15 research outputs found
Multi-media for flipped classrooms: engaged nutrition learning in a multi-media enhanced flipped classroom
No full textThis article focuses on the experiences of Health Science students changing from a traditional lecturer–centred, face–to–face teaching scenario to a multi–modal learning experience in a flipped classroom. Getting students engaged with course content is sometimes a challenge for lecturers, especially in a basic introductory compulsory course, where a student may not be interested or motivated. Furthermore, traditional teaching methods are increasingly being criticised for not speaking to the younger generation who demand more active visual methods of teaching to keep their attention. A lack of student engagement and motivation in a nutrition course prompted the lecturer to redesign the traditional teaching approach previously used in this introductory course. In addition, the unavailability of multi–media content for the specific South African context formed part of the research problem. The nutrition introduction course for second–year students was re–designed according to Picciano s model for multi–modal learning, applying multi–modal learning by incorporating self–designed multi–media study material within a flipped classroom approach. Design–based research with a mixed methods approach was followed, including a pre–course test, polls, narratives and focus group interviews. The results showed that students were initially negative and unsure about this process, but that their experience improved during the semester, and that the use of multi–media within a multi–modal learning approach enhanced their learning experience. The study also showed that close collaboration between the lecturer and the instructional designer is necessary to ensure quality effective multi–media resources, and that technical support for students is critical
Student's soft skill acquisition in an outdoor adventure education event over two years of participation
No full textOutdoor Adventure Education can be used to develop and hone the transferable or so called soft skills such as group work and problem-solving skills in higher education. These skills are also much needed to ensure employability. An outdoor adventure activity was developed and implemented by lecturers in order to bridge this gap between university and the industry in order to hone the transferable skills of students studying sport and recreation. Data were collected over two years. Two hundred students participated in the research study with a mean age of 22±4 years. Data were collected qualitatively and analysed and subsequently numerically coded to ensure statistical analyses. Analyses indicated no statistical differences between skills learned in the first and second year. Students were then divided into first time and second time participants and statistical differences were found. The second time participants reported mostly on leadership skills learned and first time participants on teamwork. Implementing an outdoor Adventure Education event was effective in developing skills in students much needed for success in higher education as well as becoming well-rounded individuals whom possess all the qualities for rewarding employment
The association between calf circumference and appendicular skeletal muscle mass index of black urban women in Tlokwe City
No full textBackground: Sarcopenia, the loss of muscle mass and strength, is associated with adverse health outcomes. Calf circumference (CC) has been proposed as a surrogate measure of muscle mass in the elderly; however, ethnic/sex specific cut-off values remain to be established.
Objective: A study was undertaken to investigate the relationship between CC and appendicular skeletal muscle mass (ASM), and the ASM index (ASMI), as well as to determine whether CC could be used to diagnose sarcopenia.
Methods: This was a cross-sectional study of 247 older black women living from Tlokwe, South Africa. ASM was measured using dual-energy X-ray absorptiometry, and the ASMI was calculated. Receiver operator characteristics curves and maximum Youden index were applied to identify a CC cut-off point for sarcopenia according to low gait speed (< 0.8 m/s), low hand-grip strength (< 16 kg) and low ASMI using a South African cut-off point for sarcopenia (ASMI < 4.94 kg/m2).
Results: A strong positive correlation between CC and ASMI (r = 0.84, p 0.60.
Conclusion: A CC of 30 cm is proposed as a simple and inexpensive way to predict, screen or diagnose sarcopenia in black women in low-resource health settings. An accessible, inexpensive screening or diagnostic tool could facilitate timely interventions and preventio
Associations between specific measures of adiposity and high blood pressure in black South African women
No full textMSc (Dietetics), North-West University, Potchefstroom Campus, 2015Introduction: The World Health Organisation (WHO) defines overweight and obesity as a condition in which an abnormal or excessive fat accumulation exists to an extent in which health and well-being are impaired. The most recent South African National Health and Nutrition Examination Survey (SANHANES) reported that the prevalence of overweight and obesity, according to body mass index (BMI) classification, in all South African women was significantly higher than in men (24.8% and 39.2% compared to 20.1% and 10.6% for women and men, respectively). Blood pressure is often increased in obese patients and is probably the most common co-morbidity associated with obesity. Currently approximately one third (30.4%) of the adult South African population has hypertension. Hypertension is responsible for a significant percentage of the high rates of cardiovascular disease and stroke in South Africa. Limited South African data are available regarding the agreement between the measures of adiposity, including BMI, waist circumference (WC) and percentage body fat (%BF), and the association with high blood pressure. Measures of adiposity were found in previous research to be ethnicity, age and gender specific. Measuring %BF to classify adiposity takes body composition into account and is a more physiological measurement of obesity than BMI. Objective: This study aimed to investigate the agreement between adiposity classified by BMI categories and %BF cut-off points, and the association between the different measures of adiposity and high blood pressure. Method: A representative sample of black women (n=435), aged 29 years to 65 years from Ikageng in the North West Province of South Africa were included in this cross-sectional epidemiological study. Socio-demographic questionnaires were completed. Pregnancy and HIV tests were performed and those with positive test results or those who declined HIV testing were excluded. Weight and height were measured and BMI was calculated. WC, %BF using dual-energy X-ray absorptiometry (DXA), and blood pressure were measured.
Results: The prevalence of overweight (BMI 25.0 kg/m² – 29.9 kg/m²) was 24.4% and obesity (BMI ≥ 30kg/m²) was 52.4%. High blood pressure was found to be present in more than two thirds of the study participants (68.5%). In this study BMI, WC and %BF as measures of adiposity were significantly correlated. There were significant agreements between combined overweight/obesity that was defined by %BF (≥35.8% 29-45 years; ≥37.7% ≥50 years) and BMI ≥ 25kg/m² (ᵡ²=199.0, p<0.0001; κ=0.68, p<0.0001), and between the presence of high %BF and obesity only, that was defined by BMI ≥ 30 kg/m² (ᵡ²=129.1, p<0.0001; κ=0.48, p<0.0001). The effect size of the agreement between the WHO BMI category for combined overweight/obesity and %BF cut-off points according to the kappa value of κ=0.68 was substantial (κ range 0.61-0.80). The effect size of the agreement between the WHO BMI category for obesity only and %BF cut-off points according to the kappa value of κ=0.48 was moderate (κ range 0.41-0.60). No association was found between high blood pressure and BMI categorised combined overweight/obesity (ᵡ²=3.19; p=0.74), but a significant association was found between high blood pressure and BMI categorised obesity only (ᵡ²=4.10; p=0.043). A significantly increased odds ratio (OR) of high blood pressure existed in the obesity BMI category (OR=1.52; p=0.045) as opposed to the overweight/obesity BMI category (OR=1.51; p=0.075). There were significant associations between high blood pressure and WC ≥ 80cm (ᵡ²=10.9; p=0.001; OR=2.08; p=0.001), WC ≥ 92cm (ᵡ²=20.1; p<0.0001; OR=1.79; p=0.011) and %BF above the age-specific cut-off points (ᵡ²=6.61; p=0.010; OR=1.70; p=0.011). Discussion and conclusion: This study found that in a sample of black urban South African women significant agreements existed between adiposity defined by %BF cut-off points for combined overweight/obesity and both WHO BMI categorised combined verweight/obesity (BMI ≥ 25 kg/m2) and obesity only (BMI ≥ 30 kg/m2), respectively. A stronger agreement was found between WHO categorised combined overweight/obesity and %BF. Furthermore, this study concluded that the BMI category according to the WHO cut-off point for overweight/obesity had insufficient sensitivity to detect the presence of high blood pressure, and that the BMI category according to the WHO cut-off point for obesity alone could detect the presence of high blood pressure. The WHO BMI classification for obesity, in contrast to the WHO BMI classification for combined overweight/obesity, is therefore appropriate to classify these black South African women at increased risk for high blood pressure. The WC and %BF cut-off points used which were specific to ethnicity, age and gender, had significant associations with high blood pressure and have good capacity to detect high blood pressure. In this study abdominal obesity as defined by the South African cut-off point of WC ≥ 92 cm had a stronger association with high blood pressure, than the international cut-off point (WC ≥ 80 cm). The South African cut-off point is, therefore, more appropriate to screen black South African women for increased risk for high blood pressure. The study therefore concluded that a stronger agreement was found between WHO categorised combined overweight/obesity and %BF than with obesity only (BMI ≥ 30 kg/m2). To ensure consistency and accuracy, and to take body composition into consideration, it is recommended that, where possible, in clinical practice the appropriate WC and %BF cut-off points together with BMI categories should be used as measures of adiposity for diagnosis of overweight and obesity and to screen or detect an increased risk for high blood pressure.Master
Dietary intake practices of adults with intellectual disability in a controlled care centre environment
No full textMSc (Dietetics), North-West University, Potchefstroom CampusBackground and aim: Globally, inadequate nutrition and consequently, obesity is highly prevalent among adults with intellectual disability. Overweight and obesity leads to an increased risk for the development of non-communicable diseases, such as diabetes mellitus, cardiovascular diseases, and cancer. Secondary conditions may result in further disability, pain, loss of employment, and depression in adults with intellectual disability. Dietary intake studies concerning the intellectually disabled population have revealed insufficient fibre, fruits and vegetables, and excessive total fat, saturated fat, and sodium consumption. Unfortunately, research is lacking in this population, especially in South Africa. Therefore, it is necessary to assess the dietary intake practices of adults with intellectual disability in a controlled, care centre environment in South Africa with the future aim of compiling intervention programmes to improve the overall quality of life in this population. Methods: The researcher used qualitative and quantitative methods to collect data. Quantitatively demographic, anthropometric, and dietary data were recorded of 66 adults (18-40 years) with intellectual disability at two care centres. The measuring instrument used for the dietary intake was a three-day food wastage study on different days, within three weeks. All snacks that the adults with intellectual disability bought at the snack shop and supermarket during the three days, were recorded. The adults with intellectual disability received three meals per day with one snack at 10:00 prepared at a central kitchen from a fixed menu. Qualitative data on the dietary intake practices during meals, between meals, and other eating occasions were recorded via three focus group discussions with caregiver staff who know the adults with intellectual disability well. Results: The mean body mass index of the men (27.3) and women (33.1) with intellectual disability in this study indicated overweight and obesity respectively. The dietary diversity and quality of the adults with intellectual disability's diet, and the menus at the care centres were low. Dietary intake was compared to the Food Based Dietary Intake Guidelines of South Africa. Fibre, carbohydrate, fruit, and vegetable dietary intake were lower than recommendations. In contrast, sodium, total fat, saturated fat, and added sugar intakes were higher than recommendations. The most popular snacks and drinks consumed by the adults with intellectual disability in this study population were salted crisps and carbonated drinks. During the focus group discussions, the caregivers complained about high-fat cooking methods used by the cooks, and therefore, expressed a need for cooking skills training. Additionally, the caregivers expressed a need for more variety in the menus, healthier snacks, and improved communication between them. Conclusion: The dietary intake of the adults with intellectual disability was not according to recommendations. The following observations translate into recommendations made in order to improve the overall quality of dietary intake of the adults with intellectual disabilities. There is a need at the centres for training in cooking skills, menu planning, and basic nutrition. The adults with intellectual disability need guidance and training in good nutrition and healthy food choices. Continuous, professional input from dietitians is recommended for the compilation of menus, as well as the training of both the staff and the adults with intellectual disability.Master
Relationships between 24-hour diet and autonomic markers of heart rate of badminton players
No full textMHSc (Human Movement Science), North-West University, Potchefstroom CampusDespite proof that diet may influence heart rate variability (HRV) and heart rate recovery (HRR)) as indicators of the autonomic nervous system (ANS) activation, no researchers have investigated the influence of a normal short-term in-competition diet on the real-life competition HRV and HRR of participants. Therefore, the objectives of this study were first, to determine the relationships between 24-hour diet and pre-, in-, and post-match HRV of badminton players; and, secondly, to determine the relationships between a 24-hour diet and the in- and post-match HRR of badminton players.
To fulfil the above-mentioned objectives, the HRV and HRR of 22 male, African, singles badminton players (age: 23.3 ± 3.9 years; height: 177.1 ± 3.0 cm; mass: 83.4 ± 14.5 kg) were measured before, during, and directly after 46 badminton matches using fixed Polar HR transmitter belts and monitors. A 24-hour diet recall questionnaire in an interview format was used to estimate the dietary intake of participants’ normal in-competition days. Results of cluster analyses reduced diet-related variables were canonically correlated to the pre-match, in-match, and post-match HRV as well as in-match and post-match HRR parameters of participants. The level of significance was set at p ≤ 0.05.
For the first objective of the study, canonical correlations of the respective relationships between the macronutrient, micronutrient, and HRV parameters over the different match periods, showed significant values (p = 0.0000-0.03), except for the canonical correlation (Rc = 0.97, p = 0.105) between the 24-hour in-competition macronutrient intake and the post-match HRV-related variables of the badminton players. Results further revealed that trans-fatty acids and available carbohydrates (CHO) were the macronutrients that had the greatest influence on changes in HRV parameters over the different match periods. In addition, calcium, potassium, vitamin D, and boron were identified as the micronutrients with the biggest influence on changes in participants’ pre-match HRV. Calcium was the only micronutrient that had a meaningful influence on HRV changes during the in-match period, whereas potassium had the most influence on post-match HRV changes.
For the second objective of the study, the canonical correlation for the relationship between micronutrient components, and the in- and post-match HRR-related variables of participants
showed a significant value (R = 0.92 p = 0.03), whereas the relationship between macronutrients, and the in- and post-match HRR of participants were non-significant (R = 0.84, p = 0.10). Results further revealed that available CHO, total sugars, added sugars, as well as trans-fatty acids, were the macronutrients with the biggest influence on changes in HRR-related variables over the two match periods. Finally, vitamin D, calcium, and potassium were the micronutrients that contributed meaningfully to changes in participants’ in- and post-match HRR.
To the knowledge of the researcher, this is the first study of its kind to investigate the influences of dietary intake on the parameters of ANS during a real-life badminton competition. Study results showed that badminton players’ HRV and HRR during different periods of a real-life badminton competition were influenced by the intake of various diet components (macro and micronutrients). Therefore, the results highlight the importance of managing athletes' in-competition diets to ensure optimal functioning of the ANS during competition participation.Master
Changes in dietary intakes and cardiovascular disease risk factors in black South Africans from 2005 to 2015 : the PURE-SA-NW study
No full textPhD (Dietetics), North-West University, Potchefstroom CampusBackground:
The diets of populations are constantly changing, and the South African population is no exception. Over the last couple of decades, the diets of rural and urban South Africans have been undergoing a rapid nutrition transition, changing from prudent traditional diets that have been typically low in fat and energy, to Westernised diets containing foods high in fat and energy. This shift in dietary patterns and nutrient intakes is referred to as the nutrition transition. Dietary changes associated with a nutrition transition are linked to an increase in non-communicable diseases (NCDs) globally, but also in South Africa in particular. The World Health Organisation (WHO) has identified NCDs as the leading cause of death worldwide. The 2018 NCD report of the WHO revealed that the majority (19%) of NCD deaths in South Africa could be attributed to cardiovascular disease (CVD). The emergence of cardiovascular diseases (CVDs) has been linked to several preventable risk factors, including hypertension, overweight, obesity, diabetes and high cholesterol levels. Lowering the prevalence of these preventable risk factors would be key to addressing the ongoing public health dilemma. Research evidence has shown that dietary and nutrient intake is associated with CVD risk. A growing body of evidence also suggests that the type of dietary fat rather than the total amount of dietary fat consumed drives CVD risk.
The primary aim of this thesis is to examine the changes in dietary intake from 2005 to 2015, as well as the associations between the changes in dietary fat intake and the changes in CVD risk from 2005 to 2010, of rural and urban South African groups amid a nutrition transition.
Methods:
This study is a sub-study of the South African leg in the North-West province of the multinational Prospective Urban and Rural Epidemiological (PURE) study (PURE-SA-NWP). Data for PURE-SA-NWP were collected from two communities, one urban and one rural. Baseline data were collected in 2005, with two follow-up collections conducted in 2010 and 2015. Dietary data were collected using a 145-item culturally sensitive quantified food frequency questionnaire (QFFQ). Only participants with complete dietary data were included in the analysis, resulting in a total of 1154 participants in Chapters 3 and 4, and 722 participants in Chapter 5.
In article 1 (Chapter 3) Wilcoxon’s two-sample test was used to test for differences between the rural and urban participants (by gender) in terms of their nutrient intakes, as well as the changes in nutrient intakes between 2005 and 2010. Wilcoxon’s signed-rank test was used to test for changes in nutrient intakes between 2005 and 2010, for each of the four groups (by gender and
locality). In article 2 (Chapter 4), stepwise regression models were estimated to test for associations between the change in fat intake and the change in CVD risk factors. In article 3 (Chapter 5), a linear mixed-model approach was used to assess the trends in energy and nutrient intake of urban and rural men and women over time (2005-2010-2015).
Results:
In 2010, rural participants consumed the amount of energy (men 9·7 MJ/d; women 9·1 MJ/d) that urban participants had consumed in 2005 (men 9·9 MJ/d; women 9·0 MJ/d). Despite the higher energy intake, not all the participants met total micronutrient needs in 2010. Among rural men, an increase in the change in waist circumference from 2005 to 2010 was associated with a decrease in the change in poly-unsaturated fat (β=-0.280; p=0.002) and an increase in the change in mono-unsaturated fat (β=0.200; p=0.027) intake.
For rural men and women, trend analysis (2005, 2010, 2015) indicated significant upward trends in total energy (p < 0.001) (men: 7.60 MJ to 13.26 MJ, women: 6.60 MJ in 2005 to 11.89 MJ), and most macro- (p < 0.001) and micronutrients (p < 0.001) from 2005 to 2015. Upward trends were also observed in the proportion of total energy intake from all macronutrients (except alcohol) (p < 0.001). The observed trends for rural and urban participants differed significantly (p < 0.001 for interaction effect) for total energy intake as well as intakes of most micro- and macronutrients.
Discussion and conclusion:
Findings from the 2005 to 2010 data clearly showed that the nutrition transition was occurring at a rapid pace in rural and urban groups. Despite the significant increases in energy and fat intake from 2005 to 2010, changes in fat intake were, overall, not strongly associated with the changes in CVD risk factors.
From the in-depth trend analysis of energy and nutrient intakes of urban and rural participants of the PURE-SA-NWP study (2005-2015), it is evident that rural and urban groups differ significantly in terms of dietary changes occurring during the nutrition transition. The rural groups were experiencing a nutrition transition so rapid that they not only caught up with the urban groups in terms of energy and nutrient intake but had surpassed them by 2015. Energy and nutrient intakes in the urban areas, on the other hand, seemed to have flattened down by 2015. Our results highlight the importance of timeous monitoring of the various drivers of the nutrition transition and the urgent need to steer the nutrition transition in a more positive direction to prevent the progressive worsening of our NCD burden.Doctora
The intake and quality of breakfast consumption in adolescents attending public secondary schools in the North West province, South Africa
No full textObjectives: The objectives of the study were to determine the proportion and quality of breakfast intake in adolescents, and to determine the" effect of breakfast intake and quality on overall diet quality. Design: A cross–sectional quantitative study design was used. Setting: The setting was seven public secondary schools in Potchefstroom and the surrounding areas in North West province. Subjects: The subjects were randomly selected adolescents in grades 9–11 (n = 244). "Outcome measures: A self–administered demographic questionnaire was completed by the adolescents. Single 24–hour recall, using" "the four–stage multiple–pass method, was conducted to obtain information on breakfast and dietary intake for the day. Breakfast quality" was measured by applying a breakfast quality score. The Diet Quality Index Revised was used to assess the quality of the overall diet. Spearman s rank correlation coefficient was employed to assess an association between the continuous variables. The chi–square or Fisher s exact test was utilised to assess an association between the categorical variables. "Results: The proportion of breakfast intake and skipping was 81% and 19%, respectively. The mean breakfast quality score was moderate" (3.1). No significant difference was shown in the diet quality score for the breakfast eaters and skippers. The breakfast quality score was "marginally associated with calcium intake (p–value < 0.0001, r = 0.418), phosphorous intake (p–value < 0.0001, r = 0.378) and total diversity" "score (p–value < 0.0001, r = 0.369)." "Conclusion: The proportion of breakfast skipping, moderate quality of the breakfast consumed and trend of improved nutrient intake with" improved breakfast quality highlights the need for breakfast education and intervention as part of the Integrated School Health Polic
Physical activity energy expenditure and sarcopenia in black South African urban women
No full textBackground:Black women are believed to be genetically less predisposed to age-related sarcopenia. The objective of this study was to investigate lifestyle factors associated with sarcopenia in black South African (SA) urban women.Methods:In a cross-sectional study, 247 women (mean age 57 y) were randomly selected. Anthropometric and sociodemographic variables, dietary intakes, and physical activity were measured. Activity was also measured by combined accelerometery/heart rate monitoring (ActiHeart), and HIV status was tested. Dual energy x-ray absorptiometry was used to measure appendicular skeletal mass (ASM). Sarcopenia was defined according to a recently derived SA cutpoint of ASM index (ASM/height squared) < 4.94 kg/m2.Results:In total, 8.9% of the women were sarcopenic, decreasing to 8.1% after exclusion of participants who were HIV positive. In multiple regressions with ASM index, grip strength, and gait speed, respectively, as dependent variables, only activity energy expenditure (β = .27) was significantly associated with ASM index. Age (β = –.50) and activity energy expenditure (β = .17) were significantly associated with gait speed. Age (β = –.11) and lean mass (β = .21) were significantly associated with handgrip strength.Conclusions:Sarcopenia was prevalent among these SA women and was associated with low physical activity energy expenditure
