Thesis (M.S.)--Eastern Illinois University, 2008. / Includes bibliographical references (leaves 48-54).

Thesis (M.S.)--Virginia Polytechnic Institute and State University, 1992. / Vita. Abstract. Includes bibliographical references (leaves 28-33). Also available via the Internet.

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2009. / Title from title screen (site viewed January 12, 2010). PDF text: v, 101 p. ; 1.58 Mb. UMI publication number: AAT 3365739. Includes bibliographical references. Also available in microfilm and microfiche formats.

Dissertation submitted in fulfilment of the requirements for the Degree of Magister Technologiae: Consumer Science Food and Nutrition, Durban University of Technology, 2011. / The objective of the study was to conduct a situational analysis of elderly people on state pension living in Umlazi, KwaZulu-Natal South Africa. The research focused on the socioeconomic status, dietary intake, nutritional status, and health status of this community. Methodology The sample comprised 270 (224 women and 46 men) randomly selected elderly people within the 12 wards of Umlazi. The methods used for assessment included a sociodemographic questionnaire which determined the socioeconomic status. A 24-hr recall questionnaire and food frequency questionnaire were used to determine dietary intake, while anthropometric measurements were conducted to determine the nutritional status. A health questionnaire, including a salt administration questionnaire was used to determine the health status of the elderly in this community. Trained field workers and nurses assisted in data collection and food consumption data was captured and analysed by a qualified dietician using Food Finder version 3.0 computer software program. Descriptive statistics (frequencies, means, standard deviations and confidence intervals) were determined with the assistance of a bio-statistician. Socio-demographic and health data were captured onto an Excel(R) spreadsheet by the researcher. These questionnaires were analysed using the Statistical Package for Social Sciences (SPSS) for Windows version 17, 0 software program. Results The majority of respondents lived in brick houses (84.8%) and the living space generally consisted of more than three rooms (87.4%). However, the majority of respondents who lived with >4 to 10 members were 67.4% whilst only 32.6% of households consisted of less than 4 members. The mean household size was 5.1 (±SD 2.9) people, this further illustrates that the majority of respondents lived with 5 people per household. Grandchildren were present in 70% of the households with a mean of 3 (±SD 5) grandchildren in each household. Results also indicate that 84.6% of the elderly were the bread winners in these households. The vast majority of 87.8% of the population had no other source of income. The majority of vi Pagevi respondents with an income had a total monthly income of R500- R1500 (82.9%) followed by R1501- R2500 (14.1%) and only 3% had more than R2500 total income. Food expenditure for most (80%) households was >R500 of the total income. Food shortages due to limited income were frequent in 54% of households who regularly experienced this problem, whilst 26% sometimes experienced shortages, 15.4% often encounted shortages whereas 2.6% encounted shortages seldomly and 2.2% never. A large majority of respondents owned electrical assets, the most commonly owned included a televison (80.3%) , a radio (75.5%) and a refrigerator (75.1). The majority of food items consumed were carbohydrate based and the portion sizes were relatively big, on average 1348.5g per day. The energy contribution from carbohydrates was 65% which is considered to be on the high side (WHO goals 55-75%). Protein intake was fairly common, with a 15% contribution to energy from total protein (WHO goals 10-15%). The frequency of vegetable and fruit intake was very low, the portion sizes were also small and did not meet the recommended daily intake. The energy contributions showed that 89.2% of the women consumed a diet that supplied <100% of Estimated Energy Requirements (EERs) and all the men consumed <100% of the EERs for energy. Sixty three percent of the women and 91.1% of the men consumed <100% of the EARs for protein. The mean carbohydrate intake in the sample was significantly higher than the EAR but the women consumed <100% of the EARs for carbohydrates (4.1%) and all men consumed >100% of the EARs. The majority of the vitamins for both genders indicated low intakes except for vitamin B12 and B6 in the case of men only. The majority of minerals indicated low scores for micronutrients except for iron (36.6% for men) and potassium (39.0% for men) which was consumed mostly by men than women. The mean Food Variety Score (FVS) (±SD) for all the foods consumed from all the food groups in a period of seven days was 25.8 (±14.6). The results revealed poor dietary diversity scoring. The cereal group had the highest mean variety score 5.3 (±2.5) followed by vegetables 4.5 (±2.6), fruit 3.5 (±3.1), flesh foods 3.2 (±1.6), vitamin A-rich fruit and the vegetable group 3.1 (±1.7). The anthropometric indices indicated that the mean age was 69.7 years (±SD 7.1) and mean weight of 76.5 kg (±SD 17.3). The BMI scores for the total group indicated that 52% of the respondents fell into the obese category (BMI = obese 1 >30, obese 2 >35 and obese 3> 40) and 24% of the respondents were overweight (BMI = 25-29.9). Only 20% were of moderate weight (BMI 18.5- 24.9). Although more men were overweight (34.2%) compared to 21.9% vii Pagevii of women, more women (60.1%) were obese compared to men (18.8%). The majority (83%) of the women were above the cut-off points for waist circumference ( 88cm) and 17% were within the normal values whilst 74% of the men were within recommended cut-off points ( 102cm) and only 26% exceeded the recommended scores. The results indicate that 77% of respondents were at risk of developing metabolic syndrome exceeding >0.5 waist-to-heightratio (WHTR) and 23% were at lower risk. However, the women showed a higher risk of 87.4% and men only 47.9% for metabolic risk. The correlation was significant at the p=0.01 level. There was thus as highly significant relationship between BMI and WHTR ratio for women. The health survey results indicated that 90% of the elderly population were in various stages of hypertension and 6% showed signs of developing hypertension. However, hypertension was more prevelant in women (91%) than in the men (83%). There was a statistical significant correlation (p=0.01) between waist circumference and systolic pressure for both women and men. A high percentage (82%) of the participants reported that they were currently on chronic medication whereas 18% were not using any chronic medication at the time. Although hypertension was prevalent in most respondents, it was followed by self reported diabetes (26.7%) and cancer (1.9%). Results show that elderly experienced problems with following ereas in the body skeletal joints (72.6%) as well as eyes and teeth were problematic in 75.9% of the respondents, followed by skin problems (29.6%) and ears and nose problems (28.6%). Results in the salt administrative questionnaire indicate that sodium intakes were below WHO goals <2000mg. Results also show that a high percentage of respondents (60%) generally never added salt to cooked food as the majority saw it as a health risk. Only 13% added it always to cooked food and 21% added it sometimes. Conclusions The results in the study indicate the high prevelance of poverty, food insecurity and poor nutritional and health status that compromises the quality of life of elderly living in this community. Recommendations Long-term intervention studies must be prioritised to address economic, health, social and demographic factors and future research is needed to cater for the growing needs of this population group.

Alzheimer's disease (AD) kills about 120,000 adults each year (1), perhaps ranking as the fourth or fifth leading cause of death in the United States (2). Progressively through its three stages, AD patients demonstrate an inability to identify familiar smells, lose weight, and develop malnutrition. This study was undertaken to compare the ability of AD patients verses non-AD patients concerning food identification and its potential influence on food intake. Another objective of the study was to assess whether an improved AD patient/caregiver relationship could improve the probability that the AD patient will accept more food items as a result of an enhanced relationship with the caregiver. Ten food items were used in each testing. Each patient was given a list of four food items to pick from when smelling and/or tasting each test sample. A response was required, regardless of whether or not the food item was correctly identified. Three separate tests were conducted for each patient, each a week apart, by three different administrators with a different third of the control and experin1ental patients until each had tested all of them. The data showed that AD patients have lessened food identification skills when compared to non-AD patients. Patient caregivers were able to attain the best results in toto (70.8%); almost double the results from the nurse coordinator (33.3%) and the researcher (33.4%), thus supporting the theory that the closer the patient/caregiver relationship, the greater the probability that the patient will accept more food items. / Master of Science

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 vii 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 viii 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)