The present study looks at the socio-emotional impact of malnutrition. This is done by comparing infants who are hospitalised for malnutrition, and infants hospitalised for surgical reasons. Twenty infants were selected from the medical ward (malnutrition ward), and twenty from the surgical ward were selected as a control group. Observation was used as a method of collecting data on socio-emotional behaviour. The results of analysis of variance indicated that there was a significant difference between the two groups of children in social and emotional responsiveness. Malnourished children showed less responsiveness, which was suggested by less activity, less affect, and low reactions to situations compared to the control group. The results also indicated that females are more sensitive than males. The results of this study invite possibilities for further investigations. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 1998.

Thesis (MNutr)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Background: Considering the myriad of risk factors causing nutritional deficiency, as well as the prevalence of malnutrition and feeding problems experienced by individuals with intellectual disability (ID), early detection and diagnosis of malnutrition in this population group is essential. Objectives: The main aim and objectives of the study were to determine the degree of malnutrition and body composition in individuals with ID living in a psychiatric hospital (North West Province, South Africa), to determine which degree of ID was more prone to malnutrition, to investigate the different risk factors for malnutrition in this group of individuals, and to use this data to adapt an existing screening tool used to facilitate the easier identification of malnutrition. Methodology: An observational descriptive cross-sectional study, with an analytical component, was conducted. The study consisted of two phases. During the first phase, measurements were taken of individuals with ID to determine body composition and nutritional status. During the second phase, said data, as well as other factors influencing the nutritional status of individuals with ID, were used to adapt an existing screening tool to allow for easier identification of malnutrition in the study population. The adapted screening tool was tested by nursing staff. Results: The anthropometric measurements of 244 individuals with ID were determined. The overall anthropometrical status indicated that half of the study population (52,1%, n=127) had a normal nutritional status, that 38,1% (n=93) was undernourished or at risk of becoming undernourished, and that 10,0% (n=24) was either at risk of becoming or was overnourished . Men were more prone to being undernourished or at risk of becoming undernourished (48,0%, n=73), compared to women (21,7%, n=20). Although no significant difference was found in anthropometrical status across the four severities of ID (Pearson Chi-square test (ρ=0,15)), individuals with mild ID were more likely to become obese (19,4%, n=6), and individuals with profound ID were more prone to being underweight (57,1%, n=8). It was found that 41,8% (n=102) of the total study population had a waist circumference (WC) above the normal values. A significant difference was found between increased WC and severity of ID (Pearson Chi-square test (ρ=0,00)). Other risk factors that can influence nutritional status in said population included medical conditions such as hypertension (13,0%, n=32) and epilepsy (EP) (46,0%, n=112), as well as polypharmacy (71,7%, n=175). An existing malnutrition screening tool for the population with ID was adapted by means of the addition of prevalent factors (WC measurements, presence of EP and use of medications), as well as through adaptation of the scoring system. Conclusion: Using anthropometric measurements and indices for body composition, a high prevalence of malnutrition was identified in the study population of individuals with ID. The adapted screening tool was more sensitive than the original tool in identifying individuals who were at risk of malnutrition, or who were already malnourished in this study population. The research undertaken in this respect can help health care professionals to be more aware of the interaction between the severity of ID and malnutrition. / AFRIKAANSE OPSOMMING: Agtergrond: Wanneer daar gelet word op die magdom faktore wat voedingstekorte veroorsaak en op die voorkoms van wanvoeding en voedingsprobleme onder individue met intellektuele gestremdheid (IG), is dit duidelik dat vroegtydige waarneming en diagnose van wanvoeding noodsaaklik is. Doelwitte: Die hoofdoel en doelwitte van die studie was om die graad van wanvoeding sowel as die liggaamsamestelling van individue met IG te bepaal wat in ’n psigiatriese hospitaal (Noordwes Provinsie, Suid-Afrika) inwoon. Daar is bepaal watter graad van IG individue is meer geneig tot wanvoeding. Verskillende risiko faktore van wanvoeding in hierdie groep individue is ondersoek en die data is gebruik om ’n bestaande siftingshulpmiddel aan te pas om wanvoeding makliker te kan identifiseer. Metodologie: Die studie-ontwerp was ‘n dwarssnitwaarnemingstudie met ‘n analitiese komponent. Die studie het uit twee fases bestaan. Gedurende die eerste fase is antropometriese metings van individue met IG geneem om liggaamsamestelling en voedingstatus te bereken. Gedurende die tweede fase is hierdie data, sowel as ander risiko faktore wat die voedingstatus van individue beïnvloed, gebruik om ’n bestaande siftingshulpmiddel aan te pas wat die identifisering van wanvoeding in hierdie populasie kan vergemaklik. Verpleegpersoneel het die aangepaste siftingshulpmiddel uitgetoets. Resultate: Die antropometriese metings van 244 individue met IG is bepaal. Hulle algemene antropometriese status het aangedui dat die helfte van die studiepopulasie (52,1%, n=127) ’n normale voedingstatus gehad het; 38,1% (n=93) was ondervoed of het ’n risiko gehad vir ondervoeding en 10,0% (n=24) was reeds oorvoed of het ’n risiko gehad vir oorvoeding. Mans (48,0%, n=73) was meer geneig om ondervoed te wees of het ‘n groter risiko tot ondervoeding as vroue (21,7%, n=20). Daar was geen beduidende statistiese verskille in antropometriese status tussen die vier grade van IG nie (Pearson Chi-square-toets, p=0,15), alhoewel individue met matige IG ‘n groter neiging het tot obesiteit (19,35%, n=6), terwyl uitgesproke IG ’n groter neiging tot ondergewig gehad het (57,1%, n=8). Daar is bevind dat 41,8% (n=102) van die totale studiepopulasie ’n verhoogde middelomtrek gehad het. Daar was ʼn beduidende statistiese verskil tussen verhoogde middelomtrek en graad van IG (Pearson Chi-square-toets, p=0,00). Ander risiko faktore wat die voedingstatus van hierdie populasie kan beïnvloed sluit in mediese toestande soos hipertensie (13,0%, n=32) en epilepsie (46,0%, n=112), asook die gebruik van veelvuldige medikasie (71,7%, n=175). ’n Bestaande wanvoedingsiftingshulpmiddel vir die IG populasie is aangepas deur algemene faktore (middelomtrek, voorkoms van epilepsie en gebruik van veelvuldige medikasie) in te sluit en die puntestelsel aan te pas. Gevolgtrekking: Met behulp van antropometriese metings en liggaamsmassa indekse is ’n hoë voorkoms van wanvoeding in die studiepopulasie van individue met IG waargeneem. Die aangepaste siftingshulpmiddel was meer sensitief as die oorspronklike hulpmiddel om individue wat ’n risiko loop vir wanvoeding of wat reeds wangevoed is, te identifiseer in hierdie studie populasie. Hierdie navorsing kan help om gesondheidswerkers meer bewus te maak van die interaksie tussen die graad van IG en wanvoeding.

Thesis (MPH.) -- University of Limpopo, 2021 / Background: Malnutrition has become a problem in the world, with 2.2 million deaths of children under five years of age globally have been linked to growth retardation, stunting and severe wasting, while other 600 000 children in the same age group are said to have died due to deficiencies in Vitamin A (Black, Allen, Bhutta, Caulfield, De Onis, Ezzati, Mathers, Rivera, and Maternal and Child Undernutrition Study Group, 2008 ). Objectives: This study aimed at determining the prevalence of malnutrition in children below 5 years of age, and to quantify stunting, underweight, wasting, overweight and obesity of children in the same group. Methods: This was a descriptive quantitative study. The data for the study was collected from 10 clinics, situated in the Ba-Phalaborwa District Municipality, using a standardized questionnaire. Stratified random sampling was used and stata program was used to analyse the data. Results: A total of 404 of mothers gave positive responses for children to participate in the current study, yielding to 97.1% response rate. Fifty-two-point-two percent of these children were females. The average age of the mothers of these children was 28.3 ±7.0 years Fifty-three-point-four percent of the mothers were single, 27% were divorced, 18.6% were married and 0.5% were widowed. The overall prevalence of malnutrition among the children was 26.7%. Males had higher percentage of underweight with 19.1%, compared to females (9.9%). The highest prevalence of malnutrition in females occurred in the age group 48-59 months, at 40.0%, followed by the age groups 0-11 months, 36-47 months, 24-35 months and 12-23 months at 26.9%, 25.0%, 24.0% and 17.5%, respectively. Of the different types of malnutrition, the occurrence of obesity was the lowest among the children. Conclusion The results of the findings are consistent with the findings of other studies. However, this study could not find that characteristics such as education, type of residence or financial background contribute immensely to child malnutrition.

The aim of this study was to assess the performance of the children in the study on some psychometric tests and to find out whether iron deficiency had any effect on cognitive skills as measured by the selected psychometric tests. The study also wanted to find out if there would be any gender differences on the psychometric tests. A sample of 810 children was selected from eleven schools from the rural Southern part of KwaZulu-Natal. The children were of ages eight to ten years old, were all Zulu speaking and in standard one. Blood samples were taken from all the children to determine iron levels. Psychometric tests viz., the Symbol Digit Modalities Test, Raven's Coloured Progressive Matrices, Rey's Auditory Verbal Learning Test and Young's Group Mathematics Test, were all administered to measure cognitive performance. The results showed no significant iron level effects on most of the measured cognitive skills. There were some significant gender effects on all the psychometric tests except for the Maths test. There was general low performance on all the psychometric tests. Therefore, the results highlighted the importance of designing more tests that can be standardized and thus be applicable to Zulu speaking children and other children with similar backgrounds. The tests should also be able to tap into the cognitive skills that may be affected by iron levels. There is also a great need for studies looking at the lower end of iron deficiency. / Thesis (M.Sc.)-University of Natal, Pietermaritzburg, 1998.

Submitted in fulfillment of the requirements of the Masters in Food and Nutrition, Durban University of Technology, 2017. / Introduction: Many studies have attempted to establish the association between the academic performance of university students and various factors that impact on academic performance. Students’ socio-economic backgrounds have been cited as a significant predictor of academic success among university students, with first generation students (FG) reporting a lower retention and graduation rate compared to non-first generation (NFG) students. First generation students are those that are the first in a family to enroll in institutions of higher learning, whether college or university, while NFG students, are students whose parents or siblings have attended an institution of higher learning. The low academic success rate among FG students is mainly attributed to unpreparedness for college/university, financial challenges and lack of support from family. Aim: The aim of the study was to determine the relationship between diet quality, nutrition status and academic performance of first generation and non-first generation university students in Durban. Methodology: A total of 270 randomly selected students (135 FG and 135 NFG) between the ages of 18 and 30 years participated voluntarily in the study. The study was descriptive in nature with a cross-sectional design. Trained fieldworkers administered the questionnaires in an interview setting. A socio-demographic questionnaire measured the socio-economic characteristics of the students; anthropometric measurements were used to determine the nutritional status against the WHO cut-off points; three 24 hour recall questionnaires and a food frequency questionnaire determined their diet quality and nutrition adequacy, and the students’ matric and first year results were used to measure academic performance. The socio-demographic questionnaire, anthropometric measurements and the academic results were captured on Microsoft Excel® and analyzed using the Statistical Package for Social Sciences® (SPSS) version 21.0. A trained nutrition professional captured and analyzed the 24 hour data using the Food Finder® version 3 computer programme. Results: The sample was fairly representative of both groups of students and genders with 20% (n=52) FG men, (17%; n=44) NFG men, (30%; n=78) FG women, and 33% (n=86) NFG women. The majority of FG (63.1%; n=82) and NFG (59.2%; n=77) students came from townships, and the highest number of students (FG 60.7%; n=79 and NFG 49.3%; n=64) depended on student loans to pay for university fees. Furthermore, most of the FG (76.8%; n=100) and NFG (81.5%; n=106) students lived in university residences. Although the highest number of FG students (38.5%; n=50) had a household income of between R0–R500 compared to the highest number of NFG students having a household income of R501–R1000 per month, the highest number of both groups of students (FG=25.4%; n=33 and NFG=26.2%; n=34) spent R401–R500 per month on food, and almost 50% of both groups of students indicated that they sometimes lacked money to buy food. Non-first generation students were affected by obesity more so than FG students, with one (2.27%) NFG man and 13.92% (n=12) affected by obesity class I (BMI 30-34.99), and 4.65% (n=4) NFG women falling within the obesity class II range (BMI of 35-39.99), compared to none of the FG men affected by obesity, and only 3.85% (n=3). Furthermore, a higher number of NFG students exceeded the WC cut-off points for men (102cm) and women (88cm) compared to FG students, with none of the FG men exceeding the cut-off points for men, compared to 1.82% of NFG men, and only 20.51% of FG women exceeding the cut-off points for women compared to 32.61%. The waist-to-height ratio also indicated that a higher percentage (63.74%) of NFG women exceeded the cut-off point (˃0.5) compared to 60.25% of FG women. Refined carbohydrate based foods made up the majority of the students’ diet, with the top 3 foods among FG and NFG men being carbohydrate based (maize meal pap, bread/rolls, and rice), and the top two foods being rice and bread/rolls among FG and NFG women. All the students (FG and NFG), failed to meet the WHO’s recommendation of consuming ≥400g of fruits and vegetables. Furthermore, between 80-100% of men and women (FG and NFG) failed to meet the RDI’s for calcium, magnesium, and vitamins C, D, E and K. Although both FG and NFG students reported few protein rich sources on the top 20 foods lists, all the students exceeded the DRI for protein with mean (SD) intakes of (62.62g±21.984) by FG men, 70.98g±25.534 (NFG men), 57.97g±23.248 (FG women), and 55.94g±18.397 (NFG women). Carbonated drinks were ranked 6th for both FG and NFG men, and 8th among FG and NFG women, with NFG men reporting a higher per capita intake per day (142.52g) compared to FG men (115.67g) and among women, a per capita intake of 106.07g (FG) 96.95g (NFG). Both FG and NFG students reported low food variety scores (<30 individual foods), with FG men reporting a slightly higher mean (SD) FVS (28.56±10.079) compared to 27.41±10.342 of NFG men, and NFG women reported a higher mean (SD) FVS (29.92±8.549) compared to 28.67±10.775 (FG women). The majority of the students (FG and NFG) reported high food group diversity scores (FGDS), with the majority of men (FG=98.08%; n=51 and NFG=93.18%; n=41) and women (FG=94.9%; n= 74 and NFG=100%; n=86) reporting a high FGDS (6-9 food groups). The matric results of the participants indicated that 100% (n=260) of all the students (FG and NFG) passed matric with a pass rating of 3-6, and the first year academic results indicated that the highest number of FG and NFG students passed the first year of university with a percentage range of 51-74% [FG men=92.31(n=48); NFG men=86.36 (n=38); FG women=93.59% (n=73); and NFG women=84.88 (n=73)]. The first year results also showed that a higher number of NFG (11.36%; n=5) men and women (10.47%; n=9) failed the first year of university compared to the FG men (5.77%; n=3) and women (5.13%; n=4). Conclusion: Although there are some statistically significant correlations between some of the variables, it does not prove conclusively that diet and nutrition status had an impact on the academic performance of this group of students. Due to the lack of diversity with regard to socio-demographic factors, including socio-economic profile and race, no notable differences were observed except in the case of nutrition status, where a higher incident of obesity was observed among NFG students compared to FG students. Inter-gender differences were more apparent compared to inter-generation differences. / M

Thesis (M. Sc.(Physiology)) -- University of Limpopo, 2019 / Aim: The purpose of this study was to assess the prevalence and risk factors associated with malnutrition and nutritional status of rural and urban primary school children aged 6–9 years. Literature background: Malnutrition is one of the leading causes of childhood morbidity and mortality in developing countries, affecting 10.9% of people globally, particularly in Southern Asian (15.7%) and sub-Saharan African (23.2%) countries undergoing urbanisation. Urbanisation affects diet, physical activity levels, body fatness, body composition and socio-economic factors. There is currently a shortage of information on the effect of urbanisation on nutritional status, especially in poor areas such as the Limpopo Province of South Africa. It is important to understand the effects that body fatness and associated risk factors have on stunting, wasting, underweight, and overweight/obesity in urban and rural children. Subjects and design: This was a cross-sectional study including rural (n=106) and urban (n=68) primary school children aged 6–9 years. Anthropometric (weight and height) and skinfold measurements were taken and a 24-hour recall dietary assessment was conducted twice to include a week day and a weekend day. A questionnaire was used to gather demographic, health, dietary and physical activity information. Results: The prevalence of stunting, wasting, underweight, and overweight/obese children in this population was 14%, 6%, 20%, and 26% respectively. Furthermore, the prevalence stunting, wasting, and underweight were higher in rural areas compared to urban areas. Meanwhile, the prevalence of overweight/obesity was higher in urban areas as compared to rural areas. Gender, area (urban/rural) (p=0.0001), birthweight, time spent on sedentary activities, monthly household income (p=0.0210), mode of transport to school, and breastfeeding (p=0.0560) were all found to be significantly associated with malnutrition. Weekday dietary intake of Vitamins A and D was significally associated with BF%, whereas weekend consumption of energy, protein, calcium, iron, phosphorus, and zinc were not significantly associated with BF%. The mean energy and calcium intake between the urban and rural vi population only differed significantly over weekends and not during the week, while vitamin D differed significantly between urban and rural populations during the week only. Conclusions: The current study demonstrates that children in rural areas were significantly more wasted than those residing in urban areas, while those residing in urban areas were significantly more overweight/obese compared to rural areas. All indicators used for undernutrition were associated significantly with gender and the prevalence were higher males compared to females, but this significance disappeared for overnutrition. Families with a higher income tended to have children who were overweight or obese compared to families with a lower income. Children spending a lot of time on sedentary activities were more likely to be overweight or obese, and breastfeeding seemed to protect children from becoming overweight or obese, while low birth weight was associated with stunting. The weekaday and week-end diets indicate that school feeding schemes in the rural areas may be effective in increasing total energy intake in children and this should be further investigated. In this population, stunting, wasting, and underweight were not limited to rural areas, and should still be a health concern in urban areas, despite the fact that overweight/obesity is also prevalent in urban areas. Thus, overweight/obesity in this population can be prevented by promoting breastfeeding and physical activity, while at the same time discouraging children from partaking in too many sedentary activities. / National Research Foundation (NRF)

Thesis (M. Sc. (Physiology)) -- University of Limpopo, 2019 / Aim: The purpose of this study was to assess the prevalence and risk factors associated with malnutrition and nutritional status of rural and urban primary school children aged 6–9 years. Literature background: Malnutrition is one of the leading causes of childhood morbidity and mortality in developing countries, affecting 10.9% of people globally, particularly in Southern Asian (15.7%) and sub-Saharan African (23.2%) countries undergoing urbanisation. Urbanisation affects diet, physical activity levels, body fatness, body composition and socio-economic factors. There is currently a shortage of information on the effect of urbanisation on nutritional status, especially in poor areas such as the Limpopo Province of South Africa. It is important to understand the effects that body fatness and associated risk factors have on stunting, wasting, underweight, and overweight/obesity in urban and rural children. Subjects and design: This was a cross-sectional study including rural (n=106) and urban (n=68) primary school children aged 6–9 years. Anthropometric (weight and height) and skinfold measurements were taken and a 24-hour recall dietary assessment was conducted twice to include a week day and a weekend day. A questionnaire was used to gather demographic, health, dietary and physical activity information. Results: The prevalence of stunting, wasting, underweight, and overweight/obese children in this population was 14%, 6%, 20%, and 26% respectively. Furthermore, the prevalence stunting, wasting, and underweight were higher in rural areas compared to urban areas. Meanwhile, the prevalence of overweight/obesity was higher in urban areas as compared to rural areas. Gender, area (urban/rural) (p=0.0001), birthweight, time spent on sedentary activities, monthly household income (p=0.0210), mode of transport to school, and breastfeeding (p=0.0560) were all found to be significantly associated with malnutrition. Weekday dietary intake of Vitamins A and D was significally associated with BF%, whereas weekend consumption of energy, protein, calcium, iron, phosphorus, and zinc were not significantly associated with BF%. The mean energy and calcium intake between the urban and rural vi population only differed significantly over weekends and not during the week, while vitamin D differed significantly between urban and rural populations during the week only. Conclusions: The current study demonstrates that children in rural areas were significantly more wasted than those residing in urban areas, while those residing in urban areas were significantly more overweight/obese compared to rural areas. All indicators used for undernutrition were associated significantly with gender and the prevalence were higher males compared to females, but this significance disappeared for overnutrition. Families with a higher income tended to have children who were overweight or obese compared to families with a lower income. Children spending a lot of time on sedentary activities were more likely to be overweight or obese, and breastfeeding seemed to protect children from becoming overweight or obese, while low birth weight was associated with stunting. The weekaday and week-end diets indicate that school feeding schemes in the rural areas may be effective in increasing total energy intake in children and this should be further investigated. In this population, stunting, wasting, and underweight were not limited to rural areas, and should still be a health concern in urban areas, despite the fact that overweight/obesity is also prevalent in urban areas. Thus, overweight/obesity in this population can be prevented by promoting breastfeeding and physical activity, while at the same time discouraging children from partaking in too many sedentary activities. / National Research Foundation (NRF)

The prevalence of Protein-Energy Malnutrition (PEM) in South Africa has been welldescribed in previous research studies and yet little is known about the nutritional status of toddlers in the Vosloorus Township. Using the research questions as the conceptual framework for the study, an exploratory descriptive survey was conducted to determine. • What factors give rise to malnutrition in the Vosloorus Township? • Why do toddlers on the PEM Programme fail to achieve their expected target weight? Data was collected by means of structured interviews from a sample of 50 mothers in the Vosloorus Township whose toddlers were on the PEM Programme. The fmdings indicated that the poor socio-economic conditions of the majority of households, especially unemployment, low levels of education and ignorance, contributed towards the development of malnutrition amongst toddlers and their failure to thrive on the PEM Programme. Recommendations to reduce levels of malnutrition and transform existing nutrition programmes were made. / Health Studies / M.A. (Nursing Science)

The prevalence of Protein-Energy Malnutrition (PEM) in South Africa has been welldescribed in previous research studies and yet little is known about the nutritional status of toddlers in the Vosloorus Township. Using the research questions as the conceptual framework for the study, an exploratory descriptive survey was conducted to determine. • What factors give rise to malnutrition in the Vosloorus Township? • Why do toddlers on the PEM Programme fail to achieve their expected target weight? Data was collected by means of structured interviews from a sample of 50 mothers in the Vosloorus Township whose toddlers were on the PEM Programme. The fmdings indicated that the poor socio-economic conditions of the majority of households, especially unemployment, low levels of education and ignorance, contributed towards the development of malnutrition amongst toddlers and their failure to thrive on the PEM Programme. Recommendations to reduce levels of malnutrition and transform existing nutrition programmes were made. / Health Studies / M.A. (Nursing Science)

The aim of this study was to determine how nurses manage the nutritional care of children under the age of five years at the primary healthcare level. A quantitative approach with an explorative descriptive design was used. A self-administered questionnaire and was used to collect data. The population was 34 professional nurses working in the child health sections of 16 clinics, all of whom were accessible, but one did not respond. Ten out of the target population were also observed using an observational checklist. Findings show lack of proper implementation of Integrated Management of Childhood Illnesses (IMCI) guidelines and incorrect use of the Road-to-Health booklet. Secondly, the nurses at the child healthcare section had a high workload or had little experience in child care. The need for more emphasis on nutrition during IMCI training and the re-orientation of nurses on the optimal use of the Road-to-Health booklet were identified. / Master of Public Health (MPH) / Health Studies