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Objective: To provide an update on the compliance to the Na reduction regulation (R.214) and to highlight some challenges and successes experienced by South Africa in the implementation of a mandatory Na regulation. Design: The study design was observational. Nutritional information of packaged food (specified in the R.214 regulation) was collected between February 2019 and September 2020, before and after the implementation date of the final Na targets in the regulation. Six supermarket chains that accounted for more than 50 % of the grocery retailer market share in South Africa were included. The Na content (per 100 g) of products was extracted from photographs. Products were classified according to the thirteen food categories included in R.214. The percentage of targeted food categories that met the pre and post-regulation targets as well as the percentage by which Na limits were exceeded was calculated. Setting: Low-and-middle-income suburbs in Cape Town, South Africa. Participants: N/A. Results: A total number of 3278 products were analysed. After the final implementation date, none of the categories targeted by the R.214 regulation fully complied. However, nine out of the thirteen food categories targeted by R.214 were above the 70 % compliance mark. Conclusions: The compliance to R.214 in South Africa is good, although not 100 % compliant. This research also highlights the complexities regarding the monitoring and evaluation of a national regulation. Findings from the current study could aid by providing valuable information to countries in the process of implementing a Na reduction strategy. [ABSTRACT FROM AUTHOR]

This article was commissioned for the PLoS Medicine series on Big Food that examines the activities and influence of the food and beverage industry in the health arena. Introduction Despite [...]

Objective: Vitamin D has immunoregulatory properties and appears to influence disease outcomes in patients with Crohn's disease (CD). The primary aim of this study was to evaluate the association between vitamin D status and CD activity in South Africa. Methods: In a cross-sectional study performed between September 2011 and January 2013, serum 25-hydroxyvitamin D (25(OH)D) was measured in 186 consecutive patients with CD seen at 2 inflammatory bowel disease (IBD) centers and 199 healthy controls in the Western Cape, South Africa. Lifestyle and clinical variables were identified using an investigator-administered questionnaire, as well as clinical examination and patient case notes. Vitamin D status was evaluated in 2 ways: ≤20 ng/mL vs ≥21 ng/mL and ≤29 ng/mL vs ≥30 ng/mL. Disease activity was measured by the Harvey Bradshaw Index (HBI). Various 25(OH)D threshold concentrations for predicting a higher HBI score were also investigated. Results: On multiple log-binomial regression analysis, higher HBI scores and not having taken vitamin D supplementation in the 6 months prior to enrollment were identified as risk factors for vitamin D deficiency in patients with CD, defined either as ≤20 ng/mL or as ≤29 ng/mL (p< 0.03). Compared to patients with HBI < 5, those with HBI ≥ 8 were 2.5 times more likely to have 25(OH)D concentrations ≤21 ng/mL (prevalence risk [PR] = 2.5; 95% confidence interval [CI], 1.21–6.30). The risk was similar, though not as high, when defined as ≤29 ng/mL (PR = 2.0; 95% CI, 1.13–3.51). When vitamin D deficiency was defined as <20, <30, <40, and <50 ng/mL, the sensitivity and specificity obtained were 44.9% and 78.8%; 75.5% and 62.4%; 86.7% and 44.7%; and 92.9% and 23.5%, respectively (area under the curve = 0.71;p< 0.0001). Conclusion: Low serum 25(OH)D was associated with increased CD activity in a South African cohort. [ABSTRACT FROM PUBLISHER]

Although some studies have shown that obesity and other non-communicable diseases are more common in more disadvantaged areas, no publications to date have examined the interaction of obesity with urban and rural disadvantage in lower-income countries. This study analyzed the rates of obesity and underweight in disadvantaged urban women and disadvantaged rural women in 31 lower-income countries, and calculated the age-adjusted odds ratios of urban vs. rural obesity and underweight. The odds of obesity were significantly (p<0.05) higher for urban populations in 16 of the 31 countries and in all aggregated regions; the evidence that underweight is also associated more with urban populations was mixed. Because obesity is a rapidly-growing threat to the public health and financial strength of lower-income countries, and urban disadvantage is associated with more obesity than rural disadvantage, policymakers should work to understand, predict, and prevent obesity in urban populations specifically.

Background: A huge growth in complementary and alternative medicine (CAM) took place in South Africa in the 1960s which paralleled what was happening in other parts of the western world. Naturopathy has been practised in South Africa for over 60 years, and the history of naturopathy is entwined with the broader history of CAM. No laws existed at that stage to regulate the curriculum, education and training of CAM practitioners. With the passage of time, various statutes were introduced which eventually led to changes in legislation and the establishment of a recognised training programme. Naturopathy became a legally regulated profession, the full history of which has never been documented., Objective: This article explores the history of naturopathy in South Africa., Method: A two-phase qualitative research design was used, consisting of a document search and semi-structured interviews with key informants who were identified through a process of snowballing. Information collected from the naturopaths who participated in the interviews was triangulated with documentation uncovered in the archives of the Allied Health Professions Council of South Africa (AHPCSA) and other literature available., Results: The result is a history of events which took place and reveals the effect of various legislations on the profession., Conclusion: Changes in the political system paved the way for changes in legislation which allowed for the registration and training of naturopathic practitioners. However, the lack of a functioning association and the small number of naturopathic graduates have hampered the growth of the profession, preventing it from becoming a significant contributor to the health care system., Competing Interests: The authors declare that they have no financial or personal relationships which may have inappropriately influenced them in writing this article., (© 2018. The Authors.)