South African Journal of Clinical Nutrition

The last word in science – does it exist? The case of anaemia prevalence based on haemoglobin concentration measurement

M A Dhansay — 2025-12-10

none

The role of nutrition in patients with pemphigus receiving prolonged corticosteroid therapy

F Wongkar

Pemphigus is a rare autoimmune blistering disorder that affects the skin and mucous membranes, characterised by acantholysis due to IgG-mediated autoantibody interference with desmoglein-mediated keratinocyte adhesion. Despite advances in immunosuppressive therapy, managing pemphigus remains a challenge. Both disease pathology and treatments, especially corticosteroids, contribute to nutritional deterioration. Extensive skin lesions cause high protein loss, and mucosal involvement leads to dysphagia, which leads to reduced dietary intake. At the same time, long-term steroid use will intensify the malnutrition condition due to the adverse effects of the medication, such as insulin resistance, obesity, dyslipidaemia, and calcium/vitamin D depletion. This review highlights the critical yet often overlooked role of nutritional management in pemphigus clinical care. Routine nutritional screening using Nutritional Risk Screening (NRS2002), recognised as a more reliable tool than body mass index (BMI), should be implemented along with a thorough evaluation of both macronutrient and micronutrient intake to enhance wound healing and mitigate steroid-related adverse effects. Specific recommendations include complex carbohydrates, omega-3 fatty acids, and oral nutrition supplementation. Moreover, avoiding dietary triggers such as thiol-, phenol-, and tannin-rich foods is advised to reduce flare risk in genetically susceptible individuals.
Keywords: pemphigus, prolonged corticosteroid therapy, critical role of nutrition

Associations of maternal HIV infection, anaemia and placental insufficiency with neurodevelopment and anaemia in South African children: a crosssectional study

M Nyofane — 2025-12-10

Objective: To determine associations between maternal anaemia and child neurodevelopment and anaemia among 18-month-old children exposed to maternal HIV infection and placental insufficiency.
Design: A cross-sectional study was conducted. Placental insufficiency was detected by an abnormal umbilical artery resistance index (UmA-RI) on Doppler ultrasound during gestation.
Setting: Kalafong Provincial Tertiary Hospital.
Subjects: In total, 260 mother–child pairs grouped into HIV-unexposed-uninfected children (CHUU): n = 198 vs. HIV-exposeduninfected children (CHEU): n = 62, and normal UmA-RI (N-RI): n = 225 vs. abnormal UmA-RI (AbN-RI): n = 35 were investigated. Also, CHUU/N-RI (control): n = 178 was compared with CHEU/AbN-RI (dual exposure): n = 15.
Outcome measures: Haemoglobin concentrations were tested using the HemoCue^® Hb 201+. Bayley-III assessed children’s cognitive, motor, and language development at the corrected age.
Results: More than one-third of children across the groups were mildly anaemic. Some 25.7% of mothers in AbN-RI group were mildly anaemic, significantly more than the N-RI mothers (9.8%); p = 0.027. In the CHEU group, maternal haemoglobin concentrations were associated with child haemoglobin concentrations: β = 0.19, 95% confidence interval (CI) (0.02,0.36); p = 0.028. The AbN-RI group had significantly lower mean cognitive composite scores compared with the N-RI group: 96.4 ± 12.2 vs. 100.0 ± 10.5; p = 0.017. Significantly lower mean cognitive scores were observed in CHEU/AbN-RI compared with CHUU/N-RI: 93.9 ± 12.9 vs. 100.0 ± 10.6; p < 0.001. There was no evidence to suggest an association between
haemoglobin concentration and child neurodevelopment; however, in CHEU, cognitive development was associated with LAZ: β = 3.34, 95% CI (1.13,5.54), p = 0.004.
Conclusions: Child health and nutrition-sensitive programmes need to prioritize CHEU and children with placental insufficiency as at-risk groups for cognitive delays.
Keywords: maternal HIV-exposure, anaemia, placental insufficiency, neurodevelopment

Nutrient intake and dietary practice among adolescent girls in urban and rural areas of Kano State, Nigeria

H A Abubakar — 2025-12-10

Objective: This study aimed to assess the nutrient intake and dietary practices of adolescent girls in rural and urban areas of Kano State, Nigeria, and to identify potential disparities between these settings.
Design: Cross-sectional study.
Setting: Urban and rural schools in Kano State, Nigeria.
Subject: Adolescent schoolgirls (n = 424) aged 15–19 years.
Outcome measure: Dietary intake (using a three-day 24-hour recall), eating behaviour, and physical activity were assessed using a structured questionnaire. Nutrient intake was analysed and compared with Estimated Average Requirements (EAR). Independent t-tests and chi-square tests were performed to assess urban–rural differences.
Results: Inadequate micronutrient intake was prevalent, with 100% of participants having inadequate calcium and vitamin D intake below the EAR. Significant level of inadequacy was also observed for vitamin B12 (90.8%), vitamin A (76.7%), zinc (76.2%), folate (65.1%), riboflavin (43.6%), and niacin (39.9%) among all the participants, with rural girls having significantly lower intakes (p < 0.05). Meal skipping, particularly lunch and breakfast, and low consumption of fruits and vegetables were common, especially in rural areas (p < 0.05). Food preparation practices such as cutting vegetables before washing and removing bran from grains and legumes were widespread. Food choices were influenced by taste and cost.
Conclusion: This study highlights inadequate intake of micronutrients and suboptimal dietary practices among adolescent girls in Kano State, with pronounced disparities between urban and rural areas. There is a need for targeted interventions, including culturally appropriate nutrition education, to improve fruit and vegetable intake and discourage nutrient-depleting food preparation practices of both urban and rural adolescent girls to promote healthy dietary behaviours.
Keywords adolescents, dietary practices, Kano, micronutrient intake, Nigeria

Acceptance, availability, and accessibility of reformulated sugar-sweetened beverages in Pietermaritzburg, KwaZulu-Natal, South Africa

N Baijnath — 2025-12-11

Background: The rising obesity rates in South Africa (SA) can be attributed to the high availability, accessibility, and excessive consumption of sugar-sweetened beverages (SSBs). In response, SA introduced the Health Promotion Levy (HPL) in 2018 to increase the price of SSBs and discourage consumer purchases. Some SSBs were reformulated to reduce sugar content and reduce tax liability. The sensory qualities of reformulated SSBs (RSSBs) may be different, leading to poor acceptance.
Objective: To assess the acceptability of RSSBs among consumers employed at schools, and the availability and accessibility of RSSBs at major retail grocery stores (MRGSs) in Pietermaritzburg (PMB).
Methods: A cross-sectional descriptive study was conducted at 13 schools in PMB (n = 192). A sensory evaluation was used to assess the acceptability of six RSSB samples (zero-sugar and light soft drinks, squash, sports/energy drink, iced tea, and flavoured water). A survey was conducted at MRGSs (n = 10) to assess the availability and accessibility of the RSSBs.
Results: The light (p < 0.05) and zero-sugar soft drinks (p < 0.05), and sports/energy drink (p < 0.05) were acceptable to the consumers; however, the flavoured water (p < 0.05) and iced tea (p < 0.05) were less acceptable. Soft drinks, squash; and sports/energy drinks were most available at the MRGSs. A soft drink brand was the most accessible, taking the most shelf space (mean = 1 773.90 cm ± 3 199.93 cm) and situated at all shelf levels (top, middle, and bottom).
Conclusion: Consumers were accepting of the reformulated soft drink and sports/energy drink. Furthermore, soft drinks, squashes, and sports/energy drinks were the most available and accessible RSSBs at MRGSs.
Keywords: availability, accessibility, consumers, obesity, sugar-sweetened beverages, sensory evaluation

Preliminary dietary recommendations for adult spinal cord-injured endurance hand cyclists

R E Gordon — 2025-12-11

Sports nutrition recommendations for able-bodied athletes are well established. However, sports nutrition recommendations for para-athletes are still developing. Spinal cord-injured (SCI) hand cyclists face unique physiological and nutrition-related challenges compared with able-bodied athletes, complicating the extrapolation of recommendations. This paper aims to propose preliminary dietary recommendations for adult SCI endurance hand cyclists based on their unique challenges while considering existing sports nutrition recommendations for able-bodied and para-athletes. A two-phase approach was followed. Phase one involved a review of existing literature regarding the physiological and nutrition-related challenges experienced by SCI athletes, including their current dietary intake and body composition patterns, as well as existing sports nutrition recommendations. Phase two consisted of proposing dietary recommendations for SCI endurance hand cyclists, considering the information gathered during phase one. A total of 10 preliminary recommendations are proposed, focusing on general daily intake for carbohydrates, fibre, protein, fat, and micronutrients as well as exercise-specific guidelines covering carbohydrate, fluid, and protein intake before, during, and after exercise. These preliminary recommendations are based on current available literature but provide a starting point for developing dietary recommendations for SCI hand cyclists. Future research should rigorously test these recommendations and apply them to the broader paralympic community where applicable.
Keywords: dietary recommendations, endurance exercise, spinal cord-injured hand cyclists

Haemoglobin levels and growth of South African infants aged 6–12 months exposed to maternal HIV infection

P Tshiambara — 2025-12-11

Introduction: Anaemia is a significant public health concern in women of reproductive age and children under five years old, particularly in high HIV-prevalent settings.
Objective: This study analysed differences in haemoglobin levels and growth between human immunodeficiency virus (HIV)-exposed-but-uninfected (HEU) and HIV-unexposed-uninfected (HUU) infants, and further determined correlations between haemoglobin levels and growth at 6, 9, and 12 months in the Siyakhula study.
Results: At 6, 9, and 12 months postpartum, the maternal mean haemoglobin levels and anaemia status differed significantly by HIV status (p < 0.05), while HEU and HUU infants showed similar mean haemoglobin levels and anaemia status. Anaemia was prevalent in HEU infants at 6 (27%), 9 (33%), and 12 (30%) months. The HEU infants had lower weight-for-age Z-scores (WAZ) and mid-upper-arm circumference-for-age Z-scores (MUACZ) than HUU infants at 6, 9, and 12 months (p < 0.05). At 12 months, HEU infants had lower mean weight-for-length Z-scores (WLZ) than the HUU infants (-0.2 ± 1.2 vs. 0.2 ± 1.2; p = 0.020). The HEU infants had a higher prevalence of stunting at 6 months (16% vs. 8%; p = 0.044), and less breastfeeding at 9 (36% vs. 57%; p = 0.013) and 12 (25% vs. 48%; p = 0.005) months than the HUU infants. In HEU infants, positive correlations were found between infants’ haemoglobin levels and WAZ (p = 0.039), LAZ (p = 0.007), and MUACZ (p = 0.039) at 9 months, and with WAZ (p = 0.018) and WLZ (p = 0.017) at 12 months, while negative correlations were found between infant haemoglobin levels and any breastfeeding practices at 6, 9, and 12 months (p = 0.026; p < 0.001; p = 0.036).
Conclusion: Maternal HIV infection can negatively impact infant growth, and anaemia remains a public health concern in South Africa.
Keywords: anaemia, anthropometry, growth, haemoglobin, HIV exposure, infants, nutrition

Language matters: dietitians’ lived experiences of language barriers during nutrition counselling with Sesotho-speaking mothers in the first 1 000 days of life

P Jansen — 2025-12-11

Objectives: The objectives of this study were to explore language barriers between dietitians and Sesotho-speaking mothers, the impact of these language barriers on nutrition consultations, and proposed solutions to address them.
Design: A qualitative phenomenological study was undertaken to explore the dietitians’ lived experiences through face-to-face interviews.
Setting: The study was conducted at 20 public health institutions in the Free State province.
Subjects: The sample included 22 dietitians who were purposively selected.
Results: Most of the participants reported experiencing language barriers, including dietitians lacking proficiency in Sesotho, the predominantly spoken language. The negative impact of language barriers on the nutrition care process was explored. Furthermore, some Sesotho-speaking mothers displayed resistance to receiving healthcare services in English. The role of power and privilege in language was also highlighted, given that indigenous South African languages have not received equal parity compared with English and Afrikaans. Dietitians reported difficulty in explaining nutrition concepts in Sesotho. Strategies and recommendations identified to overcome language barriers included the use of interpreters, visual aids, and codeswitching.
Conclusion and implication: The results of the current study confirm that language barriers result in communication gaps and that practical solutions are necessary to ensure the success of healthcare interventions. This study contributes to understanding the intricacies of language barriers, especially in a South African public health care setting. However, it recommended that the research be repeated in other areas of South Africa to understand the true complexity of language barriers in healthcare interventions.
Keywords: dietitians, health communication, indigenous languages, language barriers, nutrition education

Nutritional management of a patient with acute myeloid leukaemia complicated by gastrointestinal symptoms and typhlitis

Z Hugo — 2025-12-11

Leukaemia is the 11th most prevalent cancer worldwide, with acute myeloid leukaemia (AML) representing an acute and highly aggressive subtype that requires urgent medical intervention. Although national data on incidence and mortality in South Africa remain limited, an epidemiological study conducted between 2015 and 2019 identified AML as the most common form of leukaemia in the country. This case study describes a 57-year-old male newly diagnosed with AML, presenting with multiple comorbidities including poorly controlled type II diabetes and class II obesity. The report underscores the complexities of nutritional management in patients with AML, as well as the unpredictable and severe complications
arising from high-dose chemotherapy. These challenges significantly influence nutrition delivery and the ability to meet individual nutritional requirements.
Keywords: gastrointestinal complications in haematology, haematology nutrition, nutritional management in typhlitis, typhlitis in acute myeloid leukaemia

Activity 190

SAJCN Office — 2025-12-11

none

Activity 191

SAJCN Office — 2025-12-11

none

ADSA DIRECTIONS – Nov

SAJCN Office — 2025-12-11

NSSA Newsbits – November

SAJCN Office — 2025-12-11

SASPEN– Q4

SAJCN Office — 2025-12-11