Impact of food aid on food variety and dietary diversity of an elderly community in Sharpeville, South Africa.

OBJECTIVE: The objective of this paper was to discuss the impact of a two-year food aid intervention programme on dietary diversity and adequacy of an elderly community. This project was undertaken amongst the elderly (n=300), voluntarily attending a day care centre in Sharpeville, South Africa. In a baseline study (2004) in this community the dietary diversity scoring (DDS) method revealed low dietary diversity (3.41) and food variety (4.77) scores (FVS), and a trend that higher scores resulted in a better mean nutrient adequacy ratio. An intervention study, implemented in 2005, aimed to improve the dietary diversity of this elderly community by providing breakfast and lunch five days a week at the care centre. The impact of this food aid was investigated by comparing the DDS, FVS and nutrient adequacy ratios (NAR) before and after the intervention. METHODS: The methods included socio-demographic, health, food frequency questionnaire (FFQ), 24 hour-recall (24h-recall), anthropometric and biochemical measurements in 107 elderly people who regularly attended the care centre since 2004. RESULTS: At baseline, the majority of respondents (n=82, 55.1%) were classified with low DDS utilizing 0-3 food groups compared to after the intervention, where 98.1% (n=105) was classified with a high dietary diversity utilizing all nine nutritious food groups. The mean individual DDS of 3.41 that improved to 8.5 after the intervention further supported this. The mean adequacy ratio (MAR) showed a statistically significant improvement from baseline (0.77 +/- 0.48) to 1.02 +/- 0.66 after the intervention, indicating improvement of the adequacy of the overall diet to meet the daily requirements for this elderly community. CONCLUSIONS: The results of this study represent the first demonstration that food aid proved to be an effective short term nutrition intervention that improved the level of dietary diversity. Other food-based approaches or nutrition education activities should be implemented simultaneously to improve self-sufficiency in such a community for long-term effectiveness in terms of nutrient inadequacy and dietary diversity.

Zinc deficiency among the elderly attending a care centre in Sharpeville, South Africa.

BACKGROUND: The elderly are particularly prone to zinc deficiency because of nutritional and physiological vulnerabilities associated with ageing. A low socio-economic status may further increase the risk of zinc deficiency. This cross-sectional descriptive study assessed the zinc status of an elderly sample in the Vaal region, South Africa. METHODS: The participants were 170 randomly selected elderly people attending a day care centre in Sharpeville. Twenty-four-hour recalls were administered for dietary intake. Weight and height were measured and venous blood samples (n = 67) were drawn to determine biochemical indices. RESULTS: The mean age of the respondents was 71.7 years. The mean +/- SD daily dietary intake for zinc was 11.0 +/- 6.12 mg. Approximately half of the subjects (51.5%) did not reach two-thirds of the recommended dietary allowance for zinc. The mean serum zinc concentration was 61.8 +/- 8.5 microg dL(-1) (9.4 +/- 1.3 micromol L(-1)), with 76.3% of the subjects having zinc values less than the recommended values of 70 microg dL(-1) (10.7 micromol L(-1)). Maize meal was the staple in the diet of approximately half the study population. Although South African maize meal is now fortified with zinc oxide, maize also contains high concentrations of phytate, a known inhibitor of mineral bioavailability. CONCLUSIONS: The results of the present study suggested that zinc deficiency existed in these elderly people. Further research is, however, needed to elucidate possible underlying factors so that appropriate intervention can be implemented.

A community-based integrated nutrition research programme to alleviate poverty: baseline survey.

BACKGROUND: The United Nation's Children Fund (UNICEF) has indicated that urban poverty is primarily found in squatter settlements. At present, 13.5% of all South African households live in informal settlements. The main hypothesis for this empirical study was that micromechanisms would not negatively influence food, nutrition and health of residents in an informal settlement in the Vaal Triangle, South Africa. This hypothesis was tested empirically against the UNICEF framework of the immediate, underlying and basic causes of malnutrition. The purpose of this study was to establish a situation analysis of children and women before designing any intervention. OBJECTIVES: The objectives covered in this paper include Phases I and II of the project, namely planning of the project and determining the demographic and health profile of the sample as part of a situation analysis. STUDY DESIGN: This is a community participatory project. After a strategic participatory planning workshop with stakeholders, a plan of operation document, guiding all field undertakings, was drawn up (Phase 1), followed by a cross-sectional baseline survey (Phase II), situation analysis (Phase III), and implementation of community-based intervention studies (Phase IV). Impact measurement will follow in Phase V. METHODS: After the planning meeting and obtaining consent, a pretested, structured demographic and health questionnaire was used to obtain data from 357 randomly selected households in an informal settlement. Data were statistically analysed for means and standard deviations. RESULTS: The findings of the workshop evaluation indicated that 100% of the participants (n = 34) agreed that a need existed for this project, 74% (n = 24) understood the relevance, and 64% (n = 22) realized the importance for sustainable community development. In the baseline survey, 89% of the respondents lived in zinc shacks with two rooms or less (32.2%), three or four rooms (41.5%) or four rooms or more (26.3%). The household size was six people or more (33%), five people (18.5%), four people (21.3%) and three people or less (27.2%). The unemployment rate was 94.2% for respondents and 80.1% for their partners. The majority of households (42.6%) had a monthly income of