Dietary risk assessment of Discovery Health Medical Aid's vitality members in South Afric

[摘要] ENGLISH ABSTRACT: Background: The rising prevalence of non-communicable diseases (NCD) is cause for concern. Improving dietary quality is a key health promotion strategy aimed at reducing NCD morbidity and mortality. Assessments that quantify 'risky dietary behaviours are worthwhile, and may help to identify high risk individuals, that would benefit from targeted interventions.Purpose: Discovery Vitality is a wellness incentive business associated with Discovery Health medical aid in South Africa. This study developed a Dietary Behaviour Score (DBSPHR) that measured degrees of compliance of Discovery Vitality members with the 'spirit of dietary guidance. It further categorized scores and identified members who may be at risk for developing NCDs due to poor dietary compliance.Methods: The DBSPHR included proportionally weighted components related to the consumption of fruit, vegetables, low fat dairy, whole-grain foods, lean meat, chicken and discretionary fat. The study population included adult South African members of Discovery Vitality, who had completed the programme's on-line health risk assessment (PHR) between the 1st February 2010 and 31st January 2011. Stratified random sampling was used (n=1600).Half the sample included members who participated in Vitality's HealthyFoodTM benefit (HFB) programme. The different Vitality Status groups were equally represented, and reflect degrees of engagement with the programme. Genders were equally represented. DBSPHR data were categorized as: Poor (Score 0-18), Inadequate (18.5-22.5), Fair (23-26), Good (26.5-29), Excellent (29.5-36). DBSPHR data was analyzed for variables: Vitality status, HFB participation, smoking, physical activity, alcohol consumption, body mass index (BMI), age and gender. The relationships between continuous response variables and nominal input variables were analysed using analysis of variance (ANOVA). When ordinal response variables were compared versus a nominal input variable, non-parametric ANOVA methods were used. Further, the Mann-Whitney test or the Kruskal-Wallis test was used. A p-value of p < 0.05 was considered to represent statistical significance, and 95% confidence intervals were used to describe the estimation of unknown parameters.Results: Of the sample, 67.13% of members had DBSPHRs that were considered 'poor or 'inadequate. The mean DBSPHR of the sample was 20.47 points. Women achieved better DBSPHRs than men (p<0.01). Greater engagement with the Vitality programme was associated with better DBSPHRs (p<0.01). There was no significant difference between the mean DBSPHR of members participating in the HFB and Non-HFB members, however the HFB was not assessed as an intervention. Members with 'risky lifestyle behaviours such as; inactivity, smoking and consuming alcohol excessively, demonstrated lower DBSPHR than members without these risks. Obese members achieved significantly lower DBSPHRs than normal weight and overweight members (p<0.01).Conclusions: It is concerning that Discovery Vitality members did not perform better than the general global standard of inadequate compliance with the 'spirit of dietary guidance. Engagement with the Vitality programme seems to positively impact on dietary compliance. Members at an increased risk for NCD morbidity and mortality due to; aging, obesity, smoking, inactivity or non-compliance with alcohol consumption guidelines, demonstrated lower DBSPHRs compared to members without these risks. Targeted interventions aimed at addressing 'risky dietary and lifestyle behaviours may benefit these members.

[发布机构] Stellenbosch University