Masters Degrees (Dietetics And Human Nutrition)

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The accuracy of arm-associated height estimation methods compared to true height in a multi-racial group of young South African adults.
(2015) Lahner, Christen Renée.; Kassier, Susanna Maria.; Veldman, Frederick Johannes.
Background: Stretch stature is the gold standard for measuring true height, but when this is not possible height estimation methods are used. To date, only two South African studies regarding height estimation techniques have been published. Objective: To investigate the accuracy of arm-associated height estimation methods used for the calculation of true height compared to stretch stature in young South African adults. Design: A cross-sectional descriptive design was employed. Setting: Pietermaritzburg, Westville and Durban, KwaZulu-Natal, South Africa, 2015. Subjects: Convenience sample (N=900) aged 18 to 24 years, which included an equal number of subjects from both genders (n=150 per gender) stratified across race (White, Black and Indian). Results: Highly significant differences exist between genders (p<0.001), where males had larger stretch statures and arm-associated measurements than females (p<0.001). Highly significant differences exist between race groups (p<0.001), where whites had significantly different stretch statures as well as different armassociated measurements compared to Blacks and Indians. Some similarities were found between race groups, especially between Blacks and Indians. Arm-associated height estimation methods can be used as estimates of true height in accordance with the following study findings: (i) among Black African males, the World Health Organisation (WHO)-adjusted equation would seem to be the most appropriate, followed by demi-span male equation; (ii) among Black African females, the demispan female equation would seem to be the most appropriate, followed by total armspan; (iii) among Caucasian males, the total armspan would seem to be the most appropriate, followed by half-armspanx2; (iv) among Caucasian females, the total armspan would seem to be the most appropriate, followed by half-armspanx2; (v) among Indian males, the demi-span male equation would seem to be the most appropriate, followed by the WHO-adjusted equation; and (vi) among Indian females, the WHO-adjusted equation would seem to be the most appropriate, followed by demi-span female equation. Discussion:. The anthropometric variation between genders and race groups was linked to the exposure to secular growth conditions, which influences a subject's physiological ability to achieve their maximal height. The Vitruvius theory was proposed where total armspan potentially represents a subject's maximal height, and the ability for them to reach that height is dependent on exposure to consistent ambient secular growth conditions during the window period and beyond. Conclusion: In conclusion, this study's findings provides a baseline for future height studies to be conducted on the South African population, where each anthropometric method should be validated for each race and gender.
Anthropometric status and dietary habits of registered nurses, enrolled nurses and enrolled nursing auxilliaries workng at a private hospital in Pietermaritzburg, KwaZulu-Natal.
(2021) Yegambaram, Leah Bianca.; Pillay, Kirthee.
The prevalence of overweight and obesity has been increasing over the years, particularly in South Africa (SA). A major contributor to this is poor lifestyle choices such as unhealthy diets and sedentary lifestyles. The rise in overweight and obesity is alarming as both are major risk factors for non-communicable diseases (NCDs). Overweight and obesity are also becoming more prevalent among healthcare professionals, specifically nurses. However, nurses are expected to lead by example and should be role models to the patients they care for. Nurses are the backbone of healthcare facilities and being overweight or obese impacts both on themselves and on their patients. Factors contributing to overweight and obesity among nurses include consuming meals late, eating during stressful periods, low physical activity levels and working shifts. Aim: This study aimed to investigate the anthropometric status and dietary habits of registered nurses (RNs), enrolled nurses (ENs) and enrolled nursing auxiliaries (ENAs) working at a private hospital in Pietermaritzburg (PMB), KwaZulu-Natal (KZN). Objectives: (i) to determine the anthropometric status of RNs, ENs and ENAs working at a private hospital in PMB, KZN; (ii) to determine the dietary habits of RNs, ENs and ENAs working at a private hospital in PMB, KZN; (iii) to determine the factors contributing to the anthropometric status and dietary habits of RNs, ENs and ENAs working at a private hospital in PMB, KZN; (iv) to determine the prevalence of NCDs among RNs, ENs and ENAs working at a private hospital in PMB, KZN. Method: A cross-sectional descriptive study was conducted on RNs, ENs and ENAs working at a private hospital in PMB, KZN. A self-administered questionnaire was developed to obtain data on demographic characteristics, lifestyle factors, body image and weight and eating habits. Anthropometric status was determined using selected anthropometric indices including weight, height, body mass index (BMI) and waist circumference (WC). Dietary habits was assessed using a food frequency questionnaire (FFQ) and a single 24-hour recall. The 24-hour recall was analysed using the Medical Research Council (MRC) Food Finder software programme version 1.0. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 22. Results: The study sample consisted of 130 nurses; 40.8% (n=53) were RNs, 36.9% (n=48) were ENs, 2.3% (n=3) were midwives, 19.2% (n=25) were ENAs and one was a clinical nurse specialist in the neonatal intensive care unit (NICU). A significant number of the participants were either overweight (25.4%; n=33) or obese class I (29.2%; n=38) (p<0.0005). Most participants did not smoke (82.3%; n=107) or consume alcohol (59.2%; n=77). Only 50% (n=65) of participants exercised. A significant number (63.1%; n=82) indicated that they were not satisfied with their body shape/size and did not feel that they were at a healthy body weight (60%; n=78). The majority of participants underestimated their BMI using the Stunkard figure rating scale (76.9%; n=100). The majority of participants stated they had tried to lose weight before (64.6%; n=84). The most common weight loss methods were cutting down on fast foods/takeaways (67.9%; n=57) (p=0.001) and exercising (63.1%; n=53). A significant number of nurses agreed that they were role models to their patients (70.8%; n=92) and believed it was important for a nurse to have an ideal body weight (92.3%; n=120). The majority of participants skipped meals (83.8%; n=109) with the only significantly skipped meal being breakfast (63.3%; n=69). A significant number of participants prepared their own meals at home (84.6%; n=110). Participants significantly agreed that time [M (mean)=3.98; p<0.0005], cost (M=3.26; p=0.021), emotions/stress (M=3.61; p<0.0005) and convenience (M=3.38; p<0.0005) were factors that influenced their meal choices. There was significant agreement that a lack of time to prepare meals (M=3.69; p<0.0005), lack of time to eat at work (M=4.04; p<0.0005), emotions/stress (M=3.30; p<0.0010) and healthy food not being available to buy at work (M=3.22; p<0.0036), were factors preventing nurses from eating healthily. The most common food item bought at the hospital cafeteria was pies (21.5%; n=17). Fruit (52.3%; n=68), sweets (34.6%; n=45) and sugar-sweetened soft drinks (32.3%; n=42) were consumed at least once a day. The mean BMI for females (33.6 kg/m2) was significantly higher than that for males (28.1 kg/m2) (p=0.043). Most male participants had a WC above 94 cm (63.6%; n=7), while the majority of females (88.2%; n=105) had a WC above 80 cm. The mean BMI for non-smokers (BMI=33.8 kg/m2) was significantly higher than that of smokers (29.6 kg/m2) (p=0.030). A higher BMI was associated with less snacking. The mean BMI for those who skipped supper (36.3 kg/m2) was significantly higher than for those who ate supper (32.0 kg/m2) (p=0.013). The mean BMI for those who skipped meals (33.8 kg/m2) was significantly higher than for those who did not skip meals (29.6 kg/m2) (p=0.005). The FFQ showed that the starches most frequently consumed were brown and white bread/rolls, white rice, phutu (crumbly maize meal porridge) and potatoes without skin. Sweets, chips (crisps), biscuits and chocolates were also frequently eaten. In the meat, poultry, fish, eggs and meat substitutes group, eggs, processed meats and chicken cuts with skin were frequently (n=65) of participants exercised. A significant number (63.1%; n=82) indicated that they were not satisfied with their body shape/size and did not feel that they were at a healthy body weight (60%; n=78). The majority of participants underestimated their BMI using the Stunkard figure rating scale (76.9%; n=100). The majority of participants stated they had tried to lose weight before (64.6%; n=84). The most common weight loss methods were cutting down on fast foods/takeaways (67.9%; n=57) (p=0.001) and exercising (63.1%; n=53). A significant number of nurses agreed that they were role models to their patients (70.8%; n=92) and believed it was important for a nurse to have an ideal body weight (92.3%; n=120). The majority of participants skipped meals (83.8%; n=109) with the only significantly skipped meal being breakfast (63.3%; n=69). A significant number of participants prepared their own meals at home (84.6%; n=110). Participants significantly agreed that time [M (mean)=3.98; p<0.0005], cost (M=3.26; p=0.021), emotions/stress (M=3.61; p<0.0005) and convenience (M=3.38; p<0.0005) were factors that influenced their meal choices. There was significant agreement that a lack of time to prepare meals (M=3.69; p<0.0005), lack of time to eat at work (M=4.04; p<0.0005), emotions/stress (M=3.30; p<0.0010) and healthy food not being available to buy at work (M=3.22; p<0.0036), were factors preventing nurses from eating healthily. The most common food item bought at the hospital cafeteria was pies (21.5%; n=17). Fruit (52.3%; n=68), sweets (34.6%; n=45) and sugar-sweetened soft drinks (32.3%; n=42) were consumed at least once a day. The mean BMI for females (33.6 kg/m2) was significantly higher than that for males (28.1 kg/m2) (p=0.043). Most male participants had a WC above 94 cm (63.6%; n=7), while the majority of females (88.2%; n=105) had a WC above 80 cm. The mean BMI for non-smokers (BMI=33.8 kg/m2) was significantly higher than that of smokers (29.6 kg/m2) (p=0.030). A higher BMI was associated with less snacking. The mean BMI for those who skipped supper (36.3 kg/m2) was significantly higher than for those who ate supper (32.0 kg/m2) (p=0.013). The mean BMI for those who skipped meals (33.8 kg/m2) was significantly higher than for those who did not skip meals (29.6 kg/m2) (p=0.005). The FFQ showed that the starches most frequently consumed were brown and white bread/rolls, white rice, phutu (crumbly maize meal porridge) and potatoes without skin. Sweets, chips (crisps), biscuits and chocolates were also frequently eaten. In the meat, poultry, fish, eggs and meat substitutes group, eggs, processed meats and chicken cuts with skin were frequently consumed. The fruit and vegetables most frequently consumed were non-starchy vegetables, fresh fruit and fruit juice. Full cream milk, sunflower oil, tub/soft margarine and cheddar cheese were the dairy and fats eaten most often. Tea and water were consumed more often than sugar-sweetened beverages. Overall, the most frequently consumed foods were full cream milk, sunflower oil, tea, white sugar, fresh fruit, brown sugar, brown bread/rolls, tub/soft margarine, sweets and white bread/rolls. Conclusion: There was a high prevalence of overweight and obesity among the participants. According to WC, the majority of nurses had an increased risk for metabolic complications. However, most participants were not diagnosed with a NCD. Factors associated with a high BMI included being female, not smoking, skipping meals, skipping supper, less snacking and cost of meals. Nurses consumed both healthy and unhealthy foods. Overall, there was a higher intake of carbohydrates and protein and a lower intake of dietary fibre. Despite the many hours that they spend caring for patients, nurses should also pay attention to their own health and well-being. Nurses should be supported in their efforts to achieve and maintain a healthy weight and lead a healthy lifestyle.
An assessment of the effect of a peanut based ready-to-use nutritional supplement on HIV positive adults on antiretroviral therapy, attending the 1000 Hills Community Helpers Centre, Durban, KwaZulu-Natal.
(2014) Ncwane, Mphilonhle Vuyani Sibongeleni.; Veldman, Frederick Johannes.
Introduction: The aim of this study was to assess the nutritional effect of a peanut based ready-to-use food supplement (RUSF) [Sibusiso®] on HIV positive adults on antiretroviral therapy (ART). Objectives: (1) To determine whether the BMI of HIV positive adults on ART supplemented with RUSF was improved after a three months supplementation period. (2) To determine the most predominant self reported disease symptoms experienced by HIV positive adults on ART at baseline assessment. (3) To determine whether predominant disease symptoms experienced by HIV positive adults in ART improved after supplementation with Sibusiso® RUSF. (4) To determine whether appetite, meal consumption and energy levels improved among HIV positive adults on ART supplemented with Sibusiso® RUSF. (5) To determine if there was any observed changes in body fat distribution in HIV positive adults on ART after being supplemented with Sibusiso® RUSF. Materials and methods: This is a non randomised descriptive study whereby data was collected using a cross-sectional method. It included 50 HIV positive adults (between 20 and 78 years of age) on antiretroviral therapy, attending the 1000 hills community helpers’ centre, Durban, KwaZulu-Natal. A monitoring tool was used to collect data on anthropometrical measurements (weight and height), disease symptoms experienced, disease conditions identified by the researcher/research assistants, level of appetite, meal frequency consumption and energy for each subject for a period of three consecutive months. Twenty participants were interviewed to assess the body fat distribution after using the supplement using a self reporting method. Results and discussions: Study findings suggest that supplementation with RUSF for at least three months has a potential to gradually improve weight gain among HIV-positive adults on ART. The most self reported predominant disease symptom experienced before supplementation was fever, followed by nausea and persistent diarrhoea. This was in keeping with the results from other studies. After supplementation, there was a significant improvement in fever and gastroenteritis and steady but statistically significant decline in vomiting. However there was non-significant improvement in nausea and no change in persistent diarrhoea. RUSF in this study was also found to exert a beneficial effect on appetite, meal consumption and energy levels of participants. The study showed that short-term supplementation with RUSF is highly unlikely to result in lipodystrophy. Conclusion: The administration of the nutrition supplement Sibusiso® RUSF for at least three months, in conjunction with the use of ART, was found to improve nutritional status in HIV patients under the controlled condition. Sibusiso® RUSF was able to improve the episode of fever which was most dominant disease symptom at baseline while improving gastroenteritis and vomiting. However it did not have an impact on reducing the episodes of nausea and persistent diarrhoea. Sibusiso® RUSF was also able to improve appetite, meal consumption and energy of participants after a three month period.
An assessment of the quality and acceptance of a ready-to-use supplement, Sibusiso, by human immunodeficiency virus and human immunodeficiency virus/tuberculosis treated patients in KwaZulu-Natal.
(2013) Mabaso, Prudence Bongekile.; Siwela, Muthulisi.; Pillay, Kirthee.; Amonsou, Eric Oscar.; Veldman, Frederick Johannes.
Introduction: Malnutrition is a health issue directly and indirectly contributing towards high rates of morbidity and mortality globally, particularly in developing countries. South Africa (SA) is faced with a double burden of diseases with a high prevalence of both under and over nutrition. The high prevalence of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) in SA worsens undernutrition. HIV/AIDS increases nutrient requirements and inadequate food intake results in malnutrition. Nutrition support through food supplementation is important to combat the high prevalence of malnutrition in sub-Saharan African countries including South Africa. Thus, a groundnut-soya based supplementary paste, Sibusiso, has been produced. However, its nutritional composition and acceptability have not been studied. Objectives: (i) To determine the nutritional composition and physical properties of a ready-to-use supplement, Sibusiso, (ii) To determine the sensory acceptability of Sibusiso among healthy subjects; and sensory acceptability and perceptions of Sibusiso by subjects treated for HIV and HIV/TB. Materials and methods: The nutritional composition, colour and texture of Sibusiso and a commercial peanut butter (control) were analysed following standard procedures. A cross-sectional consumer acceptability test was done using a 5-point facial hedonic scale (healthy control group, n = 68; HIV, n = 88 and HIV-TB co-infection treated, n = 51). A total of six focus group discussion sessions (HIV subjects = 4 sessions and HIV/TB co-infected subjects = 2 sessions) were also conducted. Results and discussions: The protein content of Sibusiso (16 g/100 g) was almost half that of the commercial peanut butter (control), (25 g/100 g). However, Sibusiso contained 1.4 times more ash (4 g/100 g) and almost twice as much carbohydrate (40 g/100 g) compared to the commercial peanut butter (22 g/100 g). The fat (40 g/100 g) and energy (2 624 kJ/ 100 g) content of Sibusiso was not substantially different from that of the commercial peanut butter which was 43 g/100 g and 2 852 kJ/100 g, respectively. The lysine content of Sibusiso (58 mg/g) was about 1.7 times higher than that of the commercial peanut butter. The methionine (11 mg/g) and histidine (35 mg/g) content of Sibusiso was almost twice that of the commercial peanut butter, respectively. The nutrient content of Sibusiso was either similar or slightly more than that of other ready-to-use supplements such as Plumpy’nut®. Sibusiso met the FAO/WHO/UNU recommendations for essential amino acids. The consumption of 50 g of Sibusiso per day may provide approximately 35% of the Estimated Energy Requirements (EER) and 30% of the Recommended Dietary Allowance (RDA) for protein for adults. Sibusiso was brown in colour, similar to the commercial peanut butter. Its textural attributes were found similar to that of the commercial peanut butter but harder and stickier. The acceptability of Sibusiso was significantly associated (p ≤ 0.05) with the health status of consumers. Overall, Sibusiso was liked by 94% of HIV and HIV/TB individuals (mean score: 4) compared to 85% for the healthy group (control). More than 90% of the HIV/TB and HIV treated individuals liked the taste compared to the control group (86%, mean score: 4). The colour and mouthful were rated 'good' by more than 80% of the HIV and HIV/TB group, mean score: 3, with only 68% among the healthy group, mean score: 4.1. Conclusion: Sibusiso is a good source of nutrients and was found to be acceptable to HIV and HIV/TB treated consumers. It may be effective in alleviating disease-related malnutrition among vulnerable individuals such as those infected by HIV and HIV/TB.
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
Awareness, attitudes and response to the sugar-sweetened beverage tax among consumers in Pietermaritzburg, KwaZulu-Natal.
(2019) Baijnath, Nikita.; Pillay, Kirthee.
Introduction: Obesity and overweight have been identified as serious health problems both globally and in South Africa. One of the contributing factors to this epidemic is the consumption of sugar-sweetened beverages (SSBs), high in sugar and energy. Sugar-sweetened beverages are defined as: ‘beverages that contain added caloric sweeteners such as sucrose, high fructose corn syrup or fruit juice concentrates’ and include soft drinks, fruit drinks, sports/energy drinks, vitamin water drinks, sweetened ice tea and lemonade. The South African Minister of Finance implemented the sugar-sweetened beverage (SSB) tax on 01 April 2018, as part of a multidisciplinary strategy to alleviate the obesity problem. The tax is calculated according to the direct proportion of added sugar at 2.1 cents per gram of sugar that exceeds 4 g per 100 ml, resulting in an approximate 20% increase in the price of SSBs. Given that the SSB tax is relatively new in South Africa, there is a need to assess the awareness, attitudes and responses of South African consumers to the tax. Aim: This study aimed to assess the awareness, attitudes and response to the sugar-sweetened beverage tax among consumers in Pietermaritzburg, KwaZulu-Natal. Objectives: (i) To determine if consumers in Pietermaritzburg, KwaZulu-Natal are aware of the SSB tax (ii) To determine the demographic characteristics of consumers who are aware of the SSB tax in Pietermaritzburg, KwaZulu-Natal (iii) To determine the attitudes of consumers in Pietermaritzburg, KwaZulu-Natal towards the SSB tax (iv) To determine the response of consumers in Pietermaritzburg, KwaZulu-Natal to the SSB tax, in terms of purchasing behaviour. Methods: An observational cross-sectional study was conducted at seven shopping centres in Pietermaritzburg, using a self-administered questionnaire, developed for this study. The questionnaire was used to gather data on demographic characteristics, awareness and response to the SSB tax. Data was analysed using the IBM Statistical Package for Social Science (SPSS) version 23.0. Results: The participants were mostly 18-30 year old Indian or African consumers, with a low income and in possession of a matric certificate or tertiary qualification. A significant number of consumers were aware of the South African SSB tax (58.1%; n=229), however, almost half did not know when it was implemented (47.6%; n=109). Indian and white consumers were significantly more aware of the SSB tax compared to African consumers (p<0.0005). In addition, awareness increased according to income level (more than R40 000 per month) and age (31-50 year olds) (p<0.0005). The consumers were divided in their attitudes towards the SSB tax. Nearly equal amounts of participants were in agreement (35.8%; n=141) or disagreement (37.0%; n=146) with the SSB tax. Furthermore, many believed that it would benefit the country in terms of the economy or health (43.6%; n=100). However, some felt that they could not afford the tax (21.8%; n=50) or felt that the money would go to the government and not benefit the public (12.7%; n=29). Many also believed that the South African economy would be negatively affected in terms of job losses (41.1%; n=162). However, there was neither significant agreement nor significant disagreement that the SSB tax would reduce obesity or consumption rates of SSBs. In addition, many indicated that the government should not interfere with the beverage choices of South Africans (41.9%; n=165). About half of the participants stated that they would make healthier beverage choices, following the implementation of the SSB tax (53.6%; n=211). Moreover, half of the consumers indicated that they would opt for water (50.8%; n=200). Other common alternatives included 100% fruit juice (49.2%; n=194) and milk and milk products (30.2%; n=119). Finally, most participants suggested that they would like the government to help reduce the prevalence of obesity by supporting an increase in nutrition education (27.3%; n=68) and physical activity (22.5%; n=56). Conclusion: This study aimed to assess the awareness, attitudes and response to the SSB tax among consumers in Pietermaritzburg, KwaZulu-Natal. The majority of the consumers were aware of the South African SSB tax; however, almost half did not know when it was implemented. Indian and White consumers, between the ages of 31 and 50 years old, earning more than R40 000 per month, were the most aware of the South African SSB tax. Half of the consumers were in favour of the SSB tax and felt that it would improve health. The same number also indicated that they would choose water as an alternative, if SSBs were no longer affordable to them, followed by 100% fruit juice and milk and milk products. The differences in attitudes towards the SSB tax show that there is a need for consumers to know more about the SSB tax. Hence, more awareness campaigns are required. Future research should investigate the impact of the SSB tax on health, obesity rates and the economy.
Body mass index, body image and possible factors related to weight loss practices of female undergraduate students on the Pietermaritzburg campus, University of Kwazulu-Natal.
(2019) Lubisi, Zethembiso Desiree; Kassier, Susanna Maria.; Mkhwanazi, Blessing Nkazimulo.
South Africa is undergoing epidemiological transition, characterized by an increasing prevalence of obesity, especially among women. Among those 15 to 24 years of age, the prevalence of overweight and obesity at 40.9% is cause for concern, as it is associated with the development of non-communicable diseases of lifestyle. However, 18.1% of women in the above age category, indicated that they are unhappy with their current weight. Body image is related to an individual’s perception of the attractiveness of their own body, and has an impact on actual weight and weight management practices. Body image dissatisfaction refers to the negative perceptions and feelings a person has about their body and can be affected by factors such as body shape and appearance, body weight gain attitudes, and cultural norms regarding an ideal body size. In this respect, university students are of particular interest, as they are known to experience a number of stressors during the transition from secondary- to tertiary education that contributes to unhealthy eating habits, a decreased level of physical activity and subsequent weight gain. Objectives To determine the Body Mass Index (BMI), body image and factors related to weight loss practices among female undergraduate students on the Pietermaritzburg (PMB) campus of the University of KwaZulu-Natal (UKZN). Methods A cross sectional descriptive survey of conveniently sampled female undergraduate students on the PMB campus (N=316), UKZN was conducted. Weight and height were measured by trained fieldworkers for the calculation of BMI. Data was collected by means of a self-administered questionnaire to determine the socio-demographic characteristics, physical activity level, nutrition knowledge, body perceptions, weight management practices and dietary diversity of study participants. Results The majority of participants (86.7%), were black African and registered for study within the College of Agriculture, Engineering and Science (45.6 %). The mean age of the study sample was 20 ± 2 years. Participants mainly resided in private accommodation (44.3%), followed by 38.6% living in university residences. The majority (72.7%) were funded by the National Student Financial Aid Scheme (NSFAS). Participants who prepared their own meals, did so 3.7 ± 2.3 times per week, with 84.3% reporting that they prepared their own meals most days of the week. Most consumed take-aways (91.1%), with 61.2% doing so on a weekly basis. Nearly half (48.1%) of the participants had a normal BMI, followed by 19% being overweight. Furthermore, 13.3% were classified as obese class I, while 12.6% were classified as obese class II. Only 4.4% were underweight, while 2.5% were classified as obese class III. The majority (46.8%) could be classified as being moderately physically active, followed by those with a low level of physical activity at 38.6%. Only 14.6% were classified as having a high level of physical activity. A nutrition knowledge score of ≥ 50% was achieved by 63.8% of participants, followed by a third (34.3%) who had a score of less than 50%. The most noteworthy findings were that participants were not aware that starchy foods should form the basis of most meals, and that drinking boiled water does not facilitate weight loss. An assessment of participant weight management practices, revealed that 59.1% weighed themselves, with 61.0% reporting that they do so monthly. Despite the fact that the majority of participants (70.0%) classified their current body weight as normal, 56.4% had attempted weight loss. Of those who had not attempted weight loss, the majority (37.5%) indicated that the reason for not attempting weight loss, was that they were satisfied with their body weight, followed by 35% indicating that they perceived their body weight as normal. The majority of participants who attempted weight loss, resorted to healthy weight loss practices (50.9%), followed by 42.0% who made use of a combination of healthy and unhealthy weight loss practices. In terms of body image perceptions, the difference between perceived (“feel”) and ideal body size was calculated, rendering a Feel Ideal Index (FID) score of 0.4 ± 1.33, indicating that participants desired to be thinner. The majority of participants (45.0%) had a medium dietary diversity as was indicated by the consumption of 6 to 11 food groups, followed by more than a third of participants (35.6%) having a high dietary diversity score due to the consumption of more than 11 food groups. One out of five participants (19.4%) consumed diets that lacked diversity. Conclusion Body image perception and level of body image satisfaction were the most important determinants of whether participants engaged in weight management practices. This was illustrated by participants who had never attempted weight loss, indicating that the reason why they have never attempted weight loss was because they “perceived their current body weight to be normal” and that they are “satisfied with current weight”. An increase in BMI was positively associated with an increase in body image dissatisfaction (BID), resulting in overweight and obese participants attempting to lose weight. It was also noted that a larger proportion of participants indicated that they have attempted weight loss, and did so using healthy weight loss practices such as exercise, diet and reduced portion sizes. Participants desired body sizes that were thinner than their perceived current body size. This was illustrated by a positive mean FID index score of 0.4 ± 1.33. Although those with a high BMI desired a large body size, it was thinner than what they perceived themselves to be. Furthermore, participants living in university residences and private accommodation, had a higher BMI than those who lived at home. Those with a higher physical activity level (PAL), weighed themselves more often when compared to those who were less active. This may suggests that participants were engaged in physical activity to improve appearance. However, it could also be an indicator that participants were physically active for the promotion of health, general wellbeing and for social reasons. Significant relationships between nutrition knowledge score and BMI, as well as dietary diversity score were not documented. However, participants with a good nutrition knowledge score perceived their current weight to be lower than those with a poor nutrition knowledge score.
Breakfast consumption and the relationship to to socio-demographic and lifestyle factors of undergraduate students in the School of Health Sciences at the University of KwaZulu-Natal.
(2017) Seedat, Raeesa.; Pillay, Kirthee.
Introduction: Breakfast is commonly regarded as the most important meal of the day. The consumption of breakfast has been linked to various health benefits, and is widely acknowledged in available literature. There is improved nutrient intake in those who consume breakfast compared to those who skip breakfast. Consumption of breakfast leads to positive health behaviour, improved stress management, feeling energetic and making less unhealthy snack choices. On the other hand, neglecting breakfast can have negative implications, such as fatigue and decreased concentration. Furthermore, skipping breakfast is positively correlated with obesity risk. The high prevalence of overweight and obesity in South Africa could be linked to poor breakfast consumption habits and requires further investigation. Several studies have illustrated a high prevalence of breakfast skipping amongst the university student population worldwide, due to affordability and time management. It could be assumed that students studying towards qualifications in health sciences would be more inclined towards regular breakfast consumption, as part of a healthy lifestyle; however, further research is required to investigate this. Due to the paucity of data amongst South African university health science students, this study aimed to investigate breakfast consumption and the relationship to socio-demographic and lifestyle factors of undergraduate students in the School of Health Sciences, at the University of KwaZulu-Natal (UKZN). Aim: To investigate breakfast consumption and the relationship to socio-demographic and lifestyle factors of undergraduate students in the School of Health Sciences at UKZN. Objectives: • To investigate breakfast consumption and the factors that influence breakfast consumption in undergraduate students in the School of Health Sciences at UKZN. • To determine the socio-demographic and lifestyle profile of undergraduate students in the School of Health Sciences at UKZN. • To determine if there was a correlation between breakfast consumption, socio-demographic profile, lifestyle indicators and Body Mass Index (BMI) among undergraduate students in the School of Health Sciences at UKZN. Methods: A cross-sectional, descriptive study was conducted on undergraduate students in the School of Health Sciences at UKZN, based at the Westville campus. A self-administered questionnaire consisting mainly of close-ended questions was used to collect data. Weight and height measurements were taken and used to calculate BMI. Results: Most participants were between 19 to 20 years of age, were females, lived at the university residence and were in their first year of study. Most reported their health status to be good or fair, did not smoke or consume alcohol and were physically active. Breakfast was consumed by 82.1% (n=284), however, only 50.5% (n=143) consumed it daily. Breakfast consumption was associated with lower levels of fatigue and higher levels of alertness. Ready to eat or instant breakfast cereals, tea or coffee, eggs and leftovers were popular breakfast choices. Reasons for consuming breakfast included: to satisfy hunger, for energy, to be alert, prevent fatigue and for health reasons. Breakfast was skipped due to a lack of time and a lack of appetite. A significant number of those who did not eat breakfast were in their third year of study, were smokers and consumed fast foods or take-away foods frequently. Daily breakfast intake was found among a significant proportion of Indian and white participants, those who lived at home and those whose parents or family were responsible for purchasing groceries. This study found no relationship between breakfast consumption and BMI. Conclusion: The majority of students at the School of Health Sciences at UKZN consumed breakfast; however, not all consumed it regularly. Breakfast was consumed to achieve satiety, provide energy, be alert, prevent fatigue and for health reasons. Barriers to breakfast consumption included a lack of time and a lack of appetite. There was no relationship between breakfast consumption and BMI. Given its health and nutritional benefits, regular breakfast consumption should be encouraged among university students.
A comparison between the excess fluid to be removed in chronic haemodialysis patients, estimated by HD unit staff versus the multiple frequency BIA measurement.
(2015) Downs, Jane H.; Veldman, Frederick Johannes.; Kassier, Susanna Maria.
Abstract in PDF file.
Comparison of body mass index, eating behaviour and eating attitude between dietetic- and non-dietetic female undergraduate students at a South African University.
(2016) Barnard, Jendri Elizabeth.; Veldman, Frederick Johannes.; Kassier, Susanna Maria.
Abstract available in PDF file.
Comparison of indicators of household food insecurity using data from the 1999 national food consumption survey.
(2006) Sayed, Nazeeia.; Maunder, Eleni Maria Winifred.
Information on the present situation of household food insecurity in South Africa is fragmented. There is no comprehensive study comparing different indicators of household food security. Better information on the household food security situation in South Africa would permit relevant policy formulation and better decision-making on the allocation of limited resources. The availability of a national dataset, the first South African National Food Consumption Survey data (1999) , provided the opportunity to investigate some of the issues raised above, and to contribute to knowledge on the measurement of household food security. The aim of this study was to use the data from the 1999 National Food Consumption Survey (NFCS) to : • Determine and compare the prevalence of household food insecurity using different indicators of household food security ; • Determine the overlap of households identified as food insecure by the different indicators (i.e. how many of the same households are identified as food insecure); and to • Investigate whether there was any correlation between the indicators selected . The indicators of household food security selected were: household income, household hunger experienced, and using the index child: energy and vitamin A intake (from 24 Hour Recall (24HR) and Quantified Food Frequency data), dietary diversity (from 24HR data) and anthropometric indicators stunting and underweight. The cut offs to determine food insecure household were those used in the NFCS and the cut off for dietary diversity was exploratory. The main results of the study were as follows : • The prevalence estimates of household food insecurity ranged from 10% (underweight indicator) to 70% (low income indicator). Rural areas consistently had a higher prevalence of household food insecurity than urban areas . The Free State and Northern Cape provinces had higher levels of household food insecurity, with the Western Cape and Gauteng the lower levels of household food insecurity . • Quantified Food Frequency (QFF) data yielded lower prevalence of household food insecurity estimates than 24 hour recall (24HR) data. Household food insecurity as determined by low vitamin A intakes was higher than that determined by low energy intakes for both the 24HR and QFF data . • There was little overlap with the indicators (9-52%), indicating that the same households were not being identified by the different indicators. Low dietary diversity, low income, 24HR low vitamin A intake and hunger had higher overlaps with the other indicators. Only 12 of 2826 households (0.4%) were classified by all nine indicators as food insecure. • The dataset revealed a number of statistically significant correlations. Overall , low dietary diversity, low income, 24HR low energy intake and hunger had the stronger correlations with the other indicators. Food security is a complex, multi-dimensional concept, and from the findings of this study there was clearly no single best indicator of household food insecurity status. Overall , the five better performing indicators (higher overlaps and correlations) were : low income, 24 hour recall low energy intake, 24 hour recall low vitamin A intake, low dietary diversity and hunger; this merits their use over the other selected indicators in this study. The indicator selected should be appropriate for the purpose it is being used for, e.g. estimating prevalence of food insecurity versus monitoring the long term impact of an intervention. There are other important criteria in the selection of an indicator. Income data on a national scale has the advantage of being available annually in South Africa, and this saves time and money. The 24HR vitamin A intake and 24HR energy intake indicators has as its main draw back the skill and time needed to collect and analyse the information, which increases cost and decreases sustainability. Dietary diversity and hunger have the advantage of being simple to understand, and quicker and easier to administer and analyse. It is suggested that a national food security monitoring system in South Africa uses more than one indicator, namely : 1) household income from already existing national data, 2) the potential for including a hunger questionnaire in the census should be explored, and 3) when further researched and validated, dietary diversity could also be used in national surveys.
Current dietary practice of South African dietitians in the treatment symptomatic uncomplicated diverticular disease.
(2017) March, Tanya.; Biggs, Chara.
Introduction: There is a global rise in diverticular disease (DD) in Westernized countries although the prevalence in South Africa (SA) is unknown. This has a significant effect, not only on the quality of life but also economically as the requirement for surgical interventions and hospital admissions have increased, putting additional pressure on healthcare systems. Dietary approaches to the treatment of DD differ and are contradictory. The traditional restrictive low fiber diet approach recommends the avoidance of insoluble fiber including nuts, seeds, popcorn and corn while the International Current Consensus Guidelines (ICCG) from a number of countries such as Italy, Poland, Denmark, America, Great Britain, advocate a liberal unrestricted high fiber diet (HFD). Although the ICCG have concluded that the consumption of nuts, seeds and popcorn does not appear to exacerbate DD symptoms and complications, there has been anecdotal evidence that their inclusion may worsen symptoms and provoke attacks in some patients suffering with symptomatic uncomplicated DD (SUDD). There are also conflicting views as to whether fiber supplementation is necessary in SUDD. Aim: The aim was to determine dietary treatment methods used by registered dietitians (RDs) practicing in SA when treating SUDD and to determine their beliefs regarding the ICCG for SUDD, trigger foods and the use of fiber, prebiotic and probiotic supplements. Methods: Snowball sampling was used in this quantitative descriptive study to identify 155 RDs in SA who treated SUDD. The RDs completed a closed and open-ended self-administered questionnaire. Results: Diverticular disease was treated by 75% of dietitians in the private sector compared to 25% in the government sector. A third of the dietitians treated less than five patients per year and a third treated two or more patients per month. Their approach to treatment was not significantly different. A significant portion (77%) disagreed with the ICCG and 79% identified foods (including seeds, nuts, pips, wheat, popcorn and fruits), which they believed triggered symptoms. None supplemented with bran and only 1.3% recommended insoluble fiber. Supplementation with prebiotics was considered least beneficial (20%) compared to 74% who routinely prescribed probiotics. The main probiotic species prescribed were Lactobacillus acidophilus, Bifidobacterium lactis, Bifidobacterium longum, Bifidobacterium bifidum, Lactobacillus casei, Lactobacillus rhamnosous, Lactobacillus plantarum and Streptococcus thermophiles. Only 7%, however, prescribed an evidence based strain. Many RDs (74%) felt that patients responded well to their treatment with significant improvement in symptoms and had a decreased relapse rate. Conclusion: The majority of dietitians practicing in SA do not support the ICCG advocating a liberal, unrestricted HFD as the appropriate dietary approach for the treatment of SUDD. An individual treatment approach for each patient was reported throughout the study. Practice regarding the use of prebiotics and probiotics was not evidence-based.
The current infant feeding practices and related factors of Indian and Zulu mothers with 0-9 month old infants attending well baby clinics in Durban-North.
(2017) Mkhize, Zanele Prudence.; Kassier, Susanna Maria.; Veldman, Frederick Johannes.
Background: Currently there are no studies that have been conducted regarding infant feeding practices for Indian mothers neither comparing Indian mothers with other race in South Africa. Thus, this may be the first study and further research may be conducted. Objective: The objective of the study was to determine and compare the infant feeding practices and factors influencing these practices of Indian and Zulu mothers with 0-9 month’s old infants attending well-baby clinics in Durban-North of the Ethekwini District, KwaZulu-Natal. Design: A descriptive cross-sectional survey of mothers was performed. Subjects and setting: Four hundred and fifty participants (50%) Indian and (50%) Zulu mothers with infants aged 0-9 months attending Tongaat community health centre, Verulam and Trenance Park Clinics were included in the study conducted between August and October 2016. Outcome measures: A data collection tool included four indicators: (1) socio-demographic characteristics; (2) infant feeding practices (3) mother’s knowledge, attitude, perception and beliefs regarding infant feeding as well as (4) resources that could influence infant feeding practices) which were measured and compared using Chi-square test and independent samples t-test. Results: High prevalence of breastfeeding immediately after delivery was reported by both groups of Indian (95.5%) and Zulu (90.1%) mothers. However, there was a statistically significant difference between race and food/liquids given to infants before six months of age. The exclusive breastfeeding rate was (37.8%) for Indian infants and (64%) for Zulu infants, by the age of six months. The majority of mothers on both groups decided on their own to feed infants other foods and/ or liquids. For Indian mothers, returning back to work was the main reason to feed infants something other than breast milk, whereas the Zulu mothers reported to feel that their infants were hungry. Overall, clinical staff were the predominant source of infant feeding information. Conclusion: This study confirmed that breastfeeding is a universal infant feeding practice. However, there are challenges that influence the practice of appropriate infant feeding.
The current infant feeding practices and related factors of Zulu mothers with 0-6 month old infants attending PMTCT and non-PMTCT clinics in central Durban, KwaZulu-Natal : an exploratory study.
(2005) Kassier, Susanna Maria.; Maunder, Eleni Maria Winifred.
Abstract: Introduction: Exclusive breastfeeding for the first six months of an infant's life is recommended worldwide. In 1998 the South African Demographic and Health Survey (SADHS) showed that only 10% of mothers exclusively breastfeed at three months. As the HIV virus is transmissible via breast milk, UNAIDS (2002) recommends that women in developing countries should be given a choice of feeding method after being counselled on the risks and benefits of breast feeding versus formula feeding. As a result, the Prevention of Mother-to-Child Transmission (PMTCT) programme was launched in KwaZulu-Natal with the aim of providing interventions to prevent Mother-to-Child Transmission of the HIV virus. However, research has shown that infant feeding practices are influenced by numerous factors. Ultimately mothers will feed their infants in a manner they feel comfortable with, even if it is not always the most appropriate choice. Aim: The aim of this study was to determine and compare current infant feeding practices and some of the factors that influenced these practices among Zulu mothers with 0 - 6 month old infants attending PMTCT and non-PMTCT clinics in Central Durban, KwaZulu-Natal. Methodology: A cross-sectional, descriptive survey was conducted amongst 150 mothers sampled from three non-PMTCT clinics and 150 mothers sampled from three PMTCT clinics. Systematic random sampling of mothers attending the two types of clinics was used to ensure an equal number of mothers· with infants aged 0 - < 6 weeks, 6 - < 14 weeks and 14 weeks to 6 months. The number of mothers interviewed per clinic was determined proportionate to clinic size. Interviews were conducted in Zulu by trained fieldworkers according to a structured interview schedule consisting of 87 open- and closed-ended questions. Summary of most important findings and conclusion: Overall, one quarter of the mothers attending non-PMTCT and one third of mothers at PMTCT clinics were practising exclusive breastfeeding at the time of the survey. The general trend was that mothers attending PMTCT clinics were more inclined than those attending non-PMTCT clinics to breastfeed their infants exclusively (34% versus 24% respectively) or to formula feed (16,7% versus 12,7% respectively). Furthermore, there was a significant decline in exclusive breastfeeding and predominant breastfeeding with increasing infant age in both clinic groups. The opposite held true for mixed feeding and formula feeding in that infants were more inclined to mixed feeding or formula feeding with increasing infant age. In both clinic groups, exclusive breastfeeding was the method of choice in the 0 - < 6 week age category, while a preference for mixed feeding was shown in the 6 - < 14 week category. This trend persisted in the 14 week - < 6 month age category, especially in the non-PMTCT clinics, while there was a small but pronounced increase in formula feeding amongst PMTCT mothers. Although these findings can be explained as a result of implementing the PMTCT programme, the positive trends observed in non-PMTCT clinics serve as an indicator that the Integrated Nutrition Programme (INP) and Baby Friendly Hospital initiative have also had an impact on the feeding choices mothers make. Despite the limited duration of the PMTCT programme at the time of the study, indicators of the impact of the intervention include that a lower percentage of PMTCT mothers introduced foods and/or liquids in addition to breast milk to their infants before six months of age compared to non-PMTCT mothers. Furthermore, more mothers attending PMTCT clinics were shown how to breastfeed and were more likely to have received information about formula feeding. Despite these indicators of a positive impact of the PMTCT programme, the mean age for introducing liquids and/or solids in addition to breast milk was about six weeks and the incidence of this practice was very high for both groups. The similar incidence of formula feeding observed between the two clinic groups suggests the presence of constraints to safe infant feeding choices among mothers attending PMTCT clinics. As observed, infant feeding practices were still not ideal in either of the two clinic groups. However, the high level of antenatal clinic attendance documented for both groups serves as evidence that, if opportunities for providing mothers with appropriate infant feeding advice are utilized optimally, the antenatal clinic could serve as an ideal medium through which infant feeding education can take place, especially as the clinic-based nursing staff were cited as the most important source of infant feeding information by both groups of mothers in the antenatal and postnatal phases. The documented infant feeding practices should be interpreted against the backdrop of factors such as socio-demographic characteristics of the mothers, availability of resources such as social support from peers and significant others and reigning infant feeding beliefs that could influence infant feeding decisions. Predictors of exclusive breastfeeding in PMTCT and non-PMTCT clinics were determined by means of multivariate logistic regression analysis. Significant values were obtained for both clinic groups in terms of the infant not having received liquids in addition to breast milk. No additional predictors were found amongst mothers attending non-PMTCT clinics, however predictors amongst mothers attending PMTCT clinics included whether the mother had not visited the clinic since the infant's birth, whether she practiced demand feeding and whether she was experiencing stress at the time of the study. The limited number of predictors of exclusive breastfeeding documented in this study, especially among non-PMTCT mothers may be explained by the fact that infant feeding behaviour is multifactorial by nature and the interaction between factors that influence feeding choice is strong.
Determining the general - and sports-related nutrition knowledge of male adolescent rugby union players attending a secondary, urban government boy's school in Pietermaritzburg, KwaZulu-Natal.
(2014) Stegen, Bridgitte.; Kassier, Susanna Maria.
Walsh, Cartwright, Corish, Sugrue & Wood-Martin (2011) suggest that the need for sound nutritional knowledge regarding both general concepts that pertain to healthy eating habits as well as the dietary principles that should be met for optimal sports performance, is of vital importance. According to Strachan (2009), adolescent sportsrelated nutrition knowledge is an area of great concern and in need of investigation, especially amongst local adolescent rugby players. Rugby is a high contact sport and the popularity of rugby union-related matches has considerably increased on a global scale (Griffiths 2012; Walsh et al 2011; Quarrie, Alsop, Waller, Bird, Marshall & Chalmers 2001). Unfortunately, Webb & Beckford (2013) and Burkhart (2010) recognize that there is limited published research available where an investigation into the general- and sports-related nutrition knowledge of adolescent athletes was conducted. This study aims to determine the general- and sports-related nutrition knowledge of male adolescent rugby players attending a boys only secondary, urban government school in Pietermaritzburg, KwaZulu-Natal. A cross-sectional study was conducted on adolescent rugby players (N= 110) at a local urban, government school in Pietermaritzburg (mean age =15.22 ± 1.430). The players were requested to complete a nutrition knowledge questionnaire developed initially by Whati (2005) for urban South African adolescents. For the purpose of this study the questionnaire was adjusted in accordance with the study objectives using peer-reviewed journals. The results showed that urban, government-level adolescent rugby players have an adequate general- and sports-related nutrition knowledge but lacked knowledge in the field of carbohydrates, understanding of what a well- balanced diet and healthy eating entails as well as the intake and role of protein. Parents and the media were selected as the two major sources of this information. More than half the participants admitted to using a nutritional supplement 3-4 times a week. There was no statistically significant trend in the improvement of knowledge from the under 14 to the open age groups, perhaps emphasizing the lack of sound nutrition education. Several statistically significant trends regarding nutrition practices, such as iii supplement use, were seen when comparing the open age group to the non-open age category; however the nutrition knowledge showed no statistically significant difference. The results of this study correlate to similar published studies regarding nutrition knowledge of adolescent athletes. Due to the lack of locally published research concerning the nutrition knowledge of adolescent rugby players this study forms a reference point to the importance of determining the nutrition knowledge of adolescent athletes in order to understand the need for nutrition knowledge education.
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.
The dietary diversity, household food security status and presence of depression in relation to pregnancy pattern of weight gain and infant birth weight, Pietermaritzburg.
(2017) Madlala, Samukelisiwe Sthokozisiwe.; Kassier, Susanna Maria.
Abstract available in PDF file.
Dietary intake, diet-related knowledge and metabolic control of children with type 1 diabetes mellitus, aged 6-10 years attending the paediatric diabetic clinics at Grey's Hospital, Pietermaritzburg and Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal.
(2007) Pillay, Kirthee.; Maunder, Eleni.
The aim of this study was to assess the dietary intake, diet-related knowledge and metabolic control in children with Type 1 Diabetes Mellitus between the ages of 6-10 years attending the Paediatric Diabetic Clinics at Grey’s Hospital, Pietermaritzburg and Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal. This was a cross sectional observational study that was carried out in a total of 30 subjects out of a possible 35 subjects that qualified for inclusion in the study from both the Grey’s Hospital clinic (n=8) and IALCH clinic (n=22). The dietary intake was assessed in a total of 25 subjects using a three day dietary record (n=20) and a 24 hour recall of the third day of the record (n=16). Diet-related knowledge was assessed using a multiple choice questionnaire. Metabolic control was assessed using the most recent HbA1c and the mean HbA1c results over the previous 12 months from the date of data collection. Height and weight measurements were also carried out. Information on socioeconomic status and education status of the caregivers was obtained from 22 caregivers through follow-up phone calls. All measurements except for dietary intake were obtained from all subjects participating in the study. The mean percentage contribution of macronutrients to total energy was very similar to the International Society for Pediatric and Adolescent Diabetes (ISPAD) Consensus Guidelines (2002). The mean percentage contribution of macronutrients to total energy from the 3 day dietary records and the 24 hour recalls were as follows: carbohydrate (52% and 49%); sucrose (2% and 2%); protein (16% and 17%); fat (32% and 34%). Micronutrient intake was adequate for all micronutrients except for calcium and vitamin D which showed low intakes. The mean diet-related knowledge score for the sample was 67% with significantly higher scores in children older than 8 years of age. The latest HbA1c for the sample was 9.7% and the mean HbA1c over the previous 12 months from the date of data collection was 9.6%. There was a significant positive correlation between age of the participant and the latest HbA1c (r = 0.473; p=0.008) and a significant negative correlation between the education level of the caregivers and the latest HbA1c (r = - 0.578; p=0.005) and the mean HbA1c over 12 months (r = - 0.496; p=0.019). Significant differences were found between African and Indian children respectively for HbA1c, with higher values in African children. There was no correlation between BMI for age and latest HbA1c (r = 0.203, p=0.282) or mean HbA1c over 12 months (r = 0.101, p=0.594). Z score for BMI for age was also not correlated with latest HbA1c (r = 0.045, p=0.814) or mean HbA1c over 12 months (r = - 0.012, p=0.951). Children from the Grey’s Hospital Clinic were found to have higher HbA1c values (p=0.001) and lower diet-related knowledge scores as compared to the children from the IALCH Clinic (p=0.038). It should be noted that the ethnic and racial composition of the children attending these two clinics differed. In conclusion the macronutrient intake in this sample was found to be similar to the ISPAD Consensus Guidelines (2002) while calcium and vitamin D intakes were low. Overall this sample displayed good diet-related knowledge while metabolic control was found to be poor.
Dietary supplement use among dietetics students at the University of KwaZulu-Natal.
(2017) Pillay, Lynelda.; Pillay, Kirthee.
Introduction: A dietary supplement is a product, which aims to add nutritional value to the diet. The use of dietary supplements is favoured among many countries, with a steady increase in use. There are many groups that are known to make use of dietary supplements such as females, the elderly, health professionals, gym goers, pregnant women, children under the age of 18 years and university students. University students are a group that are known to make use of dietary supplements in order to improve their academic performance, increase energy and promote overall general health. It is assumed that students studying towards a nutrition-related degree such as dietetics would be more likely to use dietary supplements, due to their interest in and exposure to nutrition. However, there is a lack of published data investigating the prevalence of dietary supplement use, factors associated with use and reasons for use among South African university students, studying towards a nutrition-related degree. Therefore, this study aimed to assess the use of dietary supplements by dietetics students at the University of KwaZulu-Natal (UKZN). Aim: The aim of the study was to assess the use of dietary supplements by students registered for a Bachelor of Science or a Post Graduate Diploma in Dietetics, at UKZN. Objectives: a) To determine the prevalence of dietary supplement use among dietetics students at UKZN. b) To determine the factors associated with dietary supplement use among dietetics students at UKZN. c) To determine the reasons for use of dietary supplements among dietetics students at UKZN. Methods: A cross-sectional, descriptive study was conducted using students registered for a Bachelor of Science or a Post Graduate Diploma in Dietetics, at UKZN. A self-administered questionnaire consisting of both open and close-ended questions was developed to collect data. The sample comprised of 139 dietetics students. Results: The use of dietary supplements was reported by 23% of the dietetic students. The most commonly used supplement among the students was Centrum (multivitamin) (21.9%, n=7), followed by calcium supplements (15.6%, n=5). There was a significant relationship between use of dietary supplements and gender and race. White and Indian students used dietary supplements more than the other race groups (p<0.05). Females (p=0.018) and students who lived at home were more likely to consume dietary supplements (46.9%; n=15) (p=0.008). Fourth year students (34%) used dietary supplements the most. There was no relationship between dietary supplements and physical activity, eating habits or ability to meet dietary requirements. Common reasons for using dietary supplements were to strengthen the immune system, improve energy levels and enhance health. Expense (32.7%; n=35), adequate diet (22.4%; n=24), deem it unnecessary/waste of money (15.0%; n=16) and unsure about supplements (14.0%; n=15), were statistically significant reasons for not using a dietary supplement (p<0.05). A significant proportion of the sample (72.2%) indicated that their source of information on dietary supplements was the internet (p=0.011), followed by dietetics/nutrition lectures (41.7%). About 73.3% (n=22) of the students who used supplements indicated that they had experienced an overall improvement in physical health after use of dietary supplements (p=0.016). Other results achieved included: more energy (53%; n=16) and better memory/concentration (53.3%; n=16). Furthermore, half of the sample that used supplements (50%; n=15) reported an improved resistance to illness/ability to fight illnesses earlier. Just over half the sample (51.4%) indicated that they planned to use a dietary supplement in the future. Conclusion: There was a low prevalence of use of dietary supplements among dietetics students at UKZN. Factors such as race, gender, residence and year of study influenced the use of dietary supplements. Use of dietary supplements was more common among white and Indian students, females and those in the fourth year of study. Dietary supplements were used to strengthen the immune system, improve energy levels and enhance health. The high cost of supplements was the main deterrent to use of dietary supplements.
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.

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