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Faber M.,Nutritional Intervention Research Unit | Laubscher R.,Biostatistics Unit | Laurie S.,Agricultural Research Council Vegetable and Ornamental Plant Institute
Maternal and Child Nutrition | Year: 2013

Availability and consumption of fruits and vegetables were assessed in peri-urban households in KwaZulu-Natal Province, South Africa. Caregivers of 400 randomly selected grade 6 and 7 learners were interviewed using a questionnaire that included unquantified food frequency questions. Using a repeated 24-h dietary recall, dietary intake was quantified for learners, caregivers and 2- to 5-year-old children in the household. Usual household fruit and vegetable consumption was expressed over three Living Standard Measure (LSM) categories. Average per capita intake of fruit and/or vegetables was 99g for 2- to 5-year-old children and 124g for caregivers. For consumers, fruits and/or vegetables contributed towards total dietary intake of fibre (16-21%), calcium (13-21%), vitamin A (27-31%) and vitamin C (47-62%). For households not consuming fruits (n=297) and vegetables (n=178) daily, cost was the major constraint (≥75%). Of all households, 52% had fruit trees and 25% had a vegetable garden. Animals destroying vegetables was the major constraint to 59% of vegetable growers. Household consumption of fruits and vegetables increased over the LSM categories. Caregivers in the higher LSM group more likely used printed material for information on healthy eating, had fruit trees, were confident about vegetable gardening and sold some of their produce. To enable peri-urban populations of low socio-economic status to consume more frequently a bigger variety of fruits and vegetables, the cost of purchasing these food items needs to be addressed by government and business sector. Households should further receive support to overcome constraints which hamper the success of home gardens. © 2011 John Wiley & Sons Ltd.


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.


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.


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.


Uusiku N.P.,University of Pretoria | Oelofse A.,University of Pretoria | Duodu K.G.,University of Pretoria | Bester M.J.,University of Pretoria | Faber M.,Nutritional Intervention Research Unit
Journal of Food Composition and Analysis | Year: 2010

This paper reviews the literature on African leafy vegetables (ALVs) consumed in sub-Saharan Africa. The aim is to evaluate the nutritional value of these plant species and their potential impact on the nutritional status of the people living in sub-Saharan Africa. Processing and the presence of antinutritional factors are taken into consideration as they adversely affect the nutritional content of the ALVs. The role of dietary fiber and other important components found in ALVs is also discussed due to their importance in the prevention of chronic and lifestyle diseases. Many of the ALVs are good sources of micronutrients, especially Manihot esculenta which contains 1970μg retinol equivalents/100. g edible portion and 311. mg/100. g of vitamin C, as well as Chenopodium album with up to 6. mg/100. g iron, 18.5. mg/100. g zinc, 226. mg/100. g calcium and up to 211. mg/100. g magnesium. These vegetables may help to meet daily requirements of these and other essential nutrients, especially in individuals with marginal nutritional status. Furthermore, ALVs such as Arachis hypogea and Bidens pilosa are good sources of dietary fibre, while Nasturtium aquatica, Urtic dioica and Xanthosoma mafaffa are excellent free radical scavengers. In many instances ALVs have levels of these components that are higher than those of exotic vegetables such as spinach and cabbage. Factors such as storage, cooking methods and drying influence the micronutrient, antioxidant and antinutritional factor content of these vegetables. The consumption, cultivation and possibly the commercialization of these ALVs should therefore be promoted. © 2010 Elsevier Inc.


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.


Jooste P.L.,Nutritional Intervention Research Unit | Strydom E.,Nutritional Intervention Research Unit
Best Practice and Research: Clinical Endocrinology and Metabolism | Year: 2010

Good quality data on iodine concentrations in urine and salt samples are indispensable for the efficient management of national salt iodisation programmes and for evaluating iodine interventions. Most of the analytical methods for urinary iodine concentration are based on the manual spectrophotometric measurement of Sandell-Kolthoff reduction reaction catalysed by iodine using different oxidising reagents in the initial digestion step. Other analytical methods include semi-quantitative methods, a microplate method, automated methods; and the technologically advanced methods include the inductively coupled plasma mass-spectrometer method. Iodine in salt is determined quantitatively by the titration method, colorimetrically by the WYD iodine checker or by a technologically advanced potentiometric method. Worldwide, titration is the method of choice because of its accuracy, ease of operation and low cost. Rapid test kits are suitable for qualitative use in situations where iodised salt need to be distinguished from non-iodised salt, preferably with titration back-up. © 2009 Elsevier Ltd. All rights reserved.


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®.


Opperman M.,Cape Peninsula University of Technology | Marais D.W.,Nutritional Intervention Research Unit | Benade A.J.S.,Cape Peninsula University of Technology
Cardiovascular Journal of Africa | Year: 2011

Introduction: Substantial evidence describes the protective effects of marine-derived omega-3 (n-3) polyunsaturated fatty acids (PUFA) on cardiovascular diseases as well as many other conditions. Numerous fatty acid preparations are marketed for supplementing the Western diet, which is low in n-3 fats. Since these preparations may vary in their n-3 PUFA content, we tested 45 commercially available products on the South African market for their fatty acid composition. Method: Forty-five commercially available n-3 fatty acid supplements were analysed using gas-liquid chromatography to determine their fatty acid content. Results: More than half of the n-3 supplements available on the South African market contained ≤ 89% of the claimed content of EPA and/or DHA as stated on the product labels. To meet ISSFAL's recommendation of 500 mg EPA + DHA/ day can cost consumers between R2 and R5 per person per day (R60 to R150 p/p/month). Regarding rancidity, the majority of capsules contained conjugated diene (CD) levels higher than that of vegetable oil obtained from opened containers (three months) used for domestic cooking purposes, despite the addition of vitamin E as antioxidant. Conclusion: Since no formal regulatory structure for dietary supplements currently exists in South Africa, consumers depend on self-regulation within the nutraceutical industry for assurance of product quality, consistency, potency and purity. Our results indicate that more than half of the n-3 fatty acid supplements on the South African market do not contain the claimed EPA and/or DHA contents as stated on product labels, and they contained CD levels higher than that in unused vegetable oils obtained from opened containers used for domestic cooking purposes.


Faber M.,Nutritional Intervention Research Unit | Laurie S.,Agricultural Research Council Roodeplaat Vegetable and Ornamental Plant Institute | Maduna M.,National School Nutr. Prog. Direct. Sustainable Food Prod. in Schools SFPS and Nutrition Education | Magudulela T.,National School Nutr. Prog. Direct. Sustainable Food Prod. in Schools SFPS and Nutrition Education | Muehlhoff E.,Nutrition Education and Consumer Awareness Group
Public Health Nutrition | Year: 2014

Objective To assess the school food environment in terms of breakfast consumption, school meals, learners' lunch box, school vending and classroom activities related to nutrition. Design Cross-sectional survey. Setting Ninety purposively selected poorly resourced schools in South Africa. Subjects Questionnaires were completed by school principals (n 85), school feeding coordinators (n 77), food handlers (n 84), educators (n 687), randomly selected grade 5 to 7 learners (n 2547) and a convenience sample of parents (n 731). The school menu (n 75), meal served on the survey day, and foods at tuck shops and food vendors (n 74) were recorded. Results Twenty-two per cent of learners had not eaten breakfast; 24 % brought a lunch box, mostly with bread. Vegetables (61 %) were more often on the school menu than fruit (28 %) and were served in 41 % of schools on the survey day compared with 4 % serving fruit. Fifty-seven per cent of learners brought money to school. Parents advised learners to buy fruit (37 %) and healthy foods (23 %). Tuck shops and vendors sold mostly unhealthy foods. Lack of money/poverty (74 %) and high food prices (68 %) were major challenges for healthy eating. Most (83 %) educators showed interest in nutrition, but only 15 % had received training in nutrition. Eighty-one per cent of educators taught nutrition as part of school subjects. Conclusions The school food environment has large scope for improvement towards promoting healthy eating. This includes increasing access to vegetables and fruit, encouraging learners to carry a healthy lunch box, and regulating foods sold through tuck shops and food vendors. Copyright © The Authors 2013.

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