An assessment of the nutritional status of a representative sample of an urban African population has not previously been conducted, nor the extent to which the traditional diet has been abandoned for a western diet. To meet this end, a cross-sectional analytic study was carried out on a representative sample (N=1146) of the urban African population, aged 3 - 64 years in 1990. Particular attention was paid to specific at-risk groups viz. preschoolers (aged 3 - 6 years; N=163), adolescents (aged 15 - 18 years; N=119) and adults (19 - 44 years; N=649). The interrelationships of dietary intake with socio-economic status, demographic indicators as well as measures of urban exposure were also examined. A further aim was to determine the extent to which this rapidly urbanising population ' s macronutrient profile had shifted from a traditional towards a western atherogenic dietary pattern. This analytic study was nested in a community-based descriptive survey on risk factors for cardiovascular disease. A multi-staged, proportional sampling strategy was used. Quotas were used in the final stage of sampling, based on the age/sex distribution of a 1988 census conducted by the local authorities. Dietary data were collected by means of the 24-hour recall method, by Xhosa -speaking registered nurses who had received intensive training. Anthropometric measurements were taken, and blood samples were drawn according to standard procedures. Socio-demographic questions elicited information on the physical environment and facilities, educational level and employment status. Information was also elicited regarding urban exposure relating to lifetime migration history, thus incorporating retrospective temporality into the study des ign. From these data, an index of urban exposure was established by calculating the percentage of life spent in an urban environment. Univariate analyses of dietary, anthropometric and biochemical vitamin status were used for the descriptive components of the study of the three specific at-risk age categories. Bivariate analyses examined the effects of selected proxies of socio-economic status, and urban exposure on dietary intake. Finally, multiple linear regressions were performed on the preschoolers (N=163) and adult sample, aged 15 - 64 years (N=983) incorporating additional indicators of socio-economic status as predictors, and dietary intake data as outcome measures. Correspondence analysis further explored the relationships between dietary atherogenicity (using the Keys score) and other risk factors for degenerative disease.

Thesis (M.Sc. (Chemical Pathology)) --University of Limpopo, 2013 / Objectives: The present study investigated how the serum lipids responded to a high-fat meal in black South African subjects with different APOE genotypes, a population that until recently was reported to be consuming a traditional diet of low fat and high carbohydrates. Methods: Sixty students (males and females) of the University of Limpopo, Turfloop Campus were successfully genotyped using Restriction Fragment Length Polymorphism (RFLP) and grouped into four APOE genotype groups; ε2, ε2/ε4, ε3 and ε4. Only thirty-three subjects volunteered to participate in the oral fat-tolerance test (OFTT), but two were excluded for having abnormal total cholesterol (6.05 mmol/l) and LDL cholesterol (3.12 mmol/l) so only 31 subjects were left. The numbers per group were ε2=5, ε2/ε4=8, ε3=9 and ε4=9. After an overnight fast blood was drawn for measurements of baseline serum parameters. Subjects were administered a high fat meal 30 minutes after the baseline blood sample was drawn. Blood was drawn at intervals of 20, 40, 60, 120, 180, 240, 300 and 360 minutes for measurements of postprandial serum parameter levels. Serum parameters measured were triglyceride, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, glucose and insulin. Results Mean levels of serum lipids at baseline in mmol/l were as follows; group 1[TG=0.69(0.55-0.81), TCHOL=3.10±0.29, HDL-C=1.12±0.32, LDLC= 1.67±0.28]; group 2 [TG=0.61(0.53-1.00), TCHOL=2.98±0.53, HDLC= 1.20±0.37, LDL-C=1.43±0.37]; group 3 [TG=0.67(0.28-0.86), TCHOL=2.96±0.54, HDL-C=1.22±0.30, LDL-C=1.46±0.47]; group 4 [TG=0.76(0.51-1.16), TCHOL=3.27±0.51, HDL-C=1.12±0.17, LDLC= 1.79±0.47]. There was no significant difference in the mean levels of baseline triglyceride, total cholesterol, low density lipoprotein cholesterol, and high density lipoprotein cholesterol between the APOE groups hence no significant difference in the response to a fatty meal. Conclusions There was no significant change in serum lipid concentrations after a fatty meal in individuals with different APOE genotypes in a population that consume a traditional diet of low fat and high carbohydrates. Due to the small sample size, the results should be interpreted with caution. A larger study is recommended to ascertain the role of APOE genotypes on serum lipid response to a fatty meal in Black South African population.

Includes bibliographical references (leaves 327-346). A random population survey and a survey of vegetarians were conducted to examine South Australians' beliefs about meat and vegetarianism. Meat beliefs, barriers and benefits of vegetarianism, meat consumption, personal values, use of and trust in sources of food/nutrition/health information and demographic variables were measured.

Bibliography: leaves 441-468

A random population survey (n=601) and a survey of vegetarians (n=106) were conducted to examine South Australians' beliefs about meat and vegetarianism. Meat beliefs, barriers and benefits of vegetarianism, meat consumption, personal values, use of and trust in sources of food/nutrition/health information and demographic variables were measured via a written questionnaire. There were differences in the responses of vegetarians, semi-vegetarians, and non-vegetarians. For example, vegetarians were more likely than non-vegetarians to use and trust unorthodox information sources and to hold universal values (e.g. 'equality'). The factors associated with meat consumption and four sets of health-related beliefs about meat and vegetarianism (Meat is Necessary, Vegetarianism Health Concerns and Appreciates Meat, Meat is Unhealthy, Health Benefits of Vegetarianism) were examined. Other (health and non-health) beliefs, barriers and benefits of vegetarianism were the most important factors overall to be associated with these beliefs and with meat consumption. Information sources were also associated (particularly orthodox, unorthodox, mass media, advertising, and social sources). Together, these results provided insight into how consumption of meat and plant foods might be influenced. Finally, the proportion of prospective vegetarians was gauged. Approximately 15% of non-vegetarians were found to hold similar beliefs about vegetarianism as vegetarians. Prospective vegetarians were distinct from vegetarians and the remaining omnivores. For example, they were less likely than the remaining omnivores to eat red meat as frequently or to be Anglo-Australian. The research suggested that a significant portion of the population is interested in vegetarian diets, but that certain barriers need to be overcome if this is to increase and lead to dietary change; in particular, the beliefs that vegetarian diets are nutritionally inadequate and that meat is essential for health. Tailored communications about how to prepare healthy, tasty vegetarian meals may also be useful. The results indicated the sources of food/nutrition/health information that may be most appropriate to disseminate such messages. Additionally, it was found that ethical (e.g. environmental, animal welfare) issues were linked to health and dietary behaviour. They may need to be more fully addressed by health professionals if the public is to obtain maximum benefit from plant-based diets, with minimum risk. / Thesis (Ph.D.)--Department of Public Health, 2001.

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

A random population survey (n=601) and a survey of vegetarians (n=106) were conducted to examine South Australians' beliefs about meat and vegetarianism. Meat beliefs, barriers and benefits of vegetarianism, meat consumption, personal values, use of and trust in sources of food/nutrition/health information and demographic variables were measured via a written questionnaire. There were differences in the responses of vegetarians, semi-vegetarians, and non-vegetarians. For example, vegetarians were more likely than non-vegetarians to use and trust unorthodox information sources and to hold universal values (e.g. 'equality'). The factors associated with meat consumption and four sets of health-related beliefs about meat and vegetarianism (Meat is Necessary, Vegetarianism Health Concerns and Appreciates Meat, Meat is Unhealthy, Health Benefits of Vegetarianism) were examined. Other (health and non-health) beliefs, barriers and benefits of vegetarianism were the most important factors overall to be associated with these beliefs and with meat consumption. Information sources were also associated (particularly orthodox, unorthodox, mass media, advertising, and social sources). Together, these results provided insight into how consumption of meat and plant foods might be influenced. Finally, the proportion of prospective vegetarians was gauged. Approximately 15% of non-vegetarians were found to hold similar beliefs about vegetarianism as vegetarians. Prospective vegetarians were distinct from vegetarians and the remaining omnivores. For example, they were less likely than the remaining omnivores to eat red meat as frequently or to be Anglo-Australian. The research suggested that a significant portion of the population is interested in vegetarian diets, but that certain barriers need to be overcome if this is to increase and lead to dietary change; in particular, the beliefs that vegetarian diets are nutritionally inadequate and that meat is essential for health. Tailored communications about how to prepare healthy, tasty vegetarian meals may also be useful. The results indicated the sources of food/nutrition/health information that may be most appropriate to disseminate such messages. Additionally, it was found that ethical (e.g. environmental, animal welfare) issues were linked to health and dietary behaviour. They may need to be more fully addressed by health professionals if the public is to obtain maximum benefit from plant-based diets, with minimum risk. / Thesis (Ph.D.)--Department of Public Health, 2001.

Thesis ( Mnutr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Background: The rising prevalence of non-communicable diseases (NCD) is cause for concern. Improving dietary quality is a key health promotion strategy aimed at reducing NCD morbidity and mortality. Assessments that quantify “risky” dietary behaviours are worthwhile, and may help to identify high risk individuals, that would benefit from targeted interventions. Purpose: Discovery Vitality is a wellness incentive business associated with Discovery Health medical aid in South Africa. This study developed a Dietary Behaviour Score (DBSPHR) that measured degrees of compliance of Discovery Vitality members with the “spirit of dietary guidance”. It further categorized scores and identified members who may be at risk for developing NCDs due to poor dietary compliance. Methods: The DBSPHR included proportionally weighted components related to the consumption of fruit, vegetables, low fat dairy, whole-grain foods, lean meat, chicken and discretionary fat. The study population included adult South African members of Discovery Vitality, who had completed the programme’s on-line health risk assessment (PHR) between the 1st February 2010 and 31st January 2011. Stratified random sampling was used (n=1600). Half the sample included members who participated in Vitality’s HealthyFoodTM benefit (HFB) programme. The different Vitality Status groups were equally represented, and reflect degrees of engagement with the programme. Genders were equally represented. DBSPHR data were categorized as: Poor (Score 0-18), Inadequate (18.5-22.5), Fair (23-26), Good (26.5-29), Excellent (29.5-36). DBSPHR data was analyzed for variables: Vitality status, HFB participation, smoking, physical activity, alcohol consumption, body mass index (BMI), age and gender. The relationships between continuous response variables and nominal input variables were analysed using analysis of variance (ANOVA). When ordinal response variables were compared versus a nominal input variable, non-parametric ANOVA methods were used. Further, the Mann-Whitney test or the Kruskal-Wallis test was used. A p-value of p < 0.05 was considered to represent statistical significance, and 95% confidence intervals were used to describe the estimation of unknown parameters. Results: Of the sample, 67.13% of members had DBSPHRs that were considered “poor” or “inadequate”. The mean DBSPHR of the sample was 20.47 points. Women achieved better DBSPHRs than men (p<0.01). Greater engagement with the Vitality programme was associated with better DBSPHRs (p<0.01). There was no significant difference between the mean DBSPHR of members participating in the HFB and Non-HFB members, however the HFB was not assessed as an intervention. Members with “risky” lifestyle behaviours such as; inactivity, smoking and consuming alcohol excessively, demonstrated lower DBSPHR than members without these risks. Obese members achieved significantly lower DBSPHRs than normal weight and overweight members (p<0.01). Conclusions: It is concerning that Discovery Vitality members did not perform better than the general global standard of inadequate compliance with the “spirit of dietary guidance”. Engagement with the Vitality programme seems to positively impact on dietary compliance. Members at an increased risk for NCD morbidity and mortality due to; aging, obesity, smoking, inactivity or non-compliance with alcohol consumption guidelines, demonstrated lower DBSPHRs compared to members without these risks. Targeted interventions aimed at addressing “risky” dietary and lifestyle behaviours may benefit these members. / AFRIKAANSE OPSOMMING: Agtergrond: Die styging in voorkoms van nie-oordraagbare siektes (NOS) is rede tot kommer. Verbetering van dieetkwaliteit is ‘n sleutel gesondheidsbevordering strategie gemik daarop om NOS morbiditeit en mortaliteit te verminder. Assesserings wat “riskante” dieetgedrag kwantifiseer is waardevol en mag help om hoë risiko individue te identifiseer wat sal baatvind by geteikende intervensies. Doel: Discovery Vitality is ‘n welwees motiveringsbesigheid wat geassosieer is met Discovery Health mediese fonds in Suid-Afrika. Hierdie studie het ‘n dieet-gedragstelling (“Dietary Behaviour Score - DBSPHR”) ontwikkel wat die graad van nakoming van Discovery Vitality lede gemeet het aan die “gees van leiding oor dieet”. Dit het verder tellings gekategoriseer en lede geïdentifiseer wat ‘n verhoogde risiko vir die ontwikkeling van NOS mag hê as gevolg van swak nakoming van dieet. Metodes: Die DBSPHR het proporsioneel geweegde komponente bevat, verwant aan die inname van vrugte en groente, laevet suiwelprodukte, volgraan voedsels, maer vleis, hoender en diskresionêre vet. Die studiepopulasie het volwasse Suid-Afrikaners ingesluit wat lede van die Discovery Vitality program was en wat die program se aanlyn gesondheidsrisiko assessering tussen 1 Februarie 2010 en 31 Januarie 2011 voltooi het. Gestratifiseerde, ewekansige steekproeftrekking was gebruik (n=1600). Helfte van die steekproef het lede ingesluit wat aan Vitality se HealthyFoodTM voordeel program deelgeneem het. Die verskillende Vitality Status groepe was gelyk verteenwoordig en reflekteer verskillende grade van interaksie met die program. Geslagte was gelyk verteenwoordig. DBSPHRs data was gekategoriseer as: Swak (Telling 0-18), Onvoldoende (18.5-22.5), Matig (23-26), Goed (26.5-29), Uitstekend (29.5-36). DBSPHR data was vir die volgende veranderlikes geanaliseer: Vitality status, deelname aan die HealthyFoodTM voordeel, rook, fisiese aktiwiteit, alkohol inname, liggaamsmassa indeks (LMI), ouderdom en geslag. Die verhouding tussen aaneenlopende reaksie veranderlikes en nominale inset veranderlikes was geanaliseer deur die gebruik van analise van variansies (ANOVA). Wanneer ordinale reaksie veranderlikes vergelyk was teenoor ‘n nominale inset variansie, was nie-parametriese ANOVA metodes gebruik. Verder was die Mann-Whitney toets of die Kruskal-Wallis toets gebruik. ‘n P-waarde van p < 0.05 was gesien as verteenwoordigend van statistiese beduidendheid en 95% sekerheidsintervalle was gebruik om die skatting van onbekende parameters te beskryf.Resultate: Van die studie monster het 67.13% van die lede DBSPHRs getoon wat gereken was as “swak” of “onvoldoende”. Die gemiddelde DBSPHR van die steekfproef was 20.47 punte. Vroue het beter DBSPHR as mans behaal (p<0.01). Meer interaksie met die Vitality program was geassosieer met beter DBSPHRs (p<0.01). Daar was geen beduidende verskille tussen die gemiddelde DBSPHR van lede wat aan die HealthyFoodTM voordeel program deelneem en die lede wat nie aan die program deelneem nie, alhoewel die HealthyFoodTM voordeel nie geëvalueer was as ‘n intervensie nie. Lede met “riskante” lewenstyl gedrag soos onaktiwiteit, rook en hewige alkoholinname het laer DBSPHR getoon as lede sonder hierdie risiko’s. Vetsugtige lede het laer DBSPHR behaal as normale gewig en oorgewig lede (p<0.01). Gevolgtrekking: Dit is ‘n bron van kommer dat Discovery Vitality lede nie beter vertoon het as wat blyk ‘n algemene globale standaard van gebrekkige nakoming van die “gees van leiding oor dieet” te wees nie. Interaksie met die Vitality program blyk ‘n positiewe impak te hê op dieet nakoming. Lede wat ‘n verhoogde risiko gehad het vir NOS morbiditeit en mortaliteit as gevolg van veroudering, vetsugtigheid, rook, onaktiwiteit of verontagsaming van alkohol inname riglyne het ook laer DBSPHRs getoon in vergelyking met lede sonder hierdie risiko’s. Geteikende intervensies gemik op die aanspreek van riskante dieet en lewenstyl gedrag mag tot voordeel van hierdie lede wees.

MENVSC / Department of Ecology and Resource Management

Submitted in fulfillment of the requirements for the Degree Magister Technologiae: Consumer Science Food and Nutrition, Durban University of Technology, 2014. / Introduction: Dietary diversity is an indicator of access and measurement of household food security as it relates to income, location and seasonality. Dietary diversity is measured by physically counting the number of individual foods as well as food groups consumed over a given reference period. When dietary diversity is accurately measured, nutrient adequacy will be easily predicted. In order to measure dietary diversity accurately, it is important to determine household food security. Insufficient food and resources often result in food insecurity which leads to little or no dietary diversity. Poor populations suffer most from achieving dietary diversity because they consume a standard diet based on starchy staple food with limited fruits and vegetables resulting in multiple nutrient deficiencies. Rural communities rely on seasonal food variety in order to obtain fruits and vegetables needed by the body to limit nutrient deficiencies. Some seasons are more productive than others. Rural communities also use various coping strategies to deal with food insecurity in all four seasons. High levels of unemployment as well as a lack of nutrition education results in most rural households unable to cater for dietary diversity. Aim: The aim of the study is to determine the effect of seasonal food variety, dietary diversity and nutrient adequacy on the nutritional status of women in rural areas. Method: A hundred women in this community were weighed and measured and BMI determined and classified according to the WHO cut-off points for BMI. Waist circumference was measured in order to determine the waist-to-height ratio indication risk of metabolic syndrome. Twenty four hour recall questionnaires were used to determine actual intake compared to dietary reference intake (DRIs). Food Frequency Questionnaires for a period of seven days were completed captured and analysed using the SPSS version for descriptive statistics in order to determine food diversity. Coping strategies were determined by Focus Group interviews with community members in order to identify the various strategies used in time of food shortages. The severity of these strategies was determined by the community. Seasonal food consumption patterns and dietary intake behaviour were assessed over the four seasons. The highest frequency score (7) x severity weight (1-4) x10 strategies = maximum score of 140. Thus the higher the score the more food insecure the community is. Results: Food production from crops differs in different seasons. Food insecurity is high in summer and autumn due to a low number of food items harvested from crops. The community cope less in summer and autumn due to less crops available. The community is more food insecure in spring and winter due to the high number of food items harvested from crops. The community cope better in winter and spring due to the high level of available crops. Anthropometric measurements indicated that 41.2% of women between 31 and 50 and 49% of women between 51 and 70 years of age had a BMI of 30 and above. About 44% of total women are obese and 29% are pre obese. Only 26% had a normal weight. The 24 hour recall analysis indicates that the high level of obesity is due to the fact that a high number of participants consume large amount of carbohydrates every day. Conclusion: Overall results in this study indicated that this rural community is food insecure, on a higher level during summer and autumn, which leads to the consumption of undiversified diets. The women are malnourished and obese with a risk of metabolic syndrome. The information obtained in this study can be used to formulate strategies to develop interventions that can be used to access sufficient food in rural area in order to improve food insecurity, dietary diversity and, therefore, nutrient adequacy.