Provincial Dietary Intake Study (PDIS): Micronutrient Intakes of Children in a Representative/Random Sample of 1- to

Marjanne Senekal,Linda Drummond,Sonia Malczyk,Nelia P Steyn,Johanna Nel

doi:10.3390/ijerph17165924

Abstract

In 1999, the National Food Consumption Survey found serious risk of dietary deficiency for a number of micronutrients in 1- to 9-year-old children in South Africa. To address these shortfalls, fortification with vitamin A, thiamine, riboflavin, niacin, vitamin B6, folic acid, iron and zinc of maize meal and bread flour was made mandatory in 2003. The aim of this study was to examine micronutrient intakes of 1- to <10-year-old children after nearly 20 years of fortification in two of the most urbanized and economically active provinces, Gauteng (GTG) and the Western Cape (WC). A multistage stratified cluster random sampling design and methodology was used. Households were visited by fieldworkers who interviewed caregivers and obtained dietary intake data by means of a multiple-pass 24-h recall. Two additional 24-h recalls were completed among a nested sample of 146 participants to adjust the single 24-h recall data of the total sample using the National Cancer Institute Method. Results show that median intake of all the fortification nutrients were above the estimated average requirement (EAR), with the only concern being folate in the WC. Between a quarter and a third of children in the WC, where maize porridge intake was significantly lower than in GTG, had a folate intake below the EAR. Nutrients that are not included in the fortification mix that remain a serious concern are calcium and vitamin D, with intake of dairy and vitamin D sources being very limited in both provinces. The improvement in micronutrient intakes of children is encouraging, however the outstanding nutrient deficiency risks need attention.

Highlights

Micronutrient malnutrition caused by a deficiency of one or more essential micronutrients is prevalent globally, with children and pregnant and lactating women being the most vulnerable.It appears to be most common in low- and middle-income countries and contributes greatly to the global burden of poverty and disease with low vitamin A, iron and zinc remaining serious risks of deficiencies [1].In 1999 the National Food Consumption Survey (NFCS) found a serious dietary risk of deficiency for calcium, iron, zinc, folate, vitamin C, vitamin A, vitamin E, riboflavin, niacin, and vitamin B6 in1- to 9-year-old children in South Africa (SA) [2]
Liver intake in the 1999 NFCS was less than 1 g [36]. Based on this scenario it could be argued that it would be possible to obtain the necessary iron, zinc, thiamine, riboflavin, niacin and vitamin B6 from the diet without eating the amount of maize porridge and bread eaten by children in GTG if children’s diets include sufficient flesh foods, dairy and eggs
Our results show that fortification of maize and bread flour most probably made a considerable contribution to improvement of the intake of nutrients included in the fortification mix, namely iron, zinc, vitamin A, thiamine, riboflavin, niacin, vitamin B6 and folate in the total provincially representative dietary intake study (PDIS)

Summary

Introduction

Micronutrient malnutrition caused by a deficiency of one or more essential micronutrients is prevalent globally, with children and pregnant and lactating women being the most vulnerable.It appears to be most common in low- and middle-income countries and contributes greatly to the global burden of poverty and disease with low vitamin A, iron and zinc remaining serious risks of deficiencies [1].In 1999 the National Food Consumption Survey (NFCS) found a serious dietary risk of deficiency for calcium, iron, zinc, folate, vitamin C, vitamin A, vitamin E, riboflavin, niacin, and vitamin B6 in1- to 9-year-old children in South Africa (SA) [2]. Micronutrient malnutrition caused by a deficiency of one or more essential micronutrients is prevalent globally, with children and pregnant and lactating women being the most vulnerable. It appears to be most common in low- and middle-income countries and contributes greatly to the global burden of poverty and disease with low vitamin A, iron and zinc remaining serious risks of deficiencies [1]. In 1999 the National Food Consumption Survey (NFCS) found a serious dietary risk of deficiency for calcium, iron, zinc, folate, vitamin C, vitamin A, vitamin E, riboflavin, niacin, and vitamin B6 in. 1- to 9-year-old children in South Africa (SA) [2]. A large percentage of these 1- to 9-year-olds were. Public Health 2020, 17, 5924; doi:10.3390/ijerph17165924 www.mdpi.com/journal/ijerph

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