Aim and objectives: This study set out to investigate the diet and blood lipid profiles of subjects in transition in the North West Province in South Africa. It looked specifically at how the diet differed between rural and urban areas, how the blood lipid profiles differed between rural and urban subjects, establishing an association between dietary fat, fatty acid and cholesterol intakes respectively and blood lipid profiles, as well as investigating the differences in blood lipid profiles at different ages, body mass index (BMI) and genders respectively in rural and urban areas. Design: The present study was a cross–sectional data analysis nested within the Prospective Urban and Rural Epidemiology (PURE) study that is currently undertaken in the North West Province of South Africa amongst other countries. Methods: Baseline data was obtained in 2005. A randomised paper selection was done of people between 35 - 70 years of age with no reported chronic diseases of lifestyle, TB or HIV of those enrolled into the PURE study if they had provided written consent. Eventually a paper selection was made of 2000 subjects, 500 people in each of the four communities (rural, urban–rural, urban, established urban). For the interpretation purposes of this study, data was stratified for rural (1000 subjects) and urban (1000 subjects) only, with no further sub–division into communities. Physical activity levels and habitual diets were obtained from these subjects. Demographic and dietary intake data in the PURE study was collected using validated, culture sensitive questionnaires. Anthropometric measures and lipid analysis were determined using standardised methodology. Descriptive statistics (means, standard deviations and proportions) were calculated. One–way analysis of variance (ANOVA) was used to determine differences between the different levels of urbanisation on blood lipid profiles and dietary intake. When a dietary intake variable proved to be significant for different levels of a factor (urbanisation, blood lipid profile), post–hoc tests were calculated to determine which levels for specific variables differed significantly. Bonferroni–type adjustments were made for the multiple comparisons. Spearman correlations were calculated to determine associations. Results: Mean fat intake was significantly higher in urban areas than in rural areas (67.16 ± 33.78 g vs. 32.56 ± 17.66 g, p<0.001); and the same was true for the individual fatty acid intakes. Fat and fatty acid intakes were still within recommendations even for urban areas, and low for rural areas. N–3 intake was very low in both rural and urban areas. Serum lipids did not differ significantly between rural and urban areas. Almost half of rural (43%) and urban (47%) subjects presented with elevated total cholesterol (5.0 mmol/L). In rural areas 52% and in urban areas 55% of subjects had elevated LDL–C (3.0 mmol/L). Amongst 23% of males in rural areas and 18% of males in urban areas HDL–C levels were decreased. Of the females living in rural areas 34.3% had decreased HDL–C levels and 39% of those who lived in urban areas presented with lowered HDL–C levels. In rural areas 16.3% of subjects and in urban areas 23% of subjects presented with high triglyceride levels. TC, LDL–C and triglyceride levels were higher in higher body mass index (BMI) classes, however, obese subjects did not differ significantly from overweight subjects in terms of blood lipids, suggesting that values stabilise after reaching overweight status. These blood lipids were also higher in higher age groups and higher in women than men, probably due to the high incidence of obesity in women. Conclusions: Associations between the diet and blood lipid profiles were weak, and diet is not likely to be the only factor responsible for high TC and LDL–C levels. Blood lipid profiles did not differ significantly between rural and urban areas due to the fact that the diet was prudent in terms of fat intake in both rural and urban areas. Higher prevalence of underweight was noted in males (32% in rural areas and 28% in urban areas), while overwieght was a bigger problem amongst women (48% in rural areas and 54% in urban areas). TC, LDL–C and TAG were higher with higher BMI’s, while HDL–C levels were lower. TC, LDL–C, and TAG were higher in higher age goups while HDL–C levels were lower. Female subjects presented with higher mean triglycerides than males, probably due to higher prevalence of overweight and obesity. / Thesis (M.Sc. (Dietetics))--North-West University, Potchefstroom Campus, 2011.

This study explores the relationship between tourism, the nutrition transition, and prenatal dietary practices in the Monteverde Zone, Costa Rica. This rural tourism community, located in the central highlands of Costa Rica, has seen rapid growth and development since the tourism boom in the early 1990s, leading to changes in the local food system and increased food insecurity. This investigation added to this work by identifying the ways that prenatal dietary practices have shifted over time in the context of increased tourism and the concomitant nutrition transition, and by describing the relationship between food insecurity and nutritional status among pregnant women. In applying a critical biocultural approach, this study drew on both quantitative and qualitative methods. Pregnant women were recruited to participant in twenty-four hour diet recalls (n=21), the Household Food Insecurity and Access Scales (n=20), and semi-structured interviews (n=22). Women who had older children were also recruited for semi-structured interviews (n=20) to explore prenatal dietary practices and decision-making over time. Focus groups (N=2, n=15) and surveys with a free listing component (n=52) were administered to better understand the cultural construction of nutrition in this region, and how tourism and the nutrition transition have interacted with the local dietary norms. Overall this study found that there was a relationship between tourism, the nutrition transition, and diet, although findings suggest that pregnant women may be buffered from these effects by cultural factors. Food insecurity was present in the sample (n=7) and was associated with numerous variables, including saturated fat and zinc intake.

No description available.

Mexico has a high prevalence of stunting in children and adolescents, due to poor nutrition. Paradoxically, too many Mexican children and adolescents are currently overweight or obese (OW/OB). The dual-burden of stunting (low height for age) and OW/OB are nutritional conditions that increase the risk of developing chronic degenerative diseases in adulthood. The persistence of high levels of stunting in southern regions of Mexico, such as Yucatan, may be due to diet changes (nutrition transition) that Yucatecan population has experienced in recent years. Vitamins, such as folic acid (FA) and VB12 are micronutrients necessary for normal metabolism and growth. The relationships between the intake of these micronutrients and growth rate were identified. The impact of micronutrient consumption on body composition was also investigated. The sample population comprised 273 adolescents (152 females) aged 10-18 years, from Merida, Mexico. Dietary information was obtained using a food frequency questionnaire (FFQ) covering 106 local foods. Anthropometric and body composition measurements were taken, and socioeconomic data were gathered. Data were collected between September 2011 and July 2012. Over 50% of participants had inadequate consumption of both vitamins: 64% had inadequate intake of FA and 69% of VB12. Almost half (46.9%) were either short or stunted, and 33% were at risk of OW/OB. A higher risk of presenting OW/OB was found for participants with FA intake less than the RDI of 400 μg/day and for those with VB12 intake less than the RDI of 2.4 μg/day. No relationship was found between body fat percentage and the consumption of FA or VB12.

Background Middle-income countries are currently undergoing nutrition transition more rapidly than did high income countries. These populations are therefore at high risk of over-nutrition (obesity) and nutrition-related, non-communicable diseases before the elimination of under-nutrition and infectious diseases. Such nutritional double burden is most common in low SES groups of middle-income countries, such as the Maya of Mexico. Long-term poor environmental conditions during early life results in a population with high levels of chronic under-nutrition (stunting), and a consequent predisposition toward overweight/ obesity, and associated health risks later in life. It is important to be able to identify individuals at an increased risk of diseases related to double burden and to determine whether stunting impacts the ability to identify at risk individuals. Aims The overall purpose of this doctoral research was to examine double burden in the urban Maya, a low SES section of the Mexican population which is a current example of a population undergoing significant transition. The specific aims of this thesis were fourfold: 1) To describe the living conditions and population characteristics of the urban Maya of southern Merida in the spring and summer of 2010; 2) to determine whether body mass index (BMI) predicts adiposity indicators in a sample of women and children with a high prevalence of stunting, 3) to determine whether measures of linear growth in women can be predicted by their recalled childhood environment and 4) To determine whether the relationship between objectively estimated free-living energy expenditure and body composition is altered by stunting. Methods Data from interviews, anthropometric measurements and bioelectrical impedance analysis were collected on 58 Maya schoolchildren aged 7-9 years-old and their mothers living in the south of Merida, Mexico. Objective, free-living physical activity monitoring using combined accelerometry and heart rate monitoring of the children was also performed for one week. The interview data was used to describe the living conditions of the south of Merida. Whether stunting status or body proportions influenced the power of BMI to predict adiposity indicators was assessed for the mothers and the children. The mothers recalled early life SES was compared to their current measures of linear growth. The children s objectively estimated energy expenditure was compared to their body composition and measurements of body size. Results The Maya of southern Merida overall had access to clean drinking water and basic health care and have apparently eliminated acute under-nutrition. Yet they remained double burdened with simultaneous stunting and overweight/ obesity. Individual double burden levels were high, with 70% of the mothers were simultaneously stunted and overweight. Family level double burden was also high, with 28% of the families having an overweight mother and a stunted child. The rates of childhood malnutrition varied widely when using different cut-offs. Child stunting rates were between 15.5% and 37.9% when using -2 z-scores of Frisancho s Comprehensive (created using NHANES data) reference versus the 5th percentile of the WHO reference, respectively. Child overweight/ obesity rates were less than 10% when using weight-for-age on both the Comprehensive and WHO reference charts. Child overweight/ obesity as classified using BMI z-scores was between 27.5 to 34.5% using the Comprehensive and WHO reference, respectively, while child overfat was over 80% when using body fat percentage for age reference curves. BMI predicted adiposity indicators in these Maya children, explaining between 33 and 84% of the variance in arm fat index and waist circumference z-score, respectively. BMI was less strongly related to the mothers adiposity indicators, explaining between 19 and 70% of the variance in arm fat area and waist circumference. The relationship between BMI and adiposity indicators was unchanged by stunting or body proportions in either mothers or children. Mothers recalled early life SES was significantly related to but explained little of the variance in her measures of linear growth. Birth decade explained 5% of the variance in stature and the Modernisation index (urban/ rural birth, sugar sweetened beverage consumption, packaged food consumption) explained 5% of the variance in mothers leg length. Birth order, sibling number and consumer durable ownership were also significantly related to linear growth of the mothers. These Maya children had high levels of physical activity, as all exceeded the recommended 60 minutes of moderate-to-vigorous physical activity per day. After controlling for fat free mass, short stature did not predict lower resting energy expenditures in the children. However shorter stature did predict lower levels of activity energy expenditure, particularly in girls. Stunted girls had the lowest activity energy expenditures. Conclusions These urban Maya tend to have access to basic sanitation and services and are at a very high risk for NR-NCDs with the co-existence of chronic under-nutrition (stunting) and overweight/ obesity. The high rates of stunting do not impact the usefulness of BMI to estimate adiposity nor does stunting appear to impact children s energy expenditure. While BMI is useful to predict adiposity in these urban Maya children, it is not recommended for use in the mothers. Interventions to reduce childhood adiposity need to begin very early in life to most effectively reduce adiposity. Research into the low SES groups of middle-income countries, offers insight to what may occur in low-income countries as they advance in the nutrition transition.

No description available.

Urbanisation and the associated nutrition transition have been linked with the recent rise in osteoporotic fragility fracture incidence in many countries. Predictions indicate that hip fracture incidence will increase 6-fold in Africa and Asia by 2050, partially attributed to demographic transition and population ageing. Differences in areal bone mineral density (aBMD) between rural and urban locations indicate that urban regions of high-income countries (HIC) have lower aBMD and a higher incidence of hip fracture. The few studies conducted in low and middle-income countries (LMIC) provide inconsistent results; in contrast to HIC, most have found higher aBMD in urban populations. To investigate the impact of migrating to an urban environment, detailed studies of bone phenotype and factors affecting bone health have been conducted in two groups of pre-menopausal Gambian women: urban migrant (n=58) and rural (n=81). Both groups spent their formative years in the same rural setting of Kiang West, urban women were known to have migrated to coastal districts, concentrated in Brikama and Kanifing, when aged ≥16 years. Bone phenotype (bone mineral content (BMC); bone area (BA); aBMD, and size-adjusted BMC (adjusted for height, weight and BA) of the whole-body, lumbar spine and hip) was measured by dual energy x-ray absorptiometry (DXA), with further characterisation by peripheral quantitative computed tomography (pQCT). Data were also collected on anthropometry, body composition, food and nutrient intakes, physical activity, socio-demographic characteristics, vitamin D status, and 24hr urinary mineral outputs (Na, K, P, and Ca). Mean age and height of rural and urban migrant groups were not significantly different (p > 0.05). Urban migrant women were significantly heavier (p < 0.01). Significant differences in BMC and aBMD were found between groups at all skeletal sites, with urban women having higher BMC and aBMD; BA was not significantly different. The greatest difference in BMC was found at the lumbar spine (8.5% ± SE 3.0, p < 0.01), a meaningful difference, equivalent to 0.76 of rural SD. T- Scores were also calculated using a young adult (white, female) reference population, mean T- scores were -1.03 and -0.22, for rural and urban groups respectively. After adjusting for size, differences in whole-body and hip BMC were mostly attenuated (p > 0.05), but difference in spine BMC remained significant (6.2% ± SE 2.1, p < 0.01). These results indicate that rural-to-urban migration is associated with higher BMC; BA and height were similar, and difference in body weight could not fully account for higher BMC at the lumbar spine. Calcium intakes were low in both groups, urban migrant 294mg/d (IQR: 235 to 385) and rural 305mg/d (IQR: 222 to 420). Urban women had significantly lower intakes of potassium, magnesium and dietary fibre (p < 0.01), related to lower consumption of fruit, green leafy vegetables and groundnuts. 25-hydroxy vitamin D status was good in both groups, urban migrant 64.0 ± 14.2nmol/L and rural 68.3 ± 15.7nmol/L (M ± SD, p > 0.05). Implications for bone health of the nutrition and demographic transition, principally future fracture risk and other non-communicable diseases require further research in LMICs. ORIGINAL CONTRIBUTION TO KNOWLEDGE To my knowledge, this is the first study investigating the impact of rural-to-urban migration on bone health to be conducted in sub Saharan Africa. It is the first study of bone health and determinants of bone health in an urban population in The Gambia.

The nutrition transition is a global phenomenon in which diets have become increasingly westernized and processed while lifestyles have shifted from labor intensive to sedentary, largely on account of the advent of technology, globalization n and urbanization. Despite the prevalence of this phenomenon, very little is known regarding how the nutrition transition has affected the risk of comorbid chronic diseases among indigenous Kichwas communities in Ecuador. Aims of this study are : 1) Identify specific health outcomes (such as diabetes, hypertension, and high cholesterol) associated with the lifestyle risk factors of the nutrition transition among the Andean Kichwas indigenous population; 2) Explore the sociocultural factors (such as gender roles, culinary traditions, urbanization and globalization) which influence dietary behavior and food choices within Kichwas indigenous households; 3) Assess the construct relevance of the Nutrition Transition Questionnaire (NTQ), a pilot instrument designed to measure key constructs of the nutrition transition within indigenous Kichwas Andean households. The current study is a convergent parallel mixed methods design that consists of two components: 1) Secondary data analysis of the internal reliability of the Nutrition Transition Questionnaire, a pilot instrument designed to assess obesogenic lifestyles at the individual and household levels; 2) Primary ethnographic qualitative data collection among the Kichwas community residing in the Imbabura province of Ecuador. Thirty-four interviews were conducted with nutritional gatekeepers (i.e. women who make the majority of household dietary decisions) to explore lifestyle trends related to diet and exercise within the Kichwas community. Twenty-five intercept interviews were conducted at various food vending locations throughout the community. Internal reliability of the NTQ was assessed using Cronbach’s alpha and inter-item correlations while qualitative data were analyzed using applied thematic analysis. Chronic disease occurrence in the sample was also assessed for diabetes, hypertension, high cholesterol and obesity. Results suggest that key constructs in the Nutrition Transition Questionnaire are relevant to assessing lifestyle risk and protection regarding chronic disease. Main qualitative themes include gender roles within food preparation; the impact of collective culture upon food choices and household dietary behavior; and the protection offered by access to home gardens. The discussion highlights several differences between this study population and other indigenous populations. It also posits that a new emergent theory, Geo-Nomics theory, can provide a useful future tool in framing additional ethnographic nutrition transition research. The conclusion indicates this study’s most useful contributions to the literature, which include the development of a potential thermos intervention to decrease fast food consumption when Kichwas men commute far from home to work.

<p>Aim: The aim of this study was to investigate the prevalence and determinants of obesity amongst NAMDEB employees working at Pocket Beaches diamond mine.</p>

<p>Aim: The aim of this study was to investigate the prevalence and determinants of obesity amongst NAMDEB employees working at Pocket Beaches diamond mine.</p>