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The role of nutrition in the growth retardation of children with chronic renal failure undergoing maintenance dialysisRothney, Linda Mary January 1978 (has links)
Growth failure is a major problem in children with chronic renal failure (CRF). A number of factors have been suggested as explanations for this impaired growth including renal osteodystrophy, age of onset of chronic renal failure, degree of azotemia and nutritional status. As children with CRF are frequently unable to maintain sufficient nutrient intakes for optimal growth, the nutritional status of these individuals must obviously have a major, if as yet poorly understood, role in the observed growth failure. Therefore, a nutritional, physical and biochemical study was conducted to assess the nutritional status of seven children undergoing maintenance hemodialysis.
To evaluate the adequacy of dietary intake, fourteen day food records were obtained from each of the participants and average nutrient intakes were compared to the recommended daily nutrient intake of the Canadian Dietary Standard (CDS) (1975).
To assess the physical status of the children, height, height velocity, weight, per cent body fat, and bone age were determined. As abnormalities of taste sensitivity are known to influence dietary patterns, salivary flow rates, salivary urea concentrations, and taste detection and recognition thresholds for sweet, sour, salt and bitter were determined pre and post dialysis.
Biochemical investigations included the determination of pre and post dialysis plasma amino acid concentrations following a standardized fast of five hours, and the quantification of the amounts of amino acids lost into dialysate during a complete hemodialysis treatment.
The mean caloric intake of 54% ±11 of the CDS is inadequate for optimal growth. The mean protein intake was 1.09 ±.16 grams of protein per kilogram of body weight. The first and second limiting amino acids were histidine and threonine, respectively. Nutritional deficiencies of certain water soluble vitamins (riboflavin, niacin and pyridoxine) existed for some of the children. The mean zinc, magnesium and copper intakes were 45% ±8, 51% ±19 and 54% ±32 of the CDS, respectively.
Growth (as measured by body height and weight) was found to be retarded one to two standard deviations from normal in the children studied. Per cent body fat estimations were within normal limits, but bone age was frequently below chronological age. Taste sensitivity was impaired as shown by elevated pre dialysis sweet and bitter recognition thresholds (p<.01). This reduced taste acuity was improved post dialysis (p<.005), but did not reach normal values. Pre and post dialysis, salivary flow rates were reduced (p<.0005) and salivary urea concentrations elevated (p<.0005) when compared to normal.
Pre dialysis, plasma concentrations of taurine, a-amino-butyric acid, valine, cystine, leucine, tyrosine and tryptophan were decreased from normal levels (p<.025), and aspartic acid, proline, glycine, citrulline, ornithine, histidine, arginine, asparagine, 3-methylhistidine and hydroxyproline were elevated above normal (p<.005). The presence of subclinical protein calorie malnutrition (PCM) was indicated by a depressed plasma essential to nonessential amino acid ratio, a depressed plasma valine to glycine ratio, and an elevated plasma phenylalanine to tyrosine ratio as compared to normal. The detection of 3-methylhistidine and hydroxyproline in plasma provides additional indications of PCM. The mean amount of total amino acid lost into dialysate was 4.7 ±.9 grams. Histidine, threonine, lysine and valine were the essential amino acids lost in the largest amounts.
In conclusion, growth is retarded in children with CRF and may be due to the accumulation of metabolic end products which depress appetite and/or delay the natural rate of growth events Suboptimal nutriture, as evidenced by the presence of PCM, is a major factor in the growth retardation of these individuals. / Land and Food Systems, Faculty of / Graduate
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Parental perceptions of their child's weight and healthPham, Julie Vy 01 January 2005 (has links)
Childhood obesity is a major health problem facing children in the United States. How parents view their children's weight is an important consideration for health care professionals. The purpose of this study was to explore parental perceptions of their children's weight and health.
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Child malnutrition mortality at St Barnabas Hospital is high -- is it due to practices and attitudes of staff?: a study in a rural district hospital.Navaratnarajah, Paramalingam Kandasamy January 2004 (has links)
The case fatality rate for malnutrition at St Barnabas Hospital over the past years has been around 38%. The rates in other district hospitals in the Eastern Cape province were found to be in excess of 30%. In June 2000, the Eastern Cape Department of Health introduced a protocol for in-patient management of children with severe malnutrition, with the aim of reducing case fatality rate below 10%. St Barnabas Hospital introduced the Eastern Cape protocol in August 2003. An evaluation was done in November 2003 to assess the protocol's impact on the case fatality rate. The rate remained high, at 37.5%. This study descibed the current practices and attitudes of the nurses as St Barnabas Hospital paediatric ward, in the management of severely malnourished childen.
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Child malnutrition mortality at St Barnabas Hospital is high -- is it due to practices and attitudes of staff?: a study in a rural district hospital.Navaratnarajah, Paramalingam Kandasamy January 2004 (has links)
The case fatality rate for malnutrition at St Barnabas Hospital over the past years has been around 38%. The rates in other district hospitals in the Eastern Cape province were found to be in excess of 30%. In June 2000, the Eastern Cape Department of Health introduced a protocol for in-patient management of children with severe malnutrition, with the aim of reducing case fatality rate below 10%. St Barnabas Hospital introduced the Eastern Cape protocol in August 2003. An evaluation was done in November 2003 to assess the protocol's impact on the case fatality rate. The rate remained high, at 37.5%. This study descibed the current practices and attitudes of the nurses as St Barnabas Hospital paediatric ward, in the management of severely malnourished childen.
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Nutritional and functional effects of energy-dense food in the frail elderly /Ödlund Olin, Ann, January 2004 (has links)
Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.
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Impact assessment of the integrated nutrition programme on child malnutrition in South Africa /Musvaire, Rufaro. January 2009 (has links)
Thesis (M.Sc.) - University of KwaZulu-Natal, Pietermaritzburg, 2009. / Full text also available online. Scroll down for electronic link.
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Sociodemographic profile, nutritional status and dietaty intake of primary school children in Chesterville, KwaZulu-NatalMfeka, Portia Lungisile Nomathamsanqa January 2017 (has links)
Submitted in the fulfillment of the requirements of a Masters of Applied Science in Food and Nutrition, Durban University of Technology, Durban, South Africa, 2017. / Aim: The main aim of this study was to profile the primary school children`s household socio-economic status and evaluate their nutritional status for a healthy and active live in Chesterville, outside Durban in KwaZulu-Natal. The sample comprised of 250 children (147 girls and 103 boys), aged between 4 to 8 years and 9 to 13 years who volunteered to participate in the study and school was randomly selected.
Methodology: A quantitative research method was applied using various nutrition security assessment tools complemented by the socio-economic household profile to determine household`s ability to acquire food. Anthropometric status using WHO growth indicators assessed stunting, wasting and underweight status of the children. This was followed by the 24-hr recall and food frequency questionnaire to probe children`s diet diversity. Descriptive statistics was used to analyse data.
Result: The anthropometric indices showed that 10.3% of the children were severely stunted (<-3SD height-for-age), 33.5% were stunted (<-2SD), 2.9% were severely wasted (<-3SD BMI-for age), 5.3% were wasted (<-2SD) with 68.5% at possible risk of overweight (>+1SD), 24.3% of the children were overweight is (>+2SD) and 5.6% were obese (>+3SD) according to the WHO z-scores. The results indicate the prevalence of obesity which could be a result of the high consumption of carbohydrate dense food in the group surveyed. The parents/ caregivers and the children need nutrition education on healthy eating habits to improve their lifestyle.
The socio-demographic profile of the households indicated that 61% of the parents/ caregivers were unemployed and 39% were employed. Seventy three percent of the households were headed by women, 50% of the parents/ caregivers owned their homes, 63.6% had a tap inside the house and 94% had access to a flush toilet/sewerage system inside the house, 38% had passed grade 8 – the highest level of education, 14.4% of the parents/caregivers earned less than R2000 per month, and 10.4% earned less than R2500 per month. The low-income level, lack of post matric qualification in some of the parents /caregivers and the high unemployment rate of 61% could be a contributory factor to malnutrition in this community. Most of the parents/caregivers resided in the township and 94% lived in brick houses, while 35.6% lived in a shack that was built outside the house as an extension of the house. Most of the parents/caregivers (88%) purchased their food from a supermarket. Thirty-five-point two percent of the parents/ caregivers indicated not having enough money to spend on food, 32.8% indicated that often there is not enough money to spend on food, and 15% indicted that there is always not enough money to spend on food. Seventy-five-point two percent of the parents/ caregivers purchased their food once a month while 12.4% purchased their food once a week. Township South Africans tend to purchase food instead of growing their own food because of the lack of vegetating space. The lack of buying power and food shortages eventually leads to malnutrition. The lack of higher education in this community decreases the chances of permanent employment as a result the low-income bracket and the inability to purchase food in some occasions.
The food group diversity score showed that 64% of the respondents consumed food from nine food groups. The carbohydrate group had the highest score (6.08±1.322) followed by the vegetable group (4.76±1.383) and the meat group (4.51±1.269). The mean carbohydrate intake was higher than the Dietary Reference Intake (DRI) for girls and boys (>100% of the DRIs). The intake of fruit was lower than the >400g goal as recommended by the World Health Organisation (WHO). The consumption of fibre was low with both girls and boys consuming <100% of the fibre requirements. Iron was consumed by 54.6% of the girls in the required amount of 100% of the DRIs. The energy intake for both girls and boys was 7025.8±16278 and 7205.4± 1860.834 respectively. The girls’ consumption of protein was 11.9% and boys’ consumption was 11.4% and this is within the recommended 10-15% of the WHO.
Conclusion: The results indicate both overnutrition and undernutrition in children that were part of the survey. The top 20 food intake indicated inadequate eating patterns and that diets consisted of energy dense foods, such as carbohydrates and fats which could be responsible for obesity in the children. The high unemployment and low-income rate and inadequate money to spend on food can contribute to the prevalence of stunting and wasting in the children. Nutrition education and nutrition interventions such as focus on healthier foods, healthier methods of preparing food, a balance diet and physical activity are necessary to improve quality of life and improve health. / M
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Guidance implications related to the eating habits of adolescentsSchnel, Nadine Deboreh 06 1900 (has links)
Text in English / Due to the fact that many adolescents do not follow a balanced diet, an
investigation into the eating habits of adolescents was undertaken. Much
research has been done on eating disorders but little research has been done on the concomitants and possible precursors to unhealthy eating habits among adolescents.
A literature study was done to clarify which factors cause unhealthy eating habits. The developmental aspects of adolescence and the reciprocal effect on eating habits was also investigated.
A valid and reliable measuring instrument was developed in order to measure eating habits of adolescents. This instrument was used in an empirical investigation including 340 respondents with the aim of determining the most important factors, which relate to the eating behaviour of adolescents.
Educational implications of the findings are discussed in order to provide
curriculum developers, teachers, parents, counsellors and the media with
guidelines to help children to adopt healthy eating habits. / M.Ed. (Guidance and Counselling)
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Analysis of the nutritional status and dietary intake data of a group of elderly at a day and frail care centre in VerulamGovender, Theloshni January 2011 (has links)
Submitted in fulfillment of the requirements of the Degree of Master of Technology:
Food and Nutrition Consumer Science, Durban University of Technology, 2011. / Background: South Africa, a richly diverse developing country has been faced by the
consequences of transition attributed to urbanisation and acculturation. A Westernised
lifestyle has, therefore, resulted in increasing disease patterns that are characterized by a
combination of poverty-related diseases together with the emerging chronic diseases. The
shift to a Westernised lifestyle has resulted to a shift in the composition of dietary staples
leading to dietary factors related to an increase in lifestyle diseases. These include a high
fat, low fibre diet, as well as an inadequate intake of fruits and vegetables. However, this
in turn has led to higher energy intakes with insufficient and imbalanced micronutrient
intake.
Research conducted amongst the elderly in South Africa has clearly indicated that the
elderly live within a limited financial budget leading to extreme levels of food insecurity
and the social burden of being the head of the household, in addition to being the
caregiver to grandchildren and sick children. Due to the current living status the elderly
encounter reduced food intake in addition to a reduced variety in their diet, therefore,
micronutrient deficiencies are common amongst this age group. Therefore, a consumption
of energy-dense foods, particularly staple foods, to stretch the food budget which are
more affordable and thus allow for an increased consumption is evident.
Aim: To determine the socio-demographic profile, health and nutritional status in relation
to the dietary intake patterns to reflect malnutrition among free living elderly (60yrs+) in
Verulam.
Methodology: Fifty nine randomly selected men and 191 women aged 60+ participated
on a voluntary basis in this study. A descriptive survey method was used for this cross
sectional study. Trained fieldworkers assisted with the administration of all questionnaires
and a registered nurse measured blood pressure. Socio-demographic questionnaires were
administered to determine the socio-economic characteristics of the elderly within this
community. Anthropometric measurements determined the Body Mass Index according to
the World Health Organisation and Asian cut-off points to indentify the risk factors. The
Health questionnaire identified the health status correlated to the respondent’s profundity
of disease and deficiencies associated to dietary patterns. Blood pressure measurements
were taken to determine the hypertension prevalence related to the dietary intake. Two
24-Hour Recall questionnaires were completed by the 250 respondents to identify actual
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food intake and measured against the Dietary Recommended Intake (DRIs). A food
frequency questionnaire (FFQ) determined the respondent’s food variety score over a
period of one week. The socio-demographic questionnaire, health questionnaire, food
frequency questionnaire and anthropometric measurements were captured on an Excel®
spread sheet by the researcher and analyzed for descriptive statistics using the Statistical
Package for the Social Sciences (SPSS) version 17.0 with the assistance of a statistician.
The 24-Hour Recall data were captured and analyzed by a nutrition professional using the
MRC Food Finder® version 3.0 software, based on the South African Food Composition
tables.
Results: The majority of the respondent’s role in the family was mothers (70.8%) and
lived in an urban area (68.8%). In addition, 73.2 percent (n=183) of the respondents
shared the house with one to five people, and lived in a brick house (74.4%, n=186) with
more than 3 rooms (74.0%, n=185). The elderly in this sample were pensioners and,
therefore, 76.0 percent (n=190) received state grants of which the total household income
ranged between R1001-R1500 (35.2%, n=88). Food insecurity is prevalent as reported by
28.4 percent. Primary school was the highest level of education completed by 52.4
percent (n=131) and English is the most spoken language amongst this group (74.0%,
n=185).
Women had higher BMI values particularly in the overweight (18.32%, n=35) and obese I
and II (58.6%, n=112) categories when compared with men. Blood pressure
measurements indicated that 60.0 percent (n=150) of the respondents suffered from
hypertension. The use of chronic medication was reported by 84.4 percent (n=212). The
total range of individual food items consumed by an individual during the seven-day data
collection period measured by the (FFQ) was between 4-66 foods. However, the highest
consumption was four food items by 23.2 percent (n=58) of the respondents. The
summary of the food variety within food groups indicated a high dietary diversity, of which
the other vegetable group reported the highest individual mean FVS (±SD) of 10.86
(±5.82), followed by other fruit, cereal, flesh and Vitamin A rich groups with 5.73 (±4.41),
5.03 (±1.85), 4.08 (±2.23) and 2.43 (±1.09) respectively.
The nutrient analysis indicated a deficient intake by both men and women of all the
nutrients, except for the mean (±SD) total protein in the women 45.10 (±12.55) and
carbohydrate 212.83 (±36.97) in the men. The energy contribution indicated 98.3 percent
(n=58) men and 85.72 percent (n=158) women consumed <100 percent of the EER for
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energy. However, the findings from the Top 20 food items measured by the 24-Hour
Recall indicated that this community’s diet is largely carbohydrate-based, containing
primarily starchy staple foods, sufficient intake of animal products, and insufficient intakes
of dairy foods, fruit and vegetables, possibly resulting in the micronutrient deficiencies.
The energy distribution of the macronutrients from the average of both 24-Hour Recalls
indicates that both men and women are in range of 15-30 percent total fat intake, 10-15
percent protein and 55-75 percent carbohydrate.
Conclusion: The results of the study reflect that the elderly in this community are faced
with poverty, food insecurity as well as social factors thus contributing to a compromised
nutritional status. The progression of malnutrition in particular overnutrition is experienced
by the majority of the respondents in this study, however, an increased BMI and the
prevalence of hypertension is a risk marker for noncommunicable diseases. However, the
high prevalence of inadequate food and nutrient intake amongst elderly discloses the
need for nutrition interventions and should be aimed at modifying the elderly food choices
when purchasing food, healthier food preparation methods, increasing fruit and vegetable
portions and improving daily physical activity to attain a better quality of life. / DUT Postgraduate Development and Support Directorate (PGD)
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Nutritional status and dietary intake of adolescent girls in Mandlenkosi High School, LindelaniSilangwe, Beauty Nontuthuzelo 30 July 2013 (has links)
Dissertation submitted in the fulfilment of the requirements for the Degree of
Magister Technologie: Food and Nutrition, Durban University of Technology, 2012. / Background: Assessing the nutritional status of adolescents could be a catalyst in addressing
malnutrition at an early age and at a school level.
Objectives: The study was conducted to examine the nutritional status and dietary pattern of
adolescent girls attending school in Lindelani, KwaZulu-Natal.
Methods: Adolescent girls were selected from a randomly selected high school. A total of
157 adolescent girls aged 13 to 18 years were surveyed for socio-demographic indicators,
nutritional status and dietary intake. Data were collected by interviewing the adolescent girls
and the parents using pre-designed and pre-tested questionnaires. Weight and height were
measured and socio-demographic data collected by means of a questionnaire. Dietary intake
data were gathered by using two 24hr recall questionnaires and a QFFQ.
Results: The findings indicated that adolescent girls in Lindelani face two distinct nutrition
situations, underweight and overweight. The nutrient intake was compared with the dietary
reference intake (DRI). The prevalence of undernutrition (7.6%) among the participants
assessed as stunting (height-for-age) was based on the usual pattern of food intake. The
results revealed that 92.4% of the girls were of normal height for age (>-1SD to +3SD),
10.8% were overweight (>+2SD to <+3SD) and 1.9% were obese (>+3SD). Consumption of
high carbohydrates based food items was prevalent and carbohydrate intake correlated
positively with the BMI-for-age Z-score. The income of the household was assessed,
however, there was no statistically significant correlation (p=0.442) between BMI-for-age (Z-
scores) and the caregivers level of income. For the intake of protein and dietary fibre, at least
40 and 144 participants, respectively, did not meet the dietary recommended intake measured
by the 24hr recall. The study explains that not only is there under and over nutrition in this
group but also inadequate micronutrient intake, especially of essential nutrients such as
vitamin A, vitamin C, iron and calcium. A substantial proportion of the girls did not consume
adequate folate. The households that reported to have had adequate food at all times were
only 29.3%.
Conclusion: The results show a lack of dietary variety, which may contribute to the nutrient
deficiency. Both undernutrition and overnutrition was prevalent among the girls. The
majority of the population had a lower energy intake than recommended. Intervention
strategies are needed to improve the dietary intake of adolescent girls and overcome the crisis
of malnutrition.
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