title: The association between diet quality and subclinical inflammation among children aged 6-18 years in the Eastern Cape, South Africa.
abstract: The study aimed to investigate, for the first time, the association between diet quality (food variety and dietary diversity), intakes of anti-inflammatory nutrients and food groups, and subclinical inflammation as assessed by categories of high-sensitivity C-reactive protein (hs-CRP).
  
  
  
  Cross-sectional study.
  
  
  
  Resource-poor, rural children in the Eastern Cape, South Africa.
  
  
  
  A sample size formula determined a representative sample of 235. Five schools were purposively selected and cluster sampling used to select 240 participants. Measurements included 24 h recall and dietary diversity questionnaires, anthropometric and biochemical measurements.
  
  
  
  The sample consisted of 50·4 % (n 118) girls and 49·6 % (n 116) boys. No obesity was found, but overweight was prevalent in 4·2 % of the children. The hs-CRP concentration (median (25th, 75th percentile)) of the low, medium and high risk inflammatory categories was 0·6 (0·4, 0·7), 1·6 (1·2, 2·2) and 4·2 (3·4, 6·4) mg/l, respectively. Body composition parameters did not differ between hs-CRP groups. Most of the anti-inflammatory nutrient intakes (dietary Fe, Zn, Mg, vitamin C, folate, linolenic acid, linoleic acid, MUFA and PUFA) differed significantly between the hs-CRP groups, with intakes increasing from low to high hs-CRP groups, with similar results for linolenic acid (P=0·022) intake. No significant relationships between hs-CRP and any of the food groups could be established, but significant relationships were established between hs-CRP levels and the high density of living arrangements and unhygienic ablution facilities.
  
  
  
  Although no link could be established between overnutrition and hs-CRP levels, an association was found between hs-CRP and dietary quality, as well as socio-economic status.
authors.affiliation: 1Centre of Sustainable Livelihoods,Vaal University of Technology,Private Bag X021,Vanderbijlpark 1900,South Africa.
authors.forename: Wilna
authors.initials: W
authors.lastname: Oldewage-Theron
authors.affiliation: 3School of Food and Nutrition,MIFST, College of Health,Massey University,Auckland,New Zealand.
authors.forename: Rozanne
authors.initials: R
authors.lastname: Kruger
mesh_terms: D000293:Adolescent; D001823:Body Composition; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D003430:Cross-Sectional Studies; D004032:Diet; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage; D005260:Female; D063427:Food Quality; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence; D012424:Rural Population; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires
chemical_list: D005229:Fatty Acids, Monounsaturated; D005231:Fatty Acids, Unsaturated; D018977:Micronutrients; D002097:C-Reactive Protein
keywords: Children; High-sensitivity C-reactive protein; South Africa; Subclinical inflammation