Browsing by Author "Swart, Elizabeth Catherina"
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Item The association between dietary consumption, anthropometric measures and body composition of rural and urban Ghanaian adults: A comparative cross-sectional study(Springer Nature, 2020) Agyapong, Nana Ama Frimpomaa; Annan, Reginald Adjetey; Swart, Elizabeth CatherinaOverweight and obesity have become threats to public health in all regions across the globe including sub-Saharan Africa where prevalence used to be low. Policies to regulate the food environment and promote healthy food consumption look promising to reducing the prevalence of obesity but in Ghana there is not enough data to elicit a policy response. This study assessed the association between dietary consumption, anthropometric measures, body composition and physical activity among rural and urban Ghanaian adults.Item Dietary intake of low-income adults in South Africa: Ultra-processed food consumption a cause for concern(Cambridge University Press, 2024) Frank, Tamryn; Swart, Elizabeth Catherina; Ng, Shu WenObjective: Given the rapidly changing food environment and proliferation of ultra-processed foods (UPF) in South Africa (SA), this study aimed to critically evaluate dietary quality and adequacy of low-income adults using the nova classification system and WHO and world cancer research fund dietary guidelines. Design: Secondary household data and 1-d 24-h recalls were analysed from two cross-sectional studies conducted in 2017-2018. Foods consumed were classified according to the nova classification system. Compliance with WHO dietary guidelines and UPF consumption trends were evaluated. Setting: Three low-income areas (Langa, Khayalitsha and Mount Frere) in SA were included. Participants: In total, 2521 participants (18-50 years) were included in the study. Results: Participants had a mean energy intake of 7762 kJ/d. Most participants were within the acceptable WHO guideline range for saturated fat (80·4 %), total fat (68·1 %), Na (72·7 %) and free sugar (57·3 %). UPF comprised 39·4 % of diets among the average adult participant. Only 7·0 % of all participants met the WHO guideline for fruit and vegetables and 18·8 % met the guideline for fibre. Those within the highest quartile of share of energy from UPF consumed statistically higher amounts of dietary components to limit and were the highest energy consumers overall. Conclusions: Low-income adults living in SA are consuming insufficient protective dietary components, while UPF consumption is prevalent. Higher UPF consumers consume larger amounts of nutrients linked to increased chronic disease risk. Policy measures are urgently needed in SA to protect against the proliferation of harmful UPF and to promote and enable consumption of whole and less UPF.Item The effects of internal migration and related factors on nutrient intake and anthropometric status of children aged 1-9 years in South Africa, 1999(University of the Western Cape, 2004) Swart, Elizabeth Catherina; Jackson, Debra; Shel, Robert; School of Public Health; Faculty of Community and Health SciencesThe purpose of this study was to provide a national overview on internal migration of children and to relate these migration patterns to the nutritional status of children. This study specifically investigated the internal migration that took place during the life span of the National Food Consumption Survey study population and relates that to their dietary intake and anthropometric status.Item Exploring the knowledge, attitudes, perceptions and practices of teachers around obesity and nutrition related non-communicable diseases(University of the Western Cape, 2018) Mbangani, Roselyn; Swart, Elizabeth Catherina; Wilkenson, JillIntroduction: Non-communicable diseases (NCDs) are among the leading causes of premature death in South Africa. As is the case with many countries in transition, in South Africa the burden of pre-NCDs such as overweight and obesity is increasing. The aim of this mixed method study was to gain an understanding on the knowledge, attitudes, practices and perceptions and related factors of primary and secondary school teachers in Limpopo Province of South Africa regarding nutrition related non-communicable diseases (NR-NCDs). Methodology: A mixed method approach, parallel convergent study design was used to collect both qualitative and quantitative data from a group of randomly selected public school teachers in Rakwadu Circuit, Limpopo, with due consideration of the ethical issues involved. For the quantitative inquiry, a previously validated structured questionnaire was adapted to collect data from 114 teachers, while 2 Focus Group Discussions (FGDs) were conducted by the researcher to collect the qualitative data. Information collected included teachers‟ dietary practices, physical activity levels and their knowledge, attitudes and perceptions towards nutrition related non-communicable diseases. Each of these variables had a number of questions which were scored and a mean score for each participant was obtained. Anthropometric measurements collected included Body Mass Index (BMI) and waist circumference (WC).Item Food acquisition and consumption by NOVA food classification and lived poverty index among rural and urban households in South Africa and Ghana(Cambridge University Press, 2024) Agyapong, Nana Ama Frimpomaa; Kroll, Florian; Swart, Elizabeth Catherina; Swart, Elizabeth CatherinaObjective: This study aims to determine differences in food consumption by the NOVA food categories in South Africa and Ghana and how they relate to poverty and food supply systems. Design: This study used a cross-sectional design to assess household food acquisition and lived poverty index. Setting: The study was conducted in Khayelitsha and Mount Frere, urban and rural communities in South Africa, respectively, and Ahodwo and Ejuratia, urban and rural communities in Ghana, respectively. Participant: An adult in charge of or knowledgeable about household food acquisition and consumption was selected to participate in the study. Results: A total of 1299 households participated in the study. Supermarkets were a prominent source of ultra-processed foods for households in South Africa, while informal outlets were an important source of ultra-processed foods in Ghana. Consumption of unprocessed foods was higher among South African households (58.2%) than Ghanaian households (41.8%). In South Africa, deprivation was associated with increased odds of infrequent consumption of both unprocessed foods (OR 3.431 p<0.001) and ultra-processed foods (OR 2.656 p<0.001) compared to non-deprivation. In Ghana, no significant associations were observed between household deprivation and consumption of the NOVA food classes. Conclusion: Different food supply systems and poverty are associated with household acquisition of the different NOVA food classes. Policies should be geared towards formal shops in South Africa and informal shops in Ghana to reduce the consumption of key obesogenic foods.Item Food insecurity among university students in the Western Cape(University of the Western Cape, 2023) Tlhako, Morongoa Glenda; Swart, Elizabeth CatherinaFood insecurity is a significant public health concern on a global scale which significantly remains a contributor to many nutritional, health and developmental challenges. The aim of the study was to investigate food insecurity and the factors associated with it among registered university students at a public university in the Western Cape Province. A descriptive cross-sectional online survey design was used to assess food insecurity status, and the factors associated with it among students at the University of the Western Cape. A quantitative research approach was used. All students registered at the University of the Western Cape were invited to complete a self-administered, web-based questionnaire. The questionnaire that was used was adapted from a previous study conducted by the supervisor at UWC in 2017. The adaptations have been based on literature and also referred to the impact of the COVID-19 pandemic which resulted in major disruptions of universities given the declaration of a State of Emergency and associated national lockdown periods which commenced on 27 March 2020. The questionnaire was piloted among the students registered for the MPHN at UWC. Participants for the study were recruited on the university platforms used to communicate with students after permission was obtained from the Registrar. Marketing endeavours such as Facebook and twitter accounts were also used to promote the completion of the survey and improve participation rates.Item Mapping Obesogenic food environments in South Africa and Ghana: Correlations and contradictions(MPDI, 2019) Krol, Florian; Swart, Elizabeth Catherina; Annan, Reginald Adjetey; Thow, Anne Marie; Neves, David; Apprey, Charles; Aduku, Linda Nana Esi; Agyapong, Nana Ama Frimpomaa; Moubarac, Jean-Claude; du Toit, Andries; Aidoo, Robert; Sanders, DavidIn sub-Saharan Africa, urbanisation and food systems change contribute to rapid dietary transitions promoting obesity. It is unclear to what extent these changes are mediated by neighbourhood food environments or other factors. This paper correlates neighbourhood food provision with household consumption and poverty in Khayelitsha, South Africa and Ahodwo, Ghana. Georeferenced survey data of food consumption and provision were classified by obesity risk and protection. Outlets were mapped, and density and distribution correlated with risk classesItem Mapping obesogenic food environments in South Africa and Ghana: Correlations and contradictions(MPDI, 2019) Kroll, Florian; Swart, Elizabeth Catherina; Annan, Reginald AdjeteyIn sub-Saharan Africa, urbanisation and food systems change contribute to rapid dietary transitions promoting obesity. It is unclear to what extent these changes are mediated by neighbourhood food environments or other factors. This paper correlates neighbourhood food provision with household consumption and poverty in Khayelitsha, South Africa and Ahodwo, Ghana. Georeferenced survey data of food consumption and provision were classified by obesity risk and protection. Outlets were mapped, and density and distribution correlated with risk classes. In Khayelitsha, 71% of households exceeded dietary obesity risk thresholds while 16% consumed protective diets. Obesogenic profiles were less (26%) and protective more prevalent (23%) in Ahodwo despite greater income poverty in Khayelitsha. Here, income-deprived households consumed significantly (p < 0.005) less obesogenic and protective diets. Small informal food outlets dominated numerically but supermarkets were key household food sources in Khayelitsha. Although density of food provision in Ahodwo was higher (76/km2), Khayelitsha outlets (61/km2) provided greater access to obesogenic (57% Khayelitsha; 39% Ahodwo) and protective (43% Khayelitsha; 16% Ahodwo) foods. Consumption and provision profiles correlate more strongly in Ahodwo than Khayelitsha (rKhayelitsha = 0.624; rAhodwo = 0.862). Higher obesogenic food consumption in Khayelitsha suggests that risky food environments and poverty together promote obesogenic diets.Item Scoping review protocol exploring the relationship between food insecurity, mental health and diet intake among adolescents across the globe(BMJ, 2023) Nkwanyana, Akhona; Florence, Maria; Swart, Elizabeth CatherinaIntroduction Studies, exploring the effect of food insecurity on physical and mental health, have shown that food insecurity is associated with lower self-reports of physical and mental health. With the COVID-19 pandemic, food insecurity has increased leading to higher risks of poor mental health. Despite evidence of the negative implications of food insecurity on mental health, there is a paucity of research on these variables for adolescents specifically. The current evidence shows there is a gap in adolescent centred research linking mental health and food insecurity globally. Adolescence is a crucial period of development where habits, nutritional inadequacies linked to food insecurity and mental health problems formed due to these inadequacies can be conveyed into adulthood. The aim of this study is to systematically scope the literature exploring the relationship between mental health, food (in)security and/or diet intake of adolescents. Methods This review will be guided by Arksey and O'Malley's extended framework. The search strategy was developed by two of the authors and will be used to search literature from January 2012 to December 2022 in PubMed, Academic search complete, PsychARTICLES, Google, ScienceDirect, Scopus and Web of science core collection. Searching published and unpublished literature will be done in the chosen databases. References used in included literature will be reviewed for additional studies/sources. Articles will be assessed for eligibility by two reviewers, and any discrepancies reviewed by a third reviewer. The inclusion and exclusion criteria will be used for screening. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram will be used to document the selection process. A narrative summary and descriptive analysis will be used to summarise and report the extracted data. Ethics and dissemination Approval for this study has been granted by the University of the Western Cape Biomedical Research Ethics Committee (BM21/8/3). Strict measures will be followed to ensure methodological rigour.Item Scoping review protocol exploring the relationship between food insecurity, mental health and diet intake among adolescents across the globe(BMJ Publishing Group, 2023) Nkwanyana, Akhona; Florence, Maria; Swart, Elizabeth CatherinaStudies, exploring the effect of food insecurity on physical and mental health, have shown that food insecurity is associated with lower self-reports of physical and mental health. With the COVID-19 pandemic, food insecurity has increased leading to higher risks of poor mental health. Despite evidence of the negative implications of food insecurity on mental health, there is a paucity of research on these variables for adolescents specifically. The current evidence shows there is a gap in adolescent centred research linking mental health and food insecurity globally. Adolescence is a crucial period of development where habits, nutritional inadequacies linked to food insecurity and mental health problems formed due to these inadequacies can be conveyed into adulthood. The aim of this study is to systematically scope the literature exploring the relationship between mental health, food (in) security and/or diet intake of adolescentsItem Use of social media platforms by manufacturers to market breast-milk substitutes in South Africa(BMJ Publishing Group, 2020) Pereira-Kotze, Catherine; Doherty, Tanya M.; Swart, Elizabeth CatherinaIn South Africa (SA), exclusive breast feeding remains rare, with breast-milk substitutes (BMS) commonly being used in ways that are detrimental to infant and young child nutrition, health and survival. The use of internet, digital and mobile platforms has increased, including in low-income and middle-income countries, like SA and these platforms are avenues for BMS marketing. SA has national legislation (Regulation R991) to enforce the International Code of Marketing of BMS. This paper aims to provide pertinent examples of how BMS manufacturers in SA use social media to market their products thus violating national regulations. A digital (and social media) ethnography approach was used to study BMS organisations' activity on Facebook and Instagram.