Theses and Dissertations

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Anthropometric status, dietary intake and uric acid levels in adults aged 40 to 60 years residing in Giyani Location of Greater Giyani Municipality in Mopani District, Limpopo Province
(2026-05-19) Shilubane, Fikela; Motadi, S. A.; Mahopo, T. C.
Background: Elevated serum uric acid levels (hyperuricemia) are influenced by several dietary and lifestyle factors, including high intake of sugar, alcohol, and purine-rich foods. Hyperuricemia is a major risk factor for gout, an inflammatory condition that has become increasingly prevalent in developing countries. Effective management of hyperuricemia often requires lifestyle modifications, with or without pharmacological intervention. Despite growing global concern, limited data exist on the dietary patterns, anthropometric status, and uric acid levels of adults in rural South African communities. The aim of this study was to assess the anthropometric status, dietary intake, and uric acid levels in adults aged 40 years and above residing in the Giyani location of Greater Giyani Municipality in Mopani District, Limpopo Province. Method: The study employed a cross-sectional design, with a quantitative research approach. A simple random sampling method was used to select the communities, while convenience sampling was employed to select the participants. The following variables were measured: socio-demographic characteristics, anthropometric status, dietary intake, serum uric acid level, and blood pressure. Data was collected using a researcher-administered questionnaire. The data were initially captured in Microsoft Excel and then exported to the Statistical Package for the Social Sciences (IBM SPSS Statistics, Armonk, NY), version 29, for further analysis, including the biochemical measurements. Independent T-tests were used for comparison. Measures were implemented to ensure the validity and reliability of the instruments, and ethical standards were adhered to in order to protect the rights of the participants. The formula yielded 394 participants, and an additional 10% (39) was added to account for attrition. The total sample size was 433 participants. Results: Hyperuricemia was most prevalent among participants aged 40–44 years (40.4%) and 51–60 years (34.1%). A notably higher prevalence was observed in females (63.4%) compared to males (18.1%), emphasizing a significant sex-related difference that warrants further investigation into the determinants such as biological and sociocultural. Employed participants exhibited a higher prevalence (59.2%), as did those from larger households, particularly families with five members (52.3%). Elevated uric acid levels were found in 82% of participants. Of these, 20% were overweight and 73% were obese. Waist circumference was very high in 67%, high in 20%, and normal in 13%. Additionally, 57% had high blood pressure. Strong positive correlations were observed between BMI and uric acid (r = 0.6124), BMI and waist circumference (r = 0.6880), and systolic and diastolic blood pressure (r = 0.8772). Moderate correlations existed between waist circumference and uric acid (r = 0.4425), BMI and systolic (r = 0.3999), and BMI and diastolic pressure (r = 0.3845). Weak correlations were found between dietary diversity score and both uric acid (r = 0.0524) and BMI (r = 0.0527). Conclusion: This study investigated the anthropometric status, dietary intake, and uric acid levels among adults aged 40 and above in Giyani, Limpopo Province. The results showed a high prevalence of elevated uric acid levels, overweight and obesity, and very high waist circumference among participants. Most participants had low dietary diversity. Significant associations were found between hyperuricemia and body mass index, waist circumference, blood pressure, and lifestyle behaviours such as physical inactivity, poor sleep, and inadequate weight control. These findings align with existing literature linking hyperuricemia to metabolic syndrome, cardiovascular disease, and kidney disorders.
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Biomarkers of environmental enteric dysfunction and growth status in infants aged 3–9 months in Thulamela Municipality, Limpopo Province, in South Africa
(2026-05-19) Mudau, Zwivhuya Patience; Mushaphi, L. F.; Mabapa, N. S.
Background Stunting is the most prevalent form of chronic undernutrition affecting over 165 million children under five years of age globally (WHO, 2006). In 2017, an estimated 1 in every 4 (23%) children aged < 5 years were stunted worldwide (Budge et al., 2019). The study aims to assess biomarkers of environmental enteric dysfunction and growth status in infants aged 3–9 months. Methodology A quantitative cross-sectional study was conducted among 396 infants aged 3–9 months residing in the Thulamela Municipality. Simple random sampling was used to select six clinics per cluster, for a total of 36 clinics. Convenience sampling was used to select 396 infants aged 3–9 months. A researcher-administered questionnaire was used to gather socio-demographic and anthropometric data from the infants. The questionnaire consisted of three sections, namely, section A: which solicited socio-demographic information such as age of infants, birth weight, birth length and immunisation, which was collected from the Road to Health Booklet, section B: where feeding practices information was collected and section C: Record sheet, where anthropometric measurements and blood samples collection were recorded. A phlebotomist collected blood samples from the infants to determine haemoglobin (Hb), ferritin, soluble transferrin receptor (sTfR), retinol-binding protein (RBP-4), thyroglobulin (Tg), C-reactive protein (CRP), and alpha-1-acid glycoprotein (AGP). IBM Statistical Package for the Social Sciences (SPSS) version 26 was used to analyse the data. Blood samples were analysed at a specialised human lab at Northwest University (NWU). Data was checked for normality using the Kolmogorov-Smirnov test. Data distributed normally were presented as means with standard deviations (SD), while non-normally distributed data were presented as median values with interquartile ranges (IQRs). Categorical data were presented as frequencies. Results More than half (50.7%) of mothers knew about breastfeeding, and they mentioned health workers as their source of information. More than half of the mothers had grades 11-12, almost a quarter had tertiary education. More than three-quarters (76.4%) of mothers-initiated breastfeeding immediately after delivery. More than half (50.7%) of the mothers introduced their infants to solid foods at 4–6 months of age. More than a quarter (30.7%) of mothers cited “infant is crying a lot” as a reason for introducing solid foods and fluids. More than a quarter (38.2%) of the mothers fed their infants breast milk and maize meal soft porridge. Majority of infants (96.4%) had sufficient vitamin A. More than a quarter (30.1%) of infants were stunted, 22.2% were underweight while 10.7% of infants were overweight. The majority (68.5%) of infants had low IGF-1 levels, while only 30% had normal levels. About 73.1% of the infants had high FGF-21 levels, 3.6% had normal levels, and only 23.4% had low levels. majority of infants (73.1%) had high IFABP levels, 3.6% had normal levels, and only 23.4% had low levels. About 47.2% of the infants had low CD-14 concentrations, 42.1% had normal concentrations, and 10.7% had high concentrations. Conclusion The results of the study show that mothers have breastfeeding knowledge however complementary feeding knowledge appears to be lacking. The growth status of infants is generally good however, stunting (16.7%) and wasting (5.1%) was observed. The education level of mothers may have contributed to the low prevalence of stunting and wasting. It is concluded that infants in Thulamela have anaemia (84.4% combined). There is good reason for concern about the risks of anaemia. Iron deficiency (ID) as indicated by ferritin and soluble transferrin receptor (sTfR) show that Iron deficiency (ID) exists in infants of Thulamela. The Tg results show that half of the infants had insufficient iodine, and this is a concern given consequences of iodine deficiency. The study results also indicate a growth hormone deficiency, as evidenced by low IGF-1 levels which may hinder linear growth, impair cognitive development, and weaken immune responses to pathogen exposure. The findings also show elevated FGF-21 levels which are associated with an increased risk of growth faltering, particularly during nutritional supplementation. The results of the study show elevated IFABP levels, indicating a compromised gut barrier and associated with poor nutritional status and a higher risk of malnutrition. The study reveals that fewer than 25% of infants showed elevated plasma CD14 levels, which are linked to inadequate nutrition, obesity, and inflammation. This study observed obesity and overweight, suggesting that increased CD14 levels may stem from these conditions in infants.
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Complementary feeding education programme for caregivers of infants aged 3-12 months in Polokwane Municipality, Limpopo Province
(2025-09-05) Makwela, Maishataba Solomon; Mushaphi, L. F.; Makhado, L.
Background The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months, with the introduction of Complementary feeding (CF) and continued breastfeeding for two years or beyond. The importance of exclusive breastfeeding and a smooth transition to balanced and informed complementary feeding has been reported. However, there remains a gap in knowledge regarding whether this information is practiced at the caregiver level. An appropriate complementary feeding has the potential to improve growth and development in infants from six months to two years of age. Purpose: This study aimed to develop and implement a complementary feeding education programme for caregivers with infants aged 312 months in Polokwane Municipality, Limpopo Province. Methods A non-randomized, quasi-experimental intervention study was conducted with 187 caregivers at baseline, with 150 completing the study. Initially, the intervention group comprised 95 caregiver-infant pairs, whereas the control group included 94. Post-intervention, 77 caregiver–infant pairs in the intervention group received complementary feeding education and six months of follow-up support from a dietitian researcher, whereas 71 pairs in the control group did not receive any intervention. Data were gathered from caregivers’ households at baseline and postintervention using a pretested, structured questionnaire to ensure consistency across both time points. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 29 for descriptive and inferential statistics. Spearman’s correlation was utilized to measure the strength and direction of monotonic association between variables, whereas chi-square tests were conducted to analyse relationships between variables. The effectiveness of the intervention was evaluated using difference‒in‒differences analysis, which compared changes in anthropometric measurements between the intervention and control groups. A significance level of p < 0.05 was applied. The study adhered to fundamental ethical research principles, including confidentiality, beneficence, privacy, and minimizing bias. Ethical clearance was obtained from the University of Venda, and necessary permissions were secured from relevant gatekeepers. Results There were no significant differences between the groups regarding sex, marital status, education level, occupation, housing type, or water source. Most caregivers were female and unmarried, with similar employment and housing conditions. Water scarcity was a concern in both groups, particularly the experimental group. A significant difference was observed in food availability, with nearly 70% of the control group reporting food insecurity (p=0.002). Waste disposal also varied, as more caregivers in the experimental group discarded rubbish in their yards (p=0.048). While most births were through normal delivery, the experimental group had a significantly higher rate of caesarean section (35%) than the control group (p=0.007). The mean(±SD.) age of the infants was 4.4 (±1.1) months in the intervention group and 5.5 (±0.2) months in the control group. At baseline, the mean (±S.D.) of infant weight was 7.37 (±0.83) Kg in the intervention group and 6.69 (±0.13) kg in the control group. The average (±S.D.) length was 61.00 (±0.53) cm for the intervention group and 62.30 (±0.79) cm for the control group. Of 198 participants, 77 in the intervention group and 71 in the control group completed the study. A significant weight increase was observed in the intervention group (DID mean = 1.82 kg, p<0.001), along with a notable length gain (DID mean = 7.78 cm, p<0.01) from baseline. Additionally, the intervention group presented a significant increase in Mid-Upper-Arm Circumference (MUAC) by 1.68 cm (p=0.0465). However, the intervention had a minimal effect on head circumference, with a negligible difference (DID=0.16 cm; p=0.95). At baseline, the mean knowledge score was 29.70±0.83 in the control group and 25.10±0.97 in the intervention group. By the end of the study, the control group's mean score remained at 25.0±0.99, whereas the intervention group’s score significantly improved to 38.10±0.31. Caregivers also demonstrated improvements in key complementary feeding practices. Conclusion A community-based nutrition intervention programme implemented through demonstrations can significantly enhance caregivers' knowledge and practices related to complementary feeding while improving the anthropometric nutritional status of children aged three months to one year.
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Consumption of indigenous traditional foods and their contribution to nutrient intake among young women, between the ages of 18 and 25 in Makhado Municipality, Vhembe District, Limpopo Province, South Africa
(2026-05-19) Tlakula, Pumzele Portia; Mandiwana, T. C.; Mofokeng, K. R.; Mushaphi, L. F.
Background: Indigenous traditional foods have a major role in the diet of South Africans, however, there is a decline in the use and consumption of indigenous foods, leading to non-communicable diseases such as obesity, type 2 diabetes mellitus, hypertension, and cardiovascular diseases, alongside persistent nutritional deficiencies such as iron deficiency anaemia and vitamin A deficiency. Aim: To investigate the consumption of indigenous traditional foods and their contribution to nutrient intake, among young women between the ages of 18 and 25, in Makhado Municipality, Vhembe District, Limpopo Province, South Africa. Methodology: A cross-sectional quantitative design was adopted for this study. Simple random sampling and systematic sampling designs were employed to recruit 306 young women aged 18 to 25 years of age, from various households of Makhado municipality. Data was collected using a structured questionnaire developed for this study, which was pre-tested (pilot tested) to ensure clarity, validity, and reliability. Necessary modifications were made following the pilot study. Data was analysed using SPSS version 29; continuous variables are presented as means and standard deviations (SD), while categorical variables are expressed as frequencies. Results: Tree hundred and six young women participated in the study. The results indicated that samp was the most available carbohydrate 80% (n= 244) at the household level. The median intake of both macro- and micronutrients among participants was markedly lower than the Recommended Dietary Allowances (RDA). Protein intake was particularly low (2.9 g vs 46–56 g RDA), while essential minerals such as calcium, iron, magnesium, phosphorus, potassium, sodium, and zinc were all consumed in amounts far below recommended levels. Similarly, vitamin intakes, including vitamins C, D, E, and K, were substantially inadequate. Overall, the findings indicate a widespread deficiency in nutrient intake among the study population. The median intake of total protein was considerably lower than the Recommended Dietary Allowance (RDA). Likewise, median intakes of key vitamins, including vitamin C, vitamin D, vitamin E, and vitamin K, were markedly below recommended levels. Nearly half 46.1% (n=141) of young women had a normal BMI, while 31.5% (n=96) were at risk of developing hypertension, and 15.7% (n=48) were at an increased risk of diabetes. The study findings exhibited the association between the BMI status of the young women and daily consumption of indigenous foods. Significant correlations were observed between the BMI status and the intake of cucumisesol (ρ = −0.210, p = 0.0002), curcubitapepol (ρ = −0.191, p = 0.0008), vigna subterranean (ρ = −0.179, p = 0.0017), watermelon (ρ = −0.155, p = 0.0065) and pumpkin dish (ρ = −0.129, p = 0.0244). Conclusion and recommendations: Indigenous traditional foods are widely recognized for their nutritional value and available at the household level in Makhado Municipality, however, their actual consumption among young women remains inadequate to meet recommended nutritional requirements. Targeted nutrition education initiatives are required to encourage the frequent consumption of indigenous foods, especially those high in micronutrients and protein. Furthermore, to increase dietary diversity and lower the risk of nutrition-related non-communicable diseases in young women, community-based programs and primary healthcare nutrition counseling should be reinforced. It is also advised that local food systems be supported and that indigenous foods be included in nutrition programs and initiatives.
Open Access
Dietary salt intake, dietary practices and hypertensive status among pregnant women in Thulamela municipality
(2022-07-15) Munyai, Tshifhiwa Elphas; Mushaphi, L. F.; Mbhatsani, H. V.; De Villiers, A.
Salt intake in South Africa is beyond the 4 to 6g/day as recommended by the World Health Organization (WHO); no doubt, this is due to a high-salt diet. It is well known that high-salt diets are related to hypertension, which is the most prevalent maternal complication worldwide, and is associated with significant morbidity and mortality of the mother and foetus. Pre-eclampsia and eclampsia are the two hypertensive disorders of pregnancy; these are considered as the main causes of maternal and perinatal morbidity and mortality. High maternal deaths have been recorded in South Africa where eclampsia was the direct cause. The aim of this study was to describe dietary salt intake, dietary practices and hypertensive status among pregnant women in Thulamela Municipality (Limpopo Province). The study adopted a quantitative cross-sectional survey design where three local areas were purposively selected. Two clinics from each local area were randomly selected to give a total of three Community Health Centres (CHC) and six clinics. Pregnant women were selected by means of convenience sampling. The sample size was calculated using Slovin’s formula which resulted in a total number of 379 pregnant women. Data obtained were captured using Microsoft Excel 2016 and exported to the IBM Statistical Package for Social Sciences (SPSS) version 26 for analysis. The dietary intake was analysed using Medical Research Council of South Africa (SAMRC) Food Finder 3 (version 1.1.3) computer software. Logistic regression was used to identify factors associated with high Blood Pressure risk. Most of the participants (62.0%) were single and had passed Grade 12; majority of participants (88.1%) were unemployed and depended on parents/parents-in-law and social grant. At the time of the study, 38.3% of participants’ gestational age was 31 to 38 weeks. Analyses of the macronutrient intake by the pregnant women indicated that the mean energy intake was 5304.4±2217.5KJ per day and the mean protein intake was 35.1±16.8g per day. Majority of participants (81.0%) had received nutrition education and they usually ate three meals or more per day. Most participants (71%) indicated that they bought salt from supermarkets and added salt when cooking. Almost all the pregnant women (99.7%) were below the EAR reference values for iron while 15.0% of pregnant women were within the Estimated Average Requirement (EAR) reference value for folate intake. The study revealed that the mean diastolic pressure was 73.56±9.5mmHg and systolic pressure was 113±11.2mmHg. The majority of these pregnant women were at low risk of developing high BP. High BP risk was not associated with marital Page v of 141 status, however, there was a significant association with the educational level. Gestational age was significantly associated (p<0.05) with having a HBP risk, with those 38+ weeks having the highest risk. The study concluded that pregnant women were not meeting their daily nutrient intake, hence, there is a need to advocate for improved nutrient intake. There is also a need for other research projects to be conducted on dietary salt intake and dietary practices of pregnant women in the Thulamela Municipality.
Open Access
The effect of consuming instant-maize porridge fortified With Termites and Moringa Oleifera Leaf powders on the nutritional status of children aged three to five years old in Thulamela Municipality, South Africa (RCT)
(2023-05-19) Netshiheni, Khavhatondwi Rinah; Nesamvuni, C. N.; Mushaphi, L. F.
This chapter introduces the topic of the study, giving relevant background and highlighting the problem statement. It ends with the study's hypothesis, aim, specific objectives, significance, and conceptual framework. Malnutrition is the cause of deaths of eight million children under five years worldwide. Undernutrition is the leading cause of over one-third of children's deaths, mainly from pneumonia and diarrhoea. Additionally, in 2015, zinc deficiency and anaemia prevalence in the Vhembe District preschool children in Limpopo Province was 42.6% and 28%, respectively. This study investigated the effect of consuming instant-maize porridge fortified with termite and Moringa oleifera leaf powders on the nutritional status of children aged three to five years old. The research method used was quantitative. The study was conducted in Thulamela Municipality, one of the four municipalities in the Vhembe District. A randomised controlled trial was used, whereby participants were randomly assigned into either an experimental or control group. Twenty children from six preschools (three for the control and three for the experimental groups) participated in the study. The study was conducted in four phases, namely, Phase 1: the preparation of fortified instant-maize porridge and the assessment of safety and nutrient content of the product; Phase 2: a baseline study was done; Phase 3: participants were assigned to experimental and control groups. The consumption of 100% instant-maize porridge by the control group and fortified (80% maize, 15% termite powder and 5% Moringa oleifera powder) maize porridge by the experimental group for six months was done and Phase 4: post-intervention data collection and comparison of Phases 2 to 4 were made. The samples were prepared at the Department of Food Science & Technology at the University of Venda. Ethical certification was sought from the University of Venda Research Ethics Committee to conduct the study.
Open Access
An evaluation of the implementation of vitamin a supplementation protocol in health institutions in Mookgophong Municipality: a case study of Waterberg District
(2015-02-04) Mamaregane, Dihlolelo Vivian; Mbhenyane, X. G.
Aim: The main purpose of this study was to evaluate the implementation process of the Vitamin A Supplementation Protocol in institutions in the Mookgophong sub-district of Waterberg, Limpopo Province. Design: Multi-stage sampling was used. setting: The study was conducted in 6 clinics in Mookgophong sub-district and in one hospital in Mogalakwena which supports the clinics with resources. Subjects: There were 13 nurses, 2 pharmacists and 1 medical doctor. These health professionals served as informants. Methods: Self-reported questionnaires were used to collect data. The researcher did observations during data collection using a checklist. Descriptive statistics were used to analyse the data. Results: The results indicated that Vitamin A supplements were not always available at the health institutions studied. Most of the health workers were not trained on the Vitamin A Protocol although they could describe it. The staff said they adhered to the protocol. Conclusions: The Vitamin A Protocol was not well implemented because most staff was not trained and the capsules were not always available. T
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Food security, academic performance and physical well-being amongst students at the University of Venda
(2026-05-19) Mathole, Mashaola First; Mandiwana, T. C.; Chauke,
Introduction: Food insecurity remains a significant concern amongst university students, contributing to poor nutrition, reduced academic performance, and compromised physical well-being. Understanding this relationship is crucial for enhancing student outcomes and reducing inequalities in higher education. Aim: This study investigated the relationship between food security, academic performance, and physical well-being amongst students at the University of Venda. Methodology: The study employed a cross-sectional, stratified random sampling design. A total of 319 students, aged 18–23 years, residing both on and off campus, participated in the study. Data were collected through a structured questionnaire. Descriptive statistics (frequencies and percentages) summarised the data, while correlation and p-values tested the relationships amongst variables. Results: Males 53% and females 47%. Approximately 40,4% of students experienced some level of food insecurity, with 6,3% experiencing moderate food insecurity and 0,9% experiencing severe food insecurity. Most students 72,7% reported being physically healthy, though fewer engaged in regular exercise or maintained balanced diets. Academically, 84,3% demonstrated high motivation, and 79,3% reported effective collaboration; however, 45,8% felt overwhelmed by their workload. Weak positive correlations were observed between food security and both academic performance (ρ = 0.18) and physical well-being (ρ = 0.043), while a moderate relationship existed between academic performance and physical well-being (ρ = 0.429). Conclusion: Food insecurity has a detrimental impact on students’ academic and health outcomes. Institutional interventions promoting nutrition support and wellness programmes are essential to enhance student success and overall well-being.
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Formulation and nutrient composition of ready-to-use therapeutic food with Glycine max, Vigna subterranea, Sorghum bicolor and Moringa oleifera leaf as micronutrient premix
(2025-09-05) Akinmoladun, Oluwaseun Funmi; Nesamvuni, C. N.; Jideani, V. A.
The growing population number of malnourished under-five children across the globe requires immediate nutritional intervention. The standard peanut- and milk-based ready-to-use therapeutic food (RUTF) commonly deployed for managing severe acute malnutrition is expensive and not easily accessible in the rural areas where it is needed most. However, this intervention should be cheap, readily accessible, nutritionally dense, have an extended shelf life, and not require further preparation. Therefore, the study aimed to formulate and profile the nutritional content of a ready-to-use therapeutic food with Glycine max, Vigna subterranea, Sorghum bicolor, and Moringa oleifera (MO) leaf powder as a micronutrient premix. The objectives were firstly to develop a ready-to-use therapeutic food from local base ingredients, including Sorghum, Bambara groundnut, soybean, and Moringa oleifera leaf powdered (MOLP) micronutrient premix with the aid of linear programming (LP) tool. Secondly, the study investigated the acceptability of the developed RUTFs, including colour (L*, a*, b*, H*, C*) measurements and focus group discussion by mothers and caregivers. It also evaluated the nutritional profile, including the proximate, antinutrient, minerals, and microbial assessment of the newly developed and/or formulated RUTFs, as the third objective. The final objective assessed the in vitro digestibility, including protein, starch, and amino acid profile of the formulated RUTFs. In the first objective, six RUTFs, based on different combinations of each of the base ingredients, were generated by LP: soybean (11.73%, 14.25%, 20%, 25.34%, 22.88%, 20%), Sorghum (29.11%, 28.93%, 24.35%, 15%, 15%, 21.66%), Bambara groundnut (15%, 10%, 10%, 10%, 15%, 15%), vegetable oil (27.11%, 26.82%, 25.64%, 26.66%, 27.12%, 25.34%) and sugar (17%, 20%, 20%, 23%, 20%, 18%). Eighteen RUTFs were produced, where each RUTF was composited with the three levels of micronutrient premix (3% MOLP alone, 3% standard RUTF alone, and a mixture of MOLP and standard RUTF at 1.5% each). Following proximate analysis, eight of the eighteen RUTFs met the minimum requirements for protein (14-16%) and energy (520-550 kcal) and were selected for pre-sensory analysis. Based on the overall acceptability score from the pre-sensory trial, five (RUTFs 1,2,3,4 and 5) of the eight RUTFs were rated higher and selected for further analysis and of nutrient composition in subsequent chapters. In objective two, the sensory analysis revealed that RUTFs 3 and 4 were highest (p<0.05) in appearance and aroma, while RUTFs 2 and 4 were highest (p<0.05) in taste and texture. The colour attributes revealed L*, a* and b* to be highest (p<0.05) in RUTF 3 and decrease through RUTFs 4 and 5 to RUTFs 1 and 2. Some of the comments by the caregivers and nursing mothers involved in the acceptability trial include, 'I would buy it if it were affordable, and I do not have a problem with the colour; after all, we all eat vegetables'. Regarding their RUTF knowledge, the comment was, 'They are used for children who are not well nourished, especially underweight'. In chapter five, the proximate analysis revealed that all the RUTFs have similar moisture and fibre content. While RUTFs 1,2,3 and 5 had identical crude protein and energy, RUTF 5 had the highest (p<0.05) crude fat. RUTF 3 had the highest (p<0.05) in most macro and micro minerals. This was closely followed by RUTFs 5,4,1 and 2. While aflatoxin remains undetected in all the RUTFs, RUTFs 3 and 4 had a much higher (p<0.05) phytate and trypsin than other RUTFs. The microbial assessment revealed 'no growth' for mould, E. coli, and Staphylococcus aureus, while 'absent' was reported for Listeria monocytogenes. Other microbial loads had <10 counts. In the final objective, the predicted that glycaemic index was similar for the five RUTFs. However, RUTFs 2 and 4 had the highest (p<0.05) but similar hydrolysis index and in vitro protein digestibility. The total essential amino acids were similar in RUTFs 1,3 and 5. The study showed that LP can be used to develop ready-to-use therapeutic food with a nutritional composition comparable to the WHO standard RUTF. Based on the ease of acceptability and mineral profile, RUTF 3, formulated with standard RUTF, seems the best. Closely followed are either RUTF 4 or 5. In conclusion, even though these RUTFs are yet to be clinically tested, developing a ready-to-use therapeutic food from Sorghum, Bambara groundnut, and soybean with MOLP could provide easily accessible but nutrient-dense nutrition therapy for managing severe acute malnutrition in children under five. Ethics were considered for the acceptability study. The University of Venda Research Ethics Committee granted certification.
Open Access
Household food access and nutritional status of 2-5 years old children residing at Lambani Village in Vhembe District of Limpopo Province
(2015-07-15) Tshifhango, Pfarelo Percy; Mandiwana, T. C.
Open Access
The influence of caregivers nutrition knowledge and feeding practices on the nutritional status of children 2 to 5 years old in the Makhuduthaga Municipality, South Africa.
(2018-05-18) Motebejana, Tubake Tinny; Mbhenyane, X. G.; Nesamvuni. C. N.
Malnutrition is a problem facing virtually every country in the world. Inappropriate feeding practices such as bottle feeding, early introduction of weaning foods, lack of variety in the diet are a known major cause of the onset of malnutrition in young children. Lack of nutrition knowledge, particularly about feeding practices, is critical as it affects the nutritional status of children. The purpose of this study was to determine the influence of caregivers’ nutrition knowledge and feeding practices on the nutritional status of 2 to 5 years old children in the Makhuduthamaga Municipality, South Africa. A crosssectional study with an analytical component was carried out in the Makhuduthamaga Municipality in the Limpopo Province, South Africa. One hundred and twenty children aged 2 to 5 years and their caregivers were conveniently sampled from four villages. A validated questionnaire was used to gather demographic information, caregivers’ nutritional knowledge and feeding practices. Anthropometric measurements taken were weight, height and mid-upper arm circumference (MUAC) of the children as well as weight and height of the caregivers. Descriptive and inferential statistics were utilized. Chi-square was used to determine the influence of caregiver’s nutrition knowledge and feeding practices on the nutritional status of children. The significance level was set at p< 0.05. Most caregivers (66.7%) were between the ages of 19 and 35 years. More than half (54.2%) of the children were male. Most of the caregivers (70%) had attended school up to secondary level and only 4.2% had obtained a tertiary qualification. Most of the caregivers (85%) were unemployed. Children were mostly (70.2%) cared for by their biological mothers. Some caregivers reported not to have any source of nutrition education (41.7%), while 43.3% reported that health professionals were their source of nutrition education. Both nutrition knowledge and feeding practices were not satisfactory in the current study. Almost all children (94.2%) were breastfed at some stage in their lives. However, 47.5% were given infant formula while they were still less than six months old. It was found that more than half of the caregivers (62.5%) introduced solids foods before 6 months. Maize meal soft porridge was reported as the main solid food first introduced to 66.7% of the children, followed by infant cereals (25%). Stunting was found in 41.7% of children. Prevalence of overweight and obesity was observed amongst both caregivers and children. Overweight and obesity prevalent of caregivers was at 30.8%. No significant correlation was observed between the caregivers’ nutrition knowledge, the feeding practices and the nutritional status of children. However, family income showed positive correlation with the nutritional status of children. Nutrition education strategies intertwined with economic empowerment of mothers should be enforced to capacitate caregivers to voluntarily make proper feeding practices.
Open Access
The investigation of eating and lifestyle habits of overweight and obese teenager aged between 13-18 years in Thulamela Municipality
(2019-05-18) Ligege, Ntovhedzeni; Mbenyane, X. G.
Context: A survey made worldwide (including South Africa) revealed that most teenagers are overweight and obese and that they eat little nutritious food. Obesity and overweight are public health problems and need to be addressed from a community perspective. The reason for exploring this problem in this study was that South Africa has one of the highest rates of overweight and obesity in the world among urban and rural black women. Objective: Investigating the eating and lifestyle habits of overweight and obese female teenagers in Thulamela Local Municipality, Limpopo province, South Africa. Design, setting and participants: This was an exploratory, descriptive study conducted in 2006–2007 amongst 125 female teenagers aged 13 to 18 years from rural schools in Thulamela Local Municipality. A hundred and twenty-five questionnaires were completed and data were gathered on the demographics, social and lifestyle habits, nutrition-related problems, dietary patterns and dietary history of the participants. Measurements: Eating and lifestyle habits, physical activity, meaning of healthy and unhealthy dietary habits, weight, height and body mass index were measured. Results: Seventy percent of the respondents actively consumed three meals in a day, 83% consumed starchy snacks between meals, whilst 72% of the respondents carried lunchboxes to school. Regarding lifestyle habits, 88% of the respondents slept more hours than recommended (8 hours) 88% performed sedentary activities and 66% did physical activities such as walking. Conclusion: The results pointed out unhealthy eating and lifestyle habits influencing teenagers’ weight. Identified factors must be considered in order to develop tailored nutrition interventions to improve teenagers’ consciousness about adopting a healthy lifestyle.
Open Access
An investigation of the interppretation of the growth chart and feeding practices of caregivers of children under five years from the Greater Tzaneen Municipality, Limpopo Province, South Africa
(2016-03-08) Sibanda, M. N.; Mbhenyana, X. G.; Mushaphi, L. F.
Open Access
Iodine content of salt used in the National School Nutrition Programme at Mopani and Vhembe Districts in Limpopo Province, South Africa
(2020-09-09) Ramugondo, Mpho; Mushaphi, L. F.; Mabapa, N. S.
Background: The National School Nutrition Programme (NSNP) aims to foster better quality education by enhancing children’s learning capacity, encouraging regular attendance and punctuality, addressing micronutrient deficiencies and alleviating short term hunger. Iodine is one of the micronutrient which is used in NSNP in the form of iodised salt. Iodine deficieny affects an estimated 60 million school- age children in the developing world and is also associated with low test scores and cognitive function. Aim: The main aim of the study was to determine the iodine content of salt used in the NSNP. Methodology: A cross sectional study was conducted. The researcher aimed at describing the iodine content of salt used in schools and the iodine nutrition knowledge of the food handlers in various schools in the Mopani and Vhembe districts. The study was conducted in selected schools of Mopani and Vhembe districts receiving NSNP. The target population was food handlers employed in schools receiving NSNP from the two districts. A total of 318 schools were visited and 359 food handlers were interviewed. The salt samples were collected and analysed using standard procedures. The demographic information and the iodine nutrition knowledge were obtained using a validated questionnaire. Results: A total of 318 salt samples (Mopani=159 and Vhembe=159) were collected and analysed, representing 100% of successfully analysed. The study comprised of 359 (Mopani=200 and Vhembe=159) food handlers from two districts. Almost two thirds (64%) of the participants in Mopani district and 82.4% in Vhembe district had grades 8-12 as their highest level of education, while 4% and 5% had tertiary education in Mopani and Vhembe districts respectively. The mean iodine content was 36.53ppm and 34.24ppm in Mopani and Vhembe districts respectively which signifies adequately iodised salt. Almost three quarters (71%) of salt samples in Mopani and 65% in Vhembe were adequately (15-64ppm) iodised in this study. The results of the study suggest that almost half (47.5%) of the participants in Mopani and 34% in Vhembe had poor iodine nutrition knowledge as they could not answer the questions in the knowledge test correctly. Only 27% of the participants in Mopani and 30% in Vhembe had good knowledge. Conclusions- There are still salt samples that are inadequately iodised or not iodised at all used in the preparation of meals for NSNP in the two districts. Such instances make the programme designed to eliminate IDD fail. It can be deduced that without public awareness on the importance of iodine in the human body, the universal iodine programme will be unsuccessful.
Open Access
Iodine status of lactating mothers and infants aged 0 to 6 months in Vhembe and Mopani district of the Limpopo Province, South Africa
(2020-09-03) Hlako, Seemole Cedrick; Mushaphi, L. F.; Mabapha, N. S.
Introduction: Iodine is an essential nutrient required by humans for the synthesis of thyroid hormones, which are vital for normal growth and development. Objective: The primary aim of the study was to describe the iodine status of lactating mothers and infants aged from 0 to 6 months in the Vhembe and Mopani Districts. Methods: A cross-sectional study conducted on 246 infant-mother pair, from the Mopani and the Vhembe Districts. Data was gathered using a questionnaire. Breastmilk, mother urine, infant urine, household salt and drinking water were collected to be analysed for iodine content. Results: The median of breastmilk iodine concentration level amongst lactating mothers in the Vhembe District was 101.4 µg/l (IQR 62.9 – 175.1 µg/l) and 154.4 µg/l (IQR 92.6 – 211.8 µg/L) in Mopani. The median UIC of mothers in Vhembe was 98.5 (IQR 57.66 – 153.93), whereas in the Mopani District the median UIC of mothers was 126.08 µg/l (IQR 69.89 – 206.71 µg/L). The median UIC of infants in Vhembe was 220 (IQR 106.67 – 418.43 µg/l) and in the Mopani District was 321.94 µg/l (IQR 167.96 – 482.66 µg/l). Conclusion: The BMIC in the study signifies iodine sufficiency in both the Vhembe and the Mopani Districts. The results of this study suggest that the BMIC be included in studies assessing iodine status in lactating mothers since the UIC only reflects iodine that was consumed recently. The UIC may under estimate the maternal iodine status if it is not complemented by the BMIC data.
Open Access
Iodine status of pregnant women and children aged 6 to 12 years feeding from the same basket in Mopani District, Limpopo Province, South Africa
(2015-02-26) Mabasa, Eric; Mbhenyanem X. G.; Mabapa, N. S.
Introduction: Iodine deficiency (ID) is a worldwide problem that leads to impaired cognitive development, clinical goiter and the syndrome of endemic cretinism. Pregnant women and school age children are the most vulnerable groups for ID. Sufficient iodine is required during pregnancy to ensure adequate maternal thyroid hormones production. ID in utero and early childhood damages the developing brain, leading to the loss of millions of intelligent quotient (IQ) points globally. Objectives: The aim of the study was to assess iodine status of pregnant women and children aged 6 to 12 years feeding from the same food basket in Mopani district, Limpopo Province, South Africa. Methods: The study was cross-sectional conducted in five municipalities of Mopani District in Limpopo Province. The total number of clinics selected was 41. A total of 565 pregnant women and 116 children aged 6-12 years were recruited. Urine iodine concentration (UIC) and drinking water iodine concentration were analyzed using the Sandell-Kolthoff reaction. The salt samples were analyzed by means of the iodometric titration method. Dried blood spots on filter paper were analyzed for whole blood thyrotropin /Thyroid Stimulating Hormones (TSH) with an immunoassay. Results: The findings showed that 52.5% of household salt had iodine concentration level more than 15ppm. Most of household drinking water (41.3%) had iodine concentration level greater than 60µg/L. The median iodine concentration of drinking water in Mopani District was 46.2µg/L. Almost half of pregnant women (44.9%) had UIC level less than 150µg/L. The maternal overall median UIC level was 164µg/L indicating maternal iodine sufficiency. However, median UIC in the first and third trimesters was below 150µg/L, indicating iodine insufficiency. The TSH levels of pregnant women were measured per trimester and majority of study participants had normal TSH levels. Most children (64.3%) had UIC level greater than 300µg/L. The median UIC level of children was 386µg/L indicating excessive iodine status. Conclusion: Iodine status of children in this study was excessively high. It was twice times higher than the iodine status of pregnant women. It is difficult to explain this significant difference in iodine status of these two groups since they were feeding from the same food basket. It can then be concluded that the median UIC of school aged children may not be an adequate surrogate for monitoring iodine nutrition in pregnant women as was previously assumed.
Embargo
Menu availability, food handling practices and nutrition knowledge of food handlers in the Early Childhood Development centres at Elias Motsoaledi Local Municipality, Limpopo Province
(2025-09-05) Mphagi, Thabelo Winnie; Mushaphi, L. F.; Chauke, R. C.
Background: Nutrition is important for children's growth and development because it provides the essential components needed for physical growth, brain function, and mental development. Aim of the study: The aim of the study was to determine the food handlers' nutrition knowledge, food handling practices, and daily menu availability in Early Childhood Development centres at Elias Motsoaledi Local Municipality, Sekhukhune District. Methodology: A quantitative cross-sectional survey was conducted at Sekhukhune District, in Elias Motsoaledi Municipality. The convenience sampling method was used to select the population, which comprised of 60 registered and funded ECD centres, and 113 food handlers. A researcher-administered questionnaire and researcher-observation checklist were used to collect data. Data collected was analysed using SPSS software version 29. Results: The study was conducted in 60 registered and funded ECD centres at Sekhukhune District, Elias Motsoaledi Local Municipality, with 113 food handlers. The majority of respondents (70.8%) had completed secondary education and 17.7% had tertiary qualifications. About 72.6% of food handlers scored 80 to 100%, indicating excellent knowledge. Almost all food handlers (96.7%) washed their hands before handling food and after using the toilet, while 86.7% washed their hands with soap before eating. The majority of food handlers wear appropriate protective clothing and cover their hair when preparing food. All ECD centres had a daily menu and (91.2%) were approved by the dieticians, while (8.8%) were not approved. Most ECD centres (76.7%) had their menu displayed on the wall, but the majority of centres (68.3%) did not adhere to their daily menu. Conclusion: ECD centres should collaborate with nutrition experts during menu planning to ensure that they incorporate accessible and affordable nutritious foods into their daily meals. To enhance children's intake of essential vitamins and minerals, centres are encouraged to establish gardens where they can grow vegetables. This initiative can also help save money for other necessities.
Open Access
Nutrition knowledge and care practices of homebased caregivers in Makhado and Thulamela Municipalities of Vhembe District in Limpopo Province, South Africa
(2015-08-05) Masia, Tirhani Asnath; Mbenyane, X. G.; Mushaphi, L. F.; Mabapa, N. S.
Open Access
Nutrition knowledge of educators in primary schools in Makhuthamaga Municipality in Limpopo Province
(2019-09-20) Magoai, Matlou Martina; Mabapa, N. S.; Mbhenyane, X. G.
Introduction: Nutrition education is the change process whereby beliefs, attitudes, environmental influences, and understanding about food lead to nutrition practices that are scientifically sound, practical, and consistent with individual needs and available resources Design and Methods: The purpose of this study was to assess the nutrition knowledge of educators in Makhuduthamaga municipality, Limpopo Province. Quantitative, descriptive, and exploratory research was conducted to determine the factors that influence the nutrition knowledge of educators and explore the relationship between factors and nutrition knowledge. The simple random sampling technique was employed to select 200 educators in grades 4, 5, and 6. Data collection was done using structured questionnaires. The data was analysed using the statistical package for social science (SPSS), version 21. Results and Discussion: Of the educators who participated in the study, 66.5% were female, and 33.5% were males. Almost all (94%) of the educators were trained at a college and had teaching experience of between 21-30 years. Most of the educators (60.5%) had a diploma, while 0.5% had a master’s degree. Almost one third of educators indicated that children should eat three (3) times during the day, and 32% identified the important meals as breakfast, lunch, and supper. Most (36.5%) failed to give reasons why children should not skip meals. In terms of basic food and nutrition, majority of the educators (75%, 67%, 56%, and 55.5%) responded correctly on the importance of carbohydrates, fat, vegetables, and fruits, respectively. Only a quarter (26%) knew the importance of protein, while 75.5% knew that protein forms part of a balanced diet. Most of the educators knew the rich sources of vitamin A and fibre but did not know the rich sources of iron, iodine, and vitamin C. There was no significant difference between the level of education and nutrition knowledge (p= 0.129), and between training institution and nutrition knowledge (p= 0.534). Conclusion: The need to train educators on nutrition was one of the main recommendations that emanated from many research projects. Most educators mentioned that training and level of education were of the factors that affected their nutrition knowledge. Nutrition knowledge is becoming increasingly important in food choices and in this study educators acknowledged that training affected their nutrition knowledge.
Open Access
Nutritional composition of traditional mixed - dishes eaten by elderly women in Vhembe District
(2020-12-20) Tshidzumba, Sedzani Elsie; Mushaphi, L. F.; Mbhatsani, H. V.
Globally, one in every eight people (868 million) are malnourished and nearly two billion people suffer from some type of micronutrient deficiencies. Most traditional dishes contain exceptional capabilities to improve nutrition, bring about nutritional variety, hence, they play a significant role in reducing malnutrition, including micronutrient deficiencies sub-Saharan Africa (SSA) and South Africa in particular, where these ills still persist. The conveyance and documentation of indigenous knowledge on traditional food, which this research is aimed at, will make sure that the obtainability and consumption of these foods will be sustained. The aim of this study was to determine the nutritional composition of traditional mixed-dishes eaten by elderly women in Vhembe District. The research design was ethnographic with an analytic component; a mixed methods approach was used for data collection. The qualitative data was analysed using thematic analysis and the quantitative data was analysed using statistical methods on IMB-SPSS (version 26). Frequencies, mean, and analysis of variance (ANOVA) were used to interpret data and means were separated using Duncan’s multiple range test at p < 0.05. The study was conducted in accordance with the Declaration of Helsinki. From the results, one theme and eight sub-themes emerged from the respondents’ narratives during the in-depth interviews. Sixteen types of stiff porridge, eight types of traditional mixed-dishes and twenty-three types of indigenous leafy vegetables were documented. Boiling was the most common traditional cooking method used in food preparation by the Vhavenda and Vatsonga. The Vhavenda and Vatsonga frequently used ground peanuts in the preparation of most traditional foods. The total dietary fibre values ranged from 7.70% to 28.40% and a significantly higher total dietary fibre content was observed in tshidzimba/tihove B at p <0.05. The protein content of traditional mixed dishes varied from 11.70% to 31.50% and a relatively higher protein content was observed in bovhola/xipaswi at p <0.05. The iron content varied from 51.4 mg/100 g to 195.6 mg/100 g significantly different at (p<0.5). Thophi/tshopi had higher vitamin A (288.0 μg/100 g) and β-carotene (576.0 μg/100 g) content, respectively. Sensory evaluation showed that tshidzimba/tihove A was rated significantly higher in mouthfeel, aroma, taste and appearance and overall acceptability than tshidzimba/tihove B, thophi/tshopi and bovhola/xipaswi at p < 0.05. The conclusion is that, there is a great reliance on traditional foods by rural communities. Mixing traditional foods into composite dishes is a common practice among the Vhavenda and Vatsonga. These foods are inexpensive sources of important nutrients and their consumption must be encouraged, especially in local communities where they are readily available to prevent and lessen the burden of micronutrient deficiencies, thereby, promoting healthy lifestyle.