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

The opinion of KwaZulu-Natal dietitians regarding the use of a whole-foods plant-based diet in the management of non-communicable diseases

Background: International studies have highlighted the benefit of using a whole-food, plant-based diet (WFPBD) in the revention and treatment of non-communicable diseases (NCDs). It is imperative to gather the opinions of dietitians on this diet, in order to assess whether it is a suitable treatment option for the prevention of NCDs in South Africa.Objective: The aim was to determine whether dietitians would use a WFPBD to address NCDs, by assessing their opinions on the enefits and barriers of this diet.Methods: A cross-sectional study, using an online survey of dietitians who are practising in KwaZulu-Natal (n = 101).Results: Dietitians who work for the government were significantly more likely to have patients with NCDs referred than dietitians in private practice. The subjects reported that the training surrounding WFPBD was inadequate at university level; however, a significant sample was confident about prescribing this diet and they were interested in improving their knowledge on this topic. The strongest perceived benefits of a WFPBD were its association with improved fibre intake and the reduced consumption of saturated fats. The strongest barriers against prescribing a WFPBD were the lack of public awareness concerning the diet and personal preference for the consumption of meat and animal-sourced foods.Conclusion: Although the general opinion of a WFPBD was positive, the perceived barriers indicated suggest that this diet may be difficult to implement for the management of NCDs, particularly in the poverty-stricken areas of South Africa

What factors determine the use of the nutrition information on the food label when female consumers from Pietermaritzburg select and purchase fat spreads?

Objectives: This study set out to determine the following in relation to the nutrition information on the food labels of selected fat spreads: the demographic profile of female consumers using the food label, reasons for food label use and whether the use of the food label leads to the purchase of the selected fat spreads.Methods: One hundred and fifty women aged 25 to 45 years were chosen using an accidental, non-probability sample of consumers shopping at selected supermarkets in Pietermaritzburg. Consenting subjects were presented with a questionnaire to determine their demographic characteristics as well as their reasons for purchasing the selected fat spreads. Descriptive statistics and principal component analyses were used to analyse the results of this study.Results: Fifty-five per cent (n = 82) of this study sample reported using the nutrition information label to assist with their purchases and 68% (n = 102) found the nutrition information important when purchasing a new product.Conclusions: The female consumer most likely to use the nutrition  information on the food label had a tertiary education; was a primary food purchaser; lived with other people; had more money per month to spend on food; and was conscious of choosing the healthier option. Principal component analysis revealed that the purchase of a selected fat spread was influenced by a number of variables reflecting health awareness, the selected fat spread’s marketing, presentation and popularity, and familiarity with and cost awareness of the selected fat spread

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

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

Interaction between maternal caffeine intake during pregnancy and CYP1A2 C164A polymorphism affects infant birth size in the Hokkaido study

BACKGROUND: Caffeine, 1,3,7-trimethylxanthine, is widely consumed by women of reproductive age. Although caffeine has been proposed to inhibit fetal growth, previous studies on the effects of caffeine on infant birth size have yielded inconsistent findings. This inconsistency may result from failure to account for individual differences in caffeine metabolism related to polymorphisms in the gene for CYP1A2, the major caffeine-metabolizing enzyme. METHODS: Five hundred fourteen Japanese women participated in a prospective cohort study in Sapporo, Japan, from 2002 to 2005, and 476 mother-child pairs were included for final analysis. RESULTS: Caffeine intake was not significantly associated with mean infant birth size. When caffeine intake and CYP1A2 C164A genotype were considered together, women with the AA genotype and caffeine intake of >= 300 mg per day had a mean reduction in infant birth head circumference of 0.8 cm relative to the reference group after adjusting for confounding factors. In a subgroup analysis, only nonsmokers with the AA genotype and caffeine intake of >= 300 mg per day had infants with decreased birth weight (mean reduction, 277 g) and birth head circumference (mean reduction, 1.0 cm). CONCLUSION: Nonsmokers who rapidly metabolize caffeine may be at increased risk for having infants with decreased birth size when consuming >= 300 mg of caffeine per day.This is the author's accepted version of their manuscript of the following article: Sasaki, et al. Pediatric Research (2017) 82, 19–28. The final publication is available at: http://dx.doi.org/10.1038/pr.2017.7

The opinion of KwaZulu-Natal dietitians regarding the use of a whole-foods plant-based diet in the management of non-communicable diseases

Background: International studies have highlighted the benefit of using a whole-food, plant-based diet (WFPBD) in the prevention and treatment of non-communicable diseases (NCDs). It is imperative to gather the opinions of dietitians on this diet, in order to assess whether it is a suitable treatment option for the prevention of NCDs in South Africa. Objective: The aim was to determine whether dietitians would use a WFPBD to address NCDs, by assessing their opinions on the benefits and barriers of this diet. Methods: A cross-sectional study, using an online survey of dietitians who are practising in KwaZulu-Natal (n = 101). Results: Dietitians who work for the government were significantly more likely to have patients with NCDs referred than dietitians in private practice. The subjects reported that the training surrounding WFPBD was inadequate at university level; however, a significant sample was confident about prescribing this diet and they were interested in improving their knowledge on this topic. The strongest perceived benefits of a WFPBD were its association with improved fibre intake and the reduced consumption of saturated fats. The strongest barriers against prescribing a WFPBD were the lack of public awareness concerning the diet and personal preference for the consumption of meat and animal-sourced foods. Conclusion: Although the general opinion of a WFPBD was positive, the perceived barriers indicated suggest that this diet may be difficult to implement for the management of NCDs, particularly in the poverty-stricken areas of South Africa

The impact of unprofitable customer management strategies on shareholder value

A significant proportion of many firms’ customers are unprofitable. The question of how unprofitable customers should be managed has recently received increasing research attention from the customer and manager angles, but the effects of unprofitable customer management (UCM) strategies on shareholder value is unknown. Using an event study methodology, we examine stock market reactions to disclosures of firms’ UCM strategy decisions. Results from a sample of UCM strategy disclosure events reveal an average short-term abnormal stock return of −0.53%. Drawing on signaling theory logic, we explore a number of signal (UCM strategy), signaler (firm engaging in UCM), and signaling environment characteristics that may affect the shareholder value effects of firms’ UCM approaches. Our analyses show that investors respond more favorably to indirect UCM strategies than to direct customer divestment strategies. We also find that particular types of indirect UCM strategy approaches and strategic intent in UCM strategy adoption, stronger firm marketing capabilities and, and positive publicity can help mitigate the generally negative abnormal stock returns observed. Overall, our findings have important implications for marketing theory and provide actionable new insights for managers into how to approach the management of unprofitable customers