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The scaling up nutrition (SUN) policy framework requires extensive public-private partnership (PPP). Malnutrition is multi-dimensional and should engage multi-sectoral platforms. The SUN policy however did not fully embrace the dynamics of harnessing PPP. The objectives of the present paper are to highlight the reasons for the apprehension around PPP and illustrate how effective coordination of PPP in West Africa has contributed to implementing large-scale food fortification with micronutrients as a complementary nutrition intervention. The experience of Helen Keller International (HKI) in scaling up food fortification was emphasised with understanding of the factors contributing to indifference by the international community to private sector contribution to SUN. The roles of different stakeholders in a PPP are elucidated and the process linked to who, why and how to engage. The private sector provides direct nutrition services while the public sector creates the enabling environment for the private sector to thrive on social values. Through this approach fortified vegetable oil and wheat flour are now reaching over 70% of the population in West Africa. As a neutral broker HKI coordinated and facilitated dialogue among the different stakeholders. The core competencies of each stakeholder were harnessed and each partner was held accountable. It concludes that multi-sectoral relationship must be transparent, equitable and based on shared mutual interests. The rules and values of PPP offer opportunities for SUN

The increased use of alternative treatment for menopausal symptoms is mainly due to women's changing opinions of conventional hormone replacement therapy (HRT). The objective of this study was to assess the opinion of preand post-menopausal South African women regarding the potential menopause-related health benefits of soy. The sample used for the study was a sub-dataset of 825 respondents, which included only pre- and post-menopausal women that had heard of soy before, selected from a representative sample of the adult South African metropolitan and rural populations. A structured questionnaire was used. Neither age nor racial groups differed practically significantly in opinion regarding any of the various statements. The study also shows that a practically significant lower proportion of women in the sub-population across both age and race groups had a positive opinion on the health benefits of soy as an alternative to HRT and reliever of menopausal symptoms than those who acknowledged its benefit for preventing cardiovascular disease and osteoporosis. Practically significantly more women who used soy than women who never used soy agreed that soy keeps bones strong. In addition, more women who were of opinion that soy has few or no health benefits disagreed that soy could be used as an alternative to HRT compared to women who held a positive opinion. Die toenemende gebruik van alternatiewe behandelings vir menopousale simptome kan aan vroue se veranderende opinies oor konvensionele hormoonvervangingsterapie (HVT) toegeskryf word. Die doel van hierdie studie was om pre- en post-menopousale Suid-Afrikaanse vroue se opinie aangaande die potensiële menopouseverwante gesondheidsvoordele van soja te bepaal. Die steekproef vir die studie het uit ‘n subdatastel bestaan van 825 vroue in hul pre- en post-menopousale stadium wat al voorheen van soja gehoor het, en is vanuit ‘n verteenwoordigende steekproef van die volwasse Suid-Afrikaanse metropolitaanse en plattelandse bevolking gekies. ‘n Gestruktureerde vraelys is gebruik. Geen prakties betekenisvolle verskille is tussen die verskillende ouderdoms- of rasgroepe se opinie oor enige van die stellings gevind nie. Die studie dui ook daarop dat ‘n prakties betekenisvolle laer verhouding Suid-Afrikaanse vroue, van beide ouderdoms- en rasgroepe, ‘n positiewe opinie oor die gesondheidsvoordele van soja as HVT en verligter van menopousale simptome gehad het as oor soja se voordele om kardiovaskulêre siektes en osteoporose te voorkom. Prakties betekenisvol meer van die vroue wat soja gebruik het as dié wat dit nooit gebruik het nie, het saamgestem dat soja bene sterk hou. Meer vroue wat van die opinie was dat soja geen of min gesondheidsvoordele het nie was ook negatief teenoor die gebruik van soja as ‘n alternatief vir HVT as dié wat ‘n positiewe opinie daaroor gehad het. Keywords: soy; soy products; functional food; health benefits; menopausal symptoms; hormone replacement therapyHealth SA Gesondheid Vol. 13 (2) 2008 pp. 25-37

Studies linking diet and health and consumers’ demand for health information, has led to an increasing awareness of the role of nutrition in health and disease. Interest in soy foods and an awareness of its health benefits has also increased. The objective was to assess South African (SA) consumers’ opinions and beliefs regarding the health benefits of soy and soy products using different statements. This cross-sectional study randomly selected 3001 respondents from metropolitan and rural areas in South Africa. Data of 81% of respondents (n = 2437), who had heard of soy, were used. Trained fieldworkers administered questionnaires as face-to-face interviews. Fifteen statements probing consumers’ opinions regarding the health benefits of soy were used. The data were weighted to be representative of the total South Africa adult population (n = 18 251 000) based on gender, age, living environment and race distribution in 2000. Effect sizes were used to determine the strength of associations (practical significance), since statistical significance could be attributed to the large study population. No practically significant differences between either gender or age groups, or between rural and metropolitan respondents’ opinions were found. Most respondents in the total study population (50–75%), as well as within all race groups agreed that soy has many health benefits; soy is good for you; soy lowers cholesterol; soy is good for people with a milk allergy; soy helps keep your heart healthy; soy is good for diabetes and soy is good for growing children. Medium to large practically significant differences were found between racial groups regarding some of the statements. Practically significantly more adult Black consumers believed that soy is only for people with a low-income, and fewer that soy milk is good for people with a milk allergy than did White, Indian and Coloured consumers. Whites were relatively more positive towards the use of soy for people with a milk allergy opposed to Blacks, while Blacks were relatively more positive than Whites towards the statement that soy helps keep your bones strong. The results indicate that SA consumers held positive opinions and associate consumption of soy with several health benefits. The role of soy is seen more as being preventative than curative. It may represent a challenge to the food industry to design soy-containing products that appeal to a broader spectrum of consumers. http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1470-6431/ http://dx.doi.org/10.1111/j.1470-6431.2010.00957.x

Thesis (M.Sc. (Dietetics))--North-West University, Potchefstroom Campus, 2005. Motivation - There is international agreement and recognition that the health status of the worlds' population is a cause for concern and that one of the key risk factors for many of the diseases that are increasing at an alarming rate (heart disease, diabetes, cancer) in both developed and developing countries, is diet. Despite many successes (especially in the areas of the eradication and containment of infectious disease and reduced fertility) and the huge advances in scientific research and technology, that have increased both what is known, and what can be done, for prevention and risk management, we still face what many describe as a crisis. Knowledge it seems is not always adequately reflected in public health practice. The objective of the local (Department of Health, Directorate of Food Control) and international (WHO, Codex Alimentarius) drive towards increased and improved food labeling, is that if consumers have reliable nutrition information available at the point of purchase and if they understand how their diet affects their risk of diseases, they will be able to make risk-reducing food choices. This could ultimately have a significant positive public health impact. The food industry has also expressed an interest through the concept of functional foods (food similar in appearance to conventional food that is intended to be consumed as part of a normal diet, but has been modified to sub-serve physiological roles beyond the provision of simple nutrient requirements), that albeit in reality financially motivated, could provide consumers with the opportunity to reduce their risks of some diseases through readily available, good-tasting diets rather than through the use of curative measures only. For the success of both these initiatives in public health terms, consumers must: * accept the link between the food that they eat and their health * actively look for and trust the messages communicated * be able to correctly process and integrate the information * make a purchasing decision. This highlights the importance of in-depth consumer understanding in order to ensure that regulatory, educational and marketing strategies will affect positive behaviour change and improve health status. Little consumer research has been done in South Africa to assist all those involved (government, industry, researchers, nutrition experts I dietitians, educators) in gaining potentially important insights. Objectives - Of South Africa's almost 31 million adults, some 11 million live in the metropolitan areas and so have relative exposure to most media and access to the widest range of available food products. This group is also a microcosm of the larger South Africa - being made up of all races, ages and living standards. The overall objective of this study was to investigate the beliefs and practices of South African metropolitan adults, in relation to the food and health link and the health information contained on food packages in order to consider the implications for functional foods. The study design was focused on four key variables, namely, gender, race, age and living standard measure (LSM). Methods - The study was designed to ensure that the results would be representative of the metropolitan adult (>I6 years) population and that they could be weighted and extrapolated. 2000 adults made up of 1000 Blacks. 640 Whites, 240 Coloureds and 120 Indians, with a 50150 gender split were drawn using a stratified, random (probability) sampling method in order to allow for the legitimate use of the mathematics of probability as well as to avoid interviewer bias. The study group were interviewed, face-to-face, in home, in the preferred language from English, Afrikaans, Xhosa, Zulu, Tswana, North Sotho and South Sotho, by trained field workers. A minimum 20% back-check on each interviewer's work was undertaken to ensure reliability and validity of the data. The field worker used a pre-coded questionnaire that included seventeen food related questions designed by a multidisciplinary team of marketers, dietitians, nutritionists and research specialists. The food questions used a 5-point Likert scale in order to measure attitude. The data was captured (3 questionnaire were excluded due to being incorrectly filled in) and the computer software package STATISTICA@Release 6, which was used to perform the statistical analysis. The data was data was weighted to represent the total metropolitan population prior to analysis. Quantitative data was statistically analysed in order to generate relevant descriptive statistics, cross tabulations and statistical tests. Results - The study considered four variables; gender, race (Black, White, Coloured, Indian), age (16-29, 30-44,45+) and living standards measure (LSM 2-3, LSM 4-6, LSM 7-10), to explored four statements: 1. I believe food can have an effect on my health 2. 1 always look for health information contained on the packaging of food products 3. 1 don't take any notice of health information as it is only marketing hype 4. 1 buy food that claims to contribute to my health. The overall response to the belief that food can have an effect on health was positive (54%). There was no practical significant difference between age groups and genders but there were practical significant differences between Blacks and the other race groups (Blacks having the lowest belief in the food and health link) and between the highest LSM group and the other LSM groups (LSM 7-1 0 had the strongest belief in the link between food and health and this belief decreased with decreasing LSM). Forty-two percent of respondents always look for health information on the packaging of food, but there was no practical significant difference between all the variables, however women were more likely than men to always look for health information on food packaging. Over half the respondents (51%) stated that they look for health information and that it is not only marketing hype. There was a small practical significant difference between the top and the bottom LSM group with LSM 7-10 being less sceptical about the health information on food packaging. 67% buy foods that claim to benefit their health and there was a small practical significant difference between Blacks and Whites, with more Blacks agreeing that they buy foods that claim to contribute to health. CONCLUSION - Findings from this study indicate that adult metropolitan South Africans label reading practices are influenced by a number of factors including attitudes, beliefs and practices and that there are differences based on gender, race, age and LSM which must be considered by regulators in drafting food labeling regulations; the food industry when considering and developing functional foods; and nutrition experts when planning education strategies. Whilst the labeling of foods with health information and the development of function foods might indeed potentially empower consumers to effectively reduce their risk of many chronic diseases, on its own it is not enough. Nutrition education is vital and must be planned giving due consideration to the differences in belief and practices that exist within the different gender, race, age and LSM groups found in South Africa. Food consumption patterns are influenced by consumer attitudes, beliefs, needs, lifestyles and social trends and so more multi-disciplinary research in these fields must be encouraged to find ways to improve nutritional intakes that will lead to improved health for all South Africans. Masters

Motivation There is international agreement and recognition that the health status of the worlds' population is a cause for concern and that one of the key risk factors for many of the diseases that are increasing at an alarming rate (heart disease, diabetes, cancer) in both developed and developing countries, is diet. Despite many successes (especially in the areas of the eradication and containment of infectious disease and reduced fertility) and the huge advances in scientific research and technology, that have increased both what is known, and what can be done, for prevention and risk management, we still face what many describe as a crisis. Knowledge it seems is not always adequately reflected in public health practice. The objective of the local (Department of Health, Directorate of Food Control) and international (WHO, Codex Alimentarius) drive towards increased and improved food labelling, is that if consumers have reliable nutrition information available at the point of purchase and if they understand how their diet affects their risk of diseases, they will be able to make risk-reducing food choices. This could ultimately have a significant positive public health impact. The food industry has also expressed an interest through the concept of functional foods (food similar in appearance to conventional food that is intended to be consumed as part of a normal diet, but has been modified to subserve physiological roles beyond the provision of simple nutrient requirements), that albeit in reality financially motivated, could provide consumers with the opportunity to reduce their risks of some diseases through readily available, good-tasting diets rather than through the use of curative measures only. For the success of both these initiatives in public health terms, consumers must: o accept the link between the food that they eat and their health o actively look for and trust the messages communicated be able to correctly process and integrate the information o make a purchasing decision. This highlights the importance of in-depth consumer understanding in order to ensure that regulatory, educational and marketing strategies will affect positive behaviour change and improve health status. Little consumer research has been done in South Africa to assist all those involved (government, industry, researchers, nutrition experts I dietitians, educators) in gaining potentially important insights. Objectives Of South Africa's almost 31 million adults, some 11 million live in the metropolitan areas and so have relative exposure to most media and access to the widest range of available food products. This group is also a microcosm of the larger South Africa - being made up of all races, ages and living standards. The overall objective of this study was to investigate the beliefs and practices of South African metropolitan adults, in relation to the food and health link and the health information contained on food packages in order to consider the implications for functional foods. The study design was focussed on four key variables, namely, gender, race, age and living standard measure (LSM). Methods The study was designed to ensure that the results would be representative of the metropolitan adult (>I6 years) population and that they could be weighted and extrapolated. 2000 adults made up of 1000 Blacks. 640 Whites, 240 Coloureds and 120 Indians, with a 50150 gender split were drawn using a stratified, random (probability) sampling method in order to allow for the legitimate use of the mathematics of probability as well as to avoid interviewer bias. The study group were interviewed, face-to-face, in home, in the preferred language from English, Afrikaans, Xhosa, Zulu, Tswana, North Sotho and South Sotho, by trained field workers. A minimum 20% back-check on each interviewer's work was undertaken to ensure reliability and validity of the data. The field worker used a pre-coded questionnaire that included seventeen food related questions designed by a multidisciplinary team of marketers, dietitians, nutritionists and research specialists. The food questions used a 5-point Likert scale in order to measure attitude. The data was captured (3 questionnaire were excluded due to being incorrectly filled in) and the computer software package STATISTICA@ Release 6, which was used to perform the statistical analysis. The data was data was weighted to represent the total metropolitan population prior to analysis. Quantitative data was statistically analysed in order to generate relevant descriptive statistics, cross tabulations and statistical tests. Results The study considered four variables; gender, race (Black, White, Coloured, Indian), age (16-29, 30-44,45+) and living standards measure (LSM 2-3, LSM 4-6, LSM 7-10), to explored four statements: 1. I believe food can have an effect on my health 2. 1 always look for health information contained on the packaging of food products 3. 1 don't take any notice of health information as it is only marketing hype 4. 1 buy food that claims to contribute to my health. The overall response to the belief that food can have an effect on health was positive (54%). There was no practical significant difference between age groups and genders but there were practical significant differences between Blacks and the other race groups (Blacks having the lowest belief in the food and health link) and between the highest LSM group and the other LSM groups (LSM 7-1 0 had the strongest belief in the link between food and health and this belief decreased with decreasing LSM). Forty-two percent of respondents always look for health information on the packaging of food, but there was no practical significant difference between all the variables, however women were more likely than men to always look for health information on food packaging. Over half the respondents (51%) stated that they look for health information and that it is not only marketing hype. There was a small practical significant difference between the top and the bottom LSM group with LSM 7-10 being less sceptical about the health information on food packaging. 67% buy foods that claim to beneffi their health and there was a small practical significant difference between Blacks and Whites, with more Blacks agreeing that they buy foods that claim to contribute to health. CONCLUSION Findings from this study indicate that adult metropolitan South Africans label reading practices are influenced by a number of factors including attitudes, beliefs and practices and that there are differences based on gender, race, age and LSM which must be considered by regulators in drafting food labelling regulations; the food industry when considering and developing functional foods; and nutrition experts when planning education strategies. Whilst the labelling of foods with health information and the development of function foods might indeed potentially empower consumers to effectively reduce their risk of many chronic diseases, on its own it is not enough. Nutrition education is vital and must be planned giving due consideration to the differences in belief and practices that exist within the different gender, race, age and LSM groups found in South Africa. Food consumption patterns are influenced by consumer attitudes, beliefs, needs, lifestyles and social trends and so more multi-disciplinary research in these fields must be encouraged to find ways to improve nutritional intakes that will lead to improved health for all South Africans. Thesis (M.Sc. (Dietetics))--North-West University, Potchefstroom Campus, 2005.