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Magister Public Health - MPH / Background: Hypertension (HTN) complications are one of the leading causes of disability and mortality worldwide, with increasing trends noted in Africa. The most neglected causes of uncontrolled HTN and its complications are unhealthy diets, excess alcohol consumption and physical inactivity. Adherence to recommended lifestyle modifications remains low in Zimbabwe. This study seeks to explore the factors influencing adherence to World Health Organisation (WHO) lifestyle modification recommendations in patients with hypertension at Parirenyatwa Hospital, Harare. Methodology: An analytic cross-sectional study design was utilized. 328 hypertensive patients aged at least 18, receiving care at Parirenyatwa Hospital were recruited into the study. A self-administered questionnaire was used to collect information on demographics, knowledge and adherence to WHO recommended lifestyle modifications from participants. Statistical Package for Social Scientists (SPSS) version 20 was used for data analysis. The Spearman test was used to test for linear correlation among variables and the 5-point Likert Scale was utilized to categorize the extent of practice of dietary and physical activity recommendations by WHO.

Gestational diabetes mellitus (GDM) negatively affects the health of both mothers and babies, and is the most common pregnancy complication in the United States. Many dietary modification programs for pregnant women diagnosed with GDM rely on a one-size-fits-all approach to menu planning. The purpose of this project was to develop a diet modification program for GDM management using a patient-centered approach. The project objective was to develop the policies, procedures, and supporting documents needed to implement a successful GDM management program for pregnant women receiving antenatal care at an obstetrical clinic. The developed program incorporated strategies for clinic nursing staff to involve pregnant patients and their family members in the planning of individualized daily menus addressing social, motivational, and economic factors. Patient understanding of diet management will be evaluated through the administration of written pre and post-tests, which were included with the program materials. Long term program evaluation will be determined through the tracking of maternal weight gain and infant birth weights. This program has the potential to contribute to positive social change through the reduction of complications resulting from inadequately managed gestational diabetes mellitus.

Dietary saturated fat intake contributes to diabetes and cardiovascular disease, as shown in numerous animal and human studies. However, the hypothesis that stearic acid, a saturated fat, has beneficial effects on these conditions has not been adequately tested. Leptin receptor deficient mice (db/db) and wild-type mice were fed either chow or a high fat diet enriched in either stearic acid or oleic acid for ten weeks. The progression of diabetes was evaluated with blood glucose, insulin, and metabolic parameter measurements. At the conclusion of the study, pancreatic islet organization was examined, and blood, liver and feces were assayed for fatty acid content. The stearic acid enriched diet prevented increases in blood glucose levels independently of weight loss in db/db mice compared to an oleic acid or chow diet. Diabetic mice fed stearic acid maintained insulin responsiveness and pancreatic islet organization compared to the db/db mice fed chow and oleic diets. The islet organization of the stearic acid fed mice did not change over the course of the study and was similar to that of wild-type mice fed the same diet. Conversely, diabetic mice fed oleic acid and chow diets had decreased insulin responsiveness and disorganized islets. Stearic acid fed db/db mice had high fecal fat content and caloric intake calculations indicated low absorption of this fat. Switching to stearic acid after prolonged hyperglycemia had a rescue effect on blood glucose levels. After feeding diabetic and wild-type mice standard chow diets for 6, 8, and 10 weeks to establish hyperglycemia, mice switched to a high fat diet enriched in stearic acid, but not one enriched in oleic acid diet, had significant reductions in blood glucose levels. The ability of a stearic acid enriched high fat diet to slow the progression of diabetes and reverse hyperglycemia in db/db mice argues that risks and benefits of fats in the diet depend on the chemical structure, rather than the chemical class, of fats ingested. The beneficial effect of stearic acid appears to be associated with a decreased absorption of dietary fat.