Search

This study aimed to develop a set of mean ± standard deviation (SD) intake values for South African (SA) children for 36 of the 45 food parameters included in the original Dietary Inflammatory Index (DII®) tool. The SA food composition database contains 30 of the 45 food parameters included in the original DII®, and a supplementary database was developed for six of the food parameters not included in the SA database. The SA child mean ± SD intake of macronutrients, micronutrients and select flavonoids was calculated by age in years, using eight data sets from dietary surveys conducted in SA in the last three decades. A total sample of 5412 children was included in the calculation of the mean ± SD. The current study sample was determined to be representative of 1–

The 1999 National Food Consumption Survey in South Africa showed that food insecurity (hunger) was prevalent in households with children aged one to

This study aimed to develop a set of mean ± standard deviation (SD) intake values for South African (SA) children for 36 of the 45 food parameters included in the original Dietary Inflammatory Index (DII®) tool. The SA food composition database contains 30 of the 45 food parameters included in the original DII®, and a supplementary database was developed for six of the food parameters not included in the SA database. The SA child mean ± SD intake of macronutrients, micronutrients and select flavonoids was calculated by age in years, using eight data sets from dietary surveys conducted in SA in the last three decades. A total sample of 5412 children was included in the calculation of the mean ± SD. The current study sample was determined to be representative of 1

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

Overweight and obesity are growing concerns in adolescents, particularly in females in South Africa. The aim of this study was to evaluate the food and nutrition environment in terms of government policy programs, nutrition education provided, and foods sold at secondary schools in the Eastern Cape province. Sixteen schools and grade 8&ndash, 12 learners (N = 1360) were randomly selected from three health districts comprising poor disadvantaged communities. Based on age and sex specific body mass index (BMI) cut-off values, 13.3% of males and 5.5% of females were underweight, while 9.9% of males and 36.1% of females were overweight or obese. The main food items purchased at school were unhealthy energy-dense items such as fried flour dough balls, chocolates, candies, and crisps/chips. Nutrition knowledge scores based on the South African food-based dietary guidelines (FBDGs) were poor for 52% to 23.4% learners in Grades 8 to 12, respectively. Female learners generally had significantly higher nutrition knowledge scores compared to their male counterparts (p = 0.016). Questions poorly answered by more than 60% of learners, included the number of fruit and vegetable portions required daily, food to eat when overweight, foods containing fiber, and importance of legumes. It was noted that the majority of teachers who taught nutrition had no formal nutrition training and their responses to knowledge questions were poor indicating that they were not familiar with the FBDGs, which are part of the curriculum. Nutrition assessment as part of the Integrated School Health Program was done on few learners. Overall however, despite some challenges the government national school meal program provided meals daily to 96% of learners. In general, the school food and nutrition environment was not conducive for promoting healthy eating.

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

The objective of this study was to determine the prevalence and socio-demographic predictors of malnutrition in two urbanized economically active provinces (Gauteng N = 733, Western Cape N = 593) in South Africa. A multistage stratified cluster random sampling design was applied. Fieldworkers visited homes, measured children aged 1-&lt, 10-years old (N = 1326) and administered a questionnaire (mother/primary caregiver). In under-five year old children (N = 674) 21.6% were stunted [height-for-age z-score &lt, &minus, 2 SD], 5.6 % underweight [weight-for-age z-score &lt, 2 SD], 10.3% overweight (body mass index-for-age z-score) (BAZ)&gt, +2 SD &le, +3 SD] and 7.0% obese (BAZ &gt, +3 SD). In 5&ndash, &lt, 10-year olds (N = 626) 6.7% were stunted, 6.8% underweight, 13.4% overweight and 6.8% obese. Stunting and overweight in the same child was present in 5.7% under-five year olds and 1.7% in 5&ndash, 10-year olds. Multiple logistic regression analyses identified having a mother with a post-grade 12 qualification (OR = 0.34) and having an obese mother (OR 0.46) as protectors and being in the under-five age group (OR = 3.73) as a risk factor for stunting. Being in the under-five age group was also a risk factor for a BAZ &gt, 1 (OR 2.39), while being in the third wealth quintile was protective (OR = 0.62). Results indicate that stunting and overweight/obesity are still present at concerning levels, especially in the under-five age group.

South Africa has a high prevalence of obesity in black female adolescents and a paucity of knowledge regarding contributing dietary practices. The aim of this study was to assess the dietary practices and weight status of male and female adolescents at secondary schools in the Eastern Cape province in urban and rural areas. Sixteen schools and grade 8&ndash, 12 learners (N = 1360) were randomly selected from three health districts comprising poor disadvantaged communities. A short unquantified food frequency questionnaire was used to collect data on learners&rsquo, usual eating practices with regards to weekly meal pattern, breakfast consumption, foods taken to school, takeaways, and snacks eaten while watching television (TV). Body mass index measurements were determined for each learner. Prevalence of combined overweight and obesity differed significantly between genders, 9.9% in males versus 36.1% in females (p &lt, 0.001). Significant gender differences were noted regarding eating practices. Females had a higher frequency of eating sugary snacks (p &lt, 0.001) and a lower frequency of eating breakfast (p &lt, 0.01) than males. Females ate significantly more fried fish (p &lt, 0.05), pizza (p &lt, 0.05) fat cakes (fried dough balls) (p &lt, 0.05), hotdogs (p &lt, 0.01), candy (p &lt, 0.001), cake (p &lt, 0.01), and crisps (p &lt, 0.001). Compared to urban areas, the frequency of eating breakfast (p &lt, 0.01) and sugary snacks (p &lt, 0.05) was significantly higher in rural areas. Significantly more learners in urban areas consumed boerewors (beef sausage) rolls (p = 0.027), hamburgers (p = 0.004), and soft drinks (p = 0.019), while more learners in the rural areas consumed cordial (p = 0.001). In conclusion, a high prevalence of combined overweight and obesity was found in black female adolescents and a high prevalence of poor dietary practices was observed, with significant gender and urban&ndash, rural differences.

Objectives: The aim of this study was to determine the best dietary diversity indicator to measure dietary diversity and micronutrient adequacy in children. Methods: A national representative cross-sectional survey of children ages 1 to 9 y (N ¼ 2,200) was undertaken in all ethnic groups in South Africa. A 24-h recall was done with the mother or caregiver of each child. A dietary diversity score (DDS), the number of food groups consumed at least once in a period of 24 h, was calculated for each child in accordance with 6-, 9-, 13-, and 21food group (G) indicators and compared with a mean adequacy ratio (MAR). The nutrient adequacy ratio (NAR) was calculated for 11 micronutrients by comparing the distributions of estimated intakes with the Estimated Average Requirements for that micronutrient. The MAR was the average of all NARs. Correlations were done between MAR and DDS and sensitivity and specificity calculated for each group indicator. Results: Pearson’s correlations between food group indicators and MAR indicate that r values were all highly significant (P < 0.0001). There were no consistent or large differences found between the different group indicators although G13 and G21 appeared to be marginally better. Sensitivity and specificity values in the current study lay between DDS of 3 and 5, suggesting one of these as the best indication of (low) micronutrient adequacy. Conclusions: Overall results seem to indicate that any of the four G indicators can be used in dietary assessment studies on children, with G13 and G21 being marginally better. A cut-off DDS of 4 and 5, respectively, appear best.

In a cross-sectional study, body weight self-perceptions, preferences, and attitudes of 265 black South African adolescent females were determined. Many of these 10- to 19-year-old girls had unrealistic self-perceptions of their own weight. Overweight girls (43%) indicated having the self-image of someone with a small (

Introduction: To determine dietary intake of 19 to 64 years old urban Africans in Cape Town in 2009 and examine the changes between 1990 and 2009. Methods: A representative cross-sectional sample (n = 544), stratified by gender and age was randomly selected in 2009 from the same areas sampled in 1990. Socio-demographic data and a 24-h dietary recall were obtained by trained field workers. The associations of dietary data with an asset index and degree of urbanization were assessed. Results: Fat intakes were higher in 19–44-year-old men (32% energy (E)) and women (33.4%E) in 2009 compared with 1990 (men: 25.9%E, women: 27.0%E) while carbohydrate intakes were lower in 2009 (men 53.2%E, women: 55.5%E) than in 1990 (men: 61.3%E; women: 62%E) while sugar intake increased significantly (p < 0.01) in women. There were significant positive correlations between urbanization and total fat (p = 0.016), saturated fat (p = 0.001), monounsaturated fat (p = 0.002) and fat as a %E intake (p = 0.046). Urbanization was inversely associated with intake of carbohydrate %E (p < 0.001). Overall micronutrient intakes improved significantly compared with 1990. It should also be noted that energy and macronutrient intakes were all significant in a linear regression model using mean adequacy ratio (MAR) as a measure of dietary quality in 2009, as was duration of urbanization. Discussion: The higher fat and lower carbohydrate %E intakes in this population demonstrate a transition to a more urbanized diet over last two decades. These dietary changes reflect the nutrition transitions that typically occur as a longer time is spent in urban centers.

Aims: To determine and compare the extent of the nutrition transition between Kenyan and South African women. Methods: A nationally representative sample of women aged ≥15 years ( n=1008) was assessed in Kenya. Weight, height, and waist and hip circumferences were measured. A 24-hour dietary recall was conducted with each participant. This data was compared with data of the Demographic and Health Survey (DHS) of women in South Africa ( n=4481). Dietary intake of South African women was based on secondary data analysis of dietary studies using the 24-hour recall method ( n=1726). Results: In South Africa, 27.4% women had a BMI ≥30 kg/m2 compared with 14.2% of Kenyan women. In both countries there were large urban–rural differences in BMI, with the highest prevalence in women in urban areas. BMI increased with age, as did abdominal obesity which was equally prolific in both countries with more than 45% of women in the older groups having a waist/hip ratio ≥0.85. The nutrient mean adequacy ratio (MAR) of the South African rural diet was lower than those of the Kenyans diet (55.9; 57.3%, respectively). Dietary diversity score (DDS) and food variety score (FVS) were significantly lower in South African rural women (3.3; 4.9) compared with Kenyans (4.5; 6.8). Conclusions: Urban–rural differences in diet and weight status indicates that the nutrition transition was similar in both countries despite large sociodemographic differences; however, rural Kenyan women had a better MAR, DDS, and FVS than South African women, most probably due to 60% having access to land.

Background: The HealthKick (HK) study showed that educators (teachers) had a high prevalence of risk factors for the develop­ment of non-communicable diseases (NCDs). Little data are available on parents or other primary caregivers of learners from disadvan­taged schools.Aim: The aim of our study was to determine modifiable risk factors for the development of NCDs in a sample of caregivers of schools included in the HK intervention program.Participants: Caregivers of grade 4 children from 25 schools were invited to take part in the study and 175 participated. Caregivers were Black Africans and of mixed ethnic origin.Methods: Dietary intake was measured using a validated frequency questionnaire. Physical activity was measured by completing the Global Physical Activity Questionnaire (GPAQ). Caregivers described their smoking habits and alcohol usage. Weight and height were measured for each participant and body mass index (BMI) was calculated.Results: Eighty percent women and 50% men had a BMI ≥25 (overweight or obese). The most frequently consumed categories of foods were processed foods, energy-dense foods, and high-fat foods represent­ing unhealthy food choices. More than half of the total group (81.7%) and both males and females were meeting physical activity recommendations of 600 METs/week. Many caregivers, particularly men (53%), smoked cigarettes and reportedly consumed alcohol during the week and on weekends.Conclusion: Caregivers of children in the HK study population presented with a large number of modifiable health risk behaviors. These results highlight the importance of engaging caregivers, as part of a whole school intervention, to promote healthy eating and physical activity.Ethn Dis. 2018;28(2):93-98; doi:10.18865/ed.28.2.93

ObjectiveThe objectives of the present study were to (i) develop and validate a norm-referenced performance-rating scale to interpret a nutrition knowledge test developed for urban adolescents and (ii) develop a prototype for other researchers to follow when developing nutrition knowledge tests.DesignFor norm development the nutrition knowledge test (questionnaire) was administered to a sample representative of the questionnaire target group, referred to as the norm group. These included 512 adolescents in grades 8 (n158), 10 (n149) and 12 (n205) at three randomly selected schools in Soweto and Johannesburg. The performance scores (in percentages) obtained by the norm group were transformed toZ-scores which were categorised into stanines using establishedZ-score cut-off points. For validation purposes the questionnaire was completed by 148 volunteers: sixty university dietetics students, nineteen non-nutrition university students and sixty-nine primary-school teachers.ResultsAs required of an ideal norm group, theZ-scores formed a normal distribution (a bell-shaped curve). To facilitate interpretation of the results, theZ-score cut-off points for these categories were transformed back to performance scores (percentages) so that the performance of a testee could be interpreted directly from his/her performance in percentage. As is recommended, the nine stanine categories were reduced to five: very poor, fair/below average, good/average, very good/above average and excellent. The discriminatory validity of the norms was substantiated by showing that groups with known nutrition knowledge levels were rated appropriately and that the performance ratings of these groups differed significantly, with university dietetics students scoring 98·3 %, primary-school teachers 20·3 % and non-nutrition university students 31·6 %.ConclusionsThe norm-referenced performance-rating scale can be used with confidence to interpret the performance score achieved by a testee on the nutrition knowledge test developed for urban adolescents in South Africa. The methodology used in the study serves as a prototype for other researchers who are developing knowledge tests.

Background. Globally, in children the prevalence of overweight and obesity is increasing, and this is associated with an increased risk of non-communicable diseases in adulthood. There is a need to examine the growing trends of overweight and obesity in children and their consequences in low- and middle income countries.Objectives. To describe the prevalence of, and determine the relationship between, stunting and overweight among children in two provinces of South Africa.Methods. Secondary data analysis was conducted on anthropometric measurements of 36 - 119-month-old children from Gauteng and Mpumalanga provinces (N=519) participating in the South African National Food Consumption Survey – Fortification Baseline I (2005). The International Obesity Task Force (IOTF) body mass index (BMI) reference percentiles were used to determine overweight and obesity. The World Health Organization standards were used to derive z-scores.Results. The prevalence of overweight was 12.0% (IOTF BMI ≥25 kg/m2), including 3.7% obesity (IOTF BMI ≥30 kg/m2). The predominantly urban Gauteng Province had a significantly higher prevalence of overweight children (14.1%) compared with Mpumalanga (6.3%) (p=0.0277). The prevalence of stunting was 17.0% (16.5% Gauteng, 18.2% Mpumalanga; p>0.05). There was a significant correlation (r=−0.32) between BMI and height-for-age z-scores (p

Objective The objective of this study was to determine the relationship between added sugar and dietary "diversity, micronutrient intakes and anthropometric status in a nationally representative" "study of children, 1 8.9 years of age in South Africa." Methods "Secondary analysis of a national survey of children (weighted n = 2,200; non weighted n =" 2818) was undertaken. Validated 24–hour recalls of children were collected from mothers/ caregivers and stratified into quartiles of percentage energy from added sugar (% EAS). A "dietary diversity score (DDS) using 9 food groups, a food variety score (FVS) of individual" "food items, and a mean adequacy ratio (MAR) based on 11 micronutrients were calculated." The prevalence of stunting and overweight/obesity was also determined. Results "Added sugar intake varied from 7.5 10.3%of energy intake for rural and urban areas," respectively. Mean added sugar intake ranged from 1.0% of energy intake in Quartile 1 (1 3 years) (Q1) to 19.3% in Q4 (4 8 years). Main sources of added sugar were white sugar "(60.1%), cool drinks (squash type) (10.4%) and carbonated cool drinks (6.0%). Added" "sugar intake, correlated positively with most micronutrient intakes, DDS, FVS, and MAR." "Significant negative partial correlations, adjusted for energy intake, were found between" "added sugar intake and intakes of protein, fibre, thiamin, pantothenic acid, biotin, vitamin E," "calcium (1 3 years), phosphorus, iron (4 8 years), magnesium and zinc. The prevalence of" overweight/obesity was higher in children aged 4 8 years in Q4 of %EAS than in other quartiles [mean (95%CI) %prevalence overweight 23.0 (16.2 29.8)% in Q4 compared to 13.0 "(8.7 17.3)% in Q1, p = 0.0063]." Conclusion "Although DDS, FVS, MAR and micronutrient intakes were positively correlated with added" "sugar intakes, overall negative associations between micronutrients and added sugar" "intakes, adjusted for dietary energy, indicate micronutrient dilution. Overweight/obesity was" increased with higher added sugar intakes in the 4 8 year old children.

One serious concern of health policymakers in South Africa is the fact that there is no national data on the dietary intake of adult South Africans. The only national "dietary study was done in children in 1999. Hence, it becomes difficult to plan intervention" and strategies to combat malnutrition without national data on adults. The current review consequently assessed all dietary studies in adults from 2000 to June 2015 in an attempt to portray typical adult dietary intakes and to assess possible dietary deficiencies. Notable "findings were that, in South Africa micronutrient deficiencies are still highly prevalent and" energy intakes varied between very low intakes in informal settlements to very high intakes in "urban centers. The most commonly deficient food groups observed are fruit and vegetables," and dairy. This has been attributed to high prices and lack of availability of these food groups "in poorer urban areas and townships. In rural areas, access to healthy foods also remains a" problem. A national nutrition monitoring system is recommended in order to identify dietary deficiencies in specific population groups.

ObjectiveTo assess whether a food variety score (FVS) and/or a dietary diversity score (DDS) are good indicators of nutrient adequacy of the diet of South African children.MethodsSecondary data analyses were undertaken with nationally representative data of 1–8-year-old children (n = 2200) studied in the National Food Consumption Study in 1999. An average FVS (mean number of different food items consumed from all possible items eaten) and DDS (mean number of food groups out of nine possible groups) were calculated. A nutrient adequacy ratio (NAR) is the ratio of a subject's nutrient intake to the estimated average requirement calculated using the Food and Agriculture Organization/World Health Organization (2002) recommended nutrient intakes for children. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a percentage. MAR was used as a composite indicator for micronutrient adequacy. Pearson correlation coefficients between FVS, DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. The relationships between MAR and DDS and between anthropometric Z-scores and DDS were also evaluated.ResultsThe children had a mean FVS of 5.5 (standard deviation (SD) 2.5) and a mean DDS of 3.6 (SD 1.4). The mean MAR (ideal = 100%) was 50%, and was lowest (45%) in the 7–8-year-old group. The items with the highest frequency of consumption were from the cereal, roots and tuber group (99.6%), followed by the ‘other group’ (87.6%) comprising items such as tea, sugar, jam and sweets. The dairy group was consumed by 55.8%, meat group by 54.1%, fats by 38.9%, other vegetables by 30.8%, vitamin-A-rich by 23.8%, other fruit by 22%, legumes and nuts by 19.7% and eggs by 13.3%. There was a high correlation between MAR and both FVS (r = 0.726; P < 0.0001) and DDS (r = 0.657; P < 0.0001), indicating that either FVS or DDS can be used as an indicator of the micronutrient adequacy of the diet. Furthermore, MAR, DDS and FVS showed significant correlations with height-for-age and weight-for-age Z-scores, indicating a strong relationship between dietary diversity and indicators of child growth. A DDS of 4 and an FVS of 6 were shown to be the best indicators of MAR less than 50%, since they provided the best sensitivity and specificity.ConclusionEither FVS or DDS can be used as a simple and quick indicator of the micronutrient adequacy of the diet.

We investigated the food consumption patterns of adolescent students at schools. Our findings are intended to reveal the overall nutritional quality of foods eaten by students at school, including foods brought to school and foods purchased at school.A questionnaire was completed by 476 students, mostly from grades 7 and 10, from 14 schools in Cape Town, South Africa. The schools were representative of the various ethnic groups and socioeconomic strata of the population. The questionnaire requested information on eating habits at school, foods brought to school and food purchases, and breakfast consumption before school. We also tested whether students knew which foods are healthy and which are less healthy choices.The students were mostly 12 to 16 y of age (mean age 14.5 y). The large majority had breakfast before school (77.8%) and ate at school (79.7%). Food was brought to school by 41% to 56%, whereas 69.3% purchased food at school, mainly at the school store (tuck shop). Predefined "unhealthy" foods brought to school outnumbered "healthy" ones by 2 to 1. Among students who purchased food at school, 70.0% purchased no healthy items, whereas 73.2% purchased two or more unhealthy items. With six foods 84% of students correctly stated whether they were healthy or unhealthy; however, with cola drinks, samoosas (deep-fried pastry with spicy filling), and pies, only 47% to 61% knew that these were less healthy choices. Students' scores on this question were unrelated to whether they purchased healthy or unhealthy foods. Students who attended schools of high socioeconomic status were twice as likely to bring food to school (64.7% versus 31.0%, P0.001), scored higher marks on the quiz of healthy versus unhealthy foods (P0.01), but were no more likely to purchase healthy food.The large majority of food eaten by adolescent students in Cape Town is classified as being unhealthy choices. This applies to foods brought to school and food purchases. Consideration needs to be given to policy measures to improve this situation and to improve education of students and their parents.

Objective: The aim of this study was to determine which foods and beverages contribute most (≥ 5% of total) to energy, macronutrient and micronutrient intakes of South African children aged 12 - 108 months. It was also our intention to evaluate the dietary content according to the Food-Based Dietary Guidelines (FBDGs) (2001) for South Africans aged 7 years and older. Low energy and micronutrient intakes are widespread in South Africa and it is important to examine which foods are currently contributing to nutrient intake in order to make appropriate suggestions regarding dietary improvements.

ObjectiveThe aim of the National Food Consumption Survey (NFCS) in South Africa was to determine the nutrient intakes and anthropometric status of children (1–9 years old), as well as factors that influence their dietary intake.DesignThis was a cross-sectional survey of a nationally representative sample of all children aged 1–9 years in South Africa. A nationally representative sample with provincial representation was selected using 1996 Census information.SubjectsOf the 3120 children who were originally sampled data were obtained from 2894, a response rate of 93%.MethodsThe sociodemographic status of each household was assessed by a questionnaire. Dietary intake was assessed by means of a 24-hour recall and a food-frequency questionnaire from the caregivers of the children. Food purchasing practices were determined by means of a food procurement questionnaire. Hunger was assessed by a modified hunger scale questionnaire. Nutritional status was determined by means of anthropometric measurements: height, weight, head circumference and arm circumference.ResultsAt the national level, stunting (height-for-age below minus two standard deviations (< -2SD) from the reference median) was by far the most common nutritional disorder, affecting nearly one in five children. The children least affected (17%) were those living in urban areas. Even with regard to the latter, however, children living in informal urban areas were more severely affected (20%) compared with those living in formal urban areas (16%). A similar pattern emerged for the prevalence of underweight (weight-for-age < -2SD), with one in 10 children being affected at the national level. Furthermore, one in 10 (13%) and one in four (26%) children aged 1–3 years had an energy intake less than half and less than two-thirds of their daily energy needs, respectively. For South African children as a whole, the intakes of energy, calcium, iron, zinc, selenium, vitamins A, D, C and E, riboflavin, niacin, vitamin B6 and folic acid were below two-thirds of the Recommended Dietary Allowances. At the national level, data from the 24-hour recalls indicated that the most commonly consumed food items were maize, sugar, tea, whole milk and brown bread. For South African children overall, one in two households (52%) experienced hunger, one in four (23%) were at risk of hunger and only one in four households (25%) appeared food-secure.ConclusionThe NFCS indicated that a large majority of households were food-insecure and that energy deficit and micronutrient deficiencies were common, resulting in a high prevalence of stunting. These results were used as motivation for the introduction of mandatory fortification in South Africa.

ObjectiveTo develop a nutrition screening tool for use in older South Africans.DesignA cross-sectional validation study in 283 free-living and institutionalised black South Africans (60+ years).MethodsTrained fieldworkers administered a 24-hour recall and the Mini Nutritional Assessment (MNA) screening tool, and performed anthropometric measurements and physical function tests. Cognitive function was assessed using a validated version of the Six-Item Cognitive Impairment Test. Biochemical indicators assessed included serum albumin, haemoglobin, ferritin, vitamin B12, red-blood-cell folate, cholesterol and vitamin C. The MNA was used as the gold standard against which a novel screening tool was developed using a six-step systematic approach, namely: correspondence analysis; identification of key questions; determination of internal consistency; correlational analyses with objective measures; determination of reference cut-off values for categories of nutritional risk; and determination of sensitivity and specificity.ResultsThe new screening tool includes nine separate concepts, comprising a total of 14 questions, as well as measurement of mid-upper arm circumference. The new tool score was positively associated with level of independence in either basic activities of daily living (r= 0.472) or the more complex instrumental activities of daily living (r= 0.233). A three-category scoring system of nutritional risk was developed and shown to significantly characterise subjects according to physical function tests, level of independence and cognitive function. The new tool has good sensitivity (87.5%) and specificity (95.0%) compared with the MNA scoring system. It has a very high negative predictive value (99.5%), which means that the tool is unlikely to falsely classify subjects as well nourished/at risk when they are in fact malnourished.ConclusionA novel screening tool has been shown to have content-, construct- and criterion-related validity, and the individual items have been shown to have good internal consistency. Further validation of the tool in a new population of elderly Africans is warranted.

To determine any differences in the urinary excretion and dietary intake of sodium, potassium, magnesium and calcium intake in three South African ethnic groups, and to assess whether the blood pressure-cation association varies according to ethnic status.A cross-sectional study of 325 black, white and mixed-ancestry men and women, conveniently sampled in Cape Town. Twenty-four-hour urine samples were collected on three separate occasions for assessment of urinary electrolytes, and three 24-h dietary recalls for the corresponding urine collection times were administered by two trained fieldworkers. Para-amino benzoic acid was used as a marker of the completeness of urine collection.Mean urinary sodium values equate to a daily salt (sodium chloride) intake of 7.8, 8.5 and 9.5 g in black, mixed-ancestry and white individuals, respectively. In normotensive individuals, black and mixed-ancestry subjects had significantly lower median urinary sodium concentrations than white subjects, but these differences were not evident between black and white hypertensive subjects. No ethnic differences were found for urinary potassium, except for mixed-ancestry normotensive individuals having a lower excretion than white normotensive individuals. Urinary magnesium excretion did not differ across ethnic groups. In both normotensive and hypertensive individuals, urinary calcium concentrations differed between all three groups, with black subjects having the lowest values, approximately less than half those of white subjects.White normotensive subjects in Cape Town have higher habitual intakes of sodium, but also higher calcium intakes than their black and mixed-ancestry counterparts. Dietary differences may contribute to ethnic-related differences in blood pressure.

Objectives We wanted to develop a valid and reliable nutritional knowledge test for urban South African adolescents who were participating in the Birth-to-Twenty cohort study. The questionnaire was intended for use every second year, from ages 13 to 14 y until age 20 y. Methods The initial steps involved the development of a conceptual framework and identification of nutritional concepts in collaboration with nutritional experts, and this defined the construct of the questionnaire. The South African national teaching curriculum objectives for nutritional education and other relevant issues were selected as the desired concepts, and most items were phrased in accordance with the recently developed South African Food-Based Dietary Guidelines. Thereafter, 140 items (questions) were developed and in turn assessed by an expert panel, and the result was that only 88 items remained. This was done to ensure content and face validity of the items. The 88 items were constructed into a questionnaire and piloted for appropriateness and understanding by adolescents, ages 13 to 14 y, as a means of assessing face validity by non-experts. The edited preliminary questionnaire (still with 88 items) was administered to a nutrition expert group ( n = 71) versus a non-expert group ( n = 82), referred to as sample 1, for the purposes of performing item analysis and assessing construct validity of the questionnaire. The result of the analysis, a 63-item questionnaire, was administered to adolescents at three school grade levels, 8 ( n = 128), 10 ( n = 143), and 12 ( n = 98), referred to as sample 2, which was representative of the grades in which the Birth-to-Twenty group will be in when the questionnaire is administered. The questionnaire was administered to the sample to assess its content validity and internal consistency reliability. The final questionnaire had 60 items, and its construct, content, and internal consistency reliability were reassessed. Results The final 60-item questionnaire displayed a significant difference ( P < 0.0001) in the mean scores of the expert and non-expert groups tested. It had internal consistencies (Cronbach's α) of 0.71, 0.79, and 0.82 for grades 8, 10, and 12 respectively, and an overall value of 0.77 for all groups combined. However, it was less than 0.7 for most grade 8 pupils and for all grades at a historically disadvantaged school. Conclusion A nutritional knowledge questionnaire with construct, face, and content validities and internal consistency was developed for use in South African adolescents to evaluate their nutritional knowledge. Internal consistency was low in children at a disadvantaged school and those in grade 8 compared with multiracial groups at a multiracial school. It is recommended that pupils at disadvantaged schools be assisted by trained interviewers when taking the test.

The objective of this study was to examine dietary intake, weight status and nutrition knowledge of young black South African women in order to identify urban-rural differences. A group of 115 black female students attending a first-year pre-registration program at the University of the North participated in the study. A quantified food frequency questionnaire was used to gather data on each student's diet prior to entering the university. Height, weight, waist and hip measurements were taken, and body mass index (BMI) and waist-tohip ratio (WHR) were calculated for each participant. Each student also completed a nutrition knowledge test (NKT). Mean dietary intakes were generally comparable to the recommended dietary allowances (RDA), with the exception of calcium, zinc and iron, which were lower. Urban women consumed significantly more sugar (65.8 vs 52.2 g) and confectionery (290.4 vs 183.7 g), and significantly less legumes (6.3 vs 18.9 g), than did rural women. The prevalence of overweight (BM1 >= 25) was high in urban (22.7%) and rural (22.9%) women and WHR was significantly greater (P = 0.0003) in rural women (0.76) compared with urban ones (0.73). Nutrition knowledge test scores were poor (mean = 40.7%) and no urban-rural differences were found. There was a positive correlation between NKT and energy, protein, carbohydrate, fibre, calcium, zinc, thiamin, niacin, and folate intakes.

A group of 102 preschool children aged 13-69 months from a rural area of Lebowa were selected from a cross-sectional study of 659 children for an intervention trial (12 months) to study the effect of catfish (Clarias gariepinus) supplementation on their plasma phospholipid fatty acid status and growth. They were classified into undernourished and control groups according to their weight-for-age. The undernourished children (n = 52) received 43 g fish and 7.5 g sunflower cooking oil per day, whereas a matched (age and sex) well-nourished control group (n = 50) was not supplemented. At baseline, after 6 months and after 12 months of the study, anthropometry, haematology, blood biochemistry and plasma phospholipid fatty acid analyses were done. In the undernourished group, high baseline oleic acid (18:1 9) levels in plasma phosphatidylcholine (PC) were replaced by docosahexaenoic acid (22:6 3) with supplementation. In plasma PC, this reduction in 18:1 9 and increase in 22:6 3 was associated with significant increases in weight-for-age Z-scores, P = 0.0378 and P = 0.0415, respectively. The fish supplement and cooking oil that supplied additional 7% energy (7% E) and nutrients promoted growth of undernourished children, although this was inadequate for sustained growth during the second 6 months of intervention.

This study examined body shape dissatisfaction, eating disorder and weight management-related parameters as well as assimilation of Western cultural norms regarding body shape in black female students of urban and rural origins. Subjects (n=180; 20 ± 4,4 years old) were weighed, their height was measured and they completed the Body Shape Questionnaire, EAT-26, Eating Inventory (restraint scale), Adolescent Self-Concept Scale and a questionnaire concerning weight management behaviours. Main findings include lower prevalences of overestimation of body weight and body shape dissatisfaction, similar prevalences for dieting and the use of Hazardous weight reduction methods, and higher prevalences for overweight, obesity, disordered eating attitudes and behaviours, and dietary restraint among subjects than among similar white groups. Furthermore, those with urban origins were more likely to be restrained eaters, to have attempted weight reduction, to aim for weight loss and to fear weight gain. These data indicate that there are signs of more realism concerning weight status among black female students. However, there are also signs of assimilation of Western cultural norms concerning body shape, eating attitudes and behaviours and weight management. This diversity in the black student population in South Africa needs to be recognized when planning interventions to address eating related problems.

Background. Optimal nutrition during the first 1 000 days of life can reap lasting benefits throughout life. Objectives. To assess infant and young child-feeding (IYCF) practices and mother/caregiver-child anthropometry in two vulnerable Breede Valley communities, Western Cape. Methods. Mothers of children aged 0 - 23 months ( N =322) were interviewed to assess IYCF practices. Anthropometric measurements of mothers/caregivers and children were performed according to standard procedures. Results. Mothers reported early breastfeeding (BF) initiation in 75.2% (242/322) of cases. Of infants

ObjectiveThe 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.DesignHeights 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.SettingSouth Africa, representative sample based on census data.SubjectsChildren (n2157) and women (n2403).ResultsStunting 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-heightZ-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.ConclusionsThe 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.

Background Very little is known about street food and fast food consumption patterns in South Africa despite this being a large sector of the national economy in terms of employment provided and sales of food. The objective of this study was to determine the use of street foods and fast foods purchased by South Africans living in different provinces and geographic areas. Methods A cross-sectional survey was conducted. Structured interview-administered questionnaires in 11 official languages were conducted at the participants' homes. A nationally representative sample (n = 3287) was drawn from all ethnic groups, and provinces including participants 16 years and older. Logistic regression was done to evaluate factors impacting on fast food consumption. Results Frequent (2 ≥ times/week) street food consumption ranged from 1.8% in Northern Cape to 20.6% in Limpopo; frequent (2 ≥ times/week) fast food consumption ranged between 1.5% in North West Province to 14.7% in Gauteng. The highest intake of street food was in the medium socio-economic category (14.7%) while the highest intake of fast foods was in the high socio-economic category (13.2%). Overall, fruit was the most commonly purchased street food by all ethnic groups over the previous week although this practice was highest in black participants (35.8%). Purchases of soft drinks ranged from 4.8% in whites to 16.4% in blacks and savoury snacks from 2.3% to 14.5% in whites and blacks, respectively. Consumption of fast foods and street foods were influenced by a number of socio-demographic factors including ownership of major home appliances. Frequent fast food consumers had a significantly higher dietary diversity score (4.69; p < 0.0001) while frequent street food consumers had a significantly lower score (3.81; p < 0.0001). Conclusions A large percentage of the population purchase street foods and fast foods. This is of some concern when one notes the high prevalence of soft drink consumption in terms of its association with obesity and non-communicable diseases. These findings need to be taken into consideration when evaluating dietary patterns and nutritional adequacy of population diets.

Objective To evaluate the anthropometric status of children of obese (body mass index [BMI] ≥30 kg/m2) mothers who participated during the 2005 National Food Consumption Study. Methods The survey population consisted of children 1–9 y of age and their mothers 16 to 35 y of age living in the same households (n = 1532). A national sample of households was drawn, representative of all nine provinces and urban and rural areas. Trained fieldworkers measured the heights and weights of participants at their homes. Results The prevalence of obesity was high in the mothers (27.9%), particularly in the 26- to 35-y-old (older) group (32.3%) and in urban areas (29.1%). Children of older mothers had a significantly (P < 0.05) higher mean height-for-age Z-score (−0.91) than those of younger mothers (16 to 25 y old, −1.06). Mean weight-for-age and weight-for-height Z-scores were significantly higher in children of obese women compared with those of non-obese women (BMI

Aim: To assess the determinants of overweight and obesity in Kenyan women considered to be undergoing the nutrition transition. Methods: A nationally representative sample of women (n = 1008) was randomly drawn. Weight, height, waist, and hip circumference were measured. A 24-hour dietary recall was conducted with each participant and a socio-demographic questionnaire completed. Data was analysed by age, education, location, and socioeconomic status. Risk for obesity was calculated while adjusting for age and location. Results: Overweight and obesity (BMI ≥ 25 kg/m2) were highly prevalent in Kenya (43.3%). Urbanisation appears to be an important determinant of obesity since obesity was most prevalent in urban women in the high income group. Women in the high income group (7278 kJ) and in urban areas (7049 kJ) had the highest mean energy intakes. There were also significant urban/rural and income differences in the contribution of macronutrients to energy intake. Total fat intake was 34.5% of energy (E) in urban areas and 29.7% E in rural areas; while carbohydrates contributed 69.9% E in rural areas and 57.4% E in urban areas (p < 0.0001). Overweight was significantly more likely in the highest income group; among households where room density was low; electricity or gas was used for cooking; and households had own tap and/or own flush toilet. Conclusions: This study suggests that urbanisation and its associated economic advancement as well as changes in dietary habits are among the most important determinants of overweight and obesity in Kenyan women.

ObjectivesTo 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.DesignCross-sectional validation study in 324 conveniently sampled men and women.MethodsRepeated 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 consumption.ResultsPositive 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 −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 −1 was 12.4% and 93.9%, respectively.ConclusionA 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 sensitivity.

BackgroundA 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.ObjectivesThe 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.Study designSecondary 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.SubjectsThe combined database used in this study comprised 3229 adults.ResultsMean 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.ConclusionThe 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.

Background To determine the prevalence and associated risk factors of cardiovascular diseases in a rural adult black population from Limpopo Province in South Africa. Design A cross-sectional study. Methods A sample of 1608 women and 498 men aged 30 years and above participated in the study. Sociodemographic data, anthropometric measures (body mass index, waist/hip ratio), blood pressure and biochemical risk factors were measured. A global cardiovascular disease (CVD) risk profile was developed. Results There was a high prevalence of tobacco use for men (57%) and women (35.4%), with women (28.1%) predominantly using smokeless tobacco. Alcohol use was very common in men (57.2%). Women weighed a great deal more than men, and 51.7% were either overweight or obese. Diabetes was diagnosed in 8.8 and 8.5% of women and men, respectively. High-density lipoprotein-cholesterol was relatively high, whereas 42.3% of women and 28.5% of men had low-density lipoprotein-cholesterol levels of 3 mmol/l or more. Hypertension (blood pressure ≥ 140/90 mmHg) was found in 25.5% of women and 21.6% of men. According to the Framingham formulae, 18.9% of women and 32.1% of men had a 20% or higher chance of having a CVD event in the next 10 years. Conclusions There was a high prevalence of chronic disease risk factors in the rural, poor black community in Limpopo, South Africa. Consequently, the population had a higher than expected risk of developing a CVD event in the following 10 years when compared with similar studies in black Africans.

To investigate the association between added sugar and macronutrient and micronutrient intakes, and to assess whether added sugar intake is related to biochemical indices of nutritional status, Mini-Nutritional Assessment (MNA) score, body mass index (BMI) and performance on physical function tests.A cross-sectional, analytical study.Convenient sample of 285 institutionalised and community-dwelling black South African men and women aged 60+ y.An interviewer-administered 24-h dietary recall and MNA were performed. Serum albumin, vitamin B12, ferritin, cholesterol, haemoglobin, red blood cell (RBC) folate and plasma vitamin C were measured. Handgrip strength, BMI, 'sit-to-stand' and 'get-up-and-go' tests were measured. Outcome variables were analysed according to tertiles of added sugar, in grams and as a percentage of total energy (% E).In each tertile of sugar intake, mean MNA score fell in the 'at-risk' classification. In women, energy, protein, % E protein, fibre, thiamin, riboflavin, niacin, vitamin B6, folate, pantothenic acid, biotin, vitamin C, calcium, iron, magnesium, phosphorus, zinc, copper and selenium intake were significantly lowest in subjects in the highest % E sugar tertile. In men, no differences were found for micronutrient intake according to tertiles of total added sugar or % E added sugar. Physical function declined with increasing sugar intake, and suboptimal RBC folate and plasma ascorbic acid status was associated with increasing sugar intake (in women). No relationship was found between added sugar intake and the very high prevalence (65%) of obesity in women.A nutrient-diluting effect of added sugars intake was demonstrated in elderly black South African women. Further studies in this population are required in order to develop food-based dietary guidelines, which include messages on added sugar intake.

Objective We developed a questionnaire to evaluate dietitians' knowledge and practices about the use of dietary supplements in light of new draft regulations in South Africa that will allow dietitians to prescribe supplements for the management of nutrition-related diseases. Methods A cross-sectional validation study was carried out in two phases: 1) questionnaire planning and development and 2) determination of reliability (internal consistency). The study sample comprised 48 nurses, 105 dietetic interns, and 367 registered dietitians. An expert academic group comprising nine dietitians with research and teaching experience rated the academic relevance and importance of knowledge questions in an item pool of 355 questions to ensure face and content validity. Criterion validity was measured by testing the knowledge questions (KQs) on 48 nurses and 105 dietetic interns. Thereafter questions were deleted based on their difficulty, discrimination, and Cronbach's α values. The final questionnaire, which at this point included a test of 50 KQs, was mailed to registered dietitians ( n = 1450) in South Africa to determine internal consistency of the final KQs. Results Criterion validity of the KQs was indicated by a significant difference ( P = 0.000) in the mean test scores between nurses (36.9, 95% confidence interval 24.2 to 39.6) and dietetic interns (40.2, 95% confidence interval 38.8 to 41.7). Item discrimination was attained by the deletion of NQs having a minimum correlation of 0.20 with overall test score. Further, item difficulty was controlled for by removal of questions correctly answered by more than 80% (too easy) or fewer than 20% (too difficult). Internal consistency of the KQs, after completion by 367 dietitians, was 0.87 (Cronbach's α). The mean knowledge score of dietitians ranged from 56.5% to 62.5%, with the oldest group (≥40 y) having the highest score ( P = 0.018). Thirty-eight percent of dietitians recommended dietary supplements at least 3 times a week; 51% consumed dietary supplements themselves; and 17% sold them to clients. Conclusions A valid and reliable questionnaire that tests knowledge and practices of dietary supplements was developed for dietitians. This tool can be used by academic institutions to evaluate the knowledge and practices of final-year students. It can also be used on a representative sample of dietitians in South Africa and possibly elsewhere within the profession.

Objective There is an increase in the prevalence of overweight and obesity in children worldwide, including South Africa. We investigated the prevalences of overweight, obesity, and stunting in a current generation of children (ages 12 to 108 mo), which has a high prevalence of stunting, and evaluated the determinants of both nutritional disorders. Methods Secondary data analysis of the weight and height measurements of 12- to 108-mo-old children (weighted n=2200, non-weighted n=2894) during the 1999 National Food Consumption Survey in South Africa is reported. The body mass index reference percentiles recommended for use in children by the International Obesity Task Force were used to determine the prevalence of overweight and obesity, and the National Center for Health Statistics (NCHS) percentiles were used to determine the prevalence of stunting. Results Nationally, the prevalence of stunting (height-for-age ≤ −2 standard deviations, NCHS 50th percentile) in these children was 19.3% (95% confidence interval [CI] = 17.49 to 21.16) and was highest in 1- to 3-y-old children (24.4%) and in children of farm workers on commercial farms (25.6%). The prevalence of combined overweight and obesity (body mass index ≥ 25 kg/m 2 in 17.1%, 95% CI=15.00 to 19.23) at the national level was nearly as high as that for stunting. Further, the types of determinants for stunting and overweight were generally similar (although directionally opposite in degree of risk conferred) and included type of housing, type of toilet in the home, fuel used in cooking, presence of a refrigerator or stove, presence of a television in the house, educational level of the caregiver, and maternal education level. An example of the directionally opposite degree of risk is exemplified by the use of paraffin as a fuel being protective against being overweight (odds ratio = 0.78, 95% CI=0.63 to 0.97) but predictive of an increased risk for stunting (odds ratio=1.24, 95% CI=1.04 to 1.48). Stunting itself conferred an increased risk (odds ratio=1.80, 95% CI=1.48 to 2.20) of being overweight. Conclusion Certain defined determinants appear to play important roles in children's nutritional outcomes in relation to stunting and to overweight and obesity.

We investigated whether habitual intakes of sodium (Na), potassium, magnesium, and calcium differ across South African ethnic groups, assessed the proportion of Na intake, which is discretionary, and identified which food sources were the major contributors to Na intake.This was a cross-sectional study of 325 black, white, and mixed ancestry hypertensive and normotensive subjects. Three repeated 24-h urine samples were collected for assessment of urinary Na, and three corresponding 24-h dietary recalls were administered by trained fieldworkers. Blood pressure and weight were measured at each visit. Secondary analyses were performed on existing dietary databases obtained from four regional surveys undertaken in South African adults.Mean urinary Na excretion values equated to daily salt (NaCl) intakes of 7.8, 8.5, and 9.5 g in black, mixed ancestry, and white subjects, respectively (P0.05). Between 33% and 46% of total Na intake was discretionary, and, of the non-discretionary sources, bread was the single greatest contributor to Na intake in all groups. Ethnic differences in calcium intake were evident, with black subjects having particularly low intakes. Urban versus rural differences existed with respect to sources of dietary Na, with greater than 70% of total non-discretionary Na being provided by bread and cereals in rural black South Africans compared with 49% to 54% in urban dwellers.White South Africans have higher habitual intakes of Na, but also higher calcium intakes, than their black and mixed ancestry counterparts. All ethnic groups had Na intakes in excess of 6 g/d of salt, whereas potassium intakes in all groups were below the recommended level of 90 mM/d. Dietary differences may contribute to ethnically related differences in blood pressure.

To investigate factors associated with self-reported weight status of economically active adults from the 4 major ethnic groups in South Africa.Cross-sectional survey.South Africa.A random sample (N=2100) was selected from a database of economically active adults from the 4 major ethnic groups in South Africa (Black, White, Asian, and mixed ancestry). Of the 2100 selected, 554 subjects returned mailed questionnaires.Weight status (BMI), dieting history, meal patterns, intake of high fat food items and alcohol, level of physical activity, smoking habits, family history of obesity, and socioeconomic characteristics.Identified risk factors for overweight/obesity included: Black ethnicity, education levelor = Grade 7, inactivity, and at least one overweight parent. Protective factors included: describing one's own weight as under- or normal weight, hardly ever or never binging, not having tried to lose weight during the past year, and describing one's own health as excellent. Factors that were not related to overweight/obesity in this group included: employment status, income, smoking, meal patterns, intake of high fat food items and alcohol, and "sick" days taken off from work during the prior 6 months.