Poor dietary diversity and low nutrient density of the complementary diet for 6‐ to 24‐month‐old children in urban and ruralKwaZulu‐Natal,SouthAfrica

Abstract

Infants and toddlers have high nutritional requirements relative to body size but consume small amounts of food and therefore need nutrient-dense complementary foods. A cross-sectional study included children aged 6-24 months, stratified in three age categories (6-11 months, 12-17 months and 18-24 months) and randomly selected from an urban (n = 158) and a rural (n = 158) area, both of low socio-economic status, in the KwaZulu-Natal Province of South Africa. Dietary diversity and nutrient density of the complementary diet (excluding breast milk and formula milk) based on a repeated 24-h dietary recall was assessed. For breastfeeding children, nutrient density of the complementary diet was adequate for protein, vitamin A and vitamin C; and inadequate for 100% of children for zinc, for >80% of children for calcium, iron and niacin; and between 60% and 80% of children for vitamin B6 and riboflavin. Urban/rural differences in density for animal and plant protein, cholesterol and fibre occurred in 18-24-month-old children. Fewer than 25% of children consumed ≥4 food groups, with no urban/rural differences. Higher dietary diversity was associated with higher nutrient density for protein and several of the micronutrients including calcium, iron and zinc. The poor nutrient density for key micronutrients can probably be ascribed to lack of dietary variety, and little impact of mandatory fortification of maize meal/wheat flour on infants/toddlers' diet. Targeted strategies are needed to enable mothers to feed their children a more varied diet.

Nutritional status of children on the National School Nutrition Programme in Capricorn District, Limpopo Province, South Africa

“…[11] The present study's selection of grades was based on the ability of the children to recall information. Most of the participants were within the age range 10 -12 years.…”

Iodine status and associations with feeding practices and psychomotor milestone development in six‐month‐old South African infants

“…A set of unquantified food frequency questions was used to obtain descriptive qualitative information on the usual consumption of foods by the infants over the past 7 days (Faber et al, 2014, Smuts et al, 2005. Indicators that were of particular interest for this present analysis were whether the infant was currently breastfed, and whether the infant had already been introduced to any liquids, milk-feeds, and semi-solid or solid foods.…”

“…Indicators that were of particular interest for this present analysis were whether the infant was currently breastfed, and whether the infant had already been introduced to any liquids, milk-feeds, and semi-solid or solid foods. A set of unquantified food frequency questions was used to obtain descriptive qualitative information on the usual consumption of foods by the infants over the past 7 days (Faber et al, 2014, Smuts et al, 2005. The mother made a choice out of options to describe the infant's usual intake of listed foods.…”

“…Furthermore, despite the successful salt iodization programme in South Africa , the addition of salt to home prepared complementary foods is not recommended (Cribb, Warren, & Emmett, 2012); hence, commercial complementary foods are recommended to be fortified with iodine (Dunn, 2003, Zimmermann, 2012. Various inappropriate infant feeding practices like the early introduction of salty snacks to young infants have been reported to be common in South Africa (Faber, Laubscher, & Berti, 2014). This may have an impact on iodine status as several food manufacturing companies in the country have previously reported to use salt that contained substantial amounts of iodine (39-69 ppm) (Harris, Jooste, & Charlton, 2003).…”

Can blended flour recipes made of locally available and cheap ingredients be used for adequate complementary feeding of infants in rural settings in Burkina Faso

“…Indeed, mothers in rural settings do not know how to combine available cheap local foods to meet nutrients requirements for their children [5]. They give children undiversified complementary foods [6,7] composed mainly of a thin porridge prepared from flour of cereals (sorghum, maize, millet or rice) [7,8] with no or few additional sources of energy or protein. Such diets are very low-energy-dense with little content of protein and micronutrients.…”