The National Food Consumption Survey (NFCS): South Africa, 1999.
OBJECTIVE
The aim of the National Food Consumption Survey (NFCS) in South Africa was to determine the nutrient intakes and anthropometric status of children (1-9 years old), as well as factors that influence their dietary intake.


METHODS
This was a cross-sectional survey of a nationally representative sample of all children aged 1-9 years in South Africa. A nationally representative sample with provincial representation was selected using 1996 Census information.


METHODS
Of the 3120 children who were originally sampled data were obtained from 2894, a response rate of 93%.


METHODS
The sociodemographic status of each household was assessed by a questionnaire. Dietary intake was assessed by means of a 24-hour recall and a food-frequency questionnaire from the caregivers of the children. Food purchasing practices were determined by means of a food procurement questionnaire. Hunger was assessed by a modified hunger scale questionnaire. Nutritional status was determined by means of anthropometric measurements: height, weight, head circumference and arm circumference.


RESULTS
At the national level, stunting (height-for-age below minus two standard deviations (< -2SD) from the reference median) was by far the most common nutritional disorder, affecting nearly one in five children. The children least affected (17%) were those living in urban areas. Even with regard to the latter, however, children living in informal urban areas were more severely affected (20%) compared with those living in formal urban areas (16%). A similar pattern emerged for the prevalence of underweight (weight-for-age < -2SD), with one in 10 children being affected at the national level. Furthermore, one in 10 (13%) and one in four (26%) children aged 1-3 years had an energy intake less than half and less than two-thirds of their daily energy needs, respectively. For South African children as a whole, the intakes of energy, calcium, iron, zinc, selenium, vitamins A, D, C and E, riboflavin, niacin, vitamin B6 and folic acid were below two-thirds of the Recommended Dietary Allowances. At the national level, data from the 24-hour recalls indicated that the most commonly consumed food items were maize, sugar, tea, whole milk and brown bread. For South African children overall, one in two households (52%) experienced hunger, one in four (23%) were at risk of hunger and only one in four households (25%) appeared food-secure.


CONCLUSIONS
The NFCS indicated that a large majority of households were food-insecure and that energy deficit and micronutrient deficiencies were common, resulting in a high prevalence of stunting. These results were used as motivation for the introduction of mandatory fortification in South Africa.
Labadarios
D
D
Department of Human Nutrition, University of Stellenbosch and Tygerberg Academic Hospital, Tygerberg, South Africa. demetre@sun.ac.za
Steyn
N P
NP
Maunder
E
E
MacIntryre
U
U
Gericke
G
G
Swart
R
R
Huskisson
J
J
Dannhauser
A
A
Vorster
H H
HH
Nesmvuni
A E
AE
Nel
J H
JH
D000886:Anthropometry; D001827:Body Height / Q000502:physiology; D002648:Child; D015362:Child Nutrition Disorders / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data*; D004034:Diet Surveys; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D005527:Food, Fortified; D006801:Humans; D006815:Hunger; D007223:Infant; D008297:Male; D011939:Mental Recall; D009749:Nutrition Surveys; D009752:Nutritional Status; D013019:South Africa; D011795:Surveys and Questionnaires