Zandile June-Rose Mchiza

Nutrition and Dietetics, Nutritional Biochemistry, Diabetology
PhD
16.76

Publications

  • Nelia P Steyn, Zandile June-Rose Mchiza, Andre-Pascal Kengne
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    ABSTRACT: In this review, we describe the epidemiology of diabetes mellitus in children and adolescents in Africa, noting that there is a paucity of data with regard to the burden of disease, prevalence of undiagnosed diabetes, healthcare and acute and chronic complications. Furthermore, access to care remains an issue of great concern. Our view is that in the next 5 years, more research will be undertaken on the burden of the disease and on interventions to provide better access to care. While the majority of African countries still have a low incidence of diabetes in children, it is predicted that the incidence will increase and it is therefore essential that governments develop sustainable policies to deal with such increases.
    Expert Review of Endocrinology &amp Metabolism 12/2014; 10(1). DOI:10.1586/17446651.2015.968552
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    Nelia P. Steyn, Zandile J. Mchiza
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    ABSTRACT: This review illustrates the outcomes of the nutrition transition in Sub-Saharan Africa (SSA) and its association with overweight and obesity; the relationship with the double burden of malnutrition is also explored. We describe the increase in overweight in nearly all Sub-Saharan African countries and present data on associated increased gross domestic product, and availability of energy, protein, fat, and sugar at country national levels. Predictors of overweight are described by means of various studies undertaken in SSA, and dietary intakes of numerous countries are presented. Overall, we show that socioeconomic status, gender, age, parity, physical inactivity, and increased energy, fat, and sugar intake are powerful predictors of overweight and/or obesity. The urgency for health interventions in countries in the early stages of the nutrition transition is emphasized, particularly in view of the fact that fat intake is still less than 30% of energy intake in nearly all Sub-Saharan African countries.
    Annals of the New York Academy of Sciences 04/2014; 1311(1). DOI:10.1111/nyas.12433 · 4.31 Impact Factor
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    Zandile Mchiza, Jillian Hill, Nelia Steyn
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    ABSTRACT: Background: There is dearth of data on the nutritional value of food sold in the streets of developing middle-income countries such as South Africa (SA), despite the fact that these foods are commonly sold in urban areas. Many street foods appear to be unhealthy since they are high in saturated fats, trans fats, salt and sugar. Furthermore, they are energy-dense and may contribute to the high prevalence of obesity and its co-morbidities in SA. Aim: To conduct a situational analysis on the type, nutritional content, and hygienic conditions under which foods are sold by vendors on the streets of Cape Town (CT) and surrounding areas. Methods: All locations where vendors (n=820) sold street food (SF) in the CT and surrounding areas were surveyed. These venues included community centers, market areas, major streets, train and bus stations, and taxi ranks. The interviews were conducted by trained fieldworkers using pre-tested questionnaires. Street foods were categorized in different ways: i) by meal; ii) by single food item or beverage; iii) by the level of processing; iv) by method of cooking (fried, boiled, baked, grilled, roasted and steamed) and v) by packaging. Results: The majority of vendors had more than one food item for sale, with some specializing in specific types of food. It was observed that food items most commonly sold were snacks, such as crisps, candy bars, and biscuits (45%), cooked foods (28%), fruits and vegetables (26%), sweetened beverages or flavored water (6%), raw foods (4%), and tea and coffee (1%). Despite the variation in food items, the majority were classified as being unhealthy (i.e. energy-dense), and prepared and sold under poor hygienic conditions as shown by lack of adequate sanitation facilities, poor storage facilities, and inadequate serving procedures. Conclusion: With the exception of fruit and vegetables, the majority of foods and beverages sold by vendors were not healthy options and were prepared and sold under poor hygienic conditions.
    Fast Foods: Consumption Patterns, Role of Globalization and Health Effects, Edited by Marlin G. Sanford, 01/2014: chapter Foods Currently Sold by Street Food Vendors in the Western Cape, South Africa, Do Not Foster Good Health: pages 6x9 - (NBC-R); Nova Science Publishers., ISBN: 978-1-63321-697-6
  • Zandile June-Rose Mchiza
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    ABSTRACT: Current estimates and projections suggest that the burden of cardiovascular diseases (CVDs), diabetes and related risk factors in African countries is important, somewhat unique and rapidly growing. Various segments of the population are affected; however, the group mostly affected is young adults residing in urban areas, and increasingly those in the low socioeconomic strata. The African milieu/environment is compounded by weak health systems, which are unable to cope with the looming double burden of communicable and chronic non-communicable diseases. This review discusses the economic and developmental challenges posed by CVDs and diabetes in countries in Africa. Using several lines of evidence, we demonstrate that the cost of care for major CVDs and diabetes is beyond the coping capacities of individuals, households, families and governments in most African countries. We have reviewed modeling studies by the International Diabetes Federation (IDF) and other major international agencies on the current and projected impact that CVDs and diabetes have on the economy and development of countries in the region. Locally, appropriate strategies to limit the impact of the conditions on the economies and development of countries in Africa are suggested and discussed. These include monitoring diseases and risk factors, and primordial, primary and secondary preventions implemented following a life-course perspective. Structural, logistic, human capacity and organizational challenges to be surmounted during the implementations of these strategies will be reviewed.
    11/2013; 56(3):302-313. DOI:10.1016/j.pcad.2013.10.011
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    ABSTRACT: To determine the frequency and content of food-related television (TV) advertisements shown on South African TV. Four national TV channels were recorded between 15.00 and 21.00 hours (6 h each day, for seven consecutive days, over a 4-week period) to: (i) determine the number of food-related TV advertisements; and (ii) evaluate the content and approach used by advertisers to market their products. The data were viewed by two of the researchers and coded according to time slots, food categories, food products, health claims and presentation. Of the 1512 recorded TV advertisements, 665 (44 %) were related to food. Of these, 63 % were for food products, 21 % for alcohol, 2 % for multivitamins, 1 % for slimming products and 13 % for supermarket and pharmacy promotions. Nearly 50 % of food advertisements appeared during family viewing time. During this time the most frequent advertisements were for desserts and sweets, fast foods, hot beverages, starchy foods and sweetened drinks. The majority of the alcohol advertisements (ninety-three advertisements, 67 %) fell within the children and family viewing periods and were endorsed by celebrities. Health claims were made in 11 % of the advertisements. The most frequently used benefits claimed were 'enhances well-being', 'improves performance', 'boosts energy', 'strengthens the immune system' and 'is nutritionally balanced'. The majority of food advertisements shown to both children and adults do not foster good health despite the health claims made. The fact that alcohol advertisements are shown during times when children watch TV needs to be addressed.
    Public Health Nutrition 08/2013; 16(12):1-8. DOI:10.1017/S136898001300205X · 2.48 Impact Factor
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    ABSTRACT: OBJECTIVE: To review studies examining the nutritional value of street foods and their contribution to the diet of consumers in developing countries. DESIGN: The electronic databases PubMed/MEDLINE, Web of Science, Cochrane Library, Proquest Health and Science Direct were searched for articles on street foods in developing countries that included findings on nutritional value. RESULTS: From a total of 639 articles, twenty-three studies were retained since they met the inclusion criteria. In summary, daily energy intake from street foods in adults ranged from 13 % to 50 % of energy and in children from 13 % to 40 % of energy. Although the amounts differed from place to place, even at the lowest values of the percentage of energy intake range, energy from street foods made a significant contribution to the diet. Furthermore, the majority of studies suggest that street foods contributed significantly to the daily intake of protein, often at 50 % of the RDA. The data on fat and carbohydrate intakes are of some concern because of the assumed high contribution of street foods to the total intakes of fat, trans-fat, salt and sugar in numerous studies and their possible role in the development of obesity and non-communicable diseases. Few studies have provided data on the intake of micronutrients, but these tended to be high for Fe and vitamin A while low for Ca and thiamin. CONCLUSIONS: Street foods make a significant contribution to energy and protein intakes of people in developing countries and their use should be encouraged if they are healthy traditional foods.
    Public Health Nutrition 05/2013; DOI:10.1017/S1368980013001158 · 2.48 Impact Factor
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    First 01/2013; HSRC Press., ISBN: 978-0-7969-2448-3
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    ABSTRACT: The aim of this study was to determine whether dietitians in South Africa are competent to meet the requirements of working in a health care setting during a compulsory one-year community service (CS) program immediately after receiving their degree. A national survey was conducted using questionnaires to illicit information from dietitians on their training and competencies. In 2009, data were collected from both community service dietitians (CSDs) participating in community service programs in primary, secondary and tertiary health care centers in all provinces of South Africa, as well as from their provincial managers (nutrition coordinators). Sixteen (100% response) nutrition coordinators and 134 (80% response) dietitians participated in the quantitative survey. The majority of the CSDs reported that, overall, their academic training had prepared them for most aspects of nutrition service delivery. However, some recommended that academic programs include more training on community-based nutrition programs and in delivering optimal services to under-resourced communities as they believed that their competencies in these two areas were weakest. Furthermore, many CSDs were required to establish dietetics departments where none had previously existed; consequently, their capacity in management and administration needed improvement. In conclusion, academic training institutions should align their programs to the transformation of the health sector in South Africa by ensuring that dietitians are empowered to provide optimal public health nutrition services in under-resourced communities.
    Ethnicity & disease 01/2013; 23(1):87-94. · 0.92 Impact Factor
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    ABSTRACT: To evaluate the successes and shortcomings of the community service programme implemented by the Department of Health (DOH) in South Africa by evaluating community service dietitians' experiences and challenges during the 2009 community service year. The study employed both quantitative and qualitative research designs. A national survey was conducted using a questionnaire to illicit information on community service dietitians' working environments and the challenges they experienced. Furthermore individual interviews were conducted with a purposively selected subsample of community service dietitians to further explore issues that arose in the survey. Data were collected from community service dietitians in the public health sector in South Africa. Dietitians completing their community service year in 2009. Of the 168 community service dietitians placed in 2009, 134 (80 %) participated in the survey, while five community service dietitians in each province (n 45) were interviewed. Overall the community service dietitians were positive about the community service year and reported that it improved their confidence, skills and competencies. However, they experienced challenges related to the orientation programme, supervision/mentoring, resources available, patient referrals and communication. Despite the overall success of the community service year there are still challenges which the DOH needs to address in order to provide the best nutrition service possible for its patients.
    Public Health Nutrition 12/2011; 15(8):1411-8. DOI:10.1017/S1368980011003314 · 2.48 Impact Factor
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    ABSTRACT: To assess the status of food security--i.e., access to food, food availability and food utilization--in South Africa. A systematic search of national surveys that used the Community Childhood Hunger Identification Project (CCHIP) index to measure food security in South Africa over a period of 10 years (1999-2008) was conducted. Anthropometric data for children aged 1-9 years were used to assess food utilization, and household food inventory data were used to assess food availability. Only three national surveys had used the CCHIP index, namely, the 1999 and 2005 National Food Consumption Surveys (NFCS) and the 2008 South African Social Attitudes Survey. These surveys showed a relatively large decrease in food insecurity between 1999 and 2008. However, the consistent emerging trend indicated that in poorer households women were either feeding their children a poor diet or skipping meals so their children could eat. In terms of food access and availability, the 1999 NFCS showed that households that enjoyed food security consumed an average of 16 different food items over 24 hours, whereas poorer households spent less money on food and consumed fewer than 8 different food items. Moreover, children had low mean scores for dietary diversity (3.58; standard deviation, SD: ± 1.37) and dietary variety (5.52; SD: ± 2.54) scores. In terms of food utilization, the NFCS showed that stunting in children decreased from 21.6% in 1999 to 18% in 2005. The South African government must implement measures to improve the undesirably high level of food insecurity in poorer households.
    Bulletin of the World Health Organisation 12/2011; 89(12):891-9. DOI:10.2471/BLT.11.089243 · 5.11 Impact Factor
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    Zulfa Abrahams, Zandile McHiza, Nelia P Steyn
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    ABSTRACT: During the last century we have seen wide-reaching changes in diet, nutritional status and life expectancy. The change in diet and physical activity patterns has become known as the nutrition transition. At any given time, a country or region within a country may be at different stages within this transition. This paper examines a range of nutrition-related indicators for countries in Sub-Saharan Africa (SSA) and attempts to develop a typical model of a country in transition. Based on the availability of data, 40 countries in SSA were selected for analysis. Data were obtained from the World Health Organisation, Demographic and Health Surveys and the Food and Agriculture Organisation of the United Nations. Multiple linear regression analysis (MLRA) was used to explore the determinants of infant mortality. A six point score was developed to identify each country's stage in the nutrition transition. MLRA showed that underweight-for-age, protein and the percentage of exclusively breastfed infants were associated with the infant mortality rate (IMR). The majority of countries (n = 26) used in the analysis had nutrition transition scores of zero and one. Most of them had a high prevalence of infant mortality, children that were stunted or underweight-for-age, small percentages of women that were overweight and obese, and low intakes of energy, protein, and fat. Countries with the highest scores include South Africa, Ghana, Gabon, Cape Verde and Senegal which had relatively low IMRs, high levels of obesity/overweight, and low levels of underweight in women, as well as high intakes of energy and fat. These countries display classic signs of a population well established in the nutrition-related non-communicable disease phase of the nutrition transition. Countries in SSA are clearly undergoing a nutrition transition. More than half of them are still in the early stage, while a few have reached a point where changes in dietary patterns are affecting health outcomes in a large portion of the population. Those in the early stage of the transition are especially important, since primordial prevention can still be introduced.
    BMC Public Health 10/2011; 11:801. DOI:10.1186/1471-2458-11-801 · 2.32 Impact Factor
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    Zandile J McHiza, Julia H Goedecke, Estelle V Lambert
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    ABSTRACT: International studies suggest ethnic differences in obesity prevalence may be due, in part, to differences in body image and body size dissatisfaction between groups. Further, there is evidence to suggest that there is a familial resemblance in body image between mothers and their younger (preadolescent) daughters. This research was therefore conducted to specifically identify the extent to which family status (presented as mother-daughter resemblance) and ethnicity impact on body image attitudes and perceptions of South African mothers and their pre-adolescent daughters. Mother-daughter dyads (n = 201, 31% black, 37% mixed ancestry and 32% white) answered questions regarding their body image perception (the way they saw their body size status), their body image ideals, and body image attitudes (body size dissatisfaction in particular, presented as the Feel-Ideal Difference [FID] index score). Mothers' and daughters' body image results were compared within dyads and across ethnic groups using repeated measures of ANOVA. Overall, body image resemblances exist between South African mothers and their pre-adolescent daughters. Mothers and daughters chose similarly weighted silhouettes to represent their body size ideals (p = 0.308), regardless of their ethnicity or body mass index (BMI). The FID index scores were similar between mothers and their daughters only after the confounding effects of maternal BMI were removed (p = 0.685). The silhouettes chosen to represent thinness were also similar between mothers and their daughters (p = 0.960) regardless of ethnicity and maternal BMI. On the other hand, the silhouettes chosen to represent fatness were similar (p = 0.342) between mothers and their daughters, only after the confounding effects of maternal BMI were removed. Lastly, mothers and their daughters chose similarly weighted silhouettes as engendering feelings of beauty, respect and happiness (p = 0.813; p = 0.615 and p = 0.693, respectively). In this instance, black mother-daughter dyads chose significantly heavier silhouettes than the other ethnic groups. This implies that black mothers and daughters associate beauty, respect and happiness with a bigger body size. Resemblances exist between pre-adolescent girls and their mothers on issues related to ideal and attitudinal body image. In this regard, South African researchers should consider the effects ethnicity and family status on body image of women when developing targeted interventions to prevent or manage obesity.
    BMC Public Health 06/2011; 11(1):433. DOI:10.1186/1471-2458-11-433 · 2.32 Impact Factor
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  • Zandile June-Rose Mchiza
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    ABSTRACT: Abstract Objective. We sought to determine the validity and reliability of a self-report physical activity questionnaire (PAQ) measuring physical activity/inactivity in South African schoolgirls of different ethnic origins. Methods. Construct validity of the PAQ was tested against physical activity energy expenditure estimated from an ACTIVITYGRAM and inactivity from reported television programme viewing in 332 girls (ages 9-12 yrs, grades 4-5). Body composition (WHO BMI percentiles and percentage body fat) was used as an indirect measure of validity for the PAQ. Test-retest reliability of the PAQ was assessed in a convenience sample of 14 girls. Results. Weak but significant associations were found between the body composition and PAQ-derived total energy expenditure (r=-0.18; p<0.05 for percentage body fat; r=-0.17; p<0.01 for WHO BMI percentiles) and inactivity (r=0.35; p<0.001 for percentage body fat; r=0.23; p<0.001 for WHO BMI percentiles). Positive associations were found between moderate and vigorous energy expenditure by PAQ and the same intensity activities by ACTIVITYGRAM (r=0.19; p<0.001 and r=0.26; p< 0.001, respectively). Further, the television viewing time reported by PAQ was significantly positively related to the number of programmes noted from the television programme list. Only total energy expended while partaking in structured school sports showed good test-retest reliability (r=0.80; p<0.05). Conclusions. Our results showed that the PAQ may provide some reasonable insights into levels of physical inactivity and activity in South African primary schoolgirls. However, additional studies are required using objective measures of physical activity, such as pedometry or accelerometry, to better understand the utility of the PAQ for children.
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    ABSTRACT: We sought to validate questionnaires concerning body image perception, body size dissatisfaction and weight-related beliefs in multi-ethnic South African mothers and their daughters. Girls attending primary school (ages 9-12 years, n = 333) and their mothers (n = 204) were interviewed regarding their demographics and body image. Weight, height and skinfold thicknesses were measured. Body image questions and body mass index (BMI) were compared with silhouettes adapted from the Pathways Study for girls and Stunkard's body image figures for mothers. A Feel-Ideal Difference (FID) index score was created by subtracting the score of the silhouette selected by the participants as 'Ideal' from the one selected as most closely representing their current appearance or 'Feel'. We hypothesised that a higher FID index score would be associated with greater body size dissatisfaction. BMI percentiles in girls (r = 0.46, P < 0.05) and BMI in mothers (r = 0.68, P < 0.05) were positively correlated with the selected silhouettes based on size. Participants who reported feelings of being 'fat' and those who perceived that their family and friends were more dissatisfied with their body size had significantly higher FID index scores. Scores were lower in black than white girls (all P<0.05). No differences were found in FID index scores between ethnic groups of mothers. Internal reliability of the 'thin' and 'fat' belief constructs for girls was demonstrated by standardised Cronbach's alpha values > or = 0.7. Silhouettes, FID index, 'fat' and 'thin' belief constructs (in girls) are age-appropriate, culturally sensitive and can be used in further intervention studies to understand body image.
    Public Health Nutrition 09/2005; 8(5):509-19. DOI:10.1079/PHN2005814 · 2.48 Impact Factor
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    Zandile Mchiza
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