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Papers by Louise van den Berg

Research paper thumbnail of Statistical assessment of reliability of anthropometric measurements in the multi-site South African National Dietary Intake Survey 2022

Research Square (Research Square), Dec 22, 2023

Background Anthropometric data quality in large multicentre nutrition surveys is seldom adequatel... more Background Anthropometric data quality in large multicentre nutrition surveys is seldom adequately assessed. In preparation for the South African National Dietary Intake Survey (NDIS-2022), this study assessed site leads and eldworkers' intra-and interrater reliability for measuring weight, length/height, mid-upper arm circumference (MUAC), waist circumference (WC) and calf circumference (CC). Methods Standardised training materials and measurement protocols were developed, and new anthropometric equipment was procured. Following two training rounds (12 site lead teams, 46 eldworker teams), measurement reliability was assessed for both groups, using repeated measurements of volunteers similar to the survey target population. Reliability was statistically assessed using the technical error of measurement (TEM), relative TEM (%TEM), intra-class correlation coe cient (ICC) and coe cient of reliability (R). Agreement was visualised with Bland-Altman analysis. Results By %TEM, the best reliability was achieved for weight (%TEM = 0.260-0.923) and length/height (%TEM = 0.434-0.855), and the poorest for MUAC by eldworkers (%TEM = 2.592-3.199) and WC (%TEM = 2.353-2.945). Whole-sample ICC and R were excellent (> 0.90) for all parameters except site leads' CC inter-rater reliability (ICC = 0.896, R = 0.889) and eldworkers' inter-rater reliability for MUAC in children under two (ICC = 0.851, R = 0.881). Bland-Altman analysis revealed no signi cant bias except in eldworkers' intra-rater reliability of length/height measurement in adolescents/adults (+ 0.220 (0.042, 0.400) cm). Reliability was higher for site leads vs. eldworkers, for intra-rater vs. inter-rater assessment, and for weight and length/height vs. circumference measurements. Conclusion NDIS-2022 site leads and eldworkers displayed acceptable reliability in performing anthropometric measurements, highlighting the importance of intensive training and standardised measurement protocols. Ongoing reliability assessment during data collection is recommended.

Research paper thumbnail of Household food insecurity in South Africa from 1999 to 2021: a metrics perspective

Public Health Nutrition

Objective:To review and synthesize studies on household food security in South Africa.Design:Syst... more Objective:To review and synthesize studies on household food security in South Africa.Design:Systematic mapping review of metrics (methodological review).Setting:Electronic databases, including EBSCOHost, Scopus and Web of Science, were searched for studies and reports on household food security in South Africa, reporting household food security published between 1999 and 2021. Searching, selecting and reporting were performed according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement.Participants:South African householdsResults:Forty-eight articles reporting on six national surveys (one repeated annually since 2002) and forty sub-national studies meeting the inclusion criteria were selected. Various metrics, with different recall periods and ways of categorizing food security levels, were identified. Surveys that used similar metrics showed that the percentage of South African households that have experienced food insecurity and hunger ha...

Research paper thumbnail of Job satisfaction and perception of workloads among dietitians and nutritionists registered in South Africa

South African Journal of Clinical Nutrition

Research paper thumbnail of Current opinion: Is added dietary sugar detrimental to health?

South African Family Practice, 2011

Research paper thumbnail of Body adiposity indices are associated with hypertension in a black, urban Free State community

African journal of primary health care & family medicine, Jan 19, 2014

Non-communicable diseases, including hypertension, are increasing rapidly in resource-poor, devel... more Non-communicable diseases, including hypertension, are increasing rapidly in resource-poor, developing countries amongst populations transitioning from traditional to westernised lifestyles; and are associated with excess weight. To investigate the relationship between hypertension and various indices of body adiposity in a transitioning, urban, black population. Three hundred and thirty-nine adults (25-64 years) from a larger cross-sectional study (Assuring Health for All in the Free State) conducted in Mangaung, South Africa, were included. Standard techniques were used to determine blood pressure, HIV status, body mass index (BMI), waist-to-height ratio (WHtR) and body adiposity index (BAI). Approximately 40% of the sample was HIV-positive and 63.4% hypertensive, with the greatest risk of hypertension being amongst older men. Based on BMI, 23.0% were overweight and 32.1% obese. Waist-to-height ratio showed that 58.6% had increased cardiovascular risk. Mean BAI was 34.1%, whilst 7...

Research paper thumbnail of Incorporating Adult Learning Principles in an Intervention Implementation. Experiences from an Iron Deficiency (ID) Education Program in Ghana

European Journal of Nutrition & Food Safety, 2015

Research paper thumbnail of Nutritional status of undergraduate healthcare students at the University of the Free State

South African Family Practice, 2013

Research paper thumbnail of Iron-focussed nutritional status of mothers with children (6–59 months) in rural northern Ghana

Research paper thumbnail of Short Reports: Herbal weight-loss products: how informed are we?

Successful weight loss requires commitment and long-term lifestyle changes to decrease energy int... more Successful weight loss requires commitment and long-term lifestyle changes to decrease energy intake and increase physical activity. By contrast, freely available diet remedies are advertised as quick solutions which promise to induce weight loss with little or no effort. No statistics are available on the use of these products in South Africa. However, in the USA, nationwide surveys have found that among adults who had seriously attempted to lose weight, 44.9% of women and 19.8% of men reported using non-prescription, weight-loss products, 1 while substantial numbers of adolescents (14.4% females and 7.2% males) 2 also claimed to have used these products. Non-prescription weight-loss products are aggressively marketed, often with little or no scientific proof of efficacy and safety in humans. 1 In particular, herbal weight-loss products are perceived by the public to be "natural" and therefore harmless. 1 In many countries, including the USA and South Africa, by law, these herbal weight-loss products are classified as dietary supplements. Therefore, they escape strict regulation of their availability, as well as the advertising and labelling claims which are made about their efficacy and safety. 1 For this reason, the responsibility to provide evidence-based guidance to the consumer on these products reverts to healthcare professionals. This study aimed to assess the extent to which dietitians and pharmacists in central South Africa are informed about the ingredients of a specific, popularly used, herbal weight-loss product. Method In this study, claims that a popular over-the-counter, herbal product may assist in weight loss were evaluated for validity by assessing

Research paper thumbnail of Predictive value of different body segments to estimate height in a South African adult hospital population

Clinical Nutrition ESPEN

BACKGROUND AND AIMS Height measurement is a vital component for assessing nutritional risk, and c... more BACKGROUND AND AIMS Height measurement is a vital component for assessing nutritional risk, and calculating dietary requirements in a clinical setting where indirect calorimetry is not available. In many patients, height cannot be measured accurately, and equations based on body segments are relied on to predict height. This study aimed to evaluate if specific body segments are better associated with height than others in a South African public hospital setting. METHODS A descriptive cross-sectional study was conducted in three public hospitals in Bloemfontein, South Africa, on patients, 20-50 years of age, and able to stand upright without assistance to be measured by stadiometer. Spearman correlations were assessed between stadiometer height and arm-span, demi-span, ulna length, knee height, tibia length, fibula length and foot length (measured by standardised techniques). Multiple regression analysis was performed to identify the segment that is most closely associated with stadiometer height in the study population. RESULTS The sample included 141 participants (61.7% male, median age 38.8 years; IQR: 10.1 years). All measured body segment were statistically significantly correlated with stadiometer height, the strongest association being with knee height in both males (R2:0.77) and females (R2:0.86). Foot length and ulna length had the weakest correlation with stadiometer height in males and females, respectively. Multiple regression analysis identified knee height as having the best predictive value in determining stadiometer height. Overall, measurements of lower leg segments, particularly knee height, predicted measured height better than upper body segments. CONCLUSIONS When choosing height-prediction equations in clinical settings in populations with a high prevalence of stunting, such as South Africa, the fact that stunting affects the growth of long bones in the lower body more than in the upper body, should be considered.

Research paper thumbnail of Searching the lipidome for answers to prevent and treat non-communicable diseases

Cardiovascular journal of Africa, 2019

Research paper thumbnail of Anaemia prevalence and dietary diversity among women in the rural Free State, South Africa

Health SA Gesondheid

Background: Anaemia, a global public health problem that particularly affects women, holds major ... more Background: Anaemia, a global public health problem that particularly affects women, holds major consequences for human health.Aim: Determining dietary diversity, prevalence of anaemia and contraception use.Setting: Rural women, 25–49 years, in the Free State Province, South Africa.Methods: In a cross-sectional descriptive quantitative study, dietary diversity was determined with a 24-h recall; biochemical markers of anaemia, iron deficiency and inflammation were measured; and contraceptive use was recorded.Results: Of 134 women (median age 41 years), 51.5% had medium, and 44.8% had low dietary diversity. Overall, 76.9% consumed flesh meats and fish, but only 25.4% ate dark green leafy vegetables. Anaemia was present in 4.6%; 1.5% presented with iron deficiency; and 0.7% presented with iron deficiency anaemia, evidenced by low ferritin levels. However, 45.0% had elevated C-reactive protein (CRP). Overall, 7.5% presented with elevated homocysteine levels, but only 3.8% had low red ce...

Research paper thumbnail of Agreement between estimated and measured heights and weights in hospitalised patients — a restrospective study

South African Journal of Clinical Nutrition

Research paper thumbnail of Nutritional status, glycaemic control and barriers to treatment compliance among patients with type 2 diabetes attending public primary health clinics in Maseru, Lesotho

Journal of Endocrinology, Metabolism and Diabetes of South Africa

Research paper thumbnail of Overweight and obesity in six-year-old children in 4thand 5thquintile schools in Mangaung, South Africa

South African Journal of Clinical Nutrition

Research paper thumbnail of Obesity is associated with anaemia and iron deficiency indicators among women in the rural Free State, South Africa

South African Journal of Clinical Nutrition

Obesity and anaemia remain global public health problems, holding major consequences for human he... more Obesity and anaemia remain global public health problems, holding major consequences for human health. The objective was to determine body composition, prevalence of anaemia and iron deficiency, contraception use and associations between variables in rural women in the Free State, South Africa. Design: A cross-sectional study design was applied. Setting: The study was undertaken in rural Trompsburg, Philippolis and Springfontein. Subjects: A total of 134 HIV-uninfected non-pregnant females, aged between 25 and 49 years participated. Exposure and outcome measures: Data were collected on anthropometry, contraception use and biochemical markers of anaemia, iron deficiency and inflammation. Results: Median body mass index (BMI) (28.7 [24.2, 34.7] kg/m 2), waist circumference (90.8 [80.9, 103.0] cm) and body fat percentage (38.8 [34.3, 42.1] %) were classified as unhealthy. Only 2/134 had iron deficiency and 1/134 iron deficiency anaemia. Overall, 3.8% had low red cell folate levels. Almost half (45.0%) had elevated C-reactive protein (CRP) levels. More than half (54.1%) reported that they regularly menstruate and 71.6% currently or had previously used injectable contraceptives. Mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and transferrin saturation were significantly associated with BMI, waist circumference and body fat percentage. Conclusion: A predominant pattern of malnutrition, characterised by overweight and obesity, was prevalent. Risk for iron deficiency was associated with obesity. Prevalence of iron deficiency could be underestimated due to the large percentage with elevated CRP levels. Interventions should aim to improve the nutritional status of these women in order to reduce their risk for both chronic diseases and anaemia.

Research paper thumbnail of Food insecurity among students at the University of the Free State, South Africa

South African Journal of Clinical Nutrition

A large body of empirical evidence with regard to schoolchildren supports the fact that poor nutr... more A large body of empirical evidence with regard to schoolchildren supports the fact that poor nutrition and food insecurity negatively affect cognitive function and academic performance. 10-12 However, food insecurity in students at higher education institutions is a neglected field of research, possibly owing to the traditional, unstated

Research paper thumbnail of Still lost in translation: language barriers in South African health care remain

South African Family Practice

The patient-centred model of health care, which recognises patients' autonomy, promotes their act... more The patient-centred model of health care, which recognises patients' autonomy, promotes their active participation in decisions concerning their own health, and strives to treat patients holistically, improves health outcomes but relies on effective communication between healthcare providers and patients. In a multilingual society, a major barrier to effective communication arises when healthcare providers and their patients do not share the same first language. This review aims to explore the impact of the language barrier on the effective rendering of healthcare services in South Africa, and to raise awareness that studies regarding language barriers within the South African healthcare sector are currently limited to isiXhosa in the context of English and Afrikaans, and has been conducted almost exclusively in the Western Cape. Research, therefore, needs to be extended to healthcare settings in the rest of the country, and needs to include all the languages and cultures protected under the South African Constitution. Moreover, there is an opportunity, and a need, for interdisciplinary collaboration between language practitioners and healthcare professionals to find viable solutions to communication challenges posed by linguo-cultural barriers within the multilinguistic South African population, in order to honour the right of every citizen to equitable health care.

Research paper thumbnail of Pica practices among apparently healthy women and their young children in Ghana

Physiology & behavior, Jan 22, 2017

Pica is an increased appetite/craving for food or non-food substances like clay, and chalk, and i... more Pica is an increased appetite/craving for food or non-food substances like clay, and chalk, and is strongly associated with iron deficiency (ID) anemia. This study assessed pica practices among non-pregnant mothers and their children, 12-to-59months, in an anemia endemic population in Ghana. A cross-sectional quantitative survey was conducted in two randomly selected districts in Northern Ghana. The researchers developed semi-structured questionnaires with components on pica practice, history and experiences and administered via structured face-to-face interviews with mothers (N=161). Of this population, 139 mothers had children 12-to-59months in April 2012. Pica practice among children was reported by their mothers. Data was analysed using SPSS version 23.0. Few mothers (4%) spontaneously reported pica (for uncommon food and/or non-food substances) at the time of the interview, however, 27 (16.8%) mothers with pica were confirmed after further probing. Twelve (8.6%) children were r...

Research paper thumbnail of Vitamin D status, hypertension and body mass index in an urban black community in Mangaung, South Africa

African Journal of Primary Health Care & Family Medicine, 2016

Background: A strong relationship exists between hypertension and body weight. Research has linke... more Background: A strong relationship exists between hypertension and body weight. Research has linked both higher blood pressure and body weight with lower vitamin D status.Objective: This study assessed the vitamin D status of a low-income, urban, black community in South Africa, to examine whether serum levels of 25-hydroxy vitamin D [25(OH)D] are associated with hypertension and body mass index (BMI).Methods: Data collected from 339 adults (25–64 years) from the Assuring Health for All in the Free State (AHA-FS) study were analysed. Variables measured include serum 25(OH)D, blood pressure, weight and height to determine BMI, and HIV status.Results: Mean 25(OH)D level was 38.4 ± 11.2 ng/mL for the group; 43.5 ± 11.8 ng/mL and 37.0 ± 10.6 ng/mL for males and females, respectively. Approximately 40% of the participants were HIV-positive and 63.4% hypertensive. Based on BMI, 11.8% were underweight, 33.0% normal weight, 23.0% overweight and 32.1% obese. HIV status showed no correlation w...

Research paper thumbnail of Statistical assessment of reliability of anthropometric measurements in the multi-site South African National Dietary Intake Survey 2022

Research Square (Research Square), Dec 22, 2023

Background Anthropometric data quality in large multicentre nutrition surveys is seldom adequatel... more Background Anthropometric data quality in large multicentre nutrition surveys is seldom adequately assessed. In preparation for the South African National Dietary Intake Survey (NDIS-2022), this study assessed site leads and eldworkers' intra-and interrater reliability for measuring weight, length/height, mid-upper arm circumference (MUAC), waist circumference (WC) and calf circumference (CC). Methods Standardised training materials and measurement protocols were developed, and new anthropometric equipment was procured. Following two training rounds (12 site lead teams, 46 eldworker teams), measurement reliability was assessed for both groups, using repeated measurements of volunteers similar to the survey target population. Reliability was statistically assessed using the technical error of measurement (TEM), relative TEM (%TEM), intra-class correlation coe cient (ICC) and coe cient of reliability (R). Agreement was visualised with Bland-Altman analysis. Results By %TEM, the best reliability was achieved for weight (%TEM = 0.260-0.923) and length/height (%TEM = 0.434-0.855), and the poorest for MUAC by eldworkers (%TEM = 2.592-3.199) and WC (%TEM = 2.353-2.945). Whole-sample ICC and R were excellent (> 0.90) for all parameters except site leads' CC inter-rater reliability (ICC = 0.896, R = 0.889) and eldworkers' inter-rater reliability for MUAC in children under two (ICC = 0.851, R = 0.881). Bland-Altman analysis revealed no signi cant bias except in eldworkers' intra-rater reliability of length/height measurement in adolescents/adults (+ 0.220 (0.042, 0.400) cm). Reliability was higher for site leads vs. eldworkers, for intra-rater vs. inter-rater assessment, and for weight and length/height vs. circumference measurements. Conclusion NDIS-2022 site leads and eldworkers displayed acceptable reliability in performing anthropometric measurements, highlighting the importance of intensive training and standardised measurement protocols. Ongoing reliability assessment during data collection is recommended.

Research paper thumbnail of Household food insecurity in South Africa from 1999 to 2021: a metrics perspective

Public Health Nutrition

Objective:To review and synthesize studies on household food security in South Africa.Design:Syst... more Objective:To review and synthesize studies on household food security in South Africa.Design:Systematic mapping review of metrics (methodological review).Setting:Electronic databases, including EBSCOHost, Scopus and Web of Science, were searched for studies and reports on household food security in South Africa, reporting household food security published between 1999 and 2021. Searching, selecting and reporting were performed according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement.Participants:South African householdsResults:Forty-eight articles reporting on six national surveys (one repeated annually since 2002) and forty sub-national studies meeting the inclusion criteria were selected. Various metrics, with different recall periods and ways of categorizing food security levels, were identified. Surveys that used similar metrics showed that the percentage of South African households that have experienced food insecurity and hunger ha...

Research paper thumbnail of Job satisfaction and perception of workloads among dietitians and nutritionists registered in South Africa

South African Journal of Clinical Nutrition

Research paper thumbnail of Current opinion: Is added dietary sugar detrimental to health?

South African Family Practice, 2011

Research paper thumbnail of Body adiposity indices are associated with hypertension in a black, urban Free State community

African journal of primary health care & family medicine, Jan 19, 2014

Non-communicable diseases, including hypertension, are increasing rapidly in resource-poor, devel... more Non-communicable diseases, including hypertension, are increasing rapidly in resource-poor, developing countries amongst populations transitioning from traditional to westernised lifestyles; and are associated with excess weight. To investigate the relationship between hypertension and various indices of body adiposity in a transitioning, urban, black population. Three hundred and thirty-nine adults (25-64 years) from a larger cross-sectional study (Assuring Health for All in the Free State) conducted in Mangaung, South Africa, were included. Standard techniques were used to determine blood pressure, HIV status, body mass index (BMI), waist-to-height ratio (WHtR) and body adiposity index (BAI). Approximately 40% of the sample was HIV-positive and 63.4% hypertensive, with the greatest risk of hypertension being amongst older men. Based on BMI, 23.0% were overweight and 32.1% obese. Waist-to-height ratio showed that 58.6% had increased cardiovascular risk. Mean BAI was 34.1%, whilst 7...

Research paper thumbnail of Incorporating Adult Learning Principles in an Intervention Implementation. Experiences from an Iron Deficiency (ID) Education Program in Ghana

European Journal of Nutrition & Food Safety, 2015

Research paper thumbnail of Nutritional status of undergraduate healthcare students at the University of the Free State

South African Family Practice, 2013

Research paper thumbnail of Iron-focussed nutritional status of mothers with children (6–59 months) in rural northern Ghana

Research paper thumbnail of Short Reports: Herbal weight-loss products: how informed are we?

Successful weight loss requires commitment and long-term lifestyle changes to decrease energy int... more Successful weight loss requires commitment and long-term lifestyle changes to decrease energy intake and increase physical activity. By contrast, freely available diet remedies are advertised as quick solutions which promise to induce weight loss with little or no effort. No statistics are available on the use of these products in South Africa. However, in the USA, nationwide surveys have found that among adults who had seriously attempted to lose weight, 44.9% of women and 19.8% of men reported using non-prescription, weight-loss products, 1 while substantial numbers of adolescents (14.4% females and 7.2% males) 2 also claimed to have used these products. Non-prescription weight-loss products are aggressively marketed, often with little or no scientific proof of efficacy and safety in humans. 1 In particular, herbal weight-loss products are perceived by the public to be "natural" and therefore harmless. 1 In many countries, including the USA and South Africa, by law, these herbal weight-loss products are classified as dietary supplements. Therefore, they escape strict regulation of their availability, as well as the advertising and labelling claims which are made about their efficacy and safety. 1 For this reason, the responsibility to provide evidence-based guidance to the consumer on these products reverts to healthcare professionals. This study aimed to assess the extent to which dietitians and pharmacists in central South Africa are informed about the ingredients of a specific, popularly used, herbal weight-loss product. Method In this study, claims that a popular over-the-counter, herbal product may assist in weight loss were evaluated for validity by assessing

Research paper thumbnail of Predictive value of different body segments to estimate height in a South African adult hospital population

Clinical Nutrition ESPEN

BACKGROUND AND AIMS Height measurement is a vital component for assessing nutritional risk, and c... more BACKGROUND AND AIMS Height measurement is a vital component for assessing nutritional risk, and calculating dietary requirements in a clinical setting where indirect calorimetry is not available. In many patients, height cannot be measured accurately, and equations based on body segments are relied on to predict height. This study aimed to evaluate if specific body segments are better associated with height than others in a South African public hospital setting. METHODS A descriptive cross-sectional study was conducted in three public hospitals in Bloemfontein, South Africa, on patients, 20-50 years of age, and able to stand upright without assistance to be measured by stadiometer. Spearman correlations were assessed between stadiometer height and arm-span, demi-span, ulna length, knee height, tibia length, fibula length and foot length (measured by standardised techniques). Multiple regression analysis was performed to identify the segment that is most closely associated with stadiometer height in the study population. RESULTS The sample included 141 participants (61.7% male, median age 38.8 years; IQR: 10.1 years). All measured body segment were statistically significantly correlated with stadiometer height, the strongest association being with knee height in both males (R2:0.77) and females (R2:0.86). Foot length and ulna length had the weakest correlation with stadiometer height in males and females, respectively. Multiple regression analysis identified knee height as having the best predictive value in determining stadiometer height. Overall, measurements of lower leg segments, particularly knee height, predicted measured height better than upper body segments. CONCLUSIONS When choosing height-prediction equations in clinical settings in populations with a high prevalence of stunting, such as South Africa, the fact that stunting affects the growth of long bones in the lower body more than in the upper body, should be considered.

Research paper thumbnail of Searching the lipidome for answers to prevent and treat non-communicable diseases

Cardiovascular journal of Africa, 2019

Research paper thumbnail of Anaemia prevalence and dietary diversity among women in the rural Free State, South Africa

Health SA Gesondheid

Background: Anaemia, a global public health problem that particularly affects women, holds major ... more Background: Anaemia, a global public health problem that particularly affects women, holds major consequences for human health.Aim: Determining dietary diversity, prevalence of anaemia and contraception use.Setting: Rural women, 25–49 years, in the Free State Province, South Africa.Methods: In a cross-sectional descriptive quantitative study, dietary diversity was determined with a 24-h recall; biochemical markers of anaemia, iron deficiency and inflammation were measured; and contraceptive use was recorded.Results: Of 134 women (median age 41 years), 51.5% had medium, and 44.8% had low dietary diversity. Overall, 76.9% consumed flesh meats and fish, but only 25.4% ate dark green leafy vegetables. Anaemia was present in 4.6%; 1.5% presented with iron deficiency; and 0.7% presented with iron deficiency anaemia, evidenced by low ferritin levels. However, 45.0% had elevated C-reactive protein (CRP). Overall, 7.5% presented with elevated homocysteine levels, but only 3.8% had low red ce...

Research paper thumbnail of Agreement between estimated and measured heights and weights in hospitalised patients — a restrospective study

South African Journal of Clinical Nutrition

Research paper thumbnail of Nutritional status, glycaemic control and barriers to treatment compliance among patients with type 2 diabetes attending public primary health clinics in Maseru, Lesotho

Journal of Endocrinology, Metabolism and Diabetes of South Africa

Research paper thumbnail of Overweight and obesity in six-year-old children in 4thand 5thquintile schools in Mangaung, South Africa

South African Journal of Clinical Nutrition

Research paper thumbnail of Obesity is associated with anaemia and iron deficiency indicators among women in the rural Free State, South Africa

South African Journal of Clinical Nutrition

Obesity and anaemia remain global public health problems, holding major consequences for human he... more Obesity and anaemia remain global public health problems, holding major consequences for human health. The objective was to determine body composition, prevalence of anaemia and iron deficiency, contraception use and associations between variables in rural women in the Free State, South Africa. Design: A cross-sectional study design was applied. Setting: The study was undertaken in rural Trompsburg, Philippolis and Springfontein. Subjects: A total of 134 HIV-uninfected non-pregnant females, aged between 25 and 49 years participated. Exposure and outcome measures: Data were collected on anthropometry, contraception use and biochemical markers of anaemia, iron deficiency and inflammation. Results: Median body mass index (BMI) (28.7 [24.2, 34.7] kg/m 2), waist circumference (90.8 [80.9, 103.0] cm) and body fat percentage (38.8 [34.3, 42.1] %) were classified as unhealthy. Only 2/134 had iron deficiency and 1/134 iron deficiency anaemia. Overall, 3.8% had low red cell folate levels. Almost half (45.0%) had elevated C-reactive protein (CRP) levels. More than half (54.1%) reported that they regularly menstruate and 71.6% currently or had previously used injectable contraceptives. Mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and transferrin saturation were significantly associated with BMI, waist circumference and body fat percentage. Conclusion: A predominant pattern of malnutrition, characterised by overweight and obesity, was prevalent. Risk for iron deficiency was associated with obesity. Prevalence of iron deficiency could be underestimated due to the large percentage with elevated CRP levels. Interventions should aim to improve the nutritional status of these women in order to reduce their risk for both chronic diseases and anaemia.

Research paper thumbnail of Food insecurity among students at the University of the Free State, South Africa

South African Journal of Clinical Nutrition

A large body of empirical evidence with regard to schoolchildren supports the fact that poor nutr... more A large body of empirical evidence with regard to schoolchildren supports the fact that poor nutrition and food insecurity negatively affect cognitive function and academic performance. 10-12 However, food insecurity in students at higher education institutions is a neglected field of research, possibly owing to the traditional, unstated

Research paper thumbnail of Still lost in translation: language barriers in South African health care remain

South African Family Practice

The patient-centred model of health care, which recognises patients' autonomy, promotes their act... more The patient-centred model of health care, which recognises patients' autonomy, promotes their active participation in decisions concerning their own health, and strives to treat patients holistically, improves health outcomes but relies on effective communication between healthcare providers and patients. In a multilingual society, a major barrier to effective communication arises when healthcare providers and their patients do not share the same first language. This review aims to explore the impact of the language barrier on the effective rendering of healthcare services in South Africa, and to raise awareness that studies regarding language barriers within the South African healthcare sector are currently limited to isiXhosa in the context of English and Afrikaans, and has been conducted almost exclusively in the Western Cape. Research, therefore, needs to be extended to healthcare settings in the rest of the country, and needs to include all the languages and cultures protected under the South African Constitution. Moreover, there is an opportunity, and a need, for interdisciplinary collaboration between language practitioners and healthcare professionals to find viable solutions to communication challenges posed by linguo-cultural barriers within the multilinguistic South African population, in order to honour the right of every citizen to equitable health care.

Research paper thumbnail of Pica practices among apparently healthy women and their young children in Ghana

Physiology & behavior, Jan 22, 2017

Pica is an increased appetite/craving for food or non-food substances like clay, and chalk, and i... more Pica is an increased appetite/craving for food or non-food substances like clay, and chalk, and is strongly associated with iron deficiency (ID) anemia. This study assessed pica practices among non-pregnant mothers and their children, 12-to-59months, in an anemia endemic population in Ghana. A cross-sectional quantitative survey was conducted in two randomly selected districts in Northern Ghana. The researchers developed semi-structured questionnaires with components on pica practice, history and experiences and administered via structured face-to-face interviews with mothers (N=161). Of this population, 139 mothers had children 12-to-59months in April 2012. Pica practice among children was reported by their mothers. Data was analysed using SPSS version 23.0. Few mothers (4%) spontaneously reported pica (for uncommon food and/or non-food substances) at the time of the interview, however, 27 (16.8%) mothers with pica were confirmed after further probing. Twelve (8.6%) children were r...

Research paper thumbnail of Vitamin D status, hypertension and body mass index in an urban black community in Mangaung, South Africa

African Journal of Primary Health Care & Family Medicine, 2016

Background: A strong relationship exists between hypertension and body weight. Research has linke... more Background: A strong relationship exists between hypertension and body weight. Research has linked both higher blood pressure and body weight with lower vitamin D status.Objective: This study assessed the vitamin D status of a low-income, urban, black community in South Africa, to examine whether serum levels of 25-hydroxy vitamin D [25(OH)D] are associated with hypertension and body mass index (BMI).Methods: Data collected from 339 adults (25–64 years) from the Assuring Health for All in the Free State (AHA-FS) study were analysed. Variables measured include serum 25(OH)D, blood pressure, weight and height to determine BMI, and HIV status.Results: Mean 25(OH)D level was 38.4 ± 11.2 ng/mL for the group; 43.5 ± 11.8 ng/mL and 37.0 ± 10.6 ng/mL for males and females, respectively. Approximately 40% of the participants were HIV-positive and 63.4% hypertensive. Based on BMI, 11.8% were underweight, 33.0% normal weight, 23.0% overweight and 32.1% obese. HIV status showed no correlation w...