Faculty of Health Sciences

2014): Inventory on the dietary assessment tools available and needed in Africa: a prerequisite for setting up a common methodological research infrastructure for nutritional surveillance, research and prevention of diet-related noncommunicable diseases, Critical Reviews in Food Science and Nutrition, Inventory on the dietary assessment tools available and needed in Africa: a prerequisite for setting up a common methodological research infrastructure for nutritional surveillance, research and prevention of diet-related non-communicable diseases Article title Inventory on the dietary assessment tools available and needed in Africa: a prerequisite for setting up a common methodological research infrastructure for nutritional surveillance, research and prevention of diet-related non-communicable diseases Journal ABSTRACT Objective: To carry out an inventory on the availability, challenges and needs of Dietary Assessment (DA) methods in Africa as a pre-requisite to provide evidence, and set directions (strategies) for implementing common dietary methods and support web-research infrastructure across countries. Downloaded by [University of Helsinki] at 02:57 12 December 2014 ACCEPTED MANUSCRIPT ACCEPTED MANUSCRIPT 6 Methods: The inventory was performed within the framework of the -Africa's Study on Physical Activity and Dietary Assessment Methods‖ (AS-PADAM) project. It involves International Institutional and African networks. An inventory questionnaire was developed and disseminated through the networks. Eighteen countries responded to the dietary inventory questionnaire. Results: Various DA tools were reported in Africa, 24-Hour Dietary Recall and Food Frequency Questionnaire were the most commonly used. Few tools were validated and tested for reliability. Face-to-face interview was the common method of administration. No computerised software or other new (web) technologies were reported. No tools were standardised across countries.

Background: Omega-6 (n-6) polyunsaturated fatty acid (PUFA) intake was previously reported to be adversely related to liver function in HIV-infected subjects, when compared with HIV-uninfected subjects, in a black population in South Africa. It was speculated that the use of heavily oxidized vegetable fats (abused fats) could have been responsible. Objectives: The objectives were to investigate the relation between plasma total PUFA concentrations (a marker of PUFA intake) and liver enzymes in HIV-infected asymptomatic compared with HIVuninfected black South Africans and to investigate the reuse of oil and the use of abused oils. Design: This was a case-control study nested in an epidemiologic study in 305 HIV-infected cases and 301 HIV-uninfected matched controls (matched according to location, sex, and age), as part of the PURE (Prospective Urban and Rural Epidemiology) Study, a prospective cohort study that includes a representative sample of 2000 apparently healthy black volunteers, aged between 36 and 60 y, from the North West Province of South Africa. Results: Plasma total omega-6 PUFA concentrations were negatively (P , 0.05) associated with liver enzymes (c-glutamyl transpeptidase, alanine aminotransferase, aspartate aminotranferase, and alkaline phosphatase) in both HIV-infected and HIV-uninfected subjects (r values ranged from 20.22 to 20.56). Almost all subjects (99%) reported that they did not buy oil that had been used before. Oil was only used a mean (6SD) of 2.23 6 0.85 times for deep frying before being discarded. Conclusions: The adverse relations between omega-6 PUFA intake and liver enzymes that were previously shown could not be confirmed in this study. In contrast, plasma omega-6 PUFA concentration was inversely related to liver enzymes in both HIV-infected and HIV-uninfected subjects. Subjects in this study did not use abused fats, which could partly explain these findings.

Obesity and other noncommunicable disease (NCD) risk factors are increasing in low- and middle-income countries. There are few data on the association between increased added sugar intake and NCD risk in these countries. We assessed the relation between added sugar intake and NCD risk factors in an African cohort study. Added sugars were defined as all monosaccharides and disaccharides added to foods and beverages during processing, cooking, and at the table. We conducted a 5-y follow-up of a cohort of 2010 urban and rural men and women aged 30-70 y of age at recruitment in 2005 from the North West Province in South Africa. Added sugar intake, particularly in rural areas, has increased rapidly in the past 5 y. In rural areas, the proportion of adults who consumed sucrose-sweetened beverages approximately doubled (for men, from 25% to 56%; for women, from 33% to 63%) in the past 5 y. After adjustment, subjects who consumed more added sugars (≥10% energy from added sugars) compared with those who consumed less added sugars had a higher waist circumference [mean difference (95% CI): 1.07 cm (0.35, 1.79 cm)] and body mass index (in kg/m(2)) [0.43 (0.12, 0.74)] and lower HDL cholesterol [-0.08 mmol/L (-0.14, 0.002 mmol/L)]. This cohort showed dramatic increases in added sugars and sucrose-sweetened beverage consumption in both urban and rural areas. Increased consumption was associated with increased NCD risk factors. In addition, the study showed that the nutrition transition has reached a remote rural area in South Africa. Urgent action is needed to address these trends.

The Guidelines and Guidance section contains advice on conducting and reporting medical research. N Here we present the findings of a collaborative effort by stakeholders in sub-Saharan Africa (SSA) to identify priorities for nutrition research and actions to create an enabling research environment.

Although most cardiovascular disease occurs in low-income and middle-income countries, little is known about the use of effective secondary prevention medications in these communities. We aimed to assess use of proven effective secondary preventive drugs (antiplatelet drugs, β blockers, angiotensin-converting-enzyme [ACE] inhibitors or angiotensin-receptor blockers [ARBs], and statins) in individuals with a history of coronary heart disease or stroke.

Background: All rigorous primary cardiovascular disease (CVD) prevention guidelines recommend absolute CVD risk scores to identify high-and low-risk patients, but laboratory testing can be impractical in low-and middle-income countries. The purpose of this study was to compare the ranking performance of a simple, non-laboratory-based risk score to laboratory-based scores in various South African populations. Methods: We calculated and compared 10-year CVD (or coronary heart disease (CHD)) risk for 14,772 adults from thirteen cross-sectional South African populations (data collected from 1987 to 2009). Risk characterization performance for the non-laboratory-based score was assessed by comparing rankings of risk with six laboratory-based scores (three versions of Framingham risk, SCORE for high-and low-risk countries, and CUORE) using Spearman rank correlation and percent of population equivalently characterized as 'high' or 'low' risk. Total 10-year non-laboratory-based risk of CVD death was also calculated for a representative cross-section from the 1998 South African Demographic Health Survey (DHS, n = 9,379) to estimate the national burden of CVD mortality risk.

Objective: To compare the relationships between food (nutrient) intakes and biochemical markers of nutritional status of asymptomatic HIV-infected with HIVuninfected subjects, to gain more information on the appropriate diet for HIV-infected persons at an early stage of infection. Design: Cross-sectional population-based survey. Setting: North West Province, South Africa. Subjects: Two hundred and sixteen asymptomatic HIV-infected and 1550 HIVuninfected men and women volunteers aged 15 years and older, recruited as 'apparently healthy' subjects from 37 randomly selected sites. Outcome measures: Food and nutrient intakes, measured with a validated foodfrequency questionnaire, and nutritional status indicated by anthropometric and biochemical variables, measured by a standardised methodology. Results: The prevalence of HIV infection in the study population was 11.9%. The anthropometric indices and nutrient intakes of HIV-infected and uninfected subjects did not differ significantly, indicating that these 216 HIV-infected subjects were at an early stage of infection. Of the biochemical nutritional status variables, high-density lipoprotein cholesterol and total cholesterol, haemoglobin, albumin and triglycerides were significantly lower in infected subjects. They also had higher globulin and liver enzyme levels than uninfected subjects. In infected subjects, serum albumin correlated significantly with serum lipids, serum vitamin A, serum vitamin E, serum iron, total iron-binding capacity and haemoglobin. The significant positive correlations of the liver enzymes with serum lipids, albumin, vitamin A and iron, observed in HIV-uninfected subjects, disappeared in the infected subjects. Polyunsaturated fat intake showed significant positive correlations with the increased liver enzymes in infected subjects. A principal components analysis indicated that, in infected subjects, increased liver enzymes correlated with higher consumption of maize meal and lower consumption of meat and vegetables. Conclusions and recommendations: This survey indicated that asymptomatic HIVinfected subjects who followed a diet rich in animal foods had smaller decreases in serum albumin, haemoglobin and lipid variables, and smaller increases in liver enzymes, than those who consumed a diet based on staple foods. This suggests that animal foods are associated with improved nutritional status in HIV-infected persons. These results should be confirmed with intervention studies before dietary recommendations for asymptomatic HIV-infected individuals can be made.

Alcohol consumption plays an important role in the health transition associated with urbanization in developing countries. Thus, reliable tools for assessing alcohol intake levels are necessary. We compared two biological markers of alcohol consumption and self-reported alcohol intakes in participants from urban and rural South African communities. This cross-sectional epidemiological survey was part of the North West Province, South African leg of the 12-year International Prospective Urban and Rural Epidemiology (PURE) study which investigates the health transition in urban and rural subjects. A total of 2,010 apparently healthy African volunteers (35 years and older) were recruited from a sample of 6,000 randomly-selected households. Alcohol consumption was assessed through self-reports (24-hour recalls and quantitative food frequency questionnaire) and by two biological markers: percentage carbohydrate-deficient transferrin (%CDT) and gamma-glutamyl transferase (GGT). Of the 716...