M. S.

A three-day food intake was recorded for 100 elderly patients who were subsequently interviewed to determine the relationship of income level, educational level completed, and sex of the person with the nutrient intakes of these patients. Three-day caloric and nutrient intakes were recorded and compared to the 1974 Reconmended Daily Allowances (RDA). Mean intake for a three-day period of seven nutrients showed patient averages met at least 100 percent of the RDA for all nutrients except calcium. The females had a mean intake of ninety-six percent of the RDA for calcium. The patients with the lower incomes had dietary patterns that were less adequate than the patterns for those with higher incomes, and these patients ate more carbohydrate and less protein than did the patients with higher income. Nutrient intake was increased for the patients as their level of education increased. There were no significant differences in the nutrient intakes between sexes. The males had a higher nutrient intake and had a higher percentage of protein in their diets than did the females, however, the differences were slight. It was concluded from the above results that certain beneficial changes in the study menu could be made. Especially important areas such as calcium and fat intake may need modification at some time in the future as more light is shed on these areas. / Master of Science

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.

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Bibliography: leaves 441-468

Bibliography: leaves 441-468 / x, 468 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Community Medicine, 1987

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Submitted in fulfillment of the requirements of the Degree of Master of Technology: Food and Nutrition Consumer Science, Durban University of Technology, 2011. / Background: South Africa, a richly diverse developing country has been faced by the consequences of transition attributed to urbanisation and acculturation. A Westernised lifestyle has, therefore, resulted in increasing disease patterns that are characterized by a combination of poverty-related diseases together with the emerging chronic diseases. The shift to a Westernised lifestyle has resulted to a shift in the composition of dietary staples leading to dietary factors related to an increase in lifestyle diseases. These include a high fat, low fibre diet, as well as an inadequate intake of fruits and vegetables. However, this in turn has led to higher energy intakes with insufficient and imbalanced micronutrient intake. Research conducted amongst the elderly in South Africa has clearly indicated that the elderly live within a limited financial budget leading to extreme levels of food insecurity and the social burden of being the head of the household, in addition to being the caregiver to grandchildren and sick children. Due to the current living status the elderly encounter reduced food intake in addition to a reduced variety in their diet, therefore, micronutrient deficiencies are common amongst this age group. Therefore, a consumption of energy-dense foods, particularly staple foods, to stretch the food budget which are more affordable and thus allow for an increased consumption is evident. Aim: To determine the socio-demographic profile, health and nutritional status in relation to the dietary intake patterns to reflect malnutrition among free living elderly (60yrs+) in Verulam. Methodology: Fifty nine randomly selected men and 191 women aged 60+ participated on a voluntary basis in this study. A descriptive survey method was used for this cross sectional study. Trained fieldworkers assisted with the administration of all questionnaires and a registered nurse measured blood pressure. Socio-demographic questionnaires were administered to determine the socio-economic characteristics of the elderly within this community. Anthropometric measurements determined the Body Mass Index according to the World Health Organisation and Asian cut-off points to indentify the risk factors. The Health questionnaire identified the health status correlated to the respondent’s profundity of disease and deficiencies associated to dietary patterns. Blood pressure measurements were taken to determine the hypertension prevalence related to the dietary intake. Two 24-Hour Recall questionnaires were completed by the 250 respondents to identify actual vii food intake and measured against the Dietary Recommended Intake (DRIs). A food frequency questionnaire (FFQ) determined the respondent’s food variety score over a period of one week. The socio-demographic questionnaire, health questionnaire, food frequency questionnaire and anthropometric measurements were captured on an Excel® spread sheet by the researcher and analyzed for descriptive statistics using the Statistical Package for the Social Sciences (SPSS) version 17.0 with the assistance of a statistician. The 24-Hour Recall data were captured and analyzed by a nutrition professional using the MRC Food Finder® version 3.0 software, based on the South African Food Composition tables. Results: The majority of the respondent’s role in the family was mothers (70.8%) and lived in an urban area (68.8%). In addition, 73.2 percent (n=183) of the respondents shared the house with one to five people, and lived in a brick house (74.4%, n=186) with more than 3 rooms (74.0%, n=185). The elderly in this sample were pensioners and, therefore, 76.0 percent (n=190) received state grants of which the total household income ranged between R1001-R1500 (35.2%, n=88). Food insecurity is prevalent as reported by 28.4 percent. Primary school was the highest level of education completed by 52.4 percent (n=131) and English is the most spoken language amongst this group (74.0%, n=185). Women had higher BMI values particularly in the overweight (18.32%, n=35) and obese I and II (58.6%, n=112) categories when compared with men. Blood pressure measurements indicated that 60.0 percent (n=150) of the respondents suffered from hypertension. The use of chronic medication was reported by 84.4 percent (n=212). The total range of individual food items consumed by an individual during the seven-day data collection period measured by the (FFQ) was between 4-66 foods. However, the highest consumption was four food items by 23.2 percent (n=58) of the respondents. The summary of the food variety within food groups indicated a high dietary diversity, of which the other vegetable group reported the highest individual mean FVS (±SD) of 10.86 (±5.82), followed by other fruit, cereal, flesh and Vitamin A rich groups with 5.73 (±4.41), 5.03 (±1.85), 4.08 (±2.23) and 2.43 (±1.09) respectively. The nutrient analysis indicated a deficient intake by both men and women of all the nutrients, except for the mean (±SD) total protein in the women 45.10 (±12.55) and carbohydrate 212.83 (±36.97) in the men. The energy contribution indicated 98.3 percent (n=58) men and 85.72 percent (n=158) women consumed <100 percent of the EER for viii energy. However, the findings from the Top 20 food items measured by the 24-Hour Recall indicated that this community’s diet is largely carbohydrate-based, containing primarily starchy staple foods, sufficient intake of animal products, and insufficient intakes of dairy foods, fruit and vegetables, possibly resulting in the micronutrient deficiencies. The energy distribution of the macronutrients from the average of both 24-Hour Recalls indicates that both men and women are in range of 15-30 percent total fat intake, 10-15 percent protein and 55-75 percent carbohydrate. Conclusion: The results of the study reflect that the elderly in this community are faced with poverty, food insecurity as well as social factors thus contributing to a compromised nutritional status. The progression of malnutrition in particular overnutrition is experienced by the majority of the respondents in this study, however, an increased BMI and the prevalence of hypertension is a risk marker for noncommunicable diseases. However, the high prevalence of inadequate food and nutrient intake amongst elderly discloses the need for nutrition interventions and should be aimed at modifying the elderly food choices when purchasing food, healthier food preparation methods, increasing fruit and vegetable portions and improving daily physical activity to attain a better quality of life. / DUT Postgraduate Development and Support Directorate (PGD)

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-09-13T12:51:04Z No. of bitstreams: 1 Nicole Debia .pdf: 937336 bytes, checksum: bad36ec63406f017da7cd5fac9bf7eb3 (MD5) / Made available in DSpace on 2018-09-13T12:51:05Z (GMT). No. of bitstreams: 1 Nicole Debia .pdf: 937336 bytes, checksum: bad36ec63406f017da7cd5fac9bf7eb3 (MD5) Previous issue date: 2018-08-21 / Pontifícia Universidade Católica de São Paulo - PUCSP / Aging is a process that incorporates changes not only biological, but also sociocultural, psychic and historical, characterized by its heterogeneity. With the advance of several sectors of Brazilian society, including primary and secondary health care systems, we experience the progression of longevity and the amount of elderly reaching the eighth decade of life and beyond. However, as the amount of years lived increases, so does the probability of vulnerability and disability. Behaviors involving appropriate eating habits, physical exercise practice and smoking abstention may contribute to prevent diseases and promote longevity. However, assimilation of proper feeding in routine depends on several sociocultural and economic factors. The central aim of this study was to investigate perceptions and representations of long-living older adults about their food habits, considering the relationship between food, longevity and their sociocultural meaning, more specifically: To systematize conceptual-theoretical basis of analysis to compose the references about aging, old age, culture and feeding; To outline the profile of the elderly respondents; and To characterize eating habits and their representations about food and longevity. This is an exploratory study with qualitative approach through content analysis and interviews with thirteen long-living older adults in São Paulo city. The sample profile consisted in high prevalence of women, widows, foreign and domestic (countryside inhabitants) immigrants, in cohabitation with other relatives, presence of chronic disease, Catholics, absence of smoking and financial vulnerability, in addition to low illiteracy level. All respondents reported changes in eating habits during their life course, mainly the ingestion of a greater sort of food. Among the main factors which influenced this practice, were included: information about the relationship between feeding and longevity received by media sources; food restriction from religious or cultural conceptions and the trivial food consumed over the years. It´s considered that beyond relationship between food consumption and life expectancy, conceptions related to other aspects were significant, among them, lifestyle and religiosity, illustrating aging complexity, as well as the need of multiprofessional engagement when thinking in health promotion. The importance of family proved to be significant and immigrant status was a preponderant factor in feeding patterns changes. Taboo-breaking shows itself essential, in view of new trials in feeding and nutrition sector. Finally, this research contributes to the development of new studies on the interface between nutrition and aging, as well as emerges as new a proposal in public policies in food sector and nutrition education programs focusing the elderly population / O envelhecimento é um processo que incorpora mudanças não somente biológicas, mas também socioculturais, psíquicas e históricas, caracterizando-se por sua heterogeneidade. Com o avanço de diversos setores da sociedade brasileira, incluindo saúde primária e secundária, nos deparamos com a progressão da longevidade e do número de idosos que atingem a oitava década de vida ou mais. Porém, juntamente com o aumento dos anos vividos, aumenta a probabilidade de vulnerabilidade e dependência. Atitudes que envolvam hábitos alimentares adequados, prática de exercícios físicos e abstenção do tabagismo podem contribuir para a prevenção de doenças e favorecer a longevidade. Entretanto, incorporar alimentação adequada na rotina depende de diversos fatores de ordem econômica e sociocultural. O objetivo central desta pesquisa foi investigar percepções e representações de idosos longevos sobre seus hábitos alimentares, considerando a relação entre alimentação, longevidade e seu significado sociocultural, mais especificamente: sistematizar a base teórico-conceitual das análises para composição de referências sobre envelhecimento, velhice, cultura e alimentação; delinear o perfil dos idosos entrevistados; caracterizar hábitos alimentares e suas representações sobre alimentação e longevidade. Trata-se de um estudo exploratório de abordagem qualitativa por meio da análise de conteúdo e entrevista com treze idosos longevos residentes no município de São Paulo. O perfil da amostra consistiu em maior prevalência de mulheres, viúvas, imigrantes estrangeiros e internos (zona rural), em coabitação com outros parentes, presença de doença crônica, católicos, ausência de tabagismo e de vulnerabilidade financeira, além de baixo nível de analfabetismo. Todos os entrevistados referiram mudança de hábitos alimentares ao longo da vida, principalmente em relação à ingestão de maior variedade de alimentos. Dentre os principais fatores que influenciaram nessa prática, foram incluídos: informações sobre a relação entre alimentação e longevidade recebidas principalmente pela mídia; restrição alimentar a partir de concepções religiosas ou culturais e o trivial consumido ao longo dos anos. Considera-se que, mais do que a relação do consumo alimentar com o longeviver, concepções relacionadas a outros aspectos vividos se fizeram expressivas, entre elas, o estilo de vida e religiosidade, demonstrando a complexidade do envelhecer, bem como a necessidade de engajamento multiprofissional ao se pensar na promoção da saúde. A importância da família mostrou-se significativa e a condição de imigrante foi fator preponderante na mudança de padrões alimentares. A quebra de tabus mostra-se essencial, tendo em vista novas experimentações no campo da alimentação. Coloca-se como possível contribuição da presente pesquisa o desenvolvimento de novos estudos com interface entre nutrição e envelhecimento, além da proposição de políticas públicas na área da alimentação e programas de educação nutricional voltados para o segmento idoso

This study evaluated the impact of receiving a home-delivered meal on the quality of life and nutritional risk of elders who were unable to attend congregate meal sites and who were unable to safely prepare a hot meal. Forty-three subjects on a waiting list were matched with a group currently receiving home-delivered meals. Matching criteria were functional needs measure, age, gender, and living arrangement.Home visits were conducted to collect the data and verify demographic information. Nutritional risk was assessed by the Nutrition Screening Initiative's Determine Checklist. Quality of life was measured across various domains including a global quality of life self-rating, mental health appraisal, functional ability, and food enjoyment. Two tailed t-tests failed to show differences in quality of life and nutritional risk between the groups at the 0.05 level of significance.In addition, the study reviewed the resources for meal preparation and grocery shopping possessed by the meal non-recipients that allowed them to remain at home without a meal provided. A significant difference was seen in the number of resources reported for meal preparation assistance with the meal non-recipient group reporting more informal resources. / Department of Family and Consumer Sciences