Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2008. / BACKGROUND: Although hypoglycaemia is a known complication of haemodialysis, there is little information about its prevalence among patients on maintenance haemodialysis. OBJECTIVE: To determine the prevalence of hypoglycaemia in patients on maintenance haemodialysis in Kenyatta National Hospital (Nairobi, Kenya) and to identify potential nutritionrelated causes of hypoglycaemia. METHODS: A cross-sectional, descriptive and observational study design was followed. Patients who had been on chronic maintenance haemodialysis for 3 months or longer were included in the study which was carried out from May 8 through to June 30, 2006. Random blood glucose levels were determined at baseline, 15 minutes, 30 minutes and 45 minutes, and at hourly intervals thereafter until the end of the dialysis session. The prevalence of hypoglycaemia (a blood glucose level less than 3.9 mmol/L) was then determined for the duration of haemodialysis. The relationship between minimum blood glucose levels and dietary intake, anthropometric status, primary diagnosis, co-morbid and socio-demographic factors, prescribed medication and dialysis related factors was determined. RESULTS: Among the 51 haemodialysis patients who participated in the study, the prevalence of hypoglycaemia was 16% (n=8). Eight percent (n=4) of these patients were however already hypoglycaemic on initiation of dialysis. Dietary intake of niacin ((r=0.31; p=0.02), riboflavin (r=0.30; p=0.03) and vitamin B6 (r=0.30; p=0.03) showed a significant relationship with blood glucose levels. The relationships between hypoglycaemic episodes and insulin administration (p=0.06), and between blood glucose levels and BMI (r=0.25; p=0.08 and protein intake (r=0.26; p=0.07) approached significance. There was no significant relationship between blood glucose levels and the duration of haemodialysis (p=0.942), hours of haemodialysis (p=0.27) and the dialysate solution used (p=0.12). CONCLUSIONS: Hypoglycaemia was present in 16% of patients on maintenance haemodialysis. Potential nutritional parameters which may have contributed to lower blood glucose levels in this study include a lower dietary intake of niacin, riboflavin, and vitamin B6. Lower protein intake and lower BMI was marginally associated with low blood glucose levels.

Thesis (MNutr)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Introduction and Objectives: Schools can serve as a supportive environment for the promotion of healthy eating in order to prevent childhood overweight and obesity and the development of noncommunicable diseases such as cardiovascular diseases, type 2 diabetes mellitus, fatty liver disease, muscoskeletal disorders and some cancers. Tuck shops at schools often offer unhealthy items that are energy dense and high in fat and/or sugar with a low content of vitamins, minerals and dietary fibre. The availability of unhealthy items in tuck shops prevents learners from making healthy food choices, since children tend to choose unhealthy foods when given a choice. In addition to unhealthy items offered by tuck shops, learners also bring unhealthy items to school in their lunchboxes. The aim of the study was to investigate the influence of a nutritionally-regulated tuck shop on primary school learners’ perceptions, attitudes and behaviour towards healthy eating in a Bloemfontein, Afrikaans medium, co-education primary school, and compare it to learners of a school with a conventional tuck shop. Methods: In a cross-sectional survey with an analytical component, grade 2 to 7 learners in a school with a nutritionally-regulated tuck shop (n=116) and a school with a conventional tuck shop (n=141) completed a questionnaire. Six learners per grade also took part in focus group discussions. Questions related to lunchbox contents and perceptions, attitudes and behaviour towards the tuck shop and healthy eating. Nutritional information of the items available for purchase at each of the school tuck shops was collected. Results: The lunchboxes of learners in the school with a nutritionally-regulated tuck shop contained significantly (p<0.05) more healthy items (fruit, water and muffins), as well as significantly more unhealthy items (sweets and chips). The items offered by the nutritionally-regulated tuck shop contained approximately half the kilojoules compared to items offered by the conventional tuck shop. Learners in the school with a nutritionally-regulated tuck shop liked certain fruits and vegetables significantly (p<0.05) more than learners in the school with a conventional tuck shop. Statistical significant differences (p<0.05) between different grades and gender showed that grade 2 learners in both schools had a less positive attitude towards certain fruit and vegetables compared to the older learners, while girls in both schools were more positive towards certain fruits and vegetables compared to boys. Younger learners had a more positive attitude towards their nutritionally-regulated tuck shop than older learners. In both schools learners had similar perceptions regarding the particular school’s tuck shop and healthy eating. Conclusion: The hypothesis that learners in a school with a nutritionally-regulated tuck shop have positive attitudes, perceptions and behaviour towards healthy eating was rejected. The availability of healthier items in a school tuck shop had a positive influence on certain behaviours and attitudes of learners, but the potential value of controlling the type of items available for purchase at schools might be counteracted by lunchbox contents, certain fixed eating patterns, perceptions of learners and previous exposure to a conventional tuck shop. Recommendations include a multi-pronged approach such as the Health Promoting Schools concept. / AFRIKAANSE OPSOMMING: Inleiding en doelwitte: Skole bied ‘n omgewing waar goeie eetgewoontes bevorder kan word ten einde oorgewig en vetsug in kinders te voorkom, asook die ontwikkeling van nie-oordraagbare siektes soos kardiovaskulêre siektes, tipe-2 diabetes mellitus, lewervervetting sindroom, ortopediese komplikasies en sekere soorte kanker. Snoepies in skole voorsien meestal ongesonde items met ‘n hoë energie, vet- en/of suikerinhoud en wat laag is in vitamiene, minerale en dieetvesel. Die beskikbaarheid van ongesonde items in snoepies verhoed dat leerders gesonde voelselkeuses uitoefen, omdat kinders geneig is om voorkeur aan ongesonde kos te gee as hulle 'n keuse gebied word. Benewens die ongesonde items wat snoepies aanbied, neem leerders boonop ongesonde kos in hul kosblikke skooltoe. Die doel van die studie was om by 'n Afrikaans dubbelmedium laerskool in Bloemfontein die invloed van ‘n voedingkundig-gereguleerde snoepie op leerders se persepsies, houdings en gedrag teenoor gesonde eetgewoontes te ondersoek en te vergelyk met leerders in 'n skool met 'n konvensionele snoepie. Metodes: In ‘n deursnit-opname met ‘n analitiese komponent, het graad 2 tot 7 leerders in ‘n skool met ‘n voedingkundig-gereguleerde snoepie (n=116) en ‘n skool met ‘n konvensionele snoepie (n=141), ‘n vraelys ingevul. Ses leerders in elke graad in elk van die skole het ook aan fokusgroepbesprekings deelgeneem. Vrae het oor die inhoud van kosblikke, asook persepsies, houding en gedrag teenoor die snoepie en gesonde eetgewoontes, gehandel. Voedingsinligting rakende die items wat in elk van die skole se snoepies verkoop word, is ook ingesamel. Resultate: Die kosblikke van leerders in ‘n skool met ‘n voedingkundig-gereguleerde snoepie het statisties beduidend (p<0.05) meer gesonde items bevat (vrugte, water en muffins), maar ook beduidend meer ongesonde items (lekkergoed en aartappelskyfies). Voedsel-items wat in die voedingkundig-gereguleerde snoepie beskikbaar was, het omtrent die helfte minder energie bevat as voedsel-items wat in die konvensionele snoepie beskikbaar was. Leerders in ‘n skool met ‘n voedingkundig-gereguleerde snoepie het beduidend (p<0.05) meer van sekere groente en vrugte gehou as leerders in ‘n skool met ‘n konvensionele snoepie. Statisties beduidende (p<0.05) verskille tussen verskillende grade en die houding van verskillende geslagte dui daarop dat graad 2 leerders in albei skole minder positief gevoel het oor sekere groente en vrugte as ouer leerders, terwyl meisies in albei skole ‘n meer positiewe houding teenoor sekere groente en vrugte getoon het as seuns. Jonger leerders het ‘n meer positiewe houding teenoor hulle voedingkundig-gereguleerde snoepie getoon as ouer leerders. In albei skole het leerders soortgelyke persepsies rondom hul onderskeie skole se snoepies en gesonde eetgewoontes openbaar. Gevolgtrekking: Die hipotese dat leerders in ‘n skool met ‘n voedingkundig-gereguleerde snoepie positiewe persepsies, houding en gedrag teenoor gesonde eetgewoontes toon is nie aanvaar nie. Die beskikbaarheid van gesonder items in ‘n skoolsnoepie het 'n positiewe invloed op sekere eetgewoontes en houdings van die leerders, maar die potensiële waarde daarvan om die tipes voedsel wat by skole te koop aangebied word te reguleer mag egter teengewerk word deur kosblikke se inhoud asook sekere vaste eetpatrone, persepsies van leerders en vorige blootstelling aan ‘n konvensionele snoepie. ‘n Veelvoudige benadering soos die konsep van ‘n Gesondheidbevorderingskool word aanbeveel.

No description available.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2006. / Background At least 40 - 80% of all cancer patients develop some degree of clinical malnutrition and cachexia. The complex and multi-factorial nature of cancer cachexia and the inability of conventional nutrition intervention to reverse or attenuate the effects of this syndrome have driven investigators to consider new therapies and approaches to manage the syndrome of cancer cachexia including eicosapentaenoic acid (EPA), an n-3 fatty acid of fish oil origin. Objectives The aim of this study was to review Phase I, Phase II and Phase III (RCT) trials investigating the safety and efficacy of n-3 supplementation in the treatment of cancer cachexia in adult patients with unresectable solid tumours, with special reference to weight loss, body composition, appetite, dietary intake, energy expenditure, functional status, acute phase response and quality of life. Adverse effects associated with EPA supplementation were also reviewed. Methodology and data collection The major databases were systematically searched for studies that met the inclusion criteria using a structured keyword search strategy or various combinations of these keywords. Relevancy of studies was assessed by two independent reviewers according to pre-determined inclusion and exclusion criteria. Quality was assessed by two independent reviewers using the Jadad scale. Data extraction was performed by the principal reviewer and one of the independent reviewers, and investigators of the included studies were contacted where further information was required. Meta-analysis was not appropriate due to heterogeneity of the data. However, where possible, the paired t-test was used for analysis of the data. Descriptive or non-quantitative analysis of the tabulated data provided a summary of the characteristics of the included studies enabling comparisons to be made between interventions and outcomes within the specified population. Results The search resulted in a total of 1408 citations, of which only 16 studies met the inclusion and exclusion criteria. Of these, only 4 studies were of a good quality. Although the reported data was incomplete and variable, the combined analyses suggested that the effect of EPA supplementation on weight, fat mass, dietary intake, energy expenditure, and acute phase response was not significant. Interestingly there appeared to be a significant increase increased or decreased? in lean body mass (p<0.05). There was little or no data to draw any conclusions regarding the effect of supplementation on appetite and quality of life. Conclusion Despite several limitations in this review, the data collected and analysed are suggestive of the beneficial effects of EPA supplementation, but there remains a significant lack of substantial evidence and conclusive statistical analysis to confirm that EPA supplementation is a safe and effective method of intervention in the management of patients with cancer cachexia.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2006. / OBJECTIVE: The primary aim of the study was to determine the nutritional status of vegetarian and non-vegetarian students in relation to their dietary preferences and risk factors (dietary, physical inactivity and obesity) for CHD. DESIGN: Cross-sectional analytical study. Setting: The Adventist International Institute of Advanced Studies (AIIAS) situated in the province of Cavite, Philippines. METHODS: The sampling frame was all graduate students at AIIAS (n=203). Of these students 153 returned the distributed dietary questionnaires which determined dietary practices, thus yielding a stratified random sample of 70 registered students (≥20y and ≤50y) who met the inclusion criteria of the study. Three 24-hour recalls and a self-administered food frequency questionnaire assessed dietary practices. Lifestyle was assessed by means of questionnaires, which also included the socio-demographic characteristics of the subjects. Anthropometric measurements included height, weight and waist circumferences. RESULTS: Seventy subjects participated in the study [non-vegetarian (n=38) and vegetarian (n=32)]. The mean age of subjects was 33.3 [(SD) 1.6] and 38.4 (1.9) years for non-vegetarian and vegetarian males respectively, with the respective means for females being 35.7 (2.0) and 33.2 (2.1) years. The majority of the vegetarians’ income was insignificantly below $10.000 as compared with that of non-vegetarians’, in whom annual income earned was within the $10.000- $50.000 range per year. Variations in level of education between the dietary groups were small and inconsistent, most of whom were characterized by a high education level. Within this cohort, mean BMI and WC were insignificantly lower in the vegetarians when compared with the non-vegetarians. For males, the prevalence of overweight, pre-obese and obese (p>0.05) for non-vegetarians was insignificantly higher than vegetarians. Insignificantly, female vegetarians were more pre-obese than non-vegetarians. As far as waist circumference was concerned, the prevalence of subjects observed in the alerting (≥94cm) and action zone (≥102cm) (p≤0.05) was 21% and 4% for non-vegetarian males, while 0% and 6% for vegetarian males. For females, more vegetarians were insignificantly prevalent in the alerting zone (≥80cm) as compared to the nonvegetarians. Both dietary cohorts illustrated no considerable differences that exemplified moderate to a high level of physical activity. All subjects, regardless of dietary preference, were non-smokers and consumed no alcohol (p>0.05). Overall, mean daily nutrient intake met current recommendations and there was no statistically significant difference between the two cohorts, except for fat and saturated fatty acids (SFA), which was higher among the non-vegetarians. Carbohydrate and fiber consumption was greater in the vegetarians. According to the DRIs, there were no intakes above the UL, however inadequate intakes of calcium and zinc posed possible risk of deficiency for both dietary groups. CONCLUSIONS: A small percentage of subjects in both cohorts were at risk of CHD morbidity. Both groups followed good lifestyle habits with dietary choices being of greater concern among non-vegetarians.

This thesis project will investigate the effects of fasting on the serum levels of two key regulatory hormones, insulin and thyroid hormone (T3) and the effects of these hormones on the trafficking of Glut4 on soleus muscle.

Typescript (photocopy). / Digitized by Kansas Correctional Industries

Typescript (photocopy). / Digitized by Kansas Correctional Industries

published_or_final_version / Biological Sciences / Master / Master of Philosophy

Trained male cyclists (6 in study 1, 5 in study 2) cycled to exhaustion (EXH) at 75% of VO₂ max twice; once in the non-supplemented (NS) state and once in the vitamin B-6 (B-6)(20 mg PN) supplemented (S) state. The diet contained 2.3 mg B-6 in study 1 and 1.9 mg B-6 in study 2. Urine was collected during each dietary period. During each exercise (EX) test, blood was drawn prior to (PRE), one hour during (DX), immediately after (POST) and one hour after (POST 60) EX and sweat was collected. Compared to baseline (PRE) levels, plasma pyridoxal 5'-phosphate (PLP) and vitamin B-6 (PB-6) concentrations increased at DX, decreased at POST, and decreased below PRE at POST 60 in the NS and S states. EX to EXH in the S state resulted in a greater increase in PLP DX in study 1 (31% increase vs. 16%) and PB-6 in study 2 (25% increase vs. 11%) as compared to the NS state. Red blood cell (RBC) PLP significantly increased from POST to POST 60 in the S state in study 2. The excretion of urinary 4-pyridoxic acid (4-PA) and urinary B-6 (UB-6) was not significantly altered by EX to EXH. The mean excretion of 4-PA was significantly greater in the NS state in study 2 (7.98 ±1.83 mmol/d) as compared to the excretion in study 1 (6.20 ±0.93 mmol/d), whereas the excretion was significantly greater in the S state in study 1 (92.2 ±8.69 mmol/d) compared to the excretion in study 2 (82.7 ±6.16 mmol/d). The percent of B-6 intake excreted as UB-6 (6% in study 1 and 10% in study 2) was significantly different between the studies in the NS state. Vitamin B-6 supplementation did not significantly alter the rise in growth hormone (hGH) concentration seen with EX to EXH. The loss of B-6 in sweat with EX to EXH was not altered by B-6 supplementation. The loss of B-6 in sweat ranged from 0.0011 mmol to 0.0039 mmol. Therefore, EX to EXH in the B-6 S state resulted in a greater increase in plasma PLP and PB-6 DX as compared to the NS state. The decrease in PB-6 and PLP at POST 60 in the S state coincided with a significant increase in RBC PLP, suggesting the movement of B-6 from the plasma into the RBC at POST 60. EX to EXH and B-6 supplementation did not alter the excretion of 4-PA or UB-6 suggesting that B-6 metabolism was unchanged. The loss of B-6 in sweat was comparable to previously reported values and was not altered by B-6 supplementation. B-6 supplementation did not alter the changes in hGH resulting from EX to EXH alone. / Graduation date: 1995