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The aim of the present study was to assess anthropometric status in South African children and women in 2005 in order to document temporal trends in selected anthropometric parameters.
Heights and weights were measured in a cross-sectional study of children aged 1–9 years and women aged 16–35 years. The WHO reference values and BMI cut-off points were used to determine weight status.
South Africa, representative sample based on census data.
Children (n 2157) and women (n 2403).
Stunting was the most common nutritional disorder affecting 21·7 % of children in 1999 and 20·7 % in 2005. The difference was not statistically significant. Underweight prevalence remained unchanged, affecting 8·1 % of children, whereas wasting affected 5·8 % of children nationally, a significant increase from 4·3 % of children in 1999. Rural children were most severely affected. According to the international BMI cut-off points for overweight and obesity, 10 % of children nationally were classified as overweight and 4 % as obese. The national prevalence of overweight and obesity combined for women was 51·5 %. The prevalence of overweight in children based on weight-for-height Z-score did not change significantly (8·0 % to 6·8 %, P = 0·138), but the combined overweight/obesity prevalence based on BMI cut-off points (17·1 % to 14·0 %, P = 0·02) decreased significantly from 1999 to 2005.
The double burden of undernutrition in children and overweight among women is evident in South Africa and getting worse due to increased childhood wasting combined with a high prevalence of obesity among urban women, indicating a need for urgent intervention.
A national survey found that micronutrient deficiencies are prevalent in South African children, particularly calcium, iron, zinc, riboflavin, niacin, vitamin B6, folate, vitamin A, E and C. Mandatory fortification of maize meal and wheat flour were introduced in 2003 to combat some of the deficiencies found in children. To date however, there has not been a national survey on dietary intake in adults.
The main objectives of this study were to evaluate the micronutrient intake of the diet consumed by the average adult South African by means of secondary data analyses and secondly to evaluate the effects of fortification on selected nutrient intakes.
Secondary data analysis was carried out with numerous dietary surveys on adults to create a database that included sampling (and weighting) according to ethnic/urban–rural residence in line with the population census, of which 79% were black Africans and the majority resided in rural areas. The effect of fortification was evaluated by substituting fortified foods in the diet for the unfortified products.
The combined database used in this study comprised 3229 adults.
Mean calcium, iron, folate and vitamin B6 intakes were very low particularly in women. Mean intakes of most micronutrients were lower in rural areas. Fortification of maize meal and wheat flour (bread) raised mean levels of thiamine, riboflavin, niacin, vitamin B6 and folate above the recommended nutrient intakes (RNIs). In women, despite fortification, mean iron intakes remained below the RNIs, as did calcium since it was not in the fortification mix.
The average dietary intake of adults was of poor nutrient density, particularly in rural areas. Fortification of maize meal and wheat flour (bread) considerably improved mean vitamin B6, thiamine, riboflavin, niacin, folate and iron intakes as well as the overall mean adequacy ratio of the diet.
To develop and validate a short food-frequency questionnaire to assess
habitual dietary salt intake in South Africans and to allow classification
of individuals according to intakes above or below the maximum recommended
intake of 6 g salt day−1.
Cross-sectional validation study in 324 conveniently sampled men and
Repeated 24-hour urinary Na values and 24-hour dietary recalls were obtained
on three occasions. Food items consumed by >5% of the sample and
which contributed ≥50 mg Na serving−1 were
included in the questionnaire in 42 categories. A scoring system was
devised, based on Na content of one index food per category and frequency of
Positive correlations were found between Na content of 35 of the 42 food
categories in the questionnaire and total Na intake, calculated from 24-hour
recall data. Total Na content of the questionnaire was associated with Na
estimations from 24-hour recall data (r =
0.750; P < 0.0001; n = 328) and urinary Na (r = 0.152; P
= 0.0105; n = 284). Urinary Na was higher
for subjects in tertile 3 than tertile 1 of questionnaire Na content
(P < 0.05). Questionnaire
Na content of <2400 and ≥2400 mg
day−1 equated to a reference cut-off score of 48 and
corresponded to mean (standard deviation) urinary Na values of 145 (68) and
176 (99) mmol day−1, respectively (P < 0.05). Sensitivity and
specificity against urinary Na ≥100 and <100 mmol
day−1 was 12.4% and 93.9%, respectively.
A 42-item food-frequency questionnaire has been shown to have content-,
construct- and criterion-related validity, as well as internal consistency,
with regard to categorising individuals according to their habitual salt
intake; however, the devised scoring system needs to show improved
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