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Cape Town, South Africa

Charlton K.E.,University of Wollongong | Jooste P.L.,Nutritional Intervention Research Unit | Steyn K.,University of Cape Town | Levitt N.S.,University of Cape Town | Ghosh A.,University of Wollongong
Nutrition | Year: 2013

Objective: Universal salt iodization is an effective strategy to optimize population-level iodine. At the same time as salt-lowering initiatives are encouraged globally, there is concern about compromised iodine intakes. This study investigated whether salt intakes at recommended levels resulted in a suboptimal iodine status in a country where salt is the vehicle for iodine fortification. Methods: Three 24-h urine samples were collected for the assessment of urinary sodium and one sample was taken for urinary iodine concentrations (UICs) in a convenience sample of 262 adult men and women in Cape Town, South Africa. Median UIC was compared across categories of sodium excretion equivalent to salt intakes lower than 5, 5 to 9, and greater than or equal to 9 g/d. Results: The median UIC was 120 μg/L (interquartile range 75.3-196.3), indicating iodine sufficiency. Less one-fourth (23.2%) of subjects had urinary sodium excretion values within the desirable range (salt <5 g/d), 50.7% had high values (5-9 g/d), and 22.8% had very high values (≥9 g/d). No association between urinary iodine and mean 3 × 24-h urinary sodium concentration was found (r = 0.087, P = 0.198) and UIC status did not differ according to urinary sodium categories (P = 0.804). Conclusion: In a country with mandatory universal salt iodization, consumers with salt intakes within the recommended range (<5 g/d) are iodine replete, and median UIC does not differ across categories of salt intake. This indicates that much of the dietary salt is provided from non-iodinated sources, presumably added to processed foods. © 2013 Elsevier Inc. Source


Faber M.,Nutritional Intervention Research Unit
Livestock Science | Year: 2010

Childhood malnutrition is highly prevalent in developing countries. Globally 35% (3.5 million) of child deaths before the age of five years were attributed to under nutrition in 2004. Vulnerable communities generally consume a diet based mainly on plant-based staples, and a low consumption of animal source foods, fruit and vegetables predisposes these communities to micronutrient deficiencies. In this paper, South African data is used to illustrate the poor diet and consequences thereof in vulnerable communities. Childhood malnutrition and maternal overweight often co-exist in the same community. Dietary modification strategies to address malnutrition should therefore focus on the nutritional quality of the diet, rather than on energy content only. Animal foods are particularly rich sources of bio-available iron, zinc and vitamin A (the micronutrients of greatest concern), and these nutrients are difficult to obtain in adequate amounts from plant foods alone. Foods of animal sources (particularly muscle tissue) also enhance the absorption of the less bio-available non-heme iron. Dietary modification strategies need to be introduced from a very young age. In the developed world, commercially available baby products play an important role in meeting the nutritional requirements of infants, but in developing countries cost and possible contamination (bottle feeds) prohibit the use of baby products. Addition of small amounts of foods of animal sources can improve the nutritional quality of the diet, as well as the nutritional status and functional outcomes of vulnerable populations. A moderate increase in the consumption of animal source foods will provide critical nutritional benefits without a significant increase in the risk of chronic diseases in the poor. Constraints for frequent consumption of animal source foods include availability, affordability and lack of cold storage facilities. Adequate dietary intake is essential for good nutrition, but frequent infections can also lead to malnutrition. The underlying causes of malnutrition, i.e. inadequate care on the one hand, and insufficient health services and an unhealthy environment on the other hand, should also therefore be addressed. © 2010 Elsevier B.V. All rights reserved. Source


Drimie S.,Stellenbosch University | Faber M.,Nutritional Intervention Research Unit | Vearey J.,University of Witwatersrand | Nunez L.,University of Witwatersrand
BMC Public Health | Year: 2013

Background: This paper considers the question of dietary diversity as a proxy for nutrition insecurity in communities living in the inner city and the urban informal periphery in Johannesburg. It argues that the issue of nutrition insecurity demands urgent and immediate attention by policy makers. Methods. A cross-sectional survey was undertaken for households from urban informal (n = 195) and urban formal (n = 292) areas in Johannesburg, South Africa. Foods consumed by the respondents the previous day were used to calculate a Dietary Diversity Score; a score < 4 was considered low. Results: Statistical comparisons of means between groups revealed that respondents from informal settlements consumed mostly cereals and meat/poultry/fish, while respondents in formal settlements consumed a more varied diet. Significantly more respondents living in informal settlements consumed a diet of low diversity (68.1%) versus those in formal settlements (15.4%). When grouped in quintiles, two-thirds of respondents from informal settlements fell in the lowest two, versus 15.4% living in formal settlements. Households who experienced periods of food shortages during the previous 12 months had a lower mean DDS than those from food secure households (4.00 ± 1.6 versus 4.36 ± 1.7; p = 0.026). Conclusions: Respondents in the informal settlements were more nutritionally vulnerable. Achieving nutrition security requires policies, strategies and plans to include specific nutrition considerations. © 2013 Drimie et al.; licensee BioMed Central Ltd. Source


Mkhize-Kwitshana Z.L.,University of KwaZulu - Natal | Taylor M.,University of KwaZulu - Natal | Jooste P.,Nutritional Intervention Research Unit | Mabaso M.L.H.,Human science Research Council | Walzl G.,Stellenbosch University
BMC Infectious Diseases | Year: 2011

Background: The convergent distribution of the Human Immunodeficiency Virus (HIV) and helminth infections has led to the suggestion that infection with helminths exacerbates the HIV epidemic in developing countries. In South Africa, it is estimated that 57% of the population lives in poverty and carries the highest burden of both HIV and helmith infections, however, the disease interactions are under-researched.Methods: We employed both coproscopy and Ascaris lumbricoides-specific serum IgE to increase diagnostic sensitivity and to distinguish between different helminth infection phenotypes and their effects on immune responses in HIV co-infected individuals. Coproscopy was done by formol ether and Kato Katz methods. HIV positive and negative adults were stratified according to the presence or absence of A. lumbricoides and/or Trichuris trichuria eggs with or without elevated Ascaris IgE. Lymphocyte subsets were phenotyped by flow cytometry. Viral loads, serum total IgE and eosinophils were also analysed. Lymphocyte activation markers (CCR5, HLA-DR, CD25, CD38 and CD71) were determined. Non parametric statistics were used to describe differences in the variables between the subgroups.Results: Helminth prevalence ranged between 40%-60%. Four distinct subgroups of were identified, and this included egg positive/high Ascaris-specific IgE (egg+IgEhi), egg positive/low IgE (egg+IgElo), egg negative/high IgE (egg-IgEhi) and egg negative/low IgE (egg-IgElo) individuals. The egg+IgEhisubgroup displayed lymphocytopenia, eosinophilia, (low CD4+counts in HIV-group), high viral load (in HIV+group), and an activated lymphocyte profile. High Ascaris IgE subgroups (egg+IgEhiand egg-IgEhi) had eosinophilia, highest viral loads, and lower CD4+counts in the HIV-group). Egg excretion and low IgE (egg+IgElo) status demonstrated a modified Th2immune profile with a relatively competent response to HIV.Conclusions: People with both helminth egg excretion and high Ascaris-IgE levels had dysregulated immune cells, high viral loads with more immune activation. A modified Th2helminth response in individuals with egg positive stools and low Ascaris IgE showed a better HIV related immune profile. Future research on helminth-HIV co-infection should include parasite-specific IgE measurements in addition to coproscopy to delineate the different response phenotypes. Helminth infection affects the immune response to HIV in some individuals with high IgE and egg excretion in stool. © 2011 Mkhize-Kwitshana et al; licensee BioMed Central Ltd. Source


Rautenbach F.,Cape Peninsula University of Technology | Faber M.,Nutritional Intervention Research Unit | Laurie S.,Agricultural Research Council Roodeplaat Vegetable and Ornamental Plant Institute | Laurie R.,Agricultural Research Council Roodeplaat Vegetable and Ornamental Plant Institute
Journal of Food Science | Year: 2010

The antioxidant contents (β-carotene, chlorogenic acid, and vitamin C) as well as the antioxidant capacity (ORAC, FRAP, and ABTS) of 4 sweetpotato varieties were measured in this study. The sweetpotato varieties were cultivated under different water regimes and also subjected to thermal processing. The results show that the 2 orange-fleshed varieties (Resisto and W-119) contain significant more β-carotene, chlorogenic acid, and vitamin C than the 2 cream-fleshed varieties (Bosbok and Ndou). Thermal processing decreased the carotenoid and vitamin C content of all the varieties but increased the chlorogenic acid content and antioxidant capacity. Drought stress appears to increase the β-carotene, vitamin C, and chlorogenic acid contents as well as the antioxidant capacity of some of the sweetpotato varieties, especially W-119. © 2010 Institute of Food Technologists®. Source

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