in knowledge with key breastfeeding awareness messages and a special focus on community involvement and participation. There is also a need for the whole nutrition fraternity, including government, academia and development industries, to intervene by developing more innovative approaches to increase the rate of EBF in South Africa.Keywords: exclusive breastfeeding, South Africa, low rates, infant feeding practice

Development of a Halotolerant Community in the St. Lucia Estuary (South Africa) during a Hypersaline Phase

Background: The St. Lucia Estuary, Africa’s largest estuarine lake, is currently experiencing unprecedented freshwater deprivation which has resulted in a northward gradient of drought effects, with hypersaline conditions in its northern lakes. Methodology/Principal Findings: This study documents the changes that occurred in the biotic communities at False Bay from May 2010 to June 2011, in order to better understand ecosystem functioning in hypersaline habitats. Few zooplankton taxa were able to withstand the harsh environmental conditions during 2010. These were the flatworm Macrostomum sp., the harpacticoid copepod Cletocamptus confluens, the cyclopoid copepod Apocyclops cf. dengizicus and the ciliate Fabrea cf. salina. In addition to their exceptional salinity tolerance, they were involved in a remarkably simple food web. In June 2009, a bloom of an orange-pigmented cyanobacterium (Cyanothece sp.) was recorded in False Bay and persisted uninterruptedly for 18 months. Stable isotope analysis suggests that this cyanobacterium was the main prey item of F. cf. salina. This ciliate was then consumed by A. cf. dengizicus, which in turn was presumably consumed by flamingos as they flocked in the area when the copepods attained swarming densities. On the shore, cyanobacteria mats contributed to a population explosion of the staphylinid beetle Bledius pilicollis. Although zooplankton disappeared once salinities exceeded 130, many taxa are capable of producing spores or resting cysts to bridge harsh periods. The hypersaline community was disrupted by heavy summer rains in 2011, which alleviated drought conditions and resulted in a sharp increase in zooplankton stock an

Sediment properties as important predictors of carbon storage in zostera marina meadows: a comparison of four European areas

Seagrass ecosystems are important natural carbon sinks but their efficiency varies greatly depending on species composition and environmental conditions. What causes this variation is not fully known and could have important implications for management and protection of the seagrass habitat to continue to act as a natural carbon sink. Here, we assessed sedimentary organic carbon in Zostera marina meadows (and adjacent unvegetated sediment) in four distinct areas of Europe (Gullmar Fjord on the Swedish Skagerrak coast, Asko in the Baltic Sea, Sozopol in the Black Sea and Ria Formosa in southern Portugal) down to similar to 35 cm depth. We also tested how sedimentary organic carbon in Z. marina meadows relates to different sediment characteristics, a range of seagrass-associated variables and water depth. The seagrass carbon storage varied greatly among areas, with an average organic carbon content ranging from 2.79 +/- 0.50% in the Gullmar Fjord to 0.17 +/- 0.02% in the area of Sozopol. We found that a high proportion of fine grain size, high porosity and low density of the sediment is strongly related to high carbon content in Z. marina sediment. We suggest that sediment properties should be included as an important factor when evaluating high priority areas in management of Z. marina generated carbon sinks

Expert consensus document: A 'diamond' approach to personalized treatment of angina.

In clinical guidelines, drugs for symptomatic angina are classified as being first choice (β-blockers, calcium-channel blockers, short-acting nitrates) or second choice (ivabradine, nicorandil, ranolazine, trimetazidine), with the recommendation to reserve second-choice medications for patients who have contraindications to first-choice agents, do not tolerate them, or remain symptomatic. No direct comparisons between first-choice and second-choice treatments have demonstrated the superiority of one group of drugs over the other. Meta-analyses show that all antianginal drugs have similar efficacy in reducing symptoms, but provide no evidence for improvement in survival. The newer, second-choice drugs have more evidence-based clinical data that are more contemporary than is available for traditional first-choice drugs. Considering some drugs, but not others, to be first choice is, therefore, difficult. Moreover, double or triple therapy is often needed to control angina. Patients with angina can have several comorbidities, and symptoms can result from various underlying pathophysiologies. Some agents, in addition to having antianginal effects, have properties that could be useful depending on the comorbidities present and the mechanisms of angina, but the guidelines do not provide recommendations on the optimal combinations of drugs. In this Consensus Statement, we propose an individualized approach to angina treatment, which takes into consideration the patient, their comorbidities, and the underlying mechanism of disease

Household, community, sub-national and country-level predictors of primary cooking fuel switching in nine countries from the PURE study

Introduction. Switchingfrom polluting (e.g. wood, crop waste, coal)to clean (e.g. gas, electricity) cooking fuels can reduce household air pollution exposures and climate-forcing emissions.While studies have evaluated specific interventions and assessed fuel-switching in repeated cross-sectional surveys, the role of different multilevel factors in household fuel switching, outside of interventions and across diverse community settings, is not well understood. Methods.We examined longitudinal survey data from 24 172 households in 177 rural communities across nine countries within the Prospective Urban and Rural Epidemiology study.We assessed household-level primary cooking fuel switching during a median of 10 years offollow up (∼2005–2015).We used hierarchical logistic regression models to examine the relative importance of household, community, sub-national and national-level factors contributing to primary fuel switching. Results. One-half of study households(12 369)reported changing their primary cookingfuels between baseline andfollow up surveys. Of these, 61% (7582) switchedfrom polluting (wood, dung, agricultural waste, charcoal, coal, kerosene)to clean (gas, electricity)fuels, 26% (3109)switched between different polluting fuels, 10% (1164)switched from clean to polluting fuels and 3% (522)switched between different clean fuels