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MSc (Dietetics), North-West University, Potchefstroom Campus Background: Perinatal depression is a serious problem worldwide and the prevalence is higher in low- and middle-income countries (LMIC) than in high-income countries (HIC). The South African prevalence of perinatal depression is estimated to be four times the global average. One of the potential risk factors for depression is an unhealthy diet, which women from LMIC have a higher risk of developing than women from HIC. An “unhealthier” diet has been associated with higher depressive symptoms during the perinatal period. Perinatal fatigue is common and has also been shown to have a bi-directional relationship with depression. Objectives: The aim of this study was to investigate the association between dietary patterns during early pregnancy and perinatal depression and fatigue among women. Methods: Forming part of the Nutrition during Pregnancy and Early Development (NuPED) study, dietary data were obtained at enrolment (< 18 weeks gestation) using a quantified food frequency questionnaire from which nutrient patterns were determined by means of exploratory factor analysis. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess depressive symptoms and the Multidimensional Assessment of Fatigue (MAF) scale to measure fatigue at three time points during pregnancy and two postnatally. Results: The prevalence of perinatal depression ranged from 17.3% to 26.4% and perinatal fatigue ranged from 8.4% to 18.8% across the various time points. Three nutrient patterns were identified: 1) “Plant protein, iron, thiamine and folate”, which decreased the risk of fatigue at 6 months postnatally. This decrease in risk was attributed to the B-vitamins, iron and zinc present in the nutrient pattern; 2) “Animal protein, vitamin A, vitamin B12 and copper”, which increased the risk of depression at 12 months postnatally. The increased risk of depression may be due to the high meat content of the nutrient pattern; 3) “Fatty acids and sodium” which increased the risk for depression at 6 months postnatally. A possible reason for this increased risk of depression may be the high amount of saturated fatty acids in the nutrient pattern. Perinatal fatigue was also found to be positively associated with perinatal depression. Conclusion: This research illustrates the potential role of maternal diet during pregnancy in the development of maternal fatigue and depression. Masters

PhD (Nutrition), North-West University, Potchefstroom Campus Background and rationale. Pregnancy presents a unique period during which the health and well-being of the offspring can be influenced. Maternal nutrition is known as an important modifiable factor for both fetal and infant growth and development. Dietary pattern analysis allows for the assessment of the diet as a whole. The use of nutrients as variables for dietary pattern analysis rather than foods or food groups are advised as it is universal in consumption and allows for easier comparison between study populations. Studies investigating the associations of maternal dietary patterns during pregnancy with fetal and infant growth and development are limited, with most studies conducted in high-income countries. The aim of this study was therefore to assess the associations of maternal dietary patterns during pregnancy with fetal and infant growth and development up to the age of 12 months in Johannesburg, South Africa. Study design and methodology. Generally, healthy women pregnant with a singleton

Data on breast milk fatty acid (FA) composition in South African lactating women in relation to their FA status, as well as on potential compositional changes within feed, are limited. The aim of this study was to assess the FA composition of breast milk sampled at three time points within feed, and to determine associations with red blood cell (RBC) total phospholipid FA levels in lactating South African mothers of 2–4-month-old breastfed infants. FA composition (% total FAs) was analyzed in RBC total phospholipids, and in fore-, mid-feed and hind-milk samples of lactating mothers (n = 100) of Black African descent living in a peri‑urban township. The mean age of the lactating women was 27.8 ± 6.8 years. Geometric mean (95% CI) breast milk SFA, MUFA and PUFA contents were 37.7 (37.3,38.1), 28.5 (27.9, 28.8), and 23.5 (23.2, 24.5)%, respectively. Breast milk DHA and AA contents were 0.25 (0.24, 3.71) and 0.81 (0.79, 0.83)%, respectively, in fore-, mid- and hind-milk combined. Maternal RBC EPA, DHA and AA levels were 0.37 (0.34, 0.40), 3.8 (3.6, 4.0) and 15.4 (14.8, 16.1)%, respectively. Women who reported to consume fish often (n = 3) had significantly higher RBC EPA levels than women who consumed fish sometimes (n = 56), never (n = 14) or rarely (n = 19). Breast milk DHA positively correlated with maternal RBC DHA, while no correlations were found between breast milk AA and maternal RBC AA. Breast milk ALA and DHA contents were significantly higher in mid-feed [ALA= 0.8 (0.2, 0.2), DHA=0.3 (0.2, 0.3)] and hind-milk [ALA=0.8 (0.8, 0.9), DHA=0.3 (0.3, 0.3)] than foremilk [ALA=0.8 (0.7, 0.9), DHA=0.2 (0.2, 0.3)]. In contrast, LA and AA contents remained constant within feed. In this sample of peri‑urban South African lactating mothers, breast milk was low in DHA and high in AA compared to global means. Breast milk DHA was associated with maternal RBC status, while breast milk AA was not. We further showed that breast milk ALA and DHA increased, while LA and AA remained unchanged within feed. This suggests that n-3 PUFA maybe preferentially transferred to breast milk within feed through biomagnification.

Background Recent studies are suggesting a U-shaped relationship between antenatal iron exposure and birth outcomes. Little is known about the iron status and associated birth outcomes of pregnant women in South Africa. Our aim was to assess iron status at early, mid- and late pregnancy, and to determine associations with gestational age and birth weight in women in Johannesburg, South Africa. Methods In this prospective study of 250 pregnant women, we measured haemoglobin, biomarkers of iron status and inflammation at, PLoS ONE, 14 (9), ISSN:1932-6203

PhD (Nutrition), North-West University, Potchefstroom Campus, 2019. Nutrient requirements increase during pregnancy and women are vulnerable to inadequate nutritional status during this period of rapid foetal growth. Poor dietary intake and nutritional status during pregnancy have been associated with poor birth outcomes and increased risks for noncommunicable diseases in the offspring’s adult life. Low birth weight (LBW) and prematurity are risk factors for disease in later life. It would therefore benefit population health to identify and address predictors of LBW and preterm birth, particularly in low- and middle-income populations. In South Africa, approximately 15% of babies are born LBW and approximately 12% are born preterm. Maternal iron deficiency (ID) has been associated with increased risk for LBW, while poor omega-3 (n-3) polyunsaturated fatty acid (PUFA) intake and status have been associated with premature birth. Iron is important for erythropoiesis, growth and neurodevelopment. PUFAs form an important part of the structural component of cell membranes and play a critical role in cell signalling and are therefore considered essential for optimal foetal growth and development. There are limited data available on the diet as well as the nutritional status of pregnant women in South Africa. A national study on non-pregnant women of child-bearing age has indicated that 15% of women were ID and between 23% and 33% of women were anaemic. No national data exists for fatty acid status, however regional studies on non-pregnant women have indicated that fatty acid status were reflective of dietary intake and that n-3 PUFA intakes are low and n-6 PUFA high. It is probable that the South African iron and PUFA status may contribute to complications during pregnancy, specifically related to length of gestation and birth weight. Therefore, the aim of this research was to assess dietary intake and status of iron and long-chain polyunsaturated fatty acids (LCPUFA) during pregnancy; and to determine associations of maternal iron and LCPUFA status during pregnancy with birth outcomes, in particular gestational age and birth weight, in pregnant women giving birth at Rahima Moosa Mother and Child Hospital (RMMCH) in Johannesburg. A prospective, longitudinal study design was applied. Generally healthy pregnant women (5 mg/L) at enrolment. Multivariable regression analyses showed that anaemia and ID at 22 weeks, as well as IDE at 36 weeks of gestation were associated with higher birth weight (β=168.1; 95% CI: 19.5, 316.7 and β=227.6; 95% CI: 58.4, 396.8 and β=168.7; 95% CI: 27.9, 309.5, respectively). Women in the lowest ferritin quartile at 22 weeks gave birth to babies weighing 312 g (95% CI: 94.8, 528.8) more than those in the highest quartile. In contrast, IDE at 22 weeks was associated with a higher risk for premature birth (OR: 4.62, 95% CI: 1.56, 13.68) and women in lower haemoglobin quartiles at

Background Adequate nutrition during pregnancy is important to ensure optimal birth outcomes, maternal health and offspring development. However, little is known about the dietary intake and nutritional status of pregnant women residing in urban South Africa. Therefore, the Nutrition during Pregnancy and Early Development (NuPED) cohort study was initiated to assess early nutrition-related exposures predictive of early childhood development in urban South Africa. Methods The aims of this prospective cohort study are: 1) to assess dietary intake and nutritional status of urban pregnant women in Johannesburg, South Africa, and 2) to determine associations with birth outcomes, measures of maternal health, as well as measures of offspring health and development. Pregnant women (

ObjectiveThe WHO’s global targets for non-communicable disease reduction recommend consumption ofDesign/setting/participantsA nested cohort design within WHO’s 2015 Study on global AGEing and adult health (n=2887) including individuals from households across South Africa. Randomly selected adults (n=875) provided 24-hour and spot urine samples for sodium and iodine concentration analysis (the primary and secondary outcome measures, respectively). Median 24-hour urinary iodine excretion (UIE) and spot urinary iodine concentrations (UIC) were compared by salt intakes of 9 g/day.ResultsMedian daily sodium excretion was equivalent to 6.3 g salt/day (range 1–43 g/day); 35% had urinary sodium excretion values within the desirable range (9 g salt/day). Median UIC was 130 µg/L (IQR=58–202), indicating population iodine sufficiency (≥100 µg/L). Both UIC and UIE differed across salt intake categories (pConclusionsIn a nationally representative sample of South African adults, the association between indicators of population iodine status (UIC and UIE) and salt intake, estimated using 24-hour urinary sodium excretion, indicate that low salt intakes may compromise adequacy of iodine intakes in a country with mandatory iodisation of table salt. The iodine status of populations undergoing salt reduction strategies needs to be closely monitored to prevent re-emergence of iodine deficiency.