Browsing by Author "Wiles, Nicola Laurelle."

Now showing 1 - 15 of 15

The attitude toward and the prescription of a low carbohydrate, high fat diet by KwaZulu-Natal clinical dieticians.
(2015) Joyner, Stephanie Alexandra.; Wiles, Nicola Laurelle.; Kassier, Susanna Maria.
Aim: To determine the attitude toward and the prescription of a low carbohydrate, high fat (LCHF) diet by KwaZulu-Natal clinical dieticians working in government or private practice. Objectives: The study set out to determine the following objectives: (i) dieticians’ attitudes toward a LCHF diet, (ii) the prescription of this diet in practice and concerns regarding the diet; (iii) to determine if there is a relationship between the socio-demographic characteristics, areas of work and professional interest as well as research involvement of dieticians and the prescription of a LCHF diet in practice; and to (iv) assess whether dieticians would be willing to adapt their practice methods and attitude after hearing a presentation on the LCHF diet. Method: The email addresses for 155 clinical dieticians, working in either government or private practice, were obtained from a data base. The dieticians were emailed a link to a four-part online questionnaire regarding their area of work, main professional interests, practice methods, prescription or non-prescription of a LCHF diet and research involvement. Results: The response rate to the questionnaire was 58% (n=90). The majority of the subjects were female (n=87, 97%) and had qualified at the University of KwaZulu-Natal (n=67, 74%). Patients with non-communicable diseases were the most common condition counselled by the subjects (71.3%). The latter was also the main area of interest for subjects in private practice. Upon analysis of the section pertaining to research involvement, it was found that the majority of subjects scored poorly in the questions related to the most basic of research involvement skills, with an average score of 40%. Overall, there was a negative attitude toward the prescription of the LCHF diet. Only 17% (n=15) of the subjects had prescribed the LCHF diet in practice and it had been prescribed rarely. The most common condition that the diet was prescribed for was weight loss. Subjects working in private practice were more likely to prescribe a LCHF diet for their patients compared to those working in government. More than 80% of the sample reported that they had never prescribed the diet. The most common reason provided was that it was felt there was a lack of supportive evidence for its use. Discussion: The finding that private practicing dieticians are more likely to prescribe a LCHF diet to patients may be because this type of patient is more likely to be able to afford and sustain a LCHF diet compared to the type of patients seen by subjects working in the government sector. These patients are also more likely to be aware of the LCHF diet compared to government health patients. Very few deiticians prescribed a LCHF diet; this may be a reflection of the dieticians practicing evidence evidence-based nutrition and/or it could be related to harm-avoidance. The very low level of research involvement and skill observed in the study is a concern and should be used as a basis for further investigation. Conclusion and recommendations: The low score obtained by subjects in basic research involvement could be interpreted that more emphasis should be placed on this area in undergraduate training and in the continuing professional development of qualified dieticians. More studies need to be done on the long-term safety and efficacy of a LCHF diet for the prevention and management of NCDs. Dietetic authorities should consider a country-wide advertising campaign to encourage the public to consult a Registered Dietician before following a LCHF diet
Determining the relationship between added sugar intake and body mass index (BMI) among undergraduate students between the ages of 18-25 years studying at the University of KwaZulu-Natal, Pietermaritzburg campus.
(2016) Nakhooda, Ra’eesah Ismail.; Wiles, Nicola Laurelle.
Chronic diseases of lifestyle are a major contributor towards the increased incidence of mortality and morbidity among individuals worldwide. In conjunction with this, dietary and lifestyle modifications have contributed towards the overweight and obesity problem. Recent but not conclusive evidence has suggested that the consumption of added sugars, particularly from sugar sweetened beverages (SSBs) could be the driving force behind this problem. University students are vulnerable to these dietary and lifestyle changes as they are exposed to a new environment in which independent food choices have to be made. Unfortunately the influence of the food environment often results in poor dietary habits. Determining the relationship between added sugar intake and body mass index (BMI) among undergraduate students between the ages of 18-25 years studying at the University of KwaZulu-Natal (UKZN), Pietermaritzburg campus. To determine: the demographic characteristics of the students such as age, gender, race and place of residence; the BMI of the students; the dietary intake of added sugar from foods and beverages among the students; the association between the dietary intake of added sugar and the students’ BMI; the consumption and consumption patterns of sugar sweetened beverages; the influence of demographic characteristics on the dietary intake of added sugars and the factors that influence the intake of SSBs. A cross sectional study was conducted on 387 undergraduate students between the ages of 18-25 years attending UKZN, Pietermaritzburg. Non-probability sampling was used to recruit the students. A three part questionnaire was used to gather information on anthropometric measurements, demographic characteristics, and a 24 hour dietary recall and a Food Frequency Questionnaire (FFQ) was used to assess the added sugar intake among the subjects. The study population consisted of 33.1% male subjects and 66.9% female subjects. Most of the subjects were from the Black African race group (90.4%), followed by the Indian (7%), Coloured (2.1%) and White (0.5%) race group. A vast majority of the subjects lived away from home (76.7%). A significant number of the subjects were within the normal BMI classification (64.9%) and the mean BMI of the subjects was 23.5kgm2. The prevalence of overweight and obesity was higher among the female (22% and 11.5%) than male subjects (13.3% and 2.4%) and more male subjects were within the normal BMI category (77.3%). Significant differences were observed between the subjects BMI and the consumption of some food and beverage items listed in the FFQ. Subjects with a higher BMI consumed flavoured milks less often, and consumed a greater amount of ice cream and a smaller amount of hard boiled sweets. The frequency of consumption of the foods and beverages that contained added sugar was significantly higher among the female subjects, and the male subjects consumed significantly greater amounts of these foods and beverages. Differences were observed in the consumption of added sugars across the genders, races and place of residence. Subjects that lived at home and that were Indian and female consumed most of the food and beverage categories that contained added sugars more frequently. Taste and price significantly influenced the students’ consumption of SSBs. The most frequent place of purchase and consumption of SSBs as reported by the subjects were supermarkets and on campus respectively. Most of the subjects were within the normal BMI classification. Approximately one third of the subjects were overweight or obese, however there were more overweight subjects. The prevalence of overweight and obesity was higher among the female subjects. The subjects’ diet lacked variety, and the frequency of consumption of added sugars from the various food and beverage categories was relatively high among the sample population. Differences with regards to the consumption of added sugars were observed across the categories of gender, race and place of residence. Factors such as taste and price greatly influenced the students’ consumption of SSBs. Although significant differences between BMI and the intake of some sugar containing foods and beverages existed, this aspect requires further exploration among university students. The poor dietary habits among the university students as well as the prevalence of overweight and obesity among this population group, highlight the fact that there is a great need for strategies to be implemented in order to promote healthier dietary and lifestyle habits among young adults.
Early life factors associated with stunting and overweight at 12 months in infants enrolled in the Mother and Child in the Environment (MACE) study, Durban.
(2019) Jarvie, Penelope Anne.; Wiles, Nicola Laurelle.; Naidoo, Rajen.; Veldman, Frederick Johannes.
Abstract available in PDF.
The effectiveness of a food based dietary guideline nutrition education game and educator's support material as a supplement to improve retention of knowledge in rural Grade 5 learners, living in Sweetwaters, KwaZulu-Natal.
(2013) Esteves, Rebecca Anne.; Wiles, Nicola Laurelle.; Van Onselen, Annette.
Aim: To determine the effectiveness of a Food Based Dietary Guideline (FBDG) nutrition education game and educator’s support material (ESM) as a supplement to improve retention of knowledge in rural Grade 5 learners, living in Sweetwaters, KwaZulu-Natal. Objectives: To determine: the baseline nutritional knowledge of Grade 5 learners; the effects of the ESM or a nutrition education game on the retention of FBDG knowledge, and the educators’ opinions about using both the ESM and the nutrition education game. Method: An intervention study involving 266 Grade 5 learners in four schools. A pre-test was followed by either an ESM intervention or a nutrition education game intervention. A post-test was conducted to determine the effects of both interventions on FBDG knowledge retention. A second questionnaire was administered to the educators of the learners who participated in the interventions. Results: The sample was made up of 53.8% (n=141) male participants and 46.2% (n=121) females, all between the ages of 8 and 15 years. Results showed very little improvement in the retention of knowledge as a whole. However, questions that asked about familiar concepts showed an improvement compared to those that were completely new. More complicated questions showed an improvement when the game was used, as the pictorial representation helped the learners to remember the answer. For example the average percentage for knowledge of fortification before the game was 1% while post intervention it increased to 29.6%. This showed that simple concepts based on a good pictorial representation were retained better than information that was difficult to conceptualise. All educators found the game useful and beneficial for the learners. The ESM was not as well used as the game as it was perceived to be too time consuming. Conclusion: Learners enjoyed the game and the educators gave positive feedback, however there was no significant retention of knowledge in this study. Further research needs to be done using a game as a tool for nutrition education over a longer period of time and with a greater amount of educator training.
An exploration of the impending 2018 sugar-sweetened beverage tax on the purchases of Black African women, shopping at the Edendale mall in Pietermaritzburg.
(2019) Ilangila, George Richard.; Wiles, Nicola Laurelle.; Van Onselen, Annette.
Introduction: The incidence of death from non-communication diseases (NCDs) is escalating steadily. Rapid urbanisation and changing diets in the developing countries are currently producing a “silent emergency” called overnutrition or obesity. Several studies conducted in South Africa have shown that obesity is more severe among females than males, particularly in the Black African race group. Recent literature suggested that the consumption of sugarsweetened beverages (SSBs) could have contributed towards this problem. Fiscal interventions such as taxes are increasingly being recognised worldwide as an effective tool that can help to combat the obesity epidemic at a population level. The increased price of SSBs is an important factor that could influence the purchasing decisions of consumers. Increased negative health effects of SSBs have led to action to be taken in order to limit their consumption. In conjunction with this, on February 2016, the South African Government decided to consider the use of fiscal policies by introducing taxes on SSBs in order to improve the health standards of the public. At the time of this study the SSBs tax had not been implemented, however it was important to investigate what effect the impending tax would have on the current SSB purchasing practices of Black African women. Aim: Investigating the impact of the impending 2018 sugar-sweetened beverage tax on the purchases of Black African women aged 19 and older, shopping at the Greater Edendale Mall in Pietermaritzburg. Objectives: To determine the demographic characteristics of Black African women who purchase SSBs; to determine the types of SSB Black African women are purchasing; to assess the frequency of SSB purchases by Black African women; to investigate the factors that influence Black African women to purchase SSBs and to determine the effect of the impending 2018 SSB tax on respondent purchases of SSBs. Methods: A cross sectional study with aim of investigating the impact of the impending 2018 sugar-sweetened beverage tax was conducted among 439 Black African women aged 19 and older, shopping at the Greater Edendale Mall in Pietermaritzburg. Non-probability sampling was used to recruit the respondents. A five-part questionnaire was used to gather demographic information; characteristics of respondents who purchase the SSBs; the types of SSBs iii purchased; the frequency of purchases; what motivated the respondents to purchase SSBs; and what impact the impending SSBs tax would have on SSB purchases once implemented. Results: The study population consisted of 439 Black African women. The mean age of the respondents was 33.69 years with minimum and maximum ages of 19 and 55 respectively. Around two thirds (n=328, 74.7%) had an education level of matric or up to Grade 12. Only one third (n=111, 25.4%) had a post matric qualification. Among all SSBs purchased by respondents, carbonated fizzy drinks were the most frequently purchased beverage (n= 391, 89.0%), while sport drinks were purchased least frequently (0.9%, n=4) ahead of energy drinks (n=5, 1.1%). Squashes, concentrates and syrups (Juices) were the second most frequently purchased SSBs (n=25, 4.9%), followed by flavoured water drinks (n=15, 3.4%). Most respondents (n=396, 90.2%) indicated that they purchased SSBs between one and four times a month. Price and taste were rated as being significantly important factors that influenced respondents to purchase SSBs, whilst design and packaging, recommendation by friends/family and loyalty to the product were less important factors. Most respondents (n=359, 82.0%) reported that they were not aware of the impending SSB tax. The main findings of the study revealed that nearly half of the respondents (n=213, 48.5%) indicated the intention to continue purchasing and consume their preferred beverages as usual despite the price increase due to the SSBs tax. Around one-third of respondents (n= 151, 35.1%) reported that they would reduce their SSB purchases and start consuming smaller amounts of SSBs. Few respondents (n=68, 15.5%) indicated that they would switch to cheaper drinks whilst very few (n=4, 1.0%) would opt to stop purchasing SSBs. The results of sub-group analysis in relation to the impact of impending tax depending on education level and income status revealed the existence of a significant negative correlation for price with education. A significant number of respondents with matric and less (n=188, 62.8%) indicated that they will continue purchasing SSBs as usual after the implementation of SSBs tax while significantly more of those with a higher education level (n=73, 78.5%) confirmed their intention to reduce SSB purchases. Most respondents, who earned up to R5553 as their monthly total household income (n=96, 63.2% and n=29, 19.1%), indicated that they would either continue purchasing SSBs as usual or switch to cheaper drinks respectively. iv Conversely, respondents with a higher income including those who earned R44949 per month and above (n=3, 0.7%), between R18545 – R44948 (n=35, 8.0%) as well as between R10010 – R 18544 (n=37, 8.4%) indicated that they will reduce their SSB purchases once the tax had been implemented. Conclusion: The findings from this study highlight the need to further investigate the long term effect of SSB consumption contributing to overweight and obesity, particularly in Black African women and their family members. Since differences in SSB purchases were observed depending on education and income status of the respondents, the high frequency of consumption of added sugars from carbonated fizzy drinks by respondents and their family members entails more exploration. This would give direction for appropriate policies and initiatives, along with the SSB tax that could promote healthier dietary intake habits and reduce the burden of obesity related NCDs in Black African women and their family members.
The implementation of an ISO 22000 system into a private hospital food service facility and the impact on patient satisfaction and food safety audit results.
(2015) Warren, Jane Rachael.; Wiles, Nicola Laurelle.
Aim: To determine the impact of the implementation of an ISO 22000 system in the foodservice department of a private hospital on patient satisfaction levels and results of food safety audits conducted. Objectives: To describe the demographics of hospital patients in terms of age, gender, length of hospital stay and type of special diet; to determine the patient satisfaction with the food and food service; to determine the relationship between demographics and patient satisfaction with the food and food service; to determine the impact of ISO 22000 on patient satisfaction; and to determine the impact of ISO 22000 on food safety audit results. Method: A total of one hundred and sixty hospital patients were interviewed during four surveys conducted over a period of approximately one year, during which time the ISO 22000 food safety management system was implemented into the foodservice department of a private hospital facility. Patients were surveyed using a questionnaire which gathered demographic information as well as the responses of patients to various aspects of the food and food service. The results of these surveys were analysed to describe the demographics of the patients, the relationship between demographics and satisfaction levels and satisfaction levels with the food and food service after ISO 22000 implementation. The results were analysed and compared to determine any improvements in audit scores after ISO 22000 implementation. Results: One hundred and sixty patients aged between 13 and 89 participated in the survey. One hundred and nineteen patients were female (74.4%) and forty one were male (25.6%). Most of the patients had been in hospital for between three and seven days and had not been on a special diet whilst in hospital. No statistically significant relationships were found between demographics and patient satisfaction levels with the food and food service. Overall, the responses with regards to food temperature, hygiene and cleanliness, food quality and the overall catering service indicated a generally high level of satisfaction. A statistically significant increase in satisfaction was found for the overall catering service, while a marginally significant increase was found for the food temperature after ISO 22000 implementation. The results of food safety audits improved after ISO 22000 implementation. Discussion: Despite the lack of statistically significant improvements in some areas of patient satisfaction with the food and food service in this study, the improvements that were found in patients’ satisfaction levels as well as the marked improvement in food safety audit results indicate that ISO 22000 does have a positive impact and offers many advantages in a hospital foodservice department. Conclusion: ISO 22000 implementation shows promise to increase patient satisfaction and improve the results of food safety audits. It is therefore recommended that further studies in the South African hospital environment are conducted in order to gain a clearer understanding of the impact that a food safety management system will have on patient satisfaction levels with the hospital food and food service as well as food safety audit results.
Incidence of malnutrition as measured using specific anthropometric and biochemical parameters and its relationship with chemotoxicity in children with nephroblastoma admitted to Inkosi Albert Luthuli Central Hospital between 2004-2012.
(2016) Draper, Kelly Sue.; Pillay, Kirthee.; Wiles, Nicola Laurelle.
Introduction: The prevalence of malnutrition in children with cancer in developing countries is reported to be as high as 69%. Malnutrition is worse in developing countries as the diagnosis of cancer may be delayed due to poor access to health care. The assessment of the nutritional status of paediatric oncology patients on admission to hospital is crucial as nutritional status is known to influence treatment and clinical outcomes. Several studies suggest that concurrent malnutrition and cancer in children leads to reduced chemotherapy delivery due to impaired tolerance and increased toxicity. The influence of malnutrition on the prevalence, frequency and duration of chemotoxicity in South African children with nephroblastoma has not been well researched. Aim: This study aimed to determine the incidence of malnutrition as measured using specific anthropometric and biochemical parameters and its relationship with chemotoxicity in children with nephroblastoma admitted to IALCH between 2004-2012. Objectives: a) To determine the incidence of malnutrition as measured using specific anthropometric and biochemical parameters in children with nephroblastoma admitted to IALCH between 2004-2012. b) To determine the influence of malnutrition as measured using specific anthropometric and biochemical parameters on the prevalence of chemotoxicity. c) To determine the influence of malnutrition as measured using specific anthropometric and biochemical parameters on the frequency and duration of chemotoxicity Methods: Seventy-seven children between the ages of 1-12 years diagnosed with nephroblastoma and admitted to IALCH between 2004 and 2012 were studied prospectively. Nutritional assessment took place before treatment was started and included weight, height, mid upper arm circumference (MUAC), triceps skinfold thickness (TSFT) and serum albumin. The administration of Neupogen® was used as a surrogate for haemotoxicity and the frequency and duration of its use was recorded. Results: When patients were classified by weight for age (WFA), height for age (HFA), weight for height (WFH) and body mass index (BMI) for age, malnutrition was seen in 37.5%, 39.5%, 28.4% and 30.3% of patients respectively. When the parameters MUAC and TSFT were used the prevalence of malnutrition was 56% and 52.7% respectively. There was a significant relationship between the prevalence of toxicity and MUAC. The mean frequency and duration of chemotoxicity was significantly higher in those defined as malnourished using MUAC. Frequency and duration of chemotoxicity were positively correlated. Serum albumin, when used alone, showed that 86% of the cohort had a normal nutritional status. Conclusions: Nutritional assessment in children with solid tumours should include MUAC, TSFT as well as weight and height. This is because the use of weight and height alone could underestimate the prevalence of malnutrition. Children with nephroblastoma who have malnutrition according to their MUAC are more likely to experience more frequent and longer periods of chemotoxicity. Serum albumin should not be used in isolation to identify malnutrition.
The influence of garden treatments on the nutritional profile and agronomic performance of a dark green leafy vegetable grown in a peri-urban setting.
(2018) Hepburn, Cayleigh.; Wiles, Nicola Laurelle.; Hill, Trevor Raymond.
Introduction Many nutrition interventions have been implemented to try and combat the high prevalence rate of micronutrient malnutrition and food insecurity in South Africa (SA). One of these interventions is home food gardening. Home food gardens growing Swiss chard, a commonly consumed dark-green leafy vegetable (DGLV) throughout SA, may contribute to food and micronutrient security. Aim The aim of this research was to identify, through a home food gardening study, the best affordable method of soil treatment for the production of nutrient dense Swiss chard in KwaZulu-Natal, SA. Objectives The objectives of the study were: 1. To determine the effect of fertiliser and mulch treatment combinations on the growth rate (number of days to reach maturity) of Swiss chard. 2. To determine the effect of fertiliser and mulch treatment combinations on the leaf number (yield) of Swiss chard. 3. To determine the effect of fertiliser and mulch treatment combinations on the nutrient profile of Swiss chard. Methods The study site was a home food garden in kwaMnyandu, KZN. A two factor Randomised Complete Block Design (RCBD) was used, where fixed factors (mulch and fertiliser garden treatments) were crossed with random factors (the treatment blocks containing Fordhook Giant Swiss chard (Beta vulgaris var. cicla) plants). Some of the garden treatments used in the study, organic kraal manure fertiliser and organic grass mulch, were being used at the study site. These garden treatments were available at the study site, free of charge. The other treatments used (inorganic chemical fertiliser and inorganic plastic mulch) may not be accessible by food gardeners in poorer areas due to their price. The nutrient content of Swiss chard was analysed and the garden treatment that produced the best quality of Swiss chard in terms of nutrients was identified Results When combined, fertiliser and mulch together did not significantly affect the maturity period of Swiss chard. However individually, organic and inorganic fertiliser and mulch had a significant effect on the maturity period (mean number of days taken to reach maturity) of Swiss chard compared to the control (no treatment). Fertiliser and mulch, applied to the soil in combination or individually, had no effect on the number of leaves present on Swiss chard plants at the study site. Both fertiliser and mulch treatments, independent of each other, significantly altered the nutrient profile of Swiss chard (p< 0.05), with fertiliser having a greater effect (p=0.002) than mulch (p=0.0389). However, experimental treatments containing a combination of fertiliser and mulch treatments, did not significantly affect the nutrient profile of Swiss chard (p>0.05). Conclusion Adding combinations of fertiliser and mulch to the soil, when growing Swiss chard, is not recommended to shorten the growth rate, improve the leaf number, or improve the nutrient profile of Swiss chard. To grow Swiss chard in the shortest time period (days) the most affordable garden treatment recommended is organic grass mulch. To produce Swiss chard with the best nutrient profile) the most affordable garden treatment recommended is organic kraal manure fertiliser. Considering the relevance of nutrient deficiencies in SA, the significance of the nutrient profile of the Swiss chard grown is more important than the number of days taken for the Swiss chard to reach maturity, and the number of leaves present on the plant. Therefore, the most affordable gardening method to use, to produce the best quality Swiss chard is organic kraal manure fertiliser.
Knowledge, acceptance and barriers to optimal use of iron supplements amongst pregnant women attending Mutare city clinic in Manicaland, Zimbabwe.
Mahundi, Plaxcedia.; Pillay, Kirthee.; Wiles, Nicola Laurelle.
Iron deficiency anaemia (IDA) is a global public health challenge, most prevalent in developing countries, including Zimbabwe. It mostly affects young children and women of childbearing age, particularly pregnant women. In the developing world, unbalanced diets which lack haemiron from animal sources due to high costs, predisposes many pregnant women to IDA. Most women usually enter pregnancy with already depleted iron stores, consequently resulting in high maternal mortality and morbidity, premature deliveries and low birth weight infants. Pregnant women with IDA have a high risk of complications at delivery and are also prone to infections. Therefore, to increase haemoglobin levels and prevent IDA, the World Health Organization (WHO) recommends a daily supplement of 60 mg of iron for all pregnant women for at least six months during pregnancy, until six weeks post-partum. This is meant to complement iron from the diet, because dietary sources of iron alone are inadequate to meet the iron requirements during pregnancy. However, there are many barriers to the acceptance and use of iron supplements among pregnant women. This is also exacerbated by poor knowledge on the importance of iron supplements during pregnancy. Mutare City, in Zimbabwe was chosen as the study site because there is a lack of published data on the use of iron supplements by pregnant women in this area. The aim of this study was to assess the knowledge and acceptance levels of iron supplements among pregnant women, attending Mutare City Clinic, Manicaland, Zimbabwe. The study also aimed to identify possible barriers to optimal use of iron supplements among the pregnant women. In addition, the study aimed to develop and test a nutrition education tool with the aim of creating awareness regarding the importance and use of iron supplements among pregnant women, thus improving acceptance and use of the supplements. The objectives of the study were as follows: (i) To assess knowledge on the importance of iron supplements during pregnancy amongst pregnant women attending Mutare City Clinic, Manicaland, Zimbabwe. (ii) To assess the acceptance levels of iron supplementation given during pregnancy amongst pregnant women attending Mutare City Clinic, as perceived by nurses and pregnant women attending Mutare City Clinic for ante-natal care (ANC). (iii) To identify the barriers to optimal iron supplementation by pregnant women attending Mutare City Clinic. (iv) To ascertain from pregnant women attending Mutare City Clinic, the form of the nutrition education tool to be developed, the importance of the tool, information and language to be used in the tool. (v) To develop a nutrition education tool for pregnant women attending Mutare City Clinic with the purpose of creating awareness of iron supplements. (vi) To test the developed nutrition education tool to determine its user-friendliness and acceptability among pregnant women attending the Mutare City Clinic. A survey was conducted to assess knowledge and acceptance on the importance and use of iron supplements by pregnant women. A total of 103 pregnant women, aged 16-36 years participated in the study and were selected on the basis of being either in their second or third trimesters of pregnancy, and attending Mutare City Clinic for ante-natal care (ANC). It was found that the pregnant women had inadequate nutrition knowledge to motivate them to consistently take iron supplements. Most pregnant women appreciated the importance of iron supplements, but lacked detailed knowledge to substantiate their need for taking them. The study therefore recommends early ANC booking and commencement of iron supplementation, as well as adequate nutrition education for pregnant women. To identify barriers preventing optimal use of iron supplements by pregnant women, eight focus group discussions (FGD) were conducted, with 64 women, aged 17-39 years. Major barriers preventing the optimal use of iron supplements included erratic supplies at healthcare centres, cultural and religious influences and side-effects associated with supplements and poverty. Ignorance due to inadequate nutrition education and poor communication between nurses and pregnant women, were other notable barriers. The erratic availability of iron supplements at the healthcare centre resulted in many women not taking supplements because they could not afford to buy them from private pharmacies. However, in the few instances when supplies were available at healthcare centres, some women collected iron supplements but did not use them, while some managed to use the supplements consistently. Therefore, continuous reinforcement of positive supplementation practices is recommended to motivate for compliance among pregnant women. Adequate nutrition education and counselling is necessary for promoting awareness regarding the importance of iron supplements, dietary diversity and management of side-effects. Improvements in the procurement and delivery system at a national level will help to ensure timeous provision of iron supplements to healthcare centres. Sixty-seven pregnant women in their second and third trimesters were purposively sampled to participate in eight FGDs on the development of a nutrition education tool. Pregnant women gave their views on the nutrition education tool they most preferred and the most appropriate language and information to include. The pregnant women indicated that a pamphlet was the most preferred form of nutrition education tool, with English as the preferred main language of communication, along with some Shona phrases for clarification. Three extra FGDs were conducted with 28 pregnant women to test the developed nutrition education tool for acceptability and user-friendliness by pregnant women. It was found that good use of images which are culturally sensitive, appropriate use of colours, and labelling foods in both English and Shona enhanced the identification of foods, thus improving acceptability of the developed pamphlet. Earlier results obtained from both nurses and pregnant women revealed that most pregnant women did not receive adequate nutrition education on the importance and use of iron supplements during pregnancy, leading to poor compliance. Late ANC bookings at healthcare centres affected the initiation of iron supplementation. Thus, the development of a nutrition education tool for use by pregnant women could enhance knowledge on the importance of iron supplementation, since most women had inadequate nutrition knowledge. Intensive nutrition education programmes, routine iron supplementation and use of the developed nutrition education pamphlet are recommended to reduce the prevalence of IDA among pregnant women in Zimbabwe. This study has shown that issuing iron supplements without an accompanying nutrition education tool may not effectively alleviate maternal IDA. Poor compliance with iron supplementation regimens remains a challenge because of several barriers, which also include inadequate baseline knowledge among pregnant women. Therefore, the development of a nutrition education tool is a positive move towards improving compliance, especially if the tool is offered to pregnant women timeously. The study has indicated that the tool may likely enhance understanding by consolidating nutrition education conducted at healthcare centres and iron supplements given to pregnant women. However, erratic supplies of supplements remains a challenge, as well as delayed ANC bookings by many pregnant women. Thus, this study has shown that offering a nutrition education pamphlet along with iron supplements, has the potential to create awareness and motivate towards compliance with iron supplements. This has the potential to reduce the prevalence of maternal IDA amongst pregnant women in Zimbabwe and sub-Saharan Africa.
The motives and challenges facing South African vegans and the nutritional quality of their diet.
(2020) Kohidh, Sansha.; Wiles, Nicola Laurelle.
Introduction: A vegan diet is a voluntarily chosen plant-based diet that excludes all meat and animal products and includes wholegrains and legumes, fruit and vegetables, nuts and seeds and healthy fats. There are many different motives that influence an individual to become vegan including ethical motives, environmental motives and health motives. Internationally, many studies have been conducted to investigate these motives along with the nutritional intake and quality of the vegan diet. This diet is also becoming increasingly popular in South Africa, yet there is a paucity of studies that have been conducted to determine what motivates South Africans to follow this diet, what challenges they face while following the diet and what the nutritional quality of their diet is. Aim: To determine the motives of South African vegans, challenges faced and the nutritional quality of the South African vegan diet. Objectives: To determine the demographic characteristics of South African vegans; the motives that influenced the decision to become a vegan; challenges associated with following a vegan diet and how these challenges are overcome; and to determine the nutritional quality of dietary intake compared to recommendations (EARs) consumed and identify the variety of food groups and types of processed food in the vegan diet. Methods: A cross-sectional study in the form of an online questionnaire was conducted using South African vegans who were part of the South African Vegan Society online group on Facebook. The questionnaire consisted of four sections. Section one obtained information regarding the demographics of South African vegans. Section two obtained information on the main motives for following a vegan diet. Section three obtained information on the challenges experienced while following a vegan diet and how these challenges were overcome. Section four obtained information on the nutritional quality of the vegan diet which included a veganspecific Food Frequency Questionnaire (FFQ) with 291 food items and one 24-hour recall. Results: The first two sections of the online questionnaire were completed by 205 respondents, of which 82.4% (n = 169) were female and 17.6% (n = 36) were male. The respondents were predominately White (82.4%, n = 169), resided in the Gauteng province (43.9%, n = 90), were more likely to be single (53.2%, n = 109) and belonged to the 18-29 (29.3%, n = 60) and 40-49 age category (22.0%, n = 45). Most of the respondents had followed a vegan diet for one to less than three years (38.5%, n = 79). A significant number of respondents did not engage in smoking (83.9%, n = 172) but did consume alcoholic beverages less than once a week (60.0%, n = 123) (p<0.0005). Most of the respondents participated in varying amounts and intensities of physical activity (84.9%, n = 174) and made use of nutritional supplements (72.7%, n = 149). There was a significant agreement that ethical concern for animals (p<0.0005); followed by protecting the environment (p < 0.0005); and the effect of animal product consumption on climate change (p < 0.0005) were the main motivating factors for choosing to become a vegan. Most of the respondents reported that their initial motivation to become a vegan had not changed (71%, n = 146) and there was a significant agreement that experimenting with food assisted the respondents during their transition into the vegan diet (p < 0.0005). Section three of the questionnaire was completed by 197 respondents. Over one third of the respondents reported that it was “easy” to transition into the diet (35.1%, n = 72) and their initial emotions were enthusiasm and excitement (29.3%, n = 60). A significant number of respondents reported that they did not experience any financial challenges following the diet (74.6%, n = 176) and that their main challenge was finding vegan meal options in a restaurant (p < 0.0005). The respondents in this study overcame any challenges by conducting research on the internet and agreed that vegan recipes were easily accessible (p < 0.0005). The respondents significantly agreed that a vegan diet was nutritionally complete and adequate for a healthy lifestyle (p < 0.0005). The FFQ was completed by 113 respondents. Respondents consumed a wide variety of fruit; most often bananas (22.4%, n = 46) at least once a day, leafy-vegetables- most often cooked spinach (24.9%, n = 51) at least once a week, non-leafy vegetables- most often cooked broccoli (36.1%, n = 76) at least once a week. The starches most often consumed were whole-wheat bread (18.0%, n = 37) once a week, grains and cereals- most often white or brown basmati rice (20.0%, n = 41) once a month, peas and beans- most often chickpeas (32.2%, n = 66) at least once a week, fats- most often olive oil (20.5%, n = 42) at least once a day, snacks- most often potato chips (19.0%, n = 39) at least once a month. Desserts most often consumed were eggless cake (17.1%, n = 35) at least once a month, sweeteners- most often brown sugar (17.1%, n = 35) at least once a day and beverages- coffee decaffeinated or regular (29.3%, n = 60) at least once a day. The most commonly consumed plant-based milk alternative and meat alternative was soy milk (21.0%, n = 43) consumed at least once a day and soya products (28.8%, n = 59) at least once a week respectively. The 24-hour recall was completed by 134 respondents. The mean total energy of the respondents was 7471.15 kJ (SD = 3093.39). Males had a mean total energy of 7893.76 kJ (SD = 3415.37) and females had a mean total energy of 7374.22 kJ (SD = 3023.43). All respondents met the estimated average requirement (EAR) for protein (56 g for males and 46 g for females), carbohydrates (130 g) and the percentage of total energy for fat (10 - 35%). The respondents mean intake for protein was 74.73 g (SD = 52.28), carbohydrates 190.40 g (SD = 190.40) and fat 62.34 g (SD = 62.34), which contributed 18.5%, 47.36% and 33.7% respectively, of total energy in the diet. Females consumed significantly greater amounts of added sugar than males (M = 20.51 g) vs (M= 13.18 g). Both gender categories met their EARs for fibre, iron, vitamin C, vitamin B6, vitamin A, thiamine, riboflavin, folate and vitamin K. The respondents had a decreased intake of cholesterol, saturated fat and mono-unsaturated fatty acids and higher intakes of poly-unsaturated fatty acids. Females met their EARs for zinc and niacin, 9.02 mg and 15.32 mg respectively, while males were below their EAR, consuming 9.8 mg and 15.59 mg respectively. Males met their EAR for vitamin E consuming 20.32 mg, while females were below their EAR, consuming 13.56 mg of vitamin E. The respondents were shown to be lacking in calcium, sodium, vitamin D and vitamin B12. Conclusion: This study revealed that although veganism is widespread in South Africa, White females living in Gauteng were more likely to be following this lifestyle and be members of the South African Vegan Society online group on Facebook. Their main motive for following the diet was preventing cruelty towards animals and protecting the environment and its resources. This suggests that South African vegans are concerned about animal rights and the environment and their knowledge about veganism should be further investigated. The main challenge faced by the respondents was finding vegan options in restaurants. Therefore, restaurants that are vegan-specific or have vegan options available are recommended to list their restaurants online and upload their menus to assist vegans, as the internet was commonly used for research among this group. Major retail supermarkets are recommended to increase their stock and variety of options of vegan products especially plant-based milk and meat alternatives as these products are widely consumed. Research has shown that the vegan diet is linked to many potential health benefits, yet there is concern regarding whether the diet leads to nutrient deficiencies over time. As veganism is growing in South Africa, this study highlights the need for fortified food products and nutritional supplements to reduce nutrient deficiencies in the vegan diet. Longitudinal studies will also assist in examining trends and sustainability of a vegan diet in South Africa as well as determine whether nutrient deficiencies develop over time.
Nutritional status of children with Wilms' tumour on admission to Inkosi Albert Luthuli Central Hospital in Durban, South Africa and its influence on outcome.
(2016) Lifson, Lauren Frances.; Wiles, Nicola Laurelle.; Pillay, Kirthee.
Introduction: In developing countries the prevalence of malnutrition on admission amongst children with cancer can be as high as 69%. High rates of malnutrition occur due to factors such as poverty, co-morbidities, late presentation and advanced disease process. Weight has been shown to be an inaccurate parameter for nutritional assessment of patients with solid tumours as it is influenced by tumour mass. The importance of nutritional resuscitation and support of children with cancer has been emphasised in the literature, however, nutritional assessment and management of children with cancer is not consistently implemented throughout the centres treating these patients. Malnutrition on admission has been shown to increase the risk of toxicity and infection amongst children with cancer. The influence of malnutrition at the time of admission on outcome has not, however, been conclusively established. Aim: The aims of this study were to determine the prevalence of malnutrition amongst children with Wilms‟ Tumour on admission to hospital, as well as the influence thereof on outcome after two years. Furthermore, it aimed to determine the level of nutritional support that the children received on admission to hospital. Objectives: a) To determine the prevalence of malnutrition using a combination of anthropometric and biochemical markers, defined by the AHOPCA algorithm. b) To determine the influence of nutritional status on admission on the outcome, in terms of overall survival and death, amongst children with Wilms' Tumour admitted to IALCH between 2004 and 2012. c) To determine the level of nutritional support prescribed to children with Wilms‟ Tumour within the first two weeks of admission to IALCH between 2004 and 2012. Methods: Seventy six children diagnosed with Wilms' Tumour and admitted to IALCH between 2004 and 2012 were studied prospectively. Nutritional assessment took place before starting treatment and included weight, height, mid upper arm circumference (MUAC), triceps skinfold thickness (TSFT) and serum albumin. Overall nutritional status was classified using a combination of MUAC, TSFT and albumin. Outcome was determined at two years after the date of admission. Time until commencement of nutritional intervention after admission, and nature thereof, were recorded. Results: Stunting and wasting was evident in 12 and 15% of patients, respectively. By classifying nutritional status using a combination of MUAC, TSFT and albumin, the prevalence of malnutrition was shown to be 67%. Malnourished children did not have significantly larger tumours than those who were well-nourished on admission. Malnutrition was not a predictor of poor outcome at two years after admission. Eighty four percent of patients received nutritional resuscitation within two weeks of admission, in the form of oral supplements, nasogastric feeds, or a combination thereof. Conclusion: When classifying nutritional status, utilisation of weight and height in isolation can lead to underestimation of the prevalence of malnutrition amongst children with Wilms' Tumour. Nutritional assessment and classification of children with solid tumours should include MUAC and TSFT. Malnutrition at the time of admission was not shown to be related to poorer outcome after two years. This may be due to the effects of early aggressive nutritional resuscitation as part of management by a multidisciplinary team.
The opinion of KwaZulu-Natal dieticians regarding the use of a whole foods plant based vegan diet in the managment of non-communicable diseases.
(2018) Janse Van Rensburg, Laura May.; Wiles, Nicola Laurelle.
Introduction: A whole foods plant based vegan diet (WFPBVD) is one that promotes the intake of fruit, vegetables, wholegrains, nuts and seeds. To date, many international studies have investigated a WFPBVD’s effect on non-communicable diseases (NCDs) mainly obesity, type 2 diabetes, cholesterol and heart disease. The positive outcome of these studies has resulted in some international doctors turning to a WFPBVD as a treatment method. South Africa is transitioning from infectious to NCDs such as heart disease, cancers, chronic respiratory disease and diabetes which are currently presenting a threat to health and development. Most of these NCDs can be reduced by eliminating the risk factors associated with them. Studies have shown that adopting a WFPBVD is beneficial in both the prevention and the treatment of NCDs. Dieticians are experts in the field of nutrition and therefore it was imperative to gather their opinion of this diet to assess whether they consider is a suitable treatment option for the prevention of NCDs. Aim: To determine whether dieticians would use a WFPBVD to address NCDs by assessing their opinion toward the benefits and barriers of this diet. Objectives: To determine the dieticians knowledge and attitude of a WFPBVD including definitions and use of the diet in practice; to determine the opinion toward the perceived benefits and barriers of the diet including health and personal benefits, information availability and personal barriers. Methods: A cross-sectional study was conducted on KZN dieticians registered with the Association for Dieticians in South Africa. The study involved the use of an online survey questionnaire consisting of four parts. Results: The study was completed by 101 dieticians of which 95% were female and 5% were male. Respondents were predominantly White (71.3%, n=72) followed by Black African (18.8%, n=19) with the lowest response rate from the Indian (9.9%, n=10) population. Most of the subjects obtained their qualification from the University of KwaZulu-Natal (66.3%). The sample was represented by 44.6% (n=45) of government employed dieticians and 47.5% (n=48) of private practicing dieticians (PPDs). Government dieticians were significantly more likely to be referred patients with cancer, non-communicable diseases (NCDs), HIV/AIDS and TB, liver disease and renal disease compared to non-government dieticians. All but one dietician was familiar with the term vegan and 52% of the sample was familiar with the term ‘whole foods plant based diet’. There was significant agreement that a vegan diet could be nutritionally adequate (p<0.011), but insignificant agreement that a vegan diet made up whole plant based foods could be nutritionally adequate. Subjects reported that training on a PBD at university level was inadequate however a significant sample (p<0.05) was confident in prescribing a PBD in practice and interested in improving their knowledge on this topic. The strongest perceived benefits of a WFPBVD reported were “It is associated with an improved fibre intake”, “It encourages a lower saturated fat intake due to reduced animal products” and “it is associated with reduced risk of constipation”. There was disagreement with the statements “It is an easy diet to follow” and “It is a suitable option in low-income households”. The strongest barrier reported to prescribing a WFPBVD were, “There is not enough awareness around whole food plant based vegan diets for the public” and “People prefer to consume meat and animal by-products”. Conclusion: While dieticians felt that they did not receive adequate training on a PBD at university level, they did report confidence in prescribing this type of meal plan and interest in learning more about this topic. Using a WFPBVD in the treatment and prevention of NCDs is a topic that has been studied on an international level but not yet on a national level. NCDs were reported as a major reason for referral in both government and non-government dieticians and therefore this diet could be a potential treatment option. Dieticians however did not feel that this lifestyle would be suitable in low income communities which may be an interesting topic for future research. Barriers in this study included lack of public awareness about this lifestyle as well as resistance to changing current dietary habits. However, the health benefits of a WFPBVD were seen as being significantly more important than the personal benefits of this diet. Dieticians are at the forefront of nutritional communication to the public. Developing platforms to provide more training and learning opportunities to health care providers and the public on a WFPBVD may be beneficial.
To determine the impact of dietary calcium from dairy, and/or total dairy intake on the body mass index of Grade 2 leaners in Pietermaritzburg.
(2018) Galliers, Joanne Louise.; Wiles, Nicola Laurelle.; Tyler, Nicola Claire.
Introduction: International and local figures show a steep rise in the incidence of overweight and obesity in both adults and children, with more children suffering from overweight, obesity and their associated diseases of lifestyle than ever before. The aetiology of overweight and obesity is complex, with many interrelated factors involved. The South African government implemented the Food Based Dietary Guidelines in an attempt to guide the public on making healthy food choices. One of the guidelines encourages the public to “have milk, maas or yoghurt every day” due to the beneficial health effects of these dairy products. South African studies investigating the calcium intake of different age groups have shown children to consume inadequate amounts of calcium. A recent national survey showed the age group of 7 to 8 years old in particular, to have the lowest calcium intake of all age groups studied. Several international studies have shown dairy products, and specifically milk, to have an inverse relationship with Body Mass Index (BMI) in both adult and paediatric subjects. However, other international studies have provided conflicting results. No such study has been conducted in South Africa, and so the need arose to investigate a possible association between dairy products and childrens’ BMI. Aim: To determine the impact of dietary calcium from dairy and/or total dairy intake, on the body mass index of Grade 2 learners in Pietermaritzburg. Objectives: To determine the following regarding Grade 2 learners: the prevalence of overweight and obesity by interpreting their BMI; their calcium intake from dairy, and their total dairy intake; the contribution of dairy products to meeting their calcium requirements; whether a relationship exists between their dietary calcium (from dairy), and/or total dairy intake and their BMI; and possible barriers to dairy intake. Method: A cross sectional study was conducted on 91 Grade 2 learners from quintile 5 (fee-paying) schools in Pietermaritzburg. A three-part questionnaire, comprised of an anthropometric section, demographic questions, and a semi-quantitative food frequency questionnaire (FFQ) were administered to the parents/guardians of the Grade 2 learners. The BMI of the learners was compared to both the World Health Organization (WHO) and International Obesity Task Force (IOTF) classifications for overweight and obesity. The calcium intake was obtained from the FFQ, and compared to the Estimated Average Requirement (EAR) for calcium for 4 to 8 year olds. The dairy intake was also determined, and compared to the recommended national guidelines. Results: The study population comprised 57% female and 43% male learners, of whom 40.7% were Black African, 27.5% were White, 17% were Indian and 13.2% were Coloured. Of these learners, 28.6% (WHO) and 24.2% (IOTF) were overweight and 19.8% (WHO) and 15.4% (IOTF) were obese. More female learners were overweight than male learners, but a greater percentage of male learners were obese than female learners. Calcium intake from dairy was significantly below the EAR of 800 mg per day for 75.8% (n=69) of learners, with the average intake from the FFQ recorded as 615.2 mg. The mean number of dairy servings per day was 2.03, also below the recommended number of 3 servings of dairy per day. No relationship between BMI and calcium, or BMI and total dairy intake was established. Despite the low intake of dairy, no significant barriers to the consumption of dairy were identified. Conclusion: Grade 2 learners do not consume enough dairy products in their diet, and are therefore unable to meet the calcium requirements for their age. Greater effort is required by government, schools, health professionals and parents/guardians to promote, and encourage children to consume more dairy products. Further research on this topic is recommended, where the impact of lower fat and sugar containing dairy products on body fat (as opposed to BMI) can be investigated.
The tuck shop purchasing practices of grade 4 learners at selected primary schools in Pietermar[it]zburg, South Africa.
(2011) Wiles, Nicola Laurelle.; Green, Jannette Maryann.; Veldman, Frederick Johannes.
Aim: To determine whether the tuck shop purchasing habits of Grade 4 learners were contributing towards the development of childhood overweight and obesity. Objectives: To assess the nutritional quality of the food and beverages available for learners to purchase; items regularly purchased from the tuck shop as well as factors influencing the learner’s decision to purchase these items; the anthropometric and socio-demographic characteristics of grade 4 learners as well as their nutrition knowledge related to the tuck shop items purchased. Method: A survey administered to 11 tuck shop managers, a questionnaire administered to 311 Grade 4 learners and two single-sex focus groups of 5 learners each were conducted. Results: Fifty six percent of the sample were female (n=173) and 44% were male (n=138). Twenty seven percent of the study sample was overweight (n = 83) and 27% were obese (n = 85). Eighty six percent of learners (n = 266) claimed to buy from their school tuck shop. Twenty two percent of learners purchased from their tuck shop at least three times per week (n =58). Learners who purchased from the tuck shop had a significantly higher BMI than those who did not (p = 0.020). Learners who purchased from the tuck shop spent on average R8,38 per day with a minimum of R1 and a maximum of R40 (standard deviation 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” (47.0%, n = 125). Savoury pies were the most popular "lunch" item for all learners for both food breaks (45%, n = 5 schools and 27.3%, n = 3 schools) selling the most number of units (43) per day at eight of the eleven 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 its unhealthy counterpart (465kJ vs 806kJ). Nutritional analyses of the healthy lunch options revealed total fat contents that exceeded the DRI and South African recommended limit. Perceived barriers to stocking healthy items included cost and refrigeration restrictions. The average score for the food groups was only 33% indicating that learners were not familiar with the Food Based Dietary Guidelines (FBDG). Further analyses showed that the total knowledge scores of those learners that reported to buy from the tuck shop frequently, was significantly lower when compared to the total knowledge scores of those learners who bought from the tuck shop less frequently (13.0 ± 3.9 and 11.6 ± 3.1, respectively; p < 0.05). Logistic regression analysis confirmed that the total knowledge of a learner could be used to predict whether he or she is more likely to make purchases from the tuck shop (significance = 0.017). Focus group results revealed that learners are aware of “healthy” and “unhealthy” tuck shop items. Most learners stated that they would continue to purchase items from their tuck shop if all “unhealthy” items were removed. Conclusion: Primary school tuck shops of well resourced schools in Pietermaritzburg are contributing to childhood overweight and obesity through a combination of factors. These include the poor nutritional quality of the items stocked at the tuck shop as well as the poor tuck shop purchasing practices. Much consultation is required amongst dieticians, school principals and privatised tuck shop managers to overcome barriers to stocking healthy items. School management and government have an important role to play in imposing restrictions on the sale of unhealthy items; along with improving the quality of the nutrition education curriculum to ensure that learners are able to translate their knowledge into healthier purchasing practices.
The use and interpretation of the nutrition information on the food label of selected fat spreads by female consumers aged 25-45 years, living in Pietermaritzburg.
(2006) Wiles, Nicola Laurelle.; Paterson, Marie.; Meaker, Jill.
Aim: To determine the use and interpretation of the nutrition information on the food label of selected fat spreads by female consumers aged 25 to 45 years, living in Pietermaritzburg. Objectives: This study set out to determine the following objectives regarding the food label: what the demographics of the consumers making use of the label were; how these consumers used the label and their motivation behind this label use and did the use of the label alter the purchase of that product? Method: One hundred and fifty women aged 25-45 years were chosen from an accidental, non-probability sample of consumers shopping at selected supermarkets within Pietermaritzburg. Respondents were presented with a four part questionnaire surrounding the purchase of selected fat spreads. Results: The greatest number of respondents were from the white population group (n = 65), followed by black respondents (n = 46), Indian respondents (n = 29) and then coloured respondents (n = 10). Results showed that the respondent who was 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 than R1000 a month to spend on food and was conscious of choosing the healthier option. Fifty five percent of this study sample (n = 82) claimed to use the nutrition information on the label to assist with purchases and 68% (n = 102) found the nutrition information important for purchasing a new product. Of the potential factors that have previously been found to impede the use of the nutrition information label:-inadequate print size, lack of education as well as lack of nutrition information on the food label were found to be factors restricting label use in this study. The most commonly used sources of nutrition information were the media as well as friends and family and the most trusted source was the Health Professional. Discussion: If the nutrition information is to be used both correctly and effectively, there must be a major educational campaign that sets out to meet the needs of the population that are most vulnerable, especially those with an inadequate education. Conclusion: The consumer most likely to use the nutrition information on the food label has a tertiary education, is a primary food purchaser with a large amount of money available for groceries and is conscious of choosing a healthier option. The label is most likely to be used when purchasing a fat spread for the first time.