The Use of Multivitamin/Multimineral Supplements:A Modified Delphi Consensus Panel Report

PURPOSE: Evidence supporting the use of dietary supplements, in particular, multivitamin/multimineral supplements (MVMS), has been mixed, complicating the ability of health care professionals to recommend their use. To clarify the role that MVMS can play in supporting human health, a series of consensus statements was developed based on expert opinion. METHODS: A panel of 14 international experts in nutritional science and health care was convened to develop consensus statements related to using MVMS in supporting optimal human health. The modified Delphi process included 2 rounds of remote voting and a final round of voting at a roundtable meeting where evidence summaries were presented and discussed. The level of agreement with each of 9 statements was rated on a 5-point Likert scale: agree strongly; agree with reservation; undecided; disagree; or disagree strongly. Consensus was predefined as ≥80% of the panel agreeing strongly or agreeing with reservation to a given statement. FINDINGS: Consensus was reached for all statements. The panel determined that MVMS can broadly improve micronutrient intakes when they contain at least the micronutrients that are consumed insufficiently or have limited bioavailability within a specified population. MVMS formulations may also be individualized according to age, sex, life cycle, and/or other selected characteristics. There are specific biological processes and health outcomes associated with deficient, inadequate, and adequate micronutrient levels. Adequate intake is necessary for normal biological functioning required for good health; in some instances, higher than recommended micronutrient intakes have the potential to provide additional health benefits. Meeting daily intakes established by dietary reference values should be an explicit public health goal for individuals and populations. Use of MVMS is one approach to ensure that adequate micronutrient needs are met in support of biological functions necessary to maintain health. Long-term use of MVMS not exceeding the upper limit of recommended intakes has been determined to be safe in healthy adults. There is insufficient evidence to indicate that MVMS are effective for the primary prevention of chronic medical conditions, including cardiovascular disease and cancer. However, for certain otherwise healthy subpopulations (eg, pregnant women, older adults) and some individuals with existing medical conditions who experience inadequacies in micronutrient intake, addressing inadequacies by using MVMS can provide health benefits. IMPLICATIONS: This consensus panel has described key issues related to the use of MVMS among individuals at risk of or presenting with inadequacies in micronutrient intake or biomarker status

Do lifestyle choices influence the development of overweight and obesity in the South African Air Force, Bloemfontein?

Objectives: A study was undertaken to determine the prevalence of overweight and obesity at Air Force Base Bloemspruit in Bloemfontein, Free State, and the dietary and lifestyle factors and physical activity which may play a role in the development thereof. Design: This was a descriptive cross-sectional study. Setting: Five units situated at the Air Force Base Bloemspruit, Bloemfontein were included. Subjects: The study included 166 active-duty military personnel (136 males and 30 females) aged 21–59 years. A convenience sample of volunteers participated in the study. Outcome measures: The body mass index (BMI) of the participants was calculated using weight and height, and waist circumference was measured using standardised techniques. The dietary intake of participants was evaluated using a self-administered food frequency questionnaire. Results: A high prevalence of overweight (38.6%) and obesity (36.1%) was identified in the study population. No significant associations were detected between lifestyle factors or physical activity and BMI. The majority of participants (59.6%) consumed three meals per day. Meal frequency did not differ between different BMI categories, and no associations were found between meal frequency and being overweight or obese. Inadequate intake of fruit and vegetables was observed. Conclusion: A high prevalence of overweight and obesity was observed in this study, which calls for urgent intervention. No associations were, however, found between dietary and lifestyle factors and the presence of overweight and/or obesity. Further investigation is required to identify the causes of overweight and obesity and effective ways to address this health challenge

Sociodemographic variables affecting caregivers’ attitudes towards the provision of healthy breakfast and lunchboxes to children in their care

Objective: A study was undertaken to determine the sociodemographic variables (SDV) and caregivers’ attitudes that impact on healthy eating and the provision of healthy breakfast and school lunchboxes. Design: This was a cross-sectional, descriptive study using self-administered questionnaires. Setting: Participating Quintile 5 primary schools in Bloemfontein, South Africa (SA). Participants: Caregivers of learners, aged 6–12 years (N = 1 286). Main outcome measures: To determine associations between sociodemographic variables (SDV) and attitudes towards the provision of healthy breakfast and lunchbox foods. Analysis: Wilcoxon two-sample test for unpaired data or the chi-square test to compare groups. A p-value of <0.05 indicated statistical significance. Results: Caregivers with higher income and those living with a life partner were more likely to perceive healthy food as being more expensive than less healthy food (p < 0.01 and p < 0.01, respectively) and were of the opinion that preparing lunchboxes increased their workload (p < 0.01 and p < 0.01, respectively). Caregivers with lower income had a less positive attitude towards healthy eating habits (p < 0.01). Conclusions: Caregivers mostly had a positive attitude towards providing healthy breakfast and lunchbox foods. Discrepancies between caregivers’ perception of preparation time and cost of healthy food, and the provision of healthy food to learners, were observed

Breakfast and lunchboxes provided to foundation phase learners: do caregivers’ knowledge and attitude reflect their practices?

Background: This study was conducted to determine nutritional knowledge, and to identify whether caregivers’ knowledge and attitudes related to their breakfast and lunchbox food-providing practices. Methods: A cross-sectional descriptive study was conducted. Questionnaires were used to collect the data. The study population included 1286 caregivers of foundation phase learners in Quintile 5 schools from Bloemfontein, South Africa. Results: The median score for knowledge regarding breakfast and lunchboxes of caregivers was 55.6% and 73.1%, respectively. Knowledge on breakfast and lunchbox foods was higher for caregivers older than 35 years (breakfast median 55.6, p = 0.0479 and lunchbox median 76.9, p < 0.0001) and who possessed a tertiary qualification (breakfast median 55.6, p = 0.0009 and lunchbox median 76.9, p < 0.0001). The attitudes of caregivers were generally positive towards providing healthy breakfast and lunchbox foods (breakfast median 71.4% and lunchbox median 82.5%). The primary objective of caregivers’ provision of a lunchbox was health considerations (n = 658, 54.2%) followed by being filling (n = 277, 22.8%). The median score to rate the provision of healthy breakfast foods was 26.7% and 35.6% for lunchbox foods. Healthier breakfasts and lunchboxes were provided by caregivers with a tertiary qualification. Conclusions: A need to educate caregivers on the provision of healthy breakfast and lunchbox foods has been identified