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Objective: A study was undertaken to explore the portion size estimation accuracy of bean bags as low-cost volumetric portion size estimation aids for amorphous foods. Designs: Three observational, cross-sectional and three experimental/quasi-experimental developmental evaluation sub-studies were carried out. Settings: Observational, cross-sectional: one retirement village and four schools. Experimental/quasi-experimental: one South African university. Participants: Observational, cross-sectional: elderly persons, adult women (school educators), schoolchildren. Experimental/quasi-experimental: university students. In total N = 541; > 3 800 observations. Variables measured: Using a standardised set of bean bags (test object; volume range: 60–625 ml), volumes of different amorphous foods (reference objects: actual foods or representations) in varying portion sizes had to be estimated. Accuracy (outcome measure) was perfect if volumes of test and reference object were identical. Acceptable estimation accuracy allowed for misestimation by one bean bag size. Test–retest reproducibility was also assessed. Analysis: Descriptive statistics (proportions perfect and acceptable accuracy). Results: Across the sub-studies, perfect accuracy ranged from 22–65% depending on participants, reference food and portion size. Irrespective thereof, acceptable accuracy was noted in > 70% of observations. Reproducibility varied (range: 28–67% agreement). Conclusions and implications: Perfect portion size estimation of amorphous foods remains challenging. When misestimation by 60–125 ml still serves the purpose of a dietary assessment, bean bags show promise for cost-effective food volume quantification, especially on group level in resource-limited settings. [ABSTRACT FROM AUTHOR]

Qualitative investigation can provide invaluable information towards understanding the influence of school nutrition education (NE). The study explored teachers' perceptions of the immediate impact of NE on learners' eating behaviours. Twenty-four primary school teachers in the Bronkhorstspruit district, Gauteng, South Africa, who taught nutrition topics to grades four to seven learners, participated in three focus group discussions. Transcript data obtained was analysed using the thematic approach of the framework method. Findings indicated that school support for NE was limited, which undermined the capacity of school NE to influence healthy eating behaviours of learners. The need to strengthen teachers' capacity to model positive eating behaviours was identified. Learners were perceived as being not completely ignorant of healthy eating, with limited capacity to effect changes within the resource-constrained environment. Negative influences like unhealthy choices of food from food vendors and peer influences were identified as needing to be discouraged. Positive influences like the National School Nutrition Programme (NSNP) and the school vegetable garden were to be encouraged. Understanding the prevailing school situation and environment and teachers' perceptions and roles in school NE is important in addressing issues that weaken the influence of NE on learners' eating behaviours.

The duration of pneumonia and of diarrhea is reported to be longer in HIV-infected than in uninfected children. We assessed the effect of a multi-micronutrient supplement on the duration of hospitalization in HIV-infected children. In a double-blind, randomized trial, HIV-infected children (4-24 mo) who were hospitalized with diarrhea or pneumonia were enrolled (n = 118) and given a daily dose of a multi-micronutrient supplement (containing vitamins A, B complex, C, D, E, and folic acid, as well as copper, iron, and zinc at levels based on recommended daily allowances) or a placebo until discharge from the hospital. Children's weights and heights were measured after enrollment and micronutrient concentrations were measured before discharge. On recovery from diarrhea or pneumonia, the children were discharged and the duration of hospitalization was noted. Anthropometric indices and micronutrient concentrations did not differ between children who received supplements and those who received placebos. Overall, the duration of hospitalization was shorter (P< 0.05) among children who were receiving supplements (7.3 [+ or -] 3.9 d) (mean [+ or -] SD) than in children who were receiving placebos (9.0 [+ or -] 4.9); this was independent of admission diagnosis. In children admitted with diarrhea, the duration of hospitalization was 1.6 d (19%) shorter among children receiving supplements than in those receiving placebos, and hospitalization for pneumonia was 1.9 d (20%) shorter among children receiving supplements. Short-term multi-micronutrient supplementation significantly reduced the duration of pneumonia or diarrhea in HIV-infected children who were not yet receiving antiretroviral therapy and who remained alive during hospitalization. doi: 10.3945/jn.109.110312.

The duration of pneumonia and of diarrhea is reported to be longer in HIV-infected than in uninfected children. We assessed the effect of a multi-micronutrient supplement on the duration of hospitalization in HIV-infected children. In a double-blind, randomized trial, HIV-infected children (4-24 mo) who were hospitalized with diarrhea or pneumonia were enrolled (n = 1181 and given a daily dose of a multi-micronutrient supplement (containing vitamins A, B complex, C, D, E, and folic acid, as well as copper, iron, and zinc at levels based on recommended daily allowances) or a placebo until discharge from the hospital. Children's weights and heights were measured after enrollment and micronutrient concentrations were measured before discharge. On recovery from diarrhea or pneumonia, the children were discharged and the duration of hospitalization was noted. Anthropometric indices and micronutrient concentrations did not differ between children who received supplements and those who received placebos. Overall, the duration of hospitalization was shorter (P < 0.05) among children who were receiving supplements (7.3 ± 3.9 d) (mean ± SD) than in children who were receiving placebos (9.0 ± 4.91; this was independent of admission diagnosis. In children admitted with diarrhea, the duration of hospitalization was 1.6 d (19%) shorter among children receiving supplements than in those receiving placebos, and hospitalization for pneumonia was 1.9 d (20%) shorter among children receiving supplements. Short-term multi-micronutrient supplementation significantly reduced the duration of pneumonia or diarrhea in HIV-infected children who were not yet receiving antiretroviral therapy and who remained alive during hospitalization. [ABSTRACT FROM AUTHOR]

ROTEIN-ENERGY-malnutrition (PEM) is a major cause of morbidity and mortality in young children in Africa. In South Africa, in 1987, to help combating and preventing PEM in the rural black population, the Gold Fields Nutrition Unit was inaugu rated at the Medical University of Southern Africa. In 1987-9, 442 patients (rural/peri-urban) plus their mothers or child carers were admitted, and 406 attended as outpatients. Average age was 15.4 ± 7.6 months, weight 7.0 ± 1.6kg, stay in hospital, 12 ± 10.8 days, and daily weight gain during treatment was 31 ± 48g. Mothers mainly were young and unmarried. Primary causative factors were infections, ignorance, and insufficiency of food. Since results from rehabili tation are usually poor, mothers and carers were taught how best to prepare meals using local foodstuffs. The interventions included teaching and demonstrations of how to grow vegetables, maintain an orchard, a fowl-run, and improve kitchen and laundry facilities. In 1990, in a follow-up of 73 patients, no deaths had occurred within a 12 month period. This far better than usual outcome is being furthered by setting up satellite nutrition clinics. [ABSTRACT FROM PUBLISHER]