Submitted in fulfillment of the requirements of the Degree of Master of Technology:
Food and Nutrition Consumer Science, Durban University of Technology, 2011. / Background: South Africa, a richly diverse developing country has been faced by the
consequences of transition attributed to urbanisation and acculturation. A Westernised
lifestyle has, therefore, resulted in increasing disease patterns that are characterized by a
combination of poverty-related diseases together with the emerging chronic diseases. The
shift to a Westernised lifestyle has resulted to a shift in the composition of dietary staples
leading to dietary factors related to an increase in lifestyle diseases. These include a high
fat, low fibre diet, as well as an inadequate intake of fruits and vegetables. However, this
in turn has led to higher energy intakes with insufficient and imbalanced micronutrient
intake.
Research conducted amongst the elderly in South Africa has clearly indicated that the
elderly live within a limited financial budget leading to extreme levels of food insecurity
and the social burden of being the head of the household, in addition to being the
caregiver to grandchildren and sick children. Due to the current living status the elderly
encounter reduced food intake in addition to a reduced variety in their diet, therefore,
micronutrient deficiencies are common amongst this age group. Therefore, a consumption
of energy-dense foods, particularly staple foods, to stretch the food budget which are
more affordable and thus allow for an increased consumption is evident.
Aim: To determine the socio-demographic profile, health and nutritional status in relation
to the dietary intake patterns to reflect malnutrition among free living elderly (60yrs+) in
Verulam.
Methodology: Fifty nine randomly selected men and 191 women aged 60+ participated
on a voluntary basis in this study. A descriptive survey method was used for this cross
sectional study. Trained fieldworkers assisted with the administration of all questionnaires
and a registered nurse measured blood pressure. Socio-demographic questionnaires were
administered to determine the socio-economic characteristics of the elderly within this
community. Anthropometric measurements determined the Body Mass Index according to
the World Health Organisation and Asian cut-off points to indentify the risk factors. The
Health questionnaire identified the health status correlated to the respondent’s profundity
of disease and deficiencies associated to dietary patterns. Blood pressure measurements
were taken to determine the hypertension prevalence related to the dietary intake. Two
24-Hour Recall questionnaires were completed by the 250 respondents to identify actual
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food intake and measured against the Dietary Recommended Intake (DRIs). A food
frequency questionnaire (FFQ) determined the respondent’s food variety score over a
period of one week. The socio-demographic questionnaire, health questionnaire, food
frequency questionnaire and anthropometric measurements were captured on an Excel®
spread sheet by the researcher and analyzed for descriptive statistics using the Statistical
Package for the Social Sciences (SPSS) version 17.0 with the assistance of a statistician.
The 24-Hour Recall data were captured and analyzed by a nutrition professional using the
MRC Food Finder® version 3.0 software, based on the South African Food Composition
tables.
Results: The majority of the respondent’s role in the family was mothers (70.8%) and
lived in an urban area (68.8%). In addition, 73.2 percent (n=183) of the respondents
shared the house with one to five people, and lived in a brick house (74.4%, n=186) with
more than 3 rooms (74.0%, n=185). The elderly in this sample were pensioners and,
therefore, 76.0 percent (n=190) received state grants of which the total household income
ranged between R1001-R1500 (35.2%, n=88). Food insecurity is prevalent as reported by
28.4 percent. Primary school was the highest level of education completed by 52.4
percent (n=131) and English is the most spoken language amongst this group (74.0%,
n=185).
Women had higher BMI values particularly in the overweight (18.32%, n=35) and obese I
and II (58.6%, n=112) categories when compared with men. Blood pressure
measurements indicated that 60.0 percent (n=150) of the respondents suffered from
hypertension. The use of chronic medication was reported by 84.4 percent (n=212). The
total range of individual food items consumed by an individual during the seven-day data
collection period measured by the (FFQ) was between 4-66 foods. However, the highest
consumption was four food items by 23.2 percent (n=58) of the respondents. The
summary of the food variety within food groups indicated a high dietary diversity, of which
the other vegetable group reported the highest individual mean FVS (±SD) of 10.86
(±5.82), followed by other fruit, cereal, flesh and Vitamin A rich groups with 5.73 (±4.41),
5.03 (±1.85), 4.08 (±2.23) and 2.43 (±1.09) respectively.
The nutrient analysis indicated a deficient intake by both men and women of all the
nutrients, except for the mean (±SD) total protein in the women 45.10 (±12.55) and
carbohydrate 212.83 (±36.97) in the men. The energy contribution indicated 98.3 percent
(n=58) men and 85.72 percent (n=158) women consumed <100 percent of the EER for
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energy. However, the findings from the Top 20 food items measured by the 24-Hour
Recall indicated that this community’s diet is largely carbohydrate-based, containing
primarily starchy staple foods, sufficient intake of animal products, and insufficient intakes
of dairy foods, fruit and vegetables, possibly resulting in the micronutrient deficiencies.
The energy distribution of the macronutrients from the average of both 24-Hour Recalls
indicates that both men and women are in range of 15-30 percent total fat intake, 10-15
percent protein and 55-75 percent carbohydrate.
Conclusion: The results of the study reflect that the elderly in this community are faced
with poverty, food insecurity as well as social factors thus contributing to a compromised
nutritional status. The progression of malnutrition in particular overnutrition is experienced
by the majority of the respondents in this study, however, an increased BMI and the
prevalence of hypertension is a risk marker for noncommunicable diseases. However, the
high prevalence of inadequate food and nutrient intake amongst elderly discloses the
need for nutrition interventions and should be aimed at modifying the elderly food choices
when purchasing food, healthier food preparation methods, increasing fruit and vegetable
portions and improving daily physical activity to attain a better quality of life. / DUT Postgraduate Development and Support Directorate (PGD)
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:dut/oai:localhost:10321/712 |
| Date | January 2011 |
| Creators | Govender, Theloshni |
| Contributors | Oldewage-Theron, Wilna, Napier, Carin E. |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 269 p |
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