The micronutrient intake of the average South African is not optimal. National fortification of staple foods does not solve all micronutrient deficiencies. Furthermore, urbanisation causes a shift in food intake, increasing the availability of cheaper and more energy dense food and drinks that are often lacking in micronutrients. It is unclear whether the current literature provides sufficient evidence of nutrient dilution by the moderate consumption of alcohol and/or added sugar. The aim of the present study was to evaluate the dietary intakes of a population in nutrition transition and determine the effect of intake of alcohol and added sugars on intakes of micronutrients and food groups to provide information for the development of preventive strategies in public health. A number of countries, including South Africa, suggest limited alcohol and sugar intakes in the Food Based Dietary Guidelines but do not quantify this recommendation. Data from the "Transition and Health during Urbanisation in South Africa" survey (THUSA) were analysed for dietary intakes (as determined by a validated quantified food frequency questionnaire), age and body mass index (BMI). The THUSA study was conducted during 1996 and 1998 in the North West Province and included 1854 "apparently healthy". Respondents aged 15 years and older from 37 randomly selected sites from rural and urban areas. Alcohol intake (absolute intake and percentage of energy) was the highest for men living in middle class urban areas. With increased urbanisation, the type of beer shifted from sorghum based to commercial beer. Sixty-one percent of men and 25% of women reported that they consumed alcohol at the time of the survey. Eighteen percent of men and 11.7% of women consumed more than 30g and 15g alcohol per day, respectively (intakes which are regarded as moderate). Men and women consuming the most alcohol had significantly higher mean intakes of most macro and micronutrients. However, the intake of vitamin Bi2, B6, folate, vitamin E and vitamin C did not meet the recommended dietary intake (RDA) across all levels of alcohol intake. Although the total energy intake increased with increased alcohol intake, there was no significant difference between the mean BMI of men or women with different levels of intake. One third of the population consumed more than a 100g of added sugar daily. Intake of sugar was the highest in the farm dwellers but the intake of sweets, cakes, cookies and cold drinks was the highest in the urban areas. As sugar intake increased so did energy, carbohydrates and most micronutrients. However, the intake of vitamin B12, folate, vitamin C and calcium did not meet the RDA across all levels of sugar intake. BMI did not differ between respondents with the highest and lowest sugar intake and no association was found between BMI and sugar intake. The THUSA study was conducted before fortification of staple food became law in October 2003. Maize meal and wheat flour are nowadays fortified with certain vitamins and minerals which may alleviate some micronutrient deficiencies. For future research it is imperative to establish the reasons for low intake of certain micronutrients rather than to look at a single food item in the diets of the South African adult population. Proper education on the intake of cheaper food sources of micronutrients needs to be highlighted at all levels of the health sector. / Thesis (M.Sc. (Dietetics)--North-West University, Potchefstroom Campus, 2009.

The micronutrient intake of the average South African is not optimal. National fortification of staple foods does not solve all micronutrient deficiencies. Furthermore, urbanisation causes a shift in food intake, increasing the availability of cheaper and more energy dense food and drinks that are often lacking in micronutrients. It is unclear whether the current literature provides sufficient evidence of nutrient dilution by the moderate consumption of alcohol and/or added sugar. The aim of the present study was to evaluate the dietary intakes of a population in nutrition transition and determine the effect of intake of alcohol and added sugars on intakes of micronutrients and food groups to provide information for the development of preventive strategies in public health. A number of countries, including South Africa, suggest limited alcohol and sugar intakes in the Food Based Dietary Guidelines but do not quantify this recommendation. Data from the "Transition and Health during Urbanisation in South Africa" survey (THUSA) were analysed for dietary intakes (as determined by a validated quantified food frequency questionnaire), age and body mass index (BMI). The THUSA study was conducted during 1996 and 1998 in the North West Province and included 1854 "apparently healthy". Respondents aged 15 years and older from 37 randomly selected sites from rural and urban areas. Alcohol intake (absolute intake and percentage of energy) was the highest for men living in middle class urban areas. With increased urbanisation, the type of beer shifted from sorghum based to commercial beer. Sixty-one percent of men and 25% of women reported that they consumed alcohol at the time of the survey. Eighteen percent of men and 11.7% of women consumed more than 30g and 15g alcohol per day, respectively (intakes which are regarded as moderate). Men and women consuming the most alcohol had significantly higher mean intakes of most macro and micronutrients. However, the intake of vitamin Bi2, B6, folate, vitamin E and vitamin C did not meet the recommended dietary intake (RDA) across all levels of alcohol intake. Although the total energy intake increased with increased alcohol intake, there was no significant difference between the mean BMI of men or women with different levels of intake. One third of the population consumed more than a 100g of added sugar daily. Intake of sugar was the highest in the farm dwellers but the intake of sweets, cakes, cookies and cold drinks was the highest in the urban areas. As sugar intake increased so did energy, carbohydrates and most micronutrients. However, the intake of vitamin B12, folate, vitamin C and calcium did not meet the RDA across all levels of sugar intake. BMI did not differ between respondents with the highest and lowest sugar intake and no association was found between BMI and sugar intake. The THUSA study was conducted before fortification of staple food became law in October 2003. Maize meal and wheat flour are nowadays fortified with certain vitamins and minerals which may alleviate some micronutrient deficiencies. For future research it is imperative to establish the reasons for low intake of certain micronutrients rather than to look at a single food item in the diets of the South African adult population. Proper education on the intake of cheaper food sources of micronutrients needs to be highlighted at all levels of the health sector. / Thesis (M.Sc. (Dietetics)--North-West University, Potchefstroom Campus, 2009.

Sugar intake continues to be connected to an increased risk of heart diseases, diabetes, arthritis, and certain forms of cancers, depression, and schizophrenia. The purpose of the study was to examine if sugar intake is related to personality traits in the Millennial population. The health belief model was used as the theoretical framework for conducting the study. The research questions addressed in the current study were in regards to the relationships between Millennials daily sugar intake and openness, conscientiousness, extraversion, agreeableness, and neuroticism. This study was a cross-sectional design in which a panel of randomly selected United States Millennials (N = 106) between the ages of 18-34 were requested to complete a demographic questionnaire and the Big Five Inventory. The survey was conducted online using SurveyMonkey. Multiple linear regression was used to test the five stated hypotheses. Study results indicated no significant relationship between sugar intake and the five personality traits (p > .05). A sequential multiple regression model after controlling for age and gender indicated no significant relationship between the five personality traits and Sugar Intake (p > .05). In effecting positive social change, further investigations are warranted to establish the relationships between personality traits and sugar intake which may help to inform policy to reduce the associated health risks of consuming high sugar.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / A tese descreve o consumo de alimentos marcadores da qualidade da dieta no Brasil e identifica os alimentos que mais contribuem com a ingestão de açúcar e sódio no país. Foram utilizados para este fim os dados do Sistema Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL) realizado nos anos de 2007, 2008 e 2009 e os dados provenientes do primeiro Inquérito Nacional de Alimentação (INA) realizado nos anos de 2008-2009 no Brasil. Os resultados são apresentados na forma de quatro artigos. O primeiro artigo avaliou as questões marcadoras de consumo alimentar do Sistema VIGITEL e sua evolução temporal e inclui 135.249 indivíduos de 27 cidades brasileiras, entrevistados nos anos de 2007 2009. Para os demais artigos, utilizou-se os dados obtidos no INA, para descrever os alimentos mais consumidos no país segundo sexo, grupo etário, região e faixa de renda familiar per capita (artigo 2) e identificar os alimentos que mais contribuem para o consumo de sódio (artigo 3) e de açúcar na população brasileira (artigo 4). As análises do INA baseiam-se em informações do primeiro de dois dias não consecutivos de registro alimentar de 34.003 indivíduos com 10 anos ou mais de idade. Os resultados apresentados indicam que a alimentação dos brasileiros vem se caracterizando pela introdução de alimentos processados de alta densidade energética e bebidas com adição de açúcar, embora os hábitos tradicionais de alimentação, como o consumo de arroz e feijão, ainda sejam mantidos. Entre as bebidas açucaradas os refrigerantes aparecem como importante marcador da qualidade da dieta na população brasileira. Os dados do VIGITEL evidenciaram aumento no consumo deste item de 7% e dentre os itens avaliados no inquérito, foi o que mais discriminou o consumo alimentar na população. De acordo com os dados do INA, o refrigerante foi um dos itens mais consumidos pelos brasileiros, e constitui-se também como marcador do consumo de açúcar total, de adição e livre, juntamente com sucos, café e biscoitos doces. Adolescentes apresentaram o maior consumo de açúcar, comparados aos adultos e idosos e este resultado pode ser explicado pelo alto consumo de bebidas açucaradas e biscoitos doces observado nesta faixa etária. Quanto ao consumo de sódio, alimentos processados, como carne salgada, carnes processadas, queijos, biscoitos salgados, molhos e condimentos, sanduíches, pizzas e pães figuraram entre as principais fontes de sódio na dieta do brasileiro. Nossos achados reafirmam a importância de políticas de alimentação e nutrição, que estimulem o consumo de alimentos saudáveis, como frutas, verduras e grãos integrais, e a manutenção do consumo de alimentos básicos tradicionais, como o feijão. O sistema VIGITEL deve contemplar itens do consumo alimentar que possam ter impacto na redução das doenças crônicas não transmissíveis. / This dissertation aimed to describe the most consumed foods in the Brazilian diet according to gender, age, regions and per capita family income and to identify the main sources of sugar and sodium in the country using data from the 2007-2009 Telephone-based Risk Factor Surveillance System for Chronic Diseases (VIGITEL) and from the first Brazilian National Dietary Survey (NDS). The results are described in 4 articles. The first article aimed to evaluate markers of food intake of the telephone-based risk factor surveillance system for chronic diseases (VIGITEL) and the trend of these markers. A total of 135,249 subjects from 27 brazilian cities interviewed in the 2007 2009 surveys were evaluated. For the others articles, data from the 2008-2009 Brazilian NDS were used in order to describe the most consumed foods in the country according to gender, age, regions and per capita family income (article 1) and to identify the major food sources of dietary sodium (article 3) and free, added and total sugar in Brazil (article 4). The analysis was based on food intake data obtained on the first of two non-consecutive food records from 34,003 subjects over 10 years old. Brazilian population food intake has been characterized by the increase of the consumption of high energy-dense processed foods and sugar sweetened beverages, even though the intake of traditional foods, such as rice and beans, were still observed. Among the sugar sweetened beverages, the consumption of soft drinks can be considered as marker of quality of the diet in the Brazilian population. Data from the VIGITEL showed an increase of 7% in the consumption of soft drinks, and this item was the one that discriminates food intake the most. According to the data from the 2008-2009 Brazilian NDS, soft drinks was one of most consumed food items, and could be also considered as a marker of total, added and free sugar intake, as well as, the intake of juices, cookies and coffee. Adolescents were the age group that presented the highest intake of total, added and free sugar. This result could be attributable to the largest intake of sugar sweetened beverage and cookies in this age group. Regarding sodium intake, processed foods, such as salty preserved meats, processed meats, cheeses, crackers, oils, spreads, sauces and condiments, sandwiches, pizzas, and breads were the main sources of dietary sodium in the Brazilian population diet. Our findings reinforce the importance of food and nutrition policies that encourage the intake of healthy food, such as fruits, vegetables, whole grains, and traditional foods, such as beans. VIGITEL system should include food items that may have impact in reducing the prevalence of chronic diseases.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / A tese descreve o consumo de alimentos marcadores da qualidade da dieta no Brasil e identifica os alimentos que mais contribuem com a ingestão de açúcar e sódio no país. Foram utilizados para este fim os dados do Sistema Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL) realizado nos anos de 2007, 2008 e 2009 e os dados provenientes do primeiro Inquérito Nacional de Alimentação (INA) realizado nos anos de 2008-2009 no Brasil. Os resultados são apresentados na forma de quatro artigos. O primeiro artigo avaliou as questões marcadoras de consumo alimentar do Sistema VIGITEL e sua evolução temporal e inclui 135.249 indivíduos de 27 cidades brasileiras, entrevistados nos anos de 2007 2009. Para os demais artigos, utilizou-se os dados obtidos no INA, para descrever os alimentos mais consumidos no país segundo sexo, grupo etário, região e faixa de renda familiar per capita (artigo 2) e identificar os alimentos que mais contribuem para o consumo de sódio (artigo 3) e de açúcar na população brasileira (artigo 4). As análises do INA baseiam-se em informações do primeiro de dois dias não consecutivos de registro alimentar de 34.003 indivíduos com 10 anos ou mais de idade. Os resultados apresentados indicam que a alimentação dos brasileiros vem se caracterizando pela introdução de alimentos processados de alta densidade energética e bebidas com adição de açúcar, embora os hábitos tradicionais de alimentação, como o consumo de arroz e feijão, ainda sejam mantidos. Entre as bebidas açucaradas os refrigerantes aparecem como importante marcador da qualidade da dieta na população brasileira. Os dados do VIGITEL evidenciaram aumento no consumo deste item de 7% e dentre os itens avaliados no inquérito, foi o que mais discriminou o consumo alimentar na população. De acordo com os dados do INA, o refrigerante foi um dos itens mais consumidos pelos brasileiros, e constitui-se também como marcador do consumo de açúcar total, de adição e livre, juntamente com sucos, café e biscoitos doces. Adolescentes apresentaram o maior consumo de açúcar, comparados aos adultos e idosos e este resultado pode ser explicado pelo alto consumo de bebidas açucaradas e biscoitos doces observado nesta faixa etária. Quanto ao consumo de sódio, alimentos processados, como carne salgada, carnes processadas, queijos, biscoitos salgados, molhos e condimentos, sanduíches, pizzas e pães figuraram entre as principais fontes de sódio na dieta do brasileiro. Nossos achados reafirmam a importância de políticas de alimentação e nutrição, que estimulem o consumo de alimentos saudáveis, como frutas, verduras e grãos integrais, e a manutenção do consumo de alimentos básicos tradicionais, como o feijão. O sistema VIGITEL deve contemplar itens do consumo alimentar que possam ter impacto na redução das doenças crônicas não transmissíveis. / This dissertation aimed to describe the most consumed foods in the Brazilian diet according to gender, age, regions and per capita family income and to identify the main sources of sugar and sodium in the country using data from the 2007-2009 Telephone-based Risk Factor Surveillance System for Chronic Diseases (VIGITEL) and from the first Brazilian National Dietary Survey (NDS). The results are described in 4 articles. The first article aimed to evaluate markers of food intake of the telephone-based risk factor surveillance system for chronic diseases (VIGITEL) and the trend of these markers. A total of 135,249 subjects from 27 brazilian cities interviewed in the 2007 2009 surveys were evaluated. For the others articles, data from the 2008-2009 Brazilian NDS were used in order to describe the most consumed foods in the country according to gender, age, regions and per capita family income (article 1) and to identify the major food sources of dietary sodium (article 3) and free, added and total sugar in Brazil (article 4). The analysis was based on food intake data obtained on the first of two non-consecutive food records from 34,003 subjects over 10 years old. Brazilian population food intake has been characterized by the increase of the consumption of high energy-dense processed foods and sugar sweetened beverages, even though the intake of traditional foods, such as rice and beans, were still observed. Among the sugar sweetened beverages, the consumption of soft drinks can be considered as marker of quality of the diet in the Brazilian population. Data from the VIGITEL showed an increase of 7% in the consumption of soft drinks, and this item was the one that discriminates food intake the most. According to the data from the 2008-2009 Brazilian NDS, soft drinks was one of most consumed food items, and could be also considered as a marker of total, added and free sugar intake, as well as, the intake of juices, cookies and coffee. Adolescents were the age group that presented the highest intake of total, added and free sugar. This result could be attributable to the largest intake of sugar sweetened beverage and cookies in this age group. Regarding sodium intake, processed foods, such as salty preserved meats, processed meats, cheeses, crackers, oils, spreads, sauces and condiments, sandwiches, pizzas, and breads were the main sources of dietary sodium in the Brazilian population diet. Our findings reinforce the importance of food and nutrition policies that encourage the intake of healthy food, such as fruits, vegetables, whole grains, and traditional foods, such as beans. VIGITEL system should include food items that may have impact in reducing the prevalence of chronic diseases.