Nutritional status and dietary intake patterns of children aged 7-13 years in Qwa-Qwa

Abstract

Both under and over nutrition are prevalent among children in South Africa. At national level, children suffered from under nutrition. Childhood malnutrition starts early in life, the first two years being the most vulnerable period. Malnutrition is a public health problem in South Africa, especially in young children, requiring a systematic approach to improve nutrition services and promote behavior change. The objective of this cross-sectional study was to determine the nutritional status of the primary school children in Qwa-Qwa in South Africa. The study was carried out in two phases, namely Phase 1 (Planning) and Phase 2 (data collection and analysis of socio-demographics, 24-hour recall, a food frequency questionnaire, dietary diversity and anthropometric measurements). Weight and height were measured for 70 children (100% of the sample) and analysed according to the World Health Organization documents (WHO 2007) to determine nutritional status of the respondents. The data were captured on an Excel spreadsheet by the researcher and analysed for descriptive statistics such as frequencies, standard deviations and confidence intervals on the Statistical Package for Social Sciences (SPSS), version 18.0 program. A convenience sample of 70 primary school children aged 7-13 years, including girls (n=38) and boys (n=32) forming part of 105 purposively selected households were recruited for the study. The results showed that the majority of the households (80.4%) had been living in Qwa-Qwa for more than five years and lived in RDP brick houses (86.7%) with more than four rooms (56.3%). The monthly income of the households was less than R1000.00 in the majority of the households (73.9%) and 42.0% of the households spent < R100 on food per week which is calculated at R14.29 per day and R 2.86 per household member per day. The respondents consumed a mainly carbohydrate rich diet as 10 of the 20 most consumed food items were carbohydrates (mean daily intake) such as stiff maize meal porridge(195g), soft maize meal porridge (174g) , brown and white bread(122g), potato, cooked (66g), samp, cooked (187g), potato fries (85g), breakfast cereal (300g) and rice cooked (140g). Only three vegetables and fruit formed part of the Top 20 food items mostly consumed. It is showed that very small portion sizes of mostly the vegetables and fruit as well as the protein-rich food sources were consumed. The dietary intakes of the nutrients showed deficient intakes of all except, carbohydrate, iron, Vitamin K and B12. However, these nutrients showed an adequate intake, but there were still 38% of all respondents who did not consume 100% of the EAR for the CHO compared to 38%, 73%, 71% and 60% for Fe, vitamin A, vitamin B12 and K respectively. Vitamin C intakes were low which was consistent with only three vegetables and fruit which showed that children consumed small amounts of vegetables and fruit portions. The mean (±SD) Food Variety Score for all the food groups consumed from all the food groups in a period of seven days was 23.96 (±16.08). These results revealed poor dietary diversity. Cereal was the food group with the highest mean food variety score in this study population. The mean ±SD FVS of 23.96 (±16.08) revealed poor dietary diversity in the children despite the relatively high food variety (88 individual foods consumed in seven days). More boys (28.5%) were underweight (<-2SD) compared to fewer girls (17.4%). There is thus acute malnutrition in this group of the children which is consisted with the insufficient food intakes reflected by the 24-hour recall and dietary diversity measurements. Stunting was prevalent in 21.1% and 18.7% of the girls and boys respectively, with 4.3% of all the children being severely stunted (<-3SD). This indicates chronic malnutrition and or the presence of infections over a long period leading to failure of linear growth. None of the boys and girls were overweight or obese, whilst (71.8 %) of boys and (81.5%) of girls were of normal weight. It can be concluded that poverty, household food insecurity and poor dietary intakes and diversity resulted in poor nutritional status of the children in this community. The high prevalence of inadequate nutrient intakes and poor nutritional status (under-nutrition) amongst the children in this study, demonstrates the need for effective sustainable food and nutrition interventions aimed at improving dietary intake and diversity as well as the poor nutritional status.