Genetic nutrition programmes – disappointment or empowered health? Exploring consumer engagement to understand social health change

Purpose This research aims to gain insight into how consumers interact with a commercially available genetic nutrition programme, DNAfit, to explore health change via an intervention. Design/methodology/approach Focus groups were conducted between June and October 2019, pre-, during- and post-intervention, with a total sample of 14 younger (aged 25–44 years) and 14 mature (aged 45–65 years) cohorts from New Zealand. Qualitative thematic analysis was completed with the help of NVivo software. Findings Younger participants in this study engaged less overall with DNAfit, felt the service did not match their lifestyles and did not encourage their believability of genetic personalised nutrition (GPN). In contrast, mature participants had positive engagement with GPN, as their motivation to use the service fit with their motivation for longevity. Overall, social uptake in health changes based on GPN is likely to depend on life stage. Originality/value This paper adds to limited social marketing research, which seeks novel avenues to explore how consumers engage with GPN technologies to drive social change, assisting social marketers on how to more effectively deliver health programmes that allow consumer-driven interaction to build health capabilities.

Harnessing Public Food Procurement for Sustainable Rural Livelihoods in South Africa through the National School Nutrition Programme: A Qualitative Assessment of Contributions and Challenges

This paper examines how public food procurements contributes to sustainable rural livelihoods through local sourcing of school food, what has become known as ‘home-grown’ school feeding. Specifically, it draws on in-depth interviews to explore the contributions and challenges of using local farmers as suppliers for South Africa’s National School Nutrition Programme (NSNP) using the case of the Eastern Cape Province, the country’s poorest province. The study found that participating schools in rural areas benefit from local sourcing by way of using fresh vegetables in preparing meals thanks to the utilisation of a decentralised catering model in the Eastern Cape Province. Consequently, there is evidence of farmers participating in NSNP food market earning additional income and growing more vegetables on more land in some cases. However, even though the Eastern Cape Province uses a decentralised procurement model, it has no clear-cut programme to optimise the benefits of local sourcing for NSNP. It only ‘encourages’ schools to buy vegetables grown locally. This calls for pragmatism on the side of government to, through creative procurement and initiatives such as the Agri-Parks, use NSNP as a tool for making the South African food system more inclusive, drive down rural poverty and realise sustainable rural development.

Access to Nutrition in Odisha

Celebrated as a nutrition champion, Odisha state in India has achieved significant improvements in nutrition of its women and children. The overall progress, however, masks familiar inequities, evidenced in significantly higher levels of stunting, wasting and underweight in children. The article examines access, a key underlying determinant of undernutrition, to two nutrition government schemes of Odisha—the Supplementary Nutrition Programme and Mamata—for the most vulnerable groups in the state’s Angul district. The study identifies limited awareness and lack of proactive disclosure of scheme information, excessive distance from centres that provide the schemes, caste-based power dynamics and weak monitoring institutions as key factors restricting access of specific social groups to these two schemes. The article examines the factors constraining access and considers potential solutions to overcome these bottlenecks in order to provide more effective protection mechanisms.

Development of an energy-dense biscuit suitable for primary school learners for the South African National School Nutrition Programme

South Africa has a well established National School Nutrition Programme (NSNP). Despite rescheduling the mealtime to two hours after the start of the school day to accommodate learners who come to school on an empty stomach, a gap still exists as many children start their learning day with low energy and concentration levels. A cost-effective, energy-dense snack served at the start of the school day can be a solution to sustain learners until the main meal is served. Cross-sectional surveys were used to determine the snack preferences of children and the product development process was used to develop a suitable snack. An energy-dense peanut butter biscuit was developed based on those surveys as well as a scoping review of previous snack studies. The energy-dense developed product provided 1388kJ (61.0%) of energy from fat, 688kJ (30.2%) of energy from carbohydrates and 201kJ (8.8%) of energy from protein per 100g. The biscuit conformed to microbial testing standards. Shelf-life analysis projected a shelf-life of five weeks fresh and five months in food grade packaging. Sensory results showed that there was no significant difference in sensory scores across gender (p=0.691) and age (p=0.706). More of the learners (n=56, 69.1%) found the biscuit to be ‘Super good’ than the other ratings (p<.0005). When compared with similar biscuit products currently on the market, it was found that the developed biscuit was the most reasonably priced. The developed biscuit has the potential to serve as a solution to hidden hunger for children that come to school on an empty stomach. This versatile snack solution has potential for continuity of use even during periods of national crisis as with COVID-19, when learners’ nutritional needs may be most vulnerable.

Nutrition

Malnutrition, health and survival?, Measuring nutritional status?, Pathophysiological consequences of severe malnutrition?, Clinical assessment of nutrition?, Medical management within inpatient therapeutic nutrition programmes?, Inpatient therapeutic nutrition programme?, Outpatient therapeutic nutrition programme?, Supplementary feeding programmes?, HIV/AIDS and malnutrition?, Severe malnutrition in infants months old?, Pregnancy?, Nutrition in emergencies?, Recipes and formulas for management of malnourished children?, Vitamin A deficiency?, Vitamin B thiamine deficiency: beriberi?, Vitamin B riboflavin deficiency?, Vitamin B niacin deficiency: pellagra?, Vitamin B pyridoxine deficiency?, Vitamin B deficiency?, Folate deficiency?, Vitamin C deficiency: scurvy?, Vitamin D deficiency: rickets/osteomalacia?, Vitamin E alpha-tocopherol deficiency?, Vitamin K deficiency?, Iodine deficiency?, Zinc xxx, Other micronutrients?, Obesity?

Stakeholders’ impediments in promoting school nutrition education in South Africa: Implications on youth dietary knowledge of excess fats and carbohydrates

There is prevalence of overweight and obesity in South Africa. Evidence of nutrition knowledge and challenges affecting the promotion of nutrition interventions is needed to produce more effective strategies to prevent nutrition problems in schoolchildren. The study sought to explore challenges encountered by stakeholders of the school nutrition programme in promoting nutrition education. Furthermore, the study aimed to assess the implications of the stakeholders ‘challenges on learners’ dietary knowledge of excess fats and carbohydrates. The study took place in eight secondary schools in the Pinetown District, KwaZulu-Natal,South Africa. The qualitative data from nine interviewees who were stakeholders of the school nutrition programme were analysed using thematic content analysis. Quantitative data were collected from 108 grade 12learners using self-administered questionnaires.The quantitative data was coded, collated and analysed using SPSS. Independent sample t-test was used to evaluate if there was significant difference between gender and the mean values. One-way ANOVA was used to establish if there was any significant difference between the mean values of learners’ knowledge on various nutrition principles.Learners displayed inadequate knowledge of a healthy diet(34%),the importance of vegetables in the diet (71%), the health risks of excess fats (64.8%) and excess carbohydrates (77.8%),and nutritious food to be eaten daily (40.7%). Comparison of group means of various nutrition principles using one way ANOVA indicated significant difference at p < 0.05 level[F(4, 528) = 43.3, P < 0.001]. The 44 male respondents had significantly higher scores for the awareness of health risks of excess fats t (103) = 2.6, p =0.01and excess carbohydrates t (103) = 2.7, p =0.01 compared to 61 females.Each food group could be listed only by less than 22% of the participants. Challenges encountered in promoting nutrition education included time constraints, lack of training on nutrition principles, lack of supporting documents and lack of nutrition principles in the curriculum.The inadequate knowledge displayed by learners and lack of training and supporting documents in promoting nutrition education indicate areas that can be targeted by intervention programmes to improve nutrition knowledge of learners and stakeholders.

Facilitating factors and challenges of the implementation of multisectoral nutrition programmes at the community level to improve optimal infant and young child feeding practices: a qualitative study in Burkina Faso

Objectives: To identify the drivers and challenges of successful nutrition programme implementation in a multisectoral, community-level approach to improve infant and young child feeding (IYCF) practices in northern Burkina Faso. Design: A qualitative study was conducted in 2019 through (i) individual interviews with key informants from five different sectors (health, agriculture, environment, livestock and education) and association staff, agents and community leaders and (ii) focus groups with mothers of children under the age of 2 years. Setting: Three health districts in the northern region of Burkina Faso implemented a multisectoral community nutrition programme to improve IYCF practices. Participants: Forty-seven implementing actors and twenty-four beneficiary mothers. Results: Factors influencing successful implementation include community participation; sector commitment and involvement; the existence of nutrition champions; capacity building; the integration of interventions; micronutrient powder distribution; the introduction of nutrition-sensitive interventions, such as the promotion of the consumption of orange-fleshed sweet potatoes; improved food production and small livestock rearing and the effective coordination of actors and complementary funding. The main challenges of the implementation of multisectorality are low participation among nutrition-sensitive sectors, a tendency for siloed work among sectors, scheduling conflicts, high actor mobility, differences in the target population by sector, a lack of technical skills among community workers, insufficient financial resources, low geographic convergence and coverage of beneficiaries, a lack of a multisectoral monitoring mechanism and accountability and insecurity. Conclusions: Strengthening sector participation, identifying a common targeting strategy and mobilising financial resources have the potential to significantly reduce barriers and improve the quality of implementation.

Reducing childhood obesity: evaluation of an Early Years Nutrition programme in a deprived London borough

Background: Childhood obesity is a growing global health concern, with far-reaching implications on health in childhood and in later life. Early intervention strategies are key to reducing childhood obesity. This study aims to evaluate the implementation of an Early Years Nutrition programme in the London Borough of Newham’s children’s centres. Methods: A service evaluation of the Early Years Nutrition programme was conducted at children’s centres within the borough. Information was collected on the sessions provided to parents by staff, breastfeeding promotion and nutritional topics the centres were displaying. Nutritional activities in each centre were assessed for compliance with the National Institute for Health and Care Excellence (NICE) guidelines. Results: Eight out of eleven (72.7%) centres participated. Parent sessions focused mostly on oral health (n=4/8, 50.0%). Display board topics most commonly related to generic health and wellbeing (n=4/8, 50.0%). All centres displayed the UNICEF breastfeeding logo and complied with the NICE guidelines for nutritional activities. Conclusions: The programme is consistent with NICE guidelines in the centres evaluated; however, further acquisition of data on obesity-associated factors specific to communities and preventive measures for reducing childhood obesity, such as increased parental and community engagement, promotion of breastfeeding and improved staff training, will help tailor similar programmes elsewhere with higher social and cultural acceptance.