Kirthee Pillay

Consumer acceptance of yellow, provitamin A-biofortified maize in KwaZulu-Natal

Abstract Objectives: To assess the acceptance of popular maize food products (phutu, thin porridge and samp), prepared with yellow, provitamin A-biofortified maize varieties, in 212 subjects between the ages of three and 55 years, from rural KwaZulu-Natal. Design: A cross-sectional study. Method: Preschool, primary school and secondary school subjects were randomly selected from two primary schools and one secondary school, respectively, while adult subjects constituted a convenience sample. Pre- and primary school children completed a paired preference test. Secondary school and adult subjects completed a five-point facial hedonic and a preference ranking test. Focus group discussions were conducted using adult subjects. Results: Preschool children preferred yellow maize to white maize food products: phutu (81% vs. 19%; p-value < 0.001), thin porridge (75% vs. 25%; p-value < 0.001) and samp (73% vs. 27%; p-value < 0.001). There was no statistically significant difference in preference for white and yellow maize by primary school children. Secondary school and adult subjects preferred white maize to yellow maize. Focus group discussions confirmed the preference for white maize by the adults. Conclusion: The study findings suggest that yellow, provitamin A-biofortified maize has the potential to succeed as a new strategy of dealing with the serious problem of vitamin A deficiency, especially among children of preschool age. However, in older groups, this strategy is unlikely to be successful, unless other strategies are implemented, including intensive nutrition education programmes on the nutritional benefits of the maize, targeting the market price at which yellow maize is sold, increasing its availability in local grocery stores, and improving its sensory properties through breeding.

Provitamin A carotenoids in biofortified maize and their retention during processing and preparation of South African maize foods

Provitamin A-biofortified maize may contribute to alleviating vitamin A deficiency (VAD), in developing countries. However, processing the maize into food products may reduce its provitamin A content. The aims of this study were to determine the composition of provitamin A carotenoids in biofortified maize varieties as well as to assess their retention during processing of popular maize foods consumed in KwaZulu-Natal, South Africa. The non-provitamin A carotenoid, zeaxanthin and the provitamin A carotenoids, β-cryptoxanthin, and trans and cis isomers of β-carotene, and other unidentified trans and cis isomers of β-carotene were detected in varying concentrations in the maize. Milling provitamin A-biofortified maize into mealie meal resulted in a higher retention of carotenoids compared to milling into samp. The highest retention of provitamin A carotenoids was observed in cooked phutu and cooked samp, whilst cooking into thin porridge resulted in the lowest retention of provitamin A carotenoids. In phutu, 96.6 ± 20.3% β-cryptoxanthin and 95.5 ± 13.6% of the β-carotene were retained after cooking. In samp, 91.9 ± 12.0% β-cryptoxanthin and 100.1 ± 8.8% β-carotene; and in thin porridge, 65.8 ± 4.6% β-cryptoxanthin and 74.7 ± 3.0% β-carotene were retained after cooking. This study demonstrates that provitamin A retention in maize is affected by the cooking method (and hence cooked food form) and therefore cooking methods that result in a good retention of provitamin A need to be identified and recommended.

Food and Nutrition Insecurity in Selected Rural Communities of KwaZulu-Natal, South Africa—Linking Human Nutrition and Agriculture

Lack of access to nutritious and balanced diets remains a major impediment to the health and well-being of people living in rural areas. The study utilizes a qualitative systematic approach to conduct an environmental scan and review of scientific literature of studies conducted in South Africa, specifically KwaZulu-Natal (KZN). Availability and access to nutritious, diverse and balanced diets were identified as key constraints for achieving food and nutrition security as well as for human health and well-being. This has led to both under- and over-nutrition, with the former, in particular stunting, affecting children under 5 years. A high incidence of over-nutrition, both overweight and obesity, was observed among black African females. In South Africa, poor people rely mostly on social grants and cannot afford a balanced diet. Under these circumstances, agriculture could be used to increase availability and access to diverse and nutritious foods for the attainment of a balanced diet. The wider use of traditional vegetable crops and pulses could improve availability and access to healthy and locally available alternatives. The promotion of household and community food gardens, and the use of nutrient dense crops with low levels of water use, i.e., high nutritional water productivity, offers prospects for addressing malnutrition in poor rural areas.

Acceptance of a complementary food prepared with yellow, provitamin A-biofortified maize by black caregivers in rural KwaZulu-Natal

Abstract Objectives: The objective was to assess the sensory acceptability and consumer perceptions of soft porridge made with yellow, provitamin A-biofortified maize by black African female infant caregivers from rural KwaZulu-Natal. Design: This was a cross-sectional study. Setting: The study was conducted at Edendale Hospital, located in the uMgungundlovu District, KwaZulu-Natal province. The hospital serves a high proportion of people from rural areas in this district. Subjects: Sixty black African female infant caregivers participated in the study. Outcome measures: The sensory acceptability of soft porridge made from two varieties of provitamin-A biofortified maize and one variety of white maize were evaluated by black African female infant caregivers (n = 60) using a five-point facial hedonic scale. Some of the subjects (n = 21) participated in focus group discussions to assess consumer perceptions. Results: There was no significant difference in the sensory acceptability of the biofortified maize porridge and the white maize porridge, irrespective of caregiver age (p-value > 0.05). The caregivers expressed a willingness to give their infants porridge made with provitamin A-biofortified maize if it was more affordable, readily available and beneficial to health. Conclusion: The biofortified maize soft porridge was found to be as acceptable as the white maize soft porridge to black African female infant caregivers from rural KwaZulu-Natal. Provitamin A-biofortified maize has the potential to be used as a complementary food item that would contribute to the alleviation of vitamin A deficiency.

Influence of biofortification with provitamin A on protein, selected micronutrient composition and grain quality of maize

Provitamin A-biofortified maize is currently being evaluated for use in the alleviation of vitamin A deficiency. Apart from the differences in provitamin A content, the nutritional composition of provitamin A-biofortified maize compared to white maize is hardly known. This study aimed to evaluate the protein and selected micronutrient composition of biofortified maize varieties and the quality of their grains. A total of 32 provitamin A-biofortified maize varieties was analysed for their starch, fat, protein and mineral content. The milling and storage quality of the biofortified maize grains were also assessed. When compared with the white maize variety, the biofortified varieties were higher in starch, fat and protein, but were lower in iron. The biofortified maize varieties were better sources of most of the essential amino acids relative to the white variety, but, similar to the white maize, they were deficient in histidine and lysine. Overall, the quality of the grains of the biofortified maize varieties was superior to that of the white maize grain, although, the biofortified grains were more susceptible to fungal invasion. This study indicates that, in terms of the nutrients assessed, provitamin A-biofortified maize is generally superior to white maize, except for minerals. Keywords: Biofortification, provitamin A, protein, micronutrient composition, maize. African Journal of Biotechnology Vol. 12(34), pp. 5285-5293

Dietary intake and metabolic control of children aged six to ten with type 1 diabetes mellitus in KwaZulu-Natal

Abstract Objectives: The objective of this study was to assess the dietary intake and metabolic control of children with type 1 diabetes. Design: A cross-sectional observational study was carried out. Subjects: A total of 30 subjects whose ages ranged from six to ten years were included in the study. Setting: The study was conducted at the Paediatric Diabetic Clinics at Grey’s Hospital, Pietermaritzburg and Inkosi Albert Luthuli Central Hospital (IALCH), Durban, in KwaZulu-Natal. Outcome measures: Dietary intake was assessed using a three-day dietary record. Metabolic control was assessed using glycosylated haemoglobin (HbA1c). Results: The mean percentage contributions of macronutrients to total energy as determined by the three-day dietary records were as follows: carbohydrate – 52%; added sucrose – 2%; protein – 16%; fat – 32%. The mean intakes were similar to the recommendations of the International Society for Pediatric and Adolescent Diabetes (ISPAD) Consensus Guidelines (2002). Micronutrient intake was generally adequate. The mean latest glycosylated haemoglobin (HbA1c) for the sample as at the time of the study was 9.7%. Five of the thirty subjects had HbA1c values that were within the recommended levels for children with type 1 diabetes. Conclusions: The macronutrient intake in this sample was found to be similar to the ISPAD Consensus Guidelines (2002) while micronutrient intake was adequate in most cases. Overall the sample had poor metabolic control.

Acceptance of a ready-to-use supplementary food by stable HIV-treated and HIV and tuberculosis (co-infected)-treated patients

Abstract Objectives: The objective of the study was to determine consumer acceptance and perceptions of a ready-to-use supplementary food (RUSF) by subjects treated for human immunodeficiency virus (HIV) and HIV and tuberculosis (co-infected subjects). Design: A cross-sectional study was conducted. Subjects: One hundred and thirty-nine stable HIV-treated and HIV and tuberculosis (co-infected)-treated patients participated in the study. Sixty-eight healthy subjects served as the control group. Setting: The setting was Northdale Hospital and Grey’s Hospital in Pietermaritzburg, KwaZulu-Natal. Outcome measures: Acceptance of the RUSF was assessed using a five-point facial hedonic scale by stable HIV-treated and HIV and tuberculosis (co-infected)-treated patients (n = 139) from Northdale Hospital and Grey’s Hospital in Pietermaritzburg, KwaZulu-Natal. Perceptions of the RUSF were determined through focus group discussions in which HIV-treated and HIV and tuberculosis (co-infected)-treated patients (n = 43) participated. Results: The overall acceptance of the RUSF was significantly associated with the health status of the subjects (p-value < 0.05). Overall, the product was liked by more than 90% of the HIV-treated and HIV and tuberculosis (co-infected)-treated individuals compared to 85% of the control group. More than 90% of the HIV-treated and HIV and tuberculosis (co-infected)-treated individuals liked the taste, compared to 87% of the control group. The colour and mouth feel were rated to be “good” by more than 80% of the HIV-treated and HIV and tuberculosis (co-infected)-treated group, compared to approximately 70% of the healthy group. Focus group discussions revealed that the subjects perceived the mouth feel of the RUSF to be “rough”, and that as a health supplement, the RUSF should be provided free of charge, or at a reasonable cost, at public health centres. Conclusion: The RUSF was found to be highly acceptable to stable HIV-treated and HIV and tuberculosis (co-infected)-treated subjects, although concern was raised about the mouth feel.

Consumer awareness and acceptability of bambara groundnut as a protein source for use in complementary foods in rural KwaZulu-Natal

Objectives: To determine the consumer awareness and acceptability of bambara groundnut as a protein source and to assess its potential for use in complementary feeding. Design: Cross-sectional study using a mixed-methods approach. Setting: The study took place at Gcumisa Clinic located at Swayimane, uMshwathi Municipality, in the UMgungundlovu District, KwaZulu-Natal province. Subjects: Black African female outpatients attending the Gcumisa paediatric clinic participated in the consumer-awareness survey (n = 70), consumer-acceptability tests (n = 64) and focus-group discussion (n = 16). Outcome measures: Consumer awareness of bambara groundnut and consumer acceptability of pureed samples made from bambara groundnut and common dry bean (reference) were assessed using questionnaires. A focus-group discussion was also held with some of the consumer acceptability test participants. Results: The survey participants were not familiar with bambara groundnut and its preparation methods. The sensory attributes, including overall acceptability, of the brown bambara groundnut puree compared well with that of the reference. Grain colour significantly influenced overall acceptability of the bambara groundnut puree (p < 0.05). Fifty caregivers (71%) expressed willingness to use the bambara groundnut in complementary feeding if it was accessible, affordable, and beneficial to health. Conclusion: Bambara groundnut is not a familiar legume in KwaZulu-Natal and utilisation is seemingly limited due to poor market availability and knowledge of cooking methods. However, there is potential for its use as a protein source in complementary foods. An improvement in the market availability and nutrition education to highlight the nutritional benefits of bambara groundnut are required to increase utilisation.

Physical, nutritional and antioxidant properties of Zimbabwean bambara groundnut and effects of processing methods on their chemical properties

This study examined the physical, nutritional and antioxidant properties of popular Zimbabwean bambara groundnut landraces and the effects of different processing methods on their chemical properties. The physical, nutritional and antioxidant properties of grains of the bambara landraces differed significantly with grain type, and the processing methods investigated had varying effects on the chemical properties of the grains. Bambara had significantly lower protein content than the reference common bean. Protein and carbohydrate content of the grains increased upon dehulling, while tannin (approx. 36%), total phenolic content (approx. 83%) and antioxidant activities (approx. 18%) decreased. Roasting alone seemed to have little or no effect on the nutrient content of the grains, while sifting significantly reduced the phenolic content and antioxidant activity of all the dehulled and roasted samples. The results indicate that roasting bambara grains would be a suitable method as it is relatively more conservative of nutrients and antioxidants than the other methods investigated.

Relationship between nutritional status and treatment-related neutropenia in children with nephroblastoma

Abstract Background: Assessment of nutritional status of paediatric oncology patients is crucial, as it may influence treatment and clinical outcomes. Concurrent malnutrition and cancer in children may lead to reduced chemotherapy delivery due to impaired tolerance and increased toxicity. Aim: This study aimed to determine the relationship between nutritional status and the prevalence, frequency and duration of treatment-related neutropenia in a cohort of South African children with nephroblastoma. Methods: Seventy-seven children between the ages of 1 and 12 years diagnosed with nephroblastoma at Inkosi Albert Luthuli Central Hospital (IALCH), Durban, between 2004 and 2012, were studied prospectively. Nutritional status was assessed using weight, height, mid-upper arm circumference (MUAC), triceps skinfold thickness (TSFT) and serum albumin. The administration of filgastrim (Neupogen®) was used as a surrogate for neutropenia and the frequency and duration of its use was recorded. Results: There was a significant relationship between the prevalence of treatment-induced neutropenia and malnutrition defined by MUAC. The mean frequency and duration of neutropenia was significantly higher in those classified as malnourished using MUAC. There was a positive correlation between frequency and duration of neutropenia. Conclusions: Malnutrition was prevalent among children with nephroblastoma. The prevalence of treatment-induced neutropenia was higher in those with poor nutritional status, identified by MUAC. Poor nutritional status according to MUAC was also linked to an increased frequency and duration of neutropenia. It is important to include MUAC in the nutritional assessment of children with nephroblastoma.