South African Journal of Clinical Nutrition

Qualitative research methodology: approaches for nutrition research

E Kempen — 2025-04-08

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Paving the way to detect adult malnourished patients in resource-limited settings: the first step to the right to nutritional care

E Van Tonder — 2025-04-08

Hospital malnutrition, particularly disease-related malnutrition (DRM), is a significant public health concern associated with increased morbidity, mortality and costs. The recent Global Leadership Initiative on Malnutrition (GLIM) proposed a framework to globally standardise the diagnosis of adult malnutrition (undernutrition), allowing comparison of malnutrition prevalence across clinical and geographical settings and over time. Despite substantial global progress in using screening and diagnostic tools to identify malnourished patients, some countries and institutions lag behind, particularly in relation to malnutrition screening. This is especially of concern in low- and middle-income countries, including South Africa, where socioeconomic factors can exacerbate the occurrence of DRM. From a human rights perspective, the lack of malnutrition
screening and diagnosis followed by appropriate nutritional support denies patients their fundamental right to access adequate food, nutritional care and health. This opinion paper highlights the magnitude of DRM and addresses current challenges in identifying DRM within resource-limited healthcare settings, specifically in the South African public health sector. Framing malnutrition as a human rights and ethical issue, it underscores the urgent need for timely and equitable nutritional care and proposes strategies to improve identification practices. Challenges identified comprise inadequate resources and institutional factors. Collaboration between key stakeholders, including the South African National Department of Health (including representatives from the National Health Insurance), policy-makers, medical aids, researchers and professional societies is needed to identify the most feasible malnutrition screening and diagnostic tools for constrained settings, together with a widespread coordinated implementation strategy. Prioritising nutrition as part of the holistic management of all patients will help safeguard against DRM and the associated adverse effects.
Keywords: adults, GLIM, hospital, malnutrition, resource-limited

Infant and young child feeding practices of caregivers in Copesville, Pietermaritzburg, KwaZulu-Natal

T Mzobe — 2025-04-08

Background: Although infant and young child feeding (IYCF) recommendations are widely accepted in South Africa, inappropriate IYCF practices still exist, leading to malnutrition in children.
Objective: To investigate the IYCF practices of caregivers in Copesville, Pietermaritzburg (PMB).
Design: A cross-sectional study was conducted.
Setting: Masons Clinic, Copesville, PMB.
Subjects: Two-hundred and fifty caregivers older than 18 years of age caring for a 6–24-month-old child at the time of the study.
Outcome measures: A face-to-face questionnaire was developed using recent, relevant literature and was validated for the study.
Results: The mean age of the caregivers was 32.25 (10.42) years. About 96% (n = 239) of infants were ever breastfed. The mean age at which breastfeeding was stopped was 5.9 ± 4.3 months. Mothers who were still breastfeeding planned to continue
breastfeeding for a mean duration of 12.6 ± 5.6 months. About 60% (n = 149) of infants were started on solids at the appropriate age of 6 months. Lennon Entressdruppels (16.9%; n = 14), sugar water (15.7%; n = 13) and fruit and vegetables (13.3%; n = 11) were fed before the age of six months. Forty-nine caregivers (19.6%) consulted a traditional healer regarding IYCF. Non-edible items fed to cleanse the stomach included toothpaste and polish (5.6%; n = 8) and disinfectant solution (1.7%; n = 1).
Conclusions: Caregivers should be educated on the benefits of continued breastfeeding until two years or beyond and the importance of starting solids at the appropriate age of six months. The potential dangers to the health of infants of feeding non-edible items should also be highlighted.
Keywords breastfeeding, caregivers, complementary feeding, feeding practices, infant and young child

The effect of online nutrition and lifestyle education on body image dissatisfaction, body mass index, and disordered eating among female university undergraduate students in Lagos, Nigeria

F A Olatona — 2025-04-08

Background: Despite the increasing prevalence of body image dissatisfaction (BID), the effect of social media on body image (BI) among undergraduates, and the prohibitive cost of traditional health education interventions, little is known about the effectiveness of online lifestyle interventions to address BI, body mass index (BMI) and disordered eating (DE).
Objectives: This study aimed to assess the effect of an online nutrition and lifestyle intervention programme on BI, BMI, and DE among female undergraduate students in Lagos.
Methods: A quasi-experimental study involving intervention and control groups was undertaken. A total of 1 182 students (590 students from intervention and 592 from control) responded to follow-up out of 2 015 who completed the pre-intervention survey. Data were collected using pre-tested semi-structured self-administered questionnaires. Pulver’s Figure Rating Scale was used to determine BID. BMI was calculated following standard procedures. DE was assessed using the Eating Attitudes Test (EAT-26). The intervention programme was implemented through online learning and social media for 12 weeks. SPSS (version 25) was used for analysis. The association between variables was determined using chi-square while the level of significance was set at p = < 0.05.
Results: The intervention reduced BID, BMI and DE among the intervention group significantly (p < 0.05) compared with the control group. Although the highest proportion of students with BID was among the overweight/obese, many students who were normal weight (49.2%) or underweight (47.3%) were dissatisfied.
Conclusion: Online nutrition and lifestyle education could effectively reduce BI, BMI and DE among female undergraduate students in Lagos, Nigeria.
Keywords body image dissatisfaction, online health education interventions, online lifestyle interventions, body mass index, disordered eating

A two-day professional development workshop on advanced nutrition support increased Ghanaian nutrition and dietetic professionals’ self-efficacy and practical knowledge of enteral and parenteral nutrition support

R EA Ayande — 2025-04-08

Aims: Enteral and parenteral nutrition support (NS) improves clinical outcomes in critically ill patients, yet evidence from a needs assessment indicates that Ghanaian clinical nutrition practitioners (CNPs) have low self-efficacy in administering NS, especially parenteral nutrition. This study aimed to assess changes in knowledge and self-efficacy of Ghanaian CNPs on enteral and parenteral NS following a continuous professional development (CPD) workshop.
Methods: A one-group pre-test/post-test study was used. Remote workshops curated in July 2022 and designed to meet predetermined needs were delivered over two days by registered dietitians and certified nutrition support clinicians. CNPs’ self-efficacy was assessed using a 5-point Likert scale. Practical knowledge was assessed using 7 short case scenarios for indications of enteral and parenteral NS, and open-ended questions were used to request additional qualitative information concerning self-efficacy scores. Paired-sample t-tests were used to compare pre- and post-survey scores, and qualitative data were thematized.
Results: Fifty-two participants completed both surveys. There were statistically significant increases in self-efficacy for enteral and parenteral NS delivery, including: assessing indications for enteral nutrition (EN) (d = 0.62 CI 0.30, 0.94); writing EN prescriptions (d = 0.71 CI 0.38, 1.04) and determining micronutrient additives for parenteral nutrition (PN) (d = 1.07 CI 0.70, 1.44) as well as increases in knowledge based on the practical case studies (d = 0.29 CI 0.01, 0.57). In-depth understanding of EN and PN guidelines and feelings of empowerment were identified as reasons for increased self-efficacy and practical knowledge.
Conclusion: CPD workshops are a good first step to bridge gaps in the delivery of NS by Ghanaian CNPs; however, additional practical training modules are needed to improve practitioners’ competencies in the delivery of NS.
Keywords enteral nutrition, Ghana, nutrition support workshop, parenteral nutrition

Over half of South African beverages will require warning labels for high sugar and/or artificial sweeteners

W Mukhovha — 2025-04-08

Objective: To determine the proportion of commercially available beverages that may require warning labels for high sugar content and the presence of artificial sweeteners in South Africa.
Methods: This cross-sectional study analysed 603 non-alcoholic beverages (juices, soft drinks and energy drinks), identified from the top South African supermarkets (based on market share) with shopping websites. Data were collected from May to July 2024, and included ingredient lists and nutritional information per 100 ml. Products requiring warning labels for high sugar content and artificial sweeteners were identified based on the recently proposed labelling regulations (R. 3337).
Results: 21.4% of all beverages required a warning label for high sugar content, 49.8% for artificial sweeteners, and 58.7% for at least one of these criteria. Juices, despite having the highest energy (160 kJ/100 ml), glycaemic carbohydrates (9%) and sugar content (8.4%) compared with soft and energy drinks, were least likely to need warning labels for high sugar or artificial sweeteners (30% vs. 94.1% for soft drinks and 96.9% for energy drinks).
Conclusions: More than half of South African beverages are expected to require warning labels due to high sugar content and/or artificial sweeteners. The proposed regulations are likely to favour juices, which, despite their high sugar content, are less likely to require warning labels because the sugar is naturally occurring rather than added.
Recommendations: The South African government should include beverages with high natural sugar levels, like juices, in warning label criteria. This would ensure that consumers are adequately informed about the sugar content in all types of beverages.
Keywords: artificial sweeteners, energy drinks, front-of-pack labelling, juices, soft drinks, South Africa, sugar-sweetened beverages, sugar, warning labels

Insight into the complexities of human nutrition and holistic health: the value of qualitative descriptive research

C Potterie — 2025-04-08

South Africa’s nutrition transition, driven by a complex interplay of socio-ecological factors, has led to rapidly rising rates of overweight, obesity and non-communicable diseases. While quantitative methods offer important insights, they cannot fully capture these multifaceted issues. Qualitative descriptive research, rooted in naturalistic inquiry, provides both exploratory and explanatory value with procedural simplicity in illuminating the complexities of human nutrition and holistic health in South Africa, guiding the development of more effective and culturally sensitive interventions and policies. Recommendations are offered for future research using qualitative descriptive methods to enhance our understanding of the nutrition transition and its broader health implications.
Keywords health promotion, healthy lifestyle, qualitative research, research design

Managing the complications of a complicated upper gastrointestinal surgery

M L Bradfield — 2025-04-08

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Activity 184

SAJCN Office — 2025-04-08

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Activity 185

SAJCN Office — 2025-04-08

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ADSA Directions

SAJCN Office — 2025-04-08

NSSA News

SAJCN Office — 2025-04-08

SASPEN News

SAJCN Office — 2025-04-08