Would an increase in vegetable and fruit intake help to reduce the burden of nutrition-related disease in South Africa? An umbrella review of the evidence

Mean ± Standard Deviation Intake Values for 1–<10-Year-Old South African Children for Application in the Assessment of the Inflammatory Potential of Their Diets Using the DII® Method: Developmental Research

This study aimed to develop a set of mean ± standard deviation (SD) intake values for South African (SA) children for 36 of the 45 food parameters included in the original Dietary Inflammatory Index (DII^®) tool. The SA food composition database contains 30 of the 45 food parameters included in the original DII^®, and a supplementary database was developed for six of the food parameters not included in the SA database. The SA child mean ± SD intake of macronutrients, micronutrients and select flavonoids was calculated by age in years, using eight data sets from dietary surveys conducted in SA in the last three decades. A total sample of 5412 children was included in the calculation of the mean ± SD. The current study sample was determined to be representative of 1–<10-year-old children in SA, and the plausibility of the mean intake values was confirmed by being in line with age-appropriate recommendations. Furthermore, an increase in energy, macronutrient, and most micronutrient intakes with increase in age was evident. The generated mean ± SD values for SA children can be used for calculation of the inflammatory potential of the dietary intake of SA children in the age range of 1–<10-year-old children.

Group-based intervention in a primary healthcare setting was more effective for weight loss than usual care

Background

Literature and practice recommendations for lifestyle interventions to treat the increasing number of obese patients with non-communicable diseases (NCDs) or risk factors for NCDs attending resource-constrained public healthcare facilities in South Africa are scarce.

Aim

To compare the impact of a facility-based therapeutic group (FBTG) intervention with usual care on weight in obese participants, with NCDs or risk factors for NCDs.

Setting

Public healthcare facility providing primary healthcare services in Cape Town, South Africa.

Methods

A quasi-experimental study design was used where participants chose to receive weight loss treatment with either the FBTG or usual care interventions. Both interventions involved a one-on-one medical and dietetic consultation, while FBTG participants had six additional group sessions. Follow-up assessments took place 6 months after baseline. Socio-demographic variables, blood pressure, smoking status, weight, height, waist circumference, dietary intake, physical activity and stage of change were measured.

Results

Of the 193 obese adults enrolled, 96 selected the FBTG and 97 selected usual care. There were no significant differences at baseline between the two groups. Weight loss over 6 months was greater (p < 0.001) in FBTG (median [IQR] of −2.9 [−5.1; −0.3] kg) than usual care (−0.9 [−0.9; 0.6] kg) participants. At 6 months, more FBTG completers reached the weekly target of 150 min (p = 0.009), while both groups showed improvements in dietary intake. More FBTG (74%) than usual care (49%) participants were in the action stage of change by 6 months (p = 0.010).

Conclusions

The group-based intervention was more effective than usual care in weight reduction as well as improvements in physical activity and stage of change.

A Focus on Four Popular “Functional Foods” as Part of a Strategy to Combat Metabolic Disease Through the Increased Consumption of Fruits and Vegetables

Fruit and vegetable consumption is on the rise as an increasing number of people recognize their health promoting effects, which are mediated through phytochemicals with disease combatting properties. The aim of this paper is to identify the potential benefits of fruits and vegetables in chronic diseases such as diabetes mellitus and hypertension. An electronic search of databases such as Pubmed Central, Science Direct and Web of Science from the last 5 years was conducted. Four commonly consumed edible fruit and vegetables, namely, Hypoxis hemmerocallidea (African potato), Moringa oleifera (Moringa), Persea americana (Avocado) and Psidium guajava (Guava) and their potential role in the prevention and management of metabolic syndrome and other disorders, are presented. In this narrative review plant uses extend beyond traditional medicine and include usage in food preparation, beverages, as part of fragrances, culinary flavouring, as well as cosmetic use, but more importantly have potential in contributing to the amelioration of the deleterious effects of diseases/health conditions. In addressing disease states, including metabolic syndrome and other disorders, the interest in medicinal plants continues to grow with the possibility of novel compounds and/or new drug discovery. Alternative and affordable methods of large scale harvesting of medicinal plants, as well as identification and specificity of bioactive compounds as future therapeutics are essential for sustainability.

Non-communicable disease risk factors and treatment preference of obese patients in Cape Town

BACKGROUND

Insights into the characteristics of treatment seekers for lifestyle changes and treatment preferences are necessary for intervention planning.

AIM

To compile a profile of treatment-seeking obese patients with non-communicable diseases (NCDs) or NCD risk factors and to compare patients who choose group-based (facility-based therapeutic group [FBTG]) versus usual care (individual consultations) treatment.

SETTING

A primary healthcare facility in Cape Town, South Africa.

METHODS

One hundred and ninety-three patients were recruited in this cross-sectional study. Ninety six chose FBTG while 97 chose usual care. A questionnaire, the hospital database and patients' folders were used to collect data. Weight, height and waist circumference were measured. STATA 11.0 was used for descriptive statistics and to compare the two groups.

RESULTS

The subjects' mean age was 50.4 years, 78% were women and of low education levels and income, and 41.5% had type 2 diabetes, 83.4% hypertension and 69.5% high cholesterol. Mean (s.d.) HbA1c was 9.1 (2.0)%, systolic BP 145.6 (21.0) mmHg, diastolic BP 84.5 (12.0) mmHg, cholesterol 5.4 (1.2) mmol/L), body mass indicator (BMI) 39.3 (7.3) kg/m2 and waist circumference 117 (12.6) cm). These figures were undesirable although pharmacological treatment for diabetes and hypertension was in place. Only 14% were physically active, while TV viewing was > 2h/day. Mean daily intake of fruit and vegetables (2.2 portions/day) was low while added sugar (5 teaspoons) and sugar-sweetened beverages (1.3 glasses) were high. Usual care patients had a higher smoking prevalence, HbA1c, number of NCD risk factors and refined carbohydrate intake, and a lower fruit and vegetable intake.

CONCLUSION

Treatment seekers were typically middle-aged, low income women with various modifiable and intermediate risk factors for NCDs. Patients choosing usual care could have more NCD risks.