Browsing by Subject "Nutrition"

Now showing 1 - 13 of 13
  • Thumbnail Image
    Item
    Open Access
    A multivariate statistical approach to the assessment of nutrition status
    (1972) Fellingham, Stephen A; Troskie, Casper G
    Attention is drawn to the confusion which surrounds the concept of nutrition status and the problem of selecting an optimum subset of variables by which nutrition status can best be assessed is defined. Using a multidisciplinary data set of some 60 variables observed on 1898 school children from four racial groups, the study aims to identify statistically, both those variables which are unrelated to nutrition status and also those which, although related, are so highly correlated that the measurement of all would be an unnecessary extravagance. It is found that, while the somatometric variables provide a reasonably good (but non-specific) estimate of nutrition status, the disciplines form meaningful groups and the variables of the various disciplines tend to supplement rather than replicate each other. Certain variables from most of the disciplines are, therefore, necessary for an optimum and specific estimate of nutrition status. Both the potential and the shortcomings of a number of statistical techniques are demonstrated.
  • Thumbnail Image
    Item
    Open Access
    Association between breakfast frequency and physical activity and sedentary time: a cross-sectional study in children from 12 countries
    (BioMed Central, 2019-02-21) Zakrzewski-Fruer, Julia K; Gillison, Fiona B; Katzmarzyk, Peter T; Mire, Emily F; Broyles, Stephanie T; Champagne, Catherine M; Chaput, Jean-Philippe; Denstel, Kara D; Fogelholm, Mikael; Hu, Gang; Lambert, Estelle V; Maher, Carol; Maia, José; Olds, Tim; Onywera, Vincent; Sarmiento, Olga L; Tremblay, Mark S; Tudor-Locke, Catrine; Standage, Martyn
    Background Existing research has documented inconsistent findings for the associations among breakfast frequency, physical activity (PA), and sedentary time in children. The primary aim of this study was to examine the associations among breakfast frequency and objectively-measured PA and sedentary time in a sample of children from 12 countries representing a wide range of human development, economic development and inequality. The secondary aim was to examine interactions of these associations between study sites. Methods This multinational, cross-sectional study included 6228 children aged 9–11 years from the 12 International Study of Childhood Obesity, Lifestyle and the Environment sites. Multilevel statistical models were used to examine associations between self-reported habitual breakfast frequency defined using three categories (breakfast consumed 0 to 2 days/week [rare], 3 to 5 days/week [occasional] or 6 to 7 days/week [frequent]) or two categories (breakfast consumed less than daily or daily) and accelerometry-derived PA and sedentary time during the morning (wake time to 1200 h) and afternoon (1200 h to bed time) with study site included as an interaction term. Model covariates included age, sex, highest parental education, body mass index z-score, and accelerometer waking wear time. Results Participants averaged 60 (s.d. 25) min/day in moderate-to-vigorous PA (MVPA), 315 (s.d. 53) min/day in light PA and 513 (s.d. 69) min/day sedentary. Controlling for covariates, breakfast frequency was not significantly associated with total daily or afternoon PA and sedentary time. For the morning, frequent breakfast consumption was associated with a higher proportion of time in MVPA (0.3%), higher proportion of time in light PA (1.0%) and lower min/day and proportion of time sedentary (3.4 min/day and 1.3%) than rare breakfast consumption (all p ≤ 0.05). No significant associations were found when comparing occasional with rare or frequent breakfast consumption, or daily with less than daily breakfast consumption. Very few significant interactions with study site were found. Conclusions In this multinational sample of children, frequent breakfast consumption was associated with higher MVPA and light PA time and lower sedentary time in the morning when compared with rare breakfast consumption, although the small magnitude of the associations may lack clinical relevance. Trial registration The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) is registered at (Identifier NCT01722500 ).
  • Thumbnail Image
    Item
    Open Access
    Development and validation of a quantitative choline food frequency questionnaire for use with drinking and non-drinking pregnant women in Cape Town, South Africa
    (BioMed Central, 2018-11-22) Carter, R Colin; Jacobson, Sandra W; Booley, Sharmilah; Najaar, Baheya; Dodge, Neil C; Bechard, Lori J; Meintjes, Ernesta M; Molteno, Christopher D; Duggan, Christopher P; Jacobson, Joseph L; Senekal, Marjanne
    Background Although animal and human studies have demonstrated interactions between dietary choline and fetal alcohol spectrum disorders, dietary choline deficiency in pregnancy is common in the US and worldwide. We sought to develop and validate a quantitative food frequency questionnaire (QFFQ) to estimate usual daily choline intake in pregnant mothers. Methods A panel of nutrition experts developed a Choline-QFFQ food item list, including sources with high choline content and the most commonly consumed choline-containing foods in the target population. A data base for choline content of each item was compiled. For reliability and validity testing in a prospective longitudinal cohort, 123 heavy drinking Cape Coloured pregnant women and 83 abstaining/light-drinking controls were recruited at their first antenatal clinic visit. At 3 prenatal study visits, each gravida was interviewed about alcohol, smoking, and drug use, and administered a 24-hour recall interview and the Choline-QFFQ. Results Across all visits and assessments, > 78% of heavy drinkers and controls reported choline intake below the Dietary Reference Intakes adequate intake level (450 mg/day). Women reported a decrease in choline intake over time on the QFFQ. Reliability of the QFFQ across visits was good-to-acceptable for 2 of 4 group-level tests and 4 of 5 individual-level tests for both drinkers and controls. When compared with 24-hr recall data, validity of the QFFQ was good-to-acceptable for 3 of 4 individual-level tests and 3 of 5 group-level tests. For controls, validity was good-to-acceptable for all 4 individual-level tests and all 5 group-level tests. Conclusions To our knowledge, this is the first quantitative choline food frequency screening questionnaire to be developed and validated for use with both heavy and non-drinking pregnant women and the first to be used in the Cape Coloured community in South Africa. Given the high prevalence of inadequate choline intake and the growing evidence that maternal choline supplementation can mitigate some of the adverse effects of prenatal alcohol exposure, this tool may be useful for both research and future clinical outreach programs.
  • No Thumbnail Available
    Item
    Metadata only
    Health: Analysis of the NIDS Wave 1 and 2 Datasets
    (Southern Africa Labour and Development Research Unit, 2015-05-28) Ardington, Cally; Gasealahwe, Boingotlo
  • Thumbnail Image
    Item
    Open Access
    HealthKick: a nutrition and physical activity intervention for primary schools in low-income settings
    (BioMed Central Ltd, 2010) Draper, Catherine; de Villiers, Anniza; Lambert, Estelle; Fourie, Jean; Hill, Jillian; Dalais, Lucinda; Abrahams, Zulfa; Steyn, Nelia
    BACKGROUND: The burden of non-communicable diseases, including type 2 diabetes, is growing in South Africa. This country has a complex mix of over- and under-nutrition, especially in low-income communities, and concerning levels of physical inactivity in children and youth. This paper describes HealthKick, a school-based nutrition and physical activity intervention in primary schools in these settings aimed at reducing diabetes risk factors.METHODS/DESIGN:This study includes schools within historically disadvantaged, low-income communities from an urban area close to the city of Cape Town and from two rural areas outside of Cape Town, South Africa. The three Educational Districts involved are Metropole North, Cape Winelands and the Overberg. The study has three phases: intervention mapping and formative assessment, intervention development, and outcome and process evaluation. Sixteen schools were purposively selected to participate in the study and randomly allocated as intervention (eight schools) and control (eight schools).The primary aims of HealthKick are to promote healthful eating habits and increase regular participation in health-enhancing physical activity in children, parents and teachers, to prevent overweight, and reduce risk of chronic diseases (particularly type 2 diabetes); as well as to promote the development of an environment within the school and community that facilitates the adoption of healthy lifestyles.The components of HealthKick are: action planning, toolkit (resource guide, a resource box and physical activity resource bin), and an Educators' Manual, which includes a curriculum component.DISCUSSION:This study continues to highlight the key role that educators play in implementing a school-based intervention, but that developing capacity within school staff and stakeholders is not a simple or easy task. In spite of the challenges experienced thus far, valuable findings are being produced from this study, especially from Phase 1. Materials developed could be disseminated to other schools in low-income settings both within and outside of South Africa. Owing to the novelty of the HealthKick intervention in low-income South African primary schools, the findings of the evaluation phase have the potential to impact on policy and practice within these settings.
  • Thumbnail Image
    Item
    Open Access
    Implementation of the HealthKick intervention in primary schools in low-income settings in the Western Cape Province, South Africa: a process evaluation
    (2015-08-22) de Villiers, Anniza; Steyn, Nelia P; Draper, Catherine E; Hill, Jillian; Dalais, Lucinda; Fourie, Jean; Lombard, Carl; Barkhuizen, Gerhard; Lambert, Estelle V
    Abstract Background The HealthKick intervention, introduced at eight primary schools in low-income settings in the Western Cape Province, South Africa, aimed to promote healthy lifestyles among learners, their families and school staff. Eight schools from similar settings without any active intervention served as controls. Methods The Action Planning Process (APP) guided school staff through a process that enabled them to assess areas for action; identify specific priorities; and set their own goals regarding nutrition and physical activity at their schools. Educators were introduced to the APP and trained to undertake this at their schools by holding workshops. Four action areas were covered, which included the school nutrition environment; physical activity and sport environment; staff health; and chronic disease and diabetes awareness. Intervention schools also received a toolkit comprising an educator’s manual containing planning guides, printed resource materials and a container with physical activity equipment. To facilitate the APP, a champion was identified at each school to drive the APP and liaise with the project team. Over the three-years a record was kept of activities planned and those accomplished. At the end of the intervention, focus group discussions were held with school staff at each school to capture perceptions about the APP and intervention activities. Results Overall uptake of events offered by the research team was 65.6 % in 2009, 75 % in 2010 and 62.5 % in 2011. Over the three-year intervention, the school food and nutrition environment action area scored the highest, with 55.5 % of planned actions being undertaken. In the chronic disease and diabetes awareness area 54.2 % actions were completed, while in the school physical activity and sport environment and staff health activity areas 25.9 and 20 % were completed respectively. According to educators, the low level of implementation of APP activities was because of a lack of parental involvement, time and available resources, poor physical environment at schools and socio-economic considerations. Conclusions The implementation of the HealthKick intervention was not as successful as anticipated. Actions required for future interventions include increased parental involvement, greater support from the Department of Basic Education and assurance of sufficient motivation and ‘buy-in’ from schools.
  • Thumbnail Image
    Item
    Open Access
    Investigation of beliefs relating to weight gain prevention behaviours and weight related constructs in first year female students at three South African Universities
    (2020) Lasker, Gabrielle Lana; Senekal, Marjanne
    Introduction International as well as South African research indicates that first year female students at tertiary institutions may be specifically prone to weight gain and that these students should be targeted for weight management interventions. To contribute to this field of research a self-help weight management manual was developed for South African first year female students and tested in a controlled trial. The manual was found to result significant lower weight gain in the intervention group. The research group followed on and posited that development of further elements to combine with the self-help manual should consider beliefs students hold regarding weight gain prevention behaviours and weight related constructs. This research aimed to investigate the beliefs of first year female students from three universities in the Western Cape, South Africa regarding weight gain prevention behaviours and weight related constructs. The first objective was to elicit salient beliefs held by first year female students regarding weight gain prevention behaviours (dietary patterns, physical activity alcohol intake and sleep time) and weight related constructs (eating behaviour, body shape dissatisfaction, stress, selfesteem and depression/anxiety) using a qualitative research design (Phase 1). The second objective was to identify weight gain prevention belief patterns of first year female students, to investigate the association thereof with actual weight gain prevention behaviours and weight related constructs and identify significant predictors of the belief patterns using a quantitative cross-sectional research design (Phase 2). Methods and results The target population for both Phases was English speaking 18-20-year old first year female students who were registered for the first time for a qualification at University of Cape Town (UCT), Stellenbosch University (SU) or the University of the Western Cape (UWC) in South Africa. Students who were pregnant, breastfeeding, elite athletes, following dietary restrictions for a medical condition, or had a disease that may influence their weight, were not eligible for participation. For Phase 1 total of 28 in-depth interviews were conducted with participants with representation of living situation (university residence or private accommodation, those living at home were excluded) and race (black African, mixed ancestry or white) ensured in recruitment. Eighteen of the interviews were fully coded until data saturation was apparent. The additional 10 interviews were coded for new information only. Data analysis was conducted using the audio coding option on Nvivo Version 12. Core belief themes that emerged reflect awareness of recommendations of behaviours of weight gain prevention, awareness of benefits of performance of these behaviours, awareness of consequences of not meeting the requirements as well as non-concern relating to not performing the behaviours. Further beliefs focused mainly on barriers to and facilitators these behaviours. Phase 2 comprised completion of a questionnaire that covered socio-demographics, self-reported weight and height, dietary (including alcohol intake), physical activity, sleep time, body shape satisfaction, eating behaviour, self-esteem, presence of depression/anxiety symptoms and belief statements (derived from Phase 1) by a convenience sample of 168 first year female students from the same three universities to identify weight gain prevention (WGP) belief patterns, associated factors and predictors thereof. Four weight gain belief patterns (WGP Belief Patterns) were extracted using principal component analysis: WGP Belief Pattern 1: Barriers to weight management; WGP Belief Pattern 2: Facilitators for healthy eating and exercise; WGP Belief Pattern 3: Barriers to exercise; WGP Belief Pattern 4: Social barriers to healthy eating. Numerous associations between these belief patterns and dietary patterns including snacking after dinner, problematic eating behaviours (including a higher emotional eating, cognitive restraint and uncontrolled eating), body shape dissatisfaction, attempts to prevent weight gain during the study year, a higher or lower BMI, perception of overweight/obesity as a child/adolescent, higher stress and lower self- esteem were evident. Regression analysis identified identified snacking after dinner, emotional eating, body shape dissatisfaction and attempts to prevent weight gain during the study year as predictors of a higher score, whereas a higher BMI and perception to have been thin as an adolescent as predictors of a lower score on WGB Belief Pattern 1; for WGP Belief Pattern 2: a higher BMI and a higher score for Dietary Pattern 2 (fruits, vegetables and legumes) were identified as predictors of a higher score, and a higher MET-minutes and a higher score for Dietary Pattern 1 (sugary foods/drinks, slap chips, take-outs) as predictors of a lower score; for WGP Belief Pattern 3: a higher BMI and uncontrolled eating were identified as being predictors of a higher score, and a higher self-esteem and weight gain prevention attempts in the study year as predictors of a lower score; and a higher level of body shape dissatisfaction and a higher level of cognitive restraint were identified as being predictors of a higher score, and a higher BMI, perception of being thin as a child, lower stress and a higher self-esteem as predictors of a lower score on WGP belief pattern 4. Overarching conclusions Results and conclusions of the in depth interviews conducted to assess the beliefs of first year female students from three universities in the Western Cape, South Africa, regarding weight gain prevention behaviours and weight related constructs show that a multicultural sample of students held numerous beliefs regarding potential barriers and facilitators to weight gain prevention. Results of the quantitative assessment of these beliefs in a cross-sectional survey conducted amongst the same target group resulted in the extraction of three barrier WGP Belief Patterns, including barriers to weight management per se (feeling stressed/anxious or sad/depressed, mindless eating, being awake at night, experiencing lack of health food options at university, preparing one's own meals, feeling fat, having people around you who do not eat healthy and the difficulty of not overeating were barriers to weight management), barriers to exercise (feeling sad/depressed, feeling stressed/anxious, having poor body shape satisfaction and feeling fat were barriers to exercise) and social barriers to healthy eating (socialising, judgement from peers when making healthy food choices and drinking alcohol were barriers to weight management). Specific predictors of these patterns, namely snacking patterns, cognitive restraint, uncontrolled eating, emotional eating, problematic eating behaviours, body shape dissatisfaction, overweight/obesity as a child/adolescent, higher stress levels and lower self-esteem have typically been reported to be associated with challenges to healthy weight management. A concern is that students who participated in the cross sectional survey were characterized by many of these predictors. Predictors of the single facilitator WGP Belief Pattern (facilitators of healthy eating and exercise: complying with a healthy diet plan, finding enjoyment in healthy eating, preparing vegetables in a tasty way, finding affordable ways to eat healthy, making time in the day for exercise, knowing how to prepare one's own meals, planning meals and snacks ahead and exercising) that was extracted from the quantitative data reflect factors that have typically been reported to be associated with improved weight management (healthy eating and higher physical activity levels), as well as factors that have typically been reported to be associated with weight management challenges (unhealthy eating and a higher BMI). Overarching recommendations Although the associations between the four weight gain prevention belief patterns and weight status of first year female students were not investigated in this study, factors found to be associated with and predictors of the three barrier patterns point to potential risk for the experience of weight gain prevention challenges by first year female students. Although this notion should ideally be confirmed in further research, addressing the focus of the beliefs included in the barrier belief patterns, as well as the characteristics of the students that have been reported to be associated with weight management challenges in the literature in weight gain prevention interventions for first year female students at tertiary institutions is recommended.
  • Thumbnail Image
    Item
    Open Access
    Maternal, infant and placental size at birth : a study of firstborn, term infants and their mothers in Cape Town
    (1984) Woods, David Lawrance; Malan, A F
    This study was conducted to document the size of primigravid women and their infants and placentas born at term in the Coloured community of Cape Town. It also explored the relationship between maternal, infant and placental size at birth. One thousand nine hundred and fifty seven firstborn infants delivered at term to Coloured women by the Peninsula Maternity Service during 1975 and 1976 were examined. The birth weight, crown-heel length and head circumference of each infant were measured, the gestational age assessed and the ponderal index of weight to length calculated. In addition the standing height, delivery weight and postdelivery weight of 395 of their mothers were measured and the Quetelet index of weight to height determined. The trimmed weight and chorionic plate area of 992 of the study infants' placentas were also measured and the placental thickness calculated.
  • Thumbnail Image
    Item
    Open Access
    A multivariate statistical approach to the assessment of nutrition status
    (1972) Fellingham, Stephen Arthur; Troskie, Casper G
    Attention is drawn to the confusion which surrounds the concept of nutrition status and the problem of selecting an optimum subset of variables by which nutrition status can best be assessed is defined. Using a multidisciplinary data set of some 60 variables observed on 1898 school children from four racial groups, the study aims to identify statistically, both those variables which are unrelated to nutrition status and also those which, although related, are so highly correlated that the measurement of all would be an unnecessary extravagance. It is found that, while the somatometric variables provide a reasonably good (but non-specific) estimate of nutrition status, the disciplines form meaningful groups and the variables of the various disciplines tend to supplement rather than replicate each other. Certain variables from most of the disciplines are, therefore, necessary for an optimum and specific estimate of nutrition status. Both the potential and the shortcomings of a number of statistical techniques are demonstrated.
  • Thumbnail Image
    Item
    Open Access
    Plasma vitamin A and zinc levels in HIV-infected adults in Cape Town, South Africa
    (2003) Visser, M E; Maartens, G; Kossew, G; Hussey, G D
    A cross-sectional study of 132 adults attending an HIV clinic in Cape Town, South Africa, was conducted to determine predictors of low plasma vitamin A and Zn levels. No patients were on antiretroviral therapy. The possible confounding effect of the acute-phase response was controlled by including C-reactive protein levels in multivariate analysis and by excluding active opportunistic infections. Retinol levels were low (< 1.05 μmol/l) in 39% of patients with early disease (WHO clinical stages I and II) compared with 48 and 79 % of patients with WHO stage III and IV respectively (P<0.01). Plasma Zn levels were low (< 10.7 μmol/l) in 20% of patients with early disease v. 36 and 45 % with stage III and IV disease respectively (P< 0.05). C-reactive protein levels were normal in 63 % of subjects. Weak, positive associations were found between CD4+lymphocyte count and plasma levels of retinol (r 0.27; 95 % CI 0.1, 0.43) and Zn (r 0.31; 95% CI 0.25, 0.46). Multivariate analysis showed the following independent predictors of low retinol levels: WHO stage IV (odds ratio 3.4; 95 % CI 2.1, 5.7) and body weight (odds ratio per 5 kg decrease 1.15; 95% CI, 1-08, 1.25), while only body weight was significantly associated with low Zn levels (OR per 5 kg decrease 1.19; 95% CI 1.09, 1.30). CD4+lymphocyte count <200/μl was not significantly associated with either low retinol or Zn levels. In resource-poor settings, simple clinical features (advanced disease and/or weight loss) are associated with lowered blood concentrations of vitamin A and/or Zn. The clinical significance of low plasma retinol and/or Zn levels is unclear and more research is required to establish the role of multiple micronutrient intervention strategies in HIV disease.
  • Thumbnail Image
    Item
    Open Access
    The adverse health effects associated with drought in Africa: working towards developing a vulnerability index
    (2020) Asmall, Taherah; Dalvie, Aqiel; Abrams, Amber
    Africa is uniquely vulnerable to the occurrence of drought. A rise in temperatures over Southern Africa occurs at almost twice that of the global rate. South Africa has begun to experience an increase in the frequency of drought, particularly in the Western and Eastern Cape. Droughts are associated with several health effects. The direct and indirect risks of climate change to human health have become a global concern. The most recent systematic review available on the adverse health effects associated with drought was published in 2013, and as such, an up-to-date review focusing on Africa is needed to inform a Cape Town specific health vulnerability index. This study aims to provide a review of available research exploring the association between drought and adverse health effects in Africa. The rationale for this study is to provide a solid research foundation from which a drought-specific health vulnerability index for Cape Town can be developed. A narrative review of original studies and published reviews was conducted. An extensive electronic literature search was performed using a combination of keywords, Medical Subject Heading (MeSH) terms and free text words. The Critical Appraisal Toolkit (CAT) was used to assess the quality of included studies. A total of 1922 publications were identified, of which twenty-four articles were included in this review. The main drought-related health effects that emerged were divided into 4 main categories: (1) drought and nutritional health including malnutrition, poor childhood health outcomes (wasting, stunting and underweight), mortality, anaemia, and nutritionrelated disability; (2) drought and food consumption including micronutrient deficiencies and motor neuron diseases; (3) drought and water-borne, water-washed and water- related diseases including cholera outbreaks, diarrhoeal diseases, protozoa parasite transmission, scabies outbreaks, trachoma, vector-borne disease outbreaks and malaria-related mortality; and (4) drought and health behaviours including health perceptions and health-seeking behaviours, HIV prevention and care behaviours and family planning practices. There was generally limited evidence in all health categories with several limitations. These limitations include studies with methodological weaknesses (e.g. a lack of comparison to a non-drought period), the singularity of published studies on health effects associated with drought and studies which did not account for potential confounders. While the evidence from the included studies is limited, this study highlights gaps in literature to encourage further research into understanding the direct and indirect impacts of drought on health, particularly in vulnerable groups. Furthermore, the results of this study emphasized the contextual factors which lower an individual's adaptive capacity and identified key indicators that can be used to begin to develop a broad framework for a vulnerability index
  • No Thumbnail Available
    Item
    Metadata only
    The Impact of Unconditional Cash Transfers on Nutrition: The South African Child Support Grant
    (Southern Africa Labour and Development Research Unit, 2015-05-28) Aguero, Jorge; Carter, Michael; Woolard, Ingrid
  • Thumbnail Image
    Item
    Open Access
    Vitamin C status, oxidative stress, hyperglycaemia and endothelial function in critically ill patients with septic shock : an observational study
    (2014) Katundu, Kondwani; Hill, Lauren; Davids, Lester
    Septic shock is associated with oxidative stress, reduced levels of plasma vitamin C and stress hyperglycaemia – all factors that may influence endothelial, and therefore, organ function. Vitamin C is an important antioxidant in human plasma; and it has been implicated in maintaining normal endothelial function during oxidative stress. The vitamin C status of critically ill patients in South African ICUs has not been well investigated; neither has the relationship between vitamin C status, oxidative stress, hyperglycaemia and endothelial function been studied in this patient group. In a prospective, cross-sectional study investigating these factors in critically ill patients with septic shock on inotropic support, serial blood samples from 25 patients were taken at days zero and one, following inotrope initiation, and on day seven after inotrope cessation. These samples were analysed for plasma vitamin C, thiobarbituric acid-reactive substances (TBARS) - as a biomarker of oxidative stress - and soluble vascular cell adhesion molecule-1 (sVCAM-1), and E-selectin, as markers of endothelial dysfunction. The plasma glucose to vitamin C ratios were also calculated. Daily clinical measures in the patients included Sequential Organ Failure Assessment (SOFA) score, mean arterial blood pressure, blood glucose, fluid balance and inotropic support. The clinical outcomes were recorded.