Browsing by Author "Faber, Mieke"

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    Assessment of the association of plant- based diets with cardiovascular disease risk profile in Africa: a systematic review and meta-analysis protocol
    (BMJ Publishing, 2020-06) Lopes, Tatum; Zemlin, Annalise E.; Erasmus, Rajiv T.; Faber, Mieke; Kengne, Andre P.
    Introduction Cardiovascular disease (CVD) is currently the leading cause of death worldwide. In Africa where infectious diseases are still the leading cause of death, the contribution of non-communicable diseases led by CVDs has significantly increased in recent years. The rise of CVDs in Africa is attributed at least in part to the adoption of sedentary behaviours and unhealthy eating habits, which are linked with urbanisation and westernisation of cultures. Dietary attributes associated with CVD risk have been less investigated in Africa. However, evidence from developed nations has reported a protective effect of healthy dietary patterns such as plant-based diets (PBDs) on cardiometabolic health. The current protocol is for a review aiming to assess existing evidence on the association of PBDs with CVD risk profile in African populations. Methods and analysis This protocol was developed following the 2015 guidelines of the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. We will conduct a comprehensive search of the literature for published studies on PBDs in relation to CVD risk profile in African populations. Observational studies published between January 1990 and December 2019 will be screened. A search strategy using keywords and medical subject headings terms will be applied across multiple scientific databases including PubMed-Medline, Scopus and EBSCOhost and the African Journals Online platform. Manual searches of reference lists from relevant articles will be performed. Citations will be traced using the ISI Web of Science to further identify eligible studies. Grey literature will also be screened for relevant abstracts from conference proceedings, and experts in the field will be contacted where appropriate. Two investigators will independently screen all the titles and abstracts to determine which records are eligible for full-text review. Subsequently, two investigators will review the eligible full text using the selection criteria. A third investigator will be consulted to resolve any discrepancies. Data will be extracted from studies that are eligible for the review. Meta-analysis will be performed for studies with similar or comparable methods and reported outcome measures. This will be performed overall, and by major study-level characteristics. Heterogeneity in the estimates across studies will be assessed and quantified with the use of Cochrane Q and I2 statistics, respectively. Publication biases will be investigated through funnel plots and Egger test of bias. Relevant sensitivity analyses will be performed to confirm the robustness of the findings
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    Dietary diversity of formal and informal residents in Johannesburg, South Africa
    (BioMed Central, 2013-10) Drimie, Scott; Faber, Mieke; Veary, Jo; Nunez, Lorena
    Background: This paper considers the question of dietary diversity as a proxy for nutrition insecurity in communities living in the inner city and the urban informal periphery in Johannesburg. It argues that the issue of nutrition insecurity demands urgent and immediate attention by policy makers. Methods: A cross-sectional survey was undertaken for households from urban informal (n = 195) and urban formal (n = 292) areas in Johannesburg, South Africa. Foods consumed by the respondents the previous day were used to calculate a Dietary Diversity Score; a score < 4 was considered low. Results: Statistical comparisons of means between groups revealed that respondents from informal settlements consumed mostly cereals and meat/poultry/fish, while respondents in formal settlements consumed a more varied diet. Significantly more respondents living in informal settlements consumed a diet of low diversity (68.1%) versus those in formal settlements (15.4%). When grouped in quintiles, two-thirds of respondents from informal settlements fell in the lowest two, versus 15.4% living in formal settlements. Households who experienced periods of food shortages during the previous 12 months had a lower mean DDS than those from food secure households (4.00 ± 1.6 versus 4.36 ± 1.7; p = 0.026). Conclusions: Respondents in the informal settlements were more nutritionally vulnerable. Achieving nutrition security requires policies, strategies and plans to include specific nutrition considerations.
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    Dietary practices and adolescent obesity in secondary school learners at disadvantaged schools in South Africa : urban–rural and gender differences
    (MDPI, 2020-08) Okeyo, Alice P.; Seekoe, Eunice; de Villiers, Anniza; Faber, Mieke; Nel, Johanna H.; Steyn, Nelia P.
    South Africa has a high prevalence of obesity in black female adolescents and a paucity of knowledge regarding contributing dietary practices. The aim of this study was to assess the dietary practices and weight status of male and female adolescents at secondary schools in the Eastern Cape province in urban and rural areas. Sixteen schools and grade 8–12 learners (N = 1360) were randomly selected from three health districts comprising poor disadvantaged communities. A short unquantified food frequency questionnaire was used to collect data on learners’ usual eating practices with regards to weekly meal pattern, breakfast consumption, foods taken to school, takeaways, and snacks eaten while watching television (TV). Body mass index measurements were determined for each learner. Prevalence of combined overweight and obesity differed significantly between genders, 9.9% in males versus 36.1% in females (p < 0.001). Significant gender differences were noted regarding eating practices. Females had a higher frequency of eating sugary snacks (p < 0.001) and a lower frequency of eating breakfast (p < 0.01) than males. Females ate significantly more fried fish (p < 0.05), pizza (p < 0.05) fat cakes (fried dough balls) (p < 0.05), hotdogs (p < 0.01), candy (p < 0.001), cake (p < 0.01), and crisps (p < 0.001). Compared to urban areas, the frequency of eating breakfast (p < 0.01) and sugary snacks (p < 0.05) was significantly higher in rural areas. Significantly more learners in urban areas consumed boerewors (beef sausage) rolls (p = 0.027), hamburgers (p = 0.004), and soft drinks (p = 0.019), while more learners in the rural areas consumed cordial (p = 0.001). In conclusion, a high prevalence of combined overweight and obesity was found in black female adolescents and a high prevalence of poor dietary practices was observed, with significant gender and urban–rural differences.
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    The food and nutrition environment at secondary schools in the Eastern Cape, South Africa as reported by learners
    (MDPI, 2020-06) Okeyo, Alice P.; Seekoe, Eunice; de Villiers, Anniza; Faber, Mieke; Nel, Johanna H.; Steyn, Nelia P.
    Overweight and obesity are growing concerns in adolescents, particularly in females in South Africa. The aim of this study was to evaluate the food and nutrition environment in terms of government policy programs, nutrition education provided, and foods sold at secondary schools in the Eastern Cape province. Sixteen schools and grade 8–12 learners (N = 1360) were randomly selected from three health districts comprising poor disadvantaged communities. Based on age and sex specific body mass index (BMI) cut-off values, 13.3% of males and 5.5% of females were underweight, while 9.9% of males and 36.1% of females were overweight or obese. The main food items purchased at school were unhealthy energy-dense items such as fried flour dough balls, chocolates, candies, and crisps/chips. Nutrition knowledge scores based on the South African food-based dietary guidelines (FBDGs) were poor for 52% to 23.4% learners in Grades 8 to 12, respectively. Female learners generally had significantly higher nutrition knowledge scores compared to their male counterparts (p = 0.016). Questions poorly answered by more than 60% of learners, included the number of fruit and vegetable portions required daily, food to eat when overweight, foods containing fiber, and importance of legumes. It was noted that the majority of teachers who taught nutrition had no formal nutrition training and their responses to knowledge questions were poor indicating that they were not familiar with the FBDGs, which are part of the curriculum. Nutrition assessment as part of the Integrated School Health Program was done on few learners. Overall however, despite some challenges the government national school meal program provided meals daily to 96% of learners. In general, the school food and nutrition environment was not conducive for promoting healthy eating.
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    Understanding factors associated with sarcopenic obesity in older African women from a low-income setting : a cross-sectional analysis
    (BMC (part of Springer Nature), 2021-04-14) Mendham, Amy E.; Goedecke, Julia H.; Micklesfield, Lisa K.; Brooks, Naomi E.; Faber, Mieke; Christensen, Dirk L.; Gallagher, Iain J.; Lundin-Olsson, Lillemor; Myburgh, Kathryn H; Odunitan-Wayas, Feyisayo A.; Lambert, Estelle V.; Kalula, Sebastiana; Hunter, Angus M.
    Background: High rates of food insecurity, obesity and obesity-related comorbidities in ageing South African (SA) women may amplify the risk of developing sarcopenic obesity. This study aimed to investigate the prevalence and correlates of sarcopenic obesity and its diagnostic components [grip strength, appendicular skeletal muscle mass (ASM) and body mass index (BMI)] in older SA women from a low-income setting. Methods: This cross-sectional study recruited black SA women between the ages of 60–85 years (n = 122) from a low-income community. Testing included a fasting blood sample (markers of cardiometabolic risk, HIV), whole body and regional muscle and fat mass (dual-energy absorptiometry x-ray), anthropometry, blood pressure, functional movement tests, current medication use, demographic and health questionnaires, physical activity (PA; accelerometery), household food insecurity access scale, and a one-week quantified food frequency questionnaire. Foundation for the National Institutes of Health (FNIH) criteria (grip strength and ASM, adjusted for BMI) were used to classify sarcopenia. Participants with sarcopenia alongside a BMI of > 30.0 kg/m2 were classified as having sarcopenic obesity. Prevalence using other criteria (European Working Group on Sarcopenia in Older People, Asian Working Group for Sarcopenia and the International Working Group for Sarcopenia) were also explored. Results: The prevalence of sarcopenia was 27.9%, which comprised of sarcopenia without obesity (3.3%) and sarcopenic obesity (24.6%). Other classification criteria showed that sarcopenia ranged from 0.8–14.7%, including 0.8–9.8% without obesity and 0–4.9% with sarcopenic obesity. Using multivariate-discriminant analysis (OPLS-DA) those with sarcopenic obesity presented with a descriptive profile of higher C-reactive protein, waist circumference, food security and sedentary time than women without sarcopenic obesity (p = 0.046). A similar profile described women with low BMI-adjusted grip strength (p < 0.001). Conclusions: The majority of women with sarcopenia were also obese (88%). We show a large discrepancy in the diagnostic criteria and the potential for significantly underestimating the prevalence of sarcopenia if BMI is not adjusted for. The main variables common to women with sarcopenic obesity were higher food security, lower PA and chronic inflammation. Our data highlights the importance of addressing obesity within these low-income communities to ensure the prevention of sarcopenic obesity and that quality of life is maintained with ageing.