Introduction

Prescribing patterns of vitamin D and analogues in a private healthcare patient population in South Africa

There are two forms of vitamin D. Vitamin D2 (ergocalciferol) is derived from the irradiation of ergosterol and found in food sources such as fortified foods, plant oils and mushrooms, and vitamin D3 (cholecalciferol) is derived from animal food sources such as oily fish and egg yolk and the action of sunlight on the subcutaneous layer of the skin. There are numerous studies on the benefits of vitamin D, the role that vitamin D plays in the prevention of bone disease and more recently in the immune system and the prevention and mitigation of cancer. The action of vitamin D is that of a neuro-hormone that regulates both cell growth and immunomodulation. In the former role, vitamin D is well established in its action on bone growth and repair, and the prevention of rickets and osteoporosis. Other studies have implicated vitamin D in the mitigation of bronchiectasis, prevention of early age-related macular degeneration, and in support of the immune system in people living with human immunodeficiency virus (HIV).

Handwashing knowledge and practices among caregivers of pre-school children in underprivileged areas of Nelson Mandela Bay

South Africa has been recognised as a country with one of the highest rates of inequality in the world and, despite some progress, poverty rates increased between 2011 and 2015. Poverty is associated with inadequate access to quality basic services including health, education and infrastructure (such as water and sanitation) and inadequate access to early childhood development (ECD) programmes. Inadequate water, sanitation and hygiene (WASH) practices are negatively associated with child health and development.

Screening for overweight using mid-upper arm circumference (MUAC) among children younger than two years in the Eastern Cape, South Africa

According to the WHO,1 42 million children under the age of five years are overweight or obese. The prevalence of stunting and wasting is reducing in low- and middle-income countries (LMIC), while overweight and obesity is becoming more prevalent among children. Accelerated weight gain in early life may be related to non-communicable disease risk. Overweight at one year old may greatly increase the risk of type 2 diabetes and premature death from cardiovascular disease. High rates of glucose intolerance and pre-hypertension have been observed among rural South African adolescents, indicative of the epidemiological transition taking place.

Profile of mothers whose children are treated for malnutrition at a rural district hospital in the North West province, South Africa

High child mortality remains a key health challenge in developing countries, where it is estimated that 45% of all deaths in children aged under 5 years are attributable to undernutrition.1 Although child malnutrition has decreased in most areas of the world in the past two decades, its prevalence among children younger than five years has increased in sub-Saharan Africa, and in South Africa the mortality in children younger than five years has shown a steady increase. The situation highlights the important role of adequate and appropriate child nutrition as key to the prevention of child morbidity and mortality. With South Africa being one of the most unequal societies, and having pockets of poverty-stricken communities, caregivers within impoverished communities and households often change their food consumption patterns to cope, which often results in compromised nutrition rather than providing optimum nutrition to their children.

When is the estimation of weight and height good enough? A life cycle view 

Anthropometry – the measurement of body size and proportion – is an objective component of a comprehensive nutrition assessment. As such, it is intended to give a true (accurate and precise) reflection of the reality which one wants to observe. This applies to dietetic and clinical practice as well as the scientific study of growth and nutritional status throughout the life cycle. Measurements of weight and the height/length of the human body are the foundation of anthropometric assessment. True values for these parameters are obtained through measurement, using calibrated equipment and appropriate technique

Agreement between measured height, and height predicted from published equations, in adult South African patients

Height is a fundamental measurement in hospitalised patients. Amongst many other clinical applications, accurate height measurements are required to calculate body mass index (BMI) and ideal bodyweight (IBW), which, in turn, are used in nutritional screening and the calculation of nutritional requirements of patients. International consensus advises that all patients should be screened for nutritional risk on admission, and throughout the hospital stay so that appropriate dietary intervention based on these screenings can be employed to improve and maintain proper nutritional status. Whereas some patients are admitted with poor nutritional status, others develop disease-related malnutrition during hospitalisation. Globally, hospital malnutrition is a prevalent phenomenon with devastating consequences for clinical outcomes, including increased length of stay (LOS), longer duration of rehabilitation, increased readmission, increased cost of healthcare and increased mortality.

Determining percentage body fat of male South African jockey apprentices irrespective of hydration status

Horse racing relies on a handicapping system. Each horse in every race is assigned a specific weight (handicap) to carry, according to the ability of the horse. If the weight of the kitted jockey (including helmet, whip, saddle, boots, breeches and silks) immediately prior to the race exceeds the handicap by 500 g, the rider can be fined and/or suspended from racing for a period of time. Jockeys need to maintain their weight around the minimum handicap of 52 kg in South Africa as this allows increased opportunity to race ride to generate an income and thus pursue a successful career as a professional rider. A jockey apprentice is a professional jockey in training. An apprentice jockey is a professional jockey in training.

Accreditation

Health Professions Council of South Africa

DT/A01/P00008/2022/00001

3 Clinical

DT/A01/P00008/2022/00002

3 Clinical

Certification

Attempts allowed: 2

70% pass rate





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South African Journal of Clinical Nutrition - March 2022 - Vol 35 Issue 1

6.0 CPD Points