The knowledge, attitudes and practices regarding food fortification among mill managers and the contribution of maize meal to the micronutrient intake of a national sample of South African adults

Danster-Christians, Natasha (2015-12)

Thesis (MNutr)--Stellenbosch University, 2015.

Thesis

ENGLISH SUMMARY : The knowledge, attitudes and practices regarding food fortification among mill managers and the contribution of maize meal to the micronutrient intake of a national sample of South African adults Aim: The aim of this study was to determine the knowledge, attitudes and practices regarding food fortification among maize meal and wheat flour mill managers and to determine the contribution of maize meal to the micronutrient intake of a national sample of South African adults. Methods: Staff members overseeing fortification at mills in South Africa were recruited for participation. Data were collected by means of a self-administered questionnaire distributed to 211 participants via email, post and fax. Secondly, South African adults who reported consuming maize meal (n = 2 344) as part of a national consumer survey, were included in the secondary analysis of data. Data were collected by means of a short quantified food frequency questionnaire focussing on maize. Nutrient intakes of participants who consumed maize meal were determined using the South African Food Composition Database and compared to the Dietary Reference Intakes. Results: Thirty maize meal and wheat flour mill staff (14.2%) completed the questionnaire. More than half (n = 16; 53.3%) of the participants knew when food fortification became mandatory. Only 43.3% of the mills tested the final product at the mill to ascertain if it was fortified. Only 58.3% (n = 14) of the mills obtained their fortification premixes from suppliers that were registered with the Department of Health. The overall knowledge score of mill staff was average (52.2%). The secondary analysis of data showed that the average portion of cooked maize meal consumed per day (n = 2 344) was 585 g (SD = 543 g) and contributed the following: riboflavin (20%), vitamin A (25%), zinc (34%), vitamin B6 (45%), niacin (46%), thiamin (57%), folate (67%) and iron (72%) of the Estimated Average Requirements (EAR). Hundred percent of the EAR was met for iron, thiamin and folate for 773 (33.0%), 483 (20.6%) and 621 (26.5%) of the maize meal consumers respectively. The average portion size of maize meal consumed by the unemployed (696 g) were significantly (p<0.001) higher than the employed (564 g) consumers. As a result of the higher portion size, all the micronutrients which form part of the fortification programme was significantly (p<0.001) higher for the unemployed. Vitamin A, thiamin, riboflavin, niacin, vitamin B6, folate, iron and zinc intakes were significantly lower for consumers from households earning above R6 000 compared to consumers of maize meal earning below the poverty line (R2 000). Conclusions: About half of the participants correctly answered the knowledge questions on food fortification. Despite this, there were shortcomings regarding practices amongst staff overseeing food fortification at the mills. Areas of food fortification practices at the mill level could possibly be improved, making use of results from this study. In the second study maize meal was shown to be a significant contributor in the diets of the participants. Unemployed and lower household income groups consumed more maize meal in terms of portion size and micronutrient contribution. The results underline the important contribution that the food fortification programme could potentially make to micronutrient intake through the consumption of fortified maize meal.

AFRIKAANSE OPSOMMING : Die kennis, houding en praktyke ten opsigte van voedselverryking onder meul bestuurders en die bydrae van mieliemeel tot die mikronutrient inname van ʼn nasionale monster van Suid-Afrikaanse volwassenes Doelwit: Die doelwit van die studie was om die kennis, houding en praktyke van meul personeel ten opsigte van voedselverryking van mieliemeel en koringmeel vas te stel asook om die bydrae van mieliemeel tot die mikronutriëntinname van ʼn nasionale monster van Suid-Afrikaanse volwassenes te bepaal. Metodes: Personeel verantwoordelik vir die toesighouding oor verryking by meule in Suid-Afrika was gewerf vir deelname. Data is ingesamel deur middel van ʼn self-geadministreerde vraelys wat versprei is na 211 deelnemers via e-pos, pos of faks. Tweedens was inligting van Suid-Afrikaanse volwassenes wat aangedui het dat hulle mieliemeel eet (n = 2 344), as deel van ʼn nasionale verbruikers opname, ingesluit in die sekondêre analise. Data is ingesamel deur middel van ʼn kort gekwantifiseerde voedselfrekwensie vraelys wat fokus op mieliemeel. Die nutriëntinname van deelnemers wat mieliemeel ingeneem het, is bepaal met die Suid-Afrikaanse Voedselsamestellings Databasis en vergelyk met die Aanbevole Dieetverwysings Innames. Resultate: Dertig personeellede van mieliemeel en koringmeel meule het die vraelys voltooi (14.2%). Meer as helfte (n = 16; 53.3%) van die deelnemers het geweet wanneer voedselverryking verpligtend geword het. Slegs 43.3% van die meule toets die finale produk by die meul om vas te stel of dit verryk is. Slegs 58.3% (n = 14) van die meule het hul verrykingsmengsel van verskaffers, wat geregistreer is by die Departement van Gesondheid verkry. Die algehele kennis puntetelling van meul personeel was gemiddeld (52.2%). Die resultate van die sekondêre analise van die mieliemeel inname data het getoon dat die gemiddelde porsie gekookte mieliemeel vir die groep 585 g (SD = 543 g) per dag was, en het die volgende bydrae gelewer: riboflavien (20%), vitamien A (25%), sink (34%), vitamien B6 (45%), niasien (46%), tiamien (57%), folaat (67%) en yster (72%) van die Geskatte Gemiddelde Behoeftes (GGB). Honderd persent van die GGB vir yster, tiamien en folaat is deur 773 (33.0%), 483 (20.6%) en 621 (26.5%) van die mieliemeel verbruikers onderskeidelik, ingeneem. Die gemiddelde porsie mieliemeel (696 g) ingeneem deur werklose verbruikers was aansienlik (p<0.001) groter as die porsie (564 g) deur werkende mieliemeel verbruikers. Al die mikronutriënte wat deel van die voedselfortifiseringsprogram is, was gevolglik aansienlik (p<0.001) hoër vir die werklose verbruikersgroep weens die groter porsie. Vitamien A, tiamien, riboflavien, niasien, vitamien B6, folaat, yster en sink inname was aansienlik laer vir verbruikers van huishoudings wat bo R6 000 verdien in vergelyking met verbruikers van mieliemeel wat onder die broodlyn (R2 000) verdien. Gevolgtrekkings: Omtrent helfte van die deelnemers het die kennisvrae oor voedselverryking reg beantwoord. Ten spyte daarvan, was daar tekortkominge met die voedsel verrykingspraktyke van personeel by die meule en dit kan moontlik verbeter word deur gebruik te maak van die resultate van die studie. In die tweede studie is dit bewys dat die bydrae wat mieliemeel in die dieete van die deelnemers gelewer het, aansienlik was. Werklose- en laer huishoudelike inkomste groepe het meer mieliemeel ingeneem in terme van porsie en mikronutriënt bydrae. Die resultate onderstreep die moontlike bydrae wat voedselfortifisering kan maak tot mikronutriënt inname deur die inname van verrykte mieliemeel.

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