The Integrated Nutrition Programme (INP) was implemented in 1995 to target child malnutrition in South Africa. This study assessed the impact of the INP on child malnutrition by province and age group using secondary data. Data from three national nutrition surveys, conducted in 1994, 1999 and 2005, were used to describe trends in child stunting, underweight, wasting, vitamin A deficiency and iron deficiency. The relationship between the prevalence of the human immunodeficiency virus (HIV) in prenatal women and child nutritional status; challenges and constraints to implementing the INP at provincial level; and government responses to nutrition recommendations by lead experts in the 1994 and 1999 surveys were also investigated. Child nutritional status varied across provinces. In some provinces such as the Northern Cape, stunting, underweight and wasting remained consistently high. Stunting decreased in the Eastern Cape, but rates of wasting increased between 1994 and 2005. On the other hand, Gauteng and the Western Cape generally had lower rates of malnutrition compared to the other provinces. This may be due to these provinces being the most economically active in the country thus more opportunities for employment and higher purchasing power of foods rich in micronutrients. By 2005, vitamin A deficiency had doubled in most provinces despite mandatory food fortification being implemented in 2003. KwaZulu-Natal had the highest rates of vitamin A deficiency, while Limpopo had the highest rates of iron deficiency. By 2005, malnutrition had decreased in children aged seven to nine years, but had increased in those aged one to three years. There was a significant positive correlation (p<0.01) between the prevalence of HIV in prenatal women and vitamin A deficiency nationally. The prevalence of HIV in prenatal women was positively correlated (p<0.05) with rates of wasting in children aged one to three years. Limited skills, inadequate monitoring and evaluation, and limited infrastructure were common challenges and constraints to implementing the INP at provincial level. The effect of HIV on human resources and the higher demands of HIV infected patients also posed a challenge to provinces as they implemented the INP. Government responded to most recommendations made by nutrition experts. Supplementation,food fortification, growth monitoring and nutrition promotion programmes were implemented. Based on the data, it would appear that INP activities targeted at school-going children were more effective than those targeting children under-five. Although food fortification was implemented in 2003, the vitamin A content of fortified products might not have met legislative requirements. Additionally, because vitamin A is unstable to heat and light, if vitamin A fortified foods are cooked or stored this may also influence the bioavailability of vitamin A. Maternal HIV status might have attenuated child nutrition outcomes due to the negative effect of HIV on related health conditions such as child caring and feeding practices. Some of the challenges and constraints at provincial level might have negatively affected the implementation of the INP and consequently its impact. Although government responded to most recommendations made by nutrition experts, ongoing monitoring and evaluation of child nutritional status were not adequately done, which might have also negatively affected INP outcomes. In addition, factors in the macro-environment such as food inflation and access to basic sanitation, could have lessened the impact of the INP on child malnutrition. Interventions directed at malnutrition in children under-five need to be prioritised. There needs to be rigorous monitoring of micronutrient content, especially vitamin A, of fortified foods. Future studies need to include assessment of nutritional status in HIV affected and infected children to help identify specific needs and develop appropriate policies. Frequent nutrition surveillance to assess key child malnutrition indicators is required. / Thesis (M.Sc.) - University of KwaZulu-Natal, Pietermaritzburg, 2009.

Submitted in fulfilment of the qualification of Master's Degree in Food and Nutrition, Durban University of Technology, 2017. / Aim The purpose of this study was to investigate the nutritional status of adolescent girls attending a private high school in Durban and included an investigation of what food the girls consumed on a daily basis and an account of physical activity they participated in within a one-week period to determine a relationship between the variables. Methods Adolescent girls were selected as part of a convenience study at a private high school. A total of 225 adolescent girls aged 13-18 years were surveyed for nutritional status and dietary intake as well as physical activity levels. The parent/ caregiver of each girl who participated was interviewed to ascertain socio-demographic indicators. Data was collected by interviewing the adolescent girls and the parents/ caregivers using pre-designed and pre-tested questionnaires. Weight and height were measured, physical activity levels were identified through the use of a physical activity questionnaire and socio-demographic data was collected by means of a questionnaire. Dietary intake data was gathered over two week days and one weekend day by using a 24-hour recall questionnaire and a food frequency questionnaire (FFQ). Results The majority of the participants were from well-off, financially stable families with good living conditions and well-educated and employed parents/ caregivers who provided a more than adequate variety of food and regular meals every day. The girls were of normal BMI (72.2%) and collectively had a mean BMI of 21.9, lower than the South African national average found for adolescent girls. There was a surprising number of underweight individuals (12.6%) as compared to overweight girls (10.3%). Furthermore, 99.6 percent of the girls were of normal height-for-age (≥-2 <+3SD) but were consuming far less energy than is required for the allocated age category. Energy came from the normal recommended macronutrient range with fat being on the borderline higher end of the normal range and carbohydrates coming from the lower end of the normal range; protein sources were adequately consumed. Fruit and vegetable consumption was reported to be very low subsequently leading to the poor dietary fibre intake identified across the sample group. Supplementation is taken by nearly a third (32.7%) of the girls which may contribute to their overall nutritional wellbeing. Among the top twenty foods consumed, milk, sugar, bread, tea and lettuce were the top five foods in the order stated. Although a wide variety of foods was consumed across all nine food groups over a week period, a mean daily DDS was lower but still adequate with 5.5 and the quantity of foods consumed were not of a substantial enough amount leading to poor total energy consumed and some micronutrient levels such as calcium, magnesium and folate not being met. All the participants were seen to be fairly physically active, performing a wide variety of sporting activities during school time and after school hours. The girls completed on average 199.64 minutes (SD±134.97) of physical activity per week, which is less than half of the WHO recommended physical activity minutes per week for adolescents. Significant correlations were seen between BMI and physical activity done on the weekend (p=0.041) and BMI and the amount of money spent on food per month (p=0.016) as well as extremely significant correlations between BMI and the number of minutes spent performing physical activities per week (p=0.002), as well as BMI and the amount of sport done over a one week period (p=0.005). Conclusion The results confirm that a relationship does exist between the physical activity levels and nutritional status of the adolescent girls surveyed. The majority of the population had low physical activity levels as well as low energy intake, which was supported by an inadequate quantity of food items consumed; however, anthropometric measurements showed to be majority within normal parameters with cases of underweight girls being more prominent than overweight which may suggest that over- and/ or under-reporting may have occurred. A high dietary diversity indicated a higher nutrient intake suggesting the importance of a diversified diet. / M

MENVSC / Department of Ecology and Resource Management / Certain communities in Sekhukhune area are known to be practicing geophagia. Existing standard questionnaires as adopted to generate data on human geophagia included aspects on demography, socio-economics, cultural, ecological, physico-chemical aspects, indigenous knowledge and health effects of geophagic consumers. These data were gathered through distribution of questionnaires to 200 geophagic participants, of which 135 were from Ga-Nchabeleng Village and 65 from Mphanama Village. Both the Villages were based in the rural settlements in Sekhukhune area. In this study the behaviour of geophagic individuals was investigated and cytotoxicity of plant remains consumed in geophagic soils was evaluated for any toxicity. A total of 17 different geophagic sites were identified. Six geophagic sites each were from Ga-Nchabeleng Village and six from Mphanama Village. Five other sites were selected from sites where geophagia was not practiced and were recorded as the control sites. All the 17 soil samples were analysed using Munsell Soil Color charts for soil colour classification. Samples of plant remains were collected from the same geophagic sites where soil samples were collected. Due to similar plants and vegetation type from 17 different geophagic sites, a composite study was adopted. Geophagic consumers in Ga-Nchabeleng Village identified four plant species of plant remains consumed in the soil in the area and Mphanama village identified five species different from Ga-Nchabeleng plants. Samples of plant remains were grouped according to comparable features or characteristics. Sample 1 of plant remains was composed mainly of grasses; Cynodon dactylon, Aristida congesta and Eragrostis rigidior whereas sample 2 of plant remains was composed of Acacia plant; Vachellia tortilis. The two samples of plant remains were collected from Ga-Nchabeleng Village. Sample 3 of plant remains was composed of creeping, perennial weed herbs; Alternanthera pungens Kunth and Alternanthera lorentzii. Sample 4 of plant remains was composed of prominent woody plants; Combretum apiculutum, Kirkia wilmsii and Boscia albitrunca. Samples of plant remains 3 and 4 were collected from Mphanama Village study sites. Sample 5 of plant remains was the control site and composed mainly of Acacia plants; Vachellia nilotica, Acacia vii mearnsii and Vachellia tortilis and were collected from sites not used for geophagic practices. The plant remains parts mostly consumed were roots (50%) in Ga-Nchabeleng, whereas in Mphanama Village they were stems (54.5%) and the control site had leaves at 62.5%. The five samples of plant remains were recovered using physical separation method. The plant remains were washed and dried. Retch Muhle grinding machine was used to ground the samples. Methanol was used in the extraction of all the samples of plant remains. The result from the administration of the questionnaire revealed that geophagia in this area was practiced by both male and female Sepedi-speaking individuals. Ga-Nchabeleng Village had more female geophagic participants, whereas Mphanama Village had more males who have almost undergone secondary school. However, in general for the study there were more female geophagic consumers. Geophagic consumers ingest soil known locally as Mobu, Letsopa or Leraga collected mostly from the riverbanks, mountains/hills and valleys with only a few that indicated termite mounds. Geophagic consumers in the study used colour, among other things, to describe their soil of preference. The study consisted of 200 participants of whom 172 represented the geophagic group and 28 were the control group, aged between 18-65 years analysed using chi-square crosstabulation. There was no significant difference in human health effects associated with geophagia between the geophagic group and the control group. There was also no association established between soil consumption and other non-food substances between geophagic group and control group. Chi-square (χ2) analyses revealed a significant association of gender with geophagic habits (p<0.05), while there was no association of age, educational level, income source and marital status (p>0.05) with geophagic habits. Findings of the survey when two villages are combined revealed that more females (75.60%) practice geophagia compared to males (24.40%). The respondents from both study sites preferred digging technique when collecting the soil. It was established that craving was mainly the reason behind the practice in the study area. Hygiene and environmental conditions were not considered when mining viii geophagic soil as the majority of them used dirty utensils, hands for collection and non-sterile bags and tins for packaging. Some of the soils were collected close to waste dumping sites as seen whilst visiting geophagic mining sites. Majority of the consumers had little or no knowledge that the soil could be harmful or if it contained any contaminants. This sample of interviewees provided valuable information on human geophagic practices in Sekhukhune area. It became clear that this practice was entrenched in the cultural behaviour of people in the area and a need for educating them on health related aspects. The cytotoxicity of methanolic extracts of plant remains on HEK-293T cell line was evaluated using MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide) assay for cell viability. The 50% cytotoxic concentration (CC50) was defined as the compound’s concentration (500, 250, 125, 62.5, 31.25, 15.625 and 7.8125 μg/ml) required for the reduction of cell viability by 50%. Evaluation of cell viability showed the methanolic extracts of plant remains on HEK-293T cell line ranged in the order of plant remains extract=3>1>4>2>5 according to their cytotoxicity activities. Plant remains extract 3 from Mphanama Village showed high cytotoxicity with a CC50 of 13.75 μg/ml, followed by plant remains extract 1 at 16.68 μg/ml, plant remains extract 4 at 58.95 μg/ml, plant remains extract 2 at 92.75 μg/ml and the control at 251.4 μg/ml, respectively. In the study only the methanolic extract was investigated for cytotoxicity using HEK-293T cell line. Further research need to be conducted on the individual plants of each plant remains to be able to have conclusive results on the cytotoxicity profile. This will indicate which specific plant part is toxic or whether they exhibit a higher CC50 only when in combination.

MESHWR / Department of Hydrology and Water Resources / Communities in South Africa have been noted to consume earthy materials such a soil among others. Geophagy is largely practised in the rural areas as opposed to urban places, and in these places the level of sanitation is low and people usual practice open defecation. The practice of Geophagia has been associated with cultural, medicinal, psychological, religious and nutritional deficiency among others. The aim of the study was to investigate the effects of open defecation on geophagic soils and water resources in Siloam village. The study also aimed to understand the reasons why people practice geophagia in Siloam village and the health effect associated with consumption of geophagic soils. To carry out the aim of the study, a questionnaire survey was conducted among women who practice geophagia between the ages of 18 and above in Siloam village. Two hundred and eighty-three (283) women were selected using snowball sampling method to take part in the study. From the (283) women, (200) women represent the geophagic group and (83) women represent the control group. The existing standard questionnaire adopted to generate data on human geophagia included aspects on demography, socio-economic, cultural, ecological, physicochemical aspects, indigenous knowledge and health effects of geophagic consumers. Participants were asked basic questions on why they practice geophagy, their geophagic material preferences, where they collect the geophagic material and other related questions. A total of twelve soil samples were collected from Siloam village, from the twelve soil samples collected eight were collected from sites known for geophagic practice and another four soil samples were collected from sites where geophagia is not practiced and the samples were used as control soil samples. All the twelve soil samples were analysed for the presence of geohelminths ova using Ammonium Bicarbonate Protocol (AMBIC protocol). The AMBIC protocol consists of four analytical procedures, namely, sample preparation, sample washing with AMBIC solution, geohelminths ova recovery through a modified zinc flotation method and microscopic analysis. vi Furthermore, a total of twelve water samples were collected from Nzhelele River and ponds water in Siloam village. From the twelve water samples, eight samples were collected close to where geophagic materials were collected and where open defecation is reported to be taking place and the remaining four water samples were collected randomly from Nzhelele river and water ponds in Siloam village and was recorded as a control group. A total of 12 water samples were analysed for total coliform and faecal coliform Escherichia Coli (E.coli) indicator using the membrane filter technique. The results from the administration of the questionnaire revealed there was prevalence in the practice of geophagia in the area. The study found that most of the villagers in Siloam consumed soil nearly on daily basis. According to the results, only women were involved in the geophagic practices in the area. Additionally, the study revealed that geophagic consumers were mainly in the age of child bearing age group and reddish and yellowish soils were the most preferred. Furthermore, the results showed that geophagic consumers in the area generally consumed soil commonly because of cravings and pregnancy, however, those who were not pregnant also consumed soil. The respondents reported that they mostly consumed clay and this material was consumed in its dry state and mostly unprocessed, if processed, it would be baked. This geophagic material was mainly found in the wild (riverbed, valley etc.); it was also found that most of the soil consumers did not know that the substances they consumed could be harmful to them. Among those who knew the consequences of consuming the material stated that soil consumption causes constipation, tooth decay, body poisoning, and abdominal pains. The results from the control group, 83 women who do not practice geophagia, aged between 18 and above, analysed using chi-square revealed a significant association of age with consuming soils (p<0.05), while there was no association of income source (p>0.05) and educational level (p>0.05) with consuming soils. Chi-square (χ2) analyses further revealed that there was no association of knowledge on the harmful nature of the substance (p>0.05), frequency of getting infections (p>0.05) and experiencing chronic illnesses (p>0.05) with frequency of consuming soils. vii The results of geophagic soils revealed the absence of geohelminths ova in the entire geophagic sample. Meaning geophagic consumers in Siloam village are not at risk of acquiring geohelminths infection which may be of potential risk to human health. However, geophagic consumers may be exposed to various other potentially hazardous biological and non-biological soil contents. The results of the water samples revealed that most of the water samples in the areas where open defection is reported to be practised had higher composition of faecal and total coliform bacteria. The composition was above the South African recommended standard for negligible risk of microbial infection. This has caused a great threat to those who consume soil collected near water resources, especially from riverbed and those who also use these water sources on their daily basis. The study recommends that geophagic consumers should continue to bake their materials before consumption as it might reduce the bacteria and toxic substances found in soils. The study also recommends that the residents of Siloam be made aware of the potential health hazards that might be posed to soil consumers and the effects of practicing open defecation near community water resources as high level of faecal coliform (E. coli) were found in the water. / NRF

Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder that affects women’s menstrual cycles and their levels of androgens (male hormones) and cysts on the ovaries. There is a variety of symptoms that come with this endocrine disorder, but insulin resistance is a hallmark symptom of the disorder. It’s shown that 65-70% of women with PCOS have insulin resistance and hyperinsulinemia, this is in women that are overweight, obese, or lean (Marshall & Dunaif, 2012). A lot of women with PCOS find themselves struggling to lose weight because their excess weight is tied to lifestyle and not properly nourishing their bodies, as well as their imbalanced hormones. The understanding of PCOS being a metabolic disorder led to the investigation of the need for registered dietitian nutritionists on the health team of women with PCOS could change the quality of life in women. We developed a survey based on the literature available on the topic of PCOS, diet/nutrition interventions, and the role of RDNs in the healthcare team of PCOS women of childbearing age. Only childbearing-age women (18-44) that have been diagnosed with PCOS were allowed to complete the survey. The survey was comprised of three sections and was designed to be a needs assessment on the need for registered dietitian-nutritionists to be included in the healthcare team of PCOS women. The questions were designed also show any gaps of knowledge or misconceptions about nutrition that these women may have. Lastly, it was designed to examine if women understand how nutrition relates to the management of their symptoms of PCOS and future disease risks. The data from this survey will show the need for RDNs in the healthcare team of PCOS women, and give us an understanding of nutrition education and intervention that could be developed for future studies. This understanding of how RDNs could play a role in symptom management could lead to a better quality of life in PCOS women.

Due to the fact that there has been a dramatic increase in the number of adolescents with unhealthy eating habits there is a growing recognition on the part of professionals, educators and parents for the development and implementation of an intervention programme for the facilitation of healthy eating habits. Relevant literature on eating behaviour indicated that low self-concept is associated with health compromising behaviours such as unhealthy eating habits. The nature of self-concept and eating habits was explained in order to determine important exogenous and endogenous factors as well as perspectives to use as a background for the development of a Psychoeducational intervention programme. Theoretical principles and practical applications of cognitive-behaviour therapy and hypnotherapy were analysed and used as a foundation for the development of the intervention programme. The researcher developed an Interactionism Model of Self-concept and Eating habits and a Psycho-educational programme involving cognitive-behaviour therapy and hypnotherapy to improve eating habits of adolescents. Valid and reliable measuring instruments were used in order to measure self-concept and eating habits. A pre-test post-test design was implemented to nine participants using the Adolescent Self-concept Scale (ASCS), Eating Habits Questionnaire for Adolescents (EHQA) developed by the researcher (2001) and Body Mass Index (BMI). Diagnostic measuring instruments also included the Emotions Profile Index (EPI), Draw A Person (DAP), Sentence Completion, Dietary Record and interview. Results from the empirical study indicated that adolescents with low self-concept and unhealthy eating habits responded positively to the Psycho-educational programme involving cognitive-behaviour and hypnotherapy. Specifically, there was a significant increase in selfconcept and a satisfactory improvement in eating habits. Recommendations for psychotherapy practice, educators and parents were made, based on the current research results. The contribution of the study lies in the fact that a hands-on practical implementation of the Psycho-educational programme was developed to facilitate the improvement of eating habits and it further contributes to the psychological well-being and healthy life-style of adolescents having positive implications for society. / Educational Studies / D.Ed. (Psychology of Education)

Estudo transversal do universo de pré-escolares (1544) de creches filantrópicas de Santo André, SP, Brasil, para estimar por antropometria seu crescimento e estado nutricional. Observou-se que o crescimento alcançado no conjunto está acima do referencial CDC/NCHS. Não se encontrou desnutrição, mas sim sobrepeso e obesidade, respectivamente em 16,8 e 10,8% das crianças, com tendência crescente com a idade. Entre os fatores de risco para esta condição encontrou-se o sexo feminino e o peso de nascimento mais elevado. Estes resultados apontam para a presença de uma etapa adiantada de transição epidemiólogica nutricional inclusive na população de pré-escolares de baixa renda deste Município / Cross sectional study of the universe (n=1544) of preschool children attending to philanthropic daycare centers of Santo André (SP- Brazil), to evaluate by anthropometrics their growth and nutritional status. The attained growth by the whole group was above the CDC/NCHS reference. There was no undernutrition but overweight and obesity with a prevalence of 16,8 and 10,8%, respectively, with a trend to increase with age. Higher birth weight and feminine gender were risk factors for these nutritional problems. The results pointed out an advanced step of nutritional transition, affecting the children between 2 and 6 years of age, of low income families, in this Municipality

O megaesôfago é manifestação clínica freqüente, em pacientes na fase crônica da doença de Chagas, na região Central do Brasil. Cursa com disfagia progressiva que pode levar a desnutrição protéico-calórica. O melhor tratamento para o megaesôfago é o cirúrgico. Pacientes desnutridos têm maior probabilidade de desenvolver complicações e mortalidade pósoperatória. Megaesôfago avançado ou recidivado podem ser tratados com a operação de Serra Dória, que consiste de cardioplastia, associada à gastrectomia parcial e anastomose gastrojejunal em alça exclusa, tipo Y de Roux. Torna-se de interesse avaliar o estado nutricional de pacientes portadores de megaesôfago chagásico no pré e pós-operatório, averiguando a repercussão que o estado nutricional pré-operatório possa ter sobre a evolução cirúrgica, assim como as conseqüências nutricionais da operação de Serra Dória. No presente trabalho foi realizada avaliação nutricional préoperatória em 27 pacientes portadores de magaesôfago chagásico, candidatos à operação Serra Dória. Após o 90º dia de pós-operatório, 19 pacientes foram reavaliados. Do total de pacientes, 75% tinham magaesôfago grupo IV; o restante, megaesôfago recidivado. O estado nutricional foi avaliado por meio de avaliação nutricional subjetiva global, antropometria, exames laboratoriais, além da análise de ingestão alimentar. No período pré-operatório observou-se, em mais de 60% dos doentes, desnutrição calórico-protéica do tipo marasmática caracterizada: por redução do índice de massa corpórea; pelo déficit ponderal em relação aos valores padrões; pela depleção acentuada da prega cutânea do tríceps, com preservação da circunferência muscular do braço, da albumina e da transferrina. De acordo com a avaliação nutricional subjetiva global, 2/3 dos pacientes apresentavam desnutrição. A desnutrição diagnosticada no préoperatório pela avaliação nutricional subjetiva global associou-se com o sintoma regurgitação. O estado nutricional pré-operatório não se associou a complicação ou mortalidade pós-operatória. Na avaliação pós-operatória observou-se aumento da ingestão protéica. Houve aumento do índice de massa corpórea e da prega cutânea do tríceps, além de redução dos níveis de hemoglobina no sangue periférico. Em conclusão, pacientes com megaesôfago chagásico grupo IV e recidivado, apresentam alta freqüência de desnutrição protéico-calórica. A desnutrição pré-operatória não se associa à morbimortalidade pós-operatória. No pós-operatório os pacientes apresentam recuperação da massa gordurosa corpórea / Chagasic megaesophagus is a frequent clinical manifestation in patients in a chronic phase of Chagas disease in Central Brazil. The main sympton is progressive dysphagia that can lead to protein-calorie malnutrition. Surgical intervention is the best treatment for megaesophagus. Undernourished patients present a greater probability of developing complications and postoperative mortality. Advanced or recurrent megaesophagus can be treated with Serra Dória\'s surgical procedure, which consists of cardioplasty, associated with partial gastrectomy and gastrojejunal Roux-en-Y anastomosis. An evaluation is worthwhile of the nutritional state of patients with chagasic megaesophagus in the pre- and postoperative period, as the findings have repercussions on the surgical course. The nutritional consequences of Serra Dória operation should also be observed. In the present work, a preoperative nutritional evaluation was performed in 27 patients with chagasic megaesophagus who were candidates for the Serra Dória operation. After postoperative day 90, 19 patients were reevaluated. Of the total patients, 75% presented megaesophagus group IV and the remainder recurrent megaesophagus. The nutritional state was assessed through subjective global assessment, anthropometry and laboratorial exams, besides the analysis of alimentary ingestion. In the preoperative period it was observed that over 60% of the patients had protein-calorie malnutrition of the marasmic type, characterized by: reduction in the body mass index; ponderal index deficit in relation to the standard values; marked depletion in the skin fold of the triceps, with preservation of the muscular circumference of the arm and of the albumin and transferrin levels. In agreement with the global subjective nutritional evaluation, 2/3 of the patients presented malnutrition. The diagnosis of malnutrition in the preoperative by subjective global assessment was associated with the symptom of regurgitation. The preoperative nutritional state did not correlate with complications or postoperative mortality. The postoperative evaluation showed an increase in the ingestion of proteins. There was an increase in the body mass index and the tricipital skin fold, besides a reduction in the hemoglobin levels of the peripheral blood. In conclusion, patients with group IV and recurrent chagasic megaesophagus presented a high frequency of protein-calorie malnutrition. Preoperative malnutrition was not associated to postoperative morbidity and mortality. In the postoperative the patients presented a recovery in the body fat mass

Estudo transversal do universo de pré-escolares (1544) de creches filantrópicas de Santo André, SP, Brasil, para estimar por antropometria seu crescimento e estado nutricional. Observou-se que o crescimento alcançado no conjunto está acima do referencial CDC/NCHS. Não se encontrou desnutrição, mas sim sobrepeso e obesidade, respectivamente em 16,8 e 10,8% das crianças, com tendência crescente com a idade. Entre os fatores de risco para esta condição encontrou-se o sexo feminino e o peso de nascimento mais elevado. Estes resultados apontam para a presença de uma etapa adiantada de transição epidemiólogica nutricional inclusive na população de pré-escolares de baixa renda deste Município / Cross sectional study of the universe (n=1544) of preschool children attending to philanthropic daycare centers of Santo André (SP- Brazil), to evaluate by anthropometrics their growth and nutritional status. The attained growth by the whole group was above the CDC/NCHS reference. There was no undernutrition but overweight and obesity with a prevalence of 16,8 and 10,8%, respectively, with a trend to increase with age. Higher birth weight and feminine gender were risk factors for these nutritional problems. The results pointed out an advanced step of nutritional transition, affecting the children between 2 and 6 years of age, of low income families, in this Municipality

Due to the fact that there has been a dramatic increase in the number of adolescents with unhealthy eating habits there is a growing recognition on the part of professionals, educators and parents for the development and implementation of an intervention programme for the facilitation of healthy eating habits. Relevant literature on eating behaviour indicated that low self-concept is associated with health compromising behaviours such as unhealthy eating habits. The nature of self-concept and eating habits was explained in order to determine important exogenous and endogenous factors as well as perspectives to use as a background for the development of a Psychoeducational intervention programme. Theoretical principles and practical applications of cognitive-behaviour therapy and hypnotherapy were analysed and used as a foundation for the development of the intervention programme. The researcher developed an Interactionism Model of Self-concept and Eating habits and a Psycho-educational programme involving cognitive-behaviour therapy and hypnotherapy to improve eating habits of adolescents. Valid and reliable measuring instruments were used in order to measure self-concept and eating habits. A pre-test post-test design was implemented to nine participants using the Adolescent Self-concept Scale (ASCS), Eating Habits Questionnaire for Adolescents (EHQA) developed by the researcher (2001) and Body Mass Index (BMI). Diagnostic measuring instruments also included the Emotions Profile Index (EPI), Draw A Person (DAP), Sentence Completion, Dietary Record and interview. Results from the empirical study indicated that adolescents with low self-concept and unhealthy eating habits responded positively to the Psycho-educational programme involving cognitive-behaviour and hypnotherapy. Specifically, there was a significant increase in selfconcept and a satisfactory improvement in eating habits. Recommendations for psychotherapy practice, educators and parents were made, based on the current research results. The contribution of the study lies in the fact that a hands-on practical implementation of the Psycho-educational programme was developed to facilitate the improvement of eating habits and it further contributes to the psychological well-being and healthy life-style of adolescents having positive implications for society. / Educational Studies / D.Ed. (Psychology of Education)