South African Journal of Clinical Nutrition最新文献

{"title":"Early economic benefits of perioperative nasojejunal tube feeding in non-critical care adult surgical patients with gastric feed intolerance","authors":"G. Chinnery, Anna-Lena du Toit, C. Robinson, I. Kippie, E. Jonas, M. Scriba","doi":"10.1080/16070658.2022.2154535","DOIUrl":"https://doi.org/10.1080/16070658.2022.2154535","url":null,"abstract":"Background: Fluoroscopy-guided endoscopic placement of nasojejunal tubes (NJT) for perioperative short- or medium-term enteral nutrition (EN) is potentially required for anatomical gastric feed intolerance. Methods: Indication for NJT and successful insertion rates was determined. NJT insertion costs were calculated and compared with central venous catheter (CVC) insertion. Duration of NJT patency in non-critical care surgical patients was determined in days in a local cohort. EN costs were calculated over a hypothetical 28-day period factoring in expected NJT replacements due to blockage and compared with parenteral nutrition (PN) via CVC, which included routine CVC changes every 10 days. Public and private sectors were compared. Results: One hundred and two (93.6%) NJTs were placed successfully, with gastric outlet obstruction the most frequent indication (40.4%) with a median 10 days’ (range 1–68 days, IQR 6–16.75 days) usage. Irrevocable blockage occurred in 33 tubes after a median 9 days (range 3–34 days; IQR 4.75–16 days). Calculated EN costs over 28 days, including NJT replacement every 9 days, reached US$1 676.12 and PN costs with CVC replacement every 10 days, US$3 461.35 (p < 0.001) in the public sector. In the private sector PN costs at 28 days were significantly higher (p < 0.001) at US$5 261.14 compared with EN US$3 780.71. The cost benefit of EN over PN is seen after three days in the public, and four days in the private sector. Conclusion: Exponential cost saving occurs with EN via NJT over time, even when factoring in the likelihood of NJT replacements.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45823273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The complexity of choosing healthy diets","authors":"M. Faber","doi":"10.1080/16070658.2023.2187545","DOIUrl":"https://doi.org/10.1080/16070658.2023.2187545","url":null,"abstract":"The importance of healthy diets and children ’ s right to ade-quate nutrition are embedded in the UNICEF Nutrition Strategy 2020 – 2030. 1 Whereas the first 1 000 days are the most critical period for a child ’ s cognitive and physical development, the period from age 5 to 19 years (middle childhood and adolescence) is recognised as an important opportunity for catch-up growth, psychosocial development","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"36 1","pages":"i - ii"},"PeriodicalIF":1.1,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41710065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Energy and nutrient contribution of different food groups to the dietary intake of 6- to <9-month-old infants in a low socioeconomic community in North West Province, South Africa","authors":"Tshiphiri Mukwevho, C. M. Smuts, H. Asare, M. Faber","doi":"10.1080/16070658.2022.2141051","DOIUrl":"https://doi.org/10.1080/16070658.2022.2141051","url":null,"abstract":"Objective: A study was undertaken to determine the energy and nutrient contribution of different food groups to the dietary intake of 6- to <9-month-old infants. Design: An observational study was conducted using baseline data of a preliminary randomised controlled trial that aimed to determine the effect of egg consumption on infant growth. Setting and subjects: Participants resided in a peri-urban community (Jouberton) in North West province, South Africa. The study included 6- to <9-month-old infants (n = 155); 24-hour dietary recall data were available for n = 144. Results: Most infants consumed either two (29.2%) or three (42.4%) out of eight food groups. The grains/roots/tubers group was consumed by 95.8% of infants; for consumers thereof, it contributed 75.5% of iron, 53.0% of thiamine and 42.5% of folate. Breast milk and dairy were consumed respectively by 64.4% of infants. For breastfed infants, breast milk was the major contributor of energy and fat, and some micronutrients (calcium, zinc, vitamin A, vitamin C, niacin and riboflavin); but they had lower intakes (p < 0.05) for all micronutrients except vitamin A compared with non-breastfed infants. For consumers (16.7%) of animal-source foods (ASFs), these contributed 42.8% for vitamin B12 and 33.4% for protein; and intake of protein, riboflavin and vitamin B12 was higher (p < 0.05) for consumers compared with non-consumers. The least consumed food groups were legumes (0.7%), flesh foods (6.9%) and eggs (10.4%). Conclusion: Grains/roots/tubers, dairy and breast milk made a major contribution to the intake of key nutrients. Animal-source foods were not consumed frequently, but for consumers thereof made a substantial contribution as well. Recommendation: Strategies to improve dietary diversity should encourage continued breastfeeding, aim to increase intake of food groups not frequently consumed and promote locally available food.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"36 1","pages":"126 - 135"},"PeriodicalIF":1.1,"publicationDate":"2022-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46641558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition and vasoactive substances in the critically ill patient","authors":"H. Spies, M. Frey, B. Karstens","doi":"10.1080/16070658.2022.2147663","DOIUrl":"https://doi.org/10.1080/16070658.2022.2147663","url":null,"abstract":"Background The most common cause of haemodynamic instability (a disturbance of the forces involved in circulating blood through the body) in the critically ill patient is a state of shock, whether it is hypovolaemic, cardiogenic or distributive (septic, anaphylactic or neurogenic) shock. Although the causes of the state of shock differ, the result is the same: decrease in cardiac output and insufficient tissue perfusion; hence haemodynamic instability. Interventions, including fluid therapy and the administration of vasoactive substances like vasopressors (increase in the vascular tone) and inotropic substances (increase in myocardial contraction) to restore homeostasis (haemodynamic stability), are of critical importance to prevent further deterioration.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"35 1","pages":"177 - 182"},"PeriodicalIF":1.1,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46875445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of hospital food supply to manage malnutrition","authors":"R. Blaauw","doi":"10.1080/16070658.2022.2147660","DOIUrl":"https://doi.org/10.1080/16070658.2022.2147660","url":null,"abstract":"Data on the prevalence of malnutrition amongst adult hospitalised patients globally range between 23–55%. South African data is scarce but tend to be on the higher end of the range. A study from the Eastern Cape province reported a prevalence of 48.2%, using the MUST (Malnutrition Universal Screening Tool) high-risk group. Using the Nutrition Risk Screening2002 tool to identify participants at-risk of malnutrition, a prevalence of 53.7% were reported for three academic hospitals in South Africa. A recent study from Gauteng province reported a malnutrition prevalence of 56.8%, using the Global Leadership Initiative on Malnutrition (GLIM) criteria. As malnutrition is associated with longer length of hospital stay, more complications, increased re-admissions and greater mortality, early identification and appropriate management of malnutrition is crucial.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":" ","pages":"i - ii"},"PeriodicalIF":1.1,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45907756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the infant feeding experiences of mothers living in selected Tshwane informal settlements: a qualitative study","authors":"Tshegofatso Betty Mohlala, S. Mathunjwa, Heather Legodi, M. Mataboge","doi":"10.1080/16070658.2022.2140498","DOIUrl":"https://doi.org/10.1080/16070658.2022.2140498","url":null,"abstract":"Objective: The study aimed to explore and describe the infant feeding experiences of mothers of children aged 3 to 24 months, living in two selected informal settlements in Tshwane, South Africa. Design: This exploratory qualitative study gathered data via six focus-group discussions (FGDs). These were facilitated using a semi-structured questionnaire guide with probes. Data were then transcribed, coded and thematically analysed. Setting: The study was conducted in the two selected informal settlements in the west of Tshwane, South Africa. Subjects: Biological mothers (n = 28) of infants and young children aged 3 to 24 months, living in the selected informal settlements participated. The mothers had to be living with their child with some responsibility for their daily care and feeding. Results: Three themes with six sub-themes were identified following thematic analysis. First was the mothers’ experience of infant feeding, which included their interpretations and practices of exclusive breastfeeding and complementary feeding. Second, mothers received infant feeding support from their elders based on common beliefs. The support received from healthcare workers was sometimes perceived negatively. However, healthcare workers based at healthcare facilities were important sources of exclusive breastfeeding and complementary feeding information. Third were the setting-related factors that negatively affected the mothers’ ability to access nutritious food for themselves and their infants. These included household food insecurity, plus environmental and household factors affecting food storage and preparation. Conclusion: Mothers experienced several challenging circumstances affecting their infant feeding efforts. These findings highlight the need to strengthen targeted infant feeding counselling and support for mothers living in resource-constrained environments.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"36 1","pages":"118 - 125"},"PeriodicalIF":1.1,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42229544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food and nutrition labelling as a nutrition education tool: understanding, perspectives and practices of South African dietitians.","authors":"C. Chin, M. Wicks, M. Feyasa, N. Koen","doi":"10.1080/16070658.2022.2135186","DOIUrl":"https://doi.org/10.1080/16070658.2022.2135186","url":null,"abstract":"Introduction: Food and nutrition labelling is an effective tool to address diet-related non-communicable diseases (NCDs), in which nutrition education plays an integral role. Objectives: To investigate South African dietitians’ understanding, perspectives and practices of food and nutrition labelling as a nutrition education tool. Design: A quantitative descriptive cross-sectional study was conducted. Setting: A nationwide survey was undertaken of dietitians from all sectors of practice. Subjects: Dietitians registered with the Health Professions Council of South Africa (HPCSA) (n  = 137). Outcome measures: A self-administered electronic survey was used for data collection. Results: Awareness of labelling regulations was high (86.9%); however, confidence in knowledge of regulations was lacking (53.3%), as well as knowledge regarding food-labelling regulations (R146) (52.6%). More than half (57.7%) regarded labels as relevant to their daily work and 51.8% used labels frequently, varying use depending on client needs. For education purposes, the nutrition information table (75.2%), client-specific nutrients (70.0%) and health endorsement logos (HELs) (59.2%) were most frequently used. Product healthiness was mainly evaluated using the cooking method (86.1%), level of processing (67.9%) and product category (63.5%). Least used aspects were origin/certification claims (39.4%) and animal husbandry (34.3%). Highly rated aspects included belief in label efficacy (88.3%), accuracy (81.8%), a positive attitude (87.6%) and relevance (80.2%). Conclusion: To promote optimal use of labelling as a nutrition education tool, standardisation, trustworthiness and continuing education should be addressed. Furthermore, the urgent promulgation of the draft food labelling regulations will address existing barriers to label use.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"36 1","pages":"108 - 117"},"PeriodicalIF":1.1,"publicationDate":"2022-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41439087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and acceptability of continuous at-home glucose monitoring during pregnancy: a mixed-methods pilot study","authors":"A. van Heerden, Ş. Kolozali, S. Norris","doi":"10.1080/16070658.2022.2114408","DOIUrl":"https://doi.org/10.1080/16070658.2022.2114408","url":null,"abstract":"Background: Continuous monitoring of glucose (CGM) via subcutaneous patch is an accurate self-monitoring tool of blood glucose, but also introduces a range of additional benefits such as real-time feedback. While its value among pregnant women with gestational diabetes mellitus (GDM) is established in high-income countries, little is known about the feasibility and acceptability among pregnant women without GDM in low-resource settings in low- and middle-income countries. Objectives: This study aims to assess the feasibility and acceptability of CGM with pregnant mothers in South Africa and to explore the value of a collected data set for GDM prevention. Methods: Ten women between 12 and 18 weeks pregnant were recruited from the antenatal clinic at Chris Hani Baragwanath Academic Hospital into a prospective mixed-methods pilot study. Demographic and anthropometric data, HbA1c and a lipid panel were collected. Women then wore two consecutive Freestyle Libre 2 patches for a total of 28 days. In-depth interviews were undertaken with all 10 women on study exit to explore themes of acceptability and the use of technology during pregnancy. Thematic analysis was performed on the qualitative data while exploratory data-analysis techniques were applied to the CGM data. Results: Pregnant women (n = 10) had a mean (SD) age of 29.81 years (4.39), with most being unemployed (8), unmarried (8) and without a tertiary degree (7). Analysis suggests that fear of use was greater than the actual discomfort experienced during use of the CGM patch. The main barrier to use was the patch falling off and women being uncomfortable to reapply it. This was borne out by all 10 women wearing the first patch for at least 12 of the 14 days, but only 4 managing the same with patch two – primarily applied by themselves at home. Women expressed support for the use of technology during pregnancy, especially as it related to feeling that their pregnancy was being monitored and that they were being supported. Conclusion: In this pilot study, women overwhelmingly found the wearing of a CGM patch during pregnancy to be acceptable. Feasibility was reasonable with most data being successfully retrieved from the devices over a two-week period. Longer use was found to have additional challenges. The use of CGM patches appear to be a possible candidate for inclusion in GDM prevention or behavioural interventions during pregnancy in South Africa.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"36 1","pages":"100 - 107"},"PeriodicalIF":1.1,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47749809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Completeness of the road-to-health card and factors affecting knowledge and practices of growth monitoring and promotion in caregivers of young children in KwaZulu-Natal","authors":"T. Mabesa, S. Knight, N. Nkwanyana","doi":"10.1080/16070658.2022.2114405","DOIUrl":"https://doi.org/10.1080/16070658.2022.2114405","url":null,"abstract":"Introduction: Malnutrition is an increasing public health challenge in low- and middle-income countries. Growth Monitoring and Promotion (GMP) is a United Nations International Children’s Emergency Fund (UNICEF) strategy to combat malnutrition. This study aimed to measure factors associated with knowledge and practices of GMP in caregivers of children from birth to 24 months referred to Inkosi Albert Luthuli Central Hospital (IALCH) from health facilities in KwaZulu-Natal (KZN) during 2018. Methods: An observational, analytic cross-sectional study design was used. The study sample comprised 383 caregivers of these children. Data were obtained from interviewer-administered questionnaires. Results: Most caregivers (n = 201, 52%) were between the ages of 21 and 30 years; 95% (n = 360) had more than primary education. Most (n = 341, 89%) caregivers presented the Road-to-Health Card (RTHC) for assessment, but only 7.6% (n = 26) were complete. Most caregivers (n = 281, 73%) had an excellent overall knowledge of how an RTHC contributes to GMP. However, only 38 (10%) had the skill to interpret all four of the test growth charts. There was a statistically significant association (p < 0.05) between some caregivers’ variables and their knowledge of the RTHC. Conclusion: Despite having good theoretical knowledge concerning the information in the RTHCs, most caregivers could not correctly interpret the growth charts. The education of caregivers and health workers on the importance of appropriate use of the RTHC for GMP is recommended.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"36 1","pages":"84 - 92"},"PeriodicalIF":1.1,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41615234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception of proposed preliminary food-based dietary guidelines for Lake Victoria region of Kenya: findings from a qualitative study among adult community members","authors":"E. Korir, P. Tuitoek, D. Marais","doi":"10.1080/16070658.2022.2079259","DOIUrl":"https://doi.org/10.1080/16070658.2022.2079259","url":null,"abstract":"Background: Diets in the Lake Victoria region of Kenya have been described as monotonous, consisting chiefly of starchy staple foods, accompanied by green vegetables and oil. To promote healthy eating in the region, 11 food-based dietary guidelines (FBDGs) were proposed. Objective: This study was designed to assess perception of the proposed FBDGs amongst consumers in Lake Victoria region. Design and setting: A qualitative, descriptive cross-sectional design was used to collect data from 36 focus-group discussions (FGD) among adult males (18) and females (18) in Kisumu and Homa Bay Counties. Subjects: A total of 207 adult males (26–74 years) and 211 females (18–71 years) participated in this study. Data collection and analysis: Proposed FBDGs were printed on posters and presented to FGD participants. Proceedings were audio-taped, transcribed, translated and analysed based on themes. Results: The proposed FBDGs were perceived as promoting the consumption of a balanced diet. As a concept, a balanced diet was misrepresented as composed of only three nutrients: carbohydrates, proteins and vitamins. There was no mention of fats/oils and minerals as other significant nutrient constituents of a balanced diet. Other concepts, which included ‘three regular meals’, ‘snacks’, ‘food variety’, ‘healthy and physically active lifestyle’, were polysemous. Conclusion: The findings provide insight to guide the adaptation of the national FBDGs. The findings also provide a basis for nutrition advocacy programmes and a rationale for the revision of nutrition education materials, including the school curriculum, to align content with current evidence-based information.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":"36 1","pages":"70 - 75"},"PeriodicalIF":1.1,"publicationDate":"2022-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48992751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}