{"title":"The use of linear programming to determine whether breastfed infants can achieve a nutritionally adequate complementary feeding diet: a case study of 6–11-month-old infants from KwaMashu, KwaZulu-Natal, South Africa","authors":"Nazeeia Sayed, H. Schönfeldt","doi":"10.1080/16070658.2021.1982499","DOIUrl":"https://doi.org/10.1080/16070658.2021.1982499","url":null,"abstract":"Objectives: The objectives of this study were to ascertain whether the nutrient requirements of 6–11-month-old infants can be met with a food-based approach, and to identify the nutrients of which it is difficult to achieve adequate intakes. Design, setting and subjects: A cross-sectional survey and interviews with mothers and caregivers from the KwaMashu Community Health Centre were conducted. One hundred and thirty-four interviews were completed. This information provided the food consumption input for the model using Optifood software. Results: The results revealed that with the current food pattern of infants from the study group in KwaMashu, iron, zinc and calcium are nutrients whose requirements are likely not to be met in the diet. The percentage RNI (recommended nutrient intake) for iron was 25.2%, zinc 51.3% and calcium 77%. Nutrient intakes for these nutrients of concern improved in the ‘No pattern’ diet but iron and zinc intakes remained below the RNI. According to the best diets modelled by Optifood, it appears that infants in KwaMashu would be able to achieve the recommended intakes of energy, protein, and 8 of the 11 micronutrients, as long as breastfeeding on demand continues during the complementary feeding phase. Conclusions: This study calls into question the continued food-based focus to ensure nutrient adequacy in infants. In conjunction with efforts to improve household food security and continued support and promotion of breastfeeding for the first 2 years of life, targeted micronutrient supplementation may be needed to ensure the optimal growth and development of infants in South Africa.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43880414","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":"Nutritional management of a polytrauma patient in an intensive care unit","authors":"Lisa Burgdorf","doi":"10.1080/16070658.2021.2003969","DOIUrl":"https://doi.org/10.1080/16070658.2021.2003969","url":null,"abstract":"A 32-year-old male was admitted to hospital with multiple injuries following a quadbike accident. Treatment of the patient included a left arm amputation, a right hemicolectomy and end ileostomy, and the orthopaedic management of a left femur fracture and degloving injury. The patient subsequently spent eight weeks in the intensive care unit, developing a series of complications including acute kidney injury, multiple electrolyte abnormalities, pneumonia and prolonged feed intolerance. Nutritional management required several restrictions and achieving goal nutrition was difficult. A suspected diagnosis of superior mesenteric artery syndrome was not confirmed but provided an interesting new aspect to intensive care nutrition at this facility.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43642677","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":"Field-testing of food-based dietary guidelines","authors":"M. Faber, A. de Villiers","doi":"10.1080/16070658.2021.2004690","DOIUrl":"https://doi.org/10.1080/16070658.2021.2004690","url":null,"abstract":"Food-based dietary guidelines (FBDGs) translate nutrition recommendations based on the best available scientific evidence into messages that are short, easy to understand, realistic and easy to apply in everyday settings. Development of the guidelines usually follows a structured and transparent process and applies methodology that balances rigour and pragmatism. The first phase in the development of FBDGs involves identification of (i) diet-health relationships, (ii) country specific diet-related health problems, (iii) nutrients of public health importance, (iv) foods relevant for FBDGs and (v) food consumption patterns. The developed FBDGs should then be tested and optimised, whereafter graphical illustrations of the guidelines should be developed. FBDGs provide a basis for public health programs and policies and are therefore country-specific, locally developed, and should be regularly revised. In instances where guidelines developed in one country are adapted to be used in other settings, cultural and social diversities as well as differences in dietary habits should be considered.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47024329","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":"Carbohydrate counting in type 1 diabetes mellitus: dietitians’ perceptions, training and barriers to use","authors":"M. Dimitriades, K. Pillay","doi":"10.1080/16070658.2021.1979764","DOIUrl":"https://doi.org/10.1080/16070658.2021.1979764","url":null,"abstract":"Objectives A study was undertaken to determine the perceptions, training and barriers regarding the use of carbohydrate counting in the dietary management of type 1 diabetes mellitus (T1DM) among dietitians in KwaZulu-Natal (KZN). Design A cross-sectional, descriptive study was conducted. Setting Dietitians who were registered with the Health Professions Council of South Africa (HPCSA), and working in the province of KZN at the time of the study, were invited to participate. Methods Data were collected using a self-administered electronic questionnaire distributed through SurveyMonkey, an Internet-based survey programme. Results Dietitians agreed that carbohydrate counting was a useful dietary management approach for diabetes (p < 0.05) and that it was essential to manage T1DM (p < 0.05). However, they felt it was a difficult concept for patients with T1DM to understand (p = 0.001) and teaching it to patients was time consuming (p < 0.05). Although dietitians believed that there was a strong evidence base for teaching carbohydrate counting to patients with T1DM (p < 0.05), they indicated a need for further training or education in it (p < 0.05). Barriers to using carbohydrate counting included a lack of training, confidence and experience, financial resources, time, blood glucose records and poor patient motivation and patient illiteracy (p < 0.05). Conclusions Overall, dietitians who participated in the study had a positive perception towards the use of carbohydrate counting in the management of T1DM. However, further training needs to be addressed for carbohydrate counting to be used with confidence by dietitians in KZN to optimize their management of T1DM.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44777741","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":"Is vitamin D status associated with non-communicable disease risk in children? A cohort study","authors":"M. Poopedi, S. Norris, J. Pettifor","doi":"10.1080/16070658.2021.1976608","DOIUrl":"https://doi.org/10.1080/16070658.2021.1976608","url":null,"abstract":"Background: Studies in children and adults have reported variations in 25-hydroxyvitamin D (25(OH)D), body mass index (BMI) and blood pressure (BP) over time. Furthermore, there has been a reported association of 25(OH)D with BMI, BP and lipid levels in some cross-sectional and longitudinal studies. Methods: This is a longitudinal study of a group of adolescents with measurements of 25(OH)D, BP, anthropometry and lipids at the ages of 11, 12 13, 15 and 18–20 years. For age-related changes, year 12 participants (n = 261) were matched with year 18–20 participants (n = 368), resulting in 200 paired participants. Longitudinal analyses using the Generalized Estimating Equations (GEE) comprised the following groups of participants, Year 11 (n = 288), Year 12 (n = 253), Year 13 (n = 292), Year 15 (n = 238) and Year 18–20 (n = 368). The relationship of 25(OH)D with BMI, BP and lipid levels over a period of 10 years was assessed. Results: There were significant increases in mean BMI and BP, and decreases in 25(OH)D levels with age (all p-values < 0.0001). In females, systolic BP was significantly higher in older participants (18–20) years than younger participants (12 years), but 25(OH)D was significantly higher in younger than older participants. In males, there was significant increase in BP in participants between age 12 years and 18–20 years. 25(OH)D, total cholesterol (TC) and low-density lipoprotein (LDL-C) were significantly lower in 18–20-year-old participants compared with 12-year-old participants. Longitudinally, 25(OH)D was inversely associated with LDL-C. Conclusion: There is evidence of changes in 25(OH)D, BMI and BP in adolescents over a period of 10 years. After adjusting for covariates, BMI and LDL-C were significantly negatively associated with 25(OH)D, which suggests that vitamin D status might be associated positively with favourable lipid profiles in children and adolescents.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44037960","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}
S. Saha, Upasana Mukherjee, Makenzie Miller, Li-Ling Peng, C. Napier, Heleen Grobbelaar, W. Oldewage-Theron
{"title":"Food and beverages promoting elderly health: six food-based dietary guidelines to plan good mixed meals for elderly South Africans","authors":"S. Saha, Upasana Mukherjee, Makenzie Miller, Li-Ling Peng, C. Napier, Heleen Grobbelaar, W. Oldewage-Theron","doi":"10.1080/16070658.2021.1956232","DOIUrl":"https://doi.org/10.1080/16070658.2021.1956232","url":null,"abstract":"Studies have shown that the elderly are at a higher risk of developing malnutrition due to physiological and pathological changes. Several studies have confirmed that older South Africans have insufficient dietary diversity, resulting in nutritional deficiencies. Furthermore, poor and uninformed dietary choices are associated with the development of several diseases and increased mortality. Following the Elderly Food Based Dietary Guidelines (EFBDGs) related to promoting elderly health could ensure that the elderly have an adequate intake of nutritious foods. This paper provides an overview of six FBDGs relating to promoting health and is based on the South African Food Based Dietary Guidelines.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46876871","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":"Eat clean and safe food: a food-based dietary guideline for the elderly in South Africa","authors":"Makenzie Miller, W. Oldewage-Theron, C. Napier","doi":"10.1080/16070658.2021.1947040","DOIUrl":"https://doi.org/10.1080/16070658.2021.1947040","url":null,"abstract":"As the population of elderly individuals in South Africa (SA) grows, there is a need to promote the continued health of these persons as they progress through the life cycle. Food Based Dietary Guidelines (FBDGs) for the SA elderly were developed to address this need. These thirteen guidelines for the elderly collectively offer a basis of health practices that the elderly can follow to ensure that they are taking the right steps toward maintaining their health. While the guideline ‘Eat clean and safe food’ is not included in the current SA FBDGs, this recommendation is of particular importance to the elderly, who face a much higher risk of foodborne illness than most of the general population due to a number of factors. Reduced immunity and other physiological changes are a result of ageing, malnutrition, diseases and and/or medication side effects. All these factors play a role in the elderly’s risk of foodborne illness. Increased susceptibility to certain pathogens also causes higher rates of foodborne illness infection. Lastly, elderly people’s food safety knowledge and pre-established beliefs and practices regarding food handling and preparation can be influential in their sensitivity to foodborne disease. These risk factors, coupled with the heavy burden of foodborne illness and existing gaps in food safety policy, practices and education in SA, substantiate the need for a dietary guideline to address the importance of clean and safe food consumption among the elderly in SA.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44037790","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":"An introduction to the Food-Based Dietary Guidelines for the Elderly in South Africa","authors":"C. Napier, Heleen Grobbelaar, W. Oldewage-Theron","doi":"10.1080/16070658.2021.1950376","DOIUrl":"https://doi.org/10.1080/16070658.2021.1950376","url":null,"abstract":"Food-based dietary guidelines (FBDGs) are not a new concept and are being used in many countries to promote healthy eating and the prevention of diet-related chronic diseases. The Food and Agriculture Organization (FAO) recommended FBDGs as an approach to prevent malnutrition and promote healthy dietary behaviours in populations, taking into consideration local conditions, traditional dietary practices and socioeconomic and cultural factors whilst at the same time using evidence-based scientific principles. South Africa (SA) currently has two sets of guidelines, namely the paediatric food-based dietary guidelines and the South African FBDGs for the population aged seven years and older. The recognition that elderly malnutrition remains a major public health concern in SA led to the formulation of a specific set of guidelines for this vulnerable population group based on existing nutrition-related health issues, local dietary habits and barriers to food intake experienced by those aged 60 and above. This introductory paper on the development of the elderly food-based dietary guidelines (EFBDGs) will be followed by six technical papers motivating why these guidelines are suited to address nutrition-related issues among the elderly in SA.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41755030","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":"‘Drink clean, safe water and/or other fluids through-out the day even if you do not feel thirsty’: a food-based dietary guideline for the elderly in South Africa","authors":"Upasana Mukherjee, C. Napier, W. Oldewage-Theron","doi":"10.1080/16070658.2021.1947037","DOIUrl":"https://doi.org/10.1080/16070658.2021.1947037","url":null,"abstract":"This review summarises information from available literature to support the dietary guideline ‘Drink Clean, Safe Water and/or Other Fluids Through-Out the Day Even if You Do Not Feel Thirsty’ set for the elderly of South Africa (SA). Water is essential for life and is necessary for important functions of the body like maintenance of tissue structure, blood volume regulation, temperature regulation and excretion of metabolites through kidneys. Though water is necessary for all, the elderly are especially at risk of dehydration due to altered hormonal activity and body functions that reduce their sensitivity to thirst (water intake) and urination (water excretion). Total body water is also reduced in the elderly, so they are unable to buffer the effects of water loss in the body. Therefore, water intake should be monitored properly in the elderly so that they can lead a happy and healthy life and reduce the economic burden due to hospitalisation caused by water imbalance or dehydration, which is common in the elderly. Two litres of water per day is generally considered adequate, but there is no consensus regarding the exact requirement for water as need varies due to climate and physical activity levels. The importance of water to maintain bodily functions and the risk of dehydration substantiate the need for a dietary guideline to address the importance of clean and safe water/fluid consumption regularly throughout the day among the elderly in SA.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46393339","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":"If you drink alcohol, drink sensibly: a food-based dietary guideline for the elderly in South Africa","authors":"R. Theophilus, C. Napier, W. Oldewage-Theron","doi":"10.1080/16070658.2021.1954351","DOIUrl":"https://doi.org/10.1080/16070658.2021.1954351","url":null,"abstract":"The use and misuse of alcohol has become a public health problem among the South African (SA) elderly population, among whom risky drinking is a common practice. Previous publications encouraging alcohol use have referred to two supposedly beneficial effects of alcohol, categorised as: (1) cardioprotective and haemostatic; and (2) promoting a positive balance in iron status. However, more recent evidence has weakened these assertions for all age groups as the disadvantages of alcohol use far outweigh these benefits. Some of these disadvantages can cause severe medical and physical harm to the elderly. Attempts to curb risky drinking among the SA elderly must be adopted through screening by clinicians during consultations, use of various screening and diagnostic tools available for addressing alcohol use and abuse, and exploiting the channels of alcohol exposure for appropriate interventions. Elderly populations are vulnerable to alcohol misuse irrespective of their consumption patterns or levels of use because of their ageing condition and the interaction of alcohol with medication. Therefore, there is a need to sensitise the SA elderly population on the risk posed by alcohol use, misuse or abuse, hence the FBDG ‘If you drink alcohol, drink sensibly’.","PeriodicalId":45938,"journal":{"name":"South African Journal of Clinical Nutrition","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47202514","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}