Thesis (Phd)-- Stellenbosch University, 2012. / ENGLISH ABSTRACT: Introduction: Adolescents are recognised as a nutritionally at-risk group, as they have high nutritional demand for growth and development, poor eating behaviour as well as a propensity for unhealthy behaviours. Heavy alcohol use, particularly in the form of binge drinking, is typical for an alarming proportion of school-going adolescents and is a plausible contributor to the nutritional challenges in adolescents, but this has not yet been fully investigated. Aim: This study investigated the potential influences of alcohol use on the nutritional status of adolescents with alcohol use disorders (AUDs), specifically with regards to their eating behaviour and dietary intake, growth and weight status, iron status, as well as vitamin D and calcium status. Methods: Substance use, physical activity, eating behaviour, dietary intake, growth and weight status, iron status and vitamin D and calcium status were assessed and compared in heavy drinking adolescents (meeting DSM-IV criteria for AUDs) (n=81) and in light/non-drinking adolescents without AUDs (non-AUDs)(n=81), matched for age, gender, language, socio-economic status and education. Observed dietary intake distributions were adjusted statistically to obtain usual nutrient intake distributions. Regression-adjusted differences between the groups were assessed using multi-level mixed effects linear regression, adjusting for potential confounders. Results: Lifetime alcohol dose in standard drinks of alcohol was orders of magnitude higher in the AUDs group compared to the non-AUDs group. AUDs adolescents had a binge alcohol use pattern and a “weekends-only” style of alcohol consumption. Poor eating patterns (breakfast skipping and frequent snacking), poor food choices (energy-dense and nutrient-poor foods) and low fruit and vegetable intake (non-AUDs 90 [42.4-153.3]; AUDs 88.3 [30.0-153.0] grams per day) in both groups were reflected in the poor nutritional quality of the diet. More than half of adolescents in both groups were at risk of inadequate intakes of folate (non-AUDs 97.5%; AUDs 98.8%), vitamin C (non-AUDs 65%; AUDs 67.5%), vitamin A (non-AUDs 80%; AUDs 82.5%), vitamin E (non-AUDs 78.8%; AUDs 51.3%), magnesium (non-AUDs 98.8%; AUDs 97.5%), and phosphorus (non-AUDs 76.3%; AUDs 73.8%) and all participants were at risk of inadequate calcium and vitamin D intakes. AUDs adolescents had a greater intake of unhealthy foods (energy-dense nutrient-poor) and a significantly greater energy intake than non-AUDs adolescents (p<0.001) that exceeded energy requirements. AUDs adolescents consumed foods high in unhealthy fats significantly more frequently (p=0.037) than the non-AUDs adolescents and had ensuing greater total fat (p<0.001), saturated fat (p<0.001) and cholesterol (p=0.009) intakes. Frequency of intake of sodium-rich foods was significantly higher in AUDs adolescents (p=0.001) and prevalence of risk of excessive sodium intake was significantly greater in the AUDs adolescents (45%) compared to non-AUDs adolescents (18.8%) (p<0.001). Anthropometric indices of growth and weight status were comparable between the groups and in line with that of the South African adolescent population. Female AUDs adolescents had increased odds (OR 2.42) of being overweight/obese compared to non-AUDs females. Physical activity in both groups was well below the WHO global recommendation. Iron store depletion (serum ferritin < 20 μg/L) was evident in a quarter of adolescents in both groups (non-AUDs 23.5%; AUDs 24.7%), with biochemical iron status measures (serum iron and total iron binding capacity) indicating a greater risk of iron store depletion in the AUDs group. Biochemical vitamin D insufficiency/deficiency (serum 25-hydroxyvitamin D < 30 ng/mL) was prevalent in both groups (non-AUDs 70.4%; AUDs 88.8%), although this was significantly greater in the AUDs group (p=0.013), with significantly lower serum 25-hydroxyvitamin D levels in the AUDs group compared to the non-AUDs group (p=0.038). Conclusions: Heavy alcohol use in the form of binge drinking in adolescents may have the following nutrition-related influences: increased intake of energy; unhealthy fats and sodium, increased risk of overweight/obesity in females; increased risk of iron store depletion; and increased risk of vitamin D insufficiency/deficiency. Persistence of heavy alcohol use, poor food choices and dietary intake may increase the risk for adverse nutrition-related health outcomes in the AUDs adolescents. / AFRIKAANSE OPSOMMING: Inleiding: Adolessente het 'n verhoogde risko vir wanvoeding as gevolg van hul hoë voedingbehoeftes vir groei en ontwikkeling, swak eetgedrag, asook 'n geneigdheid tot verdere ongesonde gedrag. Swaar alkohol gebruik in die vorm van “binge” drinkery kom toenemend onder skoolgaande adolessente voor. Hierdie gedrag kan moontlik bydra tot die verhoogde voeding risiko in dié ouderdomsgroep. Hierdie moontlikheid is egter nog nie ten volle ondersoek nie. Doel: Hierdie studie het die potensiële invloed van alkohol gebruik op die voedingstatus van adolessente met alkohol gebruik versteurings (AGVs) ondersoek, spesifiek met betrekking tot hul eetgedrag en dieetinname, groei en gewigstatus asook yster-, vitamien D- en kalsiumstatus. Metodes: Swaar drinkende adolessente wat voldoen aan DSM-IV kriteria vir AGVs (n=81) en lig/nie-drinkende adolessente sonder AGVs (nie-AGVs) (n=81), wat afgepaar is vir ouderdom, geslag, taal, sosio-ekonomiese status en opvoedingsvlak is gewerf vir deelname aan die studie. Middel gebruik, fisiese aktiwiteit, eetgedrag, dieetinname, groei en gewigstatus, ysterstatus en vitamien D- en kalsiumstatus is tussen die twee groepe vergelyk. Waargenome dieetinname verspreidings is statisties aangepas om gewoontelike nutriëntinname te verkry. Regressie-aangepaste verskille tussen die groepe is met behulp van ’n meervoudige gemengde effekte liniêre regressie model getoets, waartydens daar vir moontlike gestrengelde faktore aangepas is. Resultate: Leeftyd alkohol dosis, gemeet in standaard alkohol drankies, was beduidend hoër in die AGVs groep in vergelyking met die nie-AGVs groep. Alkohol gebruik in die AGVs adolessente het ‘n “binge” patroon en ‘n “slegs naweke” styl getoon. Swak eetgewoontes (oorslaan van ontbyt en gereelde peuselgewoontes), swak voedsel keuses (energie-dig en laag in nutriënte) en lae groente en vrugte inname (nie-AGVs 90.0 [42.4-153.3]; AGVs 88.3 [30.0-153.0] gram per dag), in beide groepe, is gereflekteer in die swak voeding kwaliteit van die dieet. ‘n Risiko vir onvoldoende inname van folaat (nie-AGVs 97.5%; AGVs 98.8%), vitamien C (nie-AGVs 65%; AGVs 67.5%), vitamien A (nie-AGVs 80%; AGVs 82.5%), vitamien E (nie-AGVs 78.8%; AGVs 51.3%), magnesium (nie-AGVs 98.8%; AGVs 97.5%), en fosfor (nie-AGVs 76.3%; AGVs 73.8%) was teenwoordig in meer as helfte van adolessente in beide groepe, asook Inleiding: Adolessente het 'n verhoogde risko vir wanvoeding as gevolg van hul hoë voedingbehoeftes vir groei en ontwikkeling, swak eetgedrag, asook 'n geneigdheid tot verdere ongesonde gedrag. Swaar alkohol gebruik in die vorm van “binge” drinkery kom toenemend onder skoolgaande adolessente voor. Hierdie gedrag kan moontlik bydra tot die verhoogde voeding risiko in dié ouderdomsgroep. Hierdie moontlikheid is egter nog nie ten volle ondersoek nie. Doel: Hierdie studie het die potensiële invloed van alkohol gebruik op die voedingstatus van adolessente met alkohol gebruik versteurings (AGVs) ondersoek, spesifiek met betrekking tot hul eetgedrag en dieetinname, groei en gewigstatus asook yster-, vitamien D- en kalsiumstatus. Metodes: Swaar drinkende adolessente wat voldoen aan DSM-IV kriteria vir AGVs (n=81) en lig/nie-drinkende adolessente sonder AGVs (nie-AGVs) (n=81), wat afgepaar is vir ouderdom, geslag, taal, sosio-ekonomiese status en opvoedingsvlak is gewerf vir deelname aan die studie. Middel gebruik, fisiese aktiwiteit, eetgedrag, dieetinname, groei en gewigstatus, ysterstatus en vitamien D- en kalsiumstatus is tussen die twee groepe vergelyk. Waargenome dieetinname verspreidings is statisties aangepas om gewoontelike nutriëntinname te verkry. Regressie-aangepaste verskille tussen die groepe is met behulp van ’n meervoudige gemengde effekte liniêre regressie model getoets, waartydens daar vir moontlike gestrengelde faktore aangepas is. Resultate: Leeftyd alkohol dosis, gemeet in standaard alkohol drankies, was beduidend hoër in die AGVs groep in vergelyking met die nie-AGVs groep. Alkohol gebruik in die AGVs adolessente het ‘n “binge” patroon en ‘n “slegs naweke” styl getoon. Swak eetgewoontes (oorslaan van ontbyt en gereelde peuselgewoontes), swak voedsel keuses (energie-dig en laag in nutriënte) en lae groente en vrugte inname (nie-AGVs 90.0 [42.4-153.3]; AGVs 88.3 [30.0-153.0] gram per dag), in beide groepe, is gereflekteer in die swak voeding kwaliteit van die dieet. ‘n Risiko vir onvoldoende inname van folaat (nie-AGVs 97.5%; AGVs 98.8%), vitamien C (nie-AGVs 65%; AGVs 67.5%), vitamien A (nie-AGVs 80%; AGVs 82.5%), vitamien E (nie-AGVs 78.8%; AGVs 51.3%), magnesium (nie-AGVs 98.8%; AGVs 97.5%), en fosfor (nie-AGVs 76.3%; AGVs 73.8%) was teenwoordig in meer as helfte van adolessente in beide groepe, asook

This descriptive study examines the relationship between nutritional practices and academic performance among school-age children as suggested in the literature review.

The purpose of this study was to determine whether maternal employment contributed to the general inadequacy of the adolescent's evening meal, and to examine the attitudes of adolescents regarding the mother's role in evening meal preparation. A questionnaire was administered to 1180 high school students in a suburban area of Dallas-Ft.Worth in May, 1987. The hypotheses were tested using Chi square, Pearson product moment correlation, and Anova. Results indicated that maternal employment affects adolescent evening meals in the number of meals offered per week, fully prepared by mother, and eaten away from home. The amount of adolescent participation in meal preparation was higher for the employed group. Attitudes are different between the sexes and those with employed and unemployed mothers.

This dissertation investigates how adolescents and young adults engage with social media in the context of health and wellness and explores new directions for the design of informatics interventions that utilize social media for promoting healthy nutrition among this population. Adolescence and young adulthood are critical points in the formation of life-long health habits, including healthy eating. Social media presents a unique opportunity for health promotion interventions for this population, given their high levels of engagement with social media in various areas of their lives. Yet contemporary interventions for promoting healthy eating utilize only a limited set of social media capabilities. In this dissertation, I approached these questions though a combination of studies of young adults’ attitudes, preferences, and behaviors with social media, a deployment study of a novel informatics intervention for healthy eating among adolescents and young adults, and explorations of novel ways to incorporate machine learning approaches in identifying opportunities to inspire healthy behaviors.

Thesis (MNutr (Human Nutrition))--Stellenbosch University, 2008. / Obesity is recognizably a chronic disease worldwide and childhood obesity has considerable implications for long‐term health. Manipulation of modifiable lifestyle variables, such as high‐fat energy‐dense diets and decreased physical activity are often recommended for positive (although not always significant) outcomes. This study aimed to determine the specific relationships between ready‐to‐eat cereals (RTEC) consumption (regular RTEC breakfast consumption and regular RTEC afternoon snack consumption), regular increased physical activity, and anthropometric measures [body weight, percentage body fat, and body mass index (BMI)] amongst young adolescents attending public Gauteng schools. A randomised controlled trial was conducted over 5‐weeks amongst 212 cross‐cultural, male and female, English speaking children aged 10‐13 years attending two selected public Gauteng schools. Participants were randomly allocated to one of four cohorts (Control, Step, RTEC or Step & RTEC). The control cohort had no prescribed intervention, the Step cohort had prescribed stepping intervention only (completion of 2 000 additional steps in a 20‐minute period on 3 school days per week), the RTEC cohort had prescribed RTEC consumption intervention only (consumption of a single RTEC serving at breakfast and RTEC snack serving as an afternoon snack on each school day), and the Step & RTEC cohort had both the prescribed stepping and RTEC consumption interventions. Participants were assessed anthropometrically at baseline and at the end of the 5 weeks. They also submitted a food/activity diary from which quantitative measures of their intake and activity were determined. The Step (107 845 ± 31 251) and Step & RTEC (108 793 ± 26 285) cohorts both completed significantly more mean total steps than Control (83 501 ± 22 302) and RTEC (86 082 ± 23 367) cohorts (p≤0.01), and a significant negative correlation (p=0.02; r=‐0.21) was found between the change in percentage body fat and the total steps completed. The Step & RTEC (14.32 ± 7.95) and RTEC (16.06 ± 8.82) cohorts consumed more RTEC snack servings as afternoon snacks than Control (1.13 ± 1.69) and Step (1.59 ± 2.50) cohorts (p≤0.01), and a significant negative correlation (p=0.03; r=‐0.20) was found between the participants’ change in weight and the servings of RTEC snacks consumed as an afternoon snack. No significant difference (p=0.35) was achieved in mean weight change across the four cohorts, although both Step & RTEC (‐0.12 ± 0.81) and RTEC (‐0.24 ± 0.77) cohorts showed a mean decrease in body weight. No significant difference (p=0.47) was achieved in mean change in percentage body fat across the four cohorts either, although all cohorts showed a decrease in percentage body fat, with Step cohort (‐0.32 ± 0.70) showing the greatest mean change. The stepping intervention alone brought about greatest decrease in percentage body fat, while the RTEC consumption intervention alone brought about greatest decrease in body weight and BMI. The combination of interventions was the least effective of the three interventions in bringing about decreases in percentage body fat.

Este trabalho descreve uma análise de discurso de mães sociais, a respeito da alimentação e o ambiente das refeições oferecidas às crianças e adolescentes de abrigos. Foram feitas entrevistas com onze mães sociais e três diretoras de três abrigos na Grande São Paulo, e em seguida analisadas por meio da metodologia do Discurso do Sujeito Coletivo. O estudo resultou em 32 categorias de discurso, que abordaram as preferências alimentares, tipo e ambiente da alimentação, conversas e comportamentos durante as refeições, a importância de reunir a família nas refeições, o ensino de boas maneiras, o que se faz para as crianças comerem melhor e o abastecimento dos gêneros alimentícios. Dos discursos foi verificado que as mães sociais se preocupam com os rituais familiares durante as refeições, ocasiões em que se valoriza muito o comer junto, \"todos juntos ao redor da mesa\". Todavia, dá-se preferência ao comer em silêncio do que com conversas. A tarefa de servir os pratos praticamente é assumida pela mãe social, não dando muitas oportunidades para as crianças aprenderem. O capricho na alimentação e o omportamento das crianças \"lá fora\", são também preocupações das mães, que se esforçam para lhes ensinar boas maneiras para não terem problemas fora do abrigo. Foi feito também o levantamento do estado nutricional das 108 crianças e adolescentes por meio do IMC, resultadno em 7.45% de baixo peso e desnutrição e 21.3% de sobrepeso e obesidade. Uma análise qualitativa do cardápio semanal mostrou médias de frequência boas para carboidratos e proteínas, porém com frequências falhas em hortaliças e frutas em alguns dos lares infantis. / This paper describes a speech analysis of social mothers on food and meal environment offered to children and teenagers in foster shelter homes. Eleven social mothers and three managers were interviewed in three shelter homes in São Paulo City and surroundings. An analysis of the \"collective subject speech\" metodology was carried out. From this research 32 speech categories were identified in respect of food preferences, types of food, meal environment, conversation, behavior and the importance of family gathering by mealtime, the good manners upbringing, what can be done in order to improve children´s nourishment, as well as the food supplies. It could be observed from this speech that the mothers were concerned about the importance of eating together, \"all together around the table\". However, the mothers rather eat in silence than talking to with each other. The children´s plates are always served by the social mothers, what does not give them the opportunity of helping themselves and learn how to do that. Preparing a good meal and the children´s behavior outside the shelter home are part of the social mothers´concern. They try to teach them good manners so they will have no problems outside the shelter home. The nutritional status of the 108 children and teenagers from the shelter homes was also researched through the percentiles of the body mass index. The results showed 7.45% of under weight and under nutrition, as well as 21.3% of overweight and obesity. A qualitative analysis of a weekly menu showed a good frequency means for carbohydrates and proteins, however with lacking frequencies for vegetables and fruits in some of the shelter homes.

Este trabalho descreve uma análise de discurso de mães sociais, a respeito da alimentação e o ambiente das refeições oferecidas às crianças e adolescentes de abrigos. Foram feitas entrevistas com onze mães sociais e três diretoras de três abrigos na Grande São Paulo, e em seguida analisadas por meio da metodologia do Discurso do Sujeito Coletivo. O estudo resultou em 32 categorias de discurso, que abordaram as preferências alimentares, tipo e ambiente da alimentação, conversas e comportamentos durante as refeições, a importância de reunir a família nas refeições, o ensino de boas maneiras, o que se faz para as crianças comerem melhor e o abastecimento dos gêneros alimentícios. Dos discursos foi verificado que as mães sociais se preocupam com os rituais familiares durante as refeições, ocasiões em que se valoriza muito o comer junto, \"todos juntos ao redor da mesa\". Todavia, dá-se preferência ao comer em silêncio do que com conversas. A tarefa de servir os pratos praticamente é assumida pela mãe social, não dando muitas oportunidades para as crianças aprenderem. O capricho na alimentação e o omportamento das crianças \"lá fora\", são também preocupações das mães, que se esforçam para lhes ensinar boas maneiras para não terem problemas fora do abrigo. Foi feito também o levantamento do estado nutricional das 108 crianças e adolescentes por meio do IMC, resultadno em 7.45% de baixo peso e desnutrição e 21.3% de sobrepeso e obesidade. Uma análise qualitativa do cardápio semanal mostrou médias de frequência boas para carboidratos e proteínas, porém com frequências falhas em hortaliças e frutas em alguns dos lares infantis. / This paper describes a speech analysis of social mothers on food and meal environment offered to children and teenagers in foster shelter homes. Eleven social mothers and three managers were interviewed in three shelter homes in São Paulo City and surroundings. An analysis of the \"collective subject speech\" metodology was carried out. From this research 32 speech categories were identified in respect of food preferences, types of food, meal environment, conversation, behavior and the importance of family gathering by mealtime, the good manners upbringing, what can be done in order to improve children´s nourishment, as well as the food supplies. It could be observed from this speech that the mothers were concerned about the importance of eating together, \"all together around the table\". However, the mothers rather eat in silence than talking to with each other. The children´s plates are always served by the social mothers, what does not give them the opportunity of helping themselves and learn how to do that. Preparing a good meal and the children´s behavior outside the shelter home are part of the social mothers´concern. They try to teach them good manners so they will have no problems outside the shelter home. The nutritional status of the 108 children and teenagers from the shelter homes was also researched through the percentiles of the body mass index. The results showed 7.45% of under weight and under nutrition, as well as 21.3% of overweight and obesity. A qualitative analysis of a weekly menu showed a good frequency means for carbohydrates and proteins, however with lacking frequencies for vegetables and fruits in some of the shelter homes.

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)

Text in English / The purpose this study was to explore food habits and nutritional behaviours of adolescents in a school in Lenasia South, in Gauteng Province. Qualitative, explorative research was conducted in order to recommend effective prevention strategies of non-communicable diseases. Adolescents from the selected secondary school formed the sample of the study. Data collection was done using focus groups’ discussions. Three focus group discussions were conducted in the study. The first group comprised of thirteen male adolescents, followed by ten female adolescents and the final group was a combination of both female and male learners to produce a homogenous group. Specific common eating habits and nutritional behaviours emerged from the focus group discussions which included skipping meals, high consumption of high energy dense foods and sweetened beverages. Consequently, when developing intervention programs and policies to improve health of adolescents, environmental influences that undermine efforts to improve adolescent’s dietary behaviours must be addressed. / Health Studies / MPH (Health Studies)

Text in English / The purpose this study was to explore food habits and nutritional behaviours of adolescents in a school in Lenasia South, in Gauteng Province. Qualitative, explorative research was conducted in order to recommend effective prevention strategies of non-communicable diseases. Adolescents from the selected secondary school formed the sample of the study. Data collection was done using focus groups’ discussions. Three focus group discussions were conducted in the study. The first group comprised of thirteen male adolescents, followed by ten female adolescents and the final group was a combination of both female and male learners to produce a homogenous group. Specific common eating habits and nutritional behaviours emerged from the focus group discussions which included skipping meals, high consumption of high energy dense foods and sweetened beverages. Consequently, when developing intervention programs and policies to improve health of adolescents, environmental influences that undermine efforts to improve adolescent’s dietary behaviours must be addressed. / Health Studies / M.P.H.