Nutrition knowledge and nutritional status of primary school children in QwaQwa

Objectives: To determine the nutrition knowledge and nutritional status of primary school children attending a purposively selected school in rural QwaQwa. Setting: A purposively selected public school (n = 540) in QwaQwa. Subjects: A convenience sample of all 142 school pupils, aged from nine to thirteen years. Outcome measures: The measuring instruments included a nutrition knowledge questionnaire to determine the current nutrition knowledge, and a 24-hour recall to determine food and nutrient intakes. Anthropometric measurements included weight and height, measured using standard methodologies. Results: The mean age of the respondents was 11.2 years, and all had deficient intakes of all the nutrients, except for protein, carbohydrates and thiamine. However, 53.1%, 17.1% and 14.3% of the respondents did not meet 100% of EAR for protein, carbohydrates and thiamine respectively. The anthropometric results indicated that 2.8% of the total group of respondents was severely stunted, and that 11.3% were stunted. The BMI-for-age indicated that 12.0% were overweight, and more so among the girls (15.7%) than the boys (8.3%). The respondents showed average nutrition knowledge in the majority of the questions. Conclusions: This study observed malnutrition and average nutrition knowledge, with many gaps relating to aspects, such as the role of the various food groups in the diet and safe hygiene practices. Keywords: primary school children; nutrition knowledge; nutritional statu

Maternal waist circumference as a prediction of children’s stunted status

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The effect of a combination of nutrition education, soy and vegetable gardening, and food preparation skill training interventions on dietary intake and diversity in women: a case study from Qwa-Qwa

Objective: The objective of the study was to determine if an integrated food and nutrition intervention, including home gardening, nutrition education and recipe development and training, would improve dietary diversity in women.Design: This was a single-system case study.Setting: The study setting was peri-urban Qwa-Qwa, Free State province, South Africa.Subjects: Fifty randomly selected women were included in the study from three purposively selected tribes.Outcome measures: Three 24-hour recall questionnaires were used to determine dietary intake and nutrient adequacy, a dietary diversity questionnaire to calculate the dietary diversity scores (DDSs), and the Radimer-Cornell Hunger Scale questionnaire to ascertain food insecurity.Results: The median food variety score (FVS) was 23 at baseline, and improved significantly (p-value 0.002) to 29 at follow-up. Micronutrient intake was consistently low, despite the median adequacy ratio (MAR) improving significantly (p-value 0.002) from 0.49 to 0.63 at follow-up. Despite a significantly improved MAR at follow-up, the nutrient adequacy ratio (NAR) for only three nutrients met 100% at follow-up, namely dietary iron, phosphate and vitamin B3. A strong significant positive correlation existed between FVS and the food group diversity score (r = 0.617, p-value 0.000). The FVS and DDS were higher in the food-secure group (n = 16, 32%) than in the food-insecure group (n = 34, 68%), but not significantly. Although most food groups were consumed by the women, limited foods from each group were included.Conclusion: Women in this resource-poor community lacked a variety of food in their diet, despite a high overall DDS. Thus, they had inadequate micronutrient intake and adequacy. A combination of nutrition education, soy and vegetable gardening, and food preparation skill training interventions, seemed to positively influence the nutrient adequacy and overall dietary diversity of the women participating in this study

Nutritional status and food consumption patterns of primary school children in Orange Farm

South Africa is regarded as food secure; however, food insecurity and malnutrition are still affecting school-aged children residing mostly in rural areas. This paper reports the nutritional status and consumption patterns of school children from two purposively selected schools located in Orange Farm informal settlement. Data collection methods included socio-demographic background, dietary intakes, anthropometric measurements as well as haematology and biochemical measurements. A socio-demographic questionnaire was used to assess the socio-economic background of the households and a health questionnaire to determine the health background of the caregivers, while a Quantitative Food Frequency Questionnaire (QFFQ) and 24-hour recall were used to determine dietary intake patterns. Anthropometric measurements were obtained in order to find out the prevalence of nutritional status (underweight, wasting and stunting). Haematology and biochemical data collected were used to determine the intake of nutrients and blood levels. Socio-demographic and health questionnaires were captured and analysed using the Statistical Package for Social Sciences (SPSS). Dietary intake, QFFQ and 24-hour food recall were analysed on the South African Medical Research Council FoodFinder® software program. Anthropometric measurements were captured and calculated using Anthro plus then analysed according to the World Health Organisation growth standards while biochemical measurements were analysed using biochemical analyses instrument and transferred to SPSS. The socio-demographic results indicated that household food insecurity contributed to the poor dietary intake of the children as the majority (71.0%) of the caregivers were unemployed and further confirmed by household income of less than R1000 (75.0%) for five to ten household members (44.4%). Non-communicable diseases were not reported; instead, most of the caregivers had skin problems (22.2%) and also suffered from headaches (20.0%) as well as body skeletal affections. Mainly carbohydrate-based food was consumed with limited vegetable and fruit intakes. Low energy intakes were reported with sufficient intakes of most of the micronutrients. Anthropometric results indicated that 5.0% of the children were underweight, only 2.3% of the children were wasted and 33.3% were stunted. Haematological and biochemical data indicated that all the variables were within the normal ranges and thus did not indicate any nutrients or blood level deficiency. Through the findings of this study and other similar studies conducted in South African communities, it is evident that poor nutrition and dietary intakes are still prevalent in primary school children. This increases awareness and the immediate need for nutritional status and food insecurity to be addressed.Key words: Nutritional status, consumption patterns, primary school children, Orange Far

Prevalence of and contributing factors to dyslipidaemia in low-income women aged 18-90 years in the peri-urban Vaal region

Objective: Determining the prevalence of dyslipidaemia and examining dietary and other contributing factors, namely hypertension, overweight and obesity, as well as abnormal blood lipid levels in women aged 18-90 years.Design: Cross-sectional baseline survey study.Setting: Peri-urban Vaal region.Subjects: Seven hundred and twenty-two randomly selected black women in four purposively selected settlements in the Vaal region.Outcome measures: Measurements included dietary intake (24-hour recall), anthropometric (weight and height), and blood pressure and biochemical indices (lipid profile) with venous blood samples. Data analyses included descriptive statistics, t-tests and regression analyses.Results: A large percentage (34.3%) of the women (aged 18-90 years old) was dyslipidaemic. The majority of women in the nondyslipidaemic group were overweight (52.6%). 86.2% of the women in the dyslipidaemic group were obese. The total fat intake was 20% of total energy intake in both groups. No significant differences were observed between the dietary fat intake variables between the groups. Body mass index (BMI) (ß = 0.554, p-value = 0.000), age (ß = 0.419, p-value = 0.000), education (ß = 0.250, p-value = 0.000), total energy intake (ß = 0.105, p-value = 0.006) and total fat intake (ß = 0.092, p-value = 0.018) were predictors of dyslipidaemia in these women.Conclusion: Dyslipidaemia was prevalent. High triglyceride and low high-density lipoprotein cholesterol levels were the most frequent abnormalities. Although positive associations existed between the  prevalence of dyslipidaemia and the known risk factors of cardiovascular disease, such as ageing, hypertension, obesity and an abnormal lipid profile; BMI, age and education were the main predictors of dyslipidaemia.Keywords: cardiovascular disease, women, dyslipidaemia, hypertension, dietary fat intak

Association of micronutrients and child growth in children aged 7-15 years from Qwa-Qwa, South Africa

Objectives: This study investigated the possible associations between micronutrient deficiencies and child growth in the rural community of Qwa-Qwa in the Free State province of South Africa (SA).Design: Cross-sectional observational baseline survey.Setting: Rural Qwa-Qwa, Free State, SA.Subjects: Children 7- 15 years of age (n = 73; randomly selected).Outcome Measures: Nutritional status in terms of height and weight measurements, and serum haemoglobin, vitamins A and E and zinc.Results and conclusions: The results of this study showed that there was no significant difference between the mean age of the two genders (p = 0.94). The prevalence of micronutrient deficiencies were 47.3% vitamin E, 25.0% zinc, 3.9% haemoglobin and 1.4% vitamin A. The prevalence of wasting, stunting and underweight was 19.2, 13.7 and 11.4%, respectively. Linear regression analysis showed statistically significant positive correlations between weight-for-age (WAZ) and haemoglobin (r = 0.38, p = 0.049), zinc (r = 0.71, p = 0.008) and vitamin E (r = 0.43, p = 0.029) levels, while there were no significant correlations between vitamin A with WAZ, height-for-age (HAZ) and body mass index-(BMI)-for-age (BAZ). This study shows that there are some associations between child growth and certain micronutrient deficiencies that affects the growth and well-being. Therefore, regular and continued monitoring is recommended for the benefit of, specifically South African children, but also the general population, researchers and the government.Keywords: Children, child growth, growth monitoring, micronutrien

Testing of developed Food Based Dietary Guidelines for the elderly in South Africa

The purpose of this paper is to describe the process of the testing of the Elderly Food Based Dietary Guidelines (EFBDGs). Following a literature review, stakeholder discussions and revision, preliminary English EFBDGs were proposed and circulated to an expert panel for input. The developed EFBDGs are based on the existing FBDGs which were revised in 2012 and adapted for older people following the Food and Agricultural Organisation/World Health Organisation (FAO/WHO) guidelines. Minor corrections were received and incorporated, after which the guidelines were tested for comprehension, appropriateness and applicability in consumer groups.A qualitative design was followed with focus group discussions. Firstly, the English EFBDGs were tested with IsiZulu, Afrikaans, IsiXhosa, English and Sesotho speaking elderly aged 60 years and older in KwaZulu-Natal, Gauteng, Eastern Cape and Free State provinces, respectively. Thereafter, they were adapted and translated into IsiZulu, Afrikaans, IsiXhosa and Sesotho. Secondly, the adapted and translated EFBDGs were tested in the mentioned ethnic groups.In general, as expected, the results of the tests showed that the English speaking elderly responded better to the English guidelines than the other ethnic groups. The feedback in respect of the tested translated guidelines was more positive indicating a better understanding of the EFBDGs by the various ethnic groups. This is because, not only were the English guidelines translated, but they were also adapted and words were contextualised according to the day-to-day language use of the groups.It was recommended that the guidelines be incorporated into the Integrated Nutrition Programme for the purpose of nutrition education as well as a guide for food service institutions serving the elderly. Also, it was recommended that the development of support material for health professionals and the wider community be undertaken and the material translated into all the official languages. Future strategies should include the implementation, evaluation and impact of the EFBDGs.Keywords: elderly nutrition, food based dietary guideline

Eat clean and safe food: a food-based dietary guideline for the elderly in South Africa

As the population of elderly individuals in South Africa (SA) grows, there is a need to promote the continued health of these persons as they progress through the life cycle. Food Based Dietary Guidelines (FBDGs) for the SA elderly were developed to address this need. These thirteen guidelines for the elderly collectively offer a basis of health practices that the elderly can follow to ensure that they are taking the right steps toward maintaining their health. While the guideline ‘Eat clean and safe food’ is not included in the current SA FBDGs, this recommendation is of particular importance to the elderly, who face a much higher risk of foodborne illness than most of the general population due to a number of factors. Reduced immunity and other physiological changes are a result of ageing, malnutrition, diseases and and/or medication side effects. All these factors play a role in the elderly’s risk of foodborne illness. Increased susceptibility to certain pathogens also causes higher rates of foodborne illness infection. Lastly, elderly people’s food safety knowledge and pre-established beliefs and practices regarding food handling and preparation can be influential in their sensitivity to foodborne disease. These risk factors, coupled with the heavy burden of foodborne illness and existing gaps in food safety policy, practices and education in SA, substantiate the need for a dietary guideline to address the importance of clean and safe food consumption among the elderly in SA

Soy and vegetable gardening with skills training and soy consumption are cost effective methods to improve the blood lipid profiles of women in Qwa-Qwa, South Africa

A cost effectiveness (CE) analysis was performed on a nutrition intervention program that included soy consumption, soy and vegetable gardening, and skills training designed to improve blood lipid levels in women. This intervention involved ninety women of ages 19-75 years living in Qwa-Qwa, South Africa. The actual nutrition intervention lasted 18 months. Outcomes measured were low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and serum triglycerides levels. All costs for the resources used in the program were considered and categorized into four main groups: labor, materials, transport, and miscellaneous. Following the recommendation for evaluating nutrition projects, a common base year of 2012 and discount rate of 5% were selected. The CE was calculated based on the total cost of the intervention program for all 90 women served and the number of women who achieved normal levels for a specified serum lipid during the 18 months of intervention. The CE ratios were expressed as the per subject cost of achieving the normal level of a specified serum lipid for example, HDL cholesterol. The average cost (in 2012 dollars) was approximately $869 per person. The CE ratio for serum HDL cholesterol was the lowest compared to the CE ratios of other indicators of serum lipids. Material costs accounted for the majority of the costs (71%) followed by labor (22%). Training materials, gardening tools, soy preparation equipment, and seeds, which are critical for increasing the scale of the program, together contributed to a relatively low percentage of the total cost of materials (37%). In addition, it was noted that the per person cost is likely to decrease if the scale of the intervention is increased. Soy and vegetable gardening with skill training and soy consumption may be a feasible population-wide approach to prevent the development of cardiovascular diseases among women in Qwa-Qwa, South Africa.Key words: Cardiovascular diseases, cost effectiveness, high-density lipoprotein, lipid profile, nutrition intervention, Qwa-Qwa, South Africa, soybean, vegetable gardening, wome

The impact of a nutrition programme on the dietary intake patterns of primary school children

Objective: The aim of this study was to improve the dietary intake patterns and food choices of children aged 9-13 years in a periurbancommunity.Methods: Two schools were randomly selected from within this periurban community. A nutrition education programme was implementedover one school term, with the testing of nutrition knowledge occurring pre- and post-intervention, and in the long term, with the experimentalgroup only. A validated 24-hour recall questionnaire was completed pre- and post-intervention by both the control (n = 91) and experimentalgroups (n = 81), and in the long term, by the experimental group. Food models were used to assist in the estimation of portion sizes andidentification of food items. The questionnaire was analysed using the computer software programme FoodFinder 3, with means and standarddeviations calculated for macro- and micronutrients, and comparisons made with dietary reference intakes for specific age groups. A list wasdrawn up of the 20 most commonly consumed food items, based on weights consumed. Paired t-tests were conducted to assess significancein dietary intake and food choices after the intervention. Correlations between knowledge and dietary choices were determined among theexperimental group in the long-term measurements.Results: Correlations linked protein intake to knowledge of proteins, and vitamin C intake to knowledge of fruit and vegetables. Fruit andvegetable intake remained very low. Refined sugars and fat were still consumed among the experimental group. The diet for both groups wasbased on carbohydrates.Conclusions: The objective of changing the dietary intake patterns of the children was not achieved. The intake of legumes, fruit and vegetables remained low. The lack of variety in intake results in a diet that does not meet the daily requirements of children