Dietary intake of adult women in South Africa and Nigeria with a focus on the use of spreads
Steyn, N P
Waudo, Judith N.
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This study examined nutrient intake, dietary habits, and the weight status of adult women in South Africa, Kenya, and Nigeria, with a focus on breakfast intake and the use of spreads on bread. Dietary intake from South African women was based on secondary data analysis of dietary studies which were already undertaken previously (n=992), and those from the National Food Consumption Survey and the South African Demographic and Health Study. A sample of 1008 women was randomly selected from all adult women in Kenya, as a representative sample of four districts. Data from Nigeria came from a national survey undertaken in 2003.a In all three studies, fieldworkers were trained to do personal interviews using specific questionnaires with each participant at their homes, namely a socio-demographic questionnaire, and a 24-hour recall questionnaire. Furthermore, each participant was weighed and waist and hip circumferences were measured. Reliability of the 24-hour recalls in Kenya were checked by means of repeated interviews on a sub-sample of 10% of the participants (n=104). Overall, South African women had an energy intake of 7239 kJ, carbohydrate intake of 244.5 g, protein intake of 61.6 g and a fat intake of 46.6 g while this was 6967 kJ, 231.1 g, 42.4 g and 62.3 g, respectively, in Kenyans. Generally, South African macronutrient and mineral intakes were higher than those of Kenyans were, with the exception of fat, saturated fat and iron intake. Fat intake as a percentage of total energy intake was greater in Kenya (33.1%) compared to that in South Africa (22.9%). Dietary data for South Africa showed that calcium, iron, folate, vitamin B6, and vitamin D were the most deficient in the diet. In Kenya, the most deficient nutrients were also calcium, vitamin B6, niacin, vitamin D, and folate; additionally niacin, thiamine and riboflavin intakes were low. In both countries, distinct significant urban-rural trends were noticed with regard to macronutrient and mineral intakes. Urban women had higher animal protein, fat, saturated fat, added sugar, cholesterol, sodium, selenium, potassium, and zinc intakes, while rural women had higher carbohydrate, plant protein, fibre and magnesium intakes. With regard to the vitamins in both countries, the intakes were generally higher in urban areas. 4 In South Africa the most commonly consumed foods were sugar, tea, maize porridge, brown bread, coffee, white bread, potatoes, hard (brick)b margarine and milk. In Kenya, these were tea, sugar, milk, cooking fat, maize porridge, kale, white bread, and hard margarine. In both countries, more than a third of the women had consumed hard margarine on the previous day. Cooking fat was only used by 6% of the South African women compared with 74% of the Kenyan women. This may have contributed to the higher fat and saturated fat intakes of Kenyan women. Dietary data indicate that in both countries the nutrition transition is underway. This is illustrated by the high prevalence of overweight and obesity and the urban and rural changes in the diet. The finding that more than 30% of energy intake comes from fat in Kenyan women is rather surprising, since traditionally, African diets are not high in fat. Furthermore, the fact that more than 10% of energy comes from saturated fat is not desirable. Both countries illustrate the worst of the developed and the developing world in that their diet is deficient in many micronutrients yet high in fat and saturated fats. However, this is an ideal opportunity to consider improving the fat and nutrient content of the margarines that are produced by Unilever Health Institute, since it can address the issues of over nutrition, under nutrition and micronutrient deficiencies. The most efficient ways to do this would be: 1) to improve the micronutrient content of margarine by adding vitamin B6, niacin, folate, riboflavin and thiamine to high/higher levels of the recommended intakes; 2) to reduce the total fat and saturated fat content of margarines, and to eliminate as much trans fats as possible; 3) to reduce the sodium intake of the margarines to maintain low salt intakes in Kenyan woman and to reduce levels in South African women, and; 4) to increase the omega-3 fat content of the margarines (if feasible). From a social responsibility point of view Unilever Health Institute could ensure that its advertising includes certain essential messages regarding its spreads: 1) the fact that it includes added micronutrients; a low (or zero) trans fat content; 2) has a reduced fat and saturated fat content; 3) has the added benefit of omega-3 fats, and; 4) can be used more liberally in the diets of children under age 5 years, while adults should not increase their levels above 30% of energy intake. These messages should also be used in brochures and other health promotion materials.