South African Journal of Clinical Nutrition - November 2022 - Vol 35 Issue 4

Introduction

Patients in public hospitals received insufficient food to meet daily protein and energy requirements: Cape Town Metropole, South Africa

Malnutrition is broadly defined as any imbalance in energy and nutrient intake, ranging from overnutrition to undernutrition. Undernutrition is prevalent in the developing world and is also found in age care facilities and hospitals. According to the definition of the European Society for Enteral and Parenteral Nutrition (ESPEN), undernutrition may be as a result of diseaserelated weight loss, a protein deficiency or a deficit in specific nutrients. More recently hospital acquired malnutrition has been recognised and defined as malnutrition first diagnosed 14 days after admission.

Dietary intake of first- and third-year female dietetics students at a South African university

There has been an increase in non-communicable diseases (NCDs) worldwide, where they are one of the leading causes of death. Chronic diseases, traditionally associated with older adults and the elderly, are presenting at an earlier age. In South Africa, the general population does not meet dietary recommendations, largely due to a lack of dietary diversity

Prevalence of severe acute malnutrition and its effect on under-five mortality at a regional hospital in South Africa

Severe acute malnutrition (SAM) specifically is defined as weight-for-height below −3 Z score, mid-upper arm circumference (MUAC) less than 115 mm and/or bilateral nutritional oedema. SAM is an important public health concern, because it is a preventable disease that contributes significantly to under-five morbidity and mortality. The prevalence of SAM globally is approximately 7.3% but rates vary vastly between different areas. Low- to middle-income countries carry the highest burden with rates of 14.6% reported in southern Asia and 5% in South Africa.

Should fast-food nutritional labelling in South Africa be mandatory?

The high prevalence of nutrition-related non-communicable diseases (NCDs), such as diabetes, hypertension, cardiovascular diseases and certain cancers, remains a major health burden and leading cause of mortality. The increased prevalence of these diseases in South Africa is largely due to rapid urbanisation, which associates with nutrition transition to ultra-processed and high-energy dense foods and concomitant elevated obesity rates. The association between urbanisation and the observed nutrition transition could be due to the growing expansion of, and increased access to, large modern food retailers and fast-food restaurants, which are mostly located within urban areas.3 Fast foods can be defined as convenient foods that are quickly prepared and served from outlets that include restaurants, cafés and takeaways. Examples of these foods include burgers, fried (potato) chips, chicken, fish and pizzas, which are convenient to obtain at relatively low prices but are generally high in energy, fat, sodium and sugar.

The effect of vitamins B12, B6 and folate supplementation on homocysteine metabolism in a low-income, urbanised, black elderly community in South Africa

The wave of cardiovascular disease (CVD) that was considered endemic to the developed world is expanding to developing countries. The emphasis in South African health policy is largely placed on children, youth and maternal care, whereas the health needs of the elderly tend to be marginalised. At primary health care level, no dedicated geriatric services are offered in the public health sector and older people thus need to be accommodated in facilities where overcrowding and severe staff shortages limit the attention given. This limits the detection and treatment of nutritional deficiencies of the low-income aged in South Africa (SA). A previous study conducted in the current population (Sharpeville elderly community) confirmed that these respondents are at an increased risk of CVD.4–6

Effect of simplified dietary advice on nutritional status and uremic toxins in chronic kidney disease participants

Chronic kidney disease (CKD) is highly prevalent globally and in sub-Saharan Africa. Globally, there has been an increase in CKD morbidity, mortality and disability-adjusted years of life, with an increased burden of CKD in sub-Saharan Africa. There are many complications related to CKD including anemia, malnutrition, anorexia, mineral and bone disease, electrolyte disturbances, cardiovascular disease and progression to end-stage kidney disease (ESKD). In addition, patients with CKD may have several co-morbidities including obesity, hypertension and diabetes.5 Traditional CKD nutritional advice has been challenging to convey to patients owing to the complexity of the diet. Patients had been advised to restrict fruits, vegetables, legumes, wholegrains, dairy and nuts owing to their phosphate and potassium content.6 In addition, protein restrictions are needed to mitigate deterioration of kidney function; these factors and disease-related symptoms such as nausea, vomiting and anorexia result in low adherence to dietary advice.7 To ensure sound nutritional advice and to improve adherence, these and additional factors including side effects of medications, financial constraints and dietary acceptance should be considered by healthcare professionals.

Nutrition and vasoactive substances in the critically ill patient

The most common cause of haemodynamic instability (a disturbance of the forces involved in circulating blood through the body) in the critically ill patient is a state of shock, whether it is hypovolaemic, cardiogenic or distributive (septic, anaphylactic or neurogenic) shock. Although the causes of the state of shock differ, the result is the same: decrease in cardiac output and insufficient tissue perfusion; hence haemodynamic instability. Interventions, including fluid therapy and the administration of vasoactive substances like vasopressors (increase in the vascular tone) and inotropic substances (increase in myocardial contraction) to restore homeostasis (haemodynamic stability), are of critical importance to prevent further deterioration.