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Summary: This umbrella review assessed the association between excess weight and COVID‐19 outcomes. MEDLINE, PsycINFO, and CINAHL were systematically searched for reviews that assessed the association between excess weight and COVID‐19 outcomes. A second‐order meta‐analysis was conducted on the available data for intensive care unit admission, invasive mechanical ventilation administration, disease severity, hospitalization, and mortality. The quality of included reviews was assessed using the AMSTAR‐2 appraisal tool. In total, 52 systematic reviews were included, 49 of which included meta‐analyses. The risk of severe outcomes (OR = 1.86; 95% CI: 1.70 to 2.05), intensive care unit admission (OR = 1.58; 95% CI: 1.45 to 1.72), invasive mechanical ventilation administration (OR = 1.70; 95% CI: 1.57 to 1.83), hospitalization (OR = 1.82; 95% CI: 1.61 to 2.05), and mortality (OR = 1.35; 95% CI: 1.24 to 1.48) following COVID‐19 infection was significantly higher in individuals living with excess weight compared with those with a healthy weight. There was limited evidence available in the included reviews regarding the influence of moderating factors such as ethnicity, and the majority of included reviews were of poor quality. Obesity appears to represent an important modifiable pre‐infection risk factor for severe COVID‐19 outcomes, including death. [ABSTRACT FROM AUTHOR]

Shared learning and supportive conversations between parents encourages disclosure and cultivates an environment of support. This paper presents the process evaluation through the qualitative outcomes of community parent support groups facilitated by local mentor mothers. Qualitative data collected via two (2) Focus Group Discussions (FGD) with group facilitators was followed by four (4) FGD with a total of forty of the parents from the support groups. During the two (2) FGDs with the facilitators, group values were established and adopted. The facilitators agreed amongst themselves to implement the group values to champion and promote the stability of each parent support group. Three key themes emerged from the four FGDs involving support group mothers included: (1) Awareness of mutual connection gained by attending parent groups; (2) Health and social support gained through collectively sharing knowledge and (3) Improved confidence in parenting ability through dialogue. Findings are a showcase the relevance of the group values and mutual benefits of attending parent support groups. The unique parent support initiative revealed that positive health seeking behaviour could be promoted amongst parents in the Early Childhood Development (ECD) phase using a participatory action research approach. Recommendations and implications for group work practice are provided which encourage the use of group values to enable conducive environments for participation and trust building in community based parent support groups. [ABSTRACT FROM AUTHOR]

In South Africa, prevention of mother to child transmission (PMTCT) has reduced MTCT from 3.6% in 2011 to 1.3% in 2017. However, there are challenges in reaching vulnerable HIV-positive children; those at increased risk of malnutrition or present late with advanced disease. Macro – and micronutrient deficiencies, common in HIV, may accelerate disease progression. This was a prospective cohort study of paediatric patients (aged 1–10 years) initiating ART between 08/2014 and 09/2016 at a public health facility in Johannesburg, South Africa. Trained clinic staff collected anthropometric indices and dietary intake at ART initiation and at one and three months post initiation. A blood sample was collected at ART initiation and at six months post initiation for biochemistry. We describe demographics, anthropometry, dietary intake, dietary diversity at enrolment and changes in anthropometry and biochemistry from ART initiation until six months for paediatric HIV-positive patients initiating antiretroviral therapy (ART). Twenty-seven patients were enrolled. The World Health Organization dietary intake recommendations for children were not met for the majority of nutrients including energy, fats, iron, calcium and Vitamin A at ART initiation. At least 40% of patients were receiving less than four of the main food groups. At initiation, 18.5% of children presented with severe acute malnutrition (MUAC <11cm), 14.3% were underweight (weight-for-age Z score <-2SD), 19.1% stunted (height-for-age Z score <-2SD) and 33.4% were wasted (weight-for-height <-2SD). At six months, there was a general increase in WHZ (<5 years), BMI (≥5 years), C-reactive protein, iron and albumin but a significant increase in Vitamin A. The results highlight the need for dietary counselling and provision of nutritional supplementation at ART initiation for paediatric patients. Adequate nutrition should be established early at initiation, to improve growth, development and health outcomes. [ABSTRACT FROM AUTHOR]

ObjectiveThe present paper examines dietary intake and body composition in antiretroviral (ARV)-naïve HIV-positive compared with HIV-negative South African women, as well as the impact of disease severity on these variables.DesignBaseline data from a longitudinal study assessing bone health in HIV-negative and HIV-positive premenopausal South African women over 18 years of age were used. Anthropometry and body composition, measured by dual energy X-ray absorptiometry, were analysed together with dietary intake data assessed using an interviewer-based quantitative FFQ.SettingSoweto, Johannesburg, South Africa.SubjectsBlack, urban South African women were divided into three groups: (i) HIV-negative (HIV−; n 98); (ii) HIV-positive with preserved CD4 counts (HIV+ non-ARV; n 74); and (iii) HIV-positive with low CD4 counts and due to start ARV treatment (HIV+ pre-ARV; n 75).ResultsThe prevalence of overweight and obesity was high in this population (59 %). The HIV+ pre-ARV group was lighter and had a lower BMI than the other two groups (all P < 0·001). HIV+ pre-ARV women also had lower fat and lean masses and percentage body fat than their HIV− and HIV+ non-ARV counterparts. After adjustment, there were no differences in macronutrient intakes across study groups; however, fat and sugar intakes were high and consumption of predominantly refined food items was common overall.ConclusionHIV-associated immunosuppression may be a key determinant of body composition in HIV-positive women. However, in populations with high obesity prevalence, these differences become evident only at advanced stages of infection. [ABSTRACT FROM PUBLISHER]

ObjectiveThe present study aimed to assess the relationship between dietary habits, change in socio-economic status and BMI Z-score and fat mass in a cohort of South African adolescents.DesignIn the longitudinal study, data were collected at ages 13, 15 and 17 years on a birth cohort who have been followed since 1990. Black participants with complete dietary habits data (breakfast consumption during the week and at weekends, snacking while watching television, eating main meal with family, lunchbox use, number of tuck shop purchases, fast-food consumption, confectionery consumption and sweetened beverage consumption) at all three ages and body composition data at age 17 years were included in the analyses. Generalized estimating equations were used to test the associations between individual longitudinal dietary habits and obesity (denoted by BMI Z-score and fat mass) with adjustments for change in socio-economic status between birth and age 12 years.SettingBirth to Twenty (Bt20) study, Soweto-Johannesburg, South Africa.SubjectsAdolescents (n 1298; 49·7 % male).ResultsIn males, the multivariable analyses showed that soft drink consumption was positively associated with both BMI Z-score and fat mass (P < 0·05). Furthermore, these relationships remained the same after adjustment for socio-economic indicators (P < 0·05). No associations were found in females.ConclusionsLongitudinal soft drink consumption was associated with increased BMI Z-score and fat mass in males only. Fridge ownership at birth (a proxy for greater household disposable income in this cohort) was shown to be associated with both BMI Z-score and fat mass. [ABSTRACT FROM AUTHOR]