Twenty-two adult male subject were randomly assigned to four complete liquid diets at four different fiber levels; one without added soy polysaccharide fiber which served as a control. All subjects were rotated. through four, eleven day controlled feeding periods. Complete fecal samples were collected and composited from the last five days of each eleven day period for fiber analysis. Fasting blood samples were taken on the morning prior to starting each new dietary period for plasma total cholesterol (TC), total triglycerides (TG), and high density lipoprotein-cholesterol (HDL-C) analyses, Low density lipoprotein-cholesterol (LDL-C) was determined by calculation. Increased mean dietary fiber intake led to a significant (P<.05) increase in fecal fiber from 0.4 g per day to 2.9 g per day. Mean apparent fiber digestibility significantly (P<.05) decreased from 92% on the control diet to 70% on the intermediate fiber diet. There was a nonsignificant increase in apparent fiber digestibility from the intermediate fiber diet (70%) to the high fiber diet (76%). When subjects went from self-selected diets to the zero-cholesterol, liquid formula diets, significant (P<.05) decreases were seen in plasma TC (from 164 mg/dl to a range of 129 to 136 mg/dl), LDL-C (from 108 mg/dl to a range of 81-85 mg/dl), TG (from 85 mg/dl to a range of 64 to 72 mg/dl), TC/HDL-C ratios (from 4.6 to an average of 3.8), and LDL-C/HDL-C ratios (from 2.9 to an average of 2.4). HDL-C levels did not change from the self-selected diet to the zero-cholesterol liquid formula diets (from 38 mg/dl to a range of 35 to 38 mg/dl). The addition of 20, 30, and 40 g of soy polysaccharide a fiber to the low residue control diet did not result in any further changes in plasma TC (131 mg/dl versus 129 mg/dl, 136 mg/dl, and 132 mg/dl respectively), TG (72 mg/dl versus 64 mg/dl, 69 mg/dl, and 72 mg/dl, respectively), HDL-C (36 mg/dl versus 35 mg/dl, 38 mg/dl and 37 mg/dl respectively), LDL-C (81 mg/dl versus 81 mg/dl, 85 mg/dl, and 82 mg/dl, respectively), TC/HDL-C ratios (3.8 versus 3.9, 3.8, and 3.8, respectively), and LDL-C/HDL-C ratios (2.4 versus 2.5, 2.4, and 2.3, respectively). At the end of the study when subjects went back to self-selected diets plasma TC, LDL-C, and HDL-C all significantly (P<.05) increased. / Master of Science

The purpose of this study is to show how much of the thiamin content of the noon and evening meals is contributed by meats and meat dishes which appear on the cafeteria menu, as well as the thiamin contribution of the breakfast meal to the total daily intake.

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Aim: To assess the effects of initial nutritional status on the responses to a school feeding programme (SFP) among school children in the Millennium Villages Project (MVP), Siaya District, Kenya. Objectives: To establish baseline data on the dietary intake, prevalence of undernutrition, body composition, prevalence of anaemia, body iron stores and vitamin A status in order to assess the impact of the SFP over a 30-month period on the same outcomes. Further, the study assessed the effect of initial nutritional status on the responses to the SFP on growth, the prevalence of anaemia, body iron stores and vitamin A status. Methods: In the MVP, a school meal additional to the children’s usual daily food intake was provided consisting of locally available foods (containing whole fish omena and beef). The meals contributed approximately 25% of the Estimated Energy Requirement (EER), 70% of the Estimated Average Requirement (EAR) for protein, and 18% of EAR for fat. A school meal, additional to the children’s usual daily food intake, was introduced to the control group 6 months into the study as a project scale up initiative. The meal provided 15% EER, 49 % EAR for protein and 10% EAR for fat. A total of 235 children participated in the study and were followed up for 30 months, with 118 in the MVP and 117 in the control group. Statistical analysis included descriptive, Pearson’s chi-square test, repeated measures ANOVA and multivariate logistic regression models. Results: The mean subject age was 7.9 years (2.0 SD) at baseline, and half (51.4%) were boys. More than half of the children (66%) had energy intakes less than the EER. At baseline, the prevalence of stunting, wasting and underweight was 16.9%, 6.0% and 3.6% respectively. Prevalence of linear growth deficit based on height-for-age z-score ≤-1 standard deviation was 48%. Anaemia was higher in the MVP group (82.2%; P < 0.0001) compared to controls (58.1%) while depleted body iron stores was observed in 10.7% of the children. Half of the children in the control group and 30% in the MVP group had an inadequate vitamin A status while 11% of the children had infection/inflammation. At six months after initiation of the intervention, anaemia prevalence was reduced to 41.2% among the controls and 9.3% in the intervention group (P < 0.001). Among the MVP group, children with initial inadequate nutritional status based on weight-for-age z-score WAZ ≤ -1 SD had a higher (P < 0.01) height velocity (2.3 cm/six months) by the 24th month study interval compared to those who had an initial adequate nutritional status based on weight-for-age z-score WAZ > -1 SD. Conclusion: SPF menus were associated with potential for improved growth, gain in lean body mass and reduced anaemia prevalence when inadequate nutritional status was present at baseline. / AFRIKAANSE OPSOMMING: Doel: Om die verband tussen skoolkinders se aanvanklike voedingstatus en die respons op ’n skoolvoedingsprogram (SVP) in die Millennium Villages Project (MVP), Siaya-distrik, Kenia, te bepaal. Doelwitte: Om basislyn data te versamel ten opsigte van dieetinname, prevalensie van ondervoeding, liggaamssamestelling, prevalensie van anemie, ysterstore en vitamine A status ten einde die impak van die SVP oor ‘n 30-maande periode op genoemde uitkomste te bepaal. Verder het die studie ook die effek van aanvanklike voedingstatus op die respons tot die SVP bepaal ten opsigte van groei, die prevalensie van anemie, ysterstore en vitamine A status. Metode: In die MVP is ‘n skoolmaaltyd addisioneel tot die kinders in beide studiegroepe se daaglikse voedselinname voorsien. Die SVP se spyskaarte het bestaan uit plaaslik beskikbare voedsel (bevattende die vissoort omena en beesvleis) en het ongeveer 25% van die kinders se geraamde energievereistes (EER), 70% van hul proteïenvereistes (EAR) en 18% van hul vetvereistes (EAR) voorsien. ‘n Skoolmaaltyd is addisioneel tot die kinders in die kontrolegroep se gewoontelike daaglikse voedselinname ingesluit 6 maande na aanvang van die studie as deel van die MVP se uitbreidingsinisiatief. Dié maaltyd het in 15% van die kinders se energievereistes (EER), 49% van hul proteïenvereistes (EAR) en 10% van hul vetvereistes (EAR) voorsien. Altesaam 235 kinders is by die studiegroep ingesluit – 118 in die MVP en 117 in kontrolegroepe – en is vir 30 maande bestudeer. Statistiese ontleding het beskrywende ontleding, Pearson se chi-kwadraattoets, ANOVA met herhaalde metings, en multivariansie logistiese regressiemodelle ingesluit. Resultate: Die gemiddelde ouderdom van die kinders by basislyn was 7.9 jaar (2.0 SD) en die helfte (51.4%) van die respondente was seuns. Meer as die helfte van die kinders (66%) het ‘n energieinname minder as die EER getoon. By basislyn was die prevalensie van belemmerde groei, uittering en ondergewig onderskeidelik 16.9%, 6.0% en 3.6%. Die voorkoms van onvoldoende lengtegroei gebaseer op lengte-vir-ouderdom z-telling < -1SD was 48%. Anemie was hoër in die MVP groep (82.2%; p<0.0001) vergeleke met die kontroles (58.1%), terwyl 10.7% uitgeputte ysterstore getoon het. Onvoldoende vitamine A status het voorgekom in die helfte van die kinders in die kontrolegroep en 30% van die MVP groep, en infeksie / inflammasie was teenwoordig in 11% van die kinders. Die voorkoms van anemie op ses maande na aanvang van intervensie het verbeter tot 41.2% in die kontrolegroep en 9.3% in die intervensiegroep (P < 0.001). Op 24 maande het kinders met aanvanklike onvoldoende voedingstatus (WAZ < -1SD) in die MVP-groep groter lengtetoename (2.3 cm/6 maande) getoon as hul groepgenote met aanvanklike voldoende voedingstatus gebaseer op WAZ > -1 SD (P < 0.01). Gevolgtrekking: Die skoolvoedingsprogram spyskaarte het die potensiaal getoon tot ‘n verbetering in groei, toename in maer liggaamsmassa en ‘n verlaagde voorkoms van anemie onder kinders wie se basislynvoedingstatus onvoldoende was.

Thesis (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Background: Synbiotics, probiotics and prebiotics are being added to infant formula. This study was an in-depth evaluation of research on infants fed infant formula containing synbiotics, probiotics or prebiotics and was carried out in two phases. Phase one included two systematic reviews that assessed if synbiotics, probiotics or prebiotics led to improved growth and clinical outcomes in formula fed full term and preterm infants. Phase two included two studies: A systematic review compared the methodological quality and outcomes of industry and non-industry sponsored randomized controlled trials (RCTs) and a descriptive study evaluated how the food industry applies the knowledge and evidence gained from probiotics, prebiotics or synbiotics research in infants. The research questions were: Does the consumption of probiotics, prebiotics or synbiotics supplemented infant formula lead to improved clinical outcomes in infants? Is there an association between source of funding and methodological quality, clinical outcomes and author’s conclusions in trials using probiotics, prebiotics or synbiotics supplemented formula in infants? Does the food industry use the evidence gained through probiotics, prebiotics and synbiotics research trials on infants for the benefit of the general paediatric population? The hypotheses were: Consumption of probiotics, prebiotics or synbiotics by infants leads to improved clinical outcomes; The source of funding in research trials using probiotics, prebiotics or synbiotics supplemented formula in infants is associated with outcomes in favour of the sponsor’s products and authors’ conclusions; Methodological qualities of non-industry sponsored trials are equivalent to industry sponsored trials; Evidence gathered through probiotics, prebiotics and synbiotics research is implemented by the food industry. Methods: Phase one: Both systematic reviews on preterm and full term infants: Cochrane methodology was followed using RCTs which compared preterm or full term formula containing probiotics, prebiotics or synbiotics to conventional infant formula with / without placebo among healthy preterm or full term infants. The mean difference (MD) and corresponding 95% confidence intervals (CI) were reported for continuous outcomes, risk ratio (RR) and corresponding 95% CI for dichotomous outcomes. Phase two: In the systematic review, Cochrane methodology was used to assess the risk of bias of included RCTs. Association between source of funding and risk of bias, clinical outcomes and conclusions were assessed. In the descriptive study, all listed companies that manufacture infant food products with added synbiotics, probiotics or prebiotics for infants were identified and invited to participate. A letter of invitation was sent and if they expressed willingness to take part in the study, a questionnaire with a written consent form was sent. Descriptive statistics and associations between categorical variables were to be tested using a Chi-square test. Results: Phase one: Review on preterm infants: 8 studies were included. Probiotics increased stool frequency with no effect on other clinical outcomes. Prebiotics increased stool frequency and bifidobacteria counts only. Review on full term infants: 25 studies were included. Synbiotics improved stool frequency but had no effect on other clinical outcomes. Probiotics did not have an effect on any clinical outcome. Prebiotics increased weight gain and stool frequency with no effect on other outcomes. Phase two: Systematic review: 67 studies were included, majority were funded by food industry. There was no significant association between the source of funding and four domains (sequence generation, allocation concealment, blinding, selective reporting), majority of reported clinical outcomes or authors’ conclusions. Source of funding was significantly associated with two domains (incomplete outcome data, free of other bias), antibiotic use and conclusions on weight gain. Descriptive study: 25 companies were identified and invited to participate. No company agreed to participate in the survey for different reasons. Conclusions Phase one: Review on preterm infants: There is not enough evidence to state that supplementation with probiotics or prebiotics results in improved growth and clinical outcomes in exclusively formula fed preterm infants. Review on full term infants: There is not enough evidence to state that supplementation of term infant formula with synbiotics, probiotics or prebiotics does result in improved growth or clinical outcomes in term infants. There is no data available to establish if synbiotics are superior to probiotics or prebiotics. Phase two: Systematic review: In RCTs on infants fed infant formula containing probiotics, prebiotics or synbiotics, the source of funding does not influence majority of outcomes in favour of the sponsors’ products. More non-industry funded research is needed to further assess the impact of funding on reported clinical outcomes and authors’ conclusions. Descriptive study: Due to companies refusing to participate in this study, no conclusion could be drawn on how the food industry applies evidence gained through probiotics, prebiotics or synbiotics research on infants. More transparency is needed from the infant formula manufactures on how they apply the evidence gained from probiotic, prebiotic or synbiotic research on infants. / AFRIKAANSE OPSOMMING: Agtergrond Synbiotika, probiotika en prebiotika word gereeld by baba formule gevoeg. Hierdie studie was 'n in-diepte evaluering van navorsing oor babas gevoed met formule melk wat synbiotika, probiotika of prebiotika bevat en is uitgevoer in twee fases. Fase een het twee sistematiese oorsigte ingesluit wat die rol van synbiotika, probiotika en prebiotika op verbeterde groei en kliniese uitkomste van formule gevoede volterm babas en vroeg gebore babas evalueer het. Fase twee het bestaan uit twee studies: 'n sistematiese oorsig wat die metodologiese kwaliteit en uitkomste van die bedryf en nie-bedryf geborgde ewekansige gekontroleerde proewe (RCTs) evalueer het, asook 'n beskrywende studie wat die kennis en toepassing van bewyse oor die effektiewiteit van probiotika, prebiotika of synbiotika in die voedsel industrie bestudeer het. Die hipotese stellings was: verbruik van probiotika, prebiotika of synbiotika by babas lei tot verbeterde kliniese uitkomste; die bron van befondsing vir synbiotics, probiotika of prebiotika navorsing beïnvloed uitkomste ten gunste van die borg se produkte; bewyse ingesamel deur middel van probiotika, prebiotika en synbiotika navorsing word geïmplementeer deur die voedselindustrie. Metodes Fase een: Beide sistematiese oorsigte op volterm en premature babas: Cochrane metodes is gevolg deur ewekansige, gekontroleerde studies wat vol termyn of premature formule met probiotika, prebiotika of synbiotika met konvensionele baba formule met / sonder plasebo onder gesonde volterm of premature babas bestudeer. Die gemiddelde verskil (MD) en die ooreenstemmende 95% vertrouensintervalle is gebruik vir deurlopende uitkomste, risiko verhouding (RR) en die ooreenstemmende 95% CI vir tweeledige uitkomste. Fase twee: In die sistematiese oorsig is Cochrane metodiek gebruik om die risiko van vooroordeel van ingesluite ewekansige, gekontroleerde studies te evalueer. Assosiasie tussen bron van befondsing en die risiko van vooroordeel, asook kliniese uitkomste en gevolgtrekkings was beoordeel. In die beskrywende studie, is alle genoteerde maatskappye wat babavoeding produkte vervaardig met bygevoegde synbiotika, probiotika of prebiotika vir babas geïdentifiseer en uitgenooi om deel te neem. 'n Uitnodigingsbrief is vir die relevante maatskappye gestuur om hul bereidwilligheid om deel te neem te bevestig. Indien hulle wel bereid was om deel te neem was 'n vraelys met 'n skriftelike toestemming vorm gestuur. Beskrywende statistiek en assosiasies tussen kategoriese veranderlikes was getoets met behulp van 'n Chi-kwadraat toets. Resultate Fase een: Oorsig oor premature babas: 8 studies was ingesluit. Probiotika verhoog stoelgang frekwensie met geen effek op ander kliniese uitkomste. Prebiotika verhoog ook stoelgang frekwensie en slegs bifidobakteriële tellings. Oorsig oor die vol termyn babas: 25 studies was ingesluit. Synbiotika verbeter stoelgang frekwensie, maar het geen effek op ander kliniese uitkomste gehad nie. Probiotika het nie 'n effek op enige kliniese uitkoms gehad nie. Prebiotika verhoog gewigstoename en stoelgang frekwensie met geen effek op ander uitkomste. Fase twee: Sistematiese oorsig: 67 studies was ingesluit, en die meerderheid was befonds deur die voedsel bedryf. Daar was geen beduidende assosiasie tussen die bron van befondsing en vier gebiede (toekenningsvolgorde, toekenningsverberging, studie verblinding, selektiewe verslaggewing), en die meerderheid van gerapporteerde kliniese uitkomste of skrywers se gevolgtrekkings. Die bron van befondsing was beduidend verbind met twee gebiede (onvolledige uitslag data, vry van ander vooroordeel), antibiotika gebruik en gevolgtrekkings op gewigstoename. Beskrywende studie: 25 maatskappye is geïdentifiseer en genooi om deel te neem. Geen maatskappy het ingestem om deel te neem aan die studie om verskillende redes. Gevolgtrekkings Fase een: Oorsig oor premature babas: Daar is nie genoeg bewyse dat die aanvulling met probiotika of prebiotika resultate in verbeterde groei en kliniese uitkomste in uitsluitlik formule gevoede premature babas tot gevolg het nie. Oorsig oor die volle termyn babas: Daar is nie genoeg bewyse om te sê dat die aanvulling van term baba formule met synbiotika, probiotika of prebiotika lei tot verbeterde groei of kliniese uitkomste in termyn babas. Daar is geen inligting beskikbaar om te stel of synbiotika beter is as probiotika of prebiotika nie. Fase twee: Sistematiese oorsig: In studies op babas gevoed met formule melk wat probiotika, prebiotika of synbiotika bevat het, het die bron van befondsing nie meerderheid van die uitkomste in die guns van die borge se produkte beïnvloed nie. Meer nie-industrie befondsde navorsing is nodig om verder die impak van befondsing op kliniese uitkomste en skrywers se gevolgtrekkings te evalueer. Beskrywende studie: Aangesien al die maatskappy deelname geweier het, kon geen gevolgtrekking gemaak word of die voedsel bedryf bewyse oor die gebruik van probiotika, prebiotika of synbiotika toepas nie. Meer deursigtigheid is nodig van die formule vervaardigers oor hoe hulle die bewyse oor die gebruik van probiotika, prebiotika of synbiotika toepas.

Thesis (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Background: Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder. GI symptoms and impaired quality of life affect between 10-20% of all adults, corresponding to about 25-50% of all patients who visit a gastroenterologist’s clinic. In recent years, several novel mechanisms of IBS that likely relate to previously established theories have been identified. Inflammation, postinfectious low-grade inflammation, immunological and genetic predisposition along with altered microbiota are critical in IBS development, while several dietary factors may also play a role in this syndrome. However, none of these factors accounts for the full repertoire of IBS symptoms, and the pathophysiology of this condition is not fully understood. The overarching aim of this study was to investigate the nutrient intakes, GI microbiota and the effect of Lactobacillus plantarum (L.plantarum) 299v in IBS patients. Sub-aims: 1) Update healthcare professionals on current probiotic information and provide an overview of probiotic treatment approaches, with special emphasis on IBS, 2) conduct a well designed randomised, double blind, placebo-controlled trial (RCT) with L. plantarum 299v as part of an intervention and establish whether a course of probiotics may alleviate undesirable symptoms of IBS and improve quality of life, 3) assess nutrient intake in patients with irritable bowel syndrome (IBS) compared to dietary recommendations, 4) validate and assess the reproducibility of food records and 5) identify possible nutrient risk components for establishing GI microbiota involved in IBS and as part of an intervention, determine whether a course of probiotics may alter stool microbiota. Results: 1) A review article published by the author provides an overview of current probiotic treatment options to health care professionals and indicates certain probiotics are a promising therapeutic treatment option for management of IBS symtpoms, 2) the effects of the single strain probiotic, L. plantarum 299v, supplementation was evaluated in a RCT. Compared to placebo, the probiotic supplementation showed no significant reduction in GI symptom severity scores, particularly abdominal pain relief. Quality of life was also not improved in the treatment versus control group. Both the treatment and placebo groups improved significantly over the trial period, indicating a large placebo effect, 3) nutrient intakes of the IBS patients compared to current dietary reference recommendations indicates that this group of patients are at risk for nutrient inadequacies in key macro and micronutrients, 4) the validity and reliability of the dietary data showed good reliability but poor validity as measured by plasma fatty acids and 5) the GI microbiota composition in the phenotypically different diarrhoea-predominant IBS (D-IBS) vs. constipation-predominant IBS (C-IBS) showed that D-IBS patients had significantly lower counts of Lactobacillus plantarum compared to C-IBS patients. The probiotic had no significant effects on the GI microbiota as measured by quantitative polymerase chain reaction (qPCR). It was found that nutrient intakes had a significant impact on the microbiota. Lower fibre intakes were associated with higher Bacteroides spp., lower Bifidobacteria bifidum and Lactobacillus plantarum counts in both IBS groups. Conclusion: Taken together, L.plantarum 299v did not alleviate the GI symptoms of IBS, nor was it associated with significant changes in the GI microbiota. IBS patients may be at risk of key nutrient inadequacies. The influence of nutrient intakes on the GI microbiota provides an attractive explanation as a potential pathophysiological factor for IBS. / AFRIKAANSE OPSOMMING: Agtergrond: Prikkelbare derm-sindroom (PDS) is ‘n algemene gastro-intestinale (GI) stoornis. GI simptome affekteer die lewenskwaliteit van 10-20% van alle volwassenes. Dit stem ooreen met ongeveer 25-50% van alle pasiënte wat ‘n gastroënteroloog konsulteer. Verskeie oorspronklike meganismes vir die ontwikkeling van PDS is onlangs identifiseer. Inflammasie, post-infektiewe lae-graadse inflammasie, immunologiese en genetiese vatbaarheid tesame met veranderde mikrobiota is krities vir die ontwikkeling van PDS. Sekere dieetfaktore mag ook bydraend wees tot hierdie sindroom. Geen van hierdie faktore is egter verantwoordelik vir die volle spektrum van PDS simptome nie en die patofisiologie van die toestand word ook nog nie ten volle verstaan nie. Die oorkoepelende doel van hierdie studie is om nutriëntinname, GI mikrobiota en die uitwerking van L.plantarum 299v in PDS pasiënte bepaal. Sub-doelwitte: 1) Om gesondheidswerkers in te lig aangaande die nuutste inligting oor probiotika en om ‘n oorsig van probiotika behandelingsopsies te verskaf, met spesiale klem op PDS, 2) om ‘n goed beplande ewekansige, dubbel-blinde, plasebo-beheerde kliniese studie met L.plantarum 299v as deel van die intervensie uit te voer om sodoende te bepaal of ‘n kursus probiotika ongewensde simptome van PDS kan verbeter en lewenskwaliteit sodoende verhoog, 3) om nutriëntinname in pasiënte met PDS te bepaal vergeleke met dieet aanbevelings, 4) om die geldigheid en herhaalbaarheid van voedselrekords te bepaal en 5) om moontlike nutriënt risikokomponente vir die ontwikkeling van GI mikrobiota betrokke in PDS te identifiseer en om as deel van ‘n intervensie te bepaal of ‘n kursus probiotika stoelgang mikrobiota patrone verander. Resultate: 1) ‘n Oorsigartikel gepubliseer deur die kandidaat dui probiotika aan as ‘n belowende terapeutiese opsie in die behandeling van PDS simptome, 2) die effek van ‘n enkelstam probiotikum, L.plantarum 299v, is evalueer deur ‘n ewekansige, dubbel-blinde, plasebo-beheerde kliniese studie. Vergeleke met die plasebo, het probiotiese aanvulling geen betekenisvolle vermindering in die GI simptome in PDS pasiënte tot gevolg gehad nie. Lewenskwaliteit het ook nie verbeter in die behandelde versus die kontrole groep nie. Beide die behandelde en plasebo groepe het aansienlik verbeter oor die studietydperk, wat ‘n groot plasebo effek aandui, 3) nutriëntinname van die PDS groep vergeleke met huidige dieetaanbevelings, dui daarop dat hierdie groep pasiënte ‘n risiko het vir die ontwikkeling van kern nutriënttekorte (makro- en mikronutriënte), 4) die geldigheid en betroubaarheid van die dieetdata dui op goeie betroubaarheid, maar swak geldigheid soos bepaal deur plasma vetsure en 5) die dermkanaal mikrobiotiese samestelling in die verskillende fenotipes, diarree-oorheersende PDS (D-PDS) vs. konstipasie-oorheersende PDS (K-PDS) dui daarop dat D-PDS pasiënte aansienlike minder Lactobacillus plantarum gehad het vergeleke met K-PDS pasiënte. Die probiotikum het geen beduidende uitwerking op die oorheersende mikrobiota gehad nie, soos gemeet deur kwantitatiewe polimerase kettingreaksie (kPKR). Daar is gevind dat dieet ‘n beduidende impak op die mikrobiota gehad het. Daar is ‘n verband tussen laer vesel inname en hoёr Bacteroides spp. en laer Bifidobacteria bididum en Lactobacillus plantarum tellings gevind in beide PDS groepe. Gevolgtrekking: Die L.plantarum 299v enkelstam probiotikum het nie die gastrointestinale simptome van PDS pasiënte verlig nie en daar is ook geen beduidende veranderinge in die mikrobiota gevind nie. PDS pasiënte mag ‘n verhoogde risiko toon vir kern nutriënttekorte. Die invloed van nutriëntinname op GI mikrobiota verskaf ‘n belowende verduideliking as ‘n potensiële patofisiologiese faktor in PDS.

Thesis (MNutr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Objective To develop and test a marketable, Continuing Professional Development (CPD) accredited training manual focused on the role of medical nutrition therapy (MNT) for healthcare professionals (HCP) of the multidisciplinary Type 1 and Type 2 Diabetes Mellitus (DM) management team. Methods The study consisted of two components: (a) development of the MNT manual and (b) testing of the MNT manual. The development of the MNT manual consisted of seven steps: (1) needs assessment and problem definition; (2) literature search; (3) draft one of the MNT manual; (4) peer review; (5) draft two of the MNT manual; (6) evaluation by means of a survey; and (7) the final MNT manual. The testing of the MNT manual’s impact on knowledge had a test-retest design which consisted of seven steps: (1) DM knowledge questionnaire development; (2) participant recruitment; (3) questionnaire pilot; (4) initial knowledge testing; (5) self-study of MNT manual; (6) retesting of knowledge; (7) statistical analysis. Results From the literature a total of 132 published documents were selected for inclusion in the MNT manual after grading of the information. The first draft was compiled and sent for peer review and language editing. Recommended changes were made and the second draft was developed and sent to 79 registered dietitians (RDs) who volunteered to complete a survey after reading the MNT manual. The survey indicated that the majority were satisfied with the content, which in turn led to the final MNT manual.The questionnaire was compiled using the content of the MNT manual and creating 10 questions per section of the manual. The pilot was conducted using 10% (n = 7) of the total sample. Minor changes were made. For knowledge testing, participants included RDs between the ages of 23 and 60 years, registered with the Health Professions Council of South Africa. A test-retest design was used. Participants scored a mean of 57.5% on the initial knowledge questionnaire (KQ1), ranging between 33.6% and 79.8%. They lacked knowledge on: management of the hospitalised patient; diabetes and exercise; diabetes and religion; gestational diabetes; supplements commonly used by diabetics; diabetes in prisons; diabetes in children; the function, side-effects and contra-indications of metformin. The mean score on the second knowledge questionnaire (KQ2) increased to 90.5%, with the lowest score 50.4% and the highest 99.2%.There were two questions where participants scored < 50% (mean of n = 79) which related to the type of insulin regime most suitable during Ramadan and risk factors for Type 2 DM in children. Data were also analyzed according to various socio-demographic variables, but only one significant difference was found between groups. Conclusions and implications There is adequate research available to develop a comprehensive guide for HCP on the nutritional management of DM. Such an MNT manual should be marketed for CPD purposes to encourage HCP to improve their DM management skills, as seen by the dramatic improvement in DM management knowledge of the RDs participating in this research. Future studies may include knowledge testing of other HCP, as well as testing to determine if the newly acquired information is put into practice to the benefit of DM patients. / AFRIKAANSE OPSOMMING: Objektiewe Die ontwikkeling en toets van 'n bemarkbare, Voortgesette Professionele Ontwikkeling (VPO) geakkrediteerde handleiding oor die rol van mediese voedings terapie (MVT) vir mediese personeel van die multi-dissiplinêre Tipe 1- en Tipe 2 Diabetes Mellitus (DM) behandelings span. Metodes Die studie het bestaan uit 2 komponente: (a) die ontwikkeling van die MVT handleiding en (b) die toets van die MVT handleiding. Die ontwikkeling van die MVT handleiding het bestaan uit sewe stappe: (1) assesering van benodighede en probleem definisie, (2) literatuursoektog; (3) aanvanklike konsep van die MVT handleiding; (4) eweknie evaluasie; (5) volgende konsep weergawe van die MVT handleiding; (6) evaluering deur ‘n meningsopname; en (7) die finale MVT handleiding. Die toets van die MVT handleiding se impak op die kennis het 'n toets-hertoets ontwerp gehad wat bestaan het uit sewe stappe: (1) DM kennis vraelys ontwikkeling; (2) deelnemer werwing; (3) toets van vraelys; (4) toets van aanvanklike kennis; (5) selfstudie van die MVT handleiding; (6) hertoetsing van kennis; en (7) statistiese analise. Resultate Uit die literatuur is 132 gepubliseerde dokumente gekies vir insluiting in die MVT handleiding na gradering van die kwaliteit van die inligting. Die aanvanklike konsep is ontwikkel, taalversorg en eweknie geevalueer. Aanbevole veranderinge is gemaak en die tweede konsep is ontwikkel en gestuur aan 79 dieetkundiges wat vrywillig die MVT handleiding gelees het en aan ‘n meningsopname deelgeneem het. Uit die meningsopname was dit duidelik dat die meerderheid tevrede was met die inhoud, wat gelei het tot die finale MVT handleiding.Die vraelys is opgestel met 10 vrae per afdeling van die MVT handleiding, en getoets deur 10% (n = 7) van die totale aantal deelnemers, waarna geringe veranderinge gemaak is. Vir kennis toetsing, is dieetkundiges tussen die ouderdomme van 23 en 60 jaar, wat geregistreer is by die Raad vir Gesondheidsberoepe van Suid-Afrika, ingesluit. Deelnemers het 'n gemiddeld behaal van 57.5 % op die aanvanklike kennis vraelys, met kennis wat gewissel het tussen 33.6% en 79.8%. Hulle het aanvanklik gebrekkige kennis gehad oor: die behandeling van die hospitaal pasiënt; diabetes en oefening; diabetes en godsdiens; swangerskaps diabetes; aanvullings gebruik deur diabete; diabetes in gevangenisse; pediatriese diabetes; asook die funksie, newe-effekte en kontra-indikasies van metformien. Die gemiddelde telling op die tweede kennis vraelys het toegeneem tot 90.5%, met ‘n laagste telling van 50.4% en hoogste van 99.2%. Daar was 2 vrae waar deelnemers < 50% (gemiddelde % van n = 79) behaal het. Hierdie vrae het verband gehou met die mees geskikte insulien behandeling tydens Ramadan en risikofaktore vir Tipe 2 DM in kinders. Data is ontleed volgens verskeie sosio-demografiese veranderlikes, maar slegs een beduidende verskil is tussen groepe gevind. Gevolgtrekkings en implikasies Daar is voldoende navorsing beskikbaar om ‘n omvattende handleiding vir mediese personeel oor die rol van voeding in die behandeling van DM te ontwikkel. So 'n MVT handleiding moet bemark word vir VPO doeleindes om mediese personeel aan te moedig om hul DM bestuursvaardighede te verbeter, soos gesien deur die dramatiese verbetering in DM bestuur kennis van die huidige deelnemers. Toekomstige navorsing kan die bepaling van kennis verbetering van ander mediese professies insluit, en of die verbeterde kennis in die praktyk DM pasiënte bevoordeel.

Typescript (photocopy). / Digitized by Kansas Correctional Industries

Over 60% of the population in K'asho Got'ine, NWT, obtained less than 2/3 of the Recommended Nutrient Intakes (RNI) for vitamin A and calcium, as reported in a previous nutritional assessment. Focus group discussions and a food preference assessment were conducted with adults in order to identify the cultural, ecological, and socioeconomic factors (food attributes) as well as the individual preferences which influence the consumption of vitamin A and calcium-rich traditional and market foods in K'asho Got'ine. The major attributes limiting intakes of traditional food rich in vitamin A and calcium included: lack of equipment for hunting/fishing; seasonality; distance traveled to obtain certain foods; occasional unhealthy appearance of food; no hunter/fisher in the household. The major food attributes reported as barriers to greater intakes of selected market foods were: cost, freshness, intolerance to certain items, availability and unfamiliarity. Foods that received the highest preference scores were rabbit liver, loche liver, and Canada goose meat (smoked/dried) for vitamin A-rich foods and connie eggs, rabbit flesh, woodland and barrenland caribou head for calcium-rich foods. Criteria for selection of traditional and market foods to promote in the community included: (1) convenience of the food; (2) difficulty to overcome barriers to increasing food consumption; (3) concentration level of contaminants in certain traditional food; and (4) food preference score. This study identified available and underutilized traditional and market foods rich in vitamin A and calcium which are most acceptable to the community, and may be promoted in future nutrition intervention programs.

We investigated the effect of pyridoxine supplementation on the utilization of protein in a low-protein, plant-based diet in four subjects (2 men and 2 women), aged 21 to 38 years. Following two days of a negligible protein diet, this 34 day study was divided into three dietary periods: the subjects received a low-protein, plant-based diet during period I for 10 days (no pyridoxine supplement), the same diet but with the addition of 50 mg pyridoxine HCl during period II for 7 days, and their self-chosen diets during period III for 15 days (no pyridoxine supplement). Data for period III will be reported elsewhere. The greatest portion of protein in the experimental diet was furnished by pinto beans (1.02 g nitrogen) and peanut butter (0.86 g nitrogen); nitrogen intake was kept constant at 4.56 g/d for the men and 4.15 g/d for the women during periods I and II. These diets administered during periods I and II provided 0.907 mg of vitamin B-6 for the men and 0.758 mg of vitamin B-6 for the women and was adequate in other nutrients except for protein. Overall, the effect of 50 mg pyridoxine HC1 supplementation on the utilization of protein in a low-protein plant-based diet was not statistically significant (p > 0.05) on the basis of a paired t-test for the parameters measured: nitrogen balance, apparent protein digestibility, as well as plasma and urinary urea nitrogen. Furthermore, we obtained conflicting results, when the subjects received pyridoxine, their plasma urea nitrogen increased slightly (suggesting increased protein degradation), while the percent of total urinary nitrogen excretion as urea nitrogen decreased (suggesting decreased protein degradation). These changes were not statistically significant, but limitations in the nitrogen balance technique and the analytical procedures we used may have contributed to these conflicting results. We suggest that a longer study with more subjects may show a greater improvement of plant protein utilization than we had observed. / Graduation date: 1990

Thesis (Ph. D.)--Oregon State University, 2007. / Printout. Includes bibliographical references. Also available on the World Wide Web.