South Africa has increasing numbers of persons living with HIV on antiretroviral treatment (ART). There is evidence for a relationship between food, food security and HIV. Despite increasing rates of people older than 50 living with HIV coinciding with greater levels of co-morbidity, the existing research is largely limited to those aged 15–49 years. In this paper, we therefore explore how older people living with HIV (OPLWH) in two urban communities within South Africa negotiate and ensure they have sufficient access to food and how food insecurity may affect their retention in care and ART adherence. This study used exploratory qualitative semi-structured in-depth interviews with 23 OPLWH to collect data in isiXhosa. Data were analysed using thematic content analysis. Factors at the community, household and individual levels influence (a) access to sufficient and quality food, and (b) beliefs about ART and food based on (mis)understandings of messaging from health care providers. The results demonstrate the need to explore further and clarify the nutritional guidelines that OPLWH receive from providers to ensure this does not result in reduced adherence or retention in care. They also demonstrate the role that social welfare and family or kin obligations plays in ensuring the food security of OPLWH.

Background: Consumption of fruits and vegetables reduces the risk of obesity, diabetes, cancer, cardiovascular
mortality and all-cause mortality. The study assessed the pattern of intake and the factors that influence daily intake
of commonly available fruits and vegetables in economically disadvantaged South African communities.
Methods: This is a cross-sectional study nested on an ongoing longitudinal study in South Africa. Two communities (a
rural and urban) of low socio-economic status were purposely selected from two of the nine provinces. A sample of
535 participants aged 30–75 years was randomly selected from the longitudinal cohort of 1220; 411 (78%) women.
Data were collected using validated food frequency and structured interviewer-administered questionnaires.
Descriptive and multivariate regression analysis were undertaken.
Results: A higher proportion of participants in the urban township compared to their rural community
counterparts had purchased fruits (93% vs. 51%) and vegetables (62% vs. 56%) either daily or weekly. Only
37.8% of the participants consumed at least two portions of commonly available fruits and vegetables daily,
with no differences in the two communities. Daily/weekly purchase of sugar sweetened beverages (SSBs) was
associated with daily intake of fruits and vegetables (p = 0.014). Controlling for age and gender, analysis
showed that those who spent R1000 (USD71.4) and more on groceries monthly compared to those who
spent less, and those who travelled with a personal vehicle to purchase groceries (compared to those who
took public transport) were respectively 1.6 times (AOR, 95% CI: 1.05–2.44; p = 0.030) and 2.1 times (AOR, 95%
CI: 1.06–4.09; p = 0.003) more likely to consume at least two or more portions of fruits and vegetables daily.
Those who purchased SSBs daily or weekly were less likely (AOR, 95% CI: 0.54, 0.36–0.81, p = 0.007) to consume two or
more portions of fruits and vegetables daily. The average household monthly income was very low (only
2.6% of households earned R5000 (US$357.1); and education level, attitude towards fruits and vegetables and owning
a refrigerator had no significant association with fruits and vegetable daily intake.
Conclusion: These findings indicate that affordability and frequency of purchase of sugary drinks can influence daily
intake of fruits and vegetables in resource-limited communities.
Keywords: Fruit and vegetables, Daily, Intake, Affordability, South Africa, Community

Landfill and street waste pickers in South Africa are responsible for collecting substantial volumes of recyclable material, saving municipalities millions and contributing to a generally healthier and cleaner environment. Yet waste pickers continue to operate on the fringes of the economy and are exposed to many risks, particularly health risks which have a direct impact on the sustainability of their livelihoods. This article, using a mixed-methods approach, explores the health risks to which waste pickers working on nine different landfills in the country are exposed. The socio-ecological framework was used to analyse and present the results. A key finding was that waste picking, by its very nature, lends itself to innumerable health risks, but that these can be lessened through concerted and collaborative efforts on the part of landfill operators, local authorities and other stakeholders. Integrating the ‘self-employed’ waste pickers into the formal waste management system should be comprehensive in order to limit health risks. Waste pickers will never have a risk-free environment, but facilitative policies and supportive institutions can collaboratively help to mitigate these risks and create a more sustainable and dignified working environment towards sustaining their livelihoods.
Keywords:

waste pickers; landfill; landfill waste picker; recyclables; health risks; South Africa

Author: Willeke de Bruin

To many African people, the groundnut (Arachishypogaea L.) is the most important legume providing them with much needed dietary nutrients and income. Groundnuts, also known as peanuts, are consumed in a variety of snacks and are a major ingredient in ready-to-use therapeutic food (RUTF), one of the most effective home-based nutritional therapies for children and HIV/AIDS patients, particularly in the developing world (Magamba et al., 2017).

Objectives: A study was undertaken to compare a range of dietary diversity indicators and their predictors among one-year-olds.

Design: Multivariate regression analysis was employed, where dietary diversity indicators are the outcome variables and the main predictor variables are access to resources and maternal education. Three different dietary diversity indicators are analysed: a count of food items, a count of food groups and a Healthy Food Diversity Index.

Subjects and setting: The study included participants of Birth to Twenty Plus, a longitudinal cohort study of children born in 1990 in Johannesburg, South Africa (n = 1 030).

Results: There is a low correlation between measures of dietary diversity based on simple counts of food items/groups and the Healthy Food Diversity Index. Further, the predictors differ depending on which type of indicator is used. Access to resources

(measured by an asset index) was found to be associated with an increase in counts of food items/groups but at a decreasing rate, while the opposite was found for the Healthy Food Diversity Index. There was no significant association between maternal education and the counts of food items/groups, while maternal education was positively associated with the Healthy Food Diversity Index.

Conclusions: More sophisticated measures of dietary diversity that also capture the healthiness of foods and their distribution in the diet, rather than just the number or variety, may be useful in understanding dietary patterns among children and what influences them. Maternal education appears to be particularly important for healthy food consumption among young children, while access to resources has a more complex association, with differential results at low and high levels.

Mycotoxins are fungal secondary metabolites that pose health risks to exposed individuals, requiring necessary measures to reduce them. Using liquid chromatography-tandem mass spectrometry (LC-MS/MS), mycotoxins were quantified in whole grain sorghum and ting subsequently derived from two sorghum varieties (high and low tannin). The whole grain (WG) ting samples were obtained by fermenting sorghum with Lactobacillus fermentum strains (FUA 3165 and FUA 3321). Naturally (spontaneously) fermented WG-ting under the same conditions were equally analysed. Among the mycotoxins investigated, fumonisin B1 (FB1), B2 (FB2), B3 (FB3), T-2 toxin (T-2), zearalenone (ZEA), alpha-zearalenol (α-ZOL) and beta-zearalenol (β-ZOL) were detected in sorghum. Results obtained showed that mycotoxin concentrations significantly (p ≤ 0.05) reduced after fermentation. In particular, L. fermentum FUA 3321 showed the capability to significantly (p ≤ 0.05) reduce all the mycotoxins by 98% for FB1, 84% for T-2 and up to 82% for α-ZOL, compared to raw low tannin sorghum. Fermenting with the L. fermentum strains showed potential to effectively reduce mycotoxin contamination in whole grain ting. Thus, we recommended L. fermentum FUA 3321 in particular to be used as a potential starter culture in sorghum fermentation.

 

Background: Despite increased economic growth and development, and existence of various policies and
interventions aimed at improving food security and nutrition, majority of countries in sub-Saharan Africa have very
high levels of child malnutrition. The prevalence of stunting, an indicator of chronic malnutrition, is especially high.
Methods: In this paper, we use Demographic and Health Survey datasets from three countries in the region that
obtained middle-income status over the last decade (Ghana, Kenya and Zambia), to provide a comparative
quantitative assessment of stunting levels, and examine patterns in stunting inequalities between 2007 and 2014.
Results: Our analyses reveal that stunting rates decreased in all three countries over the study period, but are still
high. In Zambia, 40% of under 5-year olds are stunted, compared to 26% in Kenya and 19% in Ghana. In all three
countries, male children and those living in the poorest households have significantly higher levels of stunting. We also
observe stark inequalities across socio-economic status, and show that these inequalities have increased over time.
Conclusions: Our results reveal that even with economic gains at the national level, there is need for continued focus
on improving the socio-economic levels of the poorest households, if child nutritional outcomes are to improve.
Keywords: Inequality, Stunting, Children, Malnutrition, Sub-Saharan Africa, Concentration indices, Concentration curves,Middle-income, Ghana, Kenya, Zambia

The superior agronomic and human nutritional properties of grain legumes (pulses)
make them an ideal foundation for future sustainable agriculture. Legume‐based
farming is particularly important in Africa, where small‐scale agricultural systems
dominate the food production landscape. Legumes provide an inexpensive source
of protein and nutrients to African households as well as natural fertilization for
the soil. Although the consumption of traditionally grown legumes has started to
decline, the production of soybeans (Glycine max Merr.) is spreading fast, especially
across southern Africa. Predictions of future land‐use allocation and production
show that the soybean is poised to dominate future production across Africa. Land
use models project an expansion of harvest area, whereas crop models project
possible yield increases. Moreover, a seed change in farming strategy is underway.
This is being driven largely by the combined cash crop value of products such as oils
and the high nutritional benefits of soybean as an animal feed. Intensification of
soybean production has the potential to reduce the dependence of Africa on
soybean imports. However, a successful “soybean bonanza” across Africa necessitates an intensive research, development, extension, and policy agenda to
ensure that soybean genetic improvements and production technology meet future demands for sustainable production.

The superior agronomic and human nutritional properties of grain legumes (pulses) make them an ideal foundation for future sustainable agriculture. Legume‐based farming is particularly important in Africa, where small‐scale agricultural systems dominate the food production landscape. Legumes provide an inexpensive source of protein and nutrients to African households as well as natural fertilization for the soil. Although the consumption of traditionally grown legumes has started to decline, the production of soybeans (Glycine max Merr.) is spreading fast, especially across southern Africa. Predictions of future land‐use allocation and production show that the soybean is poised to dominate future production across Africa. Land use models project an expansion of harvest area, whereas crop models project possible yield increases. Moreover, a seed change in farming strategy is underway. This is being driven largely by the combined cash crop value of products such as oils and the high nutritional benefits of soybean as an animal feed. Intensification of soybean production has the potential to reduce the dependence of Africa on soybean imports. However, a successful “soybean bonanza” across Africa necessitates an intensive research, development, extension, and policy agenda to ensure that soybean genetic improvements and production technology meet future demands for sustainable production.

Phosphate (Pi) deficiency reduces nodule formation and development in different legume species including common bean. Despite significant progress in the understanding of the genetic responses underlying the adaptation of nodules to Pi deficiency, it is still unclear whether this nutritional deficiency interferes with the molecular dialogue between legumes and rhizobia. If so, what part of the molecular dialogue is impaired? In this study, we provide evidence demonstrating that Pi deficiency negatively affects critical early molecular and physiological responses that are required for a successful symbiosis between common bean and rhizobia. We demonstrated that the infection thread formation and the expression of PvNSP2PvNIN, and PvFLOT2, which are genes controlling the nodulation process were significantly reduced in Pi-deficient common bean seedlings. In addition, whole-genome transcriptional analysis revealed that the expression of hormones-related genes is compromised in Pi-deficient seedlings inoculated with rhizobia. Moreover, we showed that regardless of the presence or absence of rhizobia, the expression of PvRIC1 and PvRIC2, two genes participating in the autoregulation of nodule numbers, was higher in Pi-deficient seedlings compared to control seedlings. The data presented in this study provides a mechanistic model to better understand how Pi deficiency impacts the early steps of the symbiosis between common bean and rhizobia

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