Research Articles (Human Ecology and Dietetics)
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Item The association between household socio-economic status, maternal socio-demographic characteristics and adverse birth and infant growth outcomes in sub-Saharan Africa: A systematic review(Cambridge University Press, 2020) Saïd-Mohamed, Rihlat; Ngandu, Christian Bwangandu; Momberg, Douglas J.Adverse birth outcomes and infant undernutrition remain the leading causes of morbidity and mortality in sub-Saharan Africa (SSA). Impaired infant growth and development, which often begins during foetal development, may persist during the first 2 years of life and has been associated with higher risks of cardiometabolic diseases. This systematic review assessed the associations between maternal demographic characteristics and household socio-economic status (SES), and preterm birth (PTB), small for gestational age, low birth weight (LBW), stunting, wasting and underweight in children under 2 years of age in SSA countries. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched for publications in three electronic databases (PubMed, Scopus and ScienceDirect). Eleven studies on children under 2 years of age, in four SSA regions, published in English between 1990 and 2018, were included.Item The association between the body mass index of first-year female university students and their weight-related perceptions and practices, psychological health, physical activity and other physical health indicators(Cambridge University Press, 2006) Cilliers, Janetta; Senekal, Marjanne; Kunneke, ErnestaTo investigate the association between the weight status of first-year female students (FYFS) and various weight management-related characteristics to identify possible components of a weight management programme for students. Mean (^standard deviation (SD)) body mass index (BMI) of the FYFS was 21.8 ^ 2.6 kg m22 , with 7.2% being underweight, 81.9% normal-weight, 10.0% overweight and 0.8% obese. Underweight, normal-weight and overweight students differed with regard to their perception of their weight (P , 0.001), weight goals (P , 0.001) and previous weight-loss practices (P , 0.001). Mean ^ SD score on the 26-item Eating Attitudes Test (EAT-26) was 8.5 ^ 9.0 with 8.4% classified as high scorers. Mean ^ SD score on the 34-item Body Shape Questionnaire (BSQ) was 87.7 ^ 32.2, with 76.1% classified as low, 11.9% as medium and 11.9% as high scorers. The self-concept questionnaire indicated that 36.7% had a high, 43.9% a medium and 19.4% a low self-concept. Higher BMI correlated with a higher BSQ score (P , 0.001), a lower self-concept (P ¼ 0.029) and a higher EAT-26 score (P , 0.001). Smoking was prevalent amongst 13.1% of students, and 51.2% used vitamin and/or mineral supplements. Students who quitted smoking had higher (P ¼ 0.006) BMI (22.7 ^ 2.9 kg m22 ) than those who never smoked before (21.6 ^ 2.5 kg m22 ).Item The benefits of informed non-dissent when families have difficulty making a decision(Université de Montréal, 2022) Nortje, Mila; Haque, Sajid; Nortje, NicoBeing a surrogate decision-maker is challenging for many people and having to decide to withdraw life sustaining therapies can be extremely difficult. Helping surrogates to refocus their decisions on informed non-dissent can greatly minimize unnecessary suffering for all involved. This case study describes how dignitary harm was minimized by using the concept of informed non-dissent.Item Challenges experienced while providing home based care: A community organisation's experience(University of the Western Cape, 2012) Erasmus, Charlene; Ramuhaheli, R. M.Introduction: Methods: Results: Conclusion: Keywords: The large and ever-growing number of people being infected with HIV/AIDS, led to health professionals being unable to cope with these increasing numbers. To combat this challenge, an alternative strategy such as home based care needed to be implemented. When attempting to attend to this need, a deeper understanding of the challenges facing community organizations when providing home based care is necessary in order to formulate these effective and relevant care services. The aim of the study was to explore the challenges faced by Umtha Welanga Community Organization in the provision of HIV/AIDS home based care. Acase study using a qualitative approach with in-depth interviews as the data collectionmethod was used. The Umtha Welanga Community Organization constituted the total population therefore no sampling was applied. All themembers of the management team and all the home-based caregivers were interviewed. Informed consent as well as consent for recording interview was obtained prior to data collection. Respondents were informed that participation is voluntary and that they can withdrew at any time. Data analysis began immediately after completion of all the interviews by transcribing and translating the audio-taped data. Thematic analysis was used in which data was coded and categorized. The main areas of concern were gender inequality, insufficient funding, lack of disclosure and trust, risk faced by caregivers and lack of recognition Finances appear to be, both for the organization and the home based carers, a specifically influential obstacle in the implementation and maintenance of the services. Lack of recognition by the government and lack of trust and disclosure towards care workers; create difficult conditions for them to perform their tasks and duties. Care services also present risks and dangers to caregivers such as being susceptible to criminal activity, feeling unsafe and vulnerable.Item Conceptualising COVID-19’s impacts on household food security(Springer Nature, 2020) Devereux, Stephen; Béné, Christophe; Hoddinott, JohnCOVID-19 undermines food security both directly, by disrupting food systems, and indirectly, through the impacts of lockdowns on household incomes and physical access to food. COVID-19 and responses to the pandemic could undermine food production, processing and marketing, but the most concerning impacts are on the demand-side – economic and physical access to food. This paper identifies three complementary frameworks that can contribute to understanding these effects, which are expected to persist into the post-pandemic phase, after lockdowns are lifted. FAO’s ‘four pillars’– availability, access, stability and utilisation – and the ‘food systems’ approach both provide holistic frameworks for analysing food security. Sen’s ‘entitlement’ approach is useful for disaggregating demand-side effects on household production-, labour-, trade- and transfer-based entitlements to food. Drawing on the strengths of each of these frameworks can enhance the understanding of the pandemic’s impacts on food security, while also pinpointing areas for governments and other actors to intervene in the food system, to protect the food security of households left vulnerable by COVID-19 and public responses.Item COVID-19 food security(José Frantz, 2021) May, JulianIt’s not as if South Africa started 2020 on the right foot. The latest available numbers suggest that about 11% of the country’s population (or around 6.5-million people) suffer from hunger every year. We should not lose sight of the impact of unemployment on men – hunger can be said to breed social discontent and instability. But it’s now widely accepted that it is women who bear the brunt of crises. Not only does the gender wage gap persist, but women also shoulder the overwhelming share of the caring responsibility in households. If they are without work, it’s likely that others – children included – will suffer, too.Item Decent employment and the future of agriculture. How dominant narratives prevent addressing structural issues(Frontiers Media, 2022) Losch, BrunoDecent employment in agriculture is part of the general narrative about working conditions. It is an unquestionable objective but its position high in the international agenda contributes to sideline major structural issues faced by many agricultures around the world. This is particularly the case in sub-Saharan Africa and Asia, which represent about 90% of global agricultural workers, and where agriculture still plays a major role in employment and the economy. Different trajectories of structural transformation and rates of demographic growth result in different employment challenges which are central for possible improvement of work conditions in agriculture.Item Dietary diversity and its association with nutritional status, cardiometabolic risk factors and food choices of adults at risk for type 2 diabetes mellitus in Cape Town, South Africa(MDPI, 2022) Madlala, Samukelisiwe S.; Hill, Jillian; Kunneke, ErnestaIn South Africa, the nutrition transition has led to unhealthy diets lacking variety, contributing to the rise in overweight, obesity and diet-related noncommunicable diseases. Using baseline screening data of the South African Diabetes Prevention Programme (SA-DPP) study, this study aims to determine the relationship of dietary diversity (DD) with nutritional status, cardiometabolic risk factors and food choices of adults at risk of type 2 diabetes in resource-poor communities around Cape Town. Data of 693 adults, 25–65 years old were analysed. This included socio-demographic information, anthropometric measurements, biochemical assessments, food groups consumed the previous day and consumption frequency of certain foods to reflect food choices.Item Dietary fat intake and red blood cell fatty acid composition of children and women from three different geographical areas in South Africa(Elsevier, 2016) Ford, Rosalyn; Faber, Mieke; Kunneke, Ernesta; Smuts, Cornelius M.Dietary fat intake, particularly the type of fat, is reflected in the red blood cell (RBC) fatty acid (FA) profile and is vital in growth, development and health maintenance. The FA profile (%wt/wt) of RBC membrane phospholipids (as determined by gas chromatography) and dietary intake (as determined by 24 h recall) was assessed in 2–6 y old South African children and their caregivers randomly selected from three communities, i.e. an urban Northern Cape community (urban-NC; n = 104), an urban coastal Western Cape community (urban-WC; n = 93) and a rural Limpopo Province community (rural-LP; n = 102). Mean RBC FA values across groups were compared using ANOVA and Bonferroni post-hoc test while controlling for age and gender (children); median dietary intake values were compared using a Kruskal–Wallis test. Dietary intakes for total fat, saturated FAs and polyunsaturated FAs were higher in the two urban areas compared to the rural area. Total fat intake in rural-LP, and omega-3 FA dietary intake in all three areas were lower than the South African adopted guidelines. Dietary SFA intake in both urban areas was higher than recommended by South African guidelines; this was reflected in the RBC membrane FA profile. Rural-LP children had the lowest intake of omega-3 and omega-6 FAs yet presented with the highest RBC docosahexaenoic acid (DHA) profile and highest arachidonic acid percentage. Although differences observed in dietary fat intake between the two urban and the rural area were reflected in the RBC membrane total phospholipid FA profile, the lowest total fat and α-linolenic acid (ALA) intake by rural children that presented with the highest RBC DHA profile warrants further investigation.Item Dietary patterns and colorectal cancer risk in Zimbabwe: A population based case-control study(Elsevier, 2018) Katsidzira, Leolin; Laubscher, Ria; Gangaidzo, Innocent T.; Swart, Rina; Makunike-Mutasa, Rudo; Manyanga, Tadios; Thomson, Sandie; Ramesar, Raj; Matenga, Jonathan A.; Rusakaniko, SimbarasheBACKGROUND: The rising incidence of colorectal cancer in sub-Saharan Africa may be partly caused by changing dietary patterns. We sought to establish the association between dietary patterns and colorectal cancer in Zimbabwe. METHODS: One hundred colorectal cancer cases and 200 community-based controls were recruited. Data were collected using a food frequency questionnaire, and dietary patterns derived by principal component analysis. Generalised linear and logistic regression models were used to assess the associations between dietary patterns, participant characteristics and colorectal cancer. RESULTS: Three main dietary patterns were identified: traditional African, urbanised and processed food. The traditional African diet appeared protective against colorectal cancer (Odds Ratio (OR) 0.35; 95% Confidence Interval (CI), 0.21 – 0.58), which had no association with the urban (OR 0.68; 95% CI, 0.43–1.08), or processed food (OR 0.91; 0.58–1.41) patterns. The traditional African diet was associated with rural domicile, (OR 1.26; 95% CI, 1.00–1.59), and a low income (OR1.48; 95% CI, 1.06–2.08). The urbanised diet was associated with urban domicile (OR 1.70; 95% CI, 1.38–2.10), secondary (OR 1.30; 95% CI, 1.07–1.59) or tertiary education (OR 1.48; 95% CI, 1.11–1.97), and monthly incomes of $201–500 (OR 1.30; 95% CI, 1.05–1.62), and the processed food pattern with tertiary education (OR 1.42; 95% CI, 1.05–1.92), and income > $1000/month (OR 1.48; 95% CI, 1.02–2.15). CONCLUSION: A shift away from protective, traditional African dietary patterns may partly explain the rising incidence of colorectal cancer in sub-Saharan Africa.Item Effect of different front-of-package food labels on identification of unhealthy products and intention to purchase the products– A randomised controlled trial in South Africa(Elsevier, 2022) Bopape, Makoma; Murukutla, Nandita; Wen Ng, ShuThis study aimed to evaluate the effect of different labels on participants identifying products high in nutrients of concern; identifying unhealthy products, and intention to purchase unhealthy products. This blinded randomised controlled trial included a representative sample of South African households (n = 1951). Per household we selected a member primarily responsible for food purchases. Participants were randomised into the Warning Label (WL), Guideline Dietary Amounts (GDA) or Multiple Traffic Light (MTL) arms. Each participant answered questions in a no label condition (control) followed by same questions in the label condition (experiment). Complete data were collected and analysed for 1948 participants (WL = 33.7%, GDA = 32.1% and MTL = 34.2%). The probability of correctly identifying products high in nutrients of concern and identifying products as being unhealthy was higher with the WL compared to the GDA or MTL for most items. There was no difference in performance between the GDA and the MTL when considering all items together. A higher percentage of participants reported a lower intention to purchase an unhealthy product after exposure to the WL compared to MTL for 5 out of 6 products; 2 out of 6 products for the WL compared to GDA and 2 out of 6 products for GDA compared to MTL. Compared to the control condition, exposure to each of the labels resulted in better identification of nutrients of concern, unhealthy products and a lower intention to purchase when considering all specific outcome items together. The WL showed a higher potential to enable South African consumers to identify products high in nutrients of concern, identify unhealthy products and discourage purchasing of unhealthy products.Item Effect of pomegranate (Punica granatum L) peel powder meal dietary supplementation on antioxidant status and quality of breast meat in broilers(Elsevier, 2020) Akuru, Eunice A.; Oyeagu, Chika E.; Mpendulo, Thando C.; Rautenbach, Fanie; Oguntibeju, Oluwafemi O.This study examined the antioxidant status and quality of breast meat in broiler birds fed diets supplemented with pomegranate peel powder meal (PPPM). During the 35-d feeding trial, broiler birds were fed six experimental diets: diet with 0% additives (negative control; NEGCON); diet with α-Tocopherol acetate at 200 g/tonne (positive control; POSCON); and four levels (2, 4, 6 and 8 g/kg) of PPPM, designated as PPPM2, PPPM4, PPPM6, and PPPM8. Breast muscle pH was determined 15mins and 24hrs postmortem. The breast muscles were then stored at 4 °C to determine shelf-life attributes (pH, colour, hue angle, and chroma) for 16 days. Meat from the 8 g/kg PPPM had the highest thawing loss, whereas cooking loss was lowest at 2 g/kg PPPM inclusion. The meat of birds fed 2 g/kg and 4 g/kg PPPM had the highest (P<0.05) ability to scavenge the ABTS [(2, 2-azinobis (3ethylbenzothiazoline-6 sulfonic acid))] radical cation (ABTS+), whereas, catalase activity was increased at 8 g/kg PPPM. The results obtained in this study indicate that 2 g/kg supplementation of pomegranate peel powder meal significantly improved the water-binding capacity of broiler breast meat, owing to the reduced cooking loss of the meat, and meat from the PPPM2 (2 g/kg) group had the highest ability to scavenge ABTS.Item Ethical misconduct by registered physiotherapists in South Africa (2007– 2013): A mixed methods approach(PubMed, 2015) Nortje, Nico; Hoffmann, Willem ABackground: The role of ethics in a medical context is to protect the interests of patients. Thus, it is critically important to understand the guilty verdicts related to professional standard breaches and ethics misconduct of physiotherapists. Aim: To analyse the case content and penalties of all guilty verdicts related to ethics misconduct against registered physiotherapists in South Africa. Methods: A mixed methods approach was followed consisting of epidemiological data analysis and qualitative content analysis. The data documents were formal annual lists (2007–2013) of guilty verdicts related to ethical misconduct. Quantitative data analysis focused on annual frequencies of guilty verdicts, transgression categories and the imposed penalties. Qualitative data analysis focused on content analysis of the case content for each guilty verdict. Results: Relatively few physiotherapists (0.05%) are annually found guilty of ethical misconduct. The two most frequent penalties were fines of R5000.00 and fines of R8000.00 – R10 000.00. The majority of transgressions involved fraudulent conduct (70.3%), followed by performance of procedures without patient consent (10.8%). Fraudulent conduct involved issuing misleading, inaccurate or false medical statements, and false or inaccurate medical aid scheme claims.Item Exploring the affordances of e-learning technologies for dietetics education and training(South African Medical Association, 2019) Wilkenson, JillLecturers in health science education programmes wear many hats. Their undergraduate training prepares them to deliver healthcare services as clinicians. They may enter academia as clinical educators and then advance to become classroom-based teachers. It is frequently assumed that they are equipped to fulfil the role of teacher. This was certainly the route that I followed. As a digital immigrant, my standard teaching tools were lectures supported by text-laden PowerPoint presentations. The realisation dawned that this approach was failing to meet the expectations of digital-age students – it not only favoured student passivity, but was also a missed opportunity to demonstrate responsible use of technology for communicating information to colleagues and clients in the workplace.Item Feature Reduction for the Classification of Bruise Damage to Apple Fruit Using a Contactless FT-NIR Spectroscopy with Machine Learning(MDPI, 202) Isingizwe, F; Hussein, E; Vaccari, M; Umezuruike, LSpectroscopy data are useful for modelling biological systems such as predicting quality parameters of horticultural products. However, using the wide spectrum of wavelengths is not practical in a production setting. Such data are of high dimensional nature and they tend to result in complex models that are not easily understood. Furthermore, collinearity between different wavelengths dictates that some of the data variables are redundant and may even contribute noise. The use of variable selection methods is one efficient way to obtain an optimal model, andthis was the aim of this work. Taking advantage of a non-contact spectrometer, near infrared spectral data in the range of 800–2500 nm were used to classify bruise damage in three apple cultivars, namely ‘Golden Delicious’, ‘Granny Smith’ and ‘Royal Gala’. Six prominent machine learning classification algorithms were employed, and two variable selection methods were used to determine the most relevant wavelengths for the problem of distinguishing between bruised and non-bruised fruit. The selected wavelengths clustered around 900 nm, 1300 nm, 1500 nm and 1900 nm. The best results were achieved using linear regression and support vector machine based on up to 40 wavelengths: these methods reached precision values in the range of 0.79–0.86, which were all comparable (within error bars) to a classifier based on the entire range of frequencies. The results also provided an open-source based framework that is useful towards the development of multi-spectral applications such as rapid grading of apples based on mechanical damage, and it can also be emulated and applied for other types of defects on fresh produce.Item Food insecurity and dietary deprivation: Migrant households in Nairobi, Kenya(MDPI, 2023) Onyango, Elizabeth Opiyo; Crush, Jonathan S.; Owuor, SamuelThe current study focuses on food consumption and dietary diversity among internal migrant households in Kenya using data from a city-wide household survey of Nairobi conducted in 2018. The paper examined whether migrant households are more likely to experience inferior diets, low dietary diversity, and increased dietary deprivation than their local counterparts. Second, it assesses whether some migrant households experience greater dietary deprivation than others. Third, it analyses whether rural-urban links play a role in boosting dietary diversity among migrant households. Length of stay in the city, the strength of rural-urban links, and food transfers do not show a significant relationship with greater dietary diversity. Better predictors of whether a household is able to escape dietary deprivation include education, employment, and household income. Food price increases also decrease dietary diversity as migrant households adjust their purchasing and consumption patterns.Item The hidden curriculum and integrating cure- and care-based approaches to medicine(Springer Nature, 2020) Nortj?, Nico; Choudhury, DivyaAlthough current literature about the “cure versus care” issue tends to promote a patient-centered approach, the disease-centered approach remains the prevailing model in practice. The perceived dichotomy between the two approaches has created a barrier that could make it difficult for medical students and physicians to integrate psychosocial aspects of patient care into the prevailing disease-based model. This article examines the influence of the formal and hidden curricula on the perception of these two approaches and finds that the hidden curriculum perpetuates the notion that “cure” and “care” based approaches are dichotomous despite significant changes in formal curricula that promote a more integrated approach. The authors argue that it is detrimental for clinicians to view the two approaches as oppositional rather than complementary and attempt to give recommendations on how the influence of the hidden curriculum can be reduced to get a both-cure-and-care-approach, rather than an either-cure-or-care-approach.Item Household consumption of orange-fleshed sweet potato and its associated factors in Chipata District, Eastern Province Zambia(SAGE Publications, 2017) Sakala, Patricia; Kunneke, Ernesta; Faber, MiekeBACKGROUND: The Integrating Orange Project promotes production and consumption of orange-fleshed sweet potato (OFSP) to address vitamin A deficiency among rural populations of Zambia since 2011. OBJECTIVE: This study assessed household production and consumption of OFSP and identified factors associated with consumption thereof in Integrating Orange Project areas in Chipata district, Zambia. METHODS: Respondents of 295 randomly selected households were interviewed using a structured questionnaire during the sweet potato harvest season. Associations between OFSP consumption and household factors were assessed using w2 tests. RESULTS: Frequency of OFSP consumption was categorized as 4 days during the last 7 days (30.2%), 1 to 3 days during the last 7 days (49.5%), eats OFSP but not during the last 7 days (7.1%), and never (13.2%). In total, 60.3% of households planted OFSP, and 40.0% bought OFSP, mostly from farmers within the community. Orange-fleshed sweet potato consumption was associated with the presence of children aged less than 5 years in the household (P ¼ .018), production of OFSP (P < .001), purchasing of OFSP (P < .001), and respondent having knowledge on health benefits of OFSP (P ¼ .014). Age and sex of the household head and household size had no association with OFSP consumption (P > .05). CONCLUSION: A high percentage of households consumed OFSP during the harvesting season in Integrating Orange Project areas. Programs promoting OFSP consumption should thus focus on OFSP production and sensitizing households on nutritional benefits of OFSP and target households with children aged less than 5 years as entry point.Item Impact of body composition analysis on male sexual function : A metabolic age study(Frontiers in Endocrinology, 2023-01) Leisegang, Kristian; Henkel, Ralf; Majzoub, Ahmad; Elbardisi, Haitham; Madani, Sarah; Mahdi, Mohamed; Agarwal, Ashok; Khalafalla, Kareim; Alsaid, Sami; Arafa, MohamedMetabolic Age (MetAge) and body composition analysis may reflect an individual’s metabolic status, which is believed to influence male sexual and gonadal functions. Although erectile dysfunction (ED) and hypogonadism are increasingly prevalent with age, they are also detected among younger men. This study aims to assess the impact of MetAge and body composition on male sexual and gonadal status overall, and particularly in men younger than 40 years of age.Item The influence of second-hand cigarette smoke exposure during childhood and active cigarette smoking on Crohn's Disease phenotype defined by the montreal classification scheme in a Western Cape Population, South Africa(PLoS ONE, 2015-09) Chivese, Tawanda; Basson, Abigail; Esterhuizen, TonyaSmoking may worsen the disease outcomes in patients with Crohn’s disease (CD), however the effect of exposure to second-hand cigarette smoke during childhood is unclear. In South Africa, no such literature exists. The aim of this study was to investigate whether disease phenotype, at time of diagnosis of CD, was associated with exposure to second-hand cigarette during childhood and active cigarette smoking habits.
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