Provincial Dietary Intake Study (PDIS): Energy and Macronutrient Intakes of Children in a Representative/Random Sample of 1–<10-Year-Old Children in Two Economically Active and Urbanized Provinces in South Africa

Abstract

The double burden of malnutrition is still prevalent in South Africa, hence the importance of a dietary survey to identify risks of under-and over-nutrition. A multistage stratified cluster random sampling design was applied in two economically active provinces, Gauteng (GTG) (N = 733) and Western Cape (WC) (N = 593). Field workers completed questionnaires, and a 24 h recall with children taking part aged 1-<10-years (N = 1326). Important findings were that 71% and 74%, respectively, of 3-<6-year-olds and 6-<10-year-olds had an energy intake below the estimated energy requirement (EER), while 66% 1-<3-year-olds had intakes above the EER. The percentage of children with a total fat intake below recommended levels decreased as age increased ((51%, 40% and 5%) respectively, for the three age groups). Similarly, the percentage of those who had a total fat intake above the recommendation increased with increasing age (4%, 11% and 26%, respectively, for the three age groups). Saturated fat intake above 10%E was highest in the youngest and oldest children (33% and 32%, respectively). The percentage of children with a free sugars intake above 10%E was 47%, 48% and 52% respectively, and 98-99% had a fibre intake that was less than recommended. Overall, the diet was not healthy, with the main food items being very refined, and the diet being high in salty snacks and sugary items, and low in fruit, vegetables and legumes. non-communicable diseases (NCDs) [6,7]. Rapid weight gain in infancy is also associated with long-term risk of adult weight gain and development of NCDs [8].In a recent publication of the same children whose dietary results are studied here, nutritional status by means of anthropometry was determined [9]. Stunting was found to be 39% and 23% in 1and 2-year-olds, respectively. Overweight and obesity were found to be 23% and 14% in 1-year-olds, and 11% and 9% in 2-year-olds, and those who were both stunted and overweight were 19% and 6%, respectively, in 1-and 2-year-old children. The double burden of malnutrition is clearly illustrated.The double burden of malnutrition is commonly found in many low-and middle-income countries [10] and much of this can be largely attributed to the nutrition transition taking place, in conjunction with decreased levels of physical activity [10]. The nutrition transition implies moving from a traditional diet which is high in carbohydrate and fibre and low in sugar and fat to a more contemporary Western diet which is high in fats, saturated fats, sodium and sugar [11]. One of the main drivers of this transition is urbanization [10,12].A recent review of dietary studies in developing countries by Ochola and Masibo showed what the typical dietary scenario in developing countries is [13]. This review included 50 studies from 42 countries in children and adolescents. The findings were an overall low energy intake, lack of dietary diversity, low intake of fruit and vegetables and micronutrient deficiencies. At the same time the emerging nutrition transition is stressed. This includ...

The Food Environment of Primary School Learners in a Low-to-Middle-Income Area in Cape Town, South Africa

“…For example, results from the South African Provincial Dietary Intake Survey in 1 to >10-year-old children showed that salty snacks contributed a third of total energy intake (maize porridge contributed most to total energy intake), while also being the top source of total fat and saturated fat. Granulated sugar (e.g., sugar added to hot drinks) was found to be the third highest contributor to total carbohydrate intake [49].…”

“…Two free text questions probed which food items/dishes and snacks/drinks household respondents liked and disliked the most. The availability of household food items was determined via a household inventory adapted from a previous study [49]. In instances where the household respondent was illiterate, learners were instructed to assist with the completion of the self-administered questionnaire.…”

The Food and Nutrition Environment at Secondary Schools in the Eastern Cape, South Africa as Reported by Learners

“…It is thus recommended that the Department of Basic Education find ways to enforce this mandate. Considering the overall low intake of vegetables and fruit in South African children [35] and the importance of eating sufficient amounts thereof to reduce the risk for developing certain non-communicable diseases and micronutrient deficiencies [36], the school meal together with good quality nutrition education can be a vehicle for increasing the intake of fruit and vegetables in learners.…”

Total Fat and Fatty Acid Intake among 1–7-Year-Old Children from 33 Countries: Comparison with International Recommendations

“…Prentice et al, [43] reported that breastmilk contributed significantly to fat intake up to 17 months (50%E), which declined thereafter to 30% and 15% at 17 and 24 months, respectively. In a more recent study from South Africa, Steyn et al, [45] reported that breastmilk contributed to 18.7% of total energy intake up to 3 years. Thus, in infancy and early childhood, breastmilk intake can contribute significantly to intake of energy and fat.…”