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

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

Prevalence of overweight and obesity among selected schoolchildren and adolescents in Cofimvaba, South Africa

Background: Childhood obesity has become a growing global epidemic. In South Africa, overweight and obesity during childhood and adolescence are rising. The objectives of this study were (i) to estimate the prevalence of overweight and obesity among selected students in Cofimvaba, a rural settlement in Eastern Cape province, South Africa, and (ii) to assess the accuracy of the mid-upper arm circumference (MUAC) and ultrasound triceps skin-fold thickness (TSF) methods of predicting these health parametersMethods: A cross-sectional study was conducted on 211 students (109 girls and 102 boys) selected randomly from five public schools in Cofimvaba and aged 6–19 years. The weight, height, MUAC and TSF were determined by standard techniques. Data obtained were subjected to descriptive statistics, Pearson correlations and receiver operating characteristic (ROC) curve analysis. P < 0.05 was considered statistically significant.Result: Overall 1.9% (1.8% girls and 2.0% boys) of the respondents were underweight, 14.8% (21.1% and 7.8% boys) were overweight and 2.8% (4.6% girls and 1.0% boys) were obese. The prevalence of overweight and obesity was significantly higher (p < 0.05) in girls than boys during adolescence but there was no gender difference in children (6–9 years). Most of the students (80.6%) had a healthy weight, with boys being significantly (p < 0.05) healthier than girls. The BMI showed significant strong correlations with MUAC (r = 0.926; p < 0.001) and TSF (r = 0.643; p < 0.001). ROC curve analysis gave an area under the curve (AUC) of 0.795 (95% CI, 0.761–0.889) and 0.835 (95% CI, 0.771–0.899) for MUAC and TSF respectively.Conclusion: The study found a high prevalence of overweight children in the sample and a low prevalence of stunting and underweight. The adolescent girls are at a higher risk of being overweight and obese than the boys. MUAC and TSF can adequately predict overweight and obesity among the selected students

An introduction to the Food-Based Dietary Guidelines for the Elderly in South Africa

Food-based dietary guidelines (FBDGs) are not a new concept and are being used in many countries to promote healthy eating and the prevention of diet-related chronic diseases. The Food and Agriculture Organization (FAO) recommended FBDGs as an approach to prevent malnutrition and promote healthy dietary behaviours in populations, taking into consideration local conditions, traditional dietary practices and socioeconomic and cultural factors whilst at the same time using evidence-based scientific principles. South Africa (SA) currently has two sets of guidelines, namely the paediatric food-based dietary guidelines and the South African FBDGs for the population aged seven years and older. The recognition that elderly malnutrition remains a major public health concern in SA led to the formulation of a specific set of guidelines for this vulnerable population group based on existing nutrition-related health issues, local dietary habits and barriers to food intake experienced by those aged 60 and above. This introductory paper on the development of the elderly food-based dietary guidelines (EFBDGs) will be followed by six technical papers motivating why these guidelines are suited to address nutrition-related issues among the elderly in SA

Be active: a food-based dietary guideline for elderly South Africans

The goal of this paper is to support the ‘Be active!’ food-based dietary guideline (FBDG) for South Africans of seven years and older by means of a technical guideline regarding physical activity (PA) specifically for the elderly. Optimal nutrition and physical activity (PA) are essential to ensure healthy ageing. PA is an integral part of a healthy lifestyle; however; the rate of low PA in the elderly (59.7%) is high in South Africa (SA). Regular PA reduces the risks of chronic diseases, such as diabetes, high blood pressure, heart diseases and cancers. Therefore, this review study aims to gather available information concerning PA and suitable methods to promote PA among the elderly in SA. Lack of environmental support for PA, trainers, PA-educated caregivers, poor knowledge about the recommended level of PA and its benefits, lack of motivation by healthcare providers, poor health and nutritional status, and lack of opportunity for social engagement prevent the elderly from participating in PA. Elderly individuals without any physical challenges should participate in at least 150 minutes of moderate-intensity aerobic PA in a week, or at least 75 minutes per week of vigorous-intensity aerobic PA or an equivalent combination of both types of aerobic PA. It is better to start PA slowly and increase the duration and frequency gradually. Even those who have some disease limitations should try to change their status from ‘inactive or no activity’ to ‘some level of activity’ to enjoy the health benefits of PA. More research and programmes focusing on promotion of PA need to be implemented in order to improve PA among the elderly in SA

‘Drink clean, safe water and/or other fluids through-out the day even if you do not feel thirsty’: a food-based dietary guideline for the elderly in South Africa

This review summarises information from available literature to support the dietary guideline ‘Drink Clean, Safe Water and/or Other Fluids Through-Out the Day Even if You Do Not Feel Thirsty’ set for the elderly of South Africa (SA). Water is essential for life and is necessary for important functions of the body like maintenance of tissue structure, blood volume regulation, temperature regulation and excretion of metabolites through kidneys. Though water is necessary for all, the elderly are especially at risk of dehydration due to altered hormonal activity and body functions that reduce their sensitivity to thirst (water intake) and urination (water excretion). Total body water is also reduced in the elderly, so they are unable to buffer the effects of water loss in the body. Therefore, water intake should be monitored properly in the elderly so that they can lead a happy and healthy life and reduce the economic burden due to hospitalisation caused by water imbalance or dehydration, which is common in the elderly. Two litres of water per day is generally considered adequate, but there is no consensus regarding the exact requirement for water as need varies due to climate and physical activity levels. The importance of water to maintain bodily functions and the risk of dehydration substantiate the need for a dietary guideline to address the importance of clean and safe water/fluid consumption regularly throughout the day among the elderly in SA

If you drink alcohol, drink sensibly: a food-based dietary guideline for the elderly in South Africa

The use and misuse of alcohol has become a public health problem among the South African (SA) elderly population, among whom risky drinking is a common practice. Previous publications encouraging alcohol use have referred to two supposedly beneficial effects of alcohol, categorised as: (1) cardioprotective and haemostatic; and (2) promoting a positive balance in iron status. However, more recent evidence has weakened these assertions for all age groups as the disadvantages of alcohol use far outweigh these benefits. Some of these disadvantages can cause severe medical and physical harm to the elderly. Attempts to curb risky drinking among the SA elderly must be adopted through screening by clinicians during consultations, use of various screening and diagnostic tools available for addressing alcohol use and abuse, and exploiting the channels of alcohol exposure for appropriate interventions. Elderly populations are vulnerable to alcohol misuse irrespective of their consumption patterns or levels of use because of their ageing condition and the interaction of alcohol with medication. Therefore, there is a need to sensitise the SA elderly population on the risk posed by alcohol use, misuse or abuse, hence the FBDG ‘If you drink alcohol, drink sensibly’

Double Burden of Poverty and Cardiovascular Disease Risk among Low-Resource Communities in South Africa

Limited studies evaluating the prevalence of cardiovascular risk (CVR) in resource-poor black communities in South Africa (SA), exist. The objective of this chapter is to evaluate the prevalence of CVR in a cross-sectional studies in randomly selected low income children, adults and elderly in Gauteng, Free State and Eastern Cape, SA. The test panel of CVR markers included: anthropometry, lipid profile, blood pressure, fibrinogen, high sensitive–C–reactive protein (HS–CRP), homocysteine, vitamin B12, folate, glucose and dietary intakes. The main findings indicated high CVR with prevalence of overweight/obesity, Hypertension, hyperhomocysteinaemia, increased fibrinogen and HS-CRP, as well as low intakes of dietary fibre, vitamins B6 and B12, folate and polyunsaturated- and monounsaturated fatty acids, and high intakes of dietary sodium, saturated and trans fatty acids, and added sugars. Multiple CVR factors are present among all the communities. It can thus be concluded that a double burden of poverty and risk of CVD exists across the different age groups and geographical locations in these resource-poor communities

Available food options at local shops in relation to food insecurity among older adults in Sharpeville, South Africa

Due to limited resources and complex food access systems in urban areas, especially older adults are more vulnerable to poor dietary intake and food insecurity in low-income areas in South Africa. This study assessed the prevalence of food insecurity among the older adults and explored the availability of healthy foods in local shops. It was a crosssectional study conducted in an eldercare centre in Sharpeville, South Africa with an estimated representative sample of 88 participants. Validated tools were used to measure the socio-economic, dietary diversity intake (24-hour dietary recall), household food security and access from the participants. Listing of available foods was carried out on street vendors (n=13) and spaza shops (local community shops) (n=17) within a four kilometre radius of the centre through on-site visit. A binary logistic regression was used to examine the determinants of food insecurity among older adults. More than half (54.5%) of the older adults reported severe household food insecurity. In this study, 34.1% of the older adults consumed foods from (n=64, 72.7%), eggs (n=75, 85.2%), dark green leafy vegetables (n=64, 72.7%) or vitamin Arich fruits and vegetables (n=47, 53.4%). On the other hand, in terms of food availability, fruits and vegetables were more common in street vendors whereas, fish, meat, and high calorie or salt containing snack were more available in spaza shops. All spaza shops sold high calorie or salt containing snack products (such as soda drinks, chips). Households with under-five children were 2.42 times food insecure than the households without any under-five children (p \u3c 0.05), and the participants who experienced money shortage always or often to buy food and clothes were more food insecure (p \u3c 0.05). Nutrition education along with ensuring availability and easy access to healthy foods in the market are necessary to ensure sustainable food security of older adults

Risks of excess iodine intake in Ghana: current situation, challenges, and lessons for the future

In Ghana, iodine deficiency was first reported in 1994 among 33% of the population. A nationwide Universal Salt Iodization (USI) program plus other complementary interventions were subsequently implemented as a response. Our paper reviews the current risks of excess iodine status in Ghana and identifies policy and research gaps. A mixed methods review of 12 policies and institutional reports and 13 peer‐reviewed articles was complemented with consultations with 23 key informants (salt producers and distributors, food processors, regulatory agency officials, and healthcare providers) purposively sampled between May and August 2017. The findings show a strong policy environment indicated by regulations on food and salt fortification (Act 851), including the USI regulation. However, currently, only a third of Ghanaian households use adequately iodized salt. Recent evidence shows that voluntarily fortified processed foods (including condiments) supply a considerable amount of iodine to the food system. Limited biological impact data suggest possible household exposure to excessive dietary iodine (\u3e15 parts per million). Currently, there is no systematic tracking of iodine content from fortified foods and other sources. Cross‐sectoral actions are needed to understand this situation better. Key research gap is the lack of comprehensive data on iodine content and intake from other sources in Ghana