D. Tech. (Food Service Management, Dept. of Hospitality, Faculty of Human Sciences)|cVaal University of Technology / Main Purpose of the study: To evaluate the impact of soy protein feeding intervention over a period of six months on the nutritional status of an elderly (≥60 years old) community of Sharpeville, in which poverty, household food security and malnutrition were prevalent. Methods: An experimental design that had no control group but a comparison between hypercholesterolaemic (HC) and normocholesterolaemic (NC) groups was used with 134 randomly selected elderly respondents. The first stage involved a baseline survey which determined the prevalence of risk factors for cardiovascular disease (CVD) and nutritional status among participants. Measurements included biochemical indices (serum lipids, vitamin B12, folate and homocysteine), anthropometry (weight, height and waist circumference) and dietary intake using 24h-recall and 7-day dietary diversity questionnaire. Socio-demographic information gathered from previous studies on the same subjects was used. The second stage was the preparation, formulation, and implementation of a nutrition education programme to assess its impact on nutrition knowledge after the nutrition education intervention. The nutrition education was conducted in two sections, namely an exploratory study and an experimental study. An exploratory study was conducted to assess the nutrition education needs of the elderly and was followed by the experimental study, which assessed nutrition knowledge before and after the intervention. The third stage was the implementation of the 10 grams soy protein daily feeding intervention for a period of six months and evaluation of its impact on risk factors for cardiovascular disease and on nutritional status. Sensory tests, compliance and the same measurements conducted at baseline were used at follow-up (feeding intervention). A comparison of the findings of the baseline study and follow-up study was conducted. Also to provide deeper insight into the effect of soy on the risk factors for CVD and nutritional status, respondents were further stratified into HC and NC groups based on their LDL-C levels at baseline study and results were also presented as such. The data analyses included descriptive statistics and t-tests on SPSS version 21.0. Results: From the baseline study, the dietary intake results revealed a poor dietary intake which contributed to inadequate estimated average requirements (EAR) and adequate intakes (AI) of nutrients. A mainly carbohydrate-based diet was consumed with minimal intake of dairy and legumes despite a medium dietary diversity score. The anthropometric indices at baseline indicated over-nutrition based on the reported waist circumference 97.32±10.32 (80.6%) above substantial risk of CDL, obesity (75.3%) and hypertension (56.7%), with the highest percentages for both waist circumference of substantial risk and overweight/obesity found among the women (80.9% and 79.9% respectively) and for hypertension among the men (79.1%). For the biochemical results at baseline, the prevalence of risk factors for CVD was observed as abnormal mean serum lipids such as LDL-cholesterol (3.6±1.1), HDL-cholesterol (0.73±0.4), total cholesterol:HDL-cholesterol ratio (7.9±2.9), triglyceride:HDL-cholesterol ratio (2.7±2.1) and homocysteine (17.1±9.2) in the total group. The women had high TC (5.2±1.1) indicating borderline risk of CVD as compared with men who had lower TC (4.5±0.8) and this was significantly different (p=0.049). The nutrition education programme was effective in increasing knowledge with an improvement of 14.5 percent from pre- (62.3%) to post-test (76.8%) for the total group which was statistically significant (p=0.000). The results for the soy protein feeding intervention, the dietary intake for the total group indicated a statistically significant decrease in energy intake (p=0.001), by about 20.4 percent form baseline to follow-up, while energy intake at baseline was already below the EAR. Also a statistically significant decrease was seen from baseline to follow-up for total dietary fat (p=0.004), cholesterol (p=0.008) and animal protein (p=0.000), with a statistically significant increase only on dietary folate (p=0.001) and iron (0.001). These dietary changes were also observed for the HC and NC groups after the intervention with only fat not decreasing significantly for the HC group. For the anthropometry indices, and hypertension no significant impact after the intervention for the total group and also for the HC and NC groups was observed. The biochemical results indicated a beneficial effect of the soy-based products on the following serum lipids: a significant improvement in LDL-C (p=0.000), HDL-C (p=0.000) and TC:HDL ratio (p=0.000) for the HC group while only TC:HDL ratio showed a significant improvement for the NC group after the intervention. However, high risk factors for CVD in this elderly group were still observed, with a significant decrease after the intervention of serum folate (p=0.000) below the recommended level and a significant increase in homocysteine (p=0.000) above the recommended level. Significant differences between the HC and NC groups were seen in TC, LDL-C, LDL:HDL-C ratio and TC:HDL-C ratio at the beginning of the intervention (baseline). However, at the end of the intervention (follow-up), significant differences were observed only in TC, LDL-C and homocysteine. Conclusion: Although the energy intake reduced significantly, only three of the micro-nutrients (pantothenate, Niacin and selenium) had a significant decrease between baseline and follow-up. Therefore the nutritional status of these elderly was not affected as it was also observed that there was no significant impact on anthropometric indices that took place. However this intervention had a significant impact on iron intake, which was one of the deficiencies identified amongst this elderly people from previous study. Also the nutrition education and a daily consumption of at least 10g of soy had a significant beneficial effect on LDL-C, HDL-C and TC:HDL ratio for the HC groups, thus reducing risk of CVD. Although soy had a beneficial effect on blood lipid profile no effect on hypertension was observed. The guideline of a 25g intake of soy should be encouraged as recommended by FDA as an effective cholesterol-lowering food item.

M. Tech. (Department of Hospitality, Faculty of Human Sciences) Vaal University of Technology / Introduction: The education, training and development (ETD) industry has developed fast over the past few years in our country. One need only read the national weekend papers and see all the ETD vacancies advertised to realise that ETD issues are being given increased coverage in this country. The reason for this increased focus on ETD is the need for skilled workers in organisations. Reports on our competitiveness in the world have consistently identified the lack of people development as a major stumbling block for the South African economy in competing in the global market. Objectives: The main objective of this study was to measure the impact of a training programme for the food service workers providing meals to 300 elderly people attending the Sharpeville Care of the Aged centre, in terms of a skills development programme, in order to contribute to increased productivity and provide nutritious meals to the elderly. Methods: A baseline survey was undertaken to determine the nutritional status, food consumption patterns and nutrient intake in a random sample of 300 elderly people attending the care centre five days a week. Socio-demographic and health questionnaires, as well as 24-hour recall questionnaires were completed with the assistance of trained fieldworkers. Anthropometric measurements included weight, height, and Mid-Upper Arm Circumference. Furthermore, the existing menus served to the elderly were theoretically analysed using FoodFinder® version 3 program to determine the energy, carbohydrate, protein and fat content. A developed and tested questionnaire was used to gather information from ten volunteer food service workers at the care centre to determine the training needs. The results of the baseline survey, the menu analysis and training needs assessment were used to develop a training programme that was implemented for a period of ten weeks. Learning was measured after the training programme by administering the same knowledge questionnaire, as well as by a portfolio of evidence and practical assessment. Data analyses: Data for the baseline survey was captured on an Excel spreadsheet. Data analysis was done using the Statistical package for Social Sciences (SPSS) for Windows version 10.0 program for all variables except dietary intake data. Dietary intake and food consumption data were analysed by a registered dietician using the FoodFinder® version 3 program, developed by the Medical Research Council (MRC). Daily nutrient intakes were reported as means and standard deviations and compared to RDAs. Paired t tests were done to determine correlations between knowledge of the food service workers before and after the implementation of the training programme. Results: The results indicated that the majority of the elderly had an income of between R500 and R1 000 per month and most of them reported an occasional lack of funds to meet basic household needs, confirming the presence of food insecurity. Daily dietary intakes (mean ±Standard Deviation [SD] were 5 041,2 ± 2 299,6 kilojoules (kJ) energy, 50,4 ± 28,2 gram (g) protein, 38,9 ± 28,2 g fat and 149,0 ± 76,6 g carbohydrates. The majority (29.5%) were overweight (body mass index [BMI] ~25) or obese (BMI ~30) whilst 33.5% had a mid-upper arm circumference (MUAC) of ~21.7 centimetres (em). Mean intakes of micronutrients were low in comparison with the reference standards. The volunteer food service workers were literate as the majority had higher than grade 10-12 training and 80% had previously received on-the-job training. The training programme was successfully implemented and the knowledge of the voluntary food service workers improved after the training programme was implemented. However, because of the small sample size no significance could be determined. Conclusions: The findings of this study confirmed that poverty, malnutrition, both under- and over-nutrition, as well as household food insecurity and poor health were the major problems observed in this elderly community. These findings correspond to other studies, however limited, conducted amongst the elderly in South Africa. The results indicated that, although the food service workers were literate and had received prior training, they still had a poor knowledge of appropriate food preparation method and practices, as well as nutrition, especially related to the elderly. On completion of the training programme, the knowledge of the food service workers improved. This study emphasises the importance of continued on-the-job training Recommendations: The recommendations of further research include: 1) A more detailed study to evaluate the influence of the training programme not only on knowledge and skills, but also on behaviour and attitude. 2) Periodically measuring such influence over a year to measure knowledge retention. 3) Implementation of a NEP for the elderly and its impact on nutrition knowledge and dietary intake behaviour tested. / National Research Foundation (NRF