Food Variety and Dietary Diversity as Indicators of the Dietary Adequacy and Health Status of an Elderly Population in Sharpeville, South Africa

Abstract

This cross-sectional, analytical study was a comprehensive health assessment focusing on dietary quality of 170 randomly selected elderly respondents in Sharpeville, South Africa. The methods included a sociodemographic, health food frequency questionnaire, 24h-recall questionnaires, and anthropometric and biochemical measurements. The low mean +/- standard deviation (SD) dietary diversity score (3.41 +/- 1.34) and food variety score (4.77 +/- 2.2) compared with poverty parameters confirmed household food insecurity in this community. Although three (n = 99, 58.6%) or two (n = 49, 28.9%) daily meals were mostly consumed, these were mainly carbohydrate-based and nutrient-deficient. The cereal group (2.01 +/- 0.81) had the highest mean food variety score +/- SD, followed by dairy (0.62 +/- 0.53) and flesh foods (0.40 +/- 0.53). When a mean adequacy ratio of 70% was used as a cut-off point for nutrient adequacy, it was found that the food variety score must be eight or higher and the dietary variety score must be at least six. These indicators thus have a high ability to identify those respondents with an inadequate diet but lower ability to identify those respondents with a nutritionally adequate diet. The data further showed a trend that with a higher food variety and dietary diversity, a better mean adequacy ratio is reached for this low-income group of elderly subjects. In conclusion, the results showed that food variety and dietary diversity scores give a fairly good assessment of the adequacy of the diet, and scoring dietary diversity is a significant, yet simple tool to identify elderly persons at risk of food and nutrition insecurity.

A cross-sectional baseline survey investigating the relationship between dietary diversity and cardiovascular risk factors in women from the Vaal Region, South Africa

“…These scores were calculated for a reference period of seven days [22] . These dietary diversity scores were similar to those scores used in previous studies in other developing countries [8,14,23] . The nine nutritious food groups recommended by the FAO were used to classify food intakes categorically.…”

“…Furthermore, most of the unemployed are living in informal settlements in non-permanent zinc shacks with no land available for household gardens [12] . As a result, this poor community does not rely on agriculture as a household food security strategy and dietary diversity has been found to be poor in this area [13,14] . A previous study among the same sample of women indicated a prevalence of 34.3% for dyslipidaemia, 48.6% for hypertension and 45.0% for obesity [15] .…”

Overall and within-food group diversity are associated with dietary quality in Belgium

“…Other studies from different populations and countries also found associations between overall dietary diversity and quality of the diet (21)(22)(23)(24)(25)(26)(27) . Nevertheless, a number of different groupings, classification systems and reference periods have been used.…”

Dietary diversity score and obesity: a systematic review and meta-analysis of observational studies

“…Dietary diversity has been known as a key index of high diet quality in various populations. [18][19][20] DDS evaluates the diversity within food groups that are often chosen based on healthy dietary guidelines. 21,22 The higher diversity in healthy food groups like vegetables and fruits could increase DDS but would not add substantial energy to the overall calorie content of the diet.…”