Masters Degrees (Nutrition and Dietetics)

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Browsing Masters Degrees (Nutrition and Dietetics) by Author "Du Toit, E."

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    Knowledge, attitudes and practices of primary caregivers of foundation phase learners in Bloemfontein regarding breakfast and lunchboxes
    (University of the Free State, 2019) Hansen, Thelma; Lategan-Potgieter, R.; Du Toit, E.
    Healthy breakfasts and school lunchboxes contribute to optimal nutrition during the school day and also influences the development of healthy eating habits in children over the long term. Caregivers are the most important role players in the food intake of their child, as they decide what the children in their care eat through food procurement and the meals they prepare. Children are also dependent on their caregiver to learn about healthy food practices from them. It is therefore important to determine whether caregivers are informed about healthy eating and practices and whether they have a positive or negative attitude towards providing healthy food to the children in their care. The aim of this study was to examine caregivers’ knowledge, attitudes and practices regarding healthy breakfasts and school lunchboxes and to determine whether the attitudes of the caregivers reflected in their practices regarding the provision of breakfast and lunchbox foods. The knowledge, attitudes and practices of the caregivers were also compared to socio-demographic variables to determine aspects that may affect the practices of caregivers. A cross-sectional, descriptive study was conducted, using in a sample of 1286 caregivers of foundation phase learners (aged 6 – 12 years) attending independent and public Quintile 5 primary schools in Bloemfontein, South Africa. Data on knowledge, attitudes and practices regarding breakfast and lunchbox provision were collected through printed questionnaires and caregivers had to be willing to complete the questionnaire in English. The median breakfast knowledge score of caregivers was 55.6% and median lunchbox knowledge score 73.1%. Breakfast and lunchbox food knowledge were higher for caregivers older than 35 years (median=55.6, P=0.0479 and median=76.9, P<0.0001 respectively) and those who possessed a tertiary qualification (median=55.6, P=0.0009 and median=76.9, P<0.0001 respectively), than for caregivers younger than 35 years and those without a tertiary qualification. The attitudes of caregivers were generally positive towards providing healthy breakfast and lunchbox foods to the children in their care (median=71.4% and 82.5% respectively), except for caregivers with an income of less than R20 000/month that had a lower attitude score towards providing lunchboxes (P=0.0086). Caregivers with a higher income provided a daily breakfast more often (P=0.0014) than caregivers with a lower income. Higher income caregivers however ate breakfast together with children less often (P=0.0296). Caregivers with a higher qualification also provided children more often with a daily breakfast (P=0.0011) than those with lower qualifications; and provided children with fruit (P<0.0001) and vegetables (P=0.0027) in the lunchbox more often than those with a secondary qualification. In contrast, caregivers with a lower income provided tuck shop money (P<0.0001) and fast foods (P=0.0006) more often than those with a higher income and were less positive towards healthy eating habits (P=0.0089). Caregivers with a higher income and those living with a life partner perceived healthy food to be more expensive than less healthy food (P=0.0003 and P=0.0045 respectively) and that lunchbox preparation results in an extra workload (P=0.0027 and P=0.003 respectively). Caregivers’ primary objective when providing a lunchbox was health considerations (54.2%, n=658) followed by to be filling (22.8%, n=277). The average practices score for the provision of healthy breakfast foods was 26.7% and for lunchbox foods 35.6%. Even though the practice scores were low, healthier breakfast (P=0.0013) and lunchbox foods (P=0.0001) were provided to children with caregivers that had a tertiary qualification. Overall, caregivers had a positive attitude towards providing children in their care with healthy breakfast and lunchbox foods. Unfortunately, differences still exist between the nutritional knowledge of caregivers older than 35 years and those with a tertiary qualification and younger caregivers and those with a lower qualification and the food they provide to their children. Caregivers with a higher level of nutritional knowledge tended to provide the children in their care with healthier breakfast and lunchbox foods. Therefore, the focus should be on the improvement of the nutritional knowledge of primary caregivers.
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    South African dietitians’ practices and perceptions regarding food exchange lists, as part of the food exchange system, in the nutrition care process
    (University of the Free State, 2020-11) Brand, Desire Michelle; Robb, L.; Du Toit, E.
    The nutrition care process (NCP) is a standardised method to apply nutritional therapy, followed by dietitians to promote evidence-based practice. While various tools can be used by dietitians as part of the NCP, the decision to use a certain tool is based on relevance, convenience, and trustworthiness. As food exchange lists (FELs) can be used in multiple phases of the NCP, and in light of the significance of targeted nutrition therapy and the appropriate use of tools on the nutritional outcome, it is essential to describe dietitians’ practices and perceptions regarding the use of FELs as part of the NCP. Particularly, as limited literature is available on the use of FELs by dietitians in practice, especially in South Africa, where population specific FELs are lacking. This cross-sectional survey aimed to determine South African dietitians’ practices and perceptions regarding the use of FELs as part of the NCP. All dietitians and community service dietitians residing in South Africa who were registered at the Health Professions Council of South Africa (HPCSA), were eligible to participate in this study. Dietitians’ socio-demographic information and practices and perceptions regarding the use of FELs within the NCP were determined using an online survey, created with Evasys Software®. The link to the survey was shared through e-mail newsletters to Association for Dietitians in South Africa (ADSA) members and on Dietetics-Nutrition is a Profession (DIP) and Dietetic Services Facebook pages. The survey was open for completion for a duration of two months, from February to April 2020. Dietitians in the current study were mainly female (96.2%; n = 126), with the greater proportion of dietitians being between 25-30 years of age (42.8%; n = 56), speaking Afrikaans (53.4%; n = 70) or English (50.4%; n = 66) as a home language, practising for one to four years post community service (34.4%; n = 43), based in Gauteng (29.8%; n = 39), and employed in private settings (53.4%; n = 70). Dietitians in South Africa are using FELs for different purposes in the nutritional management of various population groups, throughout all phases of the NCP, although 67.7% of dietitians applied FELs in dietary counselling and 92.1% in meal planning as part of the NCP. More dietitians employed in private settings used FELs (86.3%) compared to government (55.3%) or tertiary education/ research/ pharmaceutical sectors (64.7%). This significant association may partly be ascribed to a greater proportion of dietitians who self-designed FELs in private settings (42.5%), which appeared to have been associated with dietitians’ perceived knowledge of FELs. Also, a significantly larger proportion of dietitians employed in government settings compared to private practices considered patients’ language (25.0%; 5.8%) and literacy level (92.9%; 67.3%) in the decision to provide patients with FELs. Overall, 78.7% of dietitians obtained FELs from universities and most FELs currently in use have been updated in the past five years. Even so, the greater proportion of dietitians (46.6%) reported the lack of South African specific foods as the main reason why FELs are due for an update. Dietitians acknowledged the importance of population-specific FELs with the majority (85.3%) advocating for FELs that are specific to various ethnic groups, mainly cultural (61.9%) and language groups, as well as different literacy levels (65.4%), mostly grade 8-9 level. While a smaller percentage (39.7%) indicated that FELs should be adapted for different religions, the majority (68.3%) reported that vegetarianism / veganism should be considered. Adapting FELs according to socio-economic status was not perceived as essential to most dietitians. Majority of dietitians recommended FELs should be adapted for different stages of the life cycle, especially given the lack of resources on portion sizes in paediatric patients. Given the convenience of use, dietitians reported using alternative tools to the FELs, but also supported the idea of an electronic FEL. Main concerns affecting the use of health applications, comprised dietitians’ doubts about accessibility, ease of use, trustworthiness and costs involved. The use of a comprehensive FEL that is relevant and evidence-based, which dietitians find convenient to use, may improve nutritional outcomes in dietetic practices and promote the dietetics profession.