Faculty of Human Sciences

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Browsing Faculty of Human Sciences by Subject "641.35655"

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    Development of a food multimix to address malnutrition amongst the elderly
    (2008-05) Matiwane, N. B.; Oldewage-Theron, W. H.
    Introduction and purpose - The study was conducted in order to determine the nutritional status of the elderly attending a care centre in Sharpeville in order to develop a novel food item, to address malnutrition and to test and analyse the novel food item for acceptability (sensory analysis) and shelflife. Methodology - A randomly selected sample of 170 elderly, including males and females, aged sixty and above participated in the research. A cross-sectional survey included sociodemographic, health and twenty-four hour recall questionnaires as well as anthropometric and biochemical measurements. Trained fieldworkers assisted with data collection dietary intake and food measurements consumption data were captured and analysed with assistance of a qualified dietician using a Food Finder ® version 3.0 program in to determine the frequency, mean and standard deviations. The socio-demographic and health data, biochemical and anthropometric measurements were analysed for means and SDs. Results - Although 100 percent of the elderly received a monthly pension, the majority (72 percent) were bread winners in the households. The majority of households (65,8 percent) had a monthly income ofR 501-1 000. Eighty two percent of the respondents indicated that they bought food once a month and the food was bought mostly from local supermarkets (68,2percent) which are generally very expensive. Most households (63,1percent) spent less than R200 on food per week. Taking into consideration that the average household size was 4,9, it was calculated to be less than R5,80 per person per day. The Top 20 food consumption list indicated that the majority of food items consumed were carbohydrate-based. Dietary intake results confirmed that these households consumed mainly a carbohydrate-based diet and although the daily protein intake was sufficient, the diet was also deficient in total energy and dietary fibre, as well as a number of micronutrients including calcium, magnesium, zinc, selenium, iodine, thiamine, riboflavin, vitamins B6, C, D, E, biotin, pantothenate and folate. These findings indicated the prevalence of undernutrition The biochemical data showed that 73,1 percent of the elderly had low serum zinc levels. A large percentage of men and women had sub-optimal haemoglobin levels. Most of the biochemical variables were within the normal range, however the mean cholesterol level was 5,4 ± 1 ,4mmol/l which was higher than the normal range of 5,2mmolll. The majority ofthe females were overweight and obese, signifying overnutrition in the sample of elderly people. The health status of the respondents was also compromised. A large number of subjects were taking chronic medication (55,9percent) and suffered from a number of disorders including painful joints (70,6percent), enteral infections 72,4 percent) and chronic headaches (48,2percent). Forty one percent received chronic hypertension medication A food multimix was formulated, which involved the blending of locally available, affordable, culturally acceptable and commonly consumed food commodities mixed proportionally, drawing on the 'nutrient strengths' of each component of the mix in order to optimise the nutritive value of the end-product without the need for fortification. The initial estimates of energy and nutrient content of the ingredients needed the appropriate food databases. The nutrient content was calculated using the SA food composition data and Food Finder/Dietary Manager®. At least 30 percent target ratio of the RDA was met in most nutrients in the food multimix. Proximate analysis was carried out to determine macronutrients such as energy, protein, carbohydrate and micronutrients such as zinc and iron content of multimixes. Carbohydrate and energy content were derived using data gained from the analytical procedures. Sub-samples of formulated FMM recipes were taken and prepared for analysis and shelf life testing of the FMM, soup and spinach muffin was also carried. The end products of multimix formulated were two recipes namely cream spinach soup and low sodium spinach muffms. Eighty percent accepted the soup colour and 50percent liked the flavour, 55 percent of the elderly accepted the appearance, 75percent accepted the smell of the product. The dried spinach was mixed with the apple blended well and regarding taste, only 15 percent disliked the taste. Conclusions: The results of this study confirmed that a novel food item such as FMM can be developed to meet certain criteria. Recommendations: Further research is required where long-term effects of the implementation of the multimix in the diet of the elderly can be investigated.
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    Impact of a soy feeding programmme on the nutritional status of an elderly community in Sharpeville
    (2014-12) Marumo-Ngwenya, Kuda; Oldewage-Theron, W. H.; Egal, A. A.
    Main Purpose of the study: To evaluate the impact of soy protein feeding intervention over a period of six months on the nutritional status of an elderly (≥60 years old) community of Sharpeville, in which poverty, household food security and malnutrition were prevalent. Methods: An experimental design that had no control group but a comparison between hypercholesterolaemic (HC) and normocholesterolaemic (NC) groups was used with 134 randomly selected elderly respondents. The first stage involved a baseline survey which determined the prevalence of risk factors for cardiovascular disease (CVD) and nutritional status among participants. Measurements included biochemical indices (serum lipids, vitamin B12, folate and homocysteine), anthropometry (weight, height and waist circumference) and dietary intake using 24h-recall and 7-day dietary diversity questionnaire. Socio-demographic information gathered from previous studies on the same subjects was used. The second stage was the preparation, formulation, and implementation of a nutrition education programme to assess its impact on nutrition knowledge after the nutrition education intervention. The nutrition education was conducted in two sections, namely an exploratory study and an experimental study. An exploratory study was conducted to assess the nutrition education needs of the elderly and was followed by the experimental study, which assessed nutrition knowledge before and after the intervention. The third stage was the implementation of the 10 grams soy protein daily feeding intervention for a period of six months and evaluation of its impact on risk factors for cardiovascular disease and on nutritional status. Sensory tests, compliance and the same measurements conducted at baseline were used at follow-up (feeding intervention). A comparison of the findings of the baseline study and follow-up study was conducted. Also to provide deeper insight into the effect of soy on the risk factors for CVD and nutritional status, respondents were further stratified into HC and NC groups based on their LDL-C levels at baseline study and results were also presented as such. The data analyses included descriptive statistics and t-tests on SPSS version 21.0. Results: From the baseline study, the dietary intake results revealed a poor dietary intake which contributed to inadequate estimated average requirements (EAR) and adequate intakes (AI) of nutrients. A mainly carbohydrate-based diet was consumed with minimal intake of dairy and legumes despite a medium dietary diversity score. The anthropometric indices at baseline indicated over-nutrition based on the reported waist circumference 97.32±10.32 (80.6%) above substantial risk of CDL, obesity (75.3%) and hypertension (56.7%), with the highest percentages for both waist circumference of substantial risk and overweight/obesity found among the women (80.9% and 79.9% respectively) and for hypertension among the men (79.1%). For the biochemical results at baseline, the prevalence of risk factors for CVD was observed as abnormal mean serum lipids such as LDL-cholesterol (3.6±1.1), HDL-cholesterol (0.73±0.4), total cholesterol:HDL-cholesterol ratio (7.9±2.9), triglyceride:HDL-cholesterol ratio (2.7±2.1) and homocysteine (17.1±9.2) in the total group. The women had high TC (5.2±1.1) indicating borderline risk of CVD as compared with men who had lower TC (4.5±0.8) and this was significantly different (p=0.049). The nutrition education programme was effective in increasing knowledge with an improvement of 14.5 percent from pre- (62.3%) to post-test (76.8%) for the total group which was statistically significant (p=0.000). The results for the soy protein feeding intervention, the dietary intake for the total group indicated a statistically significant decrease in energy intake (p=0.001), by about 20.4 percent form baseline to follow-up, while energy intake at baseline was already below the EAR. Also a statistically significant decrease was seen from baseline to follow-up for total dietary fat (p=0.004), cholesterol (p=0.008) and animal protein (p=0.000), with a statistically significant increase only on dietary folate (p=0.001) and iron (0.001). These dietary changes were also observed for the HC and NC groups after the intervention with only fat not decreasing significantly for the HC group. For the anthropometry indices, and hypertension no significant impact after the intervention for the total group and also for the HC and NC groups was observed. The biochemical results indicated a beneficial effect of the soy-based products on the following serum lipids: a significant improvement in LDL-C (p=0.000), HDL-C (p=0.000) and TC:HDL ratio (p=0.000) for the HC group while only TC:HDL ratio showed a significant improvement for the NC group after the intervention. However, high risk factors for CVD in this elderly group were still observed, with a significant decrease after the intervention of serum folate (p=0.000) below the recommended level and a significant increase in homocysteine (p=0.000) above the recommended level. Significant differences between the HC and NC groups were seen in TC, LDL-C, LDL:HDL-C ratio and TC:HDL-C ratio at the beginning of the intervention (baseline). However, at the end of the intervention (follow-up), significant differences were observed only in TC, LDL-C and homocysteine. Conclusion: Although the energy intake reduced significantly, only three of the micro-nutrients (pantothenate, Niacin and selenium) had a significant decrease between baseline and follow-up. Therefore the nutritional status of these elderly was not affected as it was also observed that there was no significant impact on anthropometric indices that took place. However this intervention had a significant impact on iron intake, which was one of the deficiencies identified amongst this elderly people from previous study. Also the nutrition education and a daily consumption of at least 10g of soy had a significant beneficial effect on LDL-C, HDL-C and TC:HDL ratio for the HC groups, thus reducing risk of CVD. Although soy had a beneficial effect on blood lipid profile no effect on hypertension was observed. The guideline of a 25g intake of soy should be encouraged as recommended by FDA as an effective cholesterol-lowering food item.