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

Thesis (MNutr (Human Nutrition))--Stellenbosch University, 2008. / INTRODUCTION: The best known reference standards used to evaluate the growth and development of infants and children are the 1977 National Centre for Health Statistics (NCHS) - , the 2000 Centres for Disease Control and Prevention (CDC) - and the World Health Organization (WHO) (2006). The NCHS reference standards were used to analyse anthropometric data from the 1999 National Food Consumption Survey (NFCS). It was anticipated that using the 2000 CDC and the 2006 WHO reference standards may lead to differences in the previously estimated prevalences of stunting, wasting, underweight, risk of overweight, overweight and obesity in the study population. AIM: To compare the anthropometric status of children aged 12 - 60 months when using the 1977 NCHS -, the 2000 CDC -, and the 2006 WHO reference standards. METHODS: A secondary analysis of anthropometric data from the 1999 NFCS was conducted using different reference standards to compare anthropometric status in terms of the prevalences of stunting, wasting, underweight, risk of overweight, overweight and obesity. Relationships between anthropometric status and other variables such as breastfeeding, maternal education level and type of housing were explored. RESULTS: The prevalences of stunting, obesity and overweight were significantly higher and the prevalence of underweight and wasting were lower when using the 2006 WHO compared to the 1977 NCHS and the 2000 CDC reference standards. A significant relationship was found between weight-forheight and breastfeeding when using any one of the reference standards and between BMI-for-age and breastfeeding when using the 2006 WHO reference standard. A significant relationship was shown between maternal education level and height-for-age and weight-for-age when using any one of the three reference standards and a significant association was found between weight-for-height and BMI-for-age and the type of housing when using any of the three reference standards. CONCLUSIONS: The prevalences of stunting and obesity were higher when using the 2006 WHO reference standards compared to the 1977 NCHS and 2000 CDC reference standards. This may be due to the linear growth and rate of weight gain of breastfed infants differing from formula fed infants and the 2006 WHO reference made use of the exclusively and predominantly breastfed infant living under normal healthy conditions as the normative model which is a prescription of how children should not grow and .not an indication of how children are growing. In conclusion, the 2006 WHO reference standard must be the only reference standard used nationally and internationally when assessing the growth and nutritional status of infants and children.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--Stellenbosch University, 2008. / Introduction: More than half a million children worldwide die from the Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) each year. In Uganda, HIV/AIDS is a major cause of infant and childhood mortality. Although the government of Uganda, through various strategies, has increased access to antiretroviral drugs (ARVs), resulting in national scaling up of accessibility to antiretroviral therapy (ART), initiation of ART in resource-limited areas remains a challenge due to constraints such as the absence of or limited number of CD4 machines and related laboratory constraints. Further scaling up of ART for children would be greatly strengthened by increased access to laboratory services for CD4 counts or the introduction of alternative indicators or guidelines for the initiation of ART. Aim: This study therefore set out to investigate, through the analysis of retrospectively collected data, whether anthropometric indices (wasting - weight for height; underweight - weight for age; and stunting - height for age) could provide a useful alternative guide when deciding about initiation of ART in children aged 2-12 years in the absence of sophisticated clinical and laboratory support. Methods: The study was conducted at the Mildmay Centre, an HIV/AIDS specialist centre located in Kampala, Uganda. Parameters such as the age at which children had been initiated onto ART, duration on ART, World Health Organisation (WHO) and Centre for Disease Control (CDC) disease stages at time of initiation, anthropometry at time of initiation, CD4% staging at time of initiation, support received from food aid programmes, referral to other health centres as a result of malnutrition and care-giver nutrition education/counselling were all determined retrospectively from clinical records. Results: It was found, based on CDC (2000) growth reference charts, that of the total number of children who took part in this study (N=125), 98.4% were mildly wasted, 52.8% mildly underweight and 75.2% mildly stunted when they were initiated onto ART. Of the children, who had WHO disease staging documented - 40% (N=50), the majority - 86% (N=43) were in WHO disease staging II and III during initiation of ART. and 96% (N=48) were mildly wasted. However, the relationship between WHO disease staging and wasting, underweight, and stunting at initiation of ART in children at the Mildmay centre was not significant. The relationship between CD4% and underweight or stunted children was also not significant. It was established however, that in the absence of CD4 laboratory parameters (since CD4% is vital in the initiation of ART in children) as is the case in resource limited areas, anthropometric indices (moderate to severe wasting, weight for height -W/H) could be used concurrently with CDC and WHO disease staging to initiate ART in children. However, it is important to note that anthropometric indices on their own cannot be used as a guide for initiating ART in children. Conclusion: Anthropometric status alone cannot be used to accurately determine when to initiate ART in children 2-12 years.

Submitted in the fulfillment of the requirements of a Masters of Applied Science in Food and Nutrition, Durban University of Technology, Durban, South Africa, 2017. / Aim: The main aim of this study was to profile the primary school children`s household socio-economic status and evaluate their nutritional status for a healthy and active live in Chesterville, outside Durban in KwaZulu-Natal. The sample comprised of 250 children (147 girls and 103 boys), aged between 4 to 8 years and 9 to 13 years who volunteered to participate in the study and school was randomly selected. Methodology: A quantitative research method was applied using various nutrition security assessment tools complemented by the socio-economic household profile to determine household`s ability to acquire food. Anthropometric status using WHO growth indicators assessed stunting, wasting and underweight status of the children. This was followed by the 24-hr recall and food frequency questionnaire to probe children`s diet diversity. Descriptive statistics was used to analyse data. Result: The anthropometric indices showed that 10.3% of the children were severely stunted (<-3SD height-for-age), 33.5% were stunted (<-2SD), 2.9% were severely wasted (<-3SD BMI-for age), 5.3% were wasted (<-2SD) with 68.5% at possible risk of overweight (>+1SD), 24.3% of the children were overweight is (>+2SD) and 5.6% were obese (>+3SD) according to the WHO z-scores. The results indicate the prevalence of obesity which could be a result of the high consumption of carbohydrate dense food in the group surveyed. The parents/ caregivers and the children need nutrition education on healthy eating habits to improve their lifestyle. The socio-demographic profile of the households indicated that 61% of the parents/ caregivers were unemployed and 39% were employed. Seventy three percent of the households were headed by women, 50% of the parents/ caregivers owned their homes, 63.6% had a tap inside the house and 94% had access to a flush toilet/sewerage system inside the house, 38% had passed grade 8 – the highest level of education, 14.4% of the parents/caregivers earned less than R2000 per month, and 10.4% earned less than R2500 per month. The low-income level, lack of post matric qualification in some of the parents /caregivers and the high unemployment rate of 61% could be a contributory factor to malnutrition in this community. Most of the parents/caregivers resided in the township and 94% lived in brick houses, while 35.6% lived in a shack that was built outside the house as an extension of the house. Most of the parents/caregivers (88%) purchased their food from a supermarket. Thirty-five-point two percent of the parents/ caregivers indicated not having enough money to spend on food, 32.8% indicated that often there is not enough money to spend on food, and 15% indicted that there is always not enough money to spend on food. Seventy-five-point two percent of the parents/ caregivers purchased their food once a month while 12.4% purchased their food once a week. Township South Africans tend to purchase food instead of growing their own food because of the lack of vegetating space. The lack of buying power and food shortages eventually leads to malnutrition. The lack of higher education in this community decreases the chances of permanent employment as a result the low-income bracket and the inability to purchase food in some occasions. The food group diversity score showed that 64% of the respondents consumed food from nine food groups. The carbohydrate group had the highest score (6.08±1.322) followed by the vegetable group (4.76±1.383) and the meat group (4.51±1.269). The mean carbohydrate intake was higher than the Dietary Reference Intake (DRI) for girls and boys (>100% of the DRIs). The intake of fruit was lower than the >400g goal as recommended by the World Health Organisation (WHO). The consumption of fibre was low with both girls and boys consuming <100% of the fibre requirements. Iron was consumed by 54.6% of the girls in the required amount of 100% of the DRIs. The energy intake for both girls and boys was 7025.8±16278 and 7205.4± 1860.834 respectively. The girls’ consumption of protein was 11.9% and boys’ consumption was 11.4% and this is within the recommended 10-15% of the WHO. Conclusion: The results indicate both overnutrition and undernutrition in children that were part of the survey. The top 20 food intake indicated inadequate eating patterns and that diets consisted of energy dense foods, such as carbohydrates and fats which could be responsible for obesity in the children. The high unemployment and low-income rate and inadequate money to spend on food can contribute to the prevalence of stunting and wasting in the children. Nutrition education and nutrition interventions such as focus on healthier foods, healthier methods of preparing food, a balance diet and physical activity are necessary to improve quality of life and improve health. / M

Thesis (MTech (Public Management))--Cape Peninsula University of Technology, 2009 / The study centres on the school feeding programme in the Bonteheuwel area, which is a predominantly Coloured residential area in close proximity to Cape Town International Airport. The school feeding programme is a national initiative that is driven by the Western Cape Education Department on a provincial level. The research investigated whether the school feeding scheme is being implemented effectively and efficiently. This implies that it was necessary to determine:  The current status of school feeding in Bonteheuwel;  Whether it adequately meets the needs of needy learners; and  If the current scheme is found to be inadequate, what can be done to improve the situation? As the study uses both descriptive and empirical approaches, a questionnaire was constructed to obtain views of selected members of Bonteheuwel’s community. Responses to the questions/statements in the questionnaire were analysed by a Cape Peninsula University of Technology registered statistician and the statistical analysis provided positive answers to the above determinations, which revealed that the school feeding programme was not effective and that more should be done to improve its delivery. The final chapter proposes a number of recommendations to improve implementation of the school feeding programmme.

Orientador: Maria Helena Salgado Bagnato / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação / Made available in DSpace on 2018-08-23T17:22:40Z (GMT). No. of bitstreams: 1 Rodrigues-Ciacchi_ErikaMarafon_D.pdf: 10882265 bytes, checksum: 16e339f2207a1bf6337ba5f61b9ceee7 (MD5) Previous issue date: 2013 / Resumo: Este trabalho aborda uma ação de educação alimentar e nutricional promovida pelo governo federal brasileiro, através de três Ministérios: do Desenvolvimento Social, Educação e Saúde, entre 2005 e 2006. Denominado Criança Saudável, Educação Dez, esse projeto estava voltado para alunos das primeiras quatro séries do ensino fundamental, com o uso de cartilhas em forma de histórias em quadrinhos, com os personagens de Monteiro Lobato no cenário do Sítio do Picapau Amarelo. No trabalho, a gênese e o desenvolvimento da ação são abordados através da descrição dos seus documentos e materiais e a contextualização dos papéis desempenhados pelos seus mentores institucionais. Utilizou-se uma metodologia qualitativa, com amplo recurso a depoimentos e entrevistas. Do ponto de vista teórico, a compreensão do projeto articula-se aos conceitos de campo intelectual e científico subsidiados por P. Bourdieu, num contexto de bloco histórico referido por A. Gramsci e do discurso competente por M. Chauí. A pesquisa mostrou que essa ação teve pontos frágeis e pontos fortes. Ela não desenvolveu uma prática capaz de convidar ao diálogo profundo e necessário os setores envolvidos, pelo uso de abordagens educativas condicionantes, instrucionais, ou seja, de transmissão de conhecimento, pela ausência de uma reflexão transdisciplinar maior por parte dos Ministérios envolvidos. Entretanto, considero positivas as parcerias interministeriais firmadas, embora de bases frágeis, pela inovação na reunião de atores intersetoriais na elaboração da ação. A realização de duas pesquisas de avaliação, uma institucional e outra externa também se apresentou como relevante no processo do projeto. A análise da gênese e evolução do projeto Criança Saudável, Educação Dez, dada na articulação dos ministérios com empresas do terceiro setor revelou que existe uma concentração de poder para realização de práticas educativas em saúde nas instâncias governamentais, na análise desse estudo, em detrimento da autonomia e independência da sociedade civil na participação e condução dessas ações. / Abstract: This thesis discusses an action of food and nutrition education promoted by the brazilian federal government, through three ministries: Social Development, Health and Education, between 2005 and 2006. Called "Criança Saudável, Educação Dez", this project was aimed at students from the first four grades of elementary school, with the use of primers in the form of comics, with the characters of Monteiro Lobato in the setting of Sítio do Picapau Amarelo. At work, the genesis and development of the action are addressed through the description of their documents and materials and contextualization of the roles played by its institutional mentors. We used a qualitative methodology, with extensive use of statements and interviews. From the theoretical point of view, understanding the project articulates the concepts of the intellectual and scientific field subsidized by P. Bourdieu, in a context of historical bloc reported by A. Gramsci and competent discourse by M. Chauí. The research showed that this action had bad points and good points. Among the bad ones, I should say that the project's practice wasn't able to deepen the necessary dialogue between the engaged sectors, because of the use of strictly conditioning educational approaches that is a transmission of knowledge and because of the lack of a larger transdisciplinary reflection among the involved Ministries. However, among the good points I deem the good partnerships between ministries that were established (although on weak ground), by innovating in meeting actors along the development of that multi-sector action. Two evaluation surveys, an institutional one and an external one are very relevant too. My analysis of the rise and evolution of the project "Criança Saudável, Educação Dez", engaging ministries and third sector companies shows that government agencies are highly empowered when they carry health education programs, and that depresses the autonomy and independence of civil society participation and agency. / Doutorado / Ensino e Práticas Culturais / Doutora em Educação

Rationale: There is limited research available in South Africa that explores the breastfeeding experience among adolescent mothers; most of the studies were conducted in developed countries. One such study relating to the above mentioned developed countries stated that social and commitment factors influence the decision to breastfeed by adolescents. Furthermore, while adolescent mothers appreciate the benefits of breastfeeding, pain, public exposure and perceived complexities related to breastfeeding create barriers for them. The researcher was unable to ascertain if similar ambiguities exist among adolescent mothers in South Africa, and in the Eastern Cape (EC) in particular with its high rates of adolescent pregnancy. In order to attempt to develop age appropriate recommendations to assist adolescent mothers with their breastfeeding journey, the researcher undertook this research study to answer the following question: What are the breastfeeding experiences of adolescent mothers in the Nelson Mandela Bay Heath District (NMBHD)? Aim: The research aim was to determine the experiences of adolescent mothers regarding breastfeeding in NMBHD. Methods: The study implemented a qualitative research approach. To enhance the design, the researcher utilised an explorative, descriptive and contextual research design. The ethical principles that guided this study were autonomy, nonmaleficence, beneficence and justice. Fourteen adolescent mothers, attending PHC facilities in the NMBHD participated in the study. Participants were chosen from a purposive sampling technique and data were collected from semi-structured interviews, compromising of individual interviews. The researcher analysed the data using the using the eight steps of the Tesch analysis technique. Data was also analysed by an independent coder. Results obtained from the Tesch approach were compared to that of the independent coder results. Thereafter, the major themes and sub-themes that related to the study objectives were identified. Results: Three themes and 10 sub-themes were identified. Lack of knowledge and poor adherence to EBF, perceived breastmilk insufficiency, as well as incorrect infant feeding advice given by maternal mothers and grandmothers were associated with early introduction of complementary feeding. Most participants were motivated to breastfeed due to its economic and bonding benefits, as well as seeing their infant‟s progress in growth. Challenges of breastfeeding mentioned by the participants include: lack of support from the fathers of their infants and from health care providers, breast milk leakage, and the foul smell associated with the leaking of breast milk. The participants of the study also had suggestions to help improve the support given to adolescent mothers by health care providers in PHC facilities. Conclusions and recommendations: In conclusion, this study‟s findings revealed that adolescent mothers may need extra age appropriate education and support to assist them in breastfeeding successfully at PHC facilities, the community and schools. Maternal mothers and grandmothers were found to be the primary source of a support network for most adolescent mothers as opposed to health care providers who were categorised as being the secondary source of support. Thus, breastfeeding promotion tailored at maternal mothers and grandmothers would be beneficial in improving their knowledge about the recommended infant feeding practices and consequently aid in providing appropriate support and advice to adolescent mothers. Additionally, training and attitude modification of health care providers is needed to provide adolescent mothers with age-appropriate, effective and sensitive care and counselling.

The aim of this study was to explore and describe the body fatness and associated selected health risk factors among 10 to 12 year old adolescents attending schools in Port Elizabeth. Therefore the objectives of the study were to determine the following for the participants: • Level of fatness: weight, height, waist circumference, maximum hip circumference and skinfolds; • Fat intake; • Level of physical activity involvement (IPAQ). To achieve the aim and objectives of this study, the literature pertaining to Childhood Obesity and the possible effects thereof, were reviewed. Both an ex post facto quasi experimental and randomized one-group posttest only designs were used to describe the level of fatness and to identify the incidence of overweight and obesity among adolescents aged 10 to 12 years attending schools in Port Elizabeth. The test battery included anthropometric measurements that were identified from the literature as the factors most important to categorise body fatness such as weight, height, circumferences and skinfolds to determine the level of fatness of the participants. A 21-item Fat Measure for Dietary Intake and International Physical Activity Questionnaire were administered to determine the levels of fat intake and physical activity. Three hundred (300) adolescents were assessed of which 143 were male and 157 were female. In terms of socioeconomic status, 71.3 percent were from the ‘less poor’ quintile schools and 28.7 percent were from the ‘more poor’ quintile schools. The results obtained from the evaluation of the samples were compared in terms of their descriptive statistics and the differences were tested for statistical and practical significance. The results from the study showed that 26.7 percent of the participants were overweight and 14.7 percent were obese according to their skinfold measurements. In terms of body mass index, 79.7 percent of the participants were overweight and 14.3 percent were obese. These results are far higher than majority of the studies included. Physical activity indicated a reduction in body fatness and the most physically active participants were obese. Lastly, body fat percentage and body mass index are very closely related.

Submitted in fulfillment of the requirements of the Master of Applied Science in Food and Nutrition, Durban University of Technology, Durban, South Africa, 2016. / Introduction: South Africa, like many other developing countries, is challenged by malnutrition among children. Globally, the nutritional status of children is a cause for great concern. The nutritional shift towards diets laden with sugar, fat and salt contribute towards the burden of non-communicable diseases (NCDs). Snacking plays a pivotal role in the diets of children; however, the consumption of unhealthy snacks or ‘junk’ food poses a serious risk to a child’s nutritional well-being. Moringa oleifera was selected for snack food development in this study, as this plant is a significant source of nutrients. Aim: The aim of this study was to determine the snacking preferences of children (grades 4-7 in four schools in Verulam, KwaZulu-Natal (KZN), South Africa, in order to develop a sensory acceptable snack enhanced with Moringa oleifera. Methodology: Two hundred primary school children between grades 4-7 were selected through stratified random sampling of schools in Verulam, KZN, South Africa through informed consent to participate in this study. In addition, ten parents/caregivers formed part of the preliminary study to determine the snacking habits of children in the selected grades. This information was reported in the form of themes. A Snack Food Frequency Questionnaire (SFFQ) was administered to children for the sole purpose of determining snacking preferences. This was supplemented by an observational study to assist with identifying the most frequent tuck shop purchases. Thereafter, once the top three snack items were identified, the main study continued with the development of a healthy snack, through three cooking trials before an appropriate product was developed. The final product was made using three different amounts of dried Moringa leaves (1g Moringa, 2g Moringa and 3g Moringa per 22g portion) in a maize chip. The developed product was then subjected to nutrient testing in order to determine the vitamin A, zinc, iron and calcium content of the three different variants. The carbohydrate, fat, energy and sodium values were calculated by using the Association of Official Analytical Chemists (AOAC) International standardised methods. Microbiological and shelf life testing were also conducted to ensure the chips were safe for human consumption. Consumer acceptance sensory evaluation was conducted among the children (n=100) to determine the most preferred amount of Moringa leaf in the snack food item (either 1g of Moringa or 2g Moringa). To determine which of the two variants (sample 1 containing 1g of Moringa and sample 2 containing 2g Moringa) was preferred, two variants of the product were sampled by the participants; samples were coded in order to prevent bias. Results: Overall, the results from the focus group study revealed that children consumed snacks frequently and were given money regularly to purchase snack items from the school tuck shop. Price was a trend noted in factors that affect snack selection. The parents/caregivers responded positively towards purchasing a snack that was nutrient-rich. However, it was noted that the price should be reasonable. Results of the SFFQ indicated that the most popular snack items were chips, cold drinks and sweets; therefore these items were reviewed to determine the most viable option for further development. It was decided by the researcher and the supervisor that chips would be the snack item enhanced with three different amounts of Moringa. The consumer acceptance sensory evaluation comprised two chip samples (123 and ABC). The results of the consumer acceptance sensory evaluation showed that sample ABC (2g Moringa/22g serving) was preferred to sample 123 (1g Moringa/22g serving) for most of the sensory attributes (taste and texture). The Moringa chips (both samples) contain almost half the amount of sodium (52.8mg) when compared to a popular corn chip brand (100mg). Moringa chips contained almost less than 1 gram of fat compared to 8 grams of fat found in the corn chips children usually consume. One portion (22g) of the Moringa chips contributes a significant amount of non-haem iron (57.89%, 48.25% and 35.61% for sample 1, 2 and 3 respectively) for females aged between 9-13 years old. Conclusion: Moringa chips (2g/22g serving) received a positive response from children in the sample population. The use of indigenous plants such as Moringa, could be beneficial in food based strategies aimed at addressing malnutrition. Recommendations: This study concluded that food based strategies such as the development of the Moringa chips, should be considered as a means to create a healthy option for children in low socio-economic schools. / M

No description available.