Objective: Obesity and anaemia remain global public health problems, holding major consequences for human health. The objective was to determine body composition, prevalence of anaemia and iron deficiency, contraception use and associations between variables in rural women in the Free State, South Africa. Design: A cross-sectional study design was applied. Setting: The study was undertaken in rural Trompsburg, Philippolis and Springfontein. Subjects: A total of 134 HIV-uninfected non-pregnant females, aged between 25 and 49 years participated. Exposure and outcome measures: Data were collected on anthropometry, contraception use and biochemical markers of anaemia, iron deficiency and inflammation. Results: Median body mass index (BMI) (28.7 [24.2, 34.7] kg/m²), waist circumference (90.8 [80.9, 103.0] cm) and body fat percentage (38.8 [34.3, 42.1] %) were classified as unhealthy. Only 2/134 had iron deficiency and 1/134 iron deficiency anaemia. Overall, 3.8% had low red cell folate levels. Almost half (45.0%) had elevated C-reactive protein (CRP) levels. More than half (54.1%) reported that they regularly menstruate and 71.6% currently or had previously used injectable contraceptives. Mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and transferrin saturation were significantly associated with BMI, waist circumference and body fat percentage. Conclusion: A predominant pattern of malnutrition, characterised by overweight and obesity, was prevalent. Risk for iron deficiency was associated with obesity. Prevalence of iron deficiency could be underestimated due to the large percentage with elevated CRP levels. Interventions should aim to improve the nutritional status of these women in order to reduce their risk for both chronic diseases and anaemia.

Introduction: Although investigations into the emerging field of nutrigenomics are relatively limited and more research in this field is required, experts agree that there is potential for it to be incorporated into health care practice. If health care professionals can promote healthy dietary behavior based on nutrigenomic testing, it can assist in addressing the health consequences of poor diet and lightning the strain on the South African health care system. Methods: Registered dietitians (RDs) and general practitioners (GPs) registered with the Health Professions Council of South Africa (HPCSA) who obtained their qualification in South Africa (SA) were eligible to participate in this cross-sectional study. Participants were identified using convenience and snowball sampling. A self-administered electronic survey using EvaSys Software® was completed by those that agreed to participate. Results: Nearly all RDs (97.3%), but less than a third of GPs (30.4%), had heard of the term nutrigenomics. Approximately three-quarters of RDs (74.7%) and GPs (73.9%) had or would personally consider undergoing genetic testing. More than 40% (43.5%) of RDs ranked direct-to-consumer genetic testing companies as the most equipped, while 31.8% of GPs ranked RDs as the most equipped to provide patients with nutrigenomic services. Both RDs and GPs ranked similar reasons as “strongly agree” for why consumers were motivated to make use of nutrigenomic services, which included “motivated by a desire to prevent or manage disease” (56.7%), “prevent a disease based on family history” (65.9%), “control health outcomes based on family history” (54.9%), and “improve overall health-related quality of life” (48.6%). Cost concerns were reported as the greatest barrier to implementing nutrigenomic services (75.7%). Other barriers included confidentiality issues (47.8%) and moral concerns (37.3%). Greater individualization of diet prescription (66.5%), stronger foundations for nutrition recommendations (62.4%), and dietary prescriptions that would manage or prevent certain diseases more effectively (59.0%) were all perceived as benefits of including nutrigenomics in practice. Conclusion: This study identified perceived consumer motivators and barriers that might affect the willingness to seek nutrigenomic services in SA. In addition, the need for more nutrigenomic training opportunities, including the planning of personalized diets based on genetic testing results and interpretation of results, was confirmed. However, both RDs and GPs felt that the emerging field of nutrigenomics needs further development before it can be applied effectively in routine private and public health care in SA.

Poor birth outcomes such as low birth weight, low birth length and short gestational age, are public health concern issues in South Africa (SA). This study utilized structural equation modeling (SEM) to explore how nutritional and social factors contribute to favorable fetal growth conditions (FFGC) in pregnant women living with and without human immunodeficiency virus (HIV), in the Free State Province of SA. Sociodemographic characteristics, stress, health and nutrition-related information, and birth outcomes data were collected and analyzed from a subsample of 305 women enrolled in a cohort study from 2018–2020. Descriptive statistics were analyzed in R version 4.1.2 and SEM was conducted in Lavaan version 0.6–5. Higher gestational body mass index (GBMI) and income levels were associated with higher FFGC (p < 0.05). Household incomes were positively associated with dietary micronutrient quality (p = 0.002), GBMI (p = 0.012) and food security (p = 0.001). Low incomes (p = 0.004) and food insecurity (p < 0.001) were associated with higher stress, while social support was positively associated with food security status (p = 0.008). These findings highlight the complex interconnections between the social and nutritional factors that are associated with fetal growth conditions. Multisectoral community-based programs may be a useful strategy to address these challenges.

Background: Anaemia, a global public health problem that particularly affects women, holds major consequences for human health.Aim: Determining dietary diversity, prevalence of anaemia and contraception use.Setting: Rural women, 25–49 years, in the Free State Province, South Africa.Methods: In a cross-sectional descriptive quantitative study, dietary diversity was determined with a 24-h recall; biochemical markers of anaemia, iron deficiency and inflammation were measured; and contraceptive use was recorded.Results: Of 134 women (median age 41 years), 51.5% had medium, and 44.8% had low dietary diversity. Overall, 76.9% consumed flesh meats and fish, but only 25.4% ate dark green leafy vegetables. Anaemia was present in 4.6%; 1.5% presented with iron deficiency; and 0.7% presented with iron deficiency anaemia, evidenced by low ferritin levels. However, 45.0% had elevated C-reactive protein (CRP). Overall, 7.5% presented with elevated homocysteine levels, but only 3.8% had low red cell folate levels. More than half (54.1%) reported menstruating regularly and 71.6% used injectable contraceptives. Significant associations were found between median mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) and dietary diversity score.Conclusions: Although the prevalence of anaemia is low in this population, elevated CRP in almost half indicates that inflammation may mask iron deficiency. The older median age of the sample and approximately half of the women not menstruating regularly may also contribute to the low anaemia prevalence. Attention should be given to the women’s diets as almost half consume diets of low diversity, and not all consume foods rich in haemopoietic nutrients.

Background: Low socio‐economic status is associated with poor birth outcomes, however, few studies on this topic have been conducted in South Africa. We determined associations between socio‐demographic variables of pregnant women and birth outcome in their offspring.Methods: This study was nested in a prospective cohort study conducted at an antenatal clinic at a regional hospital in Bloemfontein, South Africa. Questionnaires on socio‐demographic information were completed on 682 pregnant women in a structured interview. Post‐delivery, 331 participants provided the Road to Health Booklets for 347 infants, in which birth data were recorded. Associations between socio‐demographic variables and birth outcome (defined as premature delivery or low length‐for‐age or low weight‐for‐length at birth) were investigated. Logistic regression with backward selection (p < 0.05) was used to select independent factors that were significantly associated with birth outcome. Variables with a p‐value of <0.15 on bivariate analysis were considered for inclusion in the model.Results: Poor birth outcome was observed in 36.3% (116/320) of women. The odds of experiencing poor birth outcome were lower for women who owned a stove versus those who did not (OR 0.11, 95% CI: 0.02–0.67), and higher for women with grade 8–10 (OR 5.84, 95% CI: 1.90–17.91) or grade 10–12 (OR 4.33, 95% CI: 1.50–12.49) as their highest level of education versus tertiary education. The odds of experiencing poor birth outcomes were also higher for those employed part‐time (OR 2.55, 95% CI: 1.10–5.93) versus full‐time and/or self‐employed.Conclusion: Our findings confirm that the presence of basic amenities such as a stove, better education and employment improve the chances of better birth outcomes. Early screening of pregnant women for the identification of socio‐demographic risk factors that may impact on birth outcome is recommended.

Higher sociodemographic status is associated with adequate nutrient intake and food security. Adequate choline intake is vital during pregnancy to support fetal development. In this cross-sectional study, information was obtained from 682 pregnant women attending an ante-natal clinic in Bloemfontein, South Africa. Sociodemographic indicators that were bivariately significantly associated with a choline intake below the adequate intake level (AI) included a higher household density ratio, no access to own flush toilets at home, household not owning a refrigerator or microwave, as well as a lower level of education. Approximately one-third of participants were severely food-insecure. Logistic regression analysis, adjusted for energy intake, showed that household overcrowding increased the odds of a choline intake below the AI (OR 1.71).