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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]

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. [ABSTRACT FROM AUTHOR]

Introduction: Infant health and nutrition in South Africa are a priority, as evidenced by the political commitment and policy development history of the last 25 years. Current efforts focus on improving breastfeeding rates, but the action plan for complementary feeding receives less attention and resourcing. A thorough analysis of the current infant feeding situation is required to assist with policy and targeted programmes associated with complementary feeding. Aim: The aim of this review was to identify and collate all published research in South Africa on the complementary feeding practices of infants and young children, aged 0–24 months. Methodology: Searches included English-language research published between 2006 and 2017, within PubMed, Scopus, Web of Science and Google Scholar. All papers included in the review had to meet defined eligibility criteria. Papers older than 11 years were excluded. In total 34 papers relevant to South Africa were identified and included in this review. Main findings: Early introduction of foods and liquids other than breast milk is a common practice. Maize porridge is a common first food for infants, but there is also a high reliance on commercial infant cereal. Water and other liquids (e.g. tea, herbal mixtures) are commonly given to infants younger than six months. There is little information on the number of meals per day. The diets of many older infants do not meet the criteria for a minimally acceptable diet. Few animal source foods are used in complementary feeding. There are indications that processed meats, soft drinks, sweets and salty crisps are given regularly to older infants between six months and one year. Conclusion: Complementary feeding practices in South Africa are suboptimal and appropriate action is needed to improve this situation. Further investigation is needed on whether older infants and young children can achieve their required dietary intakes from the food that is available to them. If a change in older infant and young child feeding behaviour is desired, then existing methods and approaches need to change. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Dietary patterns among South African older adults indicate a moderate intake of total fat and salt, as well as a high sugar intake. Total fat, saturated fat, sugar and salt intakes are associated with non-communicable diseases (NCDs) and mortality. Processed and ultra-processed foods are common in elderly households and contain high levels of fat, sugar and salt and are associated with frailty. This paper aims to review the available scientific evidence on the effect on health status of dietary sugar, fat and salt consumption among the elderly. This information will be used to confirm the need for dietary sugar, fat and salt food-based dietary guidelines for the elderly South African population. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to assess the iodine status of pregnant women and children age 6 to 12 years feeding from the same food basket in Mopani District. Design: A cross-sectional study was conducted. Setting: The setting was primary health care clinics and households from five municipalities of Mopani District in Limpopo province. Subjects: A total of 565 conveniently selected pregnant women and 116 children aged 6 to 12 years were recruited, of which 116 were mother–child pairs. Methods: The demographic information, iodine nutrition knowledge and salt consumption patterns were obtained using a validated questionnaire. Spot urine, household drinking water and salt samples were collected and analysed for iodine using standard procedures. A professional nurse, using filter paper to determine thyroid stimulating hormone (TSH) levels, collected spot finger-stick blood samples from pregnant women. Results: The findings showed that only 52.5% of household salt had an iodine concentration level of more than and equal to 15 ppm. The median iodine concentration of household drinking water was 46.2 μg/l (interquartile range [IQR] 10.8–73.4 μg/l). The TSH levels of the majority of pregnant women were normal and the maternal overall median urinary iodine concentration (UIC) was 164 μg/l (IQR 92–291 μg/l), indicating maternal iodine sufficiency. However, median UIC in the first and third trimesters was below 150 μg/l, indicating iodine insufficiency. The UIC level of children in the study was 386 μg/l (IQR 200–525 μg/l), signifying iodine excess. Conclusion: Iodine status of pregnant women in this study was sufficient, with UIC for children excessively high, more than two times higher than the iodine status of pregnant women. The reasons for the excessive UIC in school-age children need to be elucidated. [ABSTRACT FROM AUTHOR]

Objectives: The nutrition of construction workers is related to their health and safety (H&S) at work. Research on the factors influencing construction workers' food choices and overall nutrition is limited, in South Africa and indeed Africa as a whole. The present paper aims to develop and validate a questionnaire on factors influencing construction workers' food choices. Design: The study adopted a quantitative approach; 42 items, divided into six constructs, were used to develop a field-survey questionnaire after a detailed literature review. Setting: The study was conducted on eight construction sites (consisting of five building construction and three road construction sites), chosen through heterogeneity sampling, in Midrand, Centurion, Johannesburg and Samrand. Subjects: Participants included construction workers actively involved in site activities. Outcome measures: Principal components analysis (PCA) was conducted to examine the structures and validity of the constructs. Cronbach's alpha test and mean inter-item correlations were used to examine internal consistency reliability. Results: After repeated factor analysis, the questionnaire on food-choice factors revealed seven different factors: food context, biological factors, nutritional knowledge, personal ideas and systems, economic factors, resources and cultural background. These factors explained 60.09% variance. Cronbach's alpha coefficients ranged from 0.62 to 0.85, signifying good internal consistency reliability. Conclusion: The determinants of construction workers' food choices are vital considerations when designing and implementing nutrition interventions in the South African construction industry. Future research can adopt the instrument and developed model when conducting psychometric evaluations of construction workers' food-choice determinants. [ABSTRACT FROM AUTHOR]