Feeding practices of caregivers with children attending early childhood development centres in Xhariep, South Africa.

Background: In low- to middle-income countries, malnutrition is a major contributing factor in children failing to achieve their developmental potential. The prevention of malnutrition requires, among others, nutritious, diverse and safe foods in early childhood. Aim: The study aimed to determine primary caregivers' choices and motivation for the foods they fed their children. Setting: The study was conducted among early childhood development centres in the Xhariep District, Free State. Methods: A qualitative study was undertaken. Twelve participants who met the inclusion criteria were conveniently sampled. Semi-structured interviews were conducted to find out the primary caregivers' choices and motivation for foods they fed their children until data saturation was reached. Results: The mean age of the participants was 31 years. Nine of the participants relied on social grants as a source of income. The participants reported feeding their children mainly maize porridge, milk, juice, and water. Vegetables and meat were fed to the children once a week. Fruits were fed to the children at the beginning of the month. Conclusion: The level of education, employment status, and community support influenced the primary caregivers' feeding practices. The content of the diets of their children was insufficient in vegetables and fruit, not only placing the children at risk of undernutrition but also at risk of obesity and micronutrient deficiencies. Primary caregivers ensured their children were fed, although limited foods were offered. Contribution: This research creates awareness of the level of social progress and access to resources within rural communities in the Xhariep district, and gives the opportunity to extend this research to confirm these findings in other poverty-stricken areas.

Anaemia prevalence and dietary diversity among women in the rural Free State, South Africa.

BACKGROUND: Anaemia, a global public health problem that particularly affects women, holds major consequences for human health. AIM: Determining dietary diversity, prevalence of anaemia and contraception use. SETTING: Rural women, 25-49 years, in the Free State Province, South Africa. METHODS: In a cross-sectional descriptive quantitative study, dietary diversity was determined with a 24-h recall; biochemical markers of anaemia, iron deficiency and inflammation were measured; and contraceptive use was recorded. RESULTS: Of 134 women (median age 41 years), 51.5% had medium, and 44.8% had low dietary diversity. Overall, 76.9% consumed flesh meats and fish, but only 25.4% ate dark green leafy vegetables. Anaemia was present in 4.6%; 1.5% presented with iron deficiency; and 0.7% presented with iron deficiency anaemia, evidenced by low ferritin levels. However, 45.0% had elevated C-reactive protein (CRP). Overall, 7.5% presented with elevated homocysteine levels, but only 3.8% had low red cell folate levels. More than half (54.1%) reported menstruating regularly and 71.6% used injectable contraceptives. Significant associations were found between median mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) and dietary diversity score. CONCLUSIONS: Although the prevalence of anaemia is low in this population, elevated CRP in almost half indicates that inflammation may mask iron deficiency. The older median age of the sample and approximately half of the women not menstruating regularly may also contribute to the low anaemia prevalence. Attention should be given to the women's diets as almost half consume diets of low diversity, and not all consume foods rich in haemopoietic nutrients.

Vitamin D status, hypertension and body mass index in an urban black community in Mangaung, South Africa.

BACKGROUND: A strong relationship exists between hypertension and body weight. Research has linked both higher blood pressure and body weight with lower vitamin D status. OBJECTIVE: This study assessed the vitamin D status of a low-income, urban, black community in South Africa, to examine whether serum levels of 25-hydroxy vitamin D [25(OH)D] are associated with hypertension and body mass index (BMI). METHODS: Data collected from 339 adults (25-64 years) from the Assuring Health for All in the Free State (AHA-FS) study were analysed. Variables measured include serum 25(OH)D, blood pressure, weight and height to determine BMI, and HIV status. RESULTS: Mean 25(OH)D level was 38.4 ± 11.2 ng/mL for the group; 43.5 ± 11.8 ng/mL and 37.0 ± 10.6 ng/mL for males and females, respectively. Approximately 40% of the participants were HIV-positive and 63.4% hypertensive. Based on BMI, 11.8% were underweight, 33.0% normal weight, 23.0% overweight and 32.1% obese. HIV status showed no correlation with 25(OH)D levels when controlling for BMI. Poor inverse relationships were found between BMI and 25(OH)D (p = 0.01), and between mean arterial blood pressure and 25(OH)D (p = 0.05). When controlling for BMI, no correlation was found between 25(OH)D and the prevalence of hypertension or mean arterial blood pressure. CONCLUSION: Approximately 96% of participants had an adequate vitamin D status, which could be attributed to latitude, sunny conditions and expected high levels of sun exposure because of living conditions. Results confirmed a poor inverse relationship between vitamin D status and hypertension, which seems to be dependent on BMI.

Body adiposity indices are associated with hypertension in a black, urban Free State community.

BACKGROUND: Non-communicable diseases, including hypertension, are increasing rapidly in resource-poor, developing countries amongst populations transitioning from traditional to westernised lifestyles; and are associated with excess weight. AIM: To investigate the relationship between hypertension and various indices of body adiposity in a transitioning, urban, black population. SETTING: Three hundred and thirty-nine adults (25-64 years) from a larger cross-sectional study (Assuring Health for All in the Free State) conducted in Mangaung, South Africa, were included. METHODS: Standard techniques were used to determine blood pressure, HIV status, body mass index (BMI), waist-to-height ratio (WHtR) and body adiposity index (BAI). RESULTS: Approximately 40% of the sample was HIV-positive and 63.4% hypertensive, with the greatest risk of hypertension being amongst older men. Based on BMI, 23.0% were overweight and 32.1% obese. Waist-to-height ratio showed that 58.6% had increased cardiovascular risk. Mean BAI was 34.1%, whilst 76.3% had a body fat percentage in the overweight/obese category. Waist circumference representing increased cardiovascular risk was found in 44.3% of women and 3.9% of men. Significant positive correlations between mean arterial bloodpressure and BMI (r = 0.261; p < 0.001), WHtR (r = 0.357; p < 0.001) and BAI (r = 0.245; p <0.001) were found. WHtR was a stronger predictor of mean arterial pressure than BMI or BAI. HIV status showed an inverse correlation with all adiposity indices (p < 0.001). CONCLUSION: Our findings promote WHtR as a practical screening tool for increased hypertension risk in populations undergoing westernisation, and support weight loss as afirst-line intervention for the prevention and management of hypertension.

Body mass index of 16-year olds in urban Maseru, Lesotho.

BACKGROUND: Overweight and/or obesity amongst children and adolescents is a global epidemic with health consequences that track into adulthood. No data are currently available regarding overweight/obesity amongst adolescents in Lesotho.Aim and setting: To assess the prevalence of overweight and/or obesity and the associated risk factors amongst 16-year olds in urban Maseru, Lesotho. METHOD: A cross-sectional descriptive study was conducted on a systematic sample of 16-year olds ingrade four (N = 221; 56.6% girls) from randomly-selected schools in urban Maseru. Diet histories and data on lifestyle, physical activity and knowledge, attitudes and/or perceptions and practices regarding nutrition were obtained during structured interviews and body mass index (BMI) was determined. RESULTS: Amongst these 16-year olds, 27.2% girls and 8.3% boys were overweight and/or obese based on World Health Organization cut-offs for BMI; 39.8% were insufficiently active or inactive;6.4% used alcohol regularly; and 11.7% used tobacco. Whilst 28.1% reported no television watching/electronic gaming/computer usage (combined screen time) outside school, 23.6% reported ≥ 4 hours of combined screen time outside school. Most (91.4%) consumed < 3 servings of vegetables/day; 86.4% consumed < 2 servings of fruits/day; and 95.5% consumed < 2 servings of dairy/day. The majority consumed maize porridge (56.1%), bread (63.8%) and margarine/oil/fat (82.3%) daily and added sugar to their food (74.2%). Fruits, vegetables, dairy, meat, pulses and traditional foods were only consumed weekly or less often. Most bought from tuck shops (18.6% daily; 54.3% weekly). Various gaps in knowledge, perceptions and practices were identified that may benefit from educational intervention. CONCLUSIONS: The current study identifies westernised dietary and lifestyle changes, along with overweight and/or obesity, amongst 16-year old adolescents in Lesotho.