Aim. The aim of this study was to document and provide a critical analysis of the South African Food-Based Dietary Guidelines (FBDGs) development process, and to assess the appropriateness of the proposed South African FBDGs. To achieve this aim, specific study objectives included the following : (1) To document and critically analyse the South African FBDGs process in relation to the 10-step development process recommended by the FAO/WHO. (2) To assess the appropriateness of the proposed South African FBDGs in terms of consumer comprehension (perceptions, general understanding and specific interpretations), and application of the guidelines (ability to apply the guidelines when planning a typical day' s meals for their families). (3) To assess the compatibility of the proposed South Africa FBDGs in terms of food categorisation as perceived by consumers, and as depicted in the food guides that are commonly used. Methodology. An extensive literature review on the development of international dietary guidelines, the emergence of FBDGs and the FAO/WHO FBDGs process, together with documentation of the South African FBDGs process, was used to critically analyse the process used for developing the proposed South African FBDGs. Focus group discussions (n=15) and structured individual interviews (n=230) were held in ten magisterial districts within KwaZulu Natal (KZN), randomly selected according to settlement strata (rural, urban informal, urban formal) and ethnicity (Black, Indian, White) to reflect the KZN population. Participants were women with no formal nutrition training, who made the food purchasing and preparation decisions in the household. A total of 103 women participated in the focus group discussions and 230 women in the structured individual interviews. Results. The process followed by the SA FBDG Work Group has ensured that the proposed South African FBDGs are country-specific in that each FBDG is evidence-based and relates to specific nutrition-related public health concerns of South Africans. Except for the "Eat healthier snacks" FBDG, participants understood and interpreted the FBDGs as intended by health professionals, and could construct a day's meals to reflect the FBDGs. Only two other FBDGs were identified as confusing in terms of terminology used, namely, "legumes" and "foods from animals". By rewording these guidelines the FBDGs would be highly compatible in terms of personal food categorisation. Use of food guides was low, mainly due to a lack of knowledge about how to use them. In terms of food categorisation as depicted by the reportedly most commonly used food guides (3- and 5- Food Group Guides), these food guides are incompatible with the proposed FBDGs. Conclusions. Within the South African context, the FAO/WHO FBDGs development process was feasible and practical to implement. However, to ensure sustainability of the South African FBDGs process, it is strongly recommended that the Department of Health appoint a representative scientific committee specifically for the purpose of reviewing and reformulating the South African FBDGs. Results indicate that a single set of FBDGs can be appropriate for all South Africans provided that certain guidelines are reworded as suggested; and that all the guidelines are accompanied by explanatory information citing commonly consumed foods/drinks as well as practical examples of how to apply the guidelines in light of perceived barriers. In terms of the appropriateness of food guides commonly used in South Africa, there is a need to either move away from the concept of food groups and/or to develop a new South African food guide that is compatible with the proposed FBDGs. / Thesis (Ph.D.)-University of Natal, Pietermaritzburg, 2002.

An evaluation of the impact of the nutritional program "Mangeons en coeur" was conducted with 64 participants in this program. The two study objectives were to measure any changes in the dietary intake of program participants and to evaluate the performance of a food habits questionnaire in evaluating change in fat intake at the individual level. The dietary evaluation by the diet history indicated no change in the total intake of lipids (31% of energy as lipids) over the course of the program. Comparisons of the total lipid intake as measured by the diet history and food habits questionnaire indicated significant correlations at both baseline and at the end of the program.

The high rate of malnutrition (180/1000 live births) in Sierra Leone (U N Demographic Year Book, 1985) has become a major concern to the government, development agencies, medical and nutritional personnel. This study was designed to determine whether there were any significant differences between the nutritional status of the children women who participated in an FAO project and those who did not and was conducted in six villages in the Koinadugu District of Sierra Leone.By referring to a list of local protein rich foods, three-day recall of food frequency was done to estimate the protein intake. Anthropometric measures were collected and body mass index was determined. All measures were compared with standards for African-American population.The weight-for-age was significantly greater for the the 50th percentile than that of the non-project children (NPC). Protein intake less than the average of 57 grams, were seen among older children with lower weight-for -height percentile, suggesting that total food intake was inadequate for the older children. This researcher believes that the FAO project should continue but that nutrition education should be an important component of the program. / Department of Home Economics

Maternal folate intake and levels of folate in milk, serum and red cells were assessed in 57 healthy, lactating women, ages 22-38 years, throughout early (0-6 months) and later (7-23 months) lactation. Average maternal folate intake from diet alone was 212 µg/day or 78.5% RDA (1989) and mean total folate intake from diet and supplements was 314% RDA (878 µg/day) at 0-6 months and 238% RDA (620 µg/day) at >6 months. Human milk folate was sufficient to meet the RDA (1989) for infants. Milk folate was not related to maternal folate intake, maternal serum or red cell folate and was unaffected by extended lactation (7-23 months), perhaps at the expense of maternal folate stores. Compared with early lactation, serum folate decreased (p=0.0004) and red cell folate tended to decrease (p=0.08) in later lactation and were both increased by folate supplementation (p < 0.001).Level of folic acid supplementation appeared to predict red cell folate concentration. An average of 884 µg supplemental folate/day was associated with red cell folate levels >400 ng/mL, which have previously been reported as optimal for prevention of folateresponsive neural tube defects. The addition of an 880 µg/day folic acid supplement to the diet of lactating women may raise red cell folate concentrations of lactating women to protective levels. / Department of Family and Consumer Sciences

The purpose of this study was to analyze the effect of fatty acid chain length and quantity on the bioavailability of calcium. Thirteen healthy subjects were randomly assigned to a series of 5 test meals containing varying types and levels of fat and calciumconsumed over a three week time period. The test meals included 10 grams MCT oil (MCT 10), 20 grams MCT oil (MCT 20), 10 grams beef fat (BT 10), 20 grams beef fat (BT 20), and calcium only (Ca). Calcium absorption was assessed using timed urine collections following a specified calcium load. Three day food records were obtained to assess typical nutrient intakes of the subjects coming into and during the study. MCT oil provided better absorption of the calcium supplement than did the beef tallow. A difference was also noted in the absorption of calcium based on the amount of fat consumed. A higher intake of MCT oil (10 g vs. 20 g) appeared to favor the absorption of calcium. Urine calcium excretion was significantly greater (p < .009) during the MCT oil treatments (MCT 10, MCT 20) compared to the beef fat treatments (BT 10, BT 20), suggesting reduced calcium absorption during the beef fat treatments. There were no differences in mean calcium excretion based on quantity of fat consumed ( 10 g vs. 20 g), nor any interaction between type of fat and amount. Tests for detecting differences between individual treatments indicated a significance difference (p < .05) in calcium excretion between MCT 20 and BT 10 treatments. Urine calcium excretion was corrected for body size using urine calcium/creatinine ratio (Ca/Cr). There was a significant time effect between the 0 - 2, 2 - 4 hour time periods (p < .005) and the various treatments for Ca/Cr. Though not significant, mean Ca/Cr was highest for the calcium treatment (0.42), compared to the MCT oil treatments (36, z of MCT 10 & MCT 20), and beef fat treatments (28, x of BT 10 & BT 20). The beef fat treatments significantly decreased the absorption of calcium compared to the MCT oil treatments. It appears that beef fat, when compared to the calcium only treatment, decreased calcium absorption. / Department of Home Economics

The present study explored whether African American women's level of dietary fat intake could be predicted by the variables of food preferences and preparation methods, support for healthy eating from family and friends, attitudes toward health, and acculturation. The present study also explored whether African American women's level of dietary fat intake could be predicted by the variables of food preferences and preparation methods, support for healthy eating from family and friends, and attitudes toward health, as moderated by acculturation.Information was obtained from five hundred and nintey nine African American females between the ages of eighteen and forty four. The women were recruited from a Midwestern univeristy, an undergraduate and graduate chapter of an African American sorority, two African American professional organizations, and through the snowball method. Particpants completed a Demographic Questionnaire, The Eating Behavior Patterns Questionnaire, The African American Acculturation Scale Short Form, The Health Attitudes Scale, The Social Support Scale, and The Eating Patterns Subscale on the Eating Habits Questionnaire. The data was collected via hardcopy and InQsit, an online survey program.Numerous preliminary tests were run to screen the data for outliers, linearity, and multicollinearity. Then, two forced entry multiple regressions were performed. In the first analysis, the overall model was a significant predictor of dietary fat intake. African American women's preferred foods, positive and negative support from friends, overallconcern for health, and intentions to adopt positive health practices are significant predictors of their level of dietary fat intake. In fact, these variables acccounted for almost half of the amount of variance in dietary fat intake. The second model was not significant and acculturation was not a significant predictor or moderator of dietary fat intake. Although acculturation was proven to be influential to dietary behaviors in African Americans in previous literature, the findings were not confirmed in this study.Multiple possibilies may explain the lack of significant findings between level of acculturation and dietary fat intake. The women in the current study were of a higher educational and income status than women in previous studies indicating significant findings. This difference in education and income, among other factors, may account for the difference in significant findings. The information gained in this study can be used to develop pschoeducational and treatment programs aimed at helping African American women prevent or treat health problems associated with poor eating habits. Several research implications are also noted. / Department of Counseling Psychology and Guidance Services

Two major nutritional concerns in the United States today are the increasing consumption of soft drinks and the decreasing intake of fruits and vegetables. This study hypothesized that there is a negative correlation between soft drink consumption and fruit and vegetable intake among college students.Data were collected by means of a 3-day food record. The collection time occurred on three consecutive specified days with college students who ate in the college dining commons. These food records were then analyzed on computer software. A Pearson correlation coefficient was obtained by comparing the average intake of fruits and vegetables for each individual with the average intake of soft drinks for each individual. Using an alpha level of 0.05 and 75 degrees of freedom, a significant negative correlation was found between the amount of soft drinks consumed and the amount of fruits and vegetables eaten. / Department of Family and Consumer Sciences

This study was designed to measure the prevalence and nutritional impact of dairy product restriction in both pregnant and lactating women. Dairy product (DP) restriction was assessed in 2091 prenatal class attendees. Subsamples of 279 healthy pregnant and 175 exclusively breastfeeding women provided repeat 24-hour dietary recalls which were used to estimate nutrient intake and to assess dietary adequacy using adjusted nutrient distributions. Pregnancy outcome was recorded. Pregnancy. DP restriction was reported by 13.2% (95% CI: 12.7%,14.1%) of pregnant women. Significant differences were found in the proportion of restrictors (Rs, 20.8%) below the calculated EAR for adjusted protein intakes vs. nonrestrictors (NRs, 9.2%, chi 2 = 6.78, p = 0.009). Intake distributions of calcium and vitamin D were compared to their respective Als for descriptive purposes and were lower for Rs vs. NRs but dietary inadequacy could not be assessed. Infants of NRs weighed on average 120 g +/- 468.9 g more than those of Rs but this difference was not statistically significant (p = 0.06). However, in multiple regression analysis where maternal weight gain, age, education and pregravid weight were controlled for, restriction predicted a comparable loss in birthweight of 122.5 g's (p = 0.048) and vitamin D intakes were positively associated with fetal growth. Lactation. Restriction (≤250 ml milk/day) was reported by 23% (95% CI; 16%--29%) of exclusively lactating women. Protein was lower than the EAR for 60% of Rs and 37.8% of NRs (chi 2 = 6.22, p = 0.025). The proportion of Rs and NRs < EAR from diet differed for thiamin (15% vs. 0%, chi2 = 0.97, p < 0.001), riboflavin (15% vs. 1.5%, chi2 = 12.93, p < 0.001) and zinc (65.0% vs. 34.8%, chi2 = 11.6, p < 0.041). From diet and supplement intake vitamin D and calcium remained lower for Rs compared to NRs but inadequacy could not be assessed or compared. DP restriction was not associated with greater weight loss amo

Despite the recognition that culturally diverse groups of children in low income areas are at elevated risk for future health problems, no dietary/nutritional studies have been reported on this population. Children aged 9-12 were sampled from schools selected on the basis of a poverty index and ethnicity. Nutritional information (24-hour recall, heights and weights) indicated children were growing well but a high proportion were overweight. A comparison of reported energy intake to calculated BMR indicated that overweight children under-estimated their intakes. Mean intakes met the Canadian RNIs except for calcium in 10-12 year old girls. Nutrient intake was related to family size, income and ethnic origin. Validation of two alternative tools to measure fat intake proved unsuccessful. In conclusion, dietary intake for these school children was adequate for all nutrients except calcium in 10-12 year old girls, but for approximately 40% of children, intake exceeded energy requirements.

Medium chain triglycerides (MCT) have long been advocated as potential weight-lowering agents or potential tools in the treatment and prevention of human obesity. These statements have been made after findings from human and animal trials that consumption of MCT increases energy expenditure and fat oxidation compared to long chain triglycerides (LCT). In addition, animal studies have resulted in lower body weight gain and smaller fat depots when animals were fed MCT compared to those fed LCT. However, long-term controlled trials studying the effects of consumption of MCT in humans have not been conducted and the longest trial to date, 14 d of duration, has shown that the effect of MCT on energy expenditure may be transient. Therefore, we aimed to determine whether, in controlled feeding conditions, consumption of MCT for 4 wk would lead to differences in energy expenditure and substrate oxidation versus consumption of an isocaloric diet rich in LCT. Furthermore, our aim was to establish whether consumption of MCT for 4 wk would lead to greater changes in body composition than would LCT consumption. We conducted two randomized, controlled, crossover feeding trials involving overweight women and men to test our objectives. A secondary objective was to examine the potential satiating effect of MCT, and this was tested in men. Finally, a third objective was to determine whether, when combined with phytosterols and flaxseed oil, MCT consumption would result in different blood lipid profile compared to LCT. Nineteen healthy overweight women and 24 healthy overweight men participated in two separate randomized controlled trials to test these objectives. Energy expenditure and body composition were assessed at the beginning and end of each experimental phases, which differed only in the type of fat included in the controlled diets. Blood samples were also taken at baseline and endpoint of each phase to determine plasma lipid concentrations. Result