Search

The burden of malnutrition experienced globally, coupled with the increasing rate of micronutrient deficiencies, compromises the health and well-being of women during their reproductive years. Obesity places young South African women at particular risk during pregnancy, and increases obesity risk for their offspring. To address these risks, the Bukhali trial is being implemented in Soweto, South Africa with 18–28-year-old women, as part of the Healthy Lifestyle Trajectory Initiative. A dietitian is part of the Bukhali intervention team (community health workers) to provide nutritional support for overweight/obese trial participants, making use of the International Federation of Gynaecology and Obstetrics (FIGO) Nutrition Checklist. This paper reflects on the experiences and lessons learned by the Bukhali dietitian, including the use of the FIGO Nutrition Checklist and Healthy Conversation Skills to facilitate conversations about making healthy dietary behaviour changes. Identified challenges that influence nutrition and behaviour are discussed, including lack of food affordability, cultural and social influences on healthy food choices, unsupportive environments and food insecurity. Strategies to optimise this nutritional support are also mentioned. The Bukhali trial is showing that introducing additional nutrition support by a dietitian for at-risk participants has the potential to encourage young women to prioritise nutrition and health, even in the midst of contextual challenges to both nutrition and health. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

An extensive body of research demonstrates an association between vegetable and fruit intake and reduced disease risk. Available evidence indicates that greater vegetable and fruit intake has been associated with the reduced risk of many of the nutrition-related diseases and risk factors that contribute substantially to the burden of disease in South Africa. The objective of this paper is to examine current information on vegetable and fruit intake in South Africa. Using this information and other evidence, it aimed to substantiate the need for a food-based dietary guideline (FBDG) that promotes vegetable and fruit intake, namely: “Eat plenty of vegetables and fruit every day”. Furthermore, it serves to provide healthcare workers and policy-makers with background and quantitative information that is relevant the FBDG that promotes vegetable and fruit intake. Available data indicate that on national, household and individual levels in South Africa, quantities of available and consumed vegetables and fruit are much lower than the recommendations for children and adults, and the contribution of vegetables and fruit to nutrients in the diets of children is low. The evidence supports the need for a South African FBDG that promotes vegetable and fruit intake, in order to educate the public and inform policy-makers about the importance of greater vegetable and fruit intake. Practical considerations that complement this FBDG have been provided, including recommendations on variety, quantities and serving sizes across the life cycle. Recommendations for the implementation of the FBDG and overcoming barriers to eating adequate quantities of vegetables and fruit are outlined. It is recommended that evaluation and monitoring processes, at all levels of implementation of this and other FBDGs, be instituted. [ABSTRACT FROM AUTHOR]

Background: Childhood malnutrition in developing countries contributes to developmental delays, as well as increased morbidity and mortality. The effectiveness of feeding programmes as a strategy to improve childhood malnutrition has been questioned. Objective: A systematic review was undertaken to examine the effectiveness of preschool feeding programmes in fostering the growth of children in developing countries. Design: A systematic literature search was undertaken to identify published studies that related to the objective. Studies had to be randomised intervention studies that reported on the growth outcomes of children from birth to six years of age in order to be included. Setting: An initial literature search yielded 59 studies, of which 44 were excluded based on initial screening. Five more were omitted based on detailed data extraction. Ten studies met the inclusion criteria. The results of these studies were compared and narratively described in the context of the objective. Results: The studies showed a great level of heterogeneity with regard to sample characteristics, intervention and reporting of results. In the context of recovery from malnutrition, most studies reported there to be a positive effect from feeding programmes. In studies that reported on weight gain, those that employed a supervised intake of food supplements resulted in higher rates of weight gain. Micronutrient fortification was described as having a positive influence on the rate of linear growth in studies that reported on linear growth. Intensive nutrition education aimed at mothers and caregivers is a sustainable way in which to change child feeding behaviour and may contribute to the effectiveness of nutrition intervention. Conclusion: The limitations of the study included the following: there was a low number (59) of identified studies in the initial search because of the use of limited search terms, assessment of risk of bias was carried out by only one reviewer using a self-designed grading system, there were high levels of heterogeneity, and less than half of the individual studies were rated to be of a high quality. In view of these limitations, no firm conclusion can be drawn. Additional research, aimed at determining the impact of supplementary feeding programmes in supporting the growth of disadvantaged children, is encouraged. [ABSTRACT FROM AUTHOR]

Malnutrition, nutrient deficiencies and osteoporosis are common in patients with Crohn's disease, regardless of disease activity. While the role of diet in the pathogenesis of the disease remains inconclusive, upon diagnosis, nutrition therapy plays an integral role in patient care. Successful nutrition intervention involves appropriate nutritional assessment, supplemental nutrition and individualised counselling and support. [ABSTRACT FROM AUTHOR]

Clinical nutrition has evolved from providing nutrients to meet the patient's needs to nutrition therapy that additionally aims to provide specific nutrients, or combinations thereof, which can reduce infection and improve outcomes in critically ill patients. The value of immunonutrition in the management of critically ill, preoperative and postoperative patients is now acknowledged by many healthcare practitioners. Amid the demonstration of clinical and economic benefit in defined conditions, South African practitioners should aim to translate current knowledge to best practice in order to optimise nutrition therapy and ultimately clinical outcome in critically ill patients. For the future, a paradigm shift to pharmaconutrition has been suggested. This practice dissociates the administration of key single nutrients, in the form of requirement-based parenteral or enteral nutrition, from the delivery of pharmaconutrients in the full effective pharmacological dose, as evaluated in large, well-designed trials, in order to achieve therapeutic effects. This has been evaluated in large, well designed trials. The purpose of this review is not to provide an exhaustive overview of the available literature on immunonutrition, but rather to highlight key and recent significant studies, with a focus on energy and protein, glutamine, arginine, omega-3 fatty acids and micronutrients, and relate them to the South African context. Finally, the bigger picture should always be borne in mind, within the settings of the complexity of the acute phase response and the heterogeneity of the critical care population. As the evidence base evolves, the definition of optimal nutrition therapy should include all relevant components in the right mix, at the right time, to the right patients, to ensure optimal clinical benefit and outcome. [ABSTRACT FROM AUTHOR]

Despite South Africa being a food-secure country in terms of aggregate food availability, it is listed by the World Health Organization as one of 36 high-burden countries, home to large numbers of stunted children. Recent findings, in the context of both over- and under-nutrition, have indicated that adult and child malnutrition rates have deteriorated in South Africa. The complementarities and synergies between food availability, access and utilisation need to be aligned in interventions used to address and strengthen food and nutrition security. This is particularly pertinent in the context of the widespread AIDS epidemic which interacts with food insecurity in complex ways. It is against this backdrop that home-grown or small-scale food production is explored as a feasible contributor to food and nutrition security for the rural poor with particular emphasis on contextual and technical factors. By illustrating a few successful models of home gardening, the evidence for addressing micronutrient deficiencies in these types of interventions is presented. The challenges to establish sustainable home gardening practices and the efforts needed to address gender-distinctive issues are discussed. The case is made for community-based agricultural interventions as a critical component of the various interventions used to address food and nutrition security at the household level. [ABSTRACT FROM AUTHOR]

Generally, South African researchers working in the fields of nutrition and dietetics collect food intake data as a first step towards determining the nutritional status of various populations. However, on publication, the majority of the results obtained from these studies are expressed in terms of nutrient intake, whereas food intake data are either not included, or are presented in non-uniform formats. Subsequently, other researchers who wish to determine what foods South Africans are eating are not able to access food intake data from existing studies. For example, if the Food-Based Dietary Guidelines (FBDG), which are expressly based on food, and not nutrient intakes, are to be revised regularly as stipulated by the World Health Organization (WHO), very little additional food intake data from the decade following publication of the first FBDG in 2001 would be available for adult South Africans. It is probable that the consumption of certain foods may have increased because of urbanisation and Westernisation of large sectors of the population. Conversely, economic factors, including the present recession, household food insecurity and poor food choices, may have reduced the intake of nutrient-dense foods in the past decade. The present review describes the disparity in reporting of food intake data, and deficiencies in making data that are available in electronic storage systems accessible to researchers working in the fields of public health nutrition, food production and utilisation, community nutrition and education. The creation of a working committee to make food intake data more accessible is proposed. [ABSTRACT FROM AUTHOR]

Introduction: Household poverty and poor access to health and other social amenities are key drivers of malnutrition and poor child health in most low-resources settings. The Democratic Republic of Congo (DRC), in the backdrop of past instability, experiences a host of socio-economic factors that effectively result in malnutrition among under-five children -- despite immense natural resources. Recent stability and enormous mineral resource wealth has attracted mining companies to invest in the eastern provinces of the country, presenting an opportunity to improve the nutritional and overall health status of children in the region. We therefore sought to describe the prevalence of malnutrition in the region, cognisant of these developments. Methods: Seven hundred and sixty-two under-five children from 420 households in two districts in the eastern DRC were assessed in this survey. We calculated their malnutrition indicators and made comparisons between semi-urban and rural children; taking semi-urban as a good proxy for populations within the coverage of mining activities. For each indicator, all children whose appropriate parameters were available were included in the evaluation with a plausible z-score. Results: An estimated 21.5% (95% confidence interval [CI]: 18.5-24.5) of the children assessed were found to be underweight, with 6.8% being severely underweight. However, the prevalence of wasting among these children was estimated at 5.8% (95% CI: 4.1 %-7.6%), which was lower than the national average of 16%. Of significance, the age groups six to 11 and 12 to 23 months were found to be more wasted compared to other age categories. Within the six- to 11 -months age category, rural children fared better than their semi-urban counterparts at 5% (95% CI: 0%-13%) and 14.6% (95% CI: 13.6%-25.6%) respectively. Conclusion: We conclude that malnutrition among under-five children is a significant problem in the eastern DRC. Business investment in the region offers real opportunities to comprehensively address these pressing challenges that face communities. Businesses keen to address malnutrition need to be cognisant of the prevalence of the problem and its contextual drivers, particularly on the socio-economic front, to be able to conceptualise appropriate responses. [ABSTRACT FROM AUTHOR]

The article focuses on malnutrition in northern and eastern parts of Cameroon suggesting that according to the World Health Organization (WHO), malnutrition is a major threat to global public health and discusses symptoms and treatment of malnutrition.

This descriptive study included 103 children aged 12-60 months, 39 older children and 291 adults, and was performed to assess the sensory acceptability of a lipid-based food supplement. Lipid-based pastes were found to be highly acceptable, although concern exists regarding the recommended portion sizes, especially for young children with poor appetite. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 55-year-old male admitted with known diagnosis of larynx cancer. He underwent total laryngectomy, oesophageal dilatation and had a percutaneous endoscopic gastrostomy (PEG) tube inserted for feeding. He was discharged from the hospital after his sodium, urea and creatinine had normalised following treatment and nutritional support using total parenteral nutrition (TPN) guidelines from the European Society for Clinical Nutrition and Metabolism (ESPEN).

The authors reflect on the role of access to nutrient and food intake data on the struggle against malnutrition in South Africa. They argue that nutrition interventions depend on food intake data, which has limitations including the daily variation of food intake, incorrect reporting, and coding errors. They mention that supplementation provides short-term measure but does not address the cause of malnutrition. The creation of a working committee for data accessibility is also suggested.

The article discusses the report "The Child Development Index 2012: Progress,challenges and inequality". The report mentions an improvement in the child development index by 127 countries. It suggests ways in which the WHO target of a reduction of 40 percent in children who are stunted can be met by developing countries by 2015. The article describes an initiative begun in South Africa to assess and provide interventions for undernutrition in children.