Masters Degrees (Nutrition and Dietetics)

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Browsing Masters Degrees (Nutrition and Dietetics) by Advisor "Nortjé"

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    Anthropometric measurements and biochemical parameters in black women at the unit for reproductive care at Universitas Hospital, Bloemfontein
    (University of the Free State, 2004-11) Motseke, Lucia; Slabber, M.; Nortjé
    English: The prevalence of infertility in Africa is overshadowed by the high population growth rate in this continent. The number of infertile black African women seeking treatment is on the increase due to the fact that more black women are concentrating on their careers and postponing having children. The desire to reproduce is a highly motivating factor in most marriages and failure to do so places a lot of stress on the couple. Infertile women in most parts of Africa are treated as outcasts due to their infertile status. In most cases these women are either abused or divorced by their husbands. In sub-Saharan Africa, sexually transmitted diseases are the most common causes of infertility. Other causes of infertility in women include endometriosis, anovulation, tubal diseases, cervical factors and unexplained infertility. Anorexia and bulimia nervosa, as well as obesity, produce alterations in the reproductive system of women. Obesity has an effect on ovulation and on the outcomes of in vitro fertilization and assisted reproduction therapy. Anorexia nervosa on the other hand, has also been associated with amenorrhoea and oligoamenorrhoea. Insulin resistance is another factor that is linked to polycystic ovarian syndrome and infertility. Insulin resistance has also been shown to be prevalent in obese individuals, especially those with android fat distribution. Lowering insulin resistance by weight loss, results in spontaneous ovulation. The main objective of this study was to determine the anthropometrical and biochemical parameters in infertile black South African women. A total of sixty participants attending the Unit for Reproductive Health, Universitas Hospital, Bloemfontein were included in the study. Anthropometrical data measured included: body mass index; waist-to-hip ratio; waist circumference; neck circumference and body fat percentage. Blood samples were also obtained to determine the levels of fasting insulin, glucose, thyroid-stimulating hormone, luteinizing hormone, follicle-stimulating hormone, leptin, prolactin, progesterone, testosterone and C-reactive protein. The results of this study show that tubal factor infertility was the most prevalent cause of infertility and the second highest cause of infertility was male factors. The median age of the subjects of this study was 32 years. Sixty percent of the subjects had a gynoid fat distribution. More than a third of the subjects had a body mass index of more than 25 kg/m² and none of the subjects in this study had a body mass index of less than 18.5 kg/m². Eighty five percent of the subjects had a body fat percentage of more than 32 percent. These results indicate that obesity is a problem among these subjects. Biochemical parameters indicate that the median concentrations of the reproductive hormones were normal. Only 35 percent of the subjects had hyperinsulinaemia. Almost all of the subjects (83.6%) had leptin concentrations above normal. Median C-reactive protein level was also normal. No association was found between body mass index and C-reactive protein and insulin. An association was established between leptin concentrations and body mass index and the correlation between these two parameters was very strong. An association was also found between android fat distribution and hyperinsulinaemia. The high rate of obesity among the subjects of this study, places the subjects of this study at a risk of developing metabolic syndrome and other obesity-related factors. Their obesity status may also be a contributory factor to their infertile status. There should, be increased awareness of the impact of obesity on infertility and on their general health. Increased physical activity and healthy food choices should be encouraged among black infertile women. Black women should still be made aware of the fact that there are facilities available for treatment of infertility.