Thesis (PhD (Interdisciplinary Health Sciences. Human Nutrition))--Stellenbosch University, 2008. / Various enabling factors are required to incorporate technology in teaching and learning, moving towards a more learner-centred approach. Although efforts are being made to address the situation, the effective incorporation of ICT is not yet the norm in African higher education institutions (HEI). Data is available regarding the situation in African HEI, but very little is known about the situation of nutrition training. This research programme was divided into three phases. Phase I, assessment of the current use, awareness, attitudes and practices of ICT in nutrition training followed a descriptive, cross-sectional approach. A convenience sample of six HEI in South Africa, Malawi, Zambia, Swaziland and Zimbabwe was included. Data were collected from students (N = 591) and lecturing staff (N = 29) in nutrition-related courses using a questionnaire on ICT awareness, attitude and practices. Phase II, development and validation of a purpose-designed e-learning nutrition module followed a descriptive, cross-sectional approach. An e-learning module on Nutrition and HIV/AIDS with eleven sub-modules was developed, using an e-learning platform taking the specific constraints of developing countries into account. It was validated by expert reviewers (N = 27) for content validity and students (N = 175) for face validity. Phase III, to determine the impact of the module on cognitive knowledge followed an experimental before-after approach and used a set of twenty True/False questions for eight of the sub-modules (N = 173). Although there is widespread accessibility to computers, less so to the internet, in nutrition-related courses at Southern African HEI, respondents still felt that more computers should be made available. Computers are not fast enough and lack of finances is the main barrier to home and internet access. Students rate their ICT skills as average to good. Institutional ICT policies and support seem to be lacking, but their attitude to ICT is positive and supportive. Respondents felt that ICT could add a new dimension to nutrition training and are in favour of application of ICT in different modes. Most indicate that the current use of ICT in nutrition training is inadequate. The Nutrition in HIV/AIDS module was validated and found to be useful as an educational tool, being user-friendly, interactive and self-paced. The majority of students reported that their ICT skills were sufficient to complete the e-learning activity. Although generally rated as at least as effective, or more effective than conventional lectures, clearly this mode of elearning should not replace traditional teaching. The content was found to be comprehensive and evidence-based. The depth of the content was sufficient, the level correct for undergraduates and the material relevant to the Southern African context. The interactivity was deemed important, helpful and effective. Most students indicated that they would recommend the Nutrition in HIV/AIDS module to other students, that they enjoyed the presentation and learnt something new. There was an improvement in knowledge scores and/or the number of questions being answered correctly in all but one sub-module. The results confirm previous studies indicating that well-designed elearning modules have the potential to increase the performance of students.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2006. / Background At least 40 - 80% of all cancer patients develop some degree of clinical malnutrition and cachexia. The complex and multi-factorial nature of cancer cachexia and the inability of conventional nutrition intervention to reverse or attenuate the effects of this syndrome have driven investigators to consider new therapies and approaches to manage the syndrome of cancer cachexia including eicosapentaenoic acid (EPA), an n-3 fatty acid of fish oil origin. Objectives The aim of this study was to review Phase I, Phase II and Phase III (RCT) trials investigating the safety and efficacy of n-3 supplementation in the treatment of cancer cachexia in adult patients with unresectable solid tumours, with special reference to weight loss, body composition, appetite, dietary intake, energy expenditure, functional status, acute phase response and quality of life. Adverse effects associated with EPA supplementation were also reviewed. Methodology and data collection The major databases were systematically searched for studies that met the inclusion criteria using a structured keyword search strategy or various combinations of these keywords. Relevancy of studies was assessed by two independent reviewers according to pre-determined inclusion and exclusion criteria. Quality was assessed by two independent reviewers using the Jadad scale. Data extraction was performed by the principal reviewer and one of the independent reviewers, and investigators of the included studies were contacted where further information was required. Meta-analysis was not appropriate due to heterogeneity of the data. However, where possible, the paired t-test was used for analysis of the data. Descriptive or non-quantitative analysis of the tabulated data provided a summary of the characteristics of the included studies enabling comparisons to be made between interventions and outcomes within the specified population. Results The search resulted in a total of 1408 citations, of which only 16 studies met the inclusion and exclusion criteria. Of these, only 4 studies were of a good quality. Although the reported data was incomplete and variable, the combined analyses suggested that the effect of EPA supplementation on weight, fat mass, dietary intake, energy expenditure, and acute phase response was not significant. Interestingly there appeared to be a significant increase increased or decreased? in lean body mass (p<0.05). There was little or no data to draw any conclusions regarding the effect of supplementation on appetite and quality of life. Conclusion Despite several limitations in this review, the data collected and analysed are suggestive of the beneficial effects of EPA supplementation, but there remains a significant lack of substantial evidence and conclusive statistical analysis to confirm that EPA supplementation is a safe and effective method of intervention in the management of patients with cancer cachexia.

Thesis (MNutr (Human Nutrition))--Stellenbosch University, 2008. / Background: The crisis and study of health workforce has become more important in developed and developing countries. The relationship between human resource issues and health system effectiveness has been acknowledged. Human resources are seen to be one of the main constraints in achieving the millennium development goals. A number of changes have taken place within health services since 2003, including the promulgation of the new health Act 63 of 2003, restructuring processes in the Western Cape province and the development of a Comprehensive Service Plan (CSP) to implement Health Care 2010. Nationally and provincially nutrition is declared a priority, due to the documented beneficial impact of nutrition support on preventable diseases, disease of life-style, as well as the treatment of high priority disease groups, namely TB and HIV/AIDS. For appropriate planning of nutrition services, the Integrated Nutrition Programme (INP) in the Western Cape needed to review the status of the nutrition workforce in the province, towards developing a human resource plan to meet the nutrition service needs, in the provincial context, its service platforms and approved service implementation plan for public health sector. Objectives The study aimed to describe the current status of the nutrition workforce (staffing profile) in the Western Cape province in terms of staffing levels, personnel categories, location, placement, qualifications, skills, and personnel expenditure at all levels of the public health sector. Provincial maps were developed to indicate the density of personnel per category pictorially. Methods In this descriptive observational study, a targeted sampling approach was applied by developing master lists of the respective nutrition/dietetic/food service units and personnel within the geographical districts and hospitals at all levels of care. All nutrition personnel employed by the Western Cape Department of Health were included in the study. Quantitative data collection methods including coding sheets (per facility), self administered questionnaires and the official personnel database (Persal) of the Department of Health was used. Questionnaires were constructed according to the variability of services, settings, and job outputs. The respective personnel were grouped into 5 categories. Descriptive statistical methods were used to analyse data. Comparisons in terms of urban and rural distributions were also completed. Results A response rate of 86% was achieved (N = 647) with food service workers being the largest proportion of staff (N = 509), followed by dietitians (N = 64), managers (N = 31), auxiliary workers (N = 28) and administrative personnel (N= 15). Significant differences (p=0.0001- 0.05) were found amongst the respective personnel categories in terms of demographics, qualifications, training, experience, skills, competencies, time spent on the INP, and general human resource management areas. Training needs and areas of low skills were identified for the respective categories and key challenges and solutions in the nutrition workforce were highlighted. Conclusion The study indicates that the processes used to develop the workforce need to receive the same intensity as all other interventions. The results can be applied in providing evidence based information for the development of the Department of Health, Western Cape human resource plan and the integration of nutrition therein.

Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2006. / INTRODUCTION: The study investigated dietary intake, physical activity and risk for chronic diseases of lifestyle (CDL) among employees at a South African open-cast diamond mine. OBJECTIVES: The aim of the study was to determine the habits and barriers to a healthy lifestyle in order to determine the need for workplace interventions at De Beers Venetia Mine (DB-VM) to decrease the risk for CDL and optimise employee wellness. DESIGN: An analytical, cross-sectional, observational study. SAMPLING: A representative proportional stratified sample of 88 permanent employees at DB-VM was randomly selected to participate in the study. The sample was stratified according to work-shift configuration and occupational category. Permanent employees were limited to subjects with at least six months employment at DB-VM. Temporary employees and contractors were excluded from the sample. METHODS: Subjects were required to complete a validated self-administered sociodemographic-, meal frequency- and physical activity questionnaire. A validated quantified food frequency questionnaire was administered by the investigator. Anthropometric measurements including weight, height and waist circumference were performed by the investigator. RESULTS: The study documented a high prevalence of obesity among female (45%) and male (32%) employees. A total energy intake above the Estimated Energy Requirement (EER) was found in 38% of males and 64% of female subjects. Fourty eight percent of males and 64% of female subjects exceeded the Acceptable Macronutrient Distribution Rate (AMDR) for total fat intake, while the mean saturated fatty acid (SFA) intake was above the recommendation of less than 10% of total energy intake. An inadequate fibre intake was observed for 87% of males and 55% of female subjects. Folate intakes below the Estimated Average Requirement (EAR) were found in 62% male and 82% of female subjects. A “low active” physical activity level (PAL) was found in 91% of females and 67% of professionals. Significantly more females (p=0.01) and professionals (p=0.00005) demonstrated a “low active” PAL compared to males and other occupational categories. Work-related barriers to a healthy lifestyle such as long working hours, work demands, a long commute and working shifts contributed to skipping of meals and prevention of physical activity participation among employees. CONCLUSION: The study demonstrated a high prevalence of overweight and obesity among employees characterised by high fat and inadequate fibre intakes, increasing the risk for CDL. Work-related barriers contributed to an unhealthy lifestyle and specific interventions at the workplace would appear necessary to decrease the high prevalence of obesity and risk for CDL. RECOMMENDATIONS: Wellness interventions should be introduced at DB-VM to improve the health and well-being of employees.

Thesis (MNutr)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Objectives: Children with autism spectrum disorder (ASD) are known to have feeding difficulties. This study gathered information from parents/caregivers with children diagnosed with ASD. The following aspects were investigated: early feeding history, food preferences, sensory issues, current dietary practices and the use of nutritional supplements and special diets. The study also gathered information regarding these families’ experience with dietitians in supporting them with advice related to dietary problems. Methodology: An online questionnaire was used and the link to the study was placed on the National Autistic Society (NAS) of the United Kingdom’s website to recruit participants. Parents/ caregivers of children aged between 3-16 years and diagnosed with ASD, who resided in England, could take part in the study. Results: Three hundred and twenty five parents/ caregivers participated in the study. The mean age of children was 9.5 years. The majority of children were male (85%). The most common feeding problem was the transition from stage 1 weaning foods to more textured food (55.6%). Sensory problems played a large role in food acceptance. Clear preferences were made for crunchy (81.5%) or dry foods (79%), followed by food with a smooth consistency (69.8%) such as yogurt. Food appearance and presentation (64%) was the main determinant of food acceptance and specific brands and packaging played a major role. Habitual food intake and continually choosing the same foods for meals were present in the majority of children (75.6%). Specific preference was given to the following foods: starchy vegetables (62.6%), refined carbohydrates (81%), processed meat products (69.2%) and dairy products (68.6%). The use of ‘special’ and exclusion diets were not popular. However, where specifically gluten and/ or casein were excluded (19%, n=55), it was generally excluded for more than one year. Reported observations with these exclusions were: improvement in bowel habits, sleep, concentration, behaviour and social communication. The use of nutritional supplements were significantly higher (p<0.5) where exclusion diets were used. A large number of children (43.4%, n=23) on exclusion diets, have not been consulted by a dietitian. Most parents /caregivers (58.1%) had the perception that dietitians were lacking knowledge of ASD and had inadequate knowledge of current dietary interventions for children with ASD (61.7%). However, parents felt that it was reassuring to consult a dietitian, that practical advice was given to improve dietary intake and that generally it reduced their concern regarding their child’s dietary intake. Conclusion: The study highlights the complexity of ASD and the variable effect it has on eating, behaviour and dietary intake. The use of the gluten and casein free (GFCF) diet may improve general wellbeing in some children with ASD when used appropriately and warrants further investigation. It is concerning that only a minority of children on exclusion diets are consulted by dietitians to ensure nutritional adequacy. Due to the complexity of ASD and in the absence of clear guidance for dietary interventions, dietitians who work with children with ASD need to be supported by continued training opportunities in order to enhance their competencies and optimise their service delivery. / AFRIKAANSE OPSOMMING: Doelwitte: Kinders wat aan Outismespektrum-steuring (OSS) lei is geneig om voedingsprobleme te hê. Die studie het inligting ingesamel van ouers en versorgers met kinders wat met OSS gediagnoseer is. Die volgende aspekte is ondersoek: vroeë voedingsgeskiedenis, voedsel voorkeure, sensoriese probleme, huidige eetgewoontes en die gebruik van nutriëntaanvullings en spesiale diëte. Die studie het ook inligting ingesamel aangaande gesinne se ondervinding met dieetkundiges en ondersteuning met dieetprobleme. Metodologie: ‘n Elektroniese vraellys is gebruik en die skakel na die studie was op die webwerf van die National Autistic Society (NAS) van die Verenigde Koninkryk geplaas om deelnemers te werf. Ouers/ versorgers van kinders tussen die ouderdomme van 3-16 jaar, met ‘n diagnose van OSS en woonagtig in Engeland, kon deelneem aan die studie. Resultate: Drie honderd vyf en twintig ouers/ versorgers het deelgeneem aan die studie. Die gemiddelde ouderdom van die kinders was 9.5 jaar en 85% was manlik. Die mees algemene voedingsprobleem vir kinders met OSS was die oorgangsfase van gladde speningsvoedsel na growwer voedsel (55.6%). Sensoriese probleme het ‘n groot rol gespeel in voedselaanvaarding. Daar was duidelike voorkeure vir bros (81.5%) en droë voedsel (79%), gevolg deur voedsel met ‘n gladde tekstuur soos jogurt (69.8%). Die voorkoms en aanbieding van voedsel het grootliks bepaal of voedsel aanvaarbaar (64%) is. Spesifieke handelsmerke of verpakkings het ‘n groot rol gespeel (64.7%). Die meeste van die kinders (75.6%) het vaste eetgewoontes gehad en dieselfde kos tydens maaltye gekies. Die volgende voedselsoorte was verkies: styselryke groente (62.6%), verfynde koolhidrate (81%), geprosesseerde vleis produkte (69.2%) en suiwel produkte (68.6%). Die gebruik van spesiale en uitsluitingsdiëte was ongewild. Waar gluten- en kaseïen-uitsluitingsdiëte (19%, n=55) gebruik is, is dit meestal vir langer as een jaar gebruik. Met die gebruik van uitsluitingsdiëte is verbeteringe waargeneem in stoelgang gewoontes, slaap, konsentrasie, gedrag en sosiale kommunikasie. Die gebruik van nutriëntsupplemente was beduidend hoër (p<0.5) in die groep waar uitsluitingsdiëte gebruik is. ‘n Hoë persentasie kinders (43.4%, n=23) wat op uitsluitingsdiëte was, is nie deur dieetkundiges gekonsulteer nie. Die meeste ouers /versorgers (58.1%) het gevoel dat dieetkundiges gebrekkige kennis oor OSS en dieetverwante probleme het, asook onvoldoende kennis van huidige dieet intervensies vir kinders met OSS (61.7%). Ouers het wel gevoel dat dit gerusstellend was om dieetkundiges te gaan spreek vir praktiese raad om dieet inname te verbeter. Dit het ook hul kommer veminder aangaande kinders se diëte. Gevolgtrekking: Die studie benadruk die kompleksiteit van OSS en die wisselende effek wat dit op eetgewoontes, gedrag en voedsel inname het. Die gebruik van die gluten- en kaseïenvrye diëte kan moontlik die gesondheid en welsyn van sommige kinders met outisme verbeter mits dit reg gebruik word, maar vereis verdere navorsing. Dit was kommerwekkend dat ‘n minderheid van die kinders op uitsluitingsdiëte deur dieetkundiges gekonsulteer word om voldoende nutriëntinname te verseker. Aangesien OSS ‘n komplekse toestand is en daar ‘n gebrek is aan duidelike riglyne vir dieet intervensies, word dit aanbeveel dat dieetkundiges wat met kinders met OSS werk ondersteun word deur opleidingsgeleenthede om hul vaardighede te verbeter en dienslewering te optimaliseer.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2006. / OBJECTIVE: The primary aim of the study was to determine the nutritional status of vegetarian and non-vegetarian students in relation to their dietary preferences and risk factors (dietary, physical inactivity and obesity) for CHD. DESIGN: Cross-sectional analytical study. Setting: The Adventist International Institute of Advanced Studies (AIIAS) situated in the province of Cavite, Philippines. METHODS: The sampling frame was all graduate students at AIIAS (n=203). Of these students 153 returned the distributed dietary questionnaires which determined dietary practices, thus yielding a stratified random sample of 70 registered students (≥20y and ≤50y) who met the inclusion criteria of the study. Three 24-hour recalls and a self-administered food frequency questionnaire assessed dietary practices. Lifestyle was assessed by means of questionnaires, which also included the socio-demographic characteristics of the subjects. Anthropometric measurements included height, weight and waist circumferences. RESULTS: Seventy subjects participated in the study [non-vegetarian (n=38) and vegetarian (n=32)]. The mean age of subjects was 33.3 [(SD) 1.6] and 38.4 (1.9) years for non-vegetarian and vegetarian males respectively, with the respective means for females being 35.7 (2.0) and 33.2 (2.1) years. The majority of the vegetarians’ income was insignificantly below $10.000 as compared with that of non-vegetarians’, in whom annual income earned was within the $10.000- $50.000 range per year. Variations in level of education between the dietary groups were small and inconsistent, most of whom were characterized by a high education level. Within this cohort, mean BMI and WC were insignificantly lower in the vegetarians when compared with the non-vegetarians. For males, the prevalence of overweight, pre-obese and obese (p>0.05) for non-vegetarians was insignificantly higher than vegetarians. Insignificantly, female vegetarians were more pre-obese than non-vegetarians. As far as waist circumference was concerned, the prevalence of subjects observed in the alerting (≥94cm) and action zone (≥102cm) (p≤0.05) was 21% and 4% for non-vegetarian males, while 0% and 6% for vegetarian males. For females, more vegetarians were insignificantly prevalent in the alerting zone (≥80cm) as compared to the nonvegetarians. Both dietary cohorts illustrated no considerable differences that exemplified moderate to a high level of physical activity. All subjects, regardless of dietary preference, were non-smokers and consumed no alcohol (p>0.05). Overall, mean daily nutrient intake met current recommendations and there was no statistically significant difference between the two cohorts, except for fat and saturated fatty acids (SFA), which was higher among the non-vegetarians. Carbohydrate and fiber consumption was greater in the vegetarians. According to the DRIs, there were no intakes above the UL, however inadequate intakes of calcium and zinc posed possible risk of deficiency for both dietary groups. CONCLUSIONS: A small percentage of subjects in both cohorts were at risk of CHD morbidity. Both groups followed good lifestyle habits with dietary choices being of greater concern among non-vegetarians.

Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Background Patients with chronic renal failure must deal not only with the disease itself, but also have to follow a strict dietary regimen. In South Africa there is currently a great demand for new and updated recipes based on the South African Renal Exchange Lists. The focus of this research was the development and testing of recipes commonly used by renal patients following a westernised diet. Objectives The main objectives of the study were to develop and test recipes that meet the nutritional requirements of patients with chronic renal failure. The secondary objectives were to determine the gender and racial differences in participants’ responses during consumer sensory testing. Methodology The study population consisted of patients with chronic renal failure on hemodialysis and continuous ambulatory peritoneal dialysis from Tygerberg Academic Hospital (TAH). Data was collected in three phases, using census sampling: Phase 1 included the development and adaptation of recipes to suit the renal diet. Phase 2 included the consumer sensory testing of the recipes by the dialysis patients, using the 9-point hedonic scale. Phase 3 included the rating of the recipes, the final nutritional analysis and allocation of renal exchanges to one portion of each recipe, as well as the final formatting of the recipe to make it more user-friendly for the renal patient. Results In total, 45 patients took part in the sensory evaluation of 30 recipes. Eighty percent of the subjects were coloured, 4% were white while 16% were black. Fifty-one percent (n=23) were female and 49% (n=22) were male. Of the 30 recipes that were evaluated for overall acceptance, appearance, smell, texture and taste, only 7 were deemed unacceptable. Recipes were unacceptable when less than 80% of the study participants gave a mean overall score of more than 6. Significant differences in the overall acceptability scores were found between the male and female subgroups for the Fish and Vegetable Pie (p=0.031), Chicken Pilaf (p=0.008) and Date Fingers (p=0.002). The females showed a greater preference for these two main meals while the males showed a greater preference for the Date Fingers. Significant differences were found between the black and westernised subgroups for the Rice Salad (p=0.006), Wheat and Mushroom Casserole (p=0.022), Curried Wheat Salad (p=0.043) and the Coconut Ice (p=0.005), with the westernised subgroup showing a greater preference for the dishes than the black subgroup. Conclusion The 23 recipes that were acceptable to the study participants are recommended for inclusion in the RenalSmart Software programme. These recipes are suitable for patients following a westernised diet. It is proposed that recipes suitable for the black and Indian population must be developed in future research. / AFRIKAANSE OPSOMMING: Agtergrond Pasiënte met chroniese nierversaking moet nie net slegs die siektetoestand hanteer nie, maar moet ook ‘n streng dieet regime volg. Daar is huidiglik in Suid-Afrika ‘n groot behoefte vir nuwe en opgedateerde resepte gebasseer op die Suid-Afrikaanse Nier Ruillyste. Die fokus van hierdie navorsing was om resepte te ontwikkel en te toets wat algemeen ingeneem word deur nierversaking pasiënte wat ‘n westerse dieet volg. Doelwitte Die hoof doelwitte van die studie was om resepte te identifiseer en te toets wat voldoen aan die nutrisionele behoeftes van nierpasiënte met kroniese nierversaking. Die sekondêre doelwitte was om geslag en ras verskille in die deelnemers se reaksies tydens verbruiker sensoriese evaluering te bepaal. Metodologie Die studie populasie het bestaan uit pasiënte met chroniese nierversaking op hemodialise en aaneenlopende ambulatoriese peritoneale dialise van Tygerberg Akademiese Hospitaal (TAH). Data was versamel in drie fases deur gebruik te maak van sensus steekproeftrekking: Fase 1 het die ontwikkeling en aanpassings van die resepte, om dit toepaslik te maak vir die nier dieet, ingesluit. Fase 2 het die verbruiker sensoriese evaluering van die resepte deur die dialise pasiënte, met behulp van die 9-punt hedoniese skaal, ingesluit. Fase 3 het die klassifisering van die resepte, die finale nutrisionele analise en die toekenning van nier ruile per porsie van elke resep, sowel as die finale formatering om die resep meer gebruikersvriendelik te maak vir die nierpasiënt, ingesluit. Resultate In totaal het 45 pasiënte aan die sensoriese evaluering van die 30 resepte deelgeneem. Tagtig persent van die deelnemers was kleurling, 4% was wit en 16% was swart. Een en vyftig persent (n=23) was vroulik en 49% (n=22) was manlik. Van die 30 resepte wat geevalueer is vir algehele aanvaarding, voorkoms, reuk, tekstuur en smaak, was slegs 7 onaanvaarbaar gevind. Resepte is as onaanvaarbaar beskou indien minder as 80% van die deelnemers ‘n gemiddelde algehele telling van meer as 6 gegee het. Beduidende verskille in die algehele aanvaarbaarheid tellings is gevind tussen die mans en vroue vir die Vis en Groente Pastei (p=0.031), Hoender Pilaf (p=0.008) en Dadelvingers (p=0.002). Die vrouens het ‘n groter voorkeur vir die twee hoofgeregte getoon terwyl die mans ‘n groter voorkeur vir die Dadelvingers getoon het. Beduidende verskille is gevind tussen die swart en westerse sub-groepe vir die Rysslaai (p=0.006), Koring en Sampioen Kasserol (o=0.022), Kerrie Koringslaai (p=0.043) en die Klapperys (p=0.005), met die westerse sub-groep wat ‘n groter voorkeur vir dié geregte toon as die swartes. Gevolgtrekking Die 23 resepte wat aanvaarbaar gevind is sal voorgestel word om ingesluit te word in die RenalSmart Sagteware program. Die resepte is toepaslik vir pasiënte wat ‘n westerse dieet volg. Daar word voorgestel dat resepte toepaslik vir die swart en Indiër populasie ontwikkel word in toekomstige navorsing.

Thesis (MNutr)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Introduction: The study investigated the development of a simple, cost effective method to monitor food and nutritional intake of mineworkers residing in a Single Accommodation Village (SAV) by using food inventory data. Objectives: The aim of the study was to calculate average food and nutrient intake per mineworker using household data, assess actual food intake (individual data), determine food wastage and to compare food and nutritional intake between group and individual data. Methodology: The study design was a cross-sectional, observational study with an analytical component. The study population consisted of male mineworkers residing in a SAV on a platinum mine in the North West Province and included mineworkers performing mainly underground tasks. A census sampling method was used to select mineworkers participating in the study, and a pilot study was done to test the proposed study process. The study was conducted over five days, which included one weekend day. Food inventory data was recorded by capturing all food quantities (weight measured in kilogram) used for food preparation on the study days. The yield of the prepared food and expected meal participation was used to calculate an average intake per mineworker according to the household record method. An observational study was done to establish the food record data. Meal as well as food item participation was recorded. Food wastage was determined by weighing the production as well as the plate wastage and this data was used to ascertain average food intake per mineworker. Results: Approximately 700 mineworkers participated in the study. The study recorded a 96% meal participation measured against the planned participation figures during the main meal with 74% participating in all menu items. The values for breakfast and dinner were 95% meal participation for both meals with 87% menu item participation during breakfast and 82% during dinner. By using the t-distribution test it was recorded that limited values measured between the food inventory data and the food record data fell within the 95% confidence intervals even after correction for food wastage. However, when the planned participation used to calculate the household data was incorporated into an equation using actual participation data, the values fell within the 95% confidence interval demonstrating that with 95% certainty the planned values (when calculated according to the suggested equation) were within those values observed during the study. Conclusion: Household data can be used as a tool to monitor average individual food and nutritional intake of mineworkers; however both planned and actual menu item participation figures should be considered, together with the total wastage per food item. This tool can be adapted to be used in industrial catering units to monitor food and nutritional intake, which will enable identification of food or nutrient deficiencies and timeous implementation of intervention strategies. / AFRIKAANSE OPSOMMING: Inleiding: Die studie het ondersoek ingestel na die ontwikkeling van ‘n koste-effektiewe metode om die inname van voedsel en voedingstowwe van mynwerkers wat in enkel-akkommodasiebehuising (EAB) woon met behulp van voedselinventaris data te moniteer. Doelwitte: Die doel van die studie was om die gemiddelde voedsel en voedingstofinname per mynwerker met behulp van huishoudelike data te bereken, die werklike voedselinname (individuele data) te evalueer, voedselkwisting vas te stel en om voedsel- en voedingstofinname tussen groep en individuele data te vergelyk. Metode: Die studie-ontwerp was ‘n dwarssnitwaarnemingstudie met ‘n analitiese komponent. Die populasie van die studie het bestaan uit manlike mynwerkers woonagtig in ‘n EAB van ‘n platinum myn in die Noordwes Provinsie en het mynwerkers wat hoofsaaklik ondergronds werksaam is ingesluit. ‘n Sensussteekproefmetode is gebruik om deelnemende mynwerkers te selekteer en ‘n loods studie is gedoen om die voorgestelde studie model te toets. Die studie is oor vyf dae gedoen, wat een naweekdag ingesluit het. Voedselinventarisdata is versamel deur alle voedselhoeveelhede (in kilogram gemeet) wat gebruik was vir die voedsel voorbereiding op die studiedae in ag te neem. Die opbrengs van die voorbereide voedsel is gebruik om die gemiddelde inname per mynwerker volgens die huishoudelike rekord metode te bereken. ‘n Waarnemingstudie is gedoen om die voedselrekorddata vas te stel. Die voedselkwisting is bereken deur die produksie- asook bordkwisting te weeg en dan hierdie data te gebruik om die gemiddelde voedselinname per mynwerker te bereken. Resulate: Ongeveer 700 mynwerkers het aan die studie deelgeneem. Die studie het ‘n 96% maaltyddeelname opgeteken, gemeet teen die beplande deelnamesyfers tydens die hoofmaaltyd, met 74% deelname aan alle spyskaartitems. Die waardes vir ontbyt en aandete was 95% maaltyd bywoning vir beide etes, met 87% spyskaartitemdeelname tydens ontbyt en 82% tydens aandete. Die studie het beperkte waardes binne die 95% vertrouensinval tussen die voedselinventarisdata en voedselrekorddata opgeteken, selfs nadat die voedselkwistingsyfers in ag geneem is. Wanneer die beplande deelname wat gebruik is om die huishoudelike data te bereken egter in ‘n vergelyking wat werklike deelnamedata gebruik, inkorporeer word, het die waardes binne die 95% vertrouensinval geval. Dit is ‘n aanduiding dat daar met 95% sekerheid aangeneem kan word dat die beplande waardes (bereken volgens die voorgestelde vergelyking) vergelyk kan word met die waardes waargeneem tydens die studie. Gevolgtrekking: Huishoudelike data kan as ‘n meetinstrument dien om die gemiddelde individuele voedsel- en voedingstofinname van mynwerkers te moniteer. Beide beplande en werklike spyskaartitemdeelnamesyfers moet egter in ag geneem word, tesame met totale voedselkwisting per voedselitem. Hierdie instrument kan aangepas word vir gebruik in industriële voedseldienseenhede om voedsel- en voedingstofinname te moniteer, wat die identifisering van voedingstoftekorte en vroegtydige implementering van intervensie strategieë moontlik sal maak.

Thesis (MNutr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: The Ironman® triathlon is an ultra-endurance event. It has previously been shown that heavy training schedules and racing ultra-endurance events can lead to immune impairment. Evidence supporting the potential role of dietary intake and body composition on immune impairment or upper respiratory tract infections (URTIs) is currently lacking. Aim: To investigate the relationship between dietary intake, body composition and the incidence of URTI in triathletes residing in Port Elizabeth (PE), during training and competition for the Ironman® 2011 triathlon. Method: An observational longitudinal descriptive study with an analytical component was conducted. The study population included triathletes living in PE, who completed an Ironman® distance event one year prior to, and who were training for the April 2011 Ironman®. Habitual dietary intake was assessed with a quantitative food frequency questionnaire; and race dietary strategies with a three day food record. Body composition was determined with anthropometry and the incidence of URTI was assessed with the WURSS-44. A general health screen (SF-36) was also administered. Results: Habitual dietary intake during the three months pre- and post-Ironman® 2011 triathlon was adequate for all nutrients except for carbohydrate intake in female and male participants (pre-Ironman® of 4.0 (1.7) g/kg body weight (BW)/day and 5.4 (1.8) g/kg BW/day; and post-Ironman® 3.0 (1.0) g/kg BW/day and 4.7 (1.5) g/kg BW/day respectively). Carbohydrate-loading strategies were below recommendations with intakes of 6.0 (2.9) and 5.1 (2.5) g/kg BW/day for female and male participants respectively. Race day nutrition strategies were below recommendations for carbohydrate intake. Post-race dietary intake was below recommendations for carbohydrate in the female participants (0.9 (0.5) g/kg BW). Body mass index was 26.6 (3.4) kg/m2 and 26.1 kg/m2 (1.40) for female and male study participants respectively. Body fat percentage was at the upper end for endurance athletes (29.3 (9.4) % and 13.7 (5.1) % for females and males respectively). In this study 25 % of the triathletes (N=20) developed an episode of URTI during the 3 months post-Ironman®. Dietary intake parameters measured three months pre-Ironman® that had a significant influence on URTI were: potassium (p=0.04) and thiamine (p=0.02) and dietary intake parameters measured 3 months post-Ironman® that had a significant influence on URTI were: total protein (p=0.04); isoleucine (p=0.03); leucine (p=0.03); phenylalanine (p=0.03); valine (p=0.02); thiamine (p=0.01); and Beta-tocopherol (p=0.03). Dietary intake parameters measured during the race that had a significant influence on URTI were: selenium (p=0.04); folate (p=0.04) and proline (p=0.02). Body composition did not have a significant influence on URTI. Conclusion: Habitual dietary intake three months pre- and post-Ironman® as well as pre- and post Ironman race strategies were low for carbohydrate. Body composition indicated that athletes were at the upper end associated with endurance sport. There was a relationship found between an episode of URTI and dietary intake. / AFRIKAANSE OPSOMMING: Agtergrond: Die Ironman® driekamp is 'n ultra-uithouvermoë kompetisie. Daar is voorheen bewys dat swaar oefening skedules en ultra-uithouvermoë kompetisies kan lei tot ‘n immuungebrek. Daar is tans ‘n tekort aan wetenskaplike bewyse wat die potensiële rol van dieetinname en liggaamsamestelling op immuungebrek of boonste lugweginfeksies ondersoek. Doel: Die doel van die studie was om ondersoek in te stel oor die verhouding tussen dieetinname, liggaamsamestelling en die insidensie van boonste lugweg infeksies in driekamp atlete woonagtig in Port Elizabeth (PE), tydens oefening en deelname aan die Ironman® 2011 driekamp. Metodes: 'n Waargenome, longitudinale beskrywende studie is gedoen met 'n analitiese komponent. Die studiepopulasie het bestaan uit driekampatlete woonagtig in PE, wat 'n Ironman® afstand kompetisie voltooi het een jaar voor en wat oefen vir die April 2011 Ironman® kompetisie. Gewoontelike dieetinname is bepaal met 'n kwantitatiewe voedselfrekwensie vraelys, en dieet strategieë rondom die byeenkoms met 'n drie dag voedselrekord. Liggaamsamestelling is bepaal met antropometrie en die insidensie van boonste lugweg infeksies is bepaal met die WURSS-44. 'n algemene gesondheid vraelys (SF- 36) is ook ingevul. Resultate: Die gewoontelike dieetinname gedurende die drie maande voor- en na-Ironman® 2011 was voldoende vir alle voedingstowwe, behalwe vir koolhidraat-inname in die vroulike en manlike deelnemers (voor Ironman® 4.0 (1.7) g / kg liggaamsmassa (LM) / dag en 5.4 (1.8) g / kg LM / dag, en na Ironman® 3.0 (1.0) g / kg LM / dag en 4.7 (1.5) g / kg LM / dag onderskeidelik). Koolhidraatlading strategieë was ontoereikend met innames van 6.0 (2.9) en 5.1 (2.5) g / kg BW / dag vir vroulike en manlike deelnemers onderskeidelik. Die inname op die dag van die byeenkoms was onvoldoende vir koolhidraat. Die dieetinname na die byeenkoms was onvoldoende vir koolhidraat inname in die vroulike deelnemers (0.9 (0.5) g / kg LM). Die liggaamsmassa-indeks was 26.6 (3.4) kg/m2 en 26.1 (1.4) kg/m2 vir vroulike en manlike deelnemers onderskeidelik. Persentasie liggaamsvet was aan die boonste grens geassosieer met uithouvermoë oefening atlete 29.3 (9.4) % en 13.7 (5.1) % vir vrouens en mans onderskeidelik. Die insidense van boonste lugweg infeksies was 25% (N=20) gedurende die drie maande na Ironman®. Dieetinname paramters wat gemeet was drie maande voor Ironman® wat beduidende beïnvloed met boonste lugweginfeksies getoon het, was, kalium (p=0.04) en tiamien (p=0.02) en die dieetinname parameters wat drie maande na Ironman® gemeet is en betekenisvolle beïnvloed getoon het met boonste lugweginfeksies was, totale proteïen (p=0.04); isoleusien (p=0.03), leusien (p=0.03), fenielalanien (p=0.03), valien (p=0.02), tiamien (p=0.01), en B-tocopherol (p=0.03). Die dieetinname parameters wat gemeet was tydens die wedloop wat beduidende beïnvloed met boonste lugweginfeksies getoon het na Ironman® 2011 was, selenium (p=0.04), folaat (p=0.04) en prolien (p=0.02). Die antropometriese parameters gemeet het nie beïnvloed op boonste lugweginfeksies gehad nie. Gevolgtrekking: Die gewoontelike dieetinname drie maande voor- en na Ironman® sowel as voor- en na Ironman® kompetisie strategieë was onvoldoende vir koolhidrate. Liggaamsamestelling het aangedui dat atlete aan die boonste grens geassosieer met uithouvermoë oefening geval het. Daar was beduidende beïnvloed gevind tussen dieetinname en boonste lugweginfeksies.

Thesis (MNutr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: Omega-3 fatty acids and supplementation is very topical, attracting both public and interest from the industry. Findings from various research studies led a number of authorities to encourage the general population to consume more omega-3. This is the first study of its kind to be conducted in this population. Objective: To determine the current knowledge and trends of omega-3 (n-3) supplementation in parents of children at public primary schools in the City of Cape Town. Design: An observational and analytical and descriptive and cross-sectional study was performed. Methods: Purposive sampling was used to select a minimum of 150 parents from the six (6) randomly selected public primary schools. The schools were then divided into three different living standard measure (LSM) groups. The research questionnaire was made available at the Parent Teachers meetings where all parents had the option to complete the questionnaire anonymously at the meeting. Results: Six hundred and fifty seven (n=657) parents, mostly mothers, with a mean age of 37 years, completed and returned the questionnaires. The mean monthly income (p=0.00, SD=2.63) and the education level (p=0.00, SD=1.37) differed significantly between each of the three LSM groups. Prior to the study, 80.1% of parents (n=526) had heard of omega-3 supplements and overall knowledge of omega-3 was significantly better in this group (p=0.00) when compared to the group that had not heard of omega-3 previously. The overall mean omega-3 knowledge score for the three LSM groups (n=657) was 71%. The high and low LSM groups differed significantly in terms of omega-3 knowledge (p=0.02), but not statistically significantly once adjusted for income and education level (p=0.75). The main sources of information, where all parents (n=526) indicated having heard of omega-3 supplements, was from television (n = 230, 35%), books (n= 220, 33.5%) and the health worker (n=199, 30.3%). A total of 38.5% (n=253) of parents indicated that they gave their children omega-3 supplements. The overall omega-3 knowledge was significantly better (p=0.00) in parents who gave their children omega-3 supplements than the group that did not give supplements to their children. Income and the education level differed between all three LSM groups for those giving their children omega-3 supplements, but these variables did not influence the choice to give omega-3 supplements. Doctors (n=58, 22.9%) and the parents’ own decision (n=60, 23.7%) to supplement were the most favoured sources of recommendation indicated overall. Most parents indicated that the omega-3 supplement they administered was from a marine source (n=105, 41.5%). Only 35.2% (n=89) of parents giving omega-3 supplements indicated they knew the dose they were administering. Most of the children (n=90) were taking 500 mg omega-3 supplements daily. Conclusions and Recommendations: Statistically significant differences existed between the three LSM groups regarding various aspects of omega-3 knowledge and the sources from which parents had been informed and those who gave their children omega-3 supplements. Recommendations include education and public health programs supplying information to parents on omega-3 supplementation, as well as on omega-3 in the children’s diets. / AFRIKAANSE OPSOMMING: Agtergrond: Omega-3 vetsure en supplementasie is ‘n baie aktuele onderwerp, wat beide die belangstelling van die publiek en industrie betrek. Bevindinge van verskeie navorsingstudies het daartoe gelei dat verskeie instansies die algemene publiek aanmoedig om meer omega-3 in te neem. Dit is die eerste studie van sy soort wat in dié populasie groep gedoen is. Doelwit: Om die huidige kennis en tendensies/neigings in omega-3(n-3) supplementasie in ouers van kinders by publieke laerskole in die stad Kaapstad te bepaal. Ontwerp:’n Waarnemende- en en analitiese en beskrywende- dwarsdeursnitstudie is gedoen. Metode: Daar is gebruik gemaak van ‘n doelgerigte steekproefneming om ‘n minimum van 150 ouers uit ses (6) ewekansig geseleteerde publieke laerskole van uit te kies. Die skole is in drie verskillende lewenstandaardgroepe (LSM) verdeel. Die navorsingsvraelys is by ‘n Ouer-Onderwyservergadering beskikbaar gestel en alle ouers het ‘n geleentheid gehad om die vraelys anoniem by die vergadering te voltooi. Resultate: Seshonderd sewe-en-vyftig (n=657) ouers, meestel moeders, met ‘n gemiddelde ouderdom van 37 jaar, het die vraelyste voltooi en teruggegee. Die gemiddelde maandlikse inkomste (p=0.00, SD=2.63) en vlak van opvoeding (p=0.00, SD=1.37) het noemensvaardig tussen elk van die drie LSM groepe verskil. Voor die studie het 80.1% van die ouers (n=526) al van omega-3 supplemente gehoor en die algehele kennis van die groep was beduidend beter (p=0.00) as die groep wat voorheen nie van omega-3 gehoor het nie. Die gemiddelde algehele omega-3 kennistelling vir die drie LSM groepe was 71%. Die hoë en lae LSM groepe het beduidend ten opsigte van omega-3 kennis (p=0.02) verskil, maar nie statisties- beduidend wanneer dit vir inkomste en opvoedingsvlak (p=0.75) aangepas is nie. Die hoofbronne van inligting waar al die ouers (n=526) wat aangedui het dat hulle van omega-3 supplementasie gehoor het, was deur televisie (n=230, 35%), boeke (n=220, 33.5%) en die gesondheidswerker (n=199, 30.3%). ‘n Totaal van 38.5% (n=253) ouers het aangedui dat hulle hul kinders omega-3 supplemente gee. Die algehele omega-3 kennis van ouers wie hulle kinders omega-3 supplemente gee was statisties beduidend beter (p=0.00) in vergelyking met die groep wat nie supplemente vir hulle kinders gee nie. Die inkomste en opvoedingsvlak het verskil tussen all drie LSM groepe wat hulle kinders omega-3 supplementasie gegee het, maar hierdie veranderlikes het nie die keuse om omega-3 supplemente te gee beïnvloed nie. Mediese dokters (n=58, 22.9%) en die ouer se eie besluit (n=60 23.7%) om te supplementeer, was die gunsteling bronne van aanbeveling in die algemeen. Die meeste ouers het aangedui dat die omega-3 supplement wat hulle gegee het van ‘n visbron afkomstig (n=105, 41.5%) is. Net 35.2% (n=89) van die ouers wat omega-3 supplemente gee het aangedui dat hulle die dosis kenwat hulle gee. Meeste van die kinders (n=90) het 500mg omega-3 supplemente daagliks gekry. Gevolgtrekking en aanbevelings: Statistiese beduidende verskille is tussen die drie LSM groepe ten opsigte van verskeie aspekte van omega-3 kennis en bronne waaruit ouers ingelig is, sowel as die ouers wie hulle kinders omega-3 supplemente gegee het, gevind. Aanbevelings sluit opvoeding en publieke gesondheidsprogramme in, wat inligting aan ouers sal verskaf oor omega-3 supplementasie sowel as omega-3 in die kinders se diëte.