Table 6 - uploaded by Johanna Helena Nel
Content may be subject to copyright.
Comprehensive table of GEMS/Food main food groups consumed by children* and adults † in South Africa
Source publication
The primary objective of this study was to generate a reference table of food items and average amounts of these items consumed by South Africans, for the Department of Health. The reference table was required to be representative of foods and beverages eaten frequently by children and adults from all age and ethnic groups in order for the Departme...
Context in source publication
Context 1
... in each province 40 as follows: Method 1 results corresponded with results from the NFCS, which was over-sampled for lower socio-economic areas 6 , whereas the results from Method 2 ignored relationships with NFCS data and was based on the ethnic proportions of the population in South Africa. Summaries of the methods used in the 'weighting' process are shown in Table 5. Table 6 provides a comprehensive table of the GEMS/ Food main food groups for all South Africans. The percentages of the age groups consuming the GEMS/Food groups were similar throughout. ...
Similar publications
The content of cadmium, lead, nickel, mercury and selenium in 83 foods was monitored from 1993 to 1997. In comparison with similar results from 1988 to 1992, a general decrease in lead levels had occurred, whereas the contents of cadmium, nickel, mercury and selenium were stable or declined only slightly. The distribution in dietary intake of the f...
Citations
... The latter may inconsistently rank individuals as consumers or non-consumers of plant foods because it is subject to day-to-day variation. The rationale for utilising a 24-h recall to assess plant foods consumption is based on the homogenous diet of the sampled population [23], having low purchasing power to consume a variety of food groups or drastically deviate from their day-to-day meals [24]. Therefore, based on evidence from previous studies in our setting, i.e., the assumption that the diet of our sampled population remains fairly stable will minimize inconsistently ranking individuals as plant food consumers. ...
We assessed the distribution and association of cardiovascular disease (CVD) risk factors by plant foods consumption in individuals at high-risk for type 2 diabetes mellitus. This cross-sectional study utilized baseline data of 693 participants in the South African Diabetes Prevention Programme. Participants underwent a physical examination, biochemical analysis, and dietary assessment using a single non-quantified 24-h recall. Group comparisons were conducted to explore the distribution and associations of common CVD risk factors by plant foods consumption. The mean age of the participants was 51 years, with 81% being females. Consumers of yellow-coloured vitamin A-rich vegetables and tubers and maize had significantly lower systolic blood pressure, fasting insulin, low-density lipoprotein cholesterol, triglycerides, and fibrinogen levels. Cereals consumption increased the likelihood of obesity (OR = 1.72 95% CI [1.09, 2.70] p = 0.019) while the consumption of white roots and tubers decreased the likelihood of obesity (AOR = 0.64 95% CI [0.41, 1.00] p = 0.048). This study reported the consumption of some healthy plant foods with lower levels of, and decreased risk for, some CVD risk factors. A further in-depth investigation is needed to understand these associations.
... We used published results of a pooled analysis of multiple dietary databases obtained from surveys undertaken in SA between 1983 and 2000 to characterise the distribution of mean daily intake of fruit and vegetables for the year 2000. [52] We used microdata from the World Health Survey 2003 (WHS 2003) and from the South African National Health and Nutrition Examination Survey 2012 (SANHANES-1) to characterise the distribution for the years 2006 and 2012, respectively. [53,54] From WHS 2003 and SANHANES-1 microdata we calculated individual intake from responses to the relevant items included in the survey questionnaires and estimated means and standard deviations (SDs) of the population distributions by sex and 10-year age groups with standard methods (weighted averages with robust standard error). ...
Background:
Low intake of fruit and vegetables is associated with an increased risk of various non-communicable diseases, including major causes of death and disability such as cardiovascular disease, diabetes mellitus and cancers. Diets low in fruit and vegetables are prevalent in the South African (SA) population, and average intake is well below the internationally recommended threshold.
Objectives:
To estimate the burden of disease attributable to a diet low in fruit and vegetables by sex and age group in SA for the years 2000, 2006 and 2012.
Methods:
We followed World Health Organization and Global Burden of Disease Study comparative risk assessment methodology. Population attributable fractions - calculated from fruit and vegetable intake estimated from national and local surveys and relative risks for health outcomes based on the current literature - were applied to the burden estimates from the second South African National Burden of Disease Study (SANBD2). Outcome measures included deaths and disability-adjusted life years (DALYs) lost from ischaemic heart disease, stroke, type 2 diabetes, and five categories of cancers.
Results:
Between 2000 and 2012, the average intake of fruit of the SA adult population (≥25 years) declined by 7%, from 48.5 g/d (95% uncertainty interval (UI) 46.6 - 50.5) to 45.2 g/d (95% UI 42.7 - 47.6). Vegetable intake declined by 25%, from 146.9 g/d (95% UI 142.3 - 151.8) to 110.5 g/d (95% UI 105.9 - 115.0). In 2012, these consumption patterns are estimated to have caused 26 423 deaths (95% UI 24 368 - 28 006), amounting to 5.0% (95% UI 4.6 - 5.3%) of all deaths in SA, and the loss of 514 823 (95% UI 473 508 - 544 803) healthy life years or 2.5% (95% UI 2.3 - 2.6%) of all DALYs. Cardiovascular disease comprised the largest proportion of the attributable burden, with 83% of deaths and 84% of DALYs. Age-standardised death rates were higher for males (145.1 deaths per 100 000; 95% UI 127.9 - 156.2) than for females (108.0 deaths per 100 000; 95% UI 96.2 - 118.1); in both sexes, rates were lower than those observed in 2000 (-9% and -12%, respectively).
Conclusion:
Despite the overall reduction in standardised death rates observed since 2000, the absolute burden of disease attributable to inadequate intake of fruit and vegetables in SA remains of significant concern. Effective interventions supported by legislation and policy are needed to reverse the declining trends in consumption observed in most age categories and to curb the associated burden.
... These shops do not sell a variety of food items; making it worse, the food items are sold at exorbitant prices [76]. Many rural households purchase starchy foods such as maize meal; these foods are cheaper when bought in bulk [77,78]. A review conducted by Schönfeldt and Hall (2012) [74] shows that plant-based, shelf-stable, starchy staples are a predominant part of the diet in disadvantaged communities. ...
... The food frequency results indicated that onion, phutu, brown bread, tomato, rice, apple, eggs, and chicken were the most commonly consumed food items. This was similar to studies conducted in SA, which documented that mealie meal, white sugar, tea, brown bread, non-dairy creamer, brick margarine, chicken meat, full cream milk and dark green leafy vegetables were frequently consumed [8,78]. Similarly, another study conducted in KZN by Faber et al. (2013) found that sugar, maize meal porridge, bread, rice, cordial squash, hard margarine, tea, and legumes were the most commonly consumed food items. ...
Under- and over-nutrition co-exist as the double burden of malnutrition that poses a public health concern in countries of the developing regions, including South Africa (SA). Vulnerable groups such as pregnant women and children under five years are the most affected by malnutrition, especially in rural areas. Major contributing factors of malnutrition include food and nutrition insecurity, poverty, and unhealthy lifestyles. The current study aimed to assess the nutritional status, using selected anthropometric indices and dietary intake methods (repeated 24 h recall and food frequency), of four rural communities in KwaZulu-Natal (SA). Purposive sampling generated a sample of 50 households each in three rural areas: Swayimane, Tugela Ferry, and Umbumbulu and 21 households at Fountain Hill Estate. The Estimated Average Requirement cut-point method was used to assess the prevalence of inadequate nutrient intake. Stunting (30.8%; n = 12) and overweight (15.4%; n = 6) were prevalent in children under five years, whilst obesity was highly prevalent among adult females (39.1%; n = 81), especially those aged 16–35 years. There was a high intake of carbohydrates and a low intake of fibre and micronutrients, including vitamin A, thus, confirming the need for a food-based approach to address malnutrition and micronutrient deficiencies, particularly vitamin A deficiency.
... To determine the purpose and target population, we reviewed relevant population level data [35][36][37][38][39][40][41] and the policy context to identify the key nutritional problems faced by the SA population. We researched existing literature to identify the target population, their disease burden and dietary intake patterns to select the most appropriate NPM. ...
... High food prices and limited availability of nutrient-dense foods in townships and poorer urban centers are thought to be contributing factors [37]. A predominantly carbohydrate-based diet with low nutrient density is common in SA [38][39][40][41]. ...
South Africa (SA) is facing a rising prevalence of obesity and diet-related chronic diseases. The government is seeking to develop effective, evidence-based policy measures to address this. A well-designed, fit-for-purpose nutrient profiling model (NPM) can aid policy development. The aim of this study was to develop a fit-for-purpose NPM in SA. Steps included: (1) determining the purpose and target population; (2) selecting appropriate nutrients and other food components to include; (3) selecting a suitable NPM type, criteria and base; and (4) selecting appropriate numbers and thresholds. As part of the evaluation, the nutritional composition of packaged foods containing nutritional information (n = 6747) in the SA food supply chain was analyzed, a literature review was undertaken and various NPMs were evaluated. Our findings indicated that it is most appropriate to adapt an NPM and underpin regulation with a restrictive NPM that limits unhealthy food components. The Chile 2019 NPM was identified as suitable to adapt, and total sugar, saturated fat, sodium and non-sugar sweetener were identified as appropriate to restrict. This NPM has the potential to underpin restrictive policies, such as front-of-package labelling and child-directed marketing regulations in SA. These policies will support the fight against obesity and NCDs in the country.
... tries, including South Africa. [10][11][12][13][14] Over the past several decades, with the increase in corporations in South Africa that produce sugary drinks, there has been growth in sales and consumption of sugar-sweetened beverages, and these a close parallel with rising obesity rates. 15 Consumption of sugary beverages increased by almost 70% between 1999 and 2012. ...
Obesity is a major and growing public health challenge in South Africa. On April 1, 2018, South Africa became the first African country to introduce a tax on sugary beverages. The 11% tax was intended to reduce consumption of sugary drinks, which contribute to the country’s rising rates of obesity and related noncommunicable diseases (NCDs). Before the tax was passed, Vital Strategies and a coalition of local civil society groups launched an extensive public communication and advocacy campaign, based on evidence that such campaigns can help to build widespread political and public support for a proposed policy.
This case study describes how a variety of factors led to introduction of the tax, described in legislation as the Health Promotion Levy. In particular, how strategic advocacy and communication, informed by local context and local and international evidence and experience, helped to secure political and public support for the tax. Lessons learned from this campaign can inform other countries’ communication and advocacy efforts aimed at policies to address the global obesity epidemic.
... Average total cooked maize intakes in grams per day (g/day) for the 1-5 and 6-9 year old groups, were obtained from the secondary data analysis of various South African dietary surveys and were reported as 364.3 and 392.9 g/day, respectively (Steyn et al., 2003). The average dry maize intake for South African adults (157.0 g/day) was calculated using data obtained from a national maize consumption survey among 2809 adults . ...
... g/day) and 6-9 years (392.9 g/day) (Steyn et al., 2003) were used to calculate the respective dry weight intakes, using the recipe for soft maize meal porridge to correct for ingredients . ## Mean dry maize intake of adult South African maize consumers (numerical mean of 157.0 g/day; n = 2809) . ...
Fumonisin esterase FumD (EC 3.1.1.87), FUMzyme® (BIOMIN, Austria), effectively detoxifies fumonisin B my-cotoxins (FB) by hydrolysis and removal of the tricarballylic acid groups. The current study evaluated FumD detoxification of total FB (FBT) in commercial maize utilising an experimental dry milling plant by introducing the enzyme during the kernel conditioning stage. Total FB and the hydrolysed product of FB1, HFB1, in maize and milling products were determined by LC-MS/MS. During maize conditioning of 4 h 10 min substantial FB1 hy-drolysis was achieved between 1 and 4 U FumD/100 g maize. Complete conversion into HFB1 was delayed and only achieved at the highest enzyme concentration (32 U/100 g maize) reaching a 1:1 M conversion ratio. Dry milling of maize containing 3.29 ±0.20 μmole FBT/kg (2354 ±140 μg/kg) in the absence of FumD, resulted in a 2.5-fold increase in the FBT concentration in total hominy feed (8.34 ±0.22 μmol/kg) (5979 ±158 μg/kg) compared to the levels that prevail in Super (0.52 ±0.07 μmol/kg) (347 ±48 μg/kg) and Special (1.70 ±0.01 μmol/kg) (1213 ±8 μg/kg) maize meal, and Semolina (1.07 ±0.14 μmol/kg) (765 ±100 μg/kg) milling products. Introduction of FumD (40 U/kg) mainly impacted the total hominy feed product (germ +hominy milling fractions), constituting up to 30% of the reconstituted whole maize. A 99% reduction in FBT was obtained in total hominy feed, 48% in Semolina, 7% in Special maize meal, whereas no reduction was recorded in Super maize meal. FB1 reduction rates depend on the contamination level, kernel moisture and the diffusion rate from inner kernel layers to the kernel surface/aqueous interface. Risk modelling in children and adults indicated that FumD-treated whole maize and the resultant Semolina milling product intended for human consumption reduces the risk of exposure to FBT. However, no reduction in the exposure risk was observed when considering the Super and Special maize meal milling products. FB reduction in total hominy feed could open up new applications, such as its dietary incorporation as a source of fibre, minerals and bioactive plant constituents in maize-based food. In addition, the animal feed industry and subsistence maize farming communities using rudimentary milling pro-cesses, could also benefit. 1. Introduction Maize is an important staple food commodity in southern Africa and frequently contaminated with unacceptable levels of the fumonisin B (FB) mycotoxins, specifically in certain subsistence farming commu-nities where regulations are either lacking or not enforced (Alberts, Rheeder, et al., 2019; Alberts, Schatzmayr, et al., 2019). Although commercial maize is contaminated with lower levels, high consumption levels could be a risk factor for disease development in impoverished communities (Burger et al., 2010; Tshalibe et al., 2020). Milling of maize is a physical process regarded as the first step in the production of maize-based products by removing the outer structures, * Corresponding author. E-mail addresses: albertsh@cput.ac.za (J.F. Alberts), 3343572@myuwc.ac.za (I. Davids), dieter.moll@biomin.net (W.-D. Moll), gerd.schatzmayr@biomin.net (G. Schatzmayr), burgerh@cput.ac.za (H.-M. Burger), gshephard@mweb.co.za (G.S. Shephard), gelderblom@sun.ac.za (W.C.A. Gelderblom).
Contents lists available at ScienceDirect Food Control journal homepage: www.elsevier.com/locate/foodcont https://doi.org/10.1016/j.foodcont.2020.107726 Received 25 August 2020; Received in revised form 16 October 2020; Accepted 24 October 2020
Share link: https://authors.elsevier.com/a/1c5vS3PY0vXvZt
... Average total cooked maize intakes in grams per day (g/day) for the 1-5 and 6-9 year old groups, were obtained from the secondary data analysis of various South African dietary surveys and were reported as 364.3 and 392.9 g/day, respectively (Steyn et al., 2003). The average dry maize intake for South African adults (157.0 g/day) was calculated using data obtained from a national maize consumption survey among 2809 adults . ...
... g/day) and 6-9 years (392.9 g/day) (Steyn et al., 2003) were used to calculate the respective dry weight intakes, using the recipe for soft maize meal porridge to correct for ingredients . ## Mean dry maize intake of adult South African maize consumers (numerical mean of 157.0 g/day; n = 2809) . ...
Fumonisin esterase FumD (EC 3.1.1.87), FUMzyme® (BIOMIN, Austria), effectively detoxifies fumonisin B mycotoxins (FB) by hydrolysis and removal of the tricarballylic acid groups. The current study evaluated FumD detoxification of total FB (FBT) in commercial maize utilising an experimental dry milling plant by introducing the enzyme during the kernel conditioning stage. Total FB and the hydrolysed product of FB1, HFB1, in maize and milling products were determined by LC-MS/MS. During maize conditioning of 4 h 10 min substantial FB1 hydrolysis was achieved between 1 and 4 U FumD/100 g maize. Complete conversion into HFB1 was delayed and only achieved at the highest enzyme concentration (32 U/100 g maize) reaching a 1:1 M conversion ratio. Dry milling of maize containing 3.29 ± 0.20 μmole FBT/kg (2354 ± 140 μg/kg) in the absence of FumD, resulted in a 2.5-fold increase in the FBT concentration in total hominy feed (8.34 ± 0.22 μmol/kg) (5979 ± 158 μg/kg) compared to the levels that prevail in Super (0.52 ± 0.07 μmol/kg) (347 ± 48 μg/kg) and Special (1.70 ± 0.01 μmol/kg) (1213 ± 8 μg/kg) maize meal, and Semolina (1.07 ± 0.14 μmol/kg) (765 ± 100 μg/kg) milling products. Introduction of FumD (40 U/kg) mainly impacted the total hominy feed product (germ + hominy milling fractions), constituting up to 30% of the reconstituted whole maize. A 99% reduction in FBT was obtained in total hominy feed, 48% in Semolina, 7% in Special maize meal, whereas no reduction was recorded in Super maize meal. FB1 reduction rates depend on the contamination level, kernel moisture and the diffusion rate from inner kernel layers to the kernel surface/aqueous interface. Risk modelling in children and adults indicated that FumD-treated whole maize and the resultant Semolina milling product intended for human consumption reduces the risk of exposure to FBT. However, no reduction in the exposure risk was observed when considering the Super and Special maize meal milling products. FB reduction in total hominy feed could open up new applications, such as its dietary incorporation as a source of fibre, minerals and bioactive plant constituents in maize-based food. In addition, the animal feed industry and subsistence maize farming communities using rudimentary milling processes, could also benefit.
... Though some papers included in this review collected data during the dry season, 106,109,124,136 others captured data during the peak season or throughout the year. 100,101,104,128 This makes consumption estimates in this review reflective of consumption estimates throughout the year. ...
Context:
The dietary choices people make affect personal health and have consequences for the environment, both of which have serious implications for the 2030 Sustainable Development Agenda. In global reviews, the literature on meat, fruit, and vegetable consumption in sub-Saharan Africa (SSA) is limited.
Objective:
This systematic review set out to quantify meat, fruit, and vegetable consumption in SSA populations and to answer the following question: How much meat, fruit, and/or vegetables are being consumed daily by which individuals in SSA over the years?
Data sources:
Following the PRISMA guidelines, the authors systematically searched the MEDLINE, EMBASE, ASSIA CINAHL, Web of Science, POPLINE, and Google Scholar databases to identify 47 (out of 5922 search results) studies reporting meat, fruit, and/or vegetable consumption in SSA populations.
Data extraction:
Three independent investigators extracted data on year of data collection, study country, study population and geographical context, and population intake of meat, fruit, and/or vegetables.
Data analysis:
Using STATA SE version 15 software, random-effects meta-regression analyses were used to test the effect of year of data collection and method of data collection on population meat, fruit, and vegetable consumption. The analyses also tested any association between age, sex, rural/urban residence, or a country's economic development and population intake of meat, fruits, and/or vegetables. The review was started in 2017 and completed in 2019.
Results:
Richer SSA countries were likely to consume more meat (ß = 36.76, P = 0.04) and vegetables (ß =43.49, P = 0.00) than poorer countries. Vegetable intake has increased dramatically over the last 3 decades from ≈10 g to ≈110 g (ß = 4.43, P = 0.00). Vegetable (ß= -25.48, P = 0.00) consumption was higher in rural than in urban residents. Although the trend of meat consumption has risen (≈25 g to ≈75 g), the trend is nonsignificant (ß = 0.63, N.S.). Daily average per capita meat consumption was 98 g - above the 70 g recommendation - while fruit and vegetable intake (268 g) remain below the World Health Organization's recommendation (400 g).
Conclusions:
Given the low intake of plant-based foods, it is likely that SSA populations may be deficient in high-quality protein and micronutrients as suggested by the EAT-Lancet Commission. There is a need to promote both an adequate supply and demand of plant-based protein and micronutrients, including fruit, vegetables, nuts, seeds, and legumes, in SSA countries. While dietary changes in SSA may offer large absolute benefits, consideration of the magnitude of dietary change, particularly increasing or reducing meat consumption, will need to occur in a way that ensures that policy and interventions support the reduction of undernutrition and micronutrient deficiencies without worsening the prevalence and environmental impacts of noncommunicable diseases. There is also the need for preventive action that ensures that SSA populations do not increase their meat consumption as disposable incomes increase and countries' economic development rises, as is seen in most countries undergoing economic transformation.
Systematic review registration:
PROSPERO registration no. CRD42018090497.
... The Codex Alimentarius Commission (CAC) has set MLs in whole maize and maize meal at 4 and 2 mg/kg, respectively, which were recently adopted by the South African National Department of Health [35]. These ML's are not sufficient to protect rural subsistent maize farming communities against the adverse effects of the fumonisins as the maize consumption profiles resulted in probable daily intake (PDI) levels far above the PMTDI [36][37][38]. To safeguard these rural subsistent farming communities, studies are focusing on reduction of FB in food utilising different chemical and biological reduction and/or decontamination approaches. ...
Maize is a staple crop in rural subsistence regions of southern Africa, is mainly produced for direct household consumption and is often contaminated with high levels of mycotoxins. Chronic exposure to mycotoxins is a risk factor for human diseases as it is implicated in the development of cancer, neural tube defects as well as stunting in children. Although authorities may set maximum levels, these regulations are not effective in subsistence farming communities. As maize is consumed in large quantities, exposure to mycotoxins will surpass safe levels even where the contamination levels are below the regulated maximum levels. It is clear that the lowering of exposure in these communities requires an integrated approach. Detailed understanding of agricultural practices, mycotoxin occurrence, climate change/weather patterns, human exposure and risk are warranted to guide adequate intervention programmes. Risk communication and creating awareness in affected communities are also critical. A range of biologically based products for control of mycotoxigenic fungi and mycotoxins in maize have been developed and commercialised. Application of these methods is limited due to a lack of infrastructure and resources. Other challenges regarding integration and sustainability of technological and community-based mycotoxin reduction strategies include (i) food security, and (ii) the traditional use of mouldy maize.
... where C i is the average measured pesticide concentration (mg kg −1 ww), IR is the estimated daily ingestion rate (kg d −1 ) and BW is the hypothetical average body weight (kg) set at 60 kg for adults (World Health Organisation 2012). A daily ingestion rate of 0.17 kg d −1 (spinach and lettuce), 0.031 kg d −1 (onion) and 0.028 kg d −1 (peanut) per person was used based on local food consumption data (Steyn et al. 2003). OCP tissue concentration data previously obtained from two fish species (Oreochromis mossambicus, Mozambique tilapia, and Clarias gariepinus, African sharptooth catfish) commonly consumed by local residents (Buah-Kwofie et al. 2018b) were incorporated into the risk assessment. ...
Dietary intake of contaminated food is a major route of human exposure to organochlorine pesticides (OCPs). Despite the prevalence of OCP usage in southern Africa for several decades, their impact on socioeconomically vulnerable communities remains largely overlooked. We investigated the accumulation of OCPs in crops commonly cultivated by rural communities surrounding iSimangaliso Wetland Park, South Africa. All samples analysed were found to be contaminated, with total OCP concentrations ranging between 190 and 240 ng g⁻¹ ww. Elevated levels of OCP residues were detected in all products, with the majority of samples exceeding European Commission’s maximum residue limits (MRLs). We combine these results with local OCP fish tissue estimates to assess potential dietary risks. Cumulative risk assessment indicated potential non-cancer risks associated with heptachlor epoxide, while a cancer risk as high as 1 in 10 was found to be associated with aldrin and dieldrin. This far exceeds USEPA guidelines and indicates that OCP residues in crops and fish from the study area pose a high risk to human health. The results of this study call for further attention to be given to the health implications of continued OCP use not only within the study area but also in Southern Africa in general.
