The Department of Basic Education classifies the NSNP as one of the critical omponents of the government's Programme of Action, which was specifically assigned the responsibility of addressing learners' ability to learn by providing them with nutritious meals. The success of the programme may therefore contribute towards the country's realisation of the Millennium Development Goals which include the reduction of mortality and the eradication of extreme hunger and poverty by 2015 as well as achieving universal primary education. The aim of the National School Nutrition Programme seeks to promote sustainable food production initiatives in all School Nutrition Schools in order to develop skills. It also aims to enhance learning capacity of a learner through feeding and to promote nutrition education in order to improve healthy eating and lifestyles amongst communities. This study seeks to assess the current status in administering the NSNP in selected schools in Peddie, Eastern Cape. Due to the extensive nature of the geographical area of Peddie, this study focused exclusively on 25 schools. For the purpose of this study, a quantitative approach was employed through a questionnaire constructed to obtain the perceptions of the sample group. The responses from the statements in the questionnaire were analysed by a Nelson Mandela Metropolitan University registered statistician. In the last chapter a number of recommendations are stated to aid in improving the current administering status of the National School Nutrition Programme.

Elephants, as megaherbivores, are known to have extensive impacts on vegetation, especially in enclosed areas. This raises the issue that elephants in enclosed areas may become limited by resource availability. Resource limitation is generally expressed via density dependence, but elephants, due to their slow demography, may not be affected by initial changes in resource availability. This highlights the need for a more sensitive measure of resource limitation to allow for the detection of energy stress within a population before changes in vital rates occur. This study investigated visual changes in elephant body condition in relation to resource availability in a number of Eastern Cape reserves to assess whether body condition could be used to detect life stages, as well as seasons and sites which may be resource limited. Elephant life stages were divided into energy stressed (newly weaned calves, lactating females, and old females) and non-energy stressed classes (sub-adults and non-lactating females) to determine whether energy stressed life stages were more vulnerable to resource limitation. In the AENP it was found that lactating and old females exhibited significantly poorer body condition than non-energy stressed individuals, but that weaned calves had body conditions similar to non-energy stressed individuals. Comparisons between seasons revealed that all life stages exhibited better condition in winter than summer or spring, with lactating females showing little recovery of condition over time. Seasonal body conditions were correlated with rainfall recorded in the Addo Elephant National Park. Comparisons of elephant body condition between sites (n = 6) revealed that body condition varied across sites, with poorer body condition associated with areas of higher elephant density and low rainfall during the study period. Comparisons with faecal dietary quality data both between sites and seasons indicated that body condition also responded to changes in the availability of protein and neutral detergent fibre (NDF) of plant resources, with higher protein and lower values associated with better condition. Based on condition estimates of elephants occurring in the Addo Main Camp, it was established that this population is experiencing nutritional stress, with energy stressed individuals exhibiting the lowest body conditions. This was supported by dietary quality measures. Our findings suggest that elephant body condition is a good measure for detecting resource limitation, both within populations and between seasons, and that elephant body condition respond to relatively small changes in resource conditions, thus making it an effective measure for the detection of nutritional stress. Additionally, our findings show that energy stressed individuals, particularly lactating and old females are more vulnerable to resource limitation. This demonstrates the importance of monitoring these life stages for the detection of density dependence within populations. Finally, our data suggest that threshold values of faecal dietary quality may exist at which body condition within a population begins to deteriorate, making it possible to determine the condition of a population through values obtained in faecal samples.

Submitted in fulfillment of the requirements for the degree Master Technology: Consumer Science Food and Nutrition, Durban University of Technology, Durban, South Africa, 2014. / Food security is a global concern and the insecurity thereof is prevalent in South Africa even though the country is deemed to be secure in terms of food availability. The study was conducted to determine the socio-economic, health and nutrition and food security status of the community living in the Valley of a Thousand Hills in KwaZulu Natal, in addition to analysing their coping strategies. Two hundred and fifty seven respondents were required to participate in this study. Data were collected by interviewing the respondents using pre-designed and pre-tested questionnaires; socio demographic questionnaires, dietary intake questionnaires- namely 24 hour recall and Food Frequency Questionnaire (FFQ) and the coping strategy questionnaires were used. Lastly anthropometric measurements were taken to determine BMI. A prevalence of extreme poverty exists as a magnitude of the high unemployment rate, out of which 75.8% had been unemployed for more than 3 years. The household monthly income was less than R500 per month for 37.3% of the respondents. The mean Food Variety Scores (FVS) (±SD) for all foods consumed from the food groups during seven days was 22.45 (±10.32), indicating a low food variety score. In this study the food group diversity is summarized as the majority of the respondents (91.1%, n=226) being classified with a good dietary diversity score using 6-9 food groups. The mean of the three 24-Hour recall nutrient analysis indicated a deficient intake by both men and women in all of the nutrients (100% of the men and women could not meet the DRI’s for energy and calcium) except for the mean (±SD) carbohydrate intake by men aged 19-50 (214.71 ± 80.22). The main source of food intake was from the carbohydrate food group with an insufficient intake of animal products, dairy products and fruits and vegetables respectively; contributing to the macro and micro nutrient inadequacies. Ninety six percent of this community experienced some level of food insecurity with the worst Coping Strategy Index food insecurity score being 117 out of a possible 175. Four percent of this community was classified as being food secure. Overweight and obesity were the most exceptional anthropometric features by the women respondents with 26.5% (n=66) being overweight and 57% (n=142) obese. The men’s anthropometric features were predominantly normal weight. This study has established poverty and unemployment as being the principal contributors for the food insecurity experienced by the populace and poor dietary intakes. The low food variety diet consumed by the respondents resulted in the DRI’s not achieved for most nutrients. The majority of the respondents only consumed two meals a day, as a coping strategy to reduce/prevent temporary food insecurity. Intervention strategies are needed to improve the food security status and dietary intake of the community members to overcome the crisis of malnutrition. / M

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.

Abstract: Introduction: Exclusive breastfeeding for the first six months of an infant's life is recommended worldwide. In 1998 the South African Demographic and Health Survey (SADHS) showed that only 10% of mothers exclusively breastfeed at three months. As the HIV virus is transmissible via breast milk, UNAIDS (2002) recommends that women in developing countries should be given a choice of feeding method after being counselled on the risks and benefits of breast feeding versus formula feeding. As a result, the Prevention of Mother-to-Child Transmission (PMTCT) programme was launched in KwaZulu-Natal with the aim of providing interventions to prevent Mother-to-Child Transmission of the HIV virus. However, research has shown that infant feeding practices are influenced by numerous factors. Ultimately mothers will feed their infants in a manner they feel comfortable with, even if it is not always the most appropriate choice. Aim: The aim of this study was to determine and compare current infant feeding practices and some of the factors that influenced these practices among Zulu mothers with 0 - 6 month old infants attending PMTCT and non-PMTCT clinics in Central Durban, KwaZulu-Natal. Methodology: A cross-sectional, descriptive survey was conducted amongst 150 mothers sampled from three non-PMTCT clinics and 150 mothers sampled from three PMTCT clinics. Systematic random sampling of mothers attending the two types of clinics was used to ensure an equal number of mothers· with infants aged 0 - < 6 weeks, 6 - < 14 weeks and 14 weeks to 6 months. The number of mothers interviewed per clinic was determined proportionate to clinic size. Interviews were conducted in Zulu by trained fieldworkers according to a structured interview schedule consisting of 87 open- and closed-ended questions. Summary of most important findings and conclusion: Overall, one quarter of the mothers attending non-PMTCT and one third of mothers at PMTCT clinics were practising exclusive breastfeeding at the time of the survey. The general trend was that mothers attending PMTCT clinics were more inclined than those attending non-PMTCT clinics to breastfeed their infants exclusively (34% versus 24% respectively) or to formula feed (16,7% versus 12,7% respectively). Furthermore, there was a significant decline in exclusive breastfeeding and predominant breastfeeding with increasing infant age in both clinic groups. The opposite held true for mixed feeding and formula feeding in that infants were more inclined to mixed feeding or formula feeding with increasing infant age. In both clinic groups, exclusive breastfeeding was the method of choice in the 0 - < 6 week age category, while a preference for mixed feeding was shown in the 6 - < 14 week category. This trend persisted in the 14 week - < 6 month age category, especially in the non-PMTCT clinics, while there was a small but pronounced increase in formula feeding amongst PMTCT mothers. Although these findings can be explained as a result of implementing the PMTCT programme, the positive trends observed in non-PMTCT clinics serve as an indicator that the Integrated Nutrition Programme (INP) and Baby Friendly Hospital initiative have also had an impact on the feeding choices mothers make. Despite the limited duration of the PMTCT programme at the time of the study, indicators of the impact of the intervention include that a lower percentage of PMTCT mothers introduced foods and/or liquids in addition to breast milk to their infants before six months of age compared to non-PMTCT mothers. Furthermore, more mothers attending PMTCT clinics were shown how to breastfeed and were more likely to have received information about formula feeding. Despite these indicators of a positive impact of the PMTCT programme, the mean age for introducing liquids and/or solids in addition to breast milk was about six weeks and the incidence of this practice was very high for both groups. The similar incidence of formula feeding observed between the two clinic groups suggests the presence of constraints to safe infant feeding choices among mothers attending PMTCT clinics. As observed, infant feeding practices were still not ideal in either of the two clinic groups. However, the high level of antenatal clinic attendance documented for both groups serves as evidence that, if opportunities for providing mothers with appropriate infant feeding advice are utilized optimally, the antenatal clinic could serve as an ideal medium through which infant feeding education can take place, especially as the clinic-based nursing staff were cited as the most important source of infant feeding information by both groups of mothers in the antenatal and postnatal phases. The documented infant feeding practices should be interpreted against the backdrop of factors such as socio-demographic characteristics of the mothers, availability of resources such as social support from peers and significant others and reigning infant feeding beliefs that could influence infant feeding decisions. Predictors of exclusive breastfeeding in PMTCT and non-PMTCT clinics were determined by means of multivariate logistic regression analysis. Significant values were obtained for both clinic groups in terms of the infant not having received liquids in addition to breast milk. No additional predictors were found amongst mothers attending non-PMTCT clinics, however predictors amongst mothers attending PMTCT clinics included whether the mother had not visited the clinic since the infant's birth, whether she practiced demand feeding and whether she was experiencing stress at the time of the study. The limited number of predictors of exclusive breastfeeding documented in this study, especially among non-PMTCT mothers may be explained by the fact that infant feeding behaviour is multifactorial by nature and the interaction between factors that influence feeding choice is strong. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2005.

Thesis (MNutr (Human Nutrition))--Stellenbosch University, 2008. / There is convincing evidence linking school feeding to improved educational outcomes. The Primary School Nutrition Programme (PSNP) was first implemented in 1994 and aimed to improve educational outcomes by alleviating short-term hunger and improving school attendance and punctuality. Responsibility for the programme was transferred from the Department of Health (DoH) to the Department of Education (DoE) in 2004 and the name was changed to the National School Nutrition Programme (NSNP) at this time. Previous evaluations of the PSNP / NSNP had reported problems associated with foodservice management and general management aspects of the programme. The study was a cross-sectional, observational investigation of foodservice management and general management practices in primary schools running the National School Nutrition Programme (NSNP) in Pietermaritzburg, KwaZulu-Natal. Twenty-three schools were visited to investigate practices at each school relating to compliance with DoE menus and prescribed service time of the meal, the food delivery system and utilities available. The food handling and hygiene training and practices and general management practices linked to the NSNP were investigated. Most of the schools (78%) were using the DoE menus but only half (52%) served the meal at or before 10h00, which is an ongoing problem. Receiving and storage procedures were adequate at most schools. Food quality does not appear to be a problem in the Pietermaritzburg schools. The lack of expiry dates on food packages remains a problem area and should be addressed. Most of the schools had a designated kitchen area but these facilities could be upgraded. Most schools cooked on gas and 35% of schools had no running water in the kitchen. Kitchens should, at least, have hot and cold running water and adequate working space. Most schools reported that they run out of gas during the month. The monthly DoE allocation for gas should be reviewed to ensure schools have enough gas for the whole month. The holding time for cooked food should be kept to a minimum to minimise the risk of food poisoning. Some schools had insufficient plates (26%) and cutlery (35%). Standardised portion sizes were served at 70% of schools and food handlers reported that learners usually finish all the food. Food handlers at 70% of the schools had received training in food safety and hygiene but 26% of these had only received training once. Training was found to be significantly associated with hand washing (p=0.002), clean uniforms (p=0.036) iv and sanitising practices (p=0.035). Training should be provided in short, ongoing sessions. General management aspects of the NSNP remain a problem. Policies and procedures should be drawn up and implemented to provide a minimum standard of operations at schools. Monitoring should be conducted on a regular basis. The NSNP is running reasonably well in Pietermaritzburg. Adhering to prescribed meal times and upgrading kitchen facilities could result in improvements. Food handler training could also be conducted more frequently. General management aspects need to be improved.

Thesis (Mnutr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Introduction Adequate fruit and vegetable consumption can provide many health and nutrition benefits, and can contribute to nutritional adequacy and quality of the diet. Despite existing strategies, most people in South Africa do not consume the recommended intake of five fruits and vegetables per day, and micronutrient intakes remain low. Aim The aim of this study was to describe underlying factors that influence individual and household fruit and vegetable consumption, in an area of the Mitchells Plain sub-district, by engaging with community members in a participatory manner in accordance with a human rights-based approach. Methodology This study was cross-sectional and descriptive. Data collection was conducted from November 2012 until January 2013, in an area of Mitchells Plain. Focus group discussions were conducted to gain a broad understanding of factors that influence fruit and vegetable consumption in the community and to identify individuals for individual interviews. In-depth interviews were conducted with strategically selected community members considered to be influential in food preparation, distribution or consumption, in order to gain in-depth understanding of specific factors associated with fruit and vegetable consumption. Results Four focus group discussions were conducted with 40 participants in total, allocated to three different groups (18 to 29 year old females, 30 to 70 year old females, 18 to 60 year old males). Fifteen in-depth interviews were conducted with community leaders, individuals involved in food production (kitchen managers) or sale thereof (an informal vendor and a tuck shop owner), individuals involved in health education (a professional nurse) and basic education (a grade one educator), and others. Dominant themes discussed included fruit and vegetable consumption patterns (religious, cultural and traditional dishes, seasonal variation), fruit and vegetable preparation techniques and commonly prepared dishes, fruit and vegetable access (purchasing, vegetable gardens and direct provision) and changes in fruit and vegetable consumption patterns. Barriers to fruit and vegetable consumption included that although most participants considered them to be important, fruit and vegetables were not considered a priority food item (inadequate time and effort is allocated to food purchasing and preparation), negative side-effects of consumption, fruit and vegetables are perishable and benefits of fruit and vegetable consumption are not immediately apparent. Facilitators of fruit and vegetable consumption were personal preference, traditional dishes prepared that include fruit or vegetable ingredients, individuals who sell or grow fruit and vegetables having increased availability, use of convenience fruit and vegetable items, and modelling and discipline in children. Suggestions to improve consumption included education using practical advice such as fruit recipes to improve the appeal of fruit and vegetable dishes, and methods to decrease preparation time and cost. Conclusions Limited fruit and vegetable consumption is not simply determined by limited nutrition knowledge or poor decision-making by households, but rather by a much wider set of social, economic and spatial processes. Creative and innovative behaviour-changing strategies are required that target individuals but also take cognisance of wider structural barriers, and work to create an enabling environment that is supportive of healthy eating and an adequate consumption of fruit and vegetables. / AFRIKAANSE OPSOMMING: Inleiding Voldoende inname van vrugte en groente hou baie gesondheids- en voedingsvoordele in, en kan bydra tot voedingstoereikenheid en kwaliteit van die dieet. Ongeag bestaande strategieë, neem die meeste mense in Suid-Afrika nie die aanbevole vyf vrugte en groente in nie, en mikronutriënt inname bly laag. Doelwit Die doel van hierdie studie was om die onderliggende faktore wat indiwiduele en huishoudelike vrugte- en groenteverbruik in 'n area van die Mitchells Plein subdistrik beïnvloed, te beskryf, deur met lede van die gemeenskap in 'n deelnemende manier betrokke te raak in ooreenstemming met 'n menseregte-gebaseerde benadering. Metodes Hierdie deursnee studie was beskrywend. Data-insameling het vanaf November 2012 tot Januarie 2013 in 'n gedeelte van Mitchells Plein plaasgevind. Fokusgroepbesprekings is gehou om 'n breër begrip van die faktore wat vrugte- en groenteverbruik in die gemeenskap beïnvloed, te bekom en om indiwidue te identifiseer vir indiwiduele onderhoude. In-diepte onderhoude is gevoer met strategies verkose gemeenskapslede wat beskou word as invloedryk in voedselvoorbereiding, verspreiding en verbruik, om 'n dieper begrip van spesifieke faktore wat met vrugte- en groenteverbruik verband hou, te bekom. Resultate Vier fokusgroep-besprekings is gehou met 'n totaal van 40 deelnemers, versprei oor drie verskillende groepe (18 - 29 jarige vroue, 30 - 70 jarige vroue, 18 - 60 jarige mans). Vyftien in-diepte onderhoude is gevoer met gemeenskapsleiers (polities en godsdienstig), indiwidue betrokke by voedselverwerking (kombuisbestuurders) of verkope (informele verkoper en snoepwinkeleienaar), indiwidue betrokke by gesondheidsopvoeding (professionele verpleegster) en basiese onderrig (graad een opvoeder) en andere. Oorheersende temas sluit in vrugte- en groenteverbruikspatrone (godsdienstige, kulturele en tradisionele disse, seisonale wisseling in gebruik), vrugte en groente voorbereidingstegnieke en alledaagse disse, toegang tot vrugte en groente (aankoop, groentetuine en direkte voorsiening) en verandering in vrugte- en groenteverbruikspatrone. Hindernisse tot vrugte- en groenteverbruik sluit in dat hoewel die meeste deelnemers vrugte- en groenteverbruik belangrik ag, word vrugte en groente nie as 'n prioriteitsvoedsel gesien nie. Voldoende tyd en aandag word nie aan voedsel-aankope en -voorbereiding afgestaan nie, daar is negatiewe newe-effekte aan verbruik, vrugte en groente is bederfbaar en die voordele van vrugte en groenteverbruik is nie duidelik waarneembaar nie.Persoonlike voorkeur is bevorderlik vir vrugte- en groenteverbruik, sommige tradisionele disse word met vrugte of groente bestanddele voorberei, asook die groter beskikbaarheid van indiwidue wat vrugte en groente verkoop of kweek, die gebruik van vrugte en groente gemaksitems, en die gedragsmodellering en dissiplinering van kinders. Voorstelle om verbruik te verbeter het ingesluit opvoeding met praktiese raad soos vrugte en groente resepte om die aantreklikheid van vrugte en groente disse te verhoog en metodes om voorbereidingstyd en onkoste te verminder. Gevolgtrekking Beperkte vrugte en groente verbruik word nie net bepaal deur beperkte voeding kennis of swak besluitneming deur huishoudings nie, maar deur 'n veel wyer reeks van maatskaplike, ekonomiese en ruimtelike prosesse. Skeppende en innoverende gedragsveranderende-strategieë wat gemik is op indiwidue is nodig, asook aandag aan wyer strukturele hindernisser. Sodoende kan ‘n bemagtigende omgewing geskep word om gesonde eetgewoontes en die verbruik van voldoende vrugte en groente te ondersteun.

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

Submitted in fulfillment of the requirements for the degree of Masters of Applied Science in Food and Nutrition, Durban University of Technology, Durban, South Africa, 2016. / Introduction: Food and Agriculture Organisation (FAO 2015a) estimated that 220 million people (23.2%) in Sub-Saharan Africa were undernourished. Parallel to hunger, obesity rates have more than doubled globally since 1980; in 2014, 1.9 billion adults in the world were overweight and 600 million were obese (FAO 2015a). Obesity is a serious concern facing the world today and a major contributor to chronic disease such as diabetes and cardiovascular disease, which are often fatal (Bray, Frühbeck, Ryan and Wilding 2016: 1947). In South Africa, overweight and obesity have reached unacceptable numbers as over 60% of South Africans are overweight or obese. Furthermore, in 2015 South Africa was declared the fattest nation in Sub-Saharan Africa, adding another burden to the HIV epidemic (Ng, Fleming, Robinson, Thomson, Graetz, Margono, Mullany, Biryukov, Abbafati and Abera 2014: 777). Unemployment is one of the major factors that drive household food insecurity due to the fact that most people access food commercially. Therefore, income is a significant factor in ensuring that a healthy and nutritious diet is consumed regularly. The study community was at Umbilo, Durban, KwaZulu-Natal in a government owned estate called Kenneth Gardens. The estate has 286 units and accommodates approximately 1500–1800 residents. It formed part of an extensive network of cluster housing schemes developed by the apartheid government as a protectionist strategy to provide safe and affordable housing for poor and working class whites. Kenneth Gardens is currently managed by KwaZulu-Natal (KZN) Province and offers subsidized housing to residents from diverse background. Residents are low income bracket earners and many rely on state disability and pension grants for survival. Kenneth Gardens faces a wide range of social problems such as alcohol, drug abuse, domestic violence, unemployment and limited access to education (Marks 2013:26). Aim: The aim of the study was to determine the food security status, coping strategies, food intake and the nutritional status of the Kenneth Gardens community, which is situated in an urban area in KwaZulu-Natal. Methodology: One hundred and fifty (n=150) randomly selected caregivers participated in the study. The sample size was calculated using a power calculation indicating that 150 participants represent a reliable sample. The sampling procedure was simply random sampling. This study was quantitative and partly qualitative and descriptive in nature therefore, different measuring instruments were used to collect relevant data. The research tools for various variables measurements included; food security questionnaire, anthropometric measurements, a socio-demographic questionnaire, a food frequency questionnaire, and 24-hour recall questionnaires conducted in triplicate. Food security coping strategies were documented through a focus group interview with the Kenneth Gardens community members to determine strategies used to address food scarcity. All participants were weighed and measured to determine body mass index (BMI), classified according to the World Health Organisation (WHO) cut-off points. Data for socio demographic, FFQ, anthropometric measurements, and coping strategies was captured by the researcher on Excel® Spread sheets and analysed by a statistician for descriptive statistics using the Statistical Package for the Social Science (SPSS) version 17.0. Data for the 24-hour recall was captured and analysed by a nutrition professional using the MRC Food Finder® version 3.0 software, based on the South African composition tables. Results: The study population consisted of 150 households, including women (n=122) and men (n=28). The results revealed that the majority of households (52.7%, n=79) were headed by a mother, and only 40% (n=60) of households were headed by a father. Majority (47.3%, n=71) of the participants had completed matric and 7.3% (n=11) had tertiary education. English, (52%, n=78), was the most spoken home language, followed closely by Zulu, (43.3%, n=65). Thirty six percent (n=54) of the participants were unemployed and 26.7% (n=40) were employed; however over, 50% (n=40) of the employed participants were temporary. Twenty eight percent (n=42) of the participants earned less than R3000.00 per month and 31.3% (n=47) earned between R3000.00 and R6000.00 per month. Pensioners were 17.3% (n=26), who therefore received a government grant that ranges between R1500 and R1520 per month depending on the claimant’s age. The average household income was reported as R4429.20. The average number of people in the household was five, which equates to R6.00 per person per day. The results also revealed that 38% (n=57) of the household had a sole contributor to the household income; other households had two contributors (42.7, n=64) and 11.3% (n=17) had three contributors. Urban South Africans tend to purchase food as opposed to growing their own food. A lack of purchasing power results in food insecurity that eventually leads to malnutrition. The majority (56.6%, n=85) of the participants indicated a shortage of money to buy food and this inevitably leads and drive utilisation of coping strategies with high severity rate during periods of food scarcity. Bulk food was purchased once a month by the majority (68%, n=102) of the participants. The most commonly used coping strategy during periods of food scarcity was “Rely on less expensive and preferred food” with the mean score of 4.56 (±SD 2.772). The second used coping strategy was “Reduce the number of meals eaten in a day” with a mean score of 3.85 (±8.163), followed by “Contribute to a food stokvel in order to ensure food over a scarce period” (3.31, ±7.505) and “Restrict consumption by adults in order for small children to eat” (2.24, ±5.333). Utilisation of these food coping indicate a degree of food insecurity. The Body Mass Index (BMI) classification indicated that women had a higher (31.46 ±8.474) BMI than men (26.00±5.445). A total of 26.2% (n =32) women were overweight and 51.7% were obese category I, II and III. The mean BMI for the whole group was (30.44±8.261) which clearly demonstrated obesity. Nonetheless, men were not overweight; however 25% (n=7) were obese category I. Collectively, underweight was prevalent in women (3.3%, n=4) and men (3.6%, n= 1). The Food Variety Score was medium (31.91, ±10.573), which indicated a consumption of 30- 60 individual foods from four to five food groups during the seven day period; however the top 20 foods consumed from the 24-hour recall revealed that the diet was energy dense and the most consumed foods were primarily from the carbohydrate and fat group and a low consumption of fruits and vegetables was reported; hence the nutrient analysis showed a deficient intake of several nutrients, such as: calcium, vitamin A, zinc, vitamin D, vitamin E, vitamin K, zinc, magnesium, phosphorus, selenium and thiamine by both men and women. According to the WHO dietary factor goals, the acceptable macronutrient distribution ranges (AMDRs) and fruit and vegetable intake based on the 24-hour recalls, fat and protein intake exceeded the recommended 15-30 percent goal. Fruit and vegetable intake was very low in comparison to the minimum recommended intake of >400g. Carbohydrates intake for women were within the recommended 55-75 percent; however, men aged 19-50 years (50.70%) and >50 years (53.74%) did not meet the recommended intake. Conclusion: The results of this study reveal that the nutrition status of this community was compromised. The top 20 food intake indicated inadequate eating patterns and that diets comprised of energy dense foods, such as carbohydrates and fats, which could directly be responsible for the high obesity levels of >50% in women and >25% in men. Furthermore, there was low income and a high unemployment rate that proliferates the prevalence of food insecurity, hence the coping strategies reported. Malnutrition exists in communities as a result of food and nutrition insecurity which is affected by a significant number of factors that need to be considered and addressed. Nutrition interventions and nutrition education on a balanced diet, healthier methods of preparing food, and physical activity are required to ensure and improve health status, quality of life and better and sustainable coping strategies for our communities. / M

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.