Evaluation of energy and macronutrient intake of black women in Bloemfontein: a cross-sectional study

Abstract

There is growing evidence that urbanization of black South Africans is associated with changes in the structure of dietary intake. The urban diet is more diverse than the rural diet, and includes more animal foods, refined carbohydrates and fats, posing a potential risk to the health of urbanized populations. The objective of this cross-sectional study was to determine the macronutrient intake of non-pregnant, pre-menopausal black women living in Bloemfontein in South Africa. A representative group of 500 participants was randomly selected to participate. Women were divided into two age groups. Younger women were 25 - 34 years old and older women 35 - 44 years old. Macronutrient intake was determined using a validated Quantitative Food Frequency Questionnaire (QFFQ). Median macronutrient intake was compared with the Dietary Reference Intakes (DRI) as applicable. Median energy, macronutrient and cholesterol intake of younger and older women was compared using non-parametric 95% confidence intervals (CI’s). P-value less than 0.05 was considered significant. Median energy distribution of macronutrients was determined and compared with standard references. After being screened for eligibility, four pregnant women were excluded from the study, and 496 women qualified for participation. Median total energy, protein and carbohydrate intakes of all women exceeded the DRI. Median intakes of fibre were low, while median fat intakes were high. Younger women had significantly higher intakes of total fat (p = 0.034), saturated fat (p = 0.046) and PUFA (p = 0.015). Median energy distribution was 12% protein (both age groups), 32% fat (younger women) and 31% fat (older women) and 51% carbohydrates (younger women) and 53% carbohydrates (older women). The high median energy and macronutrient intakes may pose a potential risk for the development of chronic lifestyle diseases. The main focus of intervention should be to improve the quality of the diet, by decreasing fat intake and replacing this with fruit and vegetables. The benefits of a low glycaemic index and high fibre diet need to be emphasized