Abstract
BackgroundFood quality, determined by micronutrient content, is a stronger determinant of nutritional status than food quantity. Health concerns resulting from the co-existence of over-nutrition and under-nutrition in low income populations in South Africa have been fully recognized in the last two decades. This study aimed to further investigate dietary adequacy amongst adults in rural KwaZulu-Natal, by determining daily energy and nutrient intakes, and identifying the degree of satisfaction of dietary requirements.MethodsCross-sectional study assessing dietary adequacy from 24-hour dietary recalls of randomly selected 136 adults in Empangeni, KwaZulu-Natal, South Africa.ResultsResults are presented for men (n = 52) and women (n = 84) 19–50 and >50 years old. Mean energy intake was greatest in women >50 years (2852 kcal/day) and exceeded Dietary Reference Intake’s for both men and women, regardless of age. Mean daily energy intake from carbohydrates was 69% for men and 67% for women, above the Dietary Reference Intake range of 45–65%. Sodium was also consumed in excess, and the Dietary Reference Intakes of vitamins A, B12, C, D, and E, calcium, zinc and pantothenic acid were not met by the majority of the population.ConclusionDespite mandatory fortification of staple South African foods, micronutrient inadequacies are evident among adults in rural South African communities. Given the excess caloric intake and the rising prevalence of obesity and other non-communicable diseases in South Africa, a focus on diet quality may be a more effective approach to influence micronutrient status than a focus on diet quantity.
Highlights
South Africa is a multicultural country whose population consists of Caucasian, Asian, and black African peoples, with black African making up approximately 80% of the population [1]
Individuals falling in the 90% to 110% range of the Acceptable Macronutrient Distribution Ranges (AMDR) for energy and in the 90% to 110% range of the Estimated Average Requirements (EARs) for nutrients are considered to have adequate intake of that nutrient
Despite adequate intakes of protein, there is a correlation between diets lacking in animal source foods (ASF) and micronutrient deficiencies, including iron, zinc, vitamin B-12, riboflavin, calcium and vitamin A [25]
Summary
South Africa is a multicultural country whose population consists of Caucasian, Asian, and black African peoples, with black African making up approximately 80% of the population [1]. The high intake of energy dense foods among low income populations in South Africa is a source of the accelerating emergence of public health problems such as obesity [10], and the rising burden of many other non-communicable diseases [5]. Previous studies have shown a link between intake of energy-dense foods and low micronutrient intakes in rural areas of South Africa. This pattern is mediated by the low cost of energy-dense foods [4], and reinforced by the high palatability of sugar and fat [11]. This study aimed to further investigate dietary adequacy amongst adults in rural KwaZulu-Natal, by determining daily energy and nutrient intakes, and identifying the degree of satisfaction of dietary requirements
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