Academic journal article Journal of Health Population and Nutrition

Dietary Quality and Patterns and Non-Communicable Disease Risk of an Indian Community in KwaZulu-Natal, South Africa

Academic journal article Journal of Health Population and Nutrition

Dietary Quality and Patterns and Non-Communicable Disease Risk of an Indian Community in KwaZulu-Natal, South Africa

Article excerpt

Background

Global diet is undergoing an alarming transition: staple foods are becoming more refined and processed; fat and meat intakes are increasing; more processed dairy products and other foods are consumed; and larger numbers of meals are consumed outside the home, making households more reliant on the food industry. Dietary habits have collectively been influenced by urbanisation, economic development, market globalisation and industrialisation where the move from a traditional to a Western-type diet is a characteristic feature [1]. Consequently, this transition has been associated with an increase in the global prevalence of non-communicable diseases (NCDs) [2].

The role of diet in the aetiology of most NCDs is extremely important. A body of literature attests to the fact that diets and specific nutrient deficiencies and excesses influence the development of NCDs and that appropriate dietary changes may reduce the risk of NCDs [2]. Little is known about the South African Indian diet, despite their high incidence of diabetes mellitus [3] and coronary heart disease (CHD) [4]. The first migrant Indians were reported to arrive in South Africa in 1860 to work as sugarcane farm labourers. With equity and social transformation, their lifestyles have changed rapidly for the better, however, their risk for NCDs have reached epidemic proportions [5, 6].

Diet is considered a modifiable risk factor for NCDs [7]. Over recent years dietary assessment has moved away from single nutrients to assessing the whole diet and interrelations between dietary factors in relation to NCDs [8, 9]. Therefore, a number of epidemiologists propose using a dietary pattern approach to investigate food in relation to NCDs [10, 11]. Most studies use either, a priori methods such as diet indices to assess the quality of the diet or a posteriori data-driven methods, such as factor analysis to derive food patterns in an attempt to describe the dietary behaviour of a population [12] and the associated risks thereof.

The primary hypothesis of this study was that dietary quality and patterns are related to risk markers for developing nutrition-related NCDs among Indians in KwaZulu-Natal (KZN), South Africa. Therefore, the aim of this paper is to compare dietary intakes with the World Health Organization (WHO) population nutrient goals for the prevention of death and disability from NCDs [13] and to describe the dietary quality and patterns in relation to the risk markers for NCDs in an Indian community in KZN, South Africa.

Methods

Participants

At the time of the 2011 South African census, the total population of Indians was 1 286 930, of whom the majority, totalling 757 000, resided in the province of KZN [14]. Two-hundred-and-fifty apparently healthy individuals within the age range of 35-55 years were recruited from the homogenous Indian community, Stanger in the province of KZN. Once eligibility was established, participants who were willing to participate in the study were randomly selected. Individuals diagnosed previously with hypercholesterolaemia and/or diabetes mellitus and individuals using dietary food supplements were excluded. The other exclusion criteria were pregnancy, lactation, any acute or chronic illness, use of chronic medication and inability to communicate freely. Informed consent was sought and received from study participants. The study was approved by the Ethics Committee of North-West University (05 M15).

Questionnaires

Habitual dietary intakes were measured by a validated quantitative food frequency questionnaire (QFFQ) [15] modified to include Indian foods and with a one-month recall period. It was acknowledged that the diet might be affected by seasonal variability. However, fresh fruits and vegetables are widely available throughout the year in KZN while other food products obtained via the retail food markets are not affected by seasonality [16]. In a preliminary study, an inventory of foods commonly consumed by South African Indians was compiled from interviews conducted in 25 randomly selected households. …

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