Theses and dissertations (Applied Sciences)

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Application of thermostable a-Amylase from Thermomyces lanuginosus ATCC 58157 to nutritionally enhance starch based food
(2006) Padayachee, Thiriloshani
In Sub-Saharan Africa there is an urgent need to sustain and improve the quality of its food resources. Poverty eradication features high on the agenda of a number of world health organisations, while the number of underweight children in Africa continues to increase (Pellet, 1996). Providing nutritionally enhanced foods to the poor will help towards achieving this objective. Protein-energy malnutrition has been identified as one of the most important problems facing Africa, with maize as the staple diet (Nkama et al., 1995). However, a combination of several factors limits availability and the nutritional quality of maize. During starvation, energy and protein intakes decrease by 20-30%, with most of the children in Africa having an average protein intake of only 20 g per day (Igbedioh, 1996). Energy availability also affects protein utilization because of interrelationships of protein and energy metabolism (Elwyn, 1993). The diets of inhabitants in developing regions depend mainly on cereals (maize) for both protein and dietary energy which lacks indispensable amino acids, minerals, vitamins and carbohydrates. In light of these growing concerns an attempt was made to devise a scientific strategy to combat the nutritional shortfalls of maize meal. A multidisciplinary and concerted approach was followed within this project aimed at designing an improved thermostable amylase and applying the enzyme to nutritionally enhance maize meal. It was envisaged that the manipulation of maize meal, by the application of enzyme technology will improve the nutritional status of this staple food. The consequences is that an alternate solution for the eradication of an ailing, poverty stricken and malnourished African population is achievable. It is possible that the boundaries defining the limits of life will extend to even greater extremes through the application of novel technologies.
The consumption, product compliance and manufacturer insights of plant-based foods in KwaZulu-Natal
(2024-09) Govender, Camilla; Naicker, Ashika; Makanjana, Onwaba
Background: The term plant-based diet focuses predominantly on the consumption of food from plants. A plant-based diet consists mainly of wholegrains, fruits, vegetables, legumes, nuts, seeds and may also include more processed food products made from these ingredients. Food is the single most powerful lever to optimise human health and environmental sustainability. A large body of work has emerged on the environmental impact of various diets. As per the findings of the Environmental Assessment and Reference Tool (EAT)-Lancet Commission, many studies have concluded that a diet rich in plant-based foods (PBFs) has improved health and also environmental benefits. This transition has led to a noteworthy increase in the demand for PBFs globally, and South Africa is no exception. Aim: This study aimed to determine the consumption, product compliance and manufacturer insights of plant-based foods in KwaZulu-Natal (KZN). Methods: This study used a mixed methods approach, namely, qualitative and quantitative research methodology. The first objective of this study was to determine the consumption of PBFs and identify barriers and facilitators influencing the adoption of plant-based diets through a consumer survey. The study's second objective was to document the scope of plant-based products in terms of availability through in-store and online observations that were available in KZN. All products were analysed to determine the scientific and regulatory compliance of plant-based products by analysing food labels according to the Foodstuffs, Cosmetic and Disinfectant Act (Act 54, 1972), R146 Regulation relating to the labelling and advertising of foodstuffs. The qualitative aspect of the study delved into the product development practices, trends and challenges of plant-based manufacturers in South Africa through key informant interviews. The adequacy of the diet among consumers (n=100) who consumed plant-based foods was assessed through two 24-hour food recalls and analysed for dietary adequacy. Results: Three hundred and eighty consumers participated in the online survey, of which 67.7% (n=259) of participants were women and 31.3% (n=120). Regarding the frequency of consumption of PBFs, 47% (n=180) of participants consumed PBFs between 2 to 3 times a week, 27.7% (n=106) of participants consumed PBFs daily, 17.2% (n=66) of participants consumed PBFs once a week, and 4.2% (n=16) of participants consumed PBFs once a month. A significant 63.4% (n=243) of participants indicated that they spend at most R60.00 on plantbased products, p<0.001. Using the binomial test to assess if any response option was selected significantly more than others, a significant number of participants (80% n=307) p<0.001, reported that they consumed PBFs for health reasons, followed by 37% (n=142) who reported that they consumed PBFs due to religious reasons. A significant 64% (n=245) and 58.5% (n=224) of participants reported that the most common format of plant-based meat alternatives that they consumed were burgers and sausages, respectively (p<0.001). The findings of this study also revealed that there are many challenges and barriers that are associated with the adoption of PBFs. This study found that 58.5% of participants (n=224) reported that PBFs were expensive (p<0.001), and 40.5% of participants (n=155) indicated that PBFs were limited and lacked variety. A comprehensive database of plant-based products (n=431) in the South African market was documented through in-store and online observations. Eighty-nine percent (n=386) of the products documented were manufactured in South Africa.. Regarding South Africa's labelling regulation, 95% (n=411) of the plant-based products complied with legislation. Key informant interviews were conducted with manufacturers to understand the market trends and constraints within the South African plant-based food sector. Key themes emerging from the key informant interviews included consumer-centric PBFs, consumer-driven plant-based trends, growth in the plant-based market, dynamic and evolving plant-based product development, challenges in PBF manufacture and marketability, insufficient government support and market-related price of PBFs. Furthermore, the adequacy of plant-based diets was analysed using the 24-hour food recall (n=92). The majority of nutrients fell below the EAR for both males and females. Both groups exhibited dietary inadequacies in specific micronutrients: vitamin D, folate, vitamin B12, and iron. Dietary inadequacy of specific micronutrients was noted for vitamin D, Folate, vitamin B12 and iron in both groups. However, there was notable carbohydrate excess intake across both groups and genders, surpassing the recommended estimate for energy. Conclusion: This study comprehensively examined the consumption patterns, product compliance, and manufacturer insights of PBFs in KZN. The findings reveal a growing interest in flexitarian diets and frequent consumption of PBFs, driven primarily by health motivations but hindered by cost and limited variety. Retail availability of PBFs in KZN is extensive, offering consumers a wide range of choices in both fresh and frozen categories, reflecting the robust state of the plant-based industry in KZN and it can be reasonably generalised to the whole country Regulatory compliance among PBFs is generally high, although small-scale manufacturers occasionally fall short of labelling standards. Manufacturer insights indicate a consumer-driven demand for PBFs that closely mimic meat products, necessitating innovation and regulatory support to stabilise this emerging market. Nutritional assessments of plant-based diets highlight a critical need for dietary supplementation to address deficiencies in essential vitamins and minerals such as B12, iron, and zinc. The study underscores the importance of nutrition education to guide consumers towards healthier food choices within plant-based diets. In conclusion, while the plant-based food sector in KZN is expanding and meeting many consumer needs, there are significant opportunities for improvement in product variety, affordability, regulatory compliance, and nutritional adequacy. Addressing these challenges through coordinated efforts among stakeholders can further enhance the adoption and benefits of plant-based diets. The conclusions drawn from this study can be reasonably generalised to metropolitan areas of the whole country.
Development of a community engagement capacity building programme within a social justice framework for Consumer Science Food and Nutrition students at the Durban University of Technology
(2017) Grobbelaar, Hendrina Helena; Napier, Carin E.; Maistry, Savathrie
The focus of this study is to develop a capacity building programme that prepares students for service learning (SL) with the purpose of developing social responsibility and active critical citizenship underpinned by a social justice paradigm at a University of Technology (UoT). In developing countries such as South Africa that still experience severe injustices and inequality of access to, for example, certain services such as health services, it is impossible to ignore issues of human and social development and poverty reduction when promoting the university’s role in development. The developmental role of HEIs has been reinforced through the introduction and formalization of Community Engagement (CE) as a core function of higher education together with teaching and learning and research. When examining the role of universities in educating students for social responsibility and critical citizenship, it is evident that the biggest area of growth of CE has been in the form of Service Learning (SL) and community service. The study posits that in the South African context of HEIs, the potential for fostering, specifically critical discourse and creative thinking exists in what are termed as traditional universities because of the nature of the varied disciplines offered at these institutions. On the other hand, UoTs focused predominantly on the technical study field and on training students for the market place. The emphasis on Work Integrated Learning (WIL) and industry placements narrowed the focus and excluded insights into South Africa’s diversity and socioeconomic issues in the curriculum. The concept of social responsibility within a social justice paradigm is a foreign concept at UoTs in particular. To facilitate SL within a social justice paradigm and to address issues of injustice and inequality in SA at universities, the question that needs to be asked is: how should the preparation of students be shaped to adequately prepare them to become justice-orientated, socially and civically responsible students without compromising their work preparedness? This bigger question leads to the specific question of the study, which is: if the department of Food and Nutrition Consumer Sciences at the Durban University of Technology (DUT) is to develop justice orientated, socially and civically responsible students, what theoretical and philosophical considerations should guide the development of a SL capacity building programme? To achieve the purpose of the study the following objectives were identified: firstly, establish the effectiveness of the current preparation of Food and Nutrition students for SL to foster justice-orientated social and civic responsibility; secondly, determine the theoretical and philosophical considerations that should guide the development of students’ justice-orientated social and civic responsibility through SL in the field of Food and Nutrition; thirdly, develop and implement a SL capacity building programme to foster social responsibility and critical active citizenship within a social justice paradigm; finally, develop a framework for a social justice-orientated SL capacity building programme post evaluation A sequential exploratory mixed methods research protocol was applied in this study. The research process consisted of three phases. Phase I entailed the exploration of the research question with qualitative data collection (focus groups) and analysis. This phase was followed by a developmental phase (Phase II) during which the qualitative results and the theoretical and philosophical considerations evident in the literature were used to develop a capacity building programme. The programme was implemented and the impact of the programme was evaluated in Phase III through the application of the Civic Attitudes and Skills Questionnaire (CASQ). Purposeful sampling was applied in Phases I (qualitative phase) and III (quantitative phase). During phase I five focus groups were conducted (n = 43). Phase III sample consisted of two groups namely, the experimental group (n = 19) and a control group (n = 24). Focus group interviews were recorded and transcribed verbatim after which the data was coded followed by a thematic analysis. The data from the CASQ was captured on Microsoft Excel® and analysed according to CASQ scales using the Statistical Package for Social Sciences (SPSS) version 23 to determine mean and standard deviations. A paired sample 2-tailed t-test was used to determine statistical significant differences between the pre- and post-test. Results from phase I confirmed students’ understanding of CE is mostly a charitable view with little emphasis on addressing social justice issues. The results showed that SL as currently planned and executed seems to perpetuate and reinforce existing social hierarchies and paternalism. The most common expectation of participating in CE from students was to apply skills and theoretical knowledge in a community setting. Students also commented that they expected to be developed personally and to learn about others. Additionally, it is evident from the results that students did not indicate any changes in their social justice awareness. The programme developed in phase II was within the framework of four dimensions including self-awareness, awareness of others, awareness of social issues and change agent as critical to preparing students for SL with the purpose of fostering social responsibility and active critical citizenship within a social justice paradigm and guided by the Ubuntu philosophy, Freire’s critical pedagogy and Mezirow’s transformative learning theory. The results of phase III showed that the experimental group who participated in the capacity building programme showed a significant increase in the social justice related subscales indicating their intentions of future civic action and change in social justice attitudes. The results in the control group demonstrated a decrease in the mean values in the post-test for the social justice subscales. The experimental group also showed an increase in the interpersonal and problem-solving skills, leadership skills, diversity attitudes and course value subscales but it was not significant. An opposite pattern was demonstrated in the control group with significant decreases in the interpersonal and problem-solving skills, leadership skills, diversity attitudes and course value. The results showed the significant impact of the capacity building programme on students’ awareness and understanding of social justice issues. Overall, the findings of the various phases assisted in refinement of the framework for a social justice orientated SL capacity building programme. The developed framework consists of five key components: philosophy that guides social justice oriented service learning; theories that underpin service learning; a pedagogy that would effectively enhance a social justice oriented SL experience; and praxis that integrates theory and practice.
Development, validation and implementation of a sustainable, nutrition-sensitive agriculture toolkit to address food and nutrition insecurity in Lesotho
(2024-09) Mothepu, Lisebo; Napier, Carin E.; Naicker, Ashika; Duffy, Kevin Jan
Background: Global food prices continue to increase because of natural and humaninduced disasterssuch as climate change and war. As a result, poverty remainsrelatively high globally, especially in lower-middle-income countries such as Lesotho. Poverty in Lesotho is rated at 49.7% with a staggering 24% of the population experiencing extreme poverty, and it is mostly prevalent in rural areas. Out of the population of over 2 million, approximately half of the populace survives below the poverty-line, and 58, 000 people continue to experience food insecurity. Lesotho ranks at 121st out of 125 countries with sufficient data to calculate 2023 GHI scores. Thehigherthe rank theworse the hungerindex. The Global Hunger Index recorded Lesotho’s hunger score at 32.4. This is categorised as alarming on the scale ranging from low to extremely alarming. Lesotho has been grappling with chronic food insecurity, with 61% of the population affected living in rural areas and 39% affected living in urban areas due to climate challenges such as heavy rains. In summary, severe food insecurity, decrease agriculture production, poverty, poor nutritional status, and HIV/AIDS decrease the quality of life in Lesotho. Aim: The main aim of the research study was to develop, validate, and implement, a sustainable nutrition-sensitive agriculture toolkit with two programs: sustainable agriculture and sustainable nutrition-sensitive agriculture. The toolkit was developed for rural small-scale female family farmers to provide for household consumption and local small-scale commerce. The study further aimed to introduce and educate female farmers in agri-business and agro- processing through the use of Greenhouse tunnels underpinned by sustainable agriculture, sustainable local community food systems, and sustainable nutrition-sensitive agriculture to address food and nutrition insecurity and attempt to decrease hunger at the community, household, and individual levels. Methodology: The sample size was n=126 females participants residing in rural households in the district of Mohale’s Hoek, Lesotho. The sample population age ranged from 20 to over 60 years. In this randomised control trial (RCT), a combination of quantitative and qualitative methods were used. The quantitative data was used to determine the interaction between socio-economic conditions, nutritional variety, nutritional competence, food consumption patterns, food security status, and agricultural practices. The qualitative data collection used was an observational research method under naturalistic and controlled observation. This approach involved manipulating and controlling the experimental and intervention research variables to determine cause and effect relationships. The control group participants were from Maqoala n=63, and the intervention group participants were from Mpharane n=63. The toolkit was developed using relevant literature for addressing poverty, hunger, food insecurity and nutrition insecurity. In addition, the toolkit was also developed using the results obtained from the study through the administered questionnaires: sociodemographic, household hunger scale and household food insecurity access scale, nutrition knowledge and anthropometry measurements for nutritional assessment, food frequency, 24-hour food recall, agricultural and knowledge practices, preparation, and preservation practices. The toolkit comprised of two programs: sustainable agriculture and sustainable nutrition-sensitive agriculture. The toolkit was validated through the Delphi method. The intervention was run for two years, to target three planting and harvesting seasons in both the control and experimental villages. Both the experimental and control group were allocated Greenhouse tunnels with irrigation systems, temperature control systems, storage facilities and food preparation facilities. The inputs given to each group included the allocation of inputs was seedsthat were certified by the government of Lesotho:round cabbage,spinach (Swiss chard), green beans (snap beans), red beetroot, carrots (Nantes), red bell pepper, tomato (stupice), butternut squash, potato (Vivaldi), and brown onion. The experimental group was given the researcher’s training manual together with the participants training manual. The experimental group was further trained using the manual. The control group, Maqoala, was given the training manuals, without any training. Results: Results indicated that all female participants (n=126) headed the households and were caregivers who resided with other people in the households. The majority of the households (61.9%) had one room, 16.7% had two rooms, and 11.9 % had three rooms with no electricity or running water in the houses. Notably, all participants were unemployed, and experienced anxiety over running out of food before having money to buy more. Almost 44% of the participants often had a shortage of money to buy food, and 45.2% of the participants sometimes had a shortage. The average monthly spending on food for 25.4% of the households was R201 to R300, whilst 36.5% of the households on average spent a between R301 to R400 on food each month. All the participants reported having a change in food intake due to decreased accessibility. Moreover, all the participants indicated that they consumed less food than required and had to cut the size of the food served to children because there was not enough food available. An estimate 89.7% of the participants skipped meals because there was not enough food to eat. The nutrient analysis from the 24-hour food recall indicated dietary inadequacy in energy, protein, calcium, and vitamins A, B6, B12, C, and E. When assessing the dietary diversity, the participants consumed more cereals and starchy foods, as reflected by the high carbohydrate Dietary Reference Intakes (DRIs). The Body Mass Index (BMI) of 4.7% of the participants from Maqoala was in the underweight BMI range compared to 3.1% of participants from Mpharane. The outcomes could also be influenced by a lack of nutrition knowledge as the average knowledge was 52.0%, ranging from 38 to 69% in both Mpharane and Maqoala.The results highlighted high levels of hunger, food insecurity and nutrition insecurity among the participants. The results supported the development, validation, and implementation of the toolkit through the Delphi method. Firstly, the toolkit focused on sustainable agriculture, planting vegetables, selling vegetables to generate money to buy seeds for the subsequent planting phases, and consumption and preservation of vegetables for households in the control and experimental groups. The intervention results indicated that Mpharane (experiment group) participants in phase 1, harvested 468 cabbage heads, sold 278 heads, and preserved 189 heads for household consumption. In phase 2, the number of cabbages increased to 612 heads; the participants sold 422 heads and preserved 189 heads for household consumption. In phase 3, 675 cabbage heads were harvested, 485 heads were sold, and 189 were preserved for household consumption. Mpharane had an increase of 144 heads of cabbage from phase 1, 468 heads of cabbage, to phase 2, 612 heads of cabbage, and in phase 3 (675 heads of cabbage), the increase was very low, with 63 heads of cabbage between phase 2 to phase 3. Maqoala (control group) participants did not sell any of the fresh produce they harvested. Instead, they shared the harvested fresh produce with each other. In phase 1, 567 cabbage heads were harvested, and 567 heads were shared among the n=63 participants for household consumption. In phase 2, the number of cabbage heads harvested increased to 627 heads and all 627 heads were shared among the participantsfor household consumption. In phase 3, 414 cabbage heads were harvested, and 414 heads were shared among the n=63 participants for household consumption. Maqoala produced a total of 1608 heads of cabbage between phases 1, 2 and 3, and Mpharane produced a total of 1755 heads of cabbage between phases 1, 2 and 3, 147 heads of cabbage more than Maqoala. The participants from experimental group harvested 519 bundles of spinach in Phase 1. In Phase 2, 834 bundles were harvested, 329 bundles in Phase 1, 644 bundles in Phase 2 were sold, and 189 bundles were preserved for household consumption. The participants harvested 1238 bundles of spinach in phase 3, and 1048 bundles were sold, whilst 189 were preserved for household consumption. The participants in Maqoala harvested 857 bundles of spinach and used all 857 bundles for household consumption. The experimental group had a vast increase in the bundles of spinach produced in phase 3, with 1238 bundles of spinach compared to phase 1, with 468 bundles, whilst phase 2, produced 612 bundles. The total of the bundles of spinach produced by the experimental group was 2591 bundles between phases 1, 2, and 3, whilst the control group produced 2196 bundles of spinach between phases 1, 2, and 3. The experimental group produced 396 bundles more than the control group. The toolkit introduced and educated the experimental group on agriculture practices, nutrition, and developing market products. At the baseline immediately after the lesson, the participants were assessed and scored 54% in lesson 1, 66% in lesson 2 and 80% in lesson 3. At the endline, the participants were not taught again but were expected to remember the previous lessons and practices they had done during the intervention. There was a decrease in the participants'scores atthe endline. The participantsscored 43% in lesson 1, 32% in lesson 2 and 65% in lesson 3. Conclusion: The findings indicated that poverty contributes to hunger, food and nutrition insecurity, and triple burden of malnutrition: undernutrition and overnutrition, and micronutrient deficiency in Lesotho. Food and nutrition insecurity can be addressed by integrating sustainable agriculture and sustainable nutrition-sensitive agriculture. Agriculture holds significant potential as it can contribute to addressing the primary causes of nutritionrelated problems, enhance worldwide food accessibility and availability and improve family food security, nutritional value, salary, and female empowerment. For these reasons, a sustainable nutrition-sensitive agriculture toolkit for small-scale female farmers with agribusiness and agro-processing components was developed from the Lesotho data and shown to improve household vegetable production and consumption. Agrifood systems contribute to high employment of females worldwide. Agrifood systems also contribute more to the livelihoods of females compared to males, mainly in developing countries. Enriching females and ending genderinequality under agrifood systems can improve the lives of the females and their homes, decrease starvation, increase earnings and strengthen resilience.
Fishing and fish consumption contributing to the nutrient profile, dietary diversity and food security of adult caregivers in a coastal community in Rivers State, southern Nigeria
(2019-06) Legbara, Kadi Prudence; Napier, Carin E.; Hart, A.
Introduction: The contribution of fishing practices and fish consumption to food and nutrition security cannot be over emphasized, particularly where large numbers of people are poor. Nutrition research has identified fish and fishery products as key components of human nutrition as well as one of the essential foods to incorporate into daily dietary food consumption based on its potential health benefits. These benefits have promoted the consumption of fish in recent times. Fish contains proteins, vitamins and fats (Omega 3 Polyunsaturated Fatty Acids) (PUFAs) among other nutrients (Domingo 2016: 979). Recently, there has been a notable increase in the harvesting of wild stocks of fish and shellfish. Oceans are currently at their maximum sustainable yields to cope with the world’s growing population and the demand for fish and shellfish. Overexploitation and the use of harmful chemicals used in harvesting fish and oil exploitation are some of the core reasons for the global decline of fish. These factors pose a threat to the ecological health of marine resources (Bennette and Dearden 2014: 107) and the economy of low-income countries whose livelihood largely depends on fishing for household and national food security sources (Sowman and Cardoso 2010: 1164). In the research community of Buguma, the decline of the fish population is attributed to the corrosion of pipelines, sabotage and mishandling of oil production operations. The petroleum and gas/oil products from this mismanagement find access directly into the rivers and creeks. The residue from these substances settles on the ocean floor, endangering the ecosystem by killing marine life such as fish and seafood. To this end, food and nutrition insecurity have become evident in the community as livelihoods are dependent on fishing and fish is a primary source of protein. Food insecurity is further aggravated by the high rate of unemployment and low educational attainment. The households are left to apply certain strategies to cope with household food shortfalls. Having to employ certain strategies to cope with food insecurity, negatively affects nutrient adequacy. Thus, inadequate nutrient intake and imbalances have resulted in poor health outcomes and malnutrition. Aim: The study aim was to determine the fishing practices and fish consumption contributing to the nutrient profile, dietary diversity and food security of adult caregivers in a coastal community. Methodology: Two hundred and forty-seven respondents were selected using a multi-stage sampling method. The sample size was calculated using a power calculation indicating that 250 respondents represents a reliable sample out of which 247 respondents completed the research instruments. Sampling procedures were multistage (cluster and random) sampling. The study was descriptive and quantitative in nature. Research tools used to collect data were a sociodemographic questionnaire, a fishing practices questionnaire, a coping strategies questionnaire, a food frequency questionnaire, 3x24-hour dietary recall questionnaires and an anthropometric measurement questionnaire. Food frequency and food security coping strategies questionnaires were compiled through focus group discussions to establish the relevant foods consumed and the respondents were interviewed for the socio-demographic, food frequency, food security coping strategies and fishing practices data. All the respondents were also weighed and measured in order to determine Body Mass Index (BMI), Waist Circumference (WC), Waist to Height Ratio (WHtR) and Blood Pressure (BP) classified in terms of World Health Organization (WHO) reference cut-off points. Socio-demographics, fishing practices, coping strategies and food frequency data were captured on Excel spread sheets and analyzed for descriptive statistics using the Statistical Package for Social Science (SPSS) version 24.0. Data from the 24-hour recall was captured and analyzed for nutrient analysis using the MRC Food Finder® version 3.0 software and comparisons were made to the recommended nutrient standards by the World Health Organization. Results: The mean age group was 31-50 years old. Sixty-one-point one percent (n=151) of the respondents were females and males made up 38.9% (n=96). Most of the fish caught by the respondents was used for consumption (64.0%; n=126) and the rest was used for income generation (36.0%; n=71). The community had on average a secondary school education (55.5%; n=137) and recorded high rates of unemployment (80.2%; n=198) with 62.3% (n=76) actively looking for employment. The respondents indicated that between one person (47.8%; n=118) and two people (46.2%; n=114) contributed to household income. Thirty-three-point two percent (n=82) had an average income of #21,000 to #30,000 (Rand value: R3100-R4000), while 25.5% had a monthly income of #31,000 to #40,000 (Rand value: R4100-R5000), accommodating six persons (42.1%; n=104) and four persons (22.3%; n=55) in the household. Thirty-seven-point seven percent (n=93) and 25.5% (n=63) respectively complained that the household “sometimes” and “always” had insufficient funds to buy food. This had led households to adopt certain coping strategies to combat food shortages. The most frequently used strategies per mean were: “relying on less expensive or preferred foods” (11.47 ±7.949), “limiting portion size” (9.73 ±2.593) and “restricting consumption by adults in order for children to eat” (8.70 ±6.628). The negative effect of applying these coping strategies adversely compromised nutrient adequacy. The 20 top consumed foods showed consumption of more energy dense foods and less fruits and vegetables. The Food Variety Score (FVS) indicated that 51 different individual food items with mean ±SD of 20.83. (±6.546) from all food groups were consumed. Vitamin K, Biotin, pantothenate, calcium, riboflavin and thiamine were below DRIs recommendation cutting across all age groups and genders. Inappropriate imbalances in food intake reflected in BMI, WC and WHtR. The mean BMI for men (25.07kg/m2) and women (27.66kg/m2) fells into the overweight category with a mean average of 26.36kg/m2 for both genders and age groups while only women (95.46cm) were majorly found to be at risk for an elevated WC/ central obesity per mean average. The WHtR at risk factor affected the female gender (88.70%; n=133, 19-50 years and 88.90%; n=18, 51+ years old) compared to their male (44.4%; n=78, 19-50 years and 61.1%; n=18, 51+years) counterparts. Mean high BP for systolic (146.9mmHg) and diastolic (92.2mmHg) BP occurred in women 51+ years old. Conclusion: This research revealed inappropriate eating patterns and increased risk of developing NCDs. The 20 top foods consumed showed consumption of mostly macronutrients and limited consumption of fruits and vegetables across both genders and all age groups. Overweight, at risk for WC and WHtR and High Blood Pressure (HBP) were an indication of the presence of NCDs. Food insecurity resulting from a jeopardized fishing livelihood, high levels of unemployment and low educational attainment were the main causes of a compromised nutritional status in the research community. The introduction of nutrition education and an alternative means of livelihood will assist in addressing the current food and nutrition insecurity.
Food consumption patterns and nutritional risks of women in low and middle income communities in KwaNdengenzi, KwaZulu-Natal
(2018) Gumede, Sthembile; Napier, Carin E.
Food consumption patterns have changed dramatically in the recent times, with traditional diets being replaced by so-called “westernised diets” and leading to nutritional risks such as malnutrition. Contributing factors are urbanisation, climate change, agricultural produce supply (food demand is greater than produce supply) and rising prices, to name but a few. The food security status is also in question as more and more South African households are said to be living in poverty and consequently undernourished even though the country was found to be nutritionally stable compared to previous years. Unemployment and lack of nutrition education also have an impact on communities, in terms of the food being purchased and consumed. The study was conducted to determine the socio-demographic status, food consumption patterns and nutritional risk of a low-income and middle-income community that resides in KwaNdengezi Township in KwaZulu-Natal. A sample of two hundred and fifty eight participants was required for the study. The households in both the north and south of KwaNdengezi Township were randomly selected by using the number of roads listed in the eThekwini municipality map. A sample of 130 households per area was targeted. The required number of households was selected by dividing the number of identified roads resulting in three households targeted in each of the 39 roads in the north section and five households in 26 roads in the south section being targeted. Upon the agreement by participants, the study was conducted where data was collected by means of an interview setting, where participants were interviewed by fieldworkers using pre- designed and tested questionnaires. The follow up was conducted on the days following. The participants answered a three set of questionnaires including, a Socio-demographic Questionnaire (Annexure D), a Food Frequency Questionnaire (Annexure F), 24-Hour Recall questionnaires (Annexure E). The anthropometric measurements were taken in order to determine the BMI status of the participants. The participants were weighed using a Physician Scale for weight, the Stadiometer for height and non- stretchable measuring tape for waist circumference. The north and the south sections of the township were both affected by unemployment, showing worrying rates that also corresponded with other studies illustrating that unemployment is a challenge in South Africa. The unemployment rate in the north section was very high, sitting at 78.5%, compared to the south section at 63.1%; even so both these communities are economically challenged. Food insecurity was more prevalent in the north section as 36.9% of the participants reported always not having enough money to purchase food whilst 0.8% of the participants in the south section reported the same, concluding that the north section is more vulnerable to hunger leading to malnutrition and poverty. The education status of the participants in the north section was a point of concern as only 3.1% of the participants had graduated while almost 29.2% in the south section had graduated; this illustrates a very clear difference, which might also be due to unemployed household caregivers who cannot afford further education. The mean Food Variety Scores (FVS) (±SD) for the north section for all food consumed from the various food groups during seven days was 34.44 (±8.419) and for the south section it was 33.87 (±10.670), indicating a medium food variety score where both sections had a good dietary diversity score ranging from 7-9 food groups, summarising the food group diversity as being in the majority in the north section at 63.85% (n=83) while in south section it was 60.77% (n=79). The results of the energy distribution of macronutrients from the average of the 24-hr recall results when compared to the WHO dietary factor goals showed that the participants’ diet was well balanced in terms of macronutrient intake for both sections while the diet for both sections was lacking in micronutrient intake. The results of the women caregivers for both the north and the south sections illustrated a high consumption of the following foods out of the top twenty foods consumed by the community. The foods mostly consumed included sugar, maize, bread and rice for both the 19-30 and 31- 50 years age groups ranging from 195.15-248.82g for maize, 17.61-18.90g for sugar, 82.73- 108.16g for bread and 127.14-131.69g for rice, meaning that the respondents’ diet was high in calorie intake, hence the doubled DRIs for carbohydrate. Overweight and obesity tests showed alarming results as the majority (56.15%) of women caregivers in the north section were found to be obese while 63.8% of the women in the south section fell into the obesity classification, showing that the women caregivers for both sections are at risk of obesity related illnesses (NCDs). The results for waist circumference showed that 71.53% and 78.46% of the women in the north and south sections respectively were above the waist circumference cut-off point (≥88cm). When the weight-for-height ratio was measured for the whole sample most of the women caregivers (69.23%) were found to be at risk of developing metabolic syndrome. The food consumption patterns illustrated in the study corresponded significantly with the results found. Both the communities consumed a diet high in caloric and fat intake but was low in fruit and vegetable intake. This leads to obesity, resulting in non-communicable diseases as well as micro-deficiencies, leading to malnutrition because of the lack of variety in the food consumed by the population. The lack of food variety is the result of not having enough money for food purchases, explaining the question why the community cannot meet the DRIs as a result of unemployment and poverty as well as a lack of nutrition education. With that said the two communities did not show much of a difference in lifestyle and food choices being made except for the education level that was low for the north section and a bit higher for the south section, as well as livelihoods that also showed that the north section was at a lower economic level than the south section but both the sections were at risk of malnutrition and poverty and needed the same intervention in terms of assistance. In the study it was recommended that policies drafted by the government and stakeholders should be focused and tailored more on women caregiver headed households. More nutrition knowledge should be geared towards educating the most vulnerable and poverty stricken communities. The micronutrient intake must be promoted at lower and middle income communities. The agricultural sector needs to recognise and promote women farmers as well as offer assistance in order to grow their standing as farmers. The government should devise and implement projects that empower women so that they not dependent on their male counterparts.
Food security and coping strategies of a rural community within the Valley of a Thousand Hills
(2014) Felt, Leigh; Napier, Carin E.
Food security is a global concern and the insecurity thereof is prevalent in South Africa even though the country is deemed to be secure in terms of food availability. The study was conducted to determine the socio-economic, health and nutrition and food security status of the community living in the Valley of a Thousand Hills in KwaZulu Natal, in addition to analysing their coping strategies. Two hundred and fifty seven respondents were required to participate in this study. Data were collected by interviewing the respondents using pre-designed and pre-tested questionnaires; socio demographic questionnaires, dietary intake questionnaires- namely 24 hour recall and Food Frequency Questionnaire (FFQ) and the coping strategy questionnaires were used. Lastly anthropometric measurements were taken to determine BMI. A prevalence of extreme poverty exists as a magnitude of the high unemployment rate, out of which 75.8% had been unemployed for more than 3 years. The household monthly income was less than R500 per month for 37.3% of the respondents. The mean Food Variety Scores (FVS) (±SD) for all foods consumed from the food groups during seven days was 22.45 (±10.32), indicating a low food variety score. In this study the food group diversity is summarized as the majority of the respondents (91.1%, n=226) being classified with a good dietary diversity score using 6-9 food groups. The mean of the three 24-Hour recall nutrient analysis indicated a deficient intake by both men and women in all of the nutrients (100% of the men and women could not meet the DRI’s for energy and calcium) except for the mean (±SD) carbohydrate intake by men aged 19-50 (214.71 ± 80.22). The main source of food intake was from the carbohydrate food group with an insufficient intake of animal products, dairy products and fruits and vegetables respectively; contributing to the macro and micro nutrient inadequacies. Ninety six percent of this community experienced some level of food insecurity with the worst Coping Strategy Index food insecurity score being 117 out of a possible 175. Four percent of this community was classified as being food secure. Overweight and obesity were the most exceptional anthropometric features by the women respondents with 26.5% (n=66) being overweight and 57% (n=142) obese. The men’s anthropometric features were predominantly normal weight. This study has established poverty and unemployment as being the principal contributors for the food insecurity experienced by the populace and poor dietary intakes. The low food variety diet consumed by the respondents resulted in the DRI’s not achieved for most nutrients. The majority of the respondents only consumed two meals a day, as a coping strategy to reduce/prevent temporary food insecurity. Intervention strategies are needed to improve the food security status and dietary intake of the community members to overcome the crisis of malnutrition.
Food security and coping strategies of an urban community in Durban
(2016) Mtolo, Andile; Napier, Carin E.
Introduction: Food and Agriculture Organisation (FAO 2015a) estimated that 220 million people (23.2%) in Sub-Saharan Africa were undernourished. Parallel to hunger, obesity rates have more than doubled globally since 1980; in 2014, 1.9 billion adults in the world were overweight and 600 million were obese (FAO 2015a). Obesity is a serious concern facing the world today and a major contributor to chronic disease such as diabetes and cardiovascular disease, which are often fatal (Bray, Frühbeck, Ryan and Wilding 2016: 1947). In South Africa, overweight and obesity have reached unacceptable numbers as over 60% of South Africans are overweight or obese. Furthermore, in 2015 South Africa was declared the fattest nation in Sub-Saharan Africa, adding another burden to the HIV epidemic (Ng, Fleming, Robinson, Thomson, Graetz, Margono, Mullany, Biryukov, Abbafati and Abera 2014: 777). Unemployment is one of the major factors that drive household food insecurity due to the fact that most people access food commercially. Therefore, income is a significant factor in ensuring that a healthy and nutritious diet is consumed regularly. The study community was at Umbilo, Durban, KwaZulu-Natal in a government owned estate called Kenneth Gardens. The estate has 286 units and accommodates approximately 1500–1800 residents. It formed part of an extensive network of cluster housing schemes developed by the apartheid government as a protectionist strategy to provide safe and affordable housing for poor and working class whites. Kenneth Gardens is currently managed by KwaZulu-Natal (KZN) Province and offers subsidized housing to residents from diverse background. Residents are low income bracket earners and many rely on state disability and pension grants for survival. Kenneth Gardens faces a wide range of social problems such as alcohol, drug abuse, domestic violence, unemployment and limited access to education (Marks 2013:26). Aim: The aim of the study was to determine the food security status, coping strategies, food intake and the nutritional status of the Kenneth Gardens community, which is situated in an urban area in KwaZulu-Natal. Methodology: One hundred and fifty (n=150) randomly selected caregivers participated in the study. The sample size was calculated using a power calculation indicating that 150 participants represent a reliable sample. The sampling procedure was simply random sampling. This study was quantitative and partly qualitative and descriptive in nature therefore, different measuring instruments were used to collect relevant data. The research tools for various variables measurements included; food security questionnaire, anthropometric measurements, a socio-demographic questionnaire, a food frequency questionnaire, and 24-hour recall questionnaires conducted in triplicate. Food security coping strategies were documented through a focus group interview with the Kenneth Gardens community members to determine strategies used to address food scarcity. All participants were weighed and measured to determine body mass index (BMI), classified according to the World Health Organisation (WHO) cut-off points. Data for socio demographic, FFQ, anthropometric measurements, and coping strategies was captured by the researcher on Excel® Spread sheets and analysed by a statistician for descriptive statistics using the Statistical Package for the Social Science (SPSS) version 17.0. Data for the 24-hour recall was captured and analysed by a nutrition professional using the MRC Food Finder® version 3.0 software, based on the South African composition tables. Results: The study population consisted of 150 households, including women (n=122) and men (n=28). The results revealed that the majority of households (52.7%, n=79) were headed by a mother, and only 40% (n=60) of households were headed by a father. Majority (47.3%, n=71) of the participants had completed matric and 7.3% (n=11) had tertiary education. English, (52%, n=78), was the most spoken home language, followed closely by Zulu, (43.3%, n=65). Thirty six percent (n=54) of the participants were unemployed and 26.7% (n=40) were employed; however over, 50% (n=40) of the employed participants were temporary. Twenty eight percent (n=42) of the participants earned less than R3000.00 per month and 31.3% (n=47) earned between R3000.00 and R6000.00 per month. Pensioners were 17.3% (n=26), who therefore received a government grant that ranges between R1500 and R1520 per month depending on the claimant’s age. The average household income was reported as R4429.20. The average number of people in the household was five, which equates to R6.00 per person per day. The results also revealed that 38% (n=57) of the household had a sole contributor to the household income; other households had two contributors (42.7, n=64) and 11.3% (n=17) had three contributors. Urban South Africans tend to purchase food as opposed to growing their own food. A lack of purchasing power results in food insecurity that eventually leads to malnutrition. The majority (56.6%, n=85) of the participants indicated a shortage of money to buy food and this inevitably leads and drive utilisation of coping strategies with high severity rate during periods of food scarcity. Bulk food was purchased once a month by the majority (68%, n=102) of the participants. The most commonly used coping strategy during periods of food scarcity was “Rely on less expensive and preferred food” with the mean score of 4.56 (±SD 2.772). The second used coping strategy was “Reduce the number of meals eaten in a day” with a mean score of 3.85 (±8.163), followed by “Contribute to a food stokvel in order to ensure food over a scarce period” (3.31, ±7.505) and “Restrict consumption by adults in order for small children to eat” (2.24, ±5.333). Utilisation of these food coping indicate a degree of food insecurity. The Body Mass Index (BMI) classification indicated that women had a higher (31.46 ±8.474) BMI than men (26.00±5.445). A total of 26.2% (n =32) women were overweight and 51.7% were obese category I, II and III. The mean BMI for the whole group was (30.44±8.261) which clearly demonstrated obesity. Nonetheless, men were not overweight; however 25% (n=7) were obese category I. Collectively, underweight was prevalent in women (3.3%, n=4) and men (3.6%, n= 1). The Food Variety Score was medium (31.91, ±10.573), which indicated a consumption of 30- 60 individual foods from four to five food groups during the seven day period; however the top 20 foods consumed from the 24-hour recall revealed that the diet was energy dense and the most consumed foods were primarily from the carbohydrate and fat group and a low consumption of fruits and vegetables was reported; hence the nutrient analysis showed a deficient intake of several nutrients, such as: calcium, vitamin A, zinc, vitamin D, vitamin E, vitamin K, zinc, magnesium, phosphorus, selenium and thiamine by both men and women. According to the WHO dietary factor goals, the acceptable macronutrient distribution ranges (AMDRs) and fruit and vegetable intake based on the 24-hour recalls, fat and protein intake exceeded the recommended 15-30 percent goal. Fruit and vegetable intake was very low in comparison to the minimum recommended intake of >400g. Carbohydrates intake for women were within the recommended 55-75 percent; however, men aged 19-50 years (50.70%) and >50 years (53.74%) did not meet the recommended intake. Conclusion: The results of this study reveal that the nutrition status of this community was compromised. The top 20 food intake indicated inadequate eating patterns and that diets comprised of energy dense foods, such as carbohydrates and fats, which could directly be responsible for the high obesity levels of >50% in women and >25% in men. Furthermore, there was low income and a high unemployment rate that proliferates the prevalence of food insecurity, hence the coping strategies reported. Malnutrition exists in communities as a result of food and nutrition insecurity which is affected by a significant number of factors that need to be considered and addressed. Nutrition interventions and nutrition education on a balanced diet, healthier methods of preparing food, and physical activity are required to ensure and improve health status, quality of life and better and sustainable coping strategies for our communities.
Household deprivation and its relationship to food intake and nutritional status of children 6-13 years in rural Queenstown, Eastern Cape, South Africa
(2020) Kupiso, Papama; Napier, Carin E.
The study was conducted among 200 children aged six to 13 years in rural Komani, formerly known as Queenstown within the district of the Enoch Mgijima local municipality in South Africa which includes Lesseyton, Birch Farm and Machibini. Three hundred and eighty five million children worldwide lived in extremely poor households, and 19.5% of children who live in developing countries lived on less than $1.90 a day. Children who lived in extremely poor households were found mostly in developing countries. Sub-Saharan Africa had the highest rates of children that lived in extreme poverty-stricken circumstances at just below 49.0%. Poverty in children results in many adverse effects such as stunted growth, lack of education, limited access to healthcare and nutrition. Aim: This research aimed to evaluate household deprivation using the acute multidimensional poverty index (AMDPI) and its relationship to the food intake and nutritional status of children aged 6-13 years. Methods: A valid and relevant socio-economic demographic questionnaire was completed in a face-to-face interview situation with the children’s parents and caregivers to determine the socio-economic demographic background of the participants. A valid and reliable food frequency questionnaire was also completed where the parents/ caregivers and the children were asked to identify foods that the children had consumed in the last seven days to determine the dietary diversity of the participants. In addition, the participant’s average anthropometric measurements were obtained by measuring the child’s weight and height in order to determine each participant’’s height-for-age and BMI-for-age and analysed using the WHO Anthroplus. Results: It was discovered that the majority (37.0%) of the households in the three rural areas of Komani (Queenstown) were headed by the grandmothers followed by the mothers (27.5%) and the fathers (20.0%). Food insecurity was prevalent in 83.6% of the households where the parent’s/ caregivers explained that they sometimes did not have money to purchase food. The low per capita income of the households of R12 07.94 - R18 030.00 per annum, compared to South Africa’s GDP per capita of $6.100 (R107 970) income, indicated that the households lived below the poverty line. These households achieved a mean acute multi-dimensional poverty index (AMPI) score of 24.72 out of the 30.0% cut-off point set by Alkire and Santos (2010), indicating that 82.4% of the households were poor. The mean energy intake for boys and girls (six to eight years) of 5474.23kJ was inadequate compared to the recommended Estimated Energy Requirement (EER) of 7316kJ and 6896kJ, whilst both boys and girls ages nine to 13 years met their EER. In addition, all the children exceeded the Recommended Dietary Allowance (RDA) for both protein and carbohydrate. However, none of the children met the Adequate Intake (AI) for total dietary fibre. This was evident in the top 20 foods consumed by the children with the cereal group food items, namely meal, samp and beans, rice and bread all being in the top ten most consumed foods, with fat-containing food items being evident in all three age categories; indicating that the children’s diets were mainly energy-dense. Overall, the total fruit and vegetable intake of the children was substantially poor measured against the recommended goal set by the WHO of ≥400g/day, with a per capita intake per day of 60.7g (children six to eight years), 51.1g (girls nine to 13 years), and 38.3g (boys nine to 13 years). Conclusion Factors such as unemployment, lack of education and poverty all contributed to household food insecurity and poor dietary intake. This was also evident in the children’s low fruit and vegetable intake with a high intake in carbohydrate-based food items such as maize, bread, potatoes, samp and beans, indicating that the group consumed a low food variety. Although only a low prevalence of malnutrition was found in the children, many of the households were food insecure, this was further indicated by the low per capita income and low AMPI score achieved by the households, which meant that, according to the Alkire-Foster method, the households were acute multi-dimensionally poor.
The impact of an orange-fleshed sweet potato yoghurt on the nutritional status of pre-school children in Durban, South Africa
(2022-03-16) Makanjana, Onwaba Z.; Napier, Carin E.; Naicker, Ashika
Background: Malnutrition exists globally due to various factors including basic, underlying and immediate factors. Goal two of the global targets in the 2030 Agenda for Sustainable Development is to end hunger and ensure that even the poorest people have access to sufficient, nutritious and safe food all year round. The Department of Social Development (DSD) in South Africa identified Early Child Development (ECD) centres as an ideal platform for implementing strategies aimed at improving the wellbeing of children below five years of age. ECD centres are facilities designed to provide early childhood development services and programmes that include good health, proper nutrition and early learning, through a holistic approach in promoting a healthy environment that is conducive for learning and development. Rationale and objectives: The health and nutritional status of young children is a global priority, as indicated in the 2030 Agenda for Sustainable Development. The arguments in favour of promoting the development of children at a very young age are clear and compelling. Effective interventions aimed at the vulnerable groups can make a positive contribution towards the achievement of Sustainable Development Goal (SDG) 2 which aims to end hunger, achieve food security and improved nutrition and promote sustainable agriculture. Inadequate nutrition in young children not only affects physical growth and development, but mental functioning as well. The pre-school years are associated with a phase of rapid growth. Adequate nutrition during the pre-school years is critical as proper nutrition plays an essential role in preventing malnutrition and other childhood-related diseases. Dietary diversification is one of the most effective strategies in preventing malnutrition and it is recommended that it is implemented during the stage of complementary feeding. Diets lacking dietary diversity lead to inadequate intake of vital nutrients such as vitamin A and iron, which may result in micronutrient deficiencies. Vitamin A and iron deficiencies are common among pre-school children in South Africa (SA) and the orange-fleshed sweet potato (OFSP) was identified as a potentially effective strategies to address vitamin A deficiency (VAD). The purpose of the study was to determine the nutrient intake, to develop and test the impact of an OFSP yoghurt on nutritional status of pre-school children in Durban, KwaZulu-Natal, SA, by determining the vitamin A and iron status of preschool children. The objectives of the study were to establish the socio-demographic profile of the children, to take anthropometric measurements (weight and height) to establish their nutritional status, to assess the dietary intake using a 24-hour recall questionnaire, (which was repeated three times) and a Food Frequency Questionnaire (FFQ). Furthermore, the study also aimed to determine the levels of vitamin A and iron in the blood at the time of the study using the finger-prick dried blood spot method, develop a yoghurt using an OFSP, administer the yoghurt as an intervention for three consecutive months and thereafter test the impact of the yoghurt on the nutritional status of the participants. Methodology: In this intervention trial, two ECD centres, an experimental group (EG) and control group (CG) comprising of 116 children aged 24–60 months were randomly selected. In each group, the participants were stratified according to age: 24–47 months and 48–60 months. At baseline, through the caregiver of the child participant, socio-demographic data was captured, and dietary intake was measured through three 24-hour dietary recall questionnaires, which were then analysed using Food Finder® software version 3.0 developed by the South African Medical Research Council (SAMRC). The food frequency questionnaire was used to calculate the food variety and food group diversity scores. Anthropometric measurements (weight and height) were taken and the World Health Organization (WHO) Anthro software® version 3.1 was used to convert these into nutritional data indices. Blood samples were collected through dried blood spot cards in order to determine serum retinol and haemoglobin (Hb) levels, which were assessed using the WHO indicators. A yoghurt with OFSP was developed following the steps of product development. The participants in the EG were given 100g of the developed OFSP yoghurt daily for three months, while the participants in the CG were given 100g of a peach flavoured yoghurt bought from the supermarket daily for three months, excluding weekends. The peach flavour was chosen for the CG as the colour was closest to the developed OFSP yoghurt. After the intervention period, anthropometric measurements were taken, dietary intake was assessed and blood samples were taken to assess impact on serum retinol and Hb levels. Results: Regarding the socio-demographic profile, unemployment was high, as 45.6% (n=36) and 54.1% (n=20) of the participants in the EG and CG respectively, were unemployed. In terms of household characteristics, 45.6% (n=36) of the participants in the EG and 32.4% (n= 12) in the CG had a tap inside the house. Access to a flush/sewage toilet was very limited in both groups, as less than half of participants had a flush toilet (39.2%; n=31) and 40.5% (n=15) in EG and CG, respectively) and more than half of the participants had a pit latrine (60.8%; n=48) in the EG and 59.5% (n= 22) in the CG. At baseline, anthropometric results in the current study showed that 16.6% (n=2) of CG girls 48-60 months of age were stunted. Among boys, 10.5% (n=12) and 36.4% (n=4) of EG and CG boys 48-60 months of age respectively, were stunted. No change was noted among EG boys 24-47 months of age of age, as 4.8% (n=1) were severely stunted at baseline and at endline. At baseline, 8.7% (n=2) of EG girls 24-47 months of age were overweight. In the CG group, 28.6% (n=2) and 16.7% (n=2) of girls 24-47 months of age and 48-60 months of age, respectively, were overweight. Furthermore, 9.5% (n=2) of EG boys and 42.8% (n=3) of CG boys 24-47 months of age were overweight. The prevalence of overweight among boys 48-80 months of age was 10.5% (n=2) and 27.3% (n=3) in the EG and CG, respectively. The prevalence of the risk of overweight increased from 21.7% (n=5) among EG girls 24-47 months of age at baseline to 45.0% (n=9) at endline and from 14.3% (n=1) to 28.6% (n=2) in the CG group. In the CG, an increase in the prevalence of the risk of overweight was noted among boys 48-60 months of age from 36.3% (n=4) at baseline to 54.5% (n=6) at endline. At baseline, the energy intake of girls and boys 24-47 months of age was more than the estimated energy requirement (EER) for both groups, whereas for the 48-60 month age group, it was less than the EER. The mean intake of fibre and calcium was lower than the recommended dietary allowance (RDA) for all groups and most participants consumed less than the RDA for fibre and calcium. The mean fruit and vegetable intake was less than the WHO recommendation of 320g to 480g per day for 24-47 month old children, and 400g to 480g for 48-60 month old children for all participants in the current study, and there was low variety in both groups. When comparing baseline with endline results between age groups within a group, there was a decrease in energy intake in all groups. Significant differences were found among EG girls 24-47 months of age (p=0.008) and CG girls (p=0.003 for 24-47 months and p˂0.001 for 48-60 months) for energy intake. Furthermore, baseline results showed that 2.7% (n=2) and 14.3% (n=3) of participants had low serum retinol levels in the EG and CG, respectively. At endline, serum retinol increased in 5.5% (n=3) of participants in the EG and 4.5% (n=1) in the CG. Low Hb levels were found in 19.2% (n=14) of participants in the EG and 32.1% (n=9) in the CG. At endline, Hb levels increased in 3.7% (n=2) and 9.0% (n=2) of participants in the EG and CG, respectively. Conclusion: Despite the numerous efforts to improve the nutritional status of children, a high prevalence of malnutrition still exists in South Africa. Consumption of the OFSP yoghurt made a small contribution to dietary vitamin A intake for some participants and iron intake levels did not increase from baseline to endline. The intervention period was too short to show an impact on anthropometric measurements such as stunting. The socio-demographic profile indicated that participants were predominantly from low-income households, and deprived of some essential sanitation services. Other issues in the current study population included overcrowding and high unemployment, with some households running out of money to buy food. The diet of the participants, was sub-optimal for optimum growth. Malnutrition, presented through micronutrient deficiencies, stunting, overweight and obesity, co-exist in this vulnerable population.
Intervention effect of food literacy on household food waste in the KwaDukuza municipality
(2024-09) Miti, Nosipho; Naicker, Ashika; Grobbelaar, Hendrina Helena
Background: Approximately one-third of the food produced for human consumption is lost annually across the global food supply chain. In South Africa, it is estimated that around 10.3 million tonnes of food are wasted each year. Despite food waste occurring at various stages of food production, individual households have been identified as the primary producers of food waste at the consumption stage, driven by consumer behaviour and practice. While food waste is a global concern, South Africa's household food waste mimics that of developed countries. Although household food waste studies in South Africa have gained momentum, nearly all studies focus on household food waste consumer practices. No intervention study has been conducted to change consumer behaviour towards household food waste in South Africa. Likewise, the cost of household food waste, nutritional losses, and the environmental impact of household food waste have yet to be explored through an intervention. Interventions that target a change in human behaviour towards reducing household food waste can make a meaningful impact on food and nutrition security, and the environment. Aim: This study aimed to determine the intervention effect of food literacy on household food waste in the KwaDukuza municipality. Methods: In this randomised control trial (RCT), middle and high Living Standards Measure (LSM) households from five areas in the KwaDukuza municipality used in a formative study to determine household food waste behaviour and practices were eligible to participate in the study. All households at baseline received three colour-coded bins [used to separate food waste by food categories], binliners, food labels and freezer bags to contain cooked food waste. The first objective was to calculate household food waste through a weighed food waste audit at baseline and endline. A weighed food audit was conducted at each household (n=180). Objective two of this study included calculating the cost, associated nutrient losses and environmental impact of household food waste using the results of the food waste audit at baseline and endline. The cost of household food wasted was analysed using the mean price of foods from retail stores in the study area to determine the cost (Rand value) of household food waste at baseline and end line. The nutrient losses were calculated using the South African Medical Research Council Food Finder 3 web-based software at baseline and endline. The environmental impact was calculated using the My Emission Footprint calculator for food wasted at baseline and endline. The third objective of this study was to determine the intervention effect on household food waste. Households were randomly assigned into three intervention groups, intervention 1 (n=60), intervention 2 (n=60), and the control group (n=60). Households who were part of Intervention 1 received the food literacy toolkit and food literacy lessons on how to reduce household food waste; households in intervention 2 received the food literacy toolkits only and were reliant on self-efficacy to use the toolkit and households that were part of the control group did not receive any intervention. Results: Findings from the food waste audit showed that at baseline, the total mean of household food waste produced by all households (n=180) in this study was 1.53 kg (1531.29 g) per week, decreasing to 0.31 kg (307.47 g) per household/ week at the endline. A significant reduction of household food waste was recorded post-intervention (average waste per household = 307.47 g) When household food waste was separated into categories of the type of food wasted, the fresh produce pre-intervention (average waste per household = 917.73 g) was significantly more than the fresh produce postintervention (average waste = 173.43g). Meat produce wasted pre- (average waste per household = 109.56g) also surpassed the meat produce wasted post- (average waste per household = 43.26g). The cooked food wasted pre- (average waste per household = 387.07 g) was significantly greater than the cooked food post- (average waste per household = 76.39 g)-. The cost of food waste for the whole group pre- (average waste per household = R145.57) was significantly more than the cost of food waste for the whole group post- (average waste per household = R39.75). In terms of the environmental impact, the pre- (average waste per household = 7664.13 gCO2e) exceeded the environmental impact post- (average waste per household = 6407.67 gCO2e). A high nutrient loss from household food waste was recorded at baseline, and there was a significant reduction of macro-and micronutrient nutrient loss at the endline for the whole group (n=180). In intervention 1, intervention 2 and the control group, most nutrient losses such as energy, total protein, total lipids, total carbohydrates, and total dietary fibre were greater during the pre-intervention phase compared to the post-intervention phase. In this RCT, a significant reduction of household food waste was observed for the whole group (n=180) and across intervention groups. Following the 6-week intervention duration, between intervention arms, there was no discernible difference in household food waste, economic loss, nutritional loss and environmental impact. However, for every intervention group, there was a substantial decrease in all measured outcomes from baseline to endline. The main reason for this result could be attributed to the fact that households probably perceived that they were being monitored through the food waste audit at baseline and endline, implying that sensitisation of communities to their actual household food waste can be an impactful intervention strategy to conscientise consumers to reduce their household food waste. Conclusion: This study shows a clear linkage between household food waste, nutrition, economic and environmental impact. The disposal of food waste from households has a substantial and wide-ranging effect on the food chain, leading to various economic, environmental, and social challenges. The social ramifications of food waste are enormous, given the striking difference between the significant amounts wasted in affluent households and the prevalent hunger and food insecurity in many communities. In order to create a food system that is more environmentally friendly and able to withstand challenges, it is crucial to focus on and decrease the amount of food wasted in households. This requires a combined initiative of educating consumers, implementing effective waste management practices, and enacting legislation that encourages responsible consumption.
The relationship between infant feeding practices, caregivers’ nutrition knowledge and nutritional status of infants aged between 6 to 12 months in a rural community in Zimbabwe
(2022-09) Pfumvuti, Lynn; Napier, Carin E.
Introduction Undernourishment affects a child's potential lifespan from the beginning according to United Nations International Children's Emergency Fund (UNICEF) 2014: 18), and the International Food Policy Research Institute (IFPRI 2014: 7) noted at the time that 11% of African Gross Domestic Product (GDP) was lost to malnutrition, thereby justifying the urgent need to fight it. Malnutrition in the early stages of growth of an infant could cause irreversible damage to their metabolism, which would cause their health to deteriorate especially when children consumed high-energy, low-nutrient diets later in life which was common in developing countries, and this could result in adults being susceptible to noncommunicable diseases like hypertension, cardiovascular diseases, and Type 2 diabetes (Prendergast and Humphrey 2014: 250). Globally, 150.8 million children were recorded to be affected by stunting in 2017 (UNICEF/WHO/World Bank 2018: 1) and the United Nations stated that sub-Saharan Africa accounted for one-third of stunted children (UNICEF/WHO/World Bank 2020: 3). Child malnutrition is at a high level in sub-Saharan Africa (Akombi, Agho, Merom, Renzaho and Hall 2017: 1) and it is one of the main health issues especially in low–medium income countries (UNICEF 2015: 3). Poor infant feeding practices have been an endemic problem in sub-Saharan Africa for many years and this has led to malnutrition (Onyango, Borghi, De Onis, Casanovas and Garza 2013:1975). These practices have stemmed in part from the lack of nutrition knowledge on the part of caregivers and have resulted in improper weaning which has been one of the contributing factors to the persistence of malnutrition (Bewket, Welday, Mehretie and Abebe 2017: 10). Thus, poor feeding practices have significantly contributed to the high levels of malnutrition, diarrhoea and poor growth of infants, even leading to death. In Zimbabwe, only eight percent of children aged 6-23 months eat an acceptable diet (Zimbabwe Demographic Health Surveys 2015: 200). Multiple factors could cause infant malnutrition such as poverty, food insecurity and drought but this study looked specifically at the role that caregivers play in the feeding of infants in the village of Munjinga North (Ward 14) in Mashonaland West Province in Zimbabwe. Methods This was a cross-sectional study conducted in a rural community in Zimbabwe. The participants in this study included a sample of 100 purposively selected caregivers caring for infants between the ages of 6–12 months. The study was descriptive and quantitative in nature with different measuring instruments used to measure the sample population. The research tools used included a socio-demographic questionnaire, where the multidimensional poverty index (MPI) was calculated; anthropometric measurements (weight, length and Mid Upper Arm Circumference (MUAC)) were collected to give the Z-scores of the infants. A validated infant and young child feeding module and caregiver’s nutrition knowledge questionnaire were also completed. The food security coping strategy questionnaire was completed to find out about the mechanisms that the community used to adapt feeding practices during periods of food shortage in their households. Data was captured by the researcher on Excel® spreadsheets and analysed using descriptive statistics using the Statistical Package for the Social Sciences (SPSS) for Windows version 25. The anthropometrics data was analysed using WHO Anthro version 3.2.2 Results The sampling technique used in this study resulted in n=100 participants, and as the participants’ number of 100 is equal to the percentage, the percentages are not presented separately. All the caregivers were female and responsible for 37% (n=37) female infants and 63% (n=63) male infants. Most of the caregivers (90%) were the mothers of the infants whilst the remaining 10% were the grandmothers. The room density was 0.47, which showed that at least two members of the household shared a room. A significant number of the households(27%) had no toilet facilities, which compromised sanitation. Most of the women (55%) indicated that they had attained a secondary education but 98% of them were unemployed during the period of study with 55% doing piece jobs, which resulted in 92% of the families having a monthly income of between US$1 – US$100 and surviving below the Food Poverty Line for one person, which was recorded at US$31.20 per person in Zimbabwe in 2017. When measuring this community against the Multi-dimensional Poverty Index, health contributed 24.4%, education contributed 16.4% and standard of living contributed 59.2% to the poverty index. The final MPI score was 40.9%, which was well above the cut-off point of 30% and this indicated that the community of Munjinga North is living in poverty. The anthropometric measurements indicated that there is a prevalence of stunting (55%), wasting (7%), and underweight (33%) in the infants. MUAC was used to determine the level of malnutrition in the community and 23% of the infants were found to have a MUAC below -2 and -3 on the Z-score. The Z-scores for MUAC and length-for-age had a statistical significance of (p=0.01). All the infants were breastfed at birth and 95% were still breastfeeding at the time of the study. The infants were timeously introduced to solids, semisolids and soft foods (96%) and those who received a minimum meal frequency made up 81%. Minimum dietary diversity was accomplished by 36% of the participants, with 25% receiving the minimum acceptable diet. Most of the caregivers (78%) had not received training on infant nutrition hence 95% of them did not know the importance of complementary feeding. Those who had partial knowledge on the importance of breastfeeding made up 51% whilst 62% knew what exclusive breastfeeding meant. The level of training was compared to the MUAC, and a statistical significance (p=0.05) was established. The most commonly used coping strategy was to restrict the consumption by adults for children to eat with a mean score of 8.88(SD±8.572); the second most common strategy was to reduce the mothers’ consumption for the sake of the children with a mean score of 7.16 (SD±6.15), followed by buying food on credit with a mean score of 2.11 (SD±3.066). Conclusion The average age of the infants who participated in this research was nine months. The MPI score calculated showed that the Munjinga North Ward 14 community is living in chronic poverty. They are deprived of basic necessities such as electricity and safe water to drink. The health score signified a risk of raising malnourished children in the community and it was already manifesting as 23% of the infants were found to be malnourished. The majority of the households are living on an income below the poverty datum line. All the infants were breastfed at birth and the majority were still being breastfed at the time of the research; however, it was shown that only a few of the caregivers knew about the importance of breast milk and why they were breastfeeding their infants. Many caregivers were breastfeeding their infants simply because they were told to do so by their elders. This indicated a lack of nutrition knowledge which would have significant repercussions when they weaned their children. The majority of the infants were being timeously introduced to complementary feeding, which, statistically, was a good sign as it showed that they were following the WHO guideline of exclusive breastfeeding for the first six months even though the majority of the mothers were unaware why they were encouraged to do so. The majority of infants were given two meals a day (thin porridge in the morning and in the evening) and since they were also being breastfed according to the WHO guidelines it indicated an ideal meal frequency, hence the high percentage of minimum meal frequency in the community. Although the meal frequency was high, the minimum dietary diversity and minimum acceptable diet statistics were low, signifying that the infants were being introduced to foods with compromised quality. The food lacked variety and indicated deficiency in some macronutrients and many micronutrients. The poor diet quality consumed by the infants would inevitably affect their growth and development. In this study, the signs were already visible with more than half of the infants being stunted and several wasted and malnourished. Although there could be other factors that contributed to malnutrition, the research findings confirmed that there was a relationship between infant feeding practices and caregivers’ nutrition knowledge, but knowledge was not a significant predictor of MUAC (nutrition health status) of the infants aged between 6-12 months. More attention needs to be given to the training of the caregivers on infant nutrition so that they can understand the need for healthy infant feeding practices, especially considering that the first 2,000 days of an infant’s life are the most critical.
Sociodemographic profile, nutritional status and dietaty intake of primary school children in Chesterville, KwaZulu-Natal
(2017) Mfeka, Portia Lungisile Nomathamsanqa; Napier, Carin E.
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.