South African Journal of Clinical Nutrition <ol> <li class="show">The Journal accepts articles from all basic and applied areas of dietetics and human nutrition, including clinical nutrition, community nutrition, food science, food policy, food service management, nutrition policy and public health nutrition.</li> <li class="show">The Journal has a broad interpretation of the field of nutrition and recognizes that there are many factors that determine nutritional status and that need to be the subject of scientific investigation and reported in the Journal.</li> <li class="show">The Journal seeks to serve a broad readership and to provide information that will be useful to the scientific community, the academic community, government and non-government stakeholders in the nutrition field, policy makers and industry.</li> <li class="show">The Journal encourages articles from all investigators in the field of dietetics, food, nutrition and related areas. In particular young researchers and researchers from historically disadvantaged backgrounds will be encouraged and supported to submit their research work for publication.</li> <li class="show">The Journal is based in South Africa and encourages articles from other African countries to act as a forum for the discussion of African nutritional issues.</li> <li class="show">The Journal is committed to high scientific and ethical standards.</li> <li class="show">The Journal will accept letters for publication, which are relevant to the Journal.</li> <li class="show">The Journal provides a forum for publication of congress abstracts, supplements, short communications and policy statements with their technical support papers.</li> <li class="show">The views expressed in the Journal are those of the authors and not necessarily those of the Editorial Board.</li> <li class="show">The Journal will be managed by an Editor and Editorial Board with the following responsibilities:</li> <ul> <li class="show">Maintenance of scientific standards of the articles published and appointment of a review Panel of experts for the peer review process</li> <li class="show">Maintenance of ethical standards of the articles published</li> Encouragement and support of authors <li class="show">Promotion of the readership</li> <li class="show">Ensuring the spread of articles published</li> </ul> <li class="show">Maintenance of ethical standards with regard to sponsorship and advertisements</li> <li class="show">The Editorial Board of the SAJCN recognises the important role that advertisements and sponsorships play in meeting the costs of the publication and in ensuring the continued existence of the Journal. The SAJCN welcomes advertising or funding from all possible sources, provided the advertisements or funding arrangements are supportive of the objectives of the Journal and do not conflict with the mission, vision and values statements of ADSA, NSSA and SASPEN. The following guidelines shall be implemented for sponsorship and advertising:</li> <ul> <li class="show">The Jakarta Declaration, which clearly stipulates that “both the public and the private sector should promote health by pursuing policies and practices that ….. restrict production and trade in inherently harmful goods and substances such as tobacco and armaments, as well as unhealthy practices?</li> <li class="show">Advertisements/sponsorships should not conflict with the South African Code of Ethics for the Marketing of Breastmilk Substitutes. The updated code will be used as soon as it is formally released.</li> <li class="show">The Journal will accept advertisements for infant-feeds, which are therapeutic in nature, for example lactose free feeds, breast milk fortifiers, hypo-allergic feeds and feeds designed for tube feeding. Any such advertisements shall include a phrase that normally exclusive breast milk feeding is the best food for babies.</li> <li class="show">There shall be full disclosure at all times of funding sources</li> <li class="show">The decision to reject an advertisement / sponsorship rests with the Editorial Board and should be recorded, so that further investigations can be conducted if required</li> <li class="show">Non-designated support will be accepted from interested organisations and shall be acknowledged in the Journal</li> <li class="show">The allocated editorial space for advertisements should not normally exceed 40% of the total editorial space in any one issue of the Journal; however, the costs of publication of the Journal should always be borne in mind in any one given situation</li> <li class="show">The Editor, in consultation with the Editorial Board as appropriate, will be responsible for the final acceptance of any advertorial material</li> </ul> </ol> <p>Other websites related to this journal:<br>NISC <a href="" target="_blank" rel="noopener" data-saferedirecturl=";source=gmail&amp;ust=1684568969944000&amp;usg=AOvVaw2GsR7m5wTo6_bDIrFD3goH"><wbr>products/77/journals/south-<wbr>african-journal-of-clinical-<wbr>nutrition</a><br>T&amp;F <a href="" target="_blank" rel="noopener" data-saferedirecturl=";source=gmail&amp;ust=1684568969944000&amp;usg=AOvVaw16BF1kchMr8VCJE98Bl9Kt"><wbr>journals/ojcn20</a><br>SAJCN website <a href="" target="_blank" rel="noopener" data-saferedirecturl=";source=gmail&amp;ust=1684568969944000&amp;usg=AOvVaw2d88QwEyiZWfXx_CYQVUAl"><wbr>php/SAJCN</a>)</p> <p>The <em>South African Journal of Clinical Nutrition</em> (SAJCN) is also Accredited with the <strong>DHET (SAPSE)</strong> and now on the <strong>DOAJ</strong>.</p> Association for Dietetics in South Africa, the Nutrition Society of South Africa and the South African Society of Parenteral and Enteral Nutrition. en-US South African Journal of Clinical Nutrition 1607-0658 <p>Material submitted for publication in the South African Journal of Clinical Nutrition (SAJCN) is accepted provided it has not been published elsewhere. Copyright forms will be sent with acknowledgement of receipt and the SAJCN reserves copyright of the material published.</p><p>The SAJCN does not hold itself responsible for statements made by the authors.</p> Nutrition support in critical care: How does a South African unit measure up against the suggested guidelines and against the world? <p>No abstract</p> Anna-Lena du Toit Copyright (c) 2023 2023-07-24 2023-07-24 36 2 Nutritional support practices at an intensive care unit in Johannesburg, South Africa <p><strong>Objectives:</strong> Nutritional support is a fundamental component of holistic patient care in the intensive care unit (ICU). There is a paucity of local data pertaining to nutritional support practices at ICUs in South Africa. The aim of this study was to determine nutritional support practices at an academic hospital ICU in Johannesburg, South Africa.<br><strong>Methods:</strong> In this cross-sectional, descriptive and retrospective study, a simple random sampling method was utilised to select<br>50 data collection days from a three-month period (1 August–31 October 2018). Data relevant to the study were extracted from the ICU charts of patients who received formulae-based enteral and/or parenteral nutrition on the selected days. Charts were categorised into acute phase days (≤ 72 hours from ICU admission) and recovery phase days (&gt; 72 hours from ICU admission).<br><strong>Results</strong>: A total of 387 ICU charts were included in the final sample, comprising 114 acute phase and 273 recovery phase days. Overall, enteral nutrition was prescribed on 296 (76.5%) chart days while parenteral nutrition was prescribed on 111 (28.7%) chart days. The median daily fluid balance was approximately 600 ml positive. Target protein and calorie intake was achieved on 67 (17.3%) and 110 (28.4%) chart days respectively.<br><strong>Conclusion</strong>: Although protein and calorie intake was suboptimal in comparison with the recommended targets, it is in keeping with general international trends. Regular audits, training of staff, attention to minimising feeding interruptions and encouraging the timely initiation of enteral nutrition are recommended interventions that may be useful in achieving<br>nutritional targets.</p> Abdullah E Lahera Jared McDowall Mikayla van Weliea Domenic M Malingaa Alistair J Craythornea Brandon J van Aardt Tasneem Dalvieb Guy A Richards Copyright (c) 2023 2023-07-24 2023-07-24 36 2 45 50 Exploring the prevalence of multiple forms of malnutrition in children 6–18 years living in the Eastern Cape, South Africa <p><strong>Background</strong>: The existence of multiple forms of malnutrition is a growing problem in developing countries. Children living in the Eastern Cape have a relatively high prevalence of cardiovascular disease (CVD) risk factors and food insecurity, suggesting the possibility of the several coexisting forms of malnutrition. Due to the negative long-term consequences of undernutrition, overnutrition and, to a greater extent, a combination of both, it is important for this issue to be identified early in children and addressed.<br /><strong>Aim:</strong> This study was undertaken to investigate the prevalence of the different forms of malnutrition in children living in the Eastern Cape province.<br /><strong>Methods:</strong> Secondary analysis of a cross-sectional sample of 237 school-aged children, aged 6–18 years, in the Eastern Cape province of South Africa was conducted. The variables included in the analysis were the demographic data, anthropometric data and biochemical data, specifically blood profiles related to micronutrient deficiencies and CVD risk factors. Fisher’s exact test was used to compare the prevalence rates of several coexisting forms of malnutrition in the children. All data analysis was conducted in R version 4.0.3 and statistical significance was set at 0.05.<br /><strong>Results</strong>: In children with overweight/obesity, 13.6% had a micronutrient deficiency, while 37.71% of the children within the normal weight range had coexisting micronutrient deficiencies and CVD risk factors. The prevalence of folate deficiency was 73.0%, iron deficiency 6.3%, and hyperglycaemia was at 10.6%. Fisher’s exact test was used to compare the prevalence rates between genders and no statistically significant differences were observed.<br /><strong>Conclusion:</strong> Further research is needed to understand the relatively high prevalence of CVD risk factors in these children within the normal weight range and to investigate how dietary intake contributes to the overall double burden of malnutrition in children.</p> Gugulethu T Moyoa Abdulkadir A Egalb Wilna Oldewage-Therona Copyright (c) 2023 2023-07-24 2023-07-24 36 2 51–55 51–55 The relationships between socioeconomic status, dietary knowledge and patterns, and physical activity with adiposity in urban South African women <p><strong>Background:</strong> This cross-sectional study examined the relationship between socioeconomic status (SES), dietary knowledge and patterns, and physical activity level with body mass index of urban South African young women.<br /><strong>Methods:</strong> Data were collected on 160 black South African women (aged 18–24 years) and included household SES, food frequency and nutritional knowledge questionnaires, self-reported physical activity and anthropometry. To assess household SES index, 1–7 assets were categorised as a lower household SES and those with 8–13 assets as a higher household SES. Structural equation modelling analysis was used to determine the direct, indirect and total effects on adiposity of household SES, age, education, nutrition knowledge score, dietary patterns and physical activity.<br /><strong>Results:</strong> The prevalence of overweight and obesity was similar among women from high SES households compared with their low SES peers (48.4 vs. 44.8%). More than half (53%) of the women had poor dietary knowledge. Women from low SES households spent more time in moderate to vigorous intensity exercise (MVPA) compared with their high SES counterparts. Two distinct dietary patterns (Western and mixed) were identified. SEM results show that a unit increase in adherence to the ‘Mixed’ dietary pattern compared with ‘Western’ was associated with a 0.81 lower BMI kg/m<sup>2</sup> (95% CI −1.54; −0.08), while ≥ 150 minutes’ MVPA per week was associated with a 1.94 lower BMI kg/m2 (95% CI −3.48; −0.41).<br /><strong>Conclusion</strong>: The associations of SES, diet and physical activity on BMI must be taken into account when developing and designing interventions that target improvement in young women’s health.</p> Gudani Mukoma Stephanie V Wrottesleya Juliana Kagurac Tolu Onid Lisa Micklesfielda Shane A Norris Copyright (c) 2023 2023-07-24 2023-07-24 36 2 56–62 56–62 Assessment of knowledge, attitude and practice of nurses regarding enteral nutrition at a military hospital <p><strong>Background and objectives</strong>: Enteral nutrition (EN) support plays a vital role in reducing malnutrition in hospitalised patients, and its provision is primarily a nurse’s role. Therefore, nurses need to have adequate knowledge and a positive attitude regarding EN. This study aimed to determine the knowledge, attitudes and practices (KAPs) regarding enteral nutrition of nursing personnel at 1 Military Hospital and to determine the need for updated in-service training.<br /><strong>Method</strong>: A descriptive, cross-sectional study with an analytical component was used to collect data from military nurses through a validated self-administered questionnaire. A score of 80% and above was rated as adequate knowledge. Descriptive statistics were employed to describe the results and correlations were used to determine relationships between continuous variables.<br /><strong>Results:</strong> In total, 207 (86.2% response rate) questionnaires were completed. The median knowledge score was 46.3% (mean 45.8 ± 13.7%, range 6.3–81.2%). Only one participant achieved the target score of ≥ 80%, and 16.3% scored ≥ 60%. No significant differences were found between knowledge and professional rank (p = 0.14) and knowledge and years of working experience (r = −0.01; p = 0.85). A positive attitude towards EN was found and 96.1% of participants expressed the need for additional in-service training.<br /><strong>Conclusion</strong>: The nursing personnel have inadequate EN knowledge, irrespective of their professional rank and experience. However, they are perceived to have positive attitudes towards the importance and administration of EN. Therefore, inservice training should be conducted regularly to mitigate the gap in knowledge.</p> Londolani Ramuadaa Lizl Veldsmana Nedzingahe Livhuwanic Renée Blaauw Copyright (c) 2023 2023-07-24 2023-07-24 36 2 63–69 63–69 Perception of proposed preliminary food-based dietary guidelines for Lake Victoria region of Kenya: findings from a qualitative study among adult community members <p><strong>Background</strong>: Diets in the Lake Victoria region of Kenya have been described as monotonous, consisting chiefly of starchy staple<br />foods, accompanied by green vegetables and oil. To promote healthy eating in the region, 11 food-based dietary guidelines (FBDGs) were proposed.<br /><strong>Objective:</strong> This study was designed to assess perception of the proposed FBDGs amongst consumers in Lake Victoria region.<br /><strong>Design and setting</strong>: A qualitative, descriptive cross-sectional design was used to collect data from 36 focus-group discussions<br />(FGD) among adult males (18) and females (18) in Kisumu and Homa Bay Counties.<br /><strong>Subjects:</strong> A total of 207 adult males (26–74 years) and 211 females (18–71 years) participated in this study. Data collection and analysis: Proposed FBDGs were printed on posters and presented to FGD participants. Proceedings were audio-taped, transcribed, translated and analysed based on themes.<br /><strong>Results:</strong> The proposed FBDGs were perceived as promoting the consumption of a balanced diet. As a concept, a balanced diet was misrepresented as composed of only three nutrients: carbohydrates, proteins and vitamins. There was no mention of fats/ oils and minerals as other significant nutrient constituents of a balanced diet. Other concepts, which included ‘three regular meals’, ‘snacks’, ‘food variety’, ‘healthy and physically active lifestyle’, were polysemous.<br /><strong>Conclusion:</strong> The findings provide insight to guide the adaptation of the national FBDGs. The findings also provide a basis for nutrition advocacy programmes and a rationale for the revision of nutrition education materials, including the school curriculum, to align content with current evidence-based information.</p> EC Korira PJ Tuitoek Copyright (c) 2023 2023-07-24 2023-07-24 36 2 70 75 Nutritional interventions and outcomes of children with short bowel syndrome in a tertiary hospital setting in South Africa <p><strong>Objectives</strong>: To describe the impact of nutritional interventions on the outcomes of children with short bowel syndrome (SBS).<br /><strong>Design:</strong> This was a retrospective descriptive observational review where data were obtained from the patient’s medical records.<br /><strong>Subjects and setting</strong>: Children with SBS between the ages of 0 and 24 months who obtained this diagnosis between January 2005 and December 2015 at a tertiary paediatric hospital in Cape Town were investigated.<br /><strong>Results:</strong> There were 46 patients (62% male, 38% female) included in the study. The median duration of parenteral nutrition (PN) support was one month (0.6, 2.2 months), after which 83% of patients were weaned from PN. Enteral nutrition was commenced in 96% of patients, with the majority (<em>n</em> = 36; 82%) starting on day six (±6; range 1–29 days) postoperatively and 80% of patients attaining full feeds at median 1.2 months (0.2, 36 months). Patients displayed a mean weight and length gain of 15 g/day (±4; range 19–92 g) and 2 cm/month (±1.4; range 0.25–4 cm) respectively. The main complications were PN-associated cholestasis (<em>n</em> = 17), fat malabsorption (<em>n</em> = 13) and vitamin D deficiency/insufficiency (<em>n</em> = 5).<br /><strong>Conclusion</strong>: This study showed that early initiation of PN support was attained, and that most patients were able to achieve enteral autonomy.</p> BD Saaymana AJW Millar E van Niekerk Copyright (c) 2023 2023-07-24 2023-07-24 36 2 76–83 76–83