Zandile June-Rose Mchiza

Nutrition and Dietetics, Nutritional Biochemistry, Diabetology

PhD
20.12

Publications

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    ABSTRACT: Background South African studies have suggested that differences in obesity prevalence between groups may be partly related to differences in body image and body size dissatisfaction. However, there has never been a national study that measured body image and its relationship to weight control in the country. Hence, the main aim of the study was to examine body image in relation to body mass index and weight control in South Africa. Methods A cross-sectional survey and a secondary analyses of data were undertaken for 6 411 South Africans (15+ years) participating in the first South African National Health and Nutrition Examination Survey. Body image was investigated in relation to weight status and attempts to lose or gain weight. Data were analysed using STATA version 11.0. Descriptive statistics are presented as counts (numbers), percentages, means, standard error of means, and 95 % confidence intervals. Any differences in values were considered to be significantly different if the confidence intervals did not overlap. Results Overall, 84.5 % participants had a largely distorted body image and 45.3 % were highly dissatisfied about their body size. Overweight and obese participants under estimated their body size and desired to be thinner. On the other hand, normal- and under-weight participants over estimated their body size and desired to be fatter. Only 12.1 and 10.1 % of participants attempted to lose or gain weight, respectively, mainly by adjusting dietary intake and physical activity. Discussion Body mass index appears to influence body image and weight adjustment in South Africa. Conclusions South Africans at the extreme ends of the body mass index range have a largely distorted body image and are highly dissatisfied by it. This suggests a need for health education and beneficial weight control strategies to halt the obesity epidemic in the country.
    Full-text · Article · Sep 2015 · BMC Public Health
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    ABSTRACT: One serious concern of health policymakers in South Africa is the fact that there is no national data on the dietary intake of adult South Africans. The only national dietary study was done in children in 1999. Hence, it becomes difficult to plan intervention and strategies to combat malnutrition without national data on adults. The current review consequently assessed all dietary studies in adults from 2000 to June 2015 in an attempt to portray typical adult dietary intakes and to assess possible dietary deficiencies. Notable findings were that, in South Africa micronutrient deficiencies are still highly prevalent and energy intakes varied between very low intakes in informal settlements to very high intakes in urban centers. The most commonly deficient food groups observed are fruit and vegetables, and dairy. This has been attributed to high prices and lack of availability of these food groups in poorer urban areas and townships. In rural areas, access to healthy foods also remains a problem. A national nutrition monitoring system is recommended in order to identify dietary deficiencies in specific population groups.
    Full-text · Article · Sep 2015 · Nutrients
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    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.
    Full-text · Article · Dec 2014 · Expert Review of Endocrinology & Metabolism
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    Nelia P. Steyn · Zandile June-Rose 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.
    Full-text · Article · Apr 2014 · Annals of the New York Academy of Sciences
  • J. Hill · Z. Mchiza · N. Steyn

    No preview · Article · Feb 2014
  • Z. Mchiza · J. Hill · N. Steyn

    No preview · Article · Feb 2014 · Diabetes Research and Clinical Practice
  • Z. Mchiza Z
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    ABSTRACT: This South African Journal of Clinical Nutrition issue opens another window of opportunity for targeted interventions to be urgently implemented that will encourage a positive body image in young South African women of diverse ethnicities. South Africa is a unique multicultural society which comprises various cultural and religious groups. These groups contend with body image dissatisfaction due to the influences of Western culture that stretch far beyond the communities that are traditionally considered to be "Western".
    No preview · Article · Jan 2014 · South African Journal of Clinical Nutrition
  • Zandile June-Rose Mchiza

    No preview · Article · Jan 2014
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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.
    Full-text · Chapter · Jan 2014
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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.
    Full-text · Article · Nov 2013
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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.
    Full-text · Article · Aug 2013 · Public Health Nutrition
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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.
    Full-text · Article · May 2013 · Public Health Nutrition
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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.
    Full-text · Article · Mar 2013 · Ethnicity & disease
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    Shisana · Labadarios · Rehle · Simbayi · Zuma · Dhansay · Reddy · Parker · Hoosain · Naidoo · [...] · N.P. · Dwane · Makoae · Maluleke · Ramlagan · Zungu · Evans · Jacobs · Faber · SANHANES-1 Team ·

    Full-text · Book · Jan 2013
  • Z. Mchiza · E. Maunder

    No preview · Article · Jan 2013 · South African Journal of Clinical Nutrition
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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.
    Full-text · Article · Dec 2011 · Public Health Nutrition
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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.
    Full-text · Article · Dec 2011 · Bulletin of the World Health Organisation
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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.
    Full-text · Article · Oct 2011 · BMC Public Health
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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.
    Full-text · Article · Jun 2011 · BMC Public Health
  • Z.J. Mchiza · J.H. Goedecke · E.V. Lambert
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    ABSTRACT: The current study sought to identify characteristics that may be associated with the misreporting of food energy intake (EI) in urban South African women. A total of 198 women (61 black, 76 of mixed ancestry, 61 white) completed a quantifed food frequency questionnaire, from which daily energy and macronutrient intake were calculated. Body composition (body mass index [BMI], percentage of body fat), body image (Feel-Ideal Difference index and Body Shape questions) and socio-economic status (SES) (household density and asset index) were also measured. Food EI in relation to estimated basal metabolic rate ratio that was less than 1.05 represented under-reporting, whereas a ratio greater than 2.28 represented over-reporting. Results suggested that 26% of the participants under-reported, 64% adequately reported and 10% over-reported. Participants who under-reported had a higher BMI (p < 0.01) and higher percentage of body fat (p < 0.05) than those who adequately and over-reported. The majority of under-reporters were black (38%) versus 21% under-reporters of mixed ancestry and 20% white under-reporters (p < 0.01). Eighty-three per cent of black under-reporters were obese. On the other hand, a majority (63%) of overweight women of mixed ancestry and a majority (50%) of white normal-weight women under-reported their food EI. Under-reporters reported a lower intake of dietary fat (p < 0.01) and a higher intake of dietary protein (p < 0.01) than adequate or over-reporters. Food EI reporting was not infuenced by SES or body image. In conclusion, results suggest that food EI reporting is infuenced by body size, and may be ethnic-specifc in South African women.
    No preview · Article · Jan 2010 · South African Journal of Clinical Nutrition

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