Eating behaviour, eating attitude and body mass index of dietetic students versus non-dietetic majors: a South African perspective

Objectives: The objective was to determine and compare the eating behaviour, eating attitude and body mass index (BMI) of dietetic students to those of non-dietetic majors.Design: This was a cross-sectional, descriptive survey.Setting: The setting was the University of KwaZulu-Natal.Subjects: The subjects were a random sample of 83 first-year non-dietetic major students; 24 first-, 20 third- and 18 fourth-year dietetic students.Outcome measures: Outcome measures were the results of the Three-Factor Eating Questionnaire (TFEQ), Eating Attitudes Test 26 (EAT 26) and BMI.Results: According to the TFEQ, there was a high prevalence of eating restraint, followed by disinhibition of eating and hunger scores, in first-year dietetic students. Measures of these subscales were similar for non-dietetic majors. A significant difference between the two groups was observed with regard to eating restraint (p-value < 0.001). The mean scores for the EAT 26 from both of the first-year groups were not indicative of an eating disorder. A higher prevalence of disordered eating was observed in first-year dietetic students (p-value < 0.059). Lower levels of eating restraint and disinhibition were documented in dietetic students in subsequent years of study. The mean BMI of all of the participant categories was within the normal range.Conclusion: There was a higher prevalence of eating disorders in first-year dietetic students than in students taking non-dietetic majors. Eating disorders in these students highlight the need for similar studies to be conducted at other local universities offering dietetics as a subject. Keywords: dietetic students, Three-Factor Eating Questionnaire, Eating Attitudes Test 26, body mass index, eating behaviour, eating disorder

Cry, the beloved bottle: infant-feeding knowledge and the practices of mothers and caregivers in an urban township outside Bloemfontein, Free State province

Objectives: To investigate knowledge of and practices regarding bottle-feeding preparation, as well as the nutrient content and microbial safety of bottles that are prepared by mothers and caregivers for infants aged 0-24 months.Design: Cross-sectional descriptive survey.Setting: Urban township, Mangaung, outside Bloemfontein.Subjects: A sample of 189 mothers or caregivers of healthy infants aged 0-24 months, who were exclusively formula fed or mixed fed with breast milk and infant formula or cow’s milk, were randomly selected in a household survey.Outcome measures: An interviewer-administered questionnaire and/or observed practices were used for data collection. Bottle-feed samples were also collected and analysed for nutrient and microbial content.Results: Mother and caregiver knowledge on infant feeding was poor. An acceptable method for preparing a bottle feed in five steps was evaluated. Only 4.2% of the total sample applied all five steps. A total of 84.5% (n = 160) of all the collected feeds was contaminated with E coli. A lower level of maternal education was associated with a greater likelihood of feed contamination. The predominant source of bottlefeeding preparation information was clinic staff (28%).Conclusion: The findings were indicative of a lack of knowledge, and possibly resource limitations, to facilitate safe bottle-feeding practices. Acknowledgement of clinic staff as a source of infant-feeding information highlights the role of healthcare workers as facilitators of appropriate infant-feeding practices.Keywords: infant feeding practices, breastfeeding, bottle feeding, mixed feedin

When science meets culture: The prevention and management of erectile dysfunction in the 21st century

Traditionally, the term “impotence” has been used to signify a male’s inability to attain and maintain an erection. Impotence, in most circumstances, is more precisely referred to as erectile dysfunction (ED). An estimated 10-20 million men suffer from the condition. However, this number is expected to increase dramatically, with an estimated figure of 322 million by 2025. Even though the prevalence of ED increases with age, it must be stressed that ageing itself is not a cause of ED as it is  associated with metabolic syndrome, cardiovascular disease, diabetes mellitus and other noncommunicable diseases, such as obesity. Many  patients self-medicate by resorting to local herbs and overthe-counter (OTC) preparations to manage ED. Because of the increasing number of men seeking treatment for ED, there is a need to assess the safety and biological plausibility of some of the readily available preparations (as well as food and drink) that reportedly enhance sexual desire or performance. For the purpose of this review, the aphrodisiacal qualities of freely available foods and natural OTC products will be reviewed and evaluated. These  include oysters, alcoholic beverages, chocolate, chilli, Epimedium extract  (horny goat weed), Panax ginseng, Ginkgo biloba, Tribulis terrestris,  Eriosema kraussianum and Spanish fly (cantharides)

Adolescent food frequency and socio-economic status in a private urban and peri-urban school in Hilton, KwaZulu-Natal

Objective: The objective of the study was to make a comparative analysis of the dietary preferences of adolescents attending an urban versus a peri-urban school in KwaZulu-Natal, in order to investigate the association between socio-economic status and food frequency.Design: The design was a cross-sectional descriptive survey.Setting: The setting was an urban and peri-urban high school in Hilton, KwaZulu-Natal.Subjects: One hundred and eleven grade 9-11 learners from a peri-urban school, and 98 grade 9-11 learners from an urban school, volunteered to participate.Outcome measures: A non-quantified food frequency questionnaire was used to assess food frequency. A socio-demographic questionnaire developed for the purpose of this study was utilised to collect information on parental education, employment status and household or accommodation data. A Household Food Insecurity Access Scale  questionnaire was used to determine the household food insecurity of the learners.Results: The findings indicated that there was a higher preference for globalised foods (high in fat and sugar), particularly fast food, by learners from the peri-urban school (p-value < 0.01). These learners were also more likely to consume locally available, high-fat snacks (p-value < 0.01). Grade 10 urban school learners consumed more red meat and processed meats than their peri-urban school counterparts (p-value < 0.01). Negative correlations were observed between parental education and employment status (particularly of the mothers) and fast food consumption in  adolescents (p-value < 0.01).Conclusion: A high frequency of globalised or energy-dense food intake was associated with low socio-economic status. Although healthy eating habits were generally poor in urban and peri-urban adolescents, food sources varied, possibly owing to cost and availability. The importance of a diverse diet and the inclusion of a wider range of affordable, nutrient-rich foods should be promoted in the school setting, and also to parents, particularly those of a lower socio-economic status

The variety, popularity and nutritional quality of tuck shop items available for sale to primary school learners in Pietermaritzburg, South Africa

Objectives: To determine the variety, popularity and nutritional quality of the food and beverages sold to primary school pupils. Method: A cross-sectional tuck shop survey. Nutritional analyses were conducted using the South African Medical Research Council Foodfinder 3 for Windows® software. Eleven mixed-race, well-resourced, government primary schools were studied in Pietermaritzburg, South Africa. Subjects included tuck shop managers from each school. Results: Savoury pies were the most popular lunch item for all learners for both breaks (n = 5, 45%, and n = 3, 27.3%), selling the most number of units (43) per day at eight schools (72.7%). Iced popsicles were sold at almost every school, ranked as the cheapest beverage, and also sold the most number of units (40.7). Healthy beverages sold included canned fruit juice and water, while healthy snacks consisted of dried fruit, fruit salad, bananas, yoghurt and health muffins. The average healthy snack contained almost half the kilojoules of the unhealthy counterpart (465 kJ vs. 806 kJ). Nutritional analyses of the healthy lunch options revealed total fat contents that exceeded the Dietary Reference Intake and South African recommended limits. Perceived barriers to stocking healthy items included cost and refrigeration restrictions. Conclusion: School tucks shops are selling products that encourage an unhealthy lifestyle, thereby promoting the obesity epidemic. Extensive consultation is required among dietitians, school principals and privatised tuck shop managers to overcome barriers to stocking healthy food in tuck shops.Keywords: school feeding, tuck shop, Pietermaritzburg, South Afric

Tuck-shop purchasing practices of Grade 4 learners in Pietermaritzburg and childhood overweight and obesity

Objectives: To determine the anthropometric characteristics of Grade 4 learners in relation to their tuck-shop purchasing practices.Design: A cross-sectional research design using a questionnaire that was administered to Grade 4 learners.Setting and subjects: Four well-resourced primary schools in Pietermaritzburg. The study included 311 Grade 4 learners.Outcome measures: Body mass index interpreted in relation to tuck-shop purchasing practices.Results: Fifty-six per cent of the sample were female (n = 173) and 44% were male (n = 138) learners. Twenty-seven per cent of the study sample was overweight (n = 83) and 27% was obese (n = 85). Eighty-six per cent of the learners (n = 266) made purchases from their school tuck shop. Twenty-two per cent did so at least three times per week (n = 58). Learners who bought from the tuck shop had a significantly higher body mass index compared to those who did not (p-value < 0.020). Learners who purchased from the tuck shop spent an average of R8.38 per day, a minimum of R1 and a maximum of R40 (± R5.39). The most popular reasons for visiting the tuck shop included: “This is my favourite thing to eat or drink” (66.5%, n = 177), and “I only have enough money to buy this item” (47%, n = 125). Conclusion: Poor tuck-shop purchasing practices may contribute to the development of childhood overweight and obesity in learners. Successful preventative strategies should focus on restricting the amount of unhealthy items that are available for sale, imposing spending limits and motivating learners to prioritise healthy food and beverage purchases.Keywords: childhood obesity, overweight, tuck-shop practices, body mass inde

The nutritional status of young children 0-24 months attending clinics in Tshwane health sub-district 1, Gauteng Province, South Africa

Children between the ages 0 - 24 months are at high nutritional risk, which affects their growth and development, cognitive capacity, and productivity in adulthood. Therefore, this study aimed to determine the nutritional status of young children 0 - 24 months attending clinics in Tshwane Health Sub-District 1, Gauteng province, South Africa. A clinic-based cross-sectional quantitative descriptive study design was applied in this study. Anthropometric data were collected from 270 young children (107 aged 0 – 6 months, 91 aged 6.1 – 12 months, 47 aged 12.1 – 18 months, and 25 aged 18.1 – 24 months) in 10 clinics in Tshwane Health Sub-District 1 using a questionnaire. Data was captured on a Microsoft Excel 2016 spreadsheet and analysed using SAS (SAS Institute Inc, Carey, NC, USA), Release 9.4. A Pearson chi-square test was used to test for correlation between the socio-economic, demographic and the nutritional status of young children, where a P-value ≤0.05 was considered significant. The results of the study showed that 160 (59.3%) had normal weight for length, 18 (6.7%) were wasted, 22 (8.2%) were severely wasted, 24 (8.9%) were overweight and 46 (17.0%) were obese. One hundred and fifty-six (57.8%) had normal weight for age, 47 (17.4%) were underweight, 17 (6.3%) were severely underweight, 39(14.4%) had weight for age >+2SD and 11(4.1%) had weight for age >+3SD. 204 (75.6%) had normal length for age, 26 (9.6%) were stunted, 40 (14.8%) were severely stunted. For overweight young children, there was a significant association between weight and the number of people in the households, at P<0.038 and mothers weekly spend on food, at P<0.027. There was a significant association between length and the number of persons in the households at P<0.047, mothers' income at P<0.047, and mothers weekly spend on food at P<0.051. For underweight young children, there was a significant association between weight and weekly spend on food at P<0.037. There was a significant association between length and mothers' education at P<0.007. Although, the majority of young children had normal weight for length, normal weight for age and normal length for age. In this study, a significant number of young children were malnourished. The young child’s weight for length and weight for age were influenced by the mother’s weekly expenditure on food. Since the mother’s employment status influences the child's weight and length, the implementation of alternative nutrition intervention strategies to monitor and improve the nutritional status of young children is necessary

Consumer acceptance of yellow, provitamin A-biofortified maize in KwaZulu-Natal

Objectives: To assess the acceptance of popular maize food products (phutu, thin porridge and samp), prepared with yellow, provitamin A-biofortified maize varieties, in 212 subjects between the ages of three and 55 years, from rural KwaZulu-Natal.Design: A cross-sectional study.Method: Preschool, primary school and secondary school subjects were randomly selected from two primary schools and one secondary school, respectively, while adult subjects constituted a convenience sample. Pre- and primary school children completed a paired preference test. Secondary school and adult subjects completed a five-point facial hedonic and a preference ranking test. Focus group discussions were conducted using adult subjects.Results: Preschool children preferred yellow maize to white maize food products: phutu (81% vs. 19%; p-value < 0.001), thin porridge (75% vs. 25%; p-value < 0.001) and samp (73% vs. 27%; p-value < 0.001). There was no statistically significant difference in preference for white and yellow maize by primary school children. Secondary school and adult subjects preferred white maize to yellow maize. Focus group discussions confirmed the preference for white maize by the adults.Conclusion: The study findings suggest that yellow, provitamin A-biofortified maize has the potential to succeed as a new strategy of dealing with the serious problem of vitamin A deficiency, especially among children of preschool age. However, in older groups, this strategy is unlikely to be successful, unless other strategies are implemented, including intensive nutrition education programmes on the nutritional benefits of the maize, targeting the market price at which yellow maize is sold, increasing its availability in local grocery stores, and improving its sensory properties through breeding.Keywords: yellow maize, provitamin A, vitamin A deficiency, consumer acceptanc

The metabolic profiles of HIV-infected and non-infected women in Mangaung, South Africa

Objective: To determine the biochemical nutritional status of HIV-infected women in Mangaung.Design: Cross-sectional.Setting: The community of Mangaung, Free State, South Africa.Subjects: A representative group of 500 black women (25–44 years) was selected randomly to participate.Outcome measures: Biochemical analyses were performed for total  lymphocytes, serum protein, serum albumin, plasma fibrinogen, serum insulin, serum glucose, serum triglycerides and serum cholesterol using standard methodology. Values were compared to standard references, and between HIV-infected and HIV-uninfected women.Results: After screening for eligibility, 488 women qualified. Sixty-one per cent of the younger women (25–34 years) and 38% of the older women (35–44 years) were HIV-infected. HIV-infected women had significantly lower median blood values for total lymphocytes (p = 0.0001 and p = 0.02 for younger and older group respectively) and serum albumin (p = 0.0001 for both age groups), but significantly higher median concentrations of serum protein (p = 0.0001 for both age groups) than uninfected women. Plasma fibrinogen and serum insulin concentrations were significantly lower in HIV-infected younger women than in their uninfected counterparts (p = 0.002 for both parameters). Older HIV-infected women had significantly lower total serum cholesterol values (p = 0.01) than older HIV-uninfected women. Serum glucose and serum triglycerides did not differ significantly between HIV-infected and HIV-uninfected women.Conclusions: The results indicate a possible impact of HIV infection on serum protein and serum albumin, which may adversely affect biochemical nutritional status and the course of HIV progression. Future research into the causes and possible treatment of metabolic changes in women in this community should be prioritised

Nutritional quality of a ready-to-use food, and its acceptability to healthy and HIV-infected children receiving antiretroviral treatment

Objectives: The objectives of this study were to determine the nutritional quality of a ready-to-use food (RUF), and its acceptability to children who were “healthy” and to those who were human-immunodeficiency virus (HIV)-infected and receiving antiretroviral therapy (ART).Design: This was a cross-sectional survey that assessed the consumer acceptability of the RUF by the children.Setting and subjects: One hundred and eighty-eight children were selected from six schools, a day care and a hospital in Pietermaritzburg. Of these children, 123 were “healthy”, and 65 HIV-infected and receiving ART.Outcome measures: The outcome measure of the study was the nutritional quality of the RUF in terms of its nutrient levels relative to appropriate nutritional standards, and its acceptability rating by the children.Results: The RUF had appreciable levels of energy (2 624 kJ/100 g) and protein (15.7 g/100 g).The nutritional composition met the World Health Organization/World Food Programme/the United Nations Standing Committee on Nutrition/The United Nations Children’s Fund recommendations for an RUF regarding energy, protein and essential amino acid levels. Sensory evaluation indicated that the RUF was acceptable to both children who were healthy and to those who were  HIV-infected. Generally, more than 75% of the participants in both groups rated the product overall as “good”. More than 65% of the children liked the taste, smell and mouth feel.Conclusion: The RUF that was used in this study is a good source of energy and quality protein, and is acceptable to children. Further micronutrient analysis would determine the additional role of the RUF in alleviating micronutrient deficiencies, including vitamin A, zinc and iron. Since the RUF is acceptable to children who were healthy and to those who were  HIV-infected on ART, it can be used to address proteinenergy malnutrition in these target groups