Made available in DSpace on 2014-07-29T15:25:18Z (GMT). No. of bitstreams: 1 Tese Ana Clara M e S Carvalho - Patologia Clinica.pdf: 1557137 bytes, checksum: 899de7fc14fbe34def669ae52588c5f8 (MD5) Previous issue date: 2012-02-27 / Introduction: The dietary fiber, particularly soluble, are assigned the physiological effects that are important for the treatment of patients with type 2 diabetes mellitus. Objective: To evaluate the effect of supplementing wheat dextrin in insulin sensitivity, glycemic control and lipid, and nutritional status of patients with type 2 diabetes mellitus. Methodology: This is a trial blind, randomized, lasting 12 weeks.The sample consisted of 27 type 2 diabetic subjects of both sexes with a BMI ≥ 25.00 kg/m2 and sedentary. These subjects were randomized into two groups, test (n = 14) and placebo (n = 13). The test group was supplemented daily with 200 ml of orange flavor beverage without the addition of sugar and added 10 g of wheat dextrin, 30 minutes before the lunch. The control group received the same drink daily, but without the addition of fiber. Participants were instructed to maintain their lifestyle (diet and physical activity). Fasting plasma glucose, glycated hemoglobin (A1c), insulin sensitivity, lipid profile, the level of physical activity, intestinal function, food intake, and anthropometric indicators were assessed at baseline, 45 and 90 days intervention. Results: The A1c, fasting glucose and lipid profile showed no significant differences within and between groups. There was an increase in the values of HOMA-IR (p = 0.0163) and fasting insulin (p = 0.0406) at 45 days in the placebo group, with significant difference. The increase in HOMA-IR and fasting insulin resulted in decreased insulin sensitivity in the placebo group. In the test group showed no changes in insulin sensitivity. The test group showed improvement in bowel function. The fiber intake was below the recommendation for the diabetic.Food intake, body weight, BMI and waist circumference (WC) also showed no significant change. The percentage of body fat increased in the placebo group at 45 days (p = 0.0342) and decreased in the test group compared to placebo (p = 0.0216 and 0.0285). The basal metabolic rate (BMR) increased in the test group and decreased in placebo (p = 0.0198 and 0.005). Conclusion: Wheat dextrin in 10g/dia dosage did not improve insulin sensitivity, glycemic control and lipid, did not reduce body weight and WC and does not cause changes in the consumption of energy and macronutrients. There was increased consumption of fiber for the minimum of the recommendation, regulate bowel function, reduced body fat and increased the BMR. / Introdução: À fibra dietética, especialmente a fibra solúvel, são atribuídos efeitos fisiológicos que são importantes para o tratamento do paciente com diabetes mellitus tipo 2. Objetivo: Avaliar o efeito da suplementação de dextrina de trigo na sensibilidade à insulina, controle glicêmico e lipídico, e estado nutricional de portadores de diabetes mellitus tipo 2. Metodologia: Trata-se de um ensaio clínico cego, randomizado com duração de 12 semanas. A amostra foi composta por 27 indivíduos diabéticos tipo 2 de ambos os sexos, com IMC ≥ 25,00 kg/m2 e sedentários. Estes indivíduos foram randomizados em dois grupos, teste (n=14) e placebo (n=13). O grupo teste foi suplementado diariamente com 200 ml de bebida sabor laranja sem adição de açúcar e adicionada de 10 g de dextrina de trigo, 30 minutos antes do almoço. O grupo placebo recebeu diariamente a mesma bebida, mas sem adição de fibra. Os participantes foram orientados a manter seu estilo de vida (hábitos alimentares e de atividade física). A glicemia de jejum, a hemoglobina glicada (A1c), a sensibilidade à insulina, o perfil lipídico, o nível de atividade física, o funcionamento intestinal, o consumo alimentar, e os indicadores antropométricos foram avaliados no início, aos 45 e aos 90 dias de intervenção. Resultados: A A1c, a glicemia de jejum e o perfil lipídico não apresentaram diferenças significativas intra e entre grupos. Houve aumento nos valores de HOMA-IR (p=0,0163) e insulina de jejum (p=0,0406) aos 45 dias no grupo placebo, com diferença significativa. O aumento de HOMA-IR e insulina de jejum resultou em diminuição da sensibilidade à insulina do grupo placebo. No grupo teste não apresentou mudanças na sensibilidade à insulina. O grupo teste apresentou melhora no funcionamento intestinal. O consumo de fibras foi inferior a recomendação para o diabético. O consumo alimentar, o peso corporal, o IMC e a circunferência de cintura (CC) também não apresentaram mudanças significativas. A porcentagem de gordura corporal aumentou no grupo placebo aos 45 dias (p=0,0342) e diminuiu no grupo teste quando comparado ao grupo placebo (p=0,0216 e 0,0285). A Taxa de Metabolismo Basal (TMB) aumentou no grupo teste e diminuiu no placebo (p=0,0198 e 0,005). Conclusão: A dextrina de trigo na dosagem de 10g/dia não promoveu melhora na sensibilidade à insulina, no controle glicêmico e lipídico; não reduziu o peso corporal e CC e, não gerou mudanças no consumo de energia e de macronutrientes. Houve aumentou do consumo de fibra, para o mínimo da recomendação; regularização do funcionamento intestinal, redução da gordura corporal e aumento da TMB.

Modern food production is a complex, globalized system in which what we eat and how it is produced are increasingly disconnected. This thesis examines some of the ways in which global trade has changed the mix of inputs to food and feed, and how this affects food security and our perceptions of sustainability. One useful indicator of the ecological impact of trade in food and feed products is the Appropriated Ecosystem Areas (ArEAs), which estimates the terrestrial and aquatic areas needed to produce all the inputs to particular products. The method is introduced in Paper I and used to calculate and track changes in imported subsidies to Swedish agriculture over the period 1962-1994. In 1994, Swedish consumers needed agricultural areas outside their national borders to satisfy more than a third of their food consumption needs. The method is then applied to Swedish meat production in Paper II to show that the term “Made in Sweden” is often a misnomer. In 1999, almost 80% of manufactured feed for Swedish pigs, cattle and chickens was dependent on imported inputs, mainly from Europe, Southeast Asia and South America. Paper III examines ecosystem subsidies to intensive aquaculture in two nations: shrimp production in Thailand and salmon production in Norway. In both countries, aquaculture was shown to rely increasingly on imported subsidies. The rapid expansion of aquaculture turned these countries from fishmeal net exporters to fishmeal net importers, increasingly using inputs from the Southeastern Pacific Ocean. As the examined agricultural and aquacultural production systems became globalized, levels of dependence on other nations’ ecosystems, the number of external supply sources, and the distance to these sources steadily increased. Dependence on other nations is not problematic, as long as we are able to acknowledge these links and sustainably manage resources both at home and abroad. However, ecosystem subsidies are seldom recognized or made explicit in national policy or economic accounts. Economic systems are generally not designed to receive feedbacks when the status of remote ecosystems changes, much less to respond in an ecologically sensitive manner. Papers IV and V discuss the problem of “masking” of the true environmental costs of production for trade. One of our conclusions is that, while the ArEAs approach is a useful tool for illuminating environmentally-based subsidies in the policy arena, it does not reflect all of the costs. Current agricultural and aquacultural production methods have generated substantial increases in production levels, but if policy continues to support the focus on yield and production increases alone, taking the work of ecosystems for granted, vulnerability can result. Thus, a challenge is to develop a set of complementary tools that can be used in economic accounting at national and international scales that address ecosystem support and performance. We conclude that future resilience in food production systems will require more explicit links between consumers and the work of supporting ecosystems, locally and in other regions of the world, and that food security planning will require active management of the capacity of all involved ecosystems to sustain food production.

No description available.

Urban agriculture is a strategy poor urban, informal settlement residents adopt to reduce poverty and improve food security and child nutrition. It is widely asserted in the literature and development circles that household vegetable gardens can provide a significant percentage of recommended dietary allowances of macro- and micro-nutrients in the diets of pre-school children. These children are vulnerable in terms of food access and nutrition. The first five years of a child’s life are crucial to psychological well-being. This study set out to determine the impact of home gardens on access to food, dietary diversity and nutrient intake of pre-school children in an informal settlement in Eatonside, in the Vaal Region, Johannesburg, South Africa. The home gardening project was undertaken in five phases, namely the planning phase; a baseline survey (including quantitative food intake frequencies, 24-hour recall, individual dietary diversity questionnaires and anthropometric measurements); a training programme on home gardens; planting and tending the gardens and evaluating the impact of home gardens on access to food, dietary diversity and nutrient intake of pre-school children. Children aged two to five years (n=40) were selected to participate in the study. The sample population consisted of 22 boys and 18 girls. The children were categorised into three groups at the start of the project: children of 24-35 months (four boys and one girl), 36-47 months (four boys and five girls) and 48-60 months (14 boys and 12 girls). All but 10 per cent of the children’s consumption of foods in the food groups increased. At the start of the project, low consumption rates were observed for white tubers and roots, vitamin A-rich fruit, other fruit and fish. After the gardening project, the number of children consuming vegetables increased considerably. There was an increase in the intake of food groups over the period of the project. The number of children consuming vitamin A-rich increased the most, with all children (45 per cent improvement) consuming vitamin A-rich vegetables at the end of the project, compared with just over half at the start of the project. The consumption of vegetables increased with 78 per cent of the children consuming beans and 33 per cent beetroot. Most children (95 per cent) consumed cabbage, carrots and spinach post-home gardening. Seventy eight percent of children consumed beans by the end of the project, but only a third of the children had consumed beetroot during the post-project survey period. Intakes of all nutrients considered in the study improved by the end of the project, except for energy and calcium, which dropped marginally, but both remained at around 50 per cent below requirements. Twenty five percent of boys (24-35 months) were underweight and below the 50th percentile at the pre- and post-project stages. The same boys were severely stunted (on average -4.41 standard deviations below the third percentile). Of the boys aged 36-47 months, 25 per cent were stunted pre-project, but by the end of the project, this number had decreased to 50 per cent. Twenty one per cent of the older boys (48-60 months) were within their normal height for age. Twenty five per cent of girls were underweight (36-47 months). A slight change was observed in the 36-47 month group, where the mean changed from -0.14 standard deviations (below 50th percentile) pre-project to -0.5 (below 50th percentile) post-project. All girls aged 24-35 months were below -2 standard deviations pre-project. After the home gardening project, the figure dropped to 50 per cent. For girls aged 36-47 months, 25 per cent were below -3 standard deviations after the project, compared with 20 per cent pre-project. Height-for- age for girls aged 36-47 months dropped by 10 per cent below -2 standard deviation post-home gardening. Girls from 24 to 35 months were severely stunted [-3.02 (below 3rd percentile) pre- and -2.31 (below 5th percentile) post-project]. Stunting was observed in 36-47 months girls who had means of -2.39 (below 3rd percentile) and 1.86 (below 25th percentile) both pre-and post-gardening respectively and were at risk of malnutrition. The older girls were well nourished with means of height-for-age at -0.88 (below 50th percentile) pre-project and -0.92 (below 50th percentile) post-project. Home-gardening improved food access, dietary diversity, energy, protein, carbohydrate, fat, fibre, vitamin A and iron intakes, but did not make a significant impact on the malnutrition of the children in the project or ensure adequate intakes. Home gardens had a positive impact on height-for-age scores; but had no significant impact on mean weight-for-age and height-for-weight z-scores of the pre-school children. Increases in carbohydrate and fat intakes were shown to have the only significant impact on the children’s nutritional status and only with regard to improving height-for-age scores. The results show that the gardens did not have the expected impact on children’s nutrition, but confirm that increases in incomes from gardening are likely to have a greater impact through savings from consuming produce grown and selling produce to buy energy-dense foods for the children. This needs to be considered in nutrition interventions. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2010.

Information on the present situation of household food insecurity in South Africa is fragmented. There is no comprehensive study comparing different indicators of household food security. Better information on the household food security situation in South Africa would permit relevant policy formulation and better decision-making on the allocation of limited resources. The availability of a national dataset, the first South African National Food Consumption Survey data (1999) , provided the opportunity to investigate some of the issues raised above, and to contribute to knowledge on the measurement of household food security. The aim of this study was to use the data from the 1999 National Food Consumption Survey (NFCS) to : • Determine and compare the prevalence of household food insecurity using different indicators of household food security ; • Determine the overlap of households identified as food insecure by the different indicators (i.e. how many of the same households are identified as food insecure); and to • Investigate whether there was any correlation between the indicators selected . The indicators of household food security selected were: household income, household hunger experienced, and using the index child: energy and vitamin A intake (from 24 Hour Recall (24HR) and Quantified Food Frequency data), dietary diversity (from 24HR data) and anthropometric indicators stunting and underweight. The cut offs to determine food insecure household were those used in the NFCS and the cut off for dietary diversity was exploratory. The main results of the study were as follows : • The prevalence estimates of household food insecurity ranged from 10% (underweight indicator) to 70% (low income indicator). Rural areas consistently had a higher prevalence of household food insecurity than urban areas . The Free State and Northern Cape provinces had higher levels of household food insecurity, with the Western Cape and Gauteng the lower levels of household food insecurity . • Quantified Food Frequency (QFF) data yielded lower prevalence of household food insecurity estimates than 24 hour recall (24HR) data. Household food insecurity as determined by low vitamin A intakes was higher than that determined by low energy intakes for both the 24HR and QFF data . • There was little overlap with the indicators (9-52%), indicating that the same households were not being identified by the different indicators. Low dietary diversity, low income, 24HR low vitamin A intake and hunger had higher overlaps with the other indicators. Only 12 of 2826 households (0.4%) were classified by all nine indicators as food insecure. • The dataset revealed a number of statistically significant correlations. Overall , low dietary diversity, low income, 24HR low energy intake and hunger had the stronger correlations with the other indicators. Food security is a complex, multi-dimensional concept, and from the findings of this study there was clearly no single best indicator of household food insecurity status. Overall , the five better performing indicators (higher overlaps and correlations) were : low income, 24 hour recall low energy intake, 24 hour recall low vitamin A intake, low dietary diversity and hunger; this merits their use over the other selected indicators in this study. The indicator selected should be appropriate for the purpose it is being used for, e.g. estimating prevalence of food insecurity versus monitoring the long term impact of an intervention. There are other important criteria in the selection of an indicator. Income data on a national scale has the advantage of being available annually in South Africa, and this saves time and money. The 24HR vitamin A intake and 24HR energy intake indicators has as its main draw back the skill and time needed to collect and analyse the information, which increases cost and decreases sustainability. Dietary diversity and hunger have the advantage of being simple to understand, and quicker and easier to administer and analyse. It is suggested that a national food security monitoring system in South Africa uses more than one indicator, namely : 1) household income from already existing national data, 2) the potential for including a hunger questionnaire in the census should be explored, and 3) when further researched and validated, dietary diversity could also be used in national surveys. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.

Crop production is widely promoted as a solution to food insecurity, but its real impact on household food security has not been measured in South Africa. Small-scale production is a common practice for many rural poor households of South Africa. While agriculture may play a major role in reducing food insecurity, agricultural growth alone cannot solve the problem of food insecurity at household level. South Africa is food secure at the national level, but available data suggest that between 58.5 and 73 percent of South African households experience food insecurity. This study set out to measure the impact of crop production on household food security among sampled households in two communal regions, Umbumbulu and Maphephetheni, of KwaZulu-Natal, to establish whether participation in food production improved household food security. Household surveys which explored the types of crops produced, food consumed, income obtained from crop sales and the food security situation, were carried out at Umbumbulu and Maphephetheni respectively (n = 200 and n = 68). The types of crops produced were investigated using crop production seasonality charts, while the household food security situation was measured using the Coping Strategy Index tool. The main findings of the study indicated that household gardens provided food for household members, but did not provide sufficient quantities to meet year-round consumption requirements. Most sampled households relied largely on purchased foods. More than 80% of the food consumed by households came from purchases, 4% and 13% came from own production in Umbumbulu and Maphephetheni respectively. Among the households surveyed, 58% and 89% were below the poverty line for Umbumbulu and Maphephetheni respectively. Umbumbulu and Maphephetheni’s largest household income contributions came from wages or salaries. Social grants were the second most important source of household income. As participation in crop production alleviated food shortages somewhat, its contribution to food security cannot be ignored. A study needs to be conducted to investigate whether participation in both farm/non farm activities reduces the number of households below the poverty line. Government should provide extension officers to monitor and evaluate the impact of gardens on household food security. To guide the design and implementation of commercial and home gardens, households need to develop clear and consistent policies, strategies, processes and procedures, and (a sound) monitoring and evaluation framework. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.

This study set out to investigate the food insecurity coping strategies of sample households from the Embo community in the Umbumbulu district of KwaZulu-Natal. A total of 151 Ezemvelo Farmers' Organisation and 49 non-EFO members were interviewed in two rounds, beginning in October 2004 and March 2005. The total sample included 200 respondents from 176 households. A survey questionnaire was used to collect data on socio-economic characteristics, food consumption patterns and application of consumption coping strategies. The study used the Coping Strategy Index to establish the food security status of the households by calculating and comparing the Coping Strategy Index Scores of households. Households applied short-term food consumption coping strategies to cope with food shortages and resorted to short-term income coping strategies when they experienced income shocks. Coping strategies employed by households were effective in mitigating food insecurity. Most strategies applied by most households were not detrimental to livelihoods and did not compromise future household food security. Food insecurity increased the frequency and severity of application of coping strategies employed by households. Households ate less preferred foods, skipped days without eating and ate wild foods. These coping strategies were particularly dangerous to households as proper nutrition is critical for ensuring healthy and productive lives. Food security interventions need to support beneficial coping strategies currently employed by households. Relevant stakeholder like the Departments of Health and Social Development need to target nutritional interventions through workshops and training with vulnerable households. Supporting protective coping mechanisms entails protecting entitlements to land, water resources and productive and non-productive assets. Agricultural production improved the incomes and food consumption of the sampled households. Sustainable agricultural production should be promoted and sustained at household level. The Ministry of Agriculture and local development agencies should assist the community by providing production inputs, for example, provision of vegetable seeds, mechanisation, infrastructure and information on improved production techniques to encourage greater productivity and wider engagement in agriculture. Home gardens could make iii valuable contributions to family food supply and income. The Ministry of Agriculture and local development agencies should give more advice through extension and training services, providing support through negotiation of contracts with suppliers. While agriculture may play a major role in the reduction of food insecurity, attention should also be given to the promotion of non-farming activities, particularly those that can reduce food insecurity. The community and households should actively engage in the design and implementation of policies government policies and strategies for farm and non-farm interventions. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2008.

Source: Dissertation Abstracts International, Volume: 70-03, Section: B, page: 1601. Adviser: Pamela M. Diamond. Includes bibliographical references.

This dissertation examines how concerns about food system transformations affect how middle class consumers in Islamabad, Pakistan, perceive and approach food consumption in their everyday lives. The dissertation is situated in the context of risky food environments and food fears resulting from intensified, industrialised, and increasingly lengthened global food systems. Working within food geography and food environments paradigms, this dissertation explores how the transformation of food systems is associated with increasing anxiety about food security and safety for middle class urban consumers in Islamabad. Qualitative data gathered from semi-structured interviews and participant observation is used to illustrate the effects external influences, such as energy scarcity and violent events, have on everyday food environments. The dissertation examines the ways in which conceptualisations of 'good food', and trust relationships are negotiated in these dynamic food environments. The intensely geographical nature of these food environments and food systems, and the role of place-specific contexts on perceptions and adaptations related to food anxieties are emphasised. Situated in literatures on food anxiety and food consumption emerging from geography, food studies, and anthropology, this dissertation challenges dominant discourses on alternative and ethical consumption in a globalising food system. The results of this research not only contribute to literature on South Asia, but also contribute to consumption practices of a burgeoning middle class in developing countries.

No description available.