The aim of this study was to assess the dietary intake, diet-related knowledge and metabolic control in children with Type 1 Diabetes Mellitus between the ages of 6-10 years attending the Paediatric Diabetic Clinics at Grey’s Hospital, Pietermaritzburg and Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal. This was a cross sectional observational study that was carried out in a total of 30 subjects out of a possible 35 subjects that qualified for inclusion in the study from both the Grey’s Hospital clinic (n=8) and IALCH clinic (n=22). The dietary intake was assessed in a total of 25 subjects using a three day dietary record (n=20) and a 24 hour recall of the third day of the record (n=16). Diet-related knowledge was assessed using a multiple choice questionnaire. Metabolic control was assessed using the most recent HbA1c and the mean HbA1c results over the previous 12 months from the date of data collection. Height and weight measurements were also carried out. Information on socioeconomic status and education status of the caregivers was obtained from 22 caregivers through follow-up phone calls. All measurements except for dietary intake were obtained from all subjects participating in the study. The mean percentage contribution of macronutrients to total energy was very similar to the International Society for Pediatric and Adolescent Diabetes (ISPAD) Consensus Guidelines (2002). The mean percentage contribution of macronutrients to total energy from the 3 day dietary records and the 24 hour recalls were as follows: carbohydrate (52% and 49%); sucrose (2% and 2%); protein (16% and 17%); fat (32% and 34%). Micronutrient intake was adequate for all micronutrients except for calcium and vitamin D which showed low intakes. The mean diet-related knowledge score for the sample was 67% with significantly higher scores in children older than 8 years of age. The latest HbA1c for the sample was 9.7% and the mean HbA1c over the previous 12 months from the date of data collection was 9.6%. There was a significant positive correlation between age of the participant and the latest HbA1c (r = 0.473; p=0.008) and a significant negative correlation between the education level of the caregivers and the latest HbA1c (r = - 0.578; p=0.005) and the mean HbA1c over 12 months (r = - 0.496; p=0.019). Significant differences were found between African and Indian children respectively for HbA1c, with higher values in African children. There was no correlation between BMI for age and latest HbA1c (r = 0.203, p=0.282) or mean HbA1c over 12 months (r = 0.101, p=0.594). Z score for BMI for age was also not correlated with latest HbA1c (r = 0.045, p=0.814) or mean HbA1c over 12 months (r = - 0.012, p=0.951). Children from the Grey’s Hospital Clinic were found to have higher HbA1c values (p=0.001) and lower diet-related knowledge scores as compared to the children from the IALCH Clinic (p=0.038). It should be noted that the ethnic and racial composition of the children attending these two clinics differed. In conclusion the macronutrient intake in this sample was found to be similar to the ISPAD Consensus Guidelines (2002) while calcium and vitamin D intakes were low. Overall this sample displayed good diet-related knowledge while metabolic control was found to be poor. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.

MSCPNT / Department of Nutrition / Objectives: The study objectives were to determine demographic and environmental factors that can affect nutritional status of children receiving CSG, to assess the nutritional knowledge of caregivers, to determine the proportion of CSG spent on food and to determine the nutritional quality of food bought from CSG. Design: Cross-sectional descriptive with an analytical component Subjects: PCG of children under the age of 5 receiving CSG in Mogalakwena Municipality. 189 caregiver-child pairs were interviewed, in their households. Methods: Data collected by the interviewer included demographic data, Use of CSG, nutritional knowledge and the HHFI and anthropometric measurements were done by a 3rd year Nutrition student. Results: About 36.5% of participants were in the age 26-35 years, 75.7% were unmarried, 84.1% were unemployed and 72% had no matric. Mean age for children studied was 2.84±1.33, 77.8% of participants stayed in a household of more than 5 people. In terms of types of housing, 56% had formal houses, 55% had access to pit latrines and 52.9% used communal taps to access water, 41.3% used electricity for energy while 23.3% used wood to stretch the availability of electricity. Mean CSG received was R386.22 ±R208.75. Majority of participants (56.1%) indicated that CSG supports the whole family and 64.6% of the families depended solely on CSG for survival, while 27% of families had elderly people receiving pension grant which was supplementing the CSG. The CSG was used for different items, majority of families used 94.2% of the money for food at a mean of R171.55±159.25, followed by toiletry (71.6%) at a mean R61.89±69.24, then clothing (68.9%) at a mean of R70.77±97.14. Stokvel was also mentioned as one of the items contributed for by CSG, 32.3% of participants used more than R50.00 for stokvel. Different food items were purchased using CSG, 80.5 % of the money was used to purchase starchy food, mealie meal being the highest commodity at 43.7%. Offal (35.8%) was the highest protein source purchased followed by poultry at 26.4% and soya soup at 20%. Potatoes (19.6%) were mentioned as the most purchased vegetable, followed by cabbage (14.8%). There was a 53.5% of prevalence of stunting, of this 19.6% of children were severely xiii stunted, 5.3% underweight, and 32.3% of wasting. There were 22.1 % of PCG who were overweight and 12.1% were obese. The PCG BMI was negatively associated with WAZ (r= -0.48, p=0.515). There was a positive association between PCG BMI and HAZ (r=0.103, p=0.158), however when caregivers BMI was correlated to BAZ the association was strongly negatively significant (r=0.206, p=0.004). Most PCG received nutrition education from relatives, 71.1% were never educated on nutrition, 57.9% of children were fed 3X/ day. Conclusion: It is apparent from the study that malnutrition, precisely stunting is still a problem in South Africa, however this does not disregard the impact that CSG has on the lives of the poor. It affords the families to access basic needs in the household such as food, toiletry, electricity and even stokvel. The role of nutritionists/ dieticians is paramount in helping mothers to choose healthier economic food for the children in order to curb the burden of malnutrition. / NRF