Thesis (MNutr (Human Nutrition))--Stellenbosch University, 2007. / INTRODUCTION: Epidemiologic research strongly supports the importance of adequate fruit and vegetable intake for the promotion of human health and the prevention of chronic disease. Data suggest that fruit and vegetable consumption in children may protect against an array of childhood illnesses. Low fruit and vegetable intake has been recognized as a key contributor to micronutrient deficiencies in developing countries. Evidence indicates that fruit and vegetable consumption is inadequate in both developed and developing nations. A paucity of data on fruit and vegetable consumption exists in South Africa. Quantification of fruit and vegetable consumption is important for the worldwide drive to increase consumption and for strategy development to address inadequate consumption. METHODS: A secondary analysis of the dietary intake data (24 hour recall questionnaire (24-H-RQ) and quantified food frequency questionnaire (QFFQ)), collected during the 1999 National Food Consumption Survey (NFCS) in 12 – 108 month old children in South Africa, was conducted to ...

A community based survey to determine the nutritional status using anthropometric methods, of children and mothers and to assess certain socio-economic factors was carried out during November and December 1986 in Philippi, a predominantly vegetable farming area. Twenty-one (43%) of the 49 vegetable farms which were included in the study were selected by stratified random sampling. All children in the 0-6 year age group and their parents on the selected farms were included in the sample which consisted of 129 children and 212 parents. Questionnaires were administered and subjects' weights and heights were measured. It was found that 47% of children were below the National Centre for Health Statistics 5th percentile weight for age and 58% were under the 5th percentile height for age. There were 47 child deaths out of 279 births over a six-year period, thirty-four of which had occurred in the first year of life. Twenty eight percent of children had a birth weight of less than 2.5 kg. The number of cases of tuberculosis (10%) and severe diarrhoea (31%) contracted within the first year of life is unacceptably high. Twenty four percent of mothers were malnourished in terms of body mass index and fifty five percent of mothers were illiterate. Fifty nine percent of mothers were regular farm workers who worked for an average of 10.2 hours per day and a wage of R0.44 per hour. Grossly inadequate facilities existed for the care of children while the mothers worked. The average amount spent on food was insufficient to maintain normal nutrition. Although 91.5% of mothers breast fed their children and fed for a mean duration of 13.4 months, breast feeding was not exclusive. Supplementary feeding was introduced on average at 3 months of age. The long working hours of working mothers made it difficult for them to breast feed their children satisfactorily. Acceptance of the family planning services was high and immunisation cover was good. These statistics reflect the effects of extreme poverty and neglect of a community which is totally reliant on its employers for its livelihood. The parents poor educational level, coupled with their meagre financial and other physical resources gives them and their children little opportunity to improve their station in life and leaves them open to the scrounge of malnutrition and disease. Similarly, the dearth of educational and other child care facilities will ensure that this disastrous trend continues. A multidisciplinary approach, including active community involvement of both farmers and workers, to the many physical and social problems is urgently needed if the unacceptable human suffering is to be stopped.

Dietary intake is a strong determinate of the health of an individual. Healthy eating is an important prevention to non-communicable diseases. If behaviour is to be changed insight into what the attitudes and barriers are to eating healthily amongst adolescents is imperative. This can provide knowledge for future prevention campaigns for healthy eating to prevent overweight and obesity. The purpose of the study was to quantitatively describe what attitudes adolescent females have towards healthy eating and what potential barriers omits them from adopting healthy eating behaviours. Data collection was done using structured questionnaires. Girls (N=73) from 3 public all girls’ high schools within Durban, KZN, participated in this study. The findings revealed that overall adolescent girls have a positive attitude to healthy eating. A lack of time, the foods sold in the school shop and the conveniences of less healthy food have been identified as barriers to healthy eating. / Health Studies / M. A. (Public Health)

Information on the present situation of household food insecurity in South Africa is fragmented. There is no comprehensive study comparing different indicators of household food security. Better information on the household food security situation in South Africa would permit relevant policy formulation and better decision-making on the allocation of limited resources. The availability of a national dataset, the first South African National Food Consumption Survey data (1999) , provided the opportunity to investigate some of the issues raised above, and to contribute to knowledge on the measurement of household food security. The aim of this study was to use the data from the 1999 National Food Consumption Survey (NFCS) to : • Determine and compare the prevalence of household food insecurity using different indicators of household food security ; • Determine the overlap of households identified as food insecure by the different indicators (i.e. how many of the same households are identified as food insecure); and to • Investigate whether there was any correlation between the indicators selected . The indicators of household food security selected were: household income, household hunger experienced, and using the index child: energy and vitamin A intake (from 24 Hour Recall (24HR) and Quantified Food Frequency data), dietary diversity (from 24HR data) and anthropometric indicators stunting and underweight. The cut offs to determine food insecure household were those used in the NFCS and the cut off for dietary diversity was exploratory. The main results of the study were as follows : • The prevalence estimates of household food insecurity ranged from 10% (underweight indicator) to 70% (low income indicator). Rural areas consistently had a higher prevalence of household food insecurity than urban areas . The Free State and Northern Cape provinces had higher levels of household food insecurity, with the Western Cape and Gauteng the lower levels of household food insecurity . • Quantified Food Frequency (QFF) data yielded lower prevalence of household food insecurity estimates than 24 hour recall (24HR) data. Household food insecurity as determined by low vitamin A intakes was higher than that determined by low energy intakes for both the 24HR and QFF data . • There was little overlap with the indicators (9-52%), indicating that the same households were not being identified by the different indicators. Low dietary diversity, low income, 24HR low vitamin A intake and hunger had higher overlaps with the other indicators. Only 12 of 2826 households (0.4%) were classified by all nine indicators as food insecure. • The dataset revealed a number of statistically significant correlations. Overall , low dietary diversity, low income, 24HR low energy intake and hunger had the stronger correlations with the other indicators. Food security is a complex, multi-dimensional concept, and from the findings of this study there was clearly no single best indicator of household food insecurity status. Overall , the five better performing indicators (higher overlaps and correlations) were : low income, 24 hour recall low energy intake, 24 hour recall low vitamin A intake, low dietary diversity and hunger; this merits their use over the other selected indicators in this study. The indicator selected should be appropriate for the purpose it is being used for, e.g. estimating prevalence of food insecurity versus monitoring the long term impact of an intervention. There are other important criteria in the selection of an indicator. Income data on a national scale has the advantage of being available annually in South Africa, and this saves time and money. The 24HR vitamin A intake and 24HR energy intake indicators has as its main draw back the skill and time needed to collect and analyse the information, which increases cost and decreases sustainability. Dietary diversity and hunger have the advantage of being simple to understand, and quicker and easier to administer and analyse. It is suggested that a national food security monitoring system in South Africa uses more than one indicator, namely : 1) household income from already existing national data, 2) the potential for including a hunger questionnaire in the census should be explored, and 3) when further researched and validated, dietary diversity could also be used in national surveys. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.

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.

Text in English with abstracts in English, isiXhosa and isiZulu / Mother’s nutrition knowledge, one of the guiding factors in developing children’s healthy eating patterns, has received relatively little research attention. This study determines the influence of demographic factors on mothers’ nutritional knowledge in Mthatha in the Eastern Cape Province of South Africa. Quantitative, exploratory descriptive survey used group administrative questionnaire. Closed and open ended questions solicited data in 350 purposely and conveniently selected respondents. SSPS 26.0 Version analysed the data and Factor Analysis summarized for easy interpretation. Although SA FBDG are based on the current consumption of locally available foods, respondents were largely unaware of this tool. Mothers receive informal education on Dietary Guidelines from health centres, but no one knows the extent to which they understand and apply the information. There is general lack of correlation between nutrition knowledge and its application. Mothers require nutrition education and practical application of FBDG to improve their and children’s nutrition security. / Luncinane kwaye alukho nzulu uphando olukhe lwenziwa ngolwazi lomzalikazi ngendlela yokondla. Olu lwazi yenye yeenqobo zokukhokela isiqhelo sokutya ngokunempilo. Esi sifundo senziwe eMthatha, kwiMpuma Koloni yoMzantsi Afrika kwaye siqwalasela ifuthe leempawu zesimo soluntu kulwazi lomzalikazi ngendlela yokondla. Uphando lwenziwe ngokuqwalasela ulwazi olufunyenwe kubantu abaninzi ngokunika amaqela abantu uludwe lwemibuzo. Imibuzo enempendulo ethe gca (evalekileyo) okanye enempendulo exhomekeke kwizimvo zomntu (evulekileyo) yabuzwa kubantu abangama-350 ababekhethwe ngobuchule. Iinkcukacha zolwazi zahlalutywa ngokusebenzisa ubuchwepheshe beSSPS 26.0 lwaze uhlalutyo olwaziwa ngokuba yiFactor Analysis lwashwankathela ukuze ulwazi olufunyenweyo lutolikeke lula. Nangona isikhokelo sendlela yokutya esaziwa ngokuba yiSouth Africa food-based dietary guidelines (SA FBDG) sisekelwe kukutya okufumanekayo endaweni, abathathi nxaxheba abaninzi kolu phando babengazi nto ngesi sikhokelo. Abazalikazi bafumana imfundo engekho sesikweni ngesikhokelo sendlela yokutya kumaziko empilo, kodwa akukho mntu waziyo ukuba bayiqonda kangakanani, beyilandela kangakanani loo nto bayifundiswayo. Kukho ukungahambelani okuxhaphakileyo eluntwini phakathi kolwazi ngendlela yokutya nokulusebenzisa olo lwazi. Abazalikazi badinga ukufundiswa ngendlela yokutya nokusebenzisa isikhokelo iFBDG ukuze baphucule indlela yokutya bona nabantwana babo ngokukhuselekileyo. / Lusathole ukunakwa okuncane kakhulu kwezocwaningo ulwazi lukamama mayelana nokudla okunomsoco, okungenye yezinto eziqondisayo ekuthuthukiseni izindlela zokudla okunempilo ezinganeni. Lolu cwaningo luzocubungula futhi luhlonze umthelela wezimo zenhlalo ezigabeni zabantu abahlukahlukene olwazini lomama mayelana nokudla okunomsoco eMthatha esifundazweni saseMpumalanga Koloni eNingizimu Afrika. Ucwaningokuhlola (isaveyi) olukhwantithethivu (olugxile emananini kanye nobuningi) oluhlolisisayo futhi oluchazayo, lwasebenzisa iphephamibuzo eligcwaliswa ngababambiqhaza abayiqembu. Imibuzo evalekile kanye nemibuzo evulekile yasetshenziswa ukuthola idatha kubabambiqhaza bocwaningo abangama-350 ababekhethwe ngabomu ukufezekisa izinhloso zocwaningo. I-SSPS 26.0 Version yahlaziya idatha kanti futhi i-Factor Analysis yafingqa idatha ukuze ihumusheke kalula. Nakuba imihlahlandlela yokudla okunomsoco yaseNingizimu Afrika (SA FBDG) isuselwe ekudliweni kokudla okutholakala kuleli lizwe njengamanje, ababambiqhaza babengenalo ulwazi lokuthi kukhona imihlahlandlela enjengalena. Omama bayafundiswa, ngendlela engahlelekile, ezizindeni zezempilo mayelana neMihlahlandlela Yokudla Okunempilo, kodwake akekho owaziyo ukuthi baluqonda kangakanani ulwazi abaluthola lapho, futhi balusebenzisa kangakanani. Kuvamise ukuthi kungabi khona ukuhambisana nokuxhumana phakathi kolwazi oluphathelene nokudla okunomsoco kanye nokusetshenziswa kwalo. Omama bayakudinga ukufundiswa mayelana nokudla okunomsoco futhi kuqinisekiswe ukuthi imihlahlandlela yama-FBDG isetshenziswa ngendlela ephathekayo futhi ebonakalayo ukuze bakwazi ukwenza ngcono ukutholakala kokudla okunomsoco, kubona omama ngokwabo kanye nezingane zabo. / Life and Consumer Sciences / M.C.S.

Dietary intake is a strong determinate of the health of an individual. Healthy eating is an important prevention to non-communicable diseases. If behaviour is to be changed insight into what the attitudes and barriers are to eating healthily amongst adolescents is imperative. This can provide knowledge for future prevention campaigns for healthy eating to prevent overweight and obesity. The purpose of the study was to quantitatively describe what attitudes adolescent females have towards healthy eating and what potential barriers omits them from adopting healthy eating behaviours. Data collection was done using structured questionnaires. Girls (N=73) from 3 public all girls’ high schools within Durban, KZN, participated in this study. The findings revealed that overall adolescent girls have a positive attitude to healthy eating. A lack of time, the foods sold in the school shop and the conveniences of less healthy food have been identified as barriers to healthy eating. / Health Studies / M.A. (Public Health)

A high rate of micronutrient deficiencies persists in Africa with the most vulnerable groups being women and children. The Moringa oleifera tree has been identified to help alleviate malnutrition at household level because of its rich content of vitamin A in its plant form - beta-carotene, iron and vitamin C. The objectives of this study was to identify households that consumed Moringa, to identify households that required diet diversification through the use of a Household Dietary Diversity Score (HDDS) and to determine the acceptability of various dishes prepared from Moringa leaves as a possible contribution to the alleviation of malnutrition in resource poor communities. The dietary diversity score of the traditional Bapedi community is 4.7 and the results of the acceptability test of dishes prepared with Moringa indicated that Moringa could be recommended as an additional food ingredient to add micronutrient to the diet of Bapedi communities. / Agriculture and Environmental Sciences / M.A. (Human Ecology)

A high rate of micronutrient deficiencies persists in Africa with the most vulnerable groups being women and children. The Moringa oleifera tree has been identified to help alleviate malnutrition at household level because of its rich content of vitamin A in its plant form - beta-carotene, iron and vitamin C. The objectives of this study was to identify households that consumed Moringa, to identify households that required diet diversification through the use of a Household Dietary Diversity Score (HDDS) and to determine the acceptability of various dishes prepared from Moringa leaves as a possible contribution to the alleviation of malnutrition in resource poor communities. The dietary diversity score of the traditional Bapedi community is 4.7 and the results of the acceptability test of dishes prepared with Moringa indicated that Moringa could be recommended as an additional food ingredient to add micronutrient to the diet of Bapedi communities. / Agriculture and Environmental Sciences / M.A. (Human Ecology)