Lactating mothers' perceptions and sensory acceptability of a provitamin A carotenoid-iron-rich composite dish prepared from iron-biofortified common bean and orange-fleshed sweet potato in rural western Uganda.

Uganda's lactating mothers are vulnerable to deficiencies of vitamin A and iron because they consume plant-based conventional foods such as white-fleshed sweet potato (WFSP) and non-iron biofortified common bean (NIBCB) that are low in provitamin A (PVA) and iron, respectively. A PVA carotenoid-iron-rich dish was prepared from a combination of orange-fleshed sweet potato (OFSP) and iron-biofortified common bean (IBCB). This study evaluated the perceptions and sensory acceptability of OFSP+IBCB (test food) against WFSP+NIBCB (control food) among lactating mothers in rural Uganda. A total of 94 lactating mothers participated in the study. The sensory attributes (taste, color, aroma, texture, and general acceptability) of test and control foods were rated using a five-point facial hedonic scale (1 = dislike very much, 2 = dislike, 3 = neutral, 4 = like 5 = like very much). An attribute was acceptable if the participant scored from like to like very much. Focus group discussions (FGDs) were conducted to assess participant perceptions about their future consumption of OFSP+IBCB. The chi-square test was used to detect the proportion difference for each sensory attribute between OFSP+IBCB and WFSP+NIBCB, while FGD data were analyzed by thematic analysis. Taste, color, and aroma were acceptable to the mothers and not significantly different between OFSP+IBCB and WFSP+NIBCB (p > .05). Participants had positive perceptions of the taste, aroma, and color of the OFSP+IBCB and negative perceptions about the soft texture of OFSP. The lactating mothers had positive perceptions of consuming OFSP+IBCB provided they were accessible, affordable, and feasible to prepare.

A comparative study of the anthropometric status of adults and children in urban and rural communities of the North West Region of Cameroon.

BACKGROUND: Cameroon, like many other developing countries, is experiencing a double burden of malnutrition. With increasing urbanization, communities are exposed to high calorie diets and sedentary lifestyles, which contribute to overnutrition. However, the nutritional status of the communities may vary with geographic location. The aim of the current study was to investigate the prevalence of underweight, overweight and abdominal obesity among adults as well as overweight, underweight, stunting and wasting among children in selected urban and rural communities of the North West Region (NWR) of Cameroon. The study also compared these parameters between selected urban and rural areas. METHODS: Cross-sectional study design was used to investigate the anthropometric status of adults (18-65 years) and children (1-5 years) from two rural (Mankon and Mendakwe) and two urban (Mankon and Nkwen) communities in the NWR of Cameroon. The study included 156 adults and 156 children per study site from different households. A multistage sampling technique was used to select the participants and study sites Anthropometric measurements were taken using standardised methods for selected indices: weight, height, waist circumference and mid-upper arm circumference (MUAC). Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 25 and a p-value of < 0.05 was considered statistically significant. RESULTS: Adults from Nkwen (urban) were either overweight (n = 74; 47.4%) or obese (n = 44; 28.2%) with 43.6% (n = 68) from urban Mankon obese, whilst adults from rural Mankon were normal weight (49.4%; n = 77), 2.6% (n = 4) from Mendakwe (rural) were underweight and 64.1% (n = 100) were normal weight. Children in the rural areas were severely underweight (n = 45; 14.4%), while children in the urban areas were either normal (n = 158; 50.6) or overweight (n = 43; 13.8%). More females in the urban sites (n = 39; 53.4% in Nkwen and n = 43; 69.4% in urban Mankon) had a large waist circumference (WC) compared to those in the rural sites (n = 17; 22.1% in Mendakwe and n = 24; 38.1% in rural Mankon). Males in the urban areas had large WC compared to those in the rural sites (n = 19; 24.4% in Nkwen; n = 23; 24.7% in urban Mankon; n = 15; 16.1% in rural Mankon and n = 2; 2.6% in Mendakwe). Mid-upper arm circumference (MUAC) values indicated that most children in both urban (n = 147; 94.2% in Nkwen; n = 152; 97.4% in urban Mankon) and rural areas (n = 142; 91.0% in rural Mankon; n = 154; 98.7% in Mendakwe) were not acutely malnourished. CONCLUSIONS: This study found a higher prevalence of overweight and obesity among adults and children in the urban areas of Nkwen and Mankon, compared to rural Mankon and Mendakwe. Thus, there is a need to investigate and address the causes of the high prevalence of overweight and obesity in these urban areas.

Anthropometric status of nurses working at a private hospital in Pietermaritzburg, KwaZulu-Natal.

Background: The prevalence of overweight and obesity among nurses in South Africa (SA) is increasing. This is a concern as overweight and obesity increase the risk for non-communicable diseases (NCDs). Aim: This study aimed to determine the anthropometric status of nurses working at a private hospital and to identify the factors related to a high body mass index (BMI). Setting: This study was conducted at a private hospital in Pietermaritzburg (PMB), KwaZulu-Natal (KZN). Methods: Weight, height and waist circumference (WC) measurements were taken, using standardised procedures. A self-administered questionnaire was developed to collect data on factors associated with a high BMI. Results: Most participants were overweight or obese (86.2%; n = 112). The mean BMI of females (33.55 kg/m2) was significantly higher than that of males (28.08 kg/m2) (p = 0.043). Nurses who did not smoke had a significantly higher BMI (33.84 kg/m2) than those who smoked (29.58 kg/m2) (p = 0.030). Nurses who skipped meals had a higher mean BMI (33.75 kg/m2) than those who did not skip meals (29.63 kg/m2) (p = 0.005). Most females had a WC above 88 cm (66.2%; n = 86), indicating a substantially increased risk for metabolic complications. Conclusion: There was a high prevalence of overweight and obesity among the nurses according to BMI. According to WC, most female nurses had an increased risk for metabolic complications. Being female, not smoking and skipping meals were associated with a higher BMI. Contribution: This study highlights the increasing prevalence of overweight and obesity among nurses.

Dataset on effect of decolourisation on metabolomic profile of Moringa oleifera leaf powder.

Moringa leaf has been widely used in the enrichment of staple foods due to its high nutritional value and hypoglycaemic, immune boosting, antiviral, antioxidant and antimicrobial activities. However, the acceptability of these products is generally low due to the green colour imparted by the colour of Moringa leaf. Decolourisation of the leaves may improve the acceptability of the food products. The decolorisation process may not only change the chlorophyll concentration of the Moringa leaves but also its other chemical components. The data set describes the effect of decolourisation on the metabolites present in Moringa leaf powder. The raw and decolourised samples were extracted with methanol/water (80:20 v/v) and analysed using a gas chromatography-high resolution time of flight-mass spectrometer (GC-HRTOF-MS). The metabolites identified were classified based on their functional group into acids, alcohols, aldehydes, amides hydrocarbons, phenols, phytosterols, vitamins and others. The data presented can be useful in identifying functional compounds available in Moringa-based foods and understanding the effect of decolourisation on the metabolite profile.

Potential of pumpkin to combat vitamin A deficiency during complementary feeding in low and middle income countries: variety, provitamin A carotenoid content and retention, and dietary reference intakes.

The risk of child vitamin A deficiency (VAD) in low and middle income countries (LMICs) begins during the age range of complementary feeding (6-24 months), when children are fed complementary foods (CFs) deficient in vitamin A. However, pumpkin, a source of provitamin A carotenoids (PVACs) is widely cultivated in LMICs, but underutilized as a complementary food. Moreover, when consumed by humans, PVACs are bioconverted to retinol, the active form of vitamin A used by the body. This study evaluated the potential of pumpkin toward combating VAD by reviewing varieties of pumpkin cultivated in LMICs and their provitamin A carotenoid (PVAC) content; retention of PVACs in pumpkin during processing it as a CF; and the extent to which a CF prepared from pumpkin may meet the dietary reference intakes (DRIs) for vitamin A for children aged 6-24 months old. Pumpkin may combat VAD because the varieties cultivated have high ß-carotene content, it is a provitamin A biofortifiable food crop, and 100% retention of PVACs was observed when processed using home cooking methods. Feeding less than 50 g of cooked pumpkin per day meets 100% of the recommended dietary allowance (RDA) and adequate intake (AI) of vitamin A for children 6 to 24 months old. Consumption of pumpkin may be used to complement vitamin A supplementation, fortification, and diversification of CFs with animal source foods. For better yield of pumpkin in LMICs, nutrition sensitive agricultural programmes such as biofortification and agronomic management of pumpkin need to be promoted and supported.

Assessment of the Nutritional Status of Four Selected Rural Communities in KwaZulu-Natal, South Africa.

Under- and over-nutrition co-exist as the double burden of malnutrition that poses a public health concern in countries of the developing regions, including South Africa (SA). Vulnerable groups such as pregnant women and children under five years are the most affected by malnutrition, especially in rural areas. Major contributing factors of malnutrition include food and nutrition insecurity, poverty, and unhealthy lifestyles. The current study aimed to assess the nutritional status, using selected anthropometric indices and dietary intake methods (repeated 24 h recall and food frequency), of four rural communities in KwaZulu-Natal (SA). Purposive sampling generated a sample of 50 households each in three rural areas: Swayimane, Tugela Ferry, and Umbumbulu and 21 households at Fountain Hill Estate. The Estimated Average Requirement cut-point method was used to assess the prevalence of inadequate nutrient intake. Stunting (30.8%; n = 12) and overweight (15.4%; n = 6) were prevalent in children under five years, whilst obesity was highly prevalent among adult females (39.1%; n = 81), especially those aged 16-35 years. There was a high intake of carbohydrates and a low intake of fibre and micronutrients, including vitamin A, thus, confirming the need for a food-based approach to address malnutrition and micronutrient deficiencies, particularly vitamin A deficiency.

Dietary management practices for type 1 diabetes mellitus by dietitians in KwaZulu-Natal.

BACKGROUND: In South Africa, 5% - 15% of diabetics have type 1 diabetes mellitus (T1DM). Dietitians are an important part of the diabetes management team; however, there is a lack of published data on the dietary management practices for T1DM by dietitians. AIM: The aim of this study was to determine the dietary management practices for T1DM by dietitians in KwaZulu-Natal (KZN). SETTING: This study was conducted in KZN. METHODS: A cross-sectional, descriptive study was conducted using a self-administered electronic questionnaire. RESULTS: Of the 69 dietitians who participated, 58% (n = 40) used the American Diabetes Association (ADA) guidelines to manage T1DM; just under 35% (n = 24) spent over an hour with new cases; and 87% (n = 60) used face-to-face consultations for follow-up. Dietitians used the glycaemic index, portion control using the healthy eating plate, carbohydrate counting using nutritional labels and household measures and carbohydrate awareness to manage T1DM (p < 0.05). Dietitians also used the healthy eating plate (71%; n = 49) (p < 0.05) and household measures (73.9%; n = 51) (p < 0.05) to manage T1DM. Time constraints, the literacy level of the patient, available resources and language barriers all played a role in determining the dietary management practices used (p < 0.05). CONCLUSION: Most dietitians in KZN used the ADA dietary guidelines to manage T1DM, which highlights the need for South African dietary guidelines for the management of T1DM. Dietitians used a variety of different dietary methods to manage T1DM in practice. This suggests that dietitians are flexible in how they manage T1DM with no one particular method being used. A variety of factors also influenced which dietary management practices were chosen.

Effect of cooking locally available common bean (Obwelu) on iron and zinc retention, and pumpkin (Sweet cream) on provitamin A carotenoid retention in rural Uganda.

Pumpkin is a potential rich source of vitamin A precursors called provitamin A carotenoids (PVACs), while common bean is a potential rich source of iron and zinc. This study evaluated the effect of cooking locally available pumpkin, Sweet cream (Cucurbita moschata) on PVACs retention in Uganda. Furthermore, the effect of cooking locally available common bean, Obwelu (Phaseolus vulgaris) on iron and zinc retention was evaluated. Expert caregivers from the local community cooked pumpkin by either boiling or steaming, while common bean was cooked by either boiling with prior soaking or boiling without prior soaking. PVACs in raw and cooked pumpkin were analyzed by high-performance liquid chromatography (HPLC), while iron and zinc in raw and cooked common bean were analyzed by flame atomic absorption spectroscopy (FAAS). Conversion of PVACs into vitamin A retinol activity equivalents (RAE) was calculated using the Institute of Medicine (2001) recommendations for the bioconversion of PVACs into vitamin A. Micronutrient retention was measured using true retention. ß-carotene, α-carotene, and vitamin A content in raw pumpkin was 1,704 µg/100 g, 46 µg/100 g and 1,437 µgRAE/100 g, respectively. Either boiling or steaming pumpkin resulted in over 100% retention of PVACs and vitamin A. Iron and zinc retention for boiled common bean with prior soaking was 92.2% and 91.3%, respectively. Boiling common bean without prior soaking resulted in 88.4% and 75.6% retention of iron and zinc, respectively. In conclusion, to retain a high proportion of PVACs caregivers should be advised to cook Sweet cream by either boiling or steaming, while to retain a high proportion of iron and zinc, Obwelu should be prepared by boiling with prior soaking.

Sorghum-Insect Composites for Healthier Cookies: Nutritional, Functional, and Technological Evaluation.

Protein-energy malnutrition (PEM) is a major health concern in sub-Saharan Africa (SSA). Relying on unexploited and regionally available rich sources of proteins such as insects and sorghum might contribute towards addressing PEM among at-risk populations. Insects are high in nutrients, especially protein, and are abundant in SSA. Sorghum is adapted to the tropical areas of SSA and as such it is an appropriate source of energy compared with temperate cereals like wheat. It is necessary to assess whether cookies fortified with sorghum and termite would be suitable for use in addressing PEM in SSA. Whole grain sorghum meal and termite meal were mixed at a 3:1 ratio (w/w sorghum:termite) to form a sorghum-termite meal blend. Composite cookies were prepared where the sorghum-termite blend partially substituted wheat flour at 20%, 40%, and 60% (sorghum-termite blend:wheat flour (w/w). The functional and nutritional qualities of the cookies were assessed. Compared with the control (100% wheat flour), the cookies fortified with sorghum and termite had about double the quantity of protein, minerals, and amino acids. However, with increased substitution level of the sorghum-termite blend, the spread factor of the cookies decreased. There is a potential to incorporate sorghum and termite in cookies for increased intake of several nutrients by communities that are vulnerable to nutrient deficiencies, especially PEM.

Child acceptability of a novel provitamin A carotenoid, iron and zinc-rich complementary food blend prepared from pumpkin and common bean in Uganda: a randomised control trial.

BACKGROUND: Ugandan children are fed homemade complementary foods (CFs) which are usually deficient in vitamin A, iron and zinc. Novel homemade CFs rich in vitamin A, iron and zinc need to be developed, and assessed for their acceptability among target children. OBJECTIVE: Homemade provitamin A carotenoids (PVACs), iron and zinc-rich complementary food (CF), common bean pumpkin blend (BPB) formulated from pumpkin (Sweet cream) and common bean (Obwelu) and PVAC-rich pumpkin blend (PB) from Sweet cream were prepared by expert peer mothers. This study compared child acceptability of BPB and PB (control). METHODS: The crossover acceptability study randomly assigned Ugandan children 6 to 24 months old to either receive 100 g of BPB (n = 35) or 100 g of PB (n = 35) on day one. After a washout period of one day, children crossed over to receive either BPB (n = 35) or PB (n = 35). The amount of CF consumed, duration of consumption, and micronutrient intake were assessed. The CF was acceptable if children consumed ≥50 g (50%) of served food (100 g). A paired t-test was used to determine the mean differences within participants between BPB and PB. The level of statistical significant difference was set at a probability value of 5% (p = 0.05). RESULTS: The mean consumption of BPB and PB was 53.9 g and 54.4 g, respectively. The mean duration for consumption of BPB and PB was 20.6 and 20.3 min, respectively. There was no significant difference in the amounts consumed, and duration of consumption in BPB and PB (p > 0.05). The mean intake of vitamin A was significantly higher (p < 0.00001) in PB (152.5 µgRAE) compared to BPB (100.9 µgRAE). The mean iron intake was significantly higher in BPB (1.1 mg) (p < 0.00001) compared to PB (0.3 mg). Furthermore, zinc intake was significantly higher (p < 0.00001) in BPB (0.58 mg) compared to PB (0.13 mg). CONCLUSION: A homemade complementary food, BPB, made from locally available common bean and pumpkin is rich in PVACs, iron and zinc and is acceptable to children in the age range of complementary feeding in Uganda. TRIAL REGISTRATION: Pan African Clinical Trials Registry www.pactr.org as PACTR202002576768667 . Retrospectively registered. Date of registration: 29/January/2020.

Biofortified Crops for Combating Hidden Hunger in South Africa: Availability, Acceptability, Micronutrient Retention and Bioavailability.

In many poorer parts of the world, biofortification is a strategy that increases the concentration of target nutrients in staple food crops, mainly by genetic manipulation, to alleviate prevalent nutrient deficiencies. We reviewed the (i) prevalence of vitamin A, iron (Fe) and zinc (Zn) deficiencies; (ii) availability of vitamin A, iron and Zn biofortified crops, and their acceptability in South Africa. The incidence of vitamin A and iron deficiency among children below five years old is 43.6% and 11%, respectively, while the risk of Zn deficiency is 45.3% among children aged 1 to 9 years. Despite several strategies being implemented to address the problem, including supplementation and commercial fortification, the prevalence of micronutrient deficiencies is still high. Biofortification has resulted in the large-scale availability of ßcarotene-rich orange-fleshed sweet potatoes (OFSP), while provitamin A biofortified maize and Zn and/or iron biofortified common beans are at development stages. Agronomic biofortification is being investigated to enhance yields and concentrations of target nutrients in crops grown in agriculturally marginal environments. The consumer acceptability of OFSP and provitamin A biofortified maize were higher among children compared to adults. Accelerating the development of other biofortified staple crops to increase their availability, especially to the target population groups, is essential. Nutrition education should be integrated with community health programmes to improve the consumption of the biofortified crops, coupled with further research to develop suitable recipes/formulations for biofortified foods.

Caregiver Perceptions and Acceptability of a Provitamin A Carotenoid, Iron and Zinc Rich Complementary Food Blend Prepared from Common Bean and Pumpkin in Rural Uganda.

Ugandan children are vulnerable to vitamin A deficiency (VAD), iron deficiency (ID) and zinc deficiency (ZnD) because they are fed on complementary foods (CFs) low in vitamin A, iron and zinc. This study developed a novel provitamin A carotenoid (PVAC), iron and zinc rich common bean pumpkin blend (BPB) complementary food (CF) from locally available pumpkin and common bean in Uganda and aimed to determine its acceptance, compared to a control pumpkin blend (PB). Seventy caregivers participated in the study. The sensory attributes (taste, colour, aroma, texture and general acceptability) of BPB and PB were rated using a five-point facial hedonic scale (1 = very bad, 2 = bad, 3 = neutral, 4 = good, 5 = very good). Focus group discussions (FGDs) were conducted to assess the perceptions of caregivers about the BPB. The chi square test was used to detect the proportion difference for each sensory attribute between BPB and PB, whilst FGD data were analysed by thematic analysis. A proportion of 64% to 96% of the caregivers rated both BPB and PB as acceptable (good to very good) for all the sensory attributes. There was no significant difference in caregiver acceptability for all attributes between BPB and PB (p > 0.05). Caregivers had positive perceptions about the taste, texture, aroma and colour of the BPB. Caregivers were keen to know the specific varieties of common bean and pumpkin used to formulate the PVAC, iron and zinc rich BPB. In conclusion, BPB was acceptable to caregivers, and they were interested to know how to prepare and use it as a CF.

Consumer Acceptance of Biscuits Supplemented with a Sorghum-Insect Meal.

Insects are abundant in the predominantly sub-Saharan Africa region and are generally high in protein. Wheat grain contains gluten that is vital for the quality of baked goods but does not grow well in warm regions. Partial substitution of wheat with sorghum and insect in biscuits could contribute to food security among vulnerable populations. This study identified insect types most commonly consumed by the rural Olugboja community living in the rural part of the Ikare-Akoko local government area of Ondo State, Nigeria and consumer acceptance of biscuits supplemented with a sorghum and insect meal. Whole grain sorghum meal and insect meal were blended at a ratio of 3:1 (w/w sorghum: insect). Composite biscuits were made by partially substituting wheat flour with the sorghum-insect meal at 20%, 40%, and 60% (w/w). Wheat biscuit (100%) was used as a control. Regular consumers of biscuits (n = 84) evaluated the acceptability of the biscuit samples using a five-point facial hedonic scale, which was followed by focus group discussions (FGDs) to assess consumer perceptions of the use of insect as a food source. Biscuits containing the sorghum-insect meal (mean = 4.0 ± 0.6) were more acceptable than the control (3.58 ± 0.6). The biscuits supplemented with 20% of the sorghum-insect meal were the most acceptable (mean = 4.23 ± 0.6) compared to those with higher concentrations (40% and 60%). FGDs revealed that the taste of the biscuits was an important motivation for consumers to accept insect as a food source.

Consumer Perceptions and Acceptability of Traditional Dishes Prepared with Provitamin A-Biofortified Maize and Sweet Potato.

Vitamin A deficiency (VAD) is prevalent in South Africa, particularly among predominantly poor rural communities. Provitamin A (PVA)-biofortified crops could be used to address VAD; however, there are challenges of poor consumer acceptability. This study investigated the effect of replacing white maize and cream-fleshed sweet potato (CFSP) with PVA-biofortified maize and orange-fleshed sweet potato (OFSP), respectively, on consumer acceptability and perceptions of traditional dishes of rural communities in South Africa. Consumer acceptability of PVA-biofortified phutu (a crumbly maize porridge) served with either curried cabbage, chicken or bambara groundnut, separately, and boiled OFSP was evaluated by black South African adults (n = 120) using a five-point facial hedonic scale. Focus group discussions (FGDs) were conducted with 56 subjects recruited from the consumer panel to assess consumer perceptions of the food samples. The majority of the participants rated the composite dishes containing PVA-biofortified phutu as "4 = good" and the acceptability of the composite dishes varied significantly (p < 0.05). Compared to other age groups, the 50-59-year age group showed higher preference for white phutu and chicken curry, whereas the 30-39-year age group showed higher preference for PVA-biofortified phutu and chicken curry. The acceptability of OFSP and CFSP was similar. The study participants showed positive perceptions of the OFSP, as well as PVA-biofortified phutu if served with either curried chicken or cabbage. The findings suggest that PVA-biofortified maize and OFSP can replace white maize and CFSP, respectively, in selected traditional dishes of the rural communities studied to alleviate VAD.

Improving the Dietary Vitamin A Content of Rural Communities in South Africa by Replacing Non-Biofortified white Maize and Sweet Potato with Biofortified Maize and Sweet Potato in Traditional Dishes.

Biofortification of staple crops has a potential for addressing micronutrient deficiencies, such as vitamin A deficiency (VAD), which are prevalent in South Africa. The poor acceptability of provitamin A (PVA)-biofortified foods could be improved by combining them with other food items to produce modified traditional dishes. The nutritional composition of the dishes could also be improved by the modification. The study aimed to investigate the effect of replacing white maize and cream-fleshed sweet potato (CFSP)] with PVA-biofortified maize and orange-fleshed sweet potato (OFSP) on the nutritional composition of South African traditional dishes. The protein, fibre, total mineral (ash), lysine, and iron concentrations of the PVA maize phutu (traditional porridge) composite dishes (control), were not significantly different (P > 0.05) from those of white maize phutu composite dishes. However, the PVA concentration of PVA maize phutu composite dishes was higher than that of the white phutu composite dishes (P > 0.05). The OFSP had a significantly lower protein concentration, but a significantly higher (P > 0.05) fibre, ash, lysine, isoleucine, leucine, and PVA concentration, relative to the CFSP. The findings indicate that composite dishes in which white maize is replaced with PVA-biofortified maize, and switching over from CFSP to OFSP, would contribute to combating VAD in South Africa, and in other developing counties.

Dietary supplement use among dietetics students at the University of KwaZulu-Natal.

BACKGROUND: A dietary supplement is a product that aims to add nutritional value to the diet. University students are known to make use of dietary supplements to improve their academic performance, increase energy levels and promote overall general health. Based on assumption, students studying towards a nutrition-related degree may eat healthily and choose not to use dietary supplements. Alternatively, because of their interest in and exposure to nutrition, they may decide to use dietary supplements. However, there is a lack of published studies investigating the prevalence of dietary supplement use and reasons for use among South African university students studying towards a nutrition-related degree. AIM: The aim of this study was to assess the use of dietary supplements by dietetics students. SETTING: University of KwaZulu-Natal (UKZN). METHODS: A cross-sectional, descriptive study was conducted using a self-administered questionnaire. RESULTS: Of the 139 participants, 23% (n = 32) used dietary supplements. There was a greater use by female students, those who lived at home and those registered for the Postgraduate Diploma in Dietetics. Reasons for using dietary supplements included the following: to strengthen the immune system (62.5%), to improve energy levels (56.3%) and to enhance physical health (50%). Cost (32.7%; n = 35), an adequate diet (22.4%; n = 24) and not necessary or waste of money (15%; n = 16) were reasons for not using dietary supplements. Most students (84.4%) made use of a multivitamin and mineral supplement. CONCLUSION: There was a low prevalence of dietary supplement use by UKZN dietetics students, with the high cost of supplements given as the main reason for non-use.

Nutritional status of children with Wilms' tumour on admission to a South African hospital and its influence on outcome.

BACKGROUND: In developing countries up to 77% of children with cancer have been shown to be malnourished on admission. High rates of malnutrition occur due to factors such as poverty and advanced disease. Weight can be an inaccurate parameter for nutritional assessment of children with solid tumours as it is influenced by tumour mass. This study aimed to assess the prevalence of malnutrition amongst children with Wilms tumour (WT), the level of nutritional support received on admission and the influence of nutritional status on outcome. METHODS: Seventy-six children diagnosed with WT and admitted to Inkosi Albert Luthuli Central Hospital between 2004 and 2012 were studied prospectively. Nutritional assessment was conducted using weight, height, mid-upper arm circumference (MUAC) and triceps skinfold thickness (TSFT) prior to initiating treatment. Outcome was determined 2 years after admission. Time until commencement of nutritional resuscitation and nature, thereof, were recorded. RESULTS: Stunting and wasting was evident in 12% and 15% of patients, respectively. The prevalence of malnutrition was 66% when MUAC, TSFT and albumin were used. Malnutrition was not a predictor of poor outcome and did not predict advanced disease. The majority of patients (84%) received nutritional resuscitation within 2 weeks of admission. CONCLUSIONS: When classifying nutritional status in children with WT, the utilisation of weight and height in isolation can lead to an underestimation of the prevalence of malnutrition. Nutritional assessment of children with WT should also include MUAC and TSFT. Early aggressive nutritional resuscitation is recommended.

Food and Nutrition Insecurity in Selected Rural Communities of KwaZulu-Natal, South Africa-Linking Human Nutrition and Agriculture.

Lack of access to nutritious and balanced diets remains a major impediment to the health and well-being of people living in rural areas. The study utilizes a qualitative systematic approach to conduct an environmental scan and review of scientific literature of studies conducted in South Africa, specifically KwaZulu-Natal (KZN). Availability and access to nutritious, diverse and balanced diets were identified as key constraints for achieving food and nutrition security as well as for human health and well-being. This has led to both under- and over-nutrition, with the former, in particular stunting, affecting children under 5 years. A high incidence of over-nutrition, both overweight and obesity, was observed among black African females. In South Africa, poor people rely mostly on social grants and cannot afford a balanced diet. Under these circumstances, agriculture could be used to increase availability and access to diverse and nutritious foods for the attainment of a balanced diet. The wider use of traditional vegetable crops and pulses could improve availability and access to healthy and locally available alternatives. The promotion of household and community food gardens, and the use of nutrient dense crops with low levels of water use, i.e., high nutritional water productivity, offers prospects for addressing malnutrition in poor rural areas.

Provitamin A carotenoids in biofortified maize and their retention during processing and preparation of South African maize foods.

Provitamin A-biofortified maize may contribute to alleviating vitamin A deficiency (VAD), in developing countries. However, processing the maize into food products may reduce its provitamin A content. The aims of this study were to determine the composition of provitamin A carotenoids in biofortified maize varieties as well as to assess their retention during processing of popular maize foods consumed in KwaZulu-Natal, South Africa. The non-provitamin A carotenoid, zeaxanthin and the provitamin A carotenoids, ß-cryptoxanthin, and trans and cis isomers of ß-carotene, and other unidentified trans and cis isomers of ß-carotene were detected in varying concentrations in the maize. Milling provitamin A-biofortified maize into mealie meal resulted in a higher retention of carotenoids compared to milling into samp. The highest retention of provitamin A carotenoids was observed in cooked phutu and cooked samp, whilst cooking into thin porridge resulted in the lowest retention of provitamin A carotenoids. In phutu, 96.6 ± 20.3% ß-cryptoxanthin and 95.5 ± 13.6% of the ß-carotene were retained after cooking. In samp, 91.9 ± 12.0% ß-cryptoxanthin and 100.1 ± 8.8% ß-carotene; and in thin porridge, 65.8 ± 4.6% ß-cryptoxanthin and 74.7 ± 3.0% ß-carotene were retained after cooking. This study demonstrates that provitamin A retention in maize is affected by the cooking method (and hence cooked food form) and therefore cooking methods that result in a good retention of provitamin A need to be identified and recommended.