South African Journal of Clinical Nutrition

Professionalism is vital

Liesbet Koornhof — Mon, 22 Sep 2025 00:00:00 +0000

None

Perceptions on child feeding practices among mothers of children under five in Namibia: a qualitative study

George W Mukisa, Andrit Lourens, Tonderai W Shumba — Mon, 22 Sep 2025 10:41:02 +0000

Background: In developing countries, sub-optimal child feeding is widespread and deprives children of critical nutrients to support rapid growth spurs in the early years, and this remains a challenge to their growth and development. The study aimed to explore the perceptions towards child feeding of mothers of children aged under five years in Namibia.
Methods: The study utilised a qualitative approach to obtain the perceptions of mothers of children under five years towards child feeding practices. Data were collected using focus-group discussions and in-depth face-to-face interviews with mothers/caregivers of children under five residing in four urban and peri-urban areas of Namibia.
Results: The study revealed that mothers had varied perceptions concerning child feeding practices that were not consistent with the recommended infant and young child feeding (IYCF) practices. The mothers’ perceptions of child feeding were influenced by their social networks and family support systems, social media, and traditional beliefs and practices. The perceived key enablers to appropriate IYCF included the provision of special rooms and nutritious diets to breastfeeding mothers, social media, and social network and family support systems. The perceived constraints to appropriate IYCF included, financial challenges, limited family support, single motherhood, negative traditional beliefs and practices, and inadequate access to information.
Conclusions: Improving child feeding practices necessitates strengthening support groups to encourage peer-to-peer learning, capacity building of mothers, health providers, and their support networks on IYCF, and provision of income-generating activities. The formulation of a nutrition-strategic framework with community-tailored and culturally sensitive interventions has the potential to streamline intervention implementation and contribute to positive nutrition outcomes.

Keywords: child feeding, perceptions, qualitative, breastfeeding, complementary feeding, Namibia

Nutritional management of adult patients hospitalised with COVID-19 by dietitians in KwaZulu-Natal

Kirthee Pillay, Naseera Ebrahim — Mon, 22 Sep 2025 11:12:39 +0000

Background: The outbreak of a novel coronavirus disease (COVID-19) in December 2019 led to a worldwide pandemic. Dietitians treated patients hospitalised with COVID-19 without published guidelines on the nutritional management of the disease or prior training on its management.
Objectives: To determine how dietitians managed adult patients hospitalised with COVID-19 in KwaZulu-Natal (KZN).
Design: A cross-sectional study was conducted.
Setting: KZN, South Africa.
Subjects: Forty-two dietitians who had treated adult COVID-19 patients in KZN participated in the study.
Outcome measures: A self-administered questionnaire was developed and used to collect data via the online platform, Google Forms.
Results: Most dietitians (n = 29; 68%) consulted a nutrition society for recommendations on the nutritional management of COVID-19 patients, particularly the European Society for Parenteral and Enteral Nutrition (ESPEN) (n = 12; 28.6%). Values used to calculate macronutrient requirements included: 25–30 kcal/kg/day for energy (n = 12; 28.6%), 50–60% of total energy requirement (TER) for carbohydrates (n = 8; 19.0%), 1.2–1.5 g/kg/day for protein (n = 6; 14.3%), and 30% of TER for fat (n = 15; 35.7%). Dietitians used actual bodyweight (n = 13; 31.0%), or estimated bodyweight (n = 19; 45.2%), to calculate nutritional requirements (p = 0.004). Half of the dietitians used a nutrition screening tool to screen for malnutrition (n = 21; 50%), with the Nutrition Risk Screening 2002 (NRS-2002) tool being the most used (n = 13; 61.9%) (p < 0.05).
Conclusions: Nutritional requirements used by dietitians to manage patients with COVID-19 were similar to those recommended by ESPEN for critically ill patients. Weight and height of bed-bound patients were estimated. Dietitians used the NRS-2002 tool to screen patients for malnutrition.

Keywords: adult patients, COVID-19, dietitians, KwaZulu-Natal, nutritional management

Public attitudes towards responsibilities and actions to curb obesity in South Africa: Second South African Human Development Pulse Survey

Mon, 22 Sep 2025 11:14:17 +0000

Background: The obesity epidemic is a major global public health concern. Despite high food insecurity, South Africa is one of the most obesity-burdened nations in Africa. Additionally, non-communicable diseases (NCDs) are increasing in this region, with obesity presenting as a key modifiable risk factor contributing to this burden.
Methodology: This extensive, nationally representative study assessed the prevalence of overweight and obesity confirmed by healthcare professionals among South African adults (aged 18 years and older). Various socioeconomic and demographic correlates were explored while investigating public attitudes, support for action, and nutritional knowledge related to obesity.
Results: In the total sample, 3.2% reported being told by a healthcare professional that they were overweight or obese, with females at a higher rate (3.5%). Regarding responsibility for addressing overweight/obesity, more respondents with low dietary recommendation knowledge (DRK) felt that none of the suggestions made were responsible (by +12.5%) compared with those with higher knowledge. Overweight/obese individuals cited ‘gyms and leisure centres’, ‘healthcare professionals’, and all categories listed as responsible. Both males and females favoured ‘gyms and leisure centres’ (19.1% vs.19.7%) and ‘healthcare professionals’ (17.7% vs 17.1%), with urban respondents showing slightly more support for most suggestions than rural respondents (by ≥ 0.4%). When asked about actions to reduce overweight/obesity, those with low knowledge expressed neutral views to all actions (≥ 38.9%) but opposed ‘banning adverts for high-fat foods’ (41.4%), unlike those with moderate or high DRK.
Conclusion: Lower public support was found for implementing or increasing taxes to reduce obesity-related burdens. There is a need for evidence-based interventions that include nutrition education targeting vulnerable groups, such as those who are overweight or obese.

Keywords: overweight, obesity, support for action, nationally representative survey, South Africa, adults

Oxidative biomarkers, trace elements, and other biochemical markers among sickle cell patients receiving omega-3 supplements: case-control study

Afraa Salaheldin Obied, Sahar Gamil, Abdelrahim O Mohamed — Mon, 22 Sep 2025 11:03:05 +0000

Background and aims: Sickle cell anaemia (SCA) is an autosomal recessive haematological disorder in which the gene coding for the beta chain of haemoglobin is mutated. Patients with SCA have higher levels of pro-oxidants such as lipid peroxide and lower levels of antioxidants. There is previous evidence that omega-3 fatty acid supplementation is a safe and effective treatment for SCA as an adjunct therapy alongside conventional treatments, as it is beneficial in decreasing anaemia, vasoocclusive crises, inflammation, and haemolysis. This study aimed to assess the effect of omega-3 supplementation on the levels of lipid peroxide, trace elements (magnesium, copper, and zinc), and other biochemical markers in sickle cell patients.
Methods: Ninety individuals (4–20 years old) were divided into 4 groups: Group A: 51 patients with SCA on omega 3 supplements, Group B: 22 sickle cell patients not on omega 3 supplementation, Group C: 17 healthy controls, and Group D: forming the patients’ group (Group A and Group B combined). Blood samples were collected to measure lipid peroxide, magnesium, copper, zinc levels, and other biochemical markers.
Results: No differences were found between Group A and Group B for all variables except magnesium levels, which were higher in Group B (16.9 ± 7.1 mg/l for Group B and 11.9 ± 7.8 mg/l for Group A, p < 0.001). In comparison with Group C, Group D had lower haemoglobin levels (p < 0.001) and higher levels of lipid peroxide (p < 0.001). Both groups C and D had lower copper levels than the normal range.
Conclusion: No association was found between omega-3 supplementation and the level of the measured biomarkers. The cause of low copper levels in Sudanese paediatric participants should be further investigated.

Keywords: Sickle cell anemia, omega-3 fatty acid, lipid peroxide, antioxidants, trace elements

Trends in ethical transgressions amongst South African dietetic practitioners

Mon, 22 Sep 2025 11:28:07 +0000

This study investigated ethical transgressions amongst dietetic practitioners in South Africa, using publicly available data from the Health Professions Council of South Africa (HPCSA) in the period 2014–2023. The study is a follow-up on the study by Nortje and Hoffmann (2015) who analysed HPCSA transgression records for the period 2007–2013. The current study found only five transgressions committed by two dietitians out of 1 376 cases across all HPCSA-registered professions. In total, amongst the more than 4 200 registered dietetic practitioners in 2024, this constitutes a transgression rate of < 0.05% (2 of ∼4,190), a decline from the previously reported 0.24% in 2013. While possible explanations for the apparent decline in transgressions are considered, no definitive conclusion is reached. Despite limitations, the findings highlight consistently low misconduct rates among dietitians over the past two decades, potentially positioning the profession as a model for ethical adherence in healthcare. t is recommended that future research be conducted to explore factors driving the high rate of ethical compliance in dietetics and its potential application across other healthcare professions.

Keywords: ethics of care, ethical transgressions, dietetics practice, regulation of professional practice

Exploring the association of alcohol consumption, tobacco use, and multimorbidity in a nationally representative sample of South African adults

A Craig, W Mapanga, A Mtintsilana, SN Dlamini, SA Norris — Mon, 22 Sep 2025 11:31:13 +0000

Background: Non-communicable diseases are the leading cause of deaths across the globe and low-to-middle income countries (LMICs) are disproportionally affected. Consequently, people living with multimorbidity or multiple chronic conditions and the potentiating risk factors such as alcohol consumption and tobacco use is increasing in LMICs.
Methods: This study made use of nationally representative data collected from 3 459 South African adults (aged > 18 years) and assessed alcohol consumption, tobacco use, and multimorbidity and explored socioeconomic and demographic associations thereof.
Results: 20.0% of respondents reported having smoked at some point, with the majority of those indicating that they currently smoke (96.1%). Among current smokers, most were classified as light smokers, consuming fewer than 10 cigarettes per day (73.1%). Among alcohol consumers (34.2%), 6.7% of the respondents showed moderate–severe alcohol consumption. When stratified by sex, more men consumed alcohol (by > 16%) than women. Nearly 13% of the total sample reported having multimorbidity, with a larger proportion being women (by 4%) when compared with men. When stratified by urbanicity, nearly 40% of respondents in the urban group reported consuming alcohol compared with the rural group at 28.0%. In multivariable adjusted binary logistic regressions, tobacco use and alcohol consumption increased the likelihood of reporting multimorbidity (p < 0.001) when compared with their counterparts. Consuming a moderate–severe level of alcohol increased the likelihood of multimorbidity twofold (p < 0.001) in those who reside in urban areas and more than threefold (p < 0.001) in those who reside in rural areas when compared with those who do not consume alcohol. All associations are independent of other sociodemographic determinants.
Conclusion: This study highlights the complex relationship between lifestyle factors and multimorbidity and the potential effect of urbanicity and sociodemographic characteristics on these relationships. Public health interventions targeted at the consumption of alcohol therefore need to be upscaled in these settings.

Keywords: alcohol, tobacco, multimorbidity, national survey, South Africa

Lifestyle patterns and dietary habits of patients living with type 2 diabetes mellitus attending primary healthcare facilities in Limpopo province, South Africa

Mon, 22 Sep 2025 11:52:09 +0000

Background: Type 2 diabetes mellitus (T2DM) affects millions globally, including nearly two million South African adults, with increased projections by 2045.
Objectives: To assess lifestyle patterns and dietary habits of patients attending primary healthcare facilities in Limpopo Province, South Africa.
Design: This cross-sectional study assessed the sociodemographic profile, clinical data, lifestyle patterns, and dietary habits of patients living with T2DM. A structured researcher-administered questionnaire was used to collect data in Sepedi. Data were analysed descriptively using STATA 18 SE.
Setting: Community health centres and clinics in Blouberg Municipality. Participants: 225 consecutively sampled adults living with T2DM, aged ≥ 20 years.
Results: Most participants were over 60 years old (60%), female (72.44%), and had poor glycaemic control (62%). Overweight and obesity were 37.27% and 32.73%, respectively. Most women (88.28%) had high-risk waist circumferences. Tobacco and alcohol use were 13.78% and 5.78%, respectively. Most engaged in light activity (88%), and 49.78% spend 4–7 hours daily sitting at work. Daily fruit consumption was very low (4.89%), and 53.22% consumed vegetables 2–3 times per week. White porridge was the staple carbohydrate (76%), often consumed in double portions (52%). Conversely, 68.89% avoided sugary drinks, salt, and fats, and 90.67% consumed home-prepared meals.
Conclusion: Our study revealed that T2DM is prevalent among elderly women, with low fruit and vegetable intake and high carbohydrate consumption possibly linked to affordability and unavailability, rather than non-compliance with dietary recommendations. Socioeconomically tailored dietary advice, promoting vegetable gardening and physical activity among patients, as well as continuous education of healthcare professionals and community health workers, should be considered.

Keywords: alcohol, diabetes, diet, lifestyle, physical activity, smoking

Case report: nutritional management of a repaired congenital diaphragmatic hernia

S Greyvenstein, RC Dolman-Macleod — Mon, 22 Sep 2025 10:36:27 +0000

Congenital diaphragmatic hernia (CDH) is a rare diaphragm malformation that historically had low survival rates, but advances in care have improved outcomes. This case study discusses the outpatient management of an 8-month-old male infant who survived CDH but, due to a severe oral aversion, required nutritional adaptations to ensure optimal growth was maintained. Barriers experienced included volume tolerance, feeding tolerance, and the need for feeding skill development. The case emphasises the importance of individualised nutritional management.

Keywords: congenital diaphragmatic hernia (CHD), growth faltering, multidisciplinary approach, oral aversion

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