Early infant feeding practices of mothers attending a postnatal clinic in Ga-Rankuwa

Background: Despite the recommendation of the World Health Organization (WHO) of exclusive breastfeeding for the first 4-6 months of life, several South African studies on infant feeding practices have shown that the introduction of feeds other than breastmilk before 4 months is a common practice. The timing of initiation of complementary feeding within the first 4 months is, however, difficult to determine.Objective: To determine feeding practices of mothers of infants 8 weeks of age or younger, attending the postnatal clinic at Ga-Rankuwa Hospital.Methods: A cross-sectional study of mothers attending the postnatal clinic at Ga-Rankuwa Hospital using a standardised interview schedule.Results: A total of 150 mothers were interviewed. All infants in the sample were younger than 9 weeks of age. The mean age of the sample was 37.4 (5.2 weeks) ±12.1 days. Although 99% of infants were breastfed, exclusive breastfeeding was practised by only 4.6% of the sample. Water was given to 88%, infant formula to 43% and complementary feeds to 37%. Forty-six per cent of mothers said that the reason for giving water to their babies was to prevent constipation. Infant formula was added because mothers believed that their breastmilk was insufficient for their infants\' needs. Of the complemented infants, 91% had received complementary feeds before 7 weeks of age. Thin maize meal porridge providing less than 1 kJ/ml and negligible protein was the most commonly given first food.Conclusion: Breastfeeding was almost universal, exclusive breastfeeding was the exception. Mixed feeding was common, with the introduction of complementary feeds occurring within the first 2 months of life, well before the WHO recommendations.South African Journal of Clinical Nutrition Vol. 18(2) 2005: 70-7

Measuring micronutrient intakes at different levels of sugar consumption in a population in transition: the Transition and Health during Urbanisation in South Africa (THUSA) study

Objective: The objective was to investigate the absolute micronutrient intake and the possibility of micronutrient dilution of added sugar in thediets of an African population in nutritional transition.Design: A cross-sectional, comparative, population-based design was used. Respondents who consumed sugar were divided into four quartiles of percentage of added sugar intake.Setting: The setting was 37 randomly selected rural and urban areas of the North West province.Subjects: The subjects were 1 742 adult volunteers (739 men and 1 003 women), aged between 15-65 years. After exclusion of low-energyreporters, the sample comprised 1 045 subjects (472 men and 573 women).Outcome measures: The outcomes measures were the macronutrient and micronutrient intakes of subjects in different quartiles of addedsugar intake and body mass index (BMI).Results: The average intake of added sugar was 10.01% of total energy (67.12 g) in men and 11.2% total energy (67.10 g) in women.Respondents who consumed the most added sugar had significantly lower mean intakes of alcohol, but higher intakes of energy, macronutrientsand most micronutrients. The diets of those in the highest sugar intake group contained significantly less thiamine, riboflavin, niacin, vitaminB12, pantothenic acid, biotin, magnesium, phosphorus and zinc per 4.18 MJ. At every level of added sugar consumption, the mean intakesof fibre (men only), folate, ascorbic acid and calcium (men and women) did not meet the dietary reference intakes [estimated averagerequirements (EAR)] and pantothenic acid and biotin (women only) did not meet the adequate intake. There were no significant differencesin mean BMI across the quartiles of added sugar intakes in men, but the mean BMI of women who consumed the most added sugar wassignificantly higher than that of those who consumed less sugar. Respondents who consumed the most added sugar had significantly higherintakes of fruit (men only), bread and soft drinks, and lower intakes of maize meal and alcohol (men and women).Conclusion: Absolute intakes of most micronutrients were significantly higher in consumers with a high sugar intake [Quartile (Q) 4] comparedwith the lowest consumers of sugar (Q1). The lowest percentages of participants whose micronutrient intakes fell below the EAR were in Q4and Q3. However, expression of micronutrient intake per 4.18 kJ (micronutrient dilution) revealed significantly less of most micronutrients per 4.18 MJ for men and women who consumed the most added sugar, compared with those who consumed the least

Reproducibility of two, three, four and five 24-hour recalls in peri-urban African adolescents in the North West province

Background: The objective was to determine the reproducibility of two, three, four and five repeated 24-hour recalls among peri-urban African adolescents.Method: A prospective study design was used within the multidisciplinary PhysicaL Activity in the Young (PLAY) study. Eighty-seven Grade 9 learners (59 girls and 28 boys, aged 10-18 years) with a mean age of 14.7 ± 1.5 years, who had completed five 24-hour recalls, were investigated. The learners were from Seiphemelo Secondary School in Ikageng, a peri-urban area in the North West province of South Africa.Reproducibility coefficients (RCs) and 95% confidence intervals (CIs) were calculated, using the intraclass correlation coefficient formula for transformed values of selected nutrients and food groups, for two, three, four and five repeated 24-hour recalls. The RCs and 95% CIs were compared in order to identify the optimum number of 24-hour recalls to give the best reproducibility results.Results: The RCs were nutrient- and food-group sensitive and ranged from 0.25 (riboflavin) to 0.6 (carbohydrate). Although differences were not statistically significant, RCs for four and five 24-hour recalls were higher than those obtained for two and three 24-hour recalls. For most nutrients and food groups, four 24-hour recalls gave the highest RCs, with non-significant differences overall between the four and five 24-hour recalls.Conclusion: The results suggest that four 24-hour recalls would be sufficient to provide acceptable reproducibility of reported food group and nutrient intakes among peri-urban African adolescents.Keywords: adolescents, dietary assessment, reproducibility, 24-hour recalls, North West, peri-urba

Changes in Retinol-Binding Protein Concentrations and Thyroid Homeostasis with Nonoccupational Exposure to DDT

BACKGROUND: The insecticide dichlorodiphenyltrichloroethane (DDT) has been used for malaria vector control in the northern and eastern parts of the Vhembe District of Limpopo Province, South Africa, since 1945. Bioaccumulation of DDT raises concern because it reportedly affects thyroid function. OBJECTIVE: Our objective was to investigate the association between DDT uptake (as reflected in plasma concentrations) and thyroid homeostasis while considering related factors. METHODS: We compared dietary intake, serum retinol-binding protein (RBP), transthyretin (TTR) and albumin concentrations, and liver and thyroid function between cases with evidence of a body burden of DDT in the circulation (concentration of any DDT isomer ≥ 0.02 μg/g lipid; n = 278) and controls (concentration of all DDT isomers < 0.02 μg/g lipid; n = 40) in a cross-sectional study. Further analyses were performed to assess the relevance of changes in RBP status associated with DDT uptake. RESULTS: RBP concentrations below the reference range were more prevalent in cases (54% vs. 10% in controls; χ2 = 27.4; p < 0.001), which could not be explained by nutrient intake. We observed significantly lower thyroid hormone concentrations among cases (p ≤ 0.01). We also observed a significant linear trend for serum concentrations of free thyroxine and free triiodothyronine (p < 0.001) and a significant quadratic trend for serum thyroid-stimulating hormone (p = 0.025) and TTR (p < 0.001) across the control group and case groups with normal and relatively low RBP concentrations. Relatively low RBP concentrations were associated with significantly higher DDT and 1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene (DDE) isomer concentrations and with a higher DDE/DDT ratio (p ≤ 0.01), which signifies long-term exposure. Inadequate intake of vitamin A and zinc were observed in 84% and 58%, respectively, of the total study population. CONCLUSION: RBP concentrations appear to decrease in the presence of long-term DDT uptake, which may have deleterious effects on thyroid function and vitamin A nutritional status. This is of major concern in a population with poor vitamin A and zinc intake

Pan-cancer analysis of whole genomes

Cancer is driven by genetic change, and the advent of massively parallel sequencing has enabled systematic documentation of this variation at the whole-genome scale(1-3). Here we report the integrative analysis of 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). We describe the generation of the PCAWG resource, facilitated by international data sharing using compute clouds. On average, cancer genomes contained 4-5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete. Chromothripsis, in which many clustered structural variants arise in a single catastrophic event, is frequently an early event in tumour evolution; in acral melanoma, for example, these events precede most somatic point mutations and affect several cancer-associated genes simultaneously. Cancers with abnormal telomere maintenance often originate from tissues with low replicative activity and show several mechanisms of preventing telomere attrition to critical levels. Common and rare germline variants affect patterns of somatic mutation, including point mutations, structural variants and somatic retrotransposition. A collection of papers from the PCAWG Consortium describes non-coding mutations that drive cancer beyond those in the TERT promoter(4); identifies new signatures of mutational processes that cause base substitutions, small insertions and deletions and structural variation(5,6); analyses timings and patterns of tumour evolution(7); describes the diverse transcriptional consequences of somatic mutation on splicing, expression levels, fusion genes and promoter activity(8,9); and evaluates a range of more-specialized features of cancer genomes(8,10-18).Peer reviewe