a1 Department of Human Nutrition, University of Stellenbosch and Tygerberg Academic Hospital, Tygerberg 7505, South Africa
a2 Chronic Diseases of Lifestyle Unit, Medical Research Council, Tygerberg, South Africa
a3 Department of Dietetics and Human Nutrition, University of Natal, Pietermaritzburg, South Africa
a4 Department of Paediatrics and Child Health, MEDUNSA, South Africa
a5 Division of Human Nutrition, University of Pretoria, South Africa
a6 Department of Human Ecology & Nutrition, University of the Western Cape, Cape Town, South Africa
a7 Nutrition & Dietetics Unit, University of Cape Town, South Africa
a8 Department of Human Nutrition, University of the Orange Free State, Bloemfontein, South Africa
a9 Nutrition Research Group, School for Physiology & Nutrition, University of Potchefstroom, South Africa
a10 Department of Hospitality Management, Tshwaye University of Technology, Pretoria, South Africa
a11 Department of Logistics, University of Stellenbosch, South Africa
Objective The 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.
Design This 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.
Subjects Of the 3120 children who were originally sampled data were obtained from 2894, a response rate of 93%.
Methods The 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.
Results At 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.
Conclusion The 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.
(Received May 15 2005)
(Accepted June 20 2005)