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

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

Change in soy and nutrition knowledge and perceptions of smallholder South African farmers after attending a single one day soy nutrition training workshop: A pilot study

The main aim of this pilot study was to assess smallholder soy farmers’ knowledge and perceptions of soy immediately before and after participating in a one-day soy nutrition training workshop. A pre-post study design was used among a convenience sample of 78soy smallholder farmers from KwaZulu-Natal, South Africa (SA). A total of 78 men and five women participated in the training, but  because only five women attended, gender comparison analysis was not carried out. A soy nutrition training workshop, including soy cooking demonstrations, tasting, recipe development, that is based on the Social Cognitive Theory, was implemented for eight  consecutive hours with one break of 30 minutes. Pre- and post-quantitative data measuring,soy knowledge and perceptions werecollected using a modified version of a survey, tested for face and content validity and reliability, and used previously in other research study projects by the same authors among low-resource communities in SA. The data from the pre and post questionnaires indicated that only 41% of the soy smallholder farmers used soy in the household and mainly in meat dishes. The rest of the harvested soy was either sold or used for animal feed. The mean±standard deviation (SD) score of taste preference changed significantly (p=0.002) from 4.60±0.84 before, to 4.93±0.13 after the training (p=0.002) and the majority of the participants perceived it was easy to prepare soy foods; 82.1% and 88.5% before and after the training, respectively (p=0.013). Participants’ soy knowledge improved significantly (p<0.001) from a mean± (SD) score of 26.33±4.06 before to 32.00±9.46 after the intervention, indicating a significant improvement of 5.67±9.11 [13.83%] in the total score. The results from this study indicate that there is a need for nutrition education programs for smallholder farmers. Thus, improvement in both soy knowledge and preference should result in more soy being consumed first for household nutritional needs before giving it to either animals or sell it on the market. Since smallholder farmers’ nutrition education can impact both food insecurity and nutritional status improvement in one setting, more interventions of this kind are needed to further advance the frontier of this niche area of research. Key words: nutrition education, smallholder famers, soy training, South Africa emerging farmers, Knowledge perceptio

How diverse is the diet of adult South Africans?

The original publication is available at http://www.nutritionj.com/content/10/1/33Abstract. Background. The objective of the current study was to measure dietary diversity in South Africans aged 16 years and older from all population groups as a proxy of food security. Methods. A cross-sectional study representative of adults from all specified ages, provinces, geographic localities, and socio-economic strata in South Africa was used (n = 3287). Trained interviewers visited participants at their homes during the survey. Dietary data was collected by means of a face validated 24 hour recall which was not quantified. A dietary diversity score (DDS) was calculated by counting each of 9 food groups. A DDS <4 was regarded as reflecting poor dietary diversity and poor food security. Results The provinces with the highest prevalence of poor dietary diversity (DDS <4) were Limpopo (61.8%) and the Eastern Cape (59.6%). By contrast, only 15.7% of participants in Western Cape had a low score. Participants in tribal areas (63.9%) and informal urban areas (55.7%) were by far the worst affected. There were significant differences in DDS by Living Standards Mean (LSM) analysis (p < 0.05) with the lowest LSM group having the lowest mean DDS (2.93).The most commonly consumed food groups were cereals/roots; meat/fish; dairy and vegetables other than vitamin A rich. Eggs, legumes, and vitamin A rich fruit and vegetables were the least consumed. Conclusion. Overall the majority of South Africans consumed a diet low in dietary variety. The tribal areas and informal urban areas were worst affected and eggs, legumes and vitamin A rich fruit and vegetables, were the least consumed.Publishers' versio

The immune system and the impact of zinc during aging

The trace element zinc is essential for the immune system, and zinc deficiency affects multiple aspects of innate and adaptive immunity. There are remarkable parallels in the immunological changes during aging and zinc deficiency, including a reduction in the activity of the thymus and thymic hormones, a shift of the T helper cell balance toward T helper type 2 cells, decreased response to vaccination, and impaired functions of innate immune cells. Many studies confirm a decline of zinc levels with age. Most of these studies do not classify the majority of elderly as zinc deficient, but even marginal zinc deprivation can affect immune function. Consequently, oral zinc supplementation demonstrates the potential to improve immunity and efficiently downregulates chronic inflammatory responses in the elderly. These data indicate that a wide prevalence of marginal zinc deficiency in elderly people may contribute to immunosenescence

Voices of the hungry: a qualitative measure of household food access and food insecurity in South Africa

South Africa is rated a food secure nation, but large numbers of households within the country have inadequate access to nutrient-rich diverse foods. The study sought to investigate households’ physical and economic access and availability of food, in relation to local context which influences households’ access to and ability to grow food which may affect the dietary quality. We sought to understand self-reported healthy diets, food insecurity from the perspective of people who experienced it, barriers to household food security and perceptions and feelings on food access as well as strategies households use to cope with food shortages and their perceptions on improving household food security

Nutritional status and food intake data on children and adolescents in residential care facilities in Durban

Objective: The aim of this study was to examine growth indicators and dietary intake patterns of children aged 4-18 years residing in residential care facilities in Durban.Method: Thirty-three girls and 110 boys, aged 5-18 years, in three different children’s homes participated in the study. Anthropometric measurements included weight and height and were analysed using the World Health Organization’s AnthroPlus® version 1.0.2 statistical software. The seven-day-cycle menus were analysed for nutrient and energy intake using the FoodFinder® version 3 software programme. Daily nutrient intakes were reported as means and standard deviations, and comparisons were made with the dietary reference intakes for specific age groups. Average served portion sizes were established by plate waste studies and observation.Results: The results showed that stunting and overweight were prevalent in this group. 4.7% of the boys aged 4-8 years and 3.3% of the boys aged 14-18 years were severely stunted. 13.3% of the girls aged 9-13 years and 20% of the girls aged 14-18 years were stunted. The body mass index for age reported that a small number (6.7% of the girls aged 9-13 years and 3.3% of the boys aged 14-18 years) were wasted. The results also showed that 33.3% of the girls aged 4-8 years and 33.4% of the girls aged 9-13 years were at risk of being overweight. 26.7% of the girls aged 14-18 years were overweight (&gt; + 2 standard deviations). Most of the children in the 4-8 age group (83.3% of the boys and 100% of the girls) fell in the normal range for weight for age, while only one boy was underweight. One hundred per cent or more of the dietary reference intakes for energy, protein, carbohydrate and most of the micronutrients were met, except for calcium and iodine. A low intake of vitamin C among older boys and girls was reported. None of the groups met the recommended fibre intake.Conclusion: The results indicated a need for the development and implementation of a comprehensive nutrition education programme forboth child care workers and children.Keywords: nutritional status, food intake data, children, adolescents, residential care facilitie

Dietary fat intake and nutritional status indicators of primary school children in a low-income informal settlement in the Vaal region

Background: The objective of this study was to examine growth indicators, serum cholesterol, high-density lipoprotein (HDL) and low-densitylipoprotein (LDL) cholesterol and triglyceride levels, as well as dietary fat intakes usually associated with cardiovascular disease (CVD) risk inhealthy primary school children.Method: The respondents in this study included a convenience sample of 97 primary school children aged 6-13 years from a selected school.Anthropometric measurements (weight and height) and three 24-hour recall questionnaires were completed for each child. Registered nursesdrew blood from the vena cephalica of seated children after an eight-hour fast.Results: The results of this study indicated that stunting, underweight and thinness were prevalent in this group of children. The prevalencerate for stunting (12.5%) was lower than the national prevalence rate of 20%, whereas the prevalence rate for underweight (15.1%) washigher than the national prevalence rate of 10%. Overweight was prevalent in only 1% of the sample, and more so in boys (2.3%) thangirls (0%). None of the children in this study were obese. Serum cholesterol, HDL cholesterol and triglyceride levels were within the normalrange. However, the mean serum LDL cholesterol levels were very high. The total dietary fat intakes showed significant relationships withtotal dietary cholesterol (r = 0.324, p-value = 0.001), linolenic acid (r = 0.605, p-value < 0.0001) and linoleic acid (r = 0.831, p-value< 0.0001) intakes.Conclusion: In this poor community the dietary intake patterns showed a balanced macronutrient intake, despite a low energy intake, whencompared with the estimated average requirements. The low energy intake was reflected in the prevalence of stunting, underweight andthinness, with a very low prevalence of overweight and no obesity. Furthermore, most of the serum lipid profiles reflected a low risk of thesechildren acquiring CVD

The formulation and development of a multi-mix for primary school children within an informal, South Africa

No Abstract. Nigerian Food Journal Vol. 24(1) 2006: 139