Thesis (MNutr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Objective: To examine the factors that may influence the vitamin A and anthropometric status of 24-59-month-old children from an impoverished community with a very high prevalence of stunting, but virtually no vitamin A deficiency. Design: Cross sectional, descriptive study with analytical components. Setting: Calvinia West, Northern Cape Province, South Africa Subjects: Biological mothers (n=150) and their children aged 24-59 months (n=150) living in Calvinia West from 6 months of age or younger. Methods: A general interviewer-administered questionnaire comprising of socio-demographic information, a 24-hour recall and an adjusted food frequency questionnaire, focussing on liver intake, were used in the data collection process. Anthropometric measurements (weight and height) were also performed. Results: Results showed that liver consumption alone contributed to more than 100% of the Estimated Average Requirement (EAR) for vitamin A of the pre-school children in this community. Liver was eaten by 84.7% (n=127) of the children and 68% (n=102) of them ate liver at least once per month. The average portion size of the children who consumed liver was 66g at a time. The national food fortification programme contributed to a further 80 μg Retinol Equivalents (RE) and the national supplementation programme 122μg RE of vitamin A per day. There was a significant (p=0.028) inverse association between the amount of liver intake and household income. Liver intake was also significantly (p=0.016) higher in the children whose mothers were unskilled as opposed to those with skilled mothers. According to the World Health Organization (WHO) growth standards 36.9% (n=55) of the children were stunted (low height for age), 25.5% (n=38) were underweight for age and 12.1% (n=18) were wasted (low weight for height). The mean birth weight of the children (n=141) was 2826g (SD=592). Of these children, 27.7% (n=39) had a low birth weight (<2500g). There was a significant positive correlation (r=0.250; p=0.003) between the birth weight of the child and the child's current height for age. The height of the mother, as well as several indicators of socio-economic status, also correlated significantly with the height for age of the child. Conclusion: In this impoverished community the anthropometric status of the children was poor, but vitamin A deficiency was largely addressed through the regular intake of liver. Poor anthropometric status is therefore not always an indicator of micronutrient deficiencies and blanket supplementation approaches are not necessarily the solution in a country with diverse cultures and eating habits. Apart from the immediate risks and consequences of underweight, stunting and wasting in a community, stunting may also lead to overweight and obesity in the long term. This may result in diseases of lifestyle in later life, adding a further burden to an already weakened community. Appropriate evidence-based interventions aimed at the first thousand days of life should be a priority in this community. / AFRIKAANSE OPSOMMING: Doel: Om die faktore wat kan bydrae tot die vitamien A en die antropometriese status van kinders 24-59-maande in 'n arm gemeenskap met 'n baie hoë voorkoms van dwerggroei, maar byna geen vitamien A gebrek, te ondersoek. Ontwerp: Beskrywende, deursnit studie met analitiese komponente Omgewing: Calvinia Wes, Nood Kaap provinsie, Suid-Afrika Deelnemers: Biologiese moeders (n=150) en hul kinders in die ouderdomsgroep, 24-59-maande (n=150) woonagtig in Calvinia Wes sedert 6 maande van ouderdom of jonger. Metodes: 'n Vraelys bestaande uit sosio-demografiese inligting, 'n 24-uur herroep en 'n aangepaste voedsel frekwensie vraelys gefokus op die inname van lewer, was gebruik om data in te samel en voltooi deur die onderhoudvoerder. Antropometriese metings (gewig en lengte) was ook geneem. Resultate: Resultate het getoon dat lewer inname bygedra het tot meer as 100% van die geskatte gemiddelde behoefte van vitamien A vir die voorskoolse kind in hierdie gemeenskap. Lewer was deur 84.7% (n=127) van die kinders ingeneem en 68% (n=102) het dit ten minste een keer per maand geëet. Die gemiddelde porsie grootte van die kinders wat lewer ingeneem het, was 66g op 'n keer. Die nasionale voedsel fortifisering program het 'n verdere 80 μg Retinol Ekwivalente (RE) en die nasionale supplementasie program 122μg RE vitamin A per dag bygedra. Daar was 'n betekenisvolle (p=0.028) omgekeerde korrelasie tussen die die hoeveelheid lewer wat deur die kinders ingeneem is en die huishoudelike inkomste. Lewer inname was ook betekenisvol (p=0.016) meer in kinders wie se moeders ongeskool was teenoor die met geskoolde moeders. Volgens die Wêreld Gesondheid Organisasie se groeistandaarde het 36.9% (n=55) van die kinders dwerggroei getoon (te kort vir hul ouderdom), 25.5% (n=38) was ondergewig vir hul ouderdom en 12.1% (n=18) uitgeteer (ondergewig vir hul lengte). Die gemiddelde geboortegewig van die kinders (n=141) was 2826g (SA=592). Van hierdie kinders het 27.7% (n=39) 'n lae geboortegewig (<2500g) gehad. Daar was 'n betekenisvolle positiewe korrelasie (r=0.250; p=0.003) tussen die geboortegewig van die kind en die huidige lengte vir ouderdom. Die lengte van die moeder, sowel as ander sosio-ekonomiese status aanwysers het ook betekenisvol gekorreleer met die lengte vir ouderdom van die kind. Samevatting: In hierdie arm gemeenskap was die antropometriese status van die kinders swak, maar vitamien A gebrek was grootliks aangespreek deur die gereelde inname van lewer. 'n Swak antropometriese status is dus nie altyd 'n aanduiding van mikronutriënt tekorte nie en 'n oorkoepelende aanslag van supplementasie is nie noodwendig 'n oplossing in 'n land met diverse kultuur en eetgewoontes nie. Behalwe vir die onmiddelike gevare van ondergewig, dwerggroei en uittering in 'n gemeenskap, het kinders met dwerggroei 'n groter risiko om oorgewig en vetsugtig te word in die langtermyn. Dit kan lewensstyl siektes veroorsaak in latere lewe en 'n verdere las op 'n reeds verswakte gemeenskap plaas. Toepaslike intervensies, gemik op die eerste duisend dae van lewe, behoort 'n prioriteit te wees in hierdie gemeenskap.

This dissertation is about the National School Nutrition Programme (NSNP) in South Africa. This Programme was introduced by government in 1994 with the aim of alleviating poverty; unemployment and improving learning capacity of children. Specifically, it is intended to help poor children and to empower poverty-stricken communities, particularly in the rural areas across all the nine provinces. The focus of this study is on the investigation of effectiveness and efficient management of the Programme in the Eastern Cape Province, with specific reference to Mhlontlo District. Mhlontlo district is one of the predominantly rural areas in the province of the Eastern Cape, a remote area characterized by high levels of poverty and unemployment, and low levels of infrastructural developments. Surrounding Schools in the area are also affected by these problems. Learners at these schools are from poor families. It is for this reason that this scheme becomes important as it is most needed and, to effectively and efficiently realise its intended objectives, it must be properly managed. The main theme of the study revolves around effective and efficient service delivery that must be taken as the first priority in the management of NSNP. Factors that contribute to efficiency and effectiveness must be taken into consideration by all stakeholders and are outlined as follows: The aims in this study is to assess the effectiveness of management of the National School Nutrition Programme at Mhlontlo district in the eastern Cape, to identity shortcomings in the management of the Programme and to suggest possible remedies to improve the management of the Programme to effective service delivery. Against the background of the problem statement, the following questions were posited. How can the management of the National School Nutrition Programme with specific reference to Mhlontlo district be enhanced to ensure that its intended objectives are realized? What effect will improved management have on service delivery in the National School Nutrition Programme? And how will adherence to the Batho Pele Principles improve service delivery in schools with regard to the National School Nutrition Programme? The target population in this study was the learners, teachers and community of Schools around Mhlontlo District whose children are being catered for at school as respondents. Statistics of learners who are beneficiaries of this programme were obtained from surrounding Schools. The percentage of the response to the questions led to the results that services are not delivered as effectively as expected. The study concluded by recommendations of what national and provincial department of Education are required to do together with the school, service providers and the community in order to improve service delivery in schools that participate in the NSNP. Finally, the NSNP is for the deprived citizens of South Africa. The onus is on the community of Mhlontlo District, service providers, teachers and education authorities responsible for the NSNP to work together to make the programme effective for advancing the development of young people.

Thesis (MNutr (Human Nutrition))--Stellenbosch University, 2008. / There is convincing evidence linking school feeding to improved educational outcomes. The Primary School Nutrition Programme (PSNP) was first implemented in 1994 and aimed to improve educational outcomes by alleviating short-term hunger and improving school attendance and punctuality. Responsibility for the programme was transferred from the Department of Health (DoH) to the Department of Education (DoE) in 2004 and the name was changed to the National School Nutrition Programme (NSNP) at this time. Previous evaluations of the PSNP / NSNP had reported problems associated with foodservice management and general management aspects of the programme. The study was a cross-sectional, observational investigation of foodservice management and general management practices in primary schools running the National School Nutrition Programme (NSNP) in Pietermaritzburg, KwaZulu-Natal. Twenty-three schools were visited to investigate practices at each school relating to compliance with DoE menus and prescribed service time of the meal, the food delivery system and utilities available. The food handling and hygiene training and practices and general management practices linked to the NSNP were investigated. Most of the schools (78%) were using the DoE menus but only half (52%) served the meal at or before 10h00, which is an ongoing problem. Receiving and storage procedures were adequate at most schools. Food quality does not appear to be a problem in the Pietermaritzburg schools. The lack of expiry dates on food packages remains a problem area and should be addressed. Most of the schools had a designated kitchen area but these facilities could be upgraded. Most schools cooked on gas and 35% of schools had no running water in the kitchen. Kitchens should, at least, have hot and cold running water and adequate working space. Most schools reported that they run out of gas during the month. The monthly DoE allocation for gas should be reviewed to ensure schools have enough gas for the whole month. The holding time for cooked food should be kept to a minimum to minimise the risk of food poisoning. Some schools had insufficient plates (26%) and cutlery (35%). Standardised portion sizes were served at 70% of schools and food handlers reported that learners usually finish all the food. Food handlers at 70% of the schools had received training in food safety and hygiene but 26% of these had only received training once. Training was found to be significantly associated with hand washing (p=0.002), clean uniforms (p=0.036) iv and sanitising practices (p=0.035). Training should be provided in short, ongoing sessions. General management aspects of the NSNP remain a problem. Policies and procedures should be drawn up and implemented to provide a minimum standard of operations at schools. Monitoring should be conducted on a regular basis. The NSNP is running reasonably well in Pietermaritzburg. Adhering to prescribed meal times and upgrading kitchen facilities could result in improvements. Food handler training could also be conducted more frequently. General management aspects need to be improved.

Thesis (MNutr (Human Nutrition))--Stellenbosch University, 2007. / INTRODUCTION: Epidemiologic research strongly supports the importance of adequate fruit and vegetable intake for the promotion of human health and the prevention of chronic disease. Data suggest that fruit and vegetable consumption in children may protect against an array of childhood illnesses. Low fruit and vegetable intake has been recognized as a key contributor to micronutrient deficiencies in developing countries. Evidence indicates that fruit and vegetable consumption is inadequate in both developed and developing nations. A paucity of data on fruit and vegetable consumption exists in South Africa. Quantification of fruit and vegetable consumption is important for the worldwide drive to increase consumption and for strategy development to address inadequate consumption. METHODS: A secondary analysis of the dietary intake data (24 hour recall questionnaire (24-H-RQ) and quantified food frequency questionnaire (QFFQ)), collected during the 1999 National Food Consumption Survey (NFCS) in 12 – 108 month old children in South Africa, was conducted to ...

Thesis (MNutr (Human Nutrition))--Stellenbosch University, 2008. / INTRODUCTION: The best known reference standards used to evaluate the growth and development of infants and children are the 1977 National Centre for Health Statistics (NCHS) - , the 2000 Centres for Disease Control and Prevention (CDC) - and the World Health Organization (WHO) (2006). The NCHS reference standards were used to analyse anthropometric data from the 1999 National Food Consumption Survey (NFCS). It was anticipated that using the 2000 CDC and the 2006 WHO reference standards may lead to differences in the previously estimated prevalences of stunting, wasting, underweight, risk of overweight, overweight and obesity in the study population. AIM: To compare the anthropometric status of children aged 12 - 60 months when using the 1977 NCHS -, the 2000 CDC -, and the 2006 WHO reference standards. METHODS: A secondary analysis of anthropometric data from the 1999 NFCS was conducted using different reference standards to compare anthropometric status in terms of the prevalences of stunting, wasting, underweight, risk of overweight, overweight and obesity. Relationships between anthropometric status and other variables such as breastfeeding, maternal education level and type of housing were explored. RESULTS: The prevalences of stunting, obesity and overweight were significantly higher and the prevalence of underweight and wasting were lower when using the 2006 WHO compared to the 1977 NCHS and the 2000 CDC reference standards. A significant relationship was found between weight-forheight and breastfeeding when using any one of the reference standards and between BMI-for-age and breastfeeding when using the 2006 WHO reference standard. A significant relationship was shown between maternal education level and height-for-age and weight-for-age when using any one of the three reference standards and a significant association was found between weight-for-height and BMI-for-age and the type of housing when using any of the three reference standards. CONCLUSIONS: The prevalences of stunting and obesity were higher when using the 2006 WHO reference standards compared to the 1977 NCHS and 2000 CDC reference standards. This may be due to the linear growth and rate of weight gain of breastfed infants differing from formula fed infants and the 2006 WHO reference made use of the exclusively and predominantly breastfed infant living under normal healthy conditions as the normative model which is a prescription of how children should not grow and .not an indication of how children are growing. In conclusion, the 2006 WHO reference standard must be the only reference standard used nationally and internationally when assessing the growth and nutritional status of infants and children.

Submitted in the fulfillment of the requirements of a Masters of Applied Science in Food and Nutrition, Durban University of Technology, Durban, South Africa, 2017. / Aim: The main aim of this study was to profile the primary school children`s household socio-economic status and evaluate their nutritional status for a healthy and active live in Chesterville, outside Durban in KwaZulu-Natal. The sample comprised of 250 children (147 girls and 103 boys), aged between 4 to 8 years and 9 to 13 years who volunteered to participate in the study and school was randomly selected. Methodology: A quantitative research method was applied using various nutrition security assessment tools complemented by the socio-economic household profile to determine household`s ability to acquire food. Anthropometric status using WHO growth indicators assessed stunting, wasting and underweight status of the children. This was followed by the 24-hr recall and food frequency questionnaire to probe children`s diet diversity. Descriptive statistics was used to analyse data. Result: The anthropometric indices showed that 10.3% of the children were severely stunted (<-3SD height-for-age), 33.5% were stunted (<-2SD), 2.9% were severely wasted (<-3SD BMI-for age), 5.3% were wasted (<-2SD) with 68.5% at possible risk of overweight (>+1SD), 24.3% of the children were overweight is (>+2SD) and 5.6% were obese (>+3SD) according to the WHO z-scores. The results indicate the prevalence of obesity which could be a result of the high consumption of carbohydrate dense food in the group surveyed. The parents/ caregivers and the children need nutrition education on healthy eating habits to improve their lifestyle. The socio-demographic profile of the households indicated that 61% of the parents/ caregivers were unemployed and 39% were employed. Seventy three percent of the households were headed by women, 50% of the parents/ caregivers owned their homes, 63.6% had a tap inside the house and 94% had access to a flush toilet/sewerage system inside the house, 38% had passed grade 8 – the highest level of education, 14.4% of the parents/caregivers earned less than R2000 per month, and 10.4% earned less than R2500 per month. The low-income level, lack of post matric qualification in some of the parents /caregivers and the high unemployment rate of 61% could be a contributory factor to malnutrition in this community. Most of the parents/caregivers resided in the township and 94% lived in brick houses, while 35.6% lived in a shack that was built outside the house as an extension of the house. Most of the parents/caregivers (88%) purchased their food from a supermarket. Thirty-five-point two percent of the parents/ caregivers indicated not having enough money to spend on food, 32.8% indicated that often there is not enough money to spend on food, and 15% indicted that there is always not enough money to spend on food. Seventy-five-point two percent of the parents/ caregivers purchased their food once a month while 12.4% purchased their food once a week. Township South Africans tend to purchase food instead of growing their own food because of the lack of vegetating space. The lack of buying power and food shortages eventually leads to malnutrition. The lack of higher education in this community decreases the chances of permanent employment as a result the low-income bracket and the inability to purchase food in some occasions. The food group diversity score showed that 64% of the respondents consumed food from nine food groups. The carbohydrate group had the highest score (6.08±1.322) followed by the vegetable group (4.76±1.383) and the meat group (4.51±1.269). The mean carbohydrate intake was higher than the Dietary Reference Intake (DRI) for girls and boys (>100% of the DRIs). The intake of fruit was lower than the >400g goal as recommended by the World Health Organisation (WHO). The consumption of fibre was low with both girls and boys consuming <100% of the fibre requirements. Iron was consumed by 54.6% of the girls in the required amount of 100% of the DRIs. The energy intake for both girls and boys was 7025.8±16278 and 7205.4± 1860.834 respectively. The girls’ consumption of protein was 11.9% and boys’ consumption was 11.4% and this is within the recommended 10-15% of the WHO. Conclusion: The results indicate both overnutrition and undernutrition in children that were part of the survey. The top 20 food intake indicated inadequate eating patterns and that diets consisted of energy dense foods, such as carbohydrates and fats which could be responsible for obesity in the children. The high unemployment and low-income rate and inadequate money to spend on food can contribute to the prevalence of stunting and wasting in the children. Nutrition education and nutrition interventions such as focus on healthier foods, healthier methods of preparing food, a balance diet and physical activity are necessary to improve quality of life and improve health. / M

Rationale: There is limited research available in South Africa that explores the breastfeeding experience among adolescent mothers; most of the studies were conducted in developed countries. One such study relating to the above mentioned developed countries stated that social and commitment factors influence the decision to breastfeed by adolescents. Furthermore, while adolescent mothers appreciate the benefits of breastfeeding, pain, public exposure and perceived complexities related to breastfeeding create barriers for them. The researcher was unable to ascertain if similar ambiguities exist among adolescent mothers in South Africa, and in the Eastern Cape (EC) in particular with its high rates of adolescent pregnancy. In order to attempt to develop age appropriate recommendations to assist adolescent mothers with their breastfeeding journey, the researcher undertook this research study to answer the following question: What are the breastfeeding experiences of adolescent mothers in the Nelson Mandela Bay Heath District (NMBHD)? Aim: The research aim was to determine the experiences of adolescent mothers regarding breastfeeding in NMBHD. Methods: The study implemented a qualitative research approach. To enhance the design, the researcher utilised an explorative, descriptive and contextual research design. The ethical principles that guided this study were autonomy, nonmaleficence, beneficence and justice. Fourteen adolescent mothers, attending PHC facilities in the NMBHD participated in the study. Participants were chosen from a purposive sampling technique and data were collected from semi-structured interviews, compromising of individual interviews. The researcher analysed the data using the using the eight steps of the Tesch analysis technique. Data was also analysed by an independent coder. Results obtained from the Tesch approach were compared to that of the independent coder results. Thereafter, the major themes and sub-themes that related to the study objectives were identified. Results: Three themes and 10 sub-themes were identified. Lack of knowledge and poor adherence to EBF, perceived breastmilk insufficiency, as well as incorrect infant feeding advice given by maternal mothers and grandmothers were associated with early introduction of complementary feeding. Most participants were motivated to breastfeed due to its economic and bonding benefits, as well as seeing their infant‟s progress in growth. Challenges of breastfeeding mentioned by the participants include: lack of support from the fathers of their infants and from health care providers, breast milk leakage, and the foul smell associated with the leaking of breast milk. The participants of the study also had suggestions to help improve the support given to adolescent mothers by health care providers in PHC facilities. Conclusions and recommendations: In conclusion, this study‟s findings revealed that adolescent mothers may need extra age appropriate education and support to assist them in breastfeeding successfully at PHC facilities, the community and schools. Maternal mothers and grandmothers were found to be the primary source of a support network for most adolescent mothers as opposed to health care providers who were categorised as being the secondary source of support. Thus, breastfeeding promotion tailored at maternal mothers and grandmothers would be beneficial in improving their knowledge about the recommended infant feeding practices and consequently aid in providing appropriate support and advice to adolescent mothers. Additionally, training and attitude modification of health care providers is needed to provide adolescent mothers with age-appropriate, effective and sensitive care and counselling.

The aim of this study was to explore and describe the body fatness and associated selected health risk factors among 10 to 12 year old adolescents attending schools in Port Elizabeth. Therefore the objectives of the study were to determine the following for the participants: • Level of fatness: weight, height, waist circumference, maximum hip circumference and skinfolds; • Fat intake; • Level of physical activity involvement (IPAQ). To achieve the aim and objectives of this study, the literature pertaining to Childhood Obesity and the possible effects thereof, were reviewed. Both an ex post facto quasi experimental and randomized one-group posttest only designs were used to describe the level of fatness and to identify the incidence of overweight and obesity among adolescents aged 10 to 12 years attending schools in Port Elizabeth. The test battery included anthropometric measurements that were identified from the literature as the factors most important to categorise body fatness such as weight, height, circumferences and skinfolds to determine the level of fatness of the participants. A 21-item Fat Measure for Dietary Intake and International Physical Activity Questionnaire were administered to determine the levels of fat intake and physical activity. Three hundred (300) adolescents were assessed of which 143 were male and 157 were female. In terms of socioeconomic status, 71.3 percent were from the ‘less poor’ quintile schools and 28.7 percent were from the ‘more poor’ quintile schools. The results obtained from the evaluation of the samples were compared in terms of their descriptive statistics and the differences were tested for statistical and practical significance. The results from the study showed that 26.7 percent of the participants were overweight and 14.7 percent were obese according to their skinfold measurements. In terms of body mass index, 79.7 percent of the participants were overweight and 14.3 percent were obese. These results are far higher than majority of the studies included. Physical activity indicated a reduction in body fatness and the most physically active participants were obese. Lastly, body fat percentage and body mass index are very closely related.

Submitted in fulfillment of the requirements of the Master of Applied Science in Food and Nutrition, Durban University of Technology, Durban, South Africa, 2016. / Introduction: South Africa, like many other developing countries, is challenged by malnutrition among children. Globally, the nutritional status of children is a cause for great concern. The nutritional shift towards diets laden with sugar, fat and salt contribute towards the burden of non-communicable diseases (NCDs). Snacking plays a pivotal role in the diets of children; however, the consumption of unhealthy snacks or ‘junk’ food poses a serious risk to a child’s nutritional well-being. Moringa oleifera was selected for snack food development in this study, as this plant is a significant source of nutrients. Aim: The aim of this study was to determine the snacking preferences of children (grades 4-7 in four schools in Verulam, KwaZulu-Natal (KZN), South Africa, in order to develop a sensory acceptable snack enhanced with Moringa oleifera. Methodology: Two hundred primary school children between grades 4-7 were selected through stratified random sampling of schools in Verulam, KZN, South Africa through informed consent to participate in this study. In addition, ten parents/caregivers formed part of the preliminary study to determine the snacking habits of children in the selected grades. This information was reported in the form of themes. A Snack Food Frequency Questionnaire (SFFQ) was administered to children for the sole purpose of determining snacking preferences. This was supplemented by an observational study to assist with identifying the most frequent tuck shop purchases. Thereafter, once the top three snack items were identified, the main study continued with the development of a healthy snack, through three cooking trials before an appropriate product was developed. The final product was made using three different amounts of dried Moringa leaves (1g Moringa, 2g Moringa and 3g Moringa per 22g portion) in a maize chip. The developed product was then subjected to nutrient testing in order to determine the vitamin A, zinc, iron and calcium content of the three different variants. The carbohydrate, fat, energy and sodium values were calculated by using the Association of Official Analytical Chemists (AOAC) International standardised methods. Microbiological and shelf life testing were also conducted to ensure the chips were safe for human consumption. Consumer acceptance sensory evaluation was conducted among the children (n=100) to determine the most preferred amount of Moringa leaf in the snack food item (either 1g of Moringa or 2g Moringa). To determine which of the two variants (sample 1 containing 1g of Moringa and sample 2 containing 2g Moringa) was preferred, two variants of the product were sampled by the participants; samples were coded in order to prevent bias. Results: Overall, the results from the focus group study revealed that children consumed snacks frequently and were given money regularly to purchase snack items from the school tuck shop. Price was a trend noted in factors that affect snack selection. The parents/caregivers responded positively towards purchasing a snack that was nutrient-rich. However, it was noted that the price should be reasonable. Results of the SFFQ indicated that the most popular snack items were chips, cold drinks and sweets; therefore these items were reviewed to determine the most viable option for further development. It was decided by the researcher and the supervisor that chips would be the snack item enhanced with three different amounts of Moringa. The consumer acceptance sensory evaluation comprised two chip samples (123 and ABC). The results of the consumer acceptance sensory evaluation showed that sample ABC (2g Moringa/22g serving) was preferred to sample 123 (1g Moringa/22g serving) for most of the sensory attributes (taste and texture). The Moringa chips (both samples) contain almost half the amount of sodium (52.8mg) when compared to a popular corn chip brand (100mg). Moringa chips contained almost less than 1 gram of fat compared to 8 grams of fat found in the corn chips children usually consume. One portion (22g) of the Moringa chips contributes a significant amount of non-haem iron (57.89%, 48.25% and 35.61% for sample 1, 2 and 3 respectively) for females aged between 9-13 years old. Conclusion: Moringa chips (2g/22g serving) received a positive response from children in the sample population. The use of indigenous plants such as Moringa, could be beneficial in food based strategies aimed at addressing malnutrition. Recommendations: This study concluded that food based strategies such as the development of the Moringa chips, should be considered as a means to create a healthy option for children in low socio-economic schools. / M

Submitted in fulfilment of the requirements for the degree Master of Applied Science in Food and Nutrition, Durban University of Technology, 2015. / Introduction: According to the American Dietetic Association, Child care facilities (CCFs) play an essential role in the nutritional status of children as children typically spend 4-8 hours a day at a facility. As a result, the meals should provide at least 50 – 60% of daily nutritional requirements. Worldwide CCF feeding has been found to be nutritionally inadequate as energy and most micronutrient requirements are not met by the meals provided, due to the lack of nutrition knowledge of the caregivers. Studies have shown that with appropriate training there has been improvement in nutritional standards. Aim: The aim of this study was to analyse the nutritional adequacy of menus offered; and to determine the nutritional status of children aged two to five years old in registered child care facilities in the Inanda area. Methodology: CCFs (n=10) in the Inanda area were randomly selected from multiple options to participate in the study. This study was conducted on children (boys (n= 91) and girls (n=109)) of ages two to five years old. Trained fieldworkers and teachers assisted in interviewing parents to complete the socio-demographic questionnaire. The researcher gathered menus and recipes for analysis, using Foodfinder Version 3 Software. The researcher also conducted plate-waste studies to determine consumption patterns during CCF meal times. Anthropometric measurements for weight and height were collected. In order to establish BMI-for-age and height-for-age, the WHO Anthro Software and WHO AnthroPlus Software were used. Ten food handlers (FHs) were interviewed by the researcher on food preparation and serving. Results: Most children (79.40%) originate from extended families that are female-headed. The highest form of education attained by most caregivers in the sample is standard 10 (47.74%) and 45.73% are unemployed. Of the 54.27% employed, 64.71% are informally employed. Most respondents (72.87%) are living on a total household income of less than R2500. The anthropometric results of the children show very low prevalence of severe stunting (1.74%) and stunting (5.42%). Less than halve (34.48%) of the children were at a possible risk of being overweight, 13.79% were overweight and 2.46% obese. The top 20 foods served in CCFs in Inanda were cereal-based staples of rice and maize meal more frequently than meat, dairy products and fruit and vegetables – all served far less frequently. All the CCFs did not meet the 60% of daily requirements for energy, fibre, calcium and vitamin C in foods served. The CCFs have well-equipped, designated kitchens for food storage, preparation, serving and good hygiene practices. Conclusion: Meals served to two to five year olds in registered CCFs in the Inanda area are nutritionally inadequate as most facilities do not contain 60% of the daily nutrient requirements from both daily meals served. Recommendations: CCF owners and Food handlers should receive proper training and retraining on food safety and hygiene and menu planning. The government should increase the subsidy to CCFs in order to meet the nutritional needs of children in order to aid in the alleviation of under-nutrition.