Globally, the prevalence of acute malnutrition and micronutrient deficiency is high in young children, especially in developing countries. This study was undertaken to determine the impact of a nutrition education intervention programme (NEIP) on the nutritional knowledge and practices of caregivers, as well as the nutritional status of children between the ages of three to five years in the Mutale Municipality in Vhembe district, Limpopo Province. A pre-testâpost-test control group design was chosen using eight villages (four villages in the experimental group (E); four villages in the control group (C). At baseline, the study population was 125 caregivers and 129 children aged three to five years (E = 66; C = 63 children). After intervention, 86 caregivers and 89 children (E = 40; C = 49 children) were found. Only participants who participated at baseline and postintervention were included for comparison. A valid structured interview schedule was used to determine nutritional practices and knowledge. The nutrient intake was determined by two 24-hour recalls. Weight and height (to determine weight/height status) and blood samples (vitamin A and iron status) were taken using standard techniques. The NEIP was developed by the researcher using South African Food-based Dietary Guidelines (SAFBDGs) and South African Paediatric Food-based Dietary Guidelines (SAPFBDGs) as basis. The NEIP was implemented on the experimental group on two occasions, namely every week during the first three months and then during the last three to four months in a period of 12 months. Data were analysed using Statistical Analysis Software (SAS®) version 9.2 and expressed using median, minimum and maximum values to describe continuous data. Frequencies and percentage were used to describe categorical data and 95% confidence intervals were used for median and percentage differences to determine the impact of the intervention programme. The 24-hour recall data were analysed using Food Finder III version 1.1.3. The study revealed that the socio-demographic information and anthropometric nutritional status of the children did not change after intervention in both groups. Furthermore, at baseline, nearly one third of the children in both groups had marginal vitamin A status. However, after intervention, all children in both groups had adequate to normal vitamin A status, which could be due to the vitamin A supplementation and food fortification programme of the SA Government. The iron indicators were within adequate levels at pre- and post-intervention in both groups. The impact of NEIP was observed in some of the nutritional practices, since the majority of caregivers usually included starchy foods, protein-rich foods and vegetables in the childâs plate daily at baseline in both groups. However, the number of children who were given more than three meals per day showed a tendency towards an increase in the experimental group. The intake of milk and yoghurt improved significantly in the experimental group. The majority of children were eating indigenous foods. However, the intake of black jack, spider flower, wild jute plant, baobab fruit, paw-paw, mopani worms and termites improved significantly in the experimental group. The median carbohydrate and protein intake was adequate when compared to EAR/RDA in both groups at pre- and post-intervention. The median energy, carbohydrate and plant protein intake had increased significantly in the control group. The intake of iron and folate had increased significantly in both groups, while zinc intake increased significantly in the control group. After the intervention, the intake of tshimbundwa (traditional bread made with maize) also increased significantly in the control group. Furthermore, the intake of stinging nettle, meldar, wild peach, pineapple, dovhi, tshigume and thophi had improved significantly in both groups. The nutrition knowledge score was good at baseline, as the majority of caregivers in both groups were aware that children should be given a variety of foods, indigenous foods, starchy foods, protein-rich foods, vegetables and fruit. However, in the experimental group the percentage of caregivers who knew that children should be given full-cream milk and fat increased significantly at post-intervention. On other hand, the percentage of caregivers who knew tshimbundwa increased significantly in the control group. The majority of caregivers were including most of the food items on the childâs plate (starchy, protein-rich foods, vegetables and indigenous) at baseline, which left little room for improvement. However, the impact of NEIP was observed in some nutritional practices. On the other hand, minimal impact of the NEIP on nutrition knowledge was observed, since most of the caregivers had good nutritional knowledge at baseline. It is recommended that the NEIP developed in this study be adapted for the Department of Health (Nutrition Section) so that healthcare workers can present it in different communities using different media so as to increase coverage.

INTRODUCTION: The course and outcome of eating disorders can be characterised by the degree of diagnostic crossover. Crossover is relatively common, with the crossover from Anorexia Nervosa (AN) to Bulimia Nervosa (BN) being the most prevalent. Crossover commonly occurs within the first 5 years of illness and is often observed when patients are progressing to partial or full recovery. No information regarding crossover in South African persons with eating disorders has been published, hence the purpose of this study. MAIN OBJECTIVE: The main objective of the study was to describe the behaviour that may indicate crossover from weightârestored AN to BN in South African young adults. In order to achieve the main objective, anthropometric measurements and descriptive information regarding disordered eating patterns were obtained. Information regarding behaviour that may be associated with crossover from AN to BN or within AN subâtypes was collected. In addition BN patients were assessed to determine whether they have a previous history of AN, which may further indicate crossover. SUBJECTS AND METHODS: Participants were recruited from the student population of the University of the Free State and Bloemcare Psychiatric Clinic. Anthropometric measurements were taken by the researcher and one of two questionnaires (compiled by the researcher), depending on diagnosis, was completed during a semiâstructured, oneâtoâone interview between the researcher and each participant. Questionnaires were coded by the researcher and analysed by the Department of Biostatistics (UFS). RESULTS: Nine participants were recruited and included in the study. Five out of the nine participants were diagnosed with Anorexia Nervosa Restrictive type (ANR). These five participants had all crossed over to bulimic tendencies during and after the process of weight restoration. One of the five participants has crossed over to a current diagnosis of Anorexia Nervosa Binging and Purging type (ANBP). The five participants indicated that they engaged in inappropriate compensatory behaviour after a binge episode in order to prevent further weight gain or to lose weight. The most common inappropriate compensatory behaviour reported was selfâinduced vomiting. Two of the five participants indicated that they could currently be diagnosed with EDNOS because they had not completely recovered, whereas the other two participants indicated that they have fully recovered. The remaining four of the nine participants were diagnosed with BN. Two were currently diagnosed and the other two had previously been diagnosed with BN. Of the previously diagnosed BN participants, one participant had a history of ANR. The particular participant never fully recovered from the initial diagnosis and therefore crossed over from ANR to BN. The two previously diagnosed BN participants also indicated that they could be diagnosed with EDNOS at the time of the interview because they had not completely recovered. Overall the nine participants reported that they were still preoccupied with their weight at the time that the study was conducted. Seven of the nine participants indicated that they were more comfortable at a lower weight, whereas two participants indicated that they could not identify a weight at which they felt most comfortable. CONCLUSIONS: The course and outcome of eating disorders is partially determined by the occurrence of crossover. Comparable to reviewed literature, despite the small sample crossover was observed from AN to bulimic tendencies. In addition, crossover occured more commonly during the progression to partial or full recovery. With this in mind, further research should focus on whether crossover occurs as a result of the weight gain associated with recovery and whether the fear or anxiety thereof acts as a trigger. This knowledge may enable the multidiscliplinary health care team to prevent crossover from occurring in patients during the recovery period.

Breast cancer is the leading cancer in the world among women, both in industrialised and developing countries. While the USA has the highest prevalence and mortality rates of the disease, with middle prevalence rates in Eastern Europe; Africa and Asia have low rates. In South Africa breast cancer is the most common cancer and is being diagnosed with increasing prevalence among the black population. No literature is, however, currently available regarding the prevalence of breast cancer, the prevalence of the risk factors for breast cancer, or the associated mortality rates for breast cancer in Lesotho. The aim of this study was to determine the prevalence of the known risk factors for breast cancer among adult women who were diagnosed with the disease at the Queen Elizabeth II hospital, Maseru. A descriptive survey was conducted on 52 adult breast cancer patients seen at the Queen II hospital in Maseru, who gave informed consent. A trained researcher performed anthropometric measurements and administered a questionnaire on usual dietary intake and non-modifiable and modifiable risk factors for breast cancer, during structured interviews. Reliability was ensured by repeating the same questionnaire with 10% of the sample a month after conducting the main study. Regarding the non-modifiable risk factors for breast cancer, the majority of the Basotho women in this study were diagnosed with breast cancer at 46 years and older (78.7%), experienced menarche at 12 years and older, (93.9%), had reached natural menopause, did not use hormone replacement therapy, and had reached menopause before the age of 55 years (96.8%). Regarding the modifiable risk factors for breast cancer, the Basotho women had a low risk profile with low levels of education (80.8% had only primary or high school educations), low incomes (59.6%), low oral contraceptive use (65.4% had never used), and were mostly non-drinking (48.1%) and low-drinking (36.5%). Most were also, or had been, married at the time of the study (82.7%), had children (80.8%), and had breastfed for â¥12 months (86.8%). However, these Basotho women were very inactive (82.6%), with high body mass indexes (21.1% overweight; 63.5% obese), waist circumferences, and waist to hip ratios putting them at high risk for breast cancer and other chronic diseases of lifestyle. Their self-reported median total energy and macronutrient intakes were 5414.5 kJ, 49g protein (0.63 g/kg/day), 210g carbohydrate, and 21.5g fat. Dietary intakes were evaluated according to the recommendations of the USDA Food Guide Pyramid and the Dietary Guidelines for Americans 2010. Although they had low intakes of meat, particularly red meat, drank tea regularly, and used cooking methods that did not produce cancer promoting agents, all of which protect against breast cancer development; their low intakes of fruits, and low variety of plant foods put them at risk of breast cancer and other diseases due to low supply of protective antioxidants and phytochemicals. Particularly vegetables were mostly only consumed as green leafy types (moroho), while other vegetables were only consumed occasionally and by small percentages. This study is the first to report on the known risk factors of breast cancer among women in Lesotho. In summary, these Basotho patients were found to have a low risk profile for breast cancer with regard to non-modifiable risk factors, reproductive history and socio-demographic factors. The main risk factors for breast cancer were inactivity and obesity, combined with a diet low in variety of protective plant foods. Intervention programmes should thus focus on addressing these modifiable risk factors.

Bariatric surgery is recognized as the most effective treatment modality for obesity. Since obesity levels are on the increase both locally and globally, it is expected that the number of procedures performed will increase in the future. A practical limitation to performing bariatric surgery is the fact that operating space within the abdomen is limited by excessive layers of abdominal fat and the presence of a large, fatty liver. Fat deposition in the liver is common in obesity. Reducing the fatty deposits in the liver can reduce the size of the liver, thereby in theory it can also reduce the complexity of the surgical technique. A number of individual trials have evaluated the potential of energy restriction for a period of two to 12 weeks before surgery to reduce the liver size and liver fat content. Data from these trials are promising, but individually does not provide sufficient evidence to justify evidence-based recommendation in favour of the use of restricted energy diets prior to surgery. This review combines the findings of individual trials in order to provide an evidence-base for such practice. At the time of protocol development, no systematic review has been published to document the benefits of energy restricted diets in reducing liver size and fat content in obese patients who are undergoing bariatric surgery for weight loss. A systematic literature search was undertaken to identify studies published between 1980 and 2012 on the research topic. Studies were evaluated and eliminated based on inclusion and exclusion criteria so that a total ofnine studies were included in the review. Study design and methodology were appraised, and results of individual trials compared and combined where appropriate in order to provide a comprehensive overview of current literature in the form of a narrative systematic review. A meta-analysis was not possible due to differences in reporting. Results indicated that preoperative diet restriction effectively reduces liver volume by decreasing the liver fat content. It was however not clear if these changes can be directly linked to reduction in operative complexity, reduction in intra-operative blood loss, or reduction in duration of surgery. Randomized, blinded trials are needed to confirm if a relationship exists. One well-designed study indicated reduction in post-operative complications. In conclusion, this review found that preoperative restricted energy diets used for an acute period before surgery can significantly reduce liver volume and fat content in obese patients, and may translate to improved patient outcome.

Thesis PlanA (M.S.)--University of Wisconsin--Stout, 2006. / Includes bibliographical references.

Science has established the existence of relationships between malnutrition and physical disability. Therefore, alleviating malnutrition may lead to prevention of physical disability and preservation of independent living. The purpose of this study was to investigate the specific relationships of certain nutritional risk factors and indicators with severity of physical disability within older adult home delivered meal program participants. Previous research supports that older adults who participate in home delivered meal programs are at greater risk of malnutrition and subsequent physical disability than the general older adult population. An investigation of the nutritional risk factors, nutritional risk indicators, and severity of physical disability from the 2003 nutrition assessments of 304 home delivered meal program participants sample was conducted. Risk factors evaluated were alcohol, tobacco, and medication use; oral health and presence of illness; eating alone, the ability to shop for and prepare food, and the perception of having enough money for food. Nutritional risk indicators included intake of fruits, vegetables, and dairy products, the number of daily meals consumed, and incidence of unintentional weight loss. Demographic data were also evaluated; age, gender, income, race, and Food Stamp Program participation. Nutrition educators may benefit from the significant relationships identified by these analyses. Interventions designed to decrease the incidence of malnutrition in older adult home delivered meal program participants may also produce the desired outcome of less severe physical disability. / A Thesis submitted to the Department of Nutrition, Food, and Exercise Sciences in partial fulfillment of the requirements for the degree of Master of Science. / Fall Semester, 2005. / October 28, 2005. / Home Delivered Meals, Nutritional Risk Elderly, Older Adult, Nutrition / Includes bibliographical references. / Doris A. Abood, Professor Directing Thesis; Ann K. Mullis, Outside Committee Member; Laura R. Cook, Committee Member.

The evaluation of an eating disorders prevention curriculum on eating attitudes and behaviors of female college students. Purpose: The purpose of this study was to evaluate the efficacy of an academic college course on eating attitudes and behaviors of female college students. Methods: Two hundred and twenty female college students (19.4 ± 2.6 years old) participated in either the intervention (n = 76) or control (n = 144) and completed a pre-, post- and follow up (intervention only) survey that identified intuitive eating, thin-ideal internalization, restrained eating, body dissatisfaction, eating, shape and weight concerns and eating pathology. Intervention females participated in a 12-week academic curriculum based on cognitive behavioral techniques, cognitive dissonance and media literacy strategies. Cognitive behavior techniques included self monitoring, challenging irrational beliefs, monitoring of negative self-talk and positive counter statements, strategies to cope with anxiety, distress, panic and relapse prevention strategies. Cognitive dissonance techniques encouraged the participants to compare the inconsistency of their behaviors with their beliefs. Media literacy techniques invited the participant to become a critical evaluator of the media. Results: High and low risk intervention participants reported increased reliance on internal hunger and satiety cues, F (1, 76) = 4.51, p / A Dissertation submitted to the Department of Nutrition, Food and Exercise Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Fall Semester, 2010. / October 6, 2010. / Eating Disorder Prevention, Female College Students, Academic Curriculum, Body Dissatisfaction / Includes bibliographical references. / Doris A. Abood, Professor Directing Dissertation; Cathy Levenson, Committee Member; Maria Spicer, Committee Member.

The South African Demographic and Health Survey (1998 and 2003) revealed that urban black women had the highest prevalence of overweight/obesity and central obesity across all population and gender groups. This trend was confirmed by the South African National Health and Nutrition Examination Survey (SANHANES-1) who reported a substantial increase in the prevalence of obesity among black South African women. Hence, the high prevalence of overweight/obesity and central obesity among urban black South African women needs to be addressed through targeted weight loss/management interventions, as obesity and central obesity are risk factors for the development of a number of non-communicable diseases (NCDs). However, from the international literature, it is evident that overweight/obese black women are less likely to embark on a weight loss intervention, while those who seek treatment, are unlikely to complete the intervention, as weight loss interventions targeting as well as including black women have reported attrition rates ranging from 0to 79%. In addition, at this point in time, no common attrition tendencies have been documented for large clinic-based weight loss interventions targeting African-American women in the United States of America. As there is a serious paucity of published information on weight loss interventions targeting overweight/obesity in urban black South African women, the aim of this research was to investigate weight management-related focus areas in overweight/obese black (Zulu) women residing in an urban area in South Africa. This information is essential to advise the development of healthy weight loss interventions and appropriate messaging to promote weight loss and maintenance in black South African women. In order to achieve the this aim, the following research questions were formulated: (i) What is the weight management related profile of overweight/obese treatment-seeking black women; (ii) What is the outcome of a culturally sensitive healthy weight loss intervention in terms of weight loss, compliance (attendance of intervention sessions, lifestyle changes) and attrition: and (iii) Which factors may explain the outcomes of the culturally sensitive healthy weight loss intervention? To guide the investigation of these research questions the researcher first set out to identify weight management-related focus areas for overweight/obese black women from the literature. Ten succinct focus areas emerged and include the following: 1) treatment seeking behaviour; 2) weight loss success; 3) compliance to and attrition from weight loss programmes; 4) cultural influences on body shape and size perception and satisfaction; 5) cultural influences on food choices and eating patterns6) cultural influences on physical activity; 7) environmental factors and social support; 8)appropriateness of the weight loss programme for the target population; 9) dietary restraint, disinhibition, perceived hunger and bingeing and 10) psychological well-being (depression).

Includes abstract. / Includes bibliographical references. / The aim of this study is to conduct a formative assessment to explore health professionals’ capacity as well as the conditions within primary health care facilities in the Western Cape Metropole that facilitate or impede the provision of lifestyle modification education and counselling to patients with chronic diseases of lifestyle in order to make recommendations for an intervention programme that utilises available resources.

Includes bibliographical references.