Nutritional status of toddlers attending day care centres in Newton Park, Nelson Mandela Bay

[摘要] English: Current research highlights the importance of optimal nutritional status during the first three years of life, specifically toddlerhood (1 �?3 years), since this phase is characterised by crucial physical and neurological development, the establishment of lasting food preferences and eating habits, as well as an increased risk for stunting, rapid early weight gain and predisposition to development of Non-communicable Disease (NCD) in later life.However, despite the importance of optimal nutritional status in this age group, recent statistics reflect a global trend of children under five years consuming energy-dense diets with inadequate dietary diversity, hence characteristic of the nutrition transition. As a result, the incidence of stunting remains high, with statistics reflecting an increasing rate of overweight and obesity in this age group, which is suggestive of the double burden of malnutrition (DBM). The Eastern Cape Province ranked among the provinces with the highest rate of food insecurity, poor quality dietary intake and stunting in young children, yet no studies on the nutritional status of toddlers in this province could be located. Therefore, the current study aimed to evaluate the nutritional status, including socio-demographic information, clinical signs, anthropometry, dietary intake and child food security, of toddlers attending day care centres in Newton Park, Nelson Mandela Bay.A quantitative descriptive study was conducted over the period of 20 April to 27 May, recruiting 55 consenting toddlers with their primary caregiver, who attended one of the six consenting day care centres in Newton Park, Nelson Mandela Bay. Socio-demographic, child food security and dietary intake information were recorded via questionnaires by means of one-on-one semi-structured interviews conducted with caregivers, while anthropometric data was collected using standard measuring techniques and interpreted according to the current child growth standards by the World Health Organization's (WHO). Participants were predominantly English speaking (56.4%) Caucasian (56.4%) and resided in non-overpopulated formal dwellings (100%) with an average of three to four household members (72.7%).The average monthly household income reported by most caregivers (80%) were above the tax return threshold; R10 000 to R40 000 (low to average monthly income).However, considering a mean household size of three to four members, this level of income may have posed a risk for the development of low food security.Anthropometric analysis reflected the DBM, in that participants were affected by both stunting (7.3%) and overweight / obesity (9.1%). Stunting affected mostly the older age subgroup, while overnutrition was identified in those as young as one year of age. These results highlighted the presence of the DBM, as well as the associated increased risk for NCDs in adulthood.A statistically significant association was found between the level of food security and growth (weight-for-age and length/height-for-age measurements) of participants. Therefore, since one in five participants had a low level of food security, food insecurity also contributed to poor growth and development.Most participants consumed energy-dense diets, consisting largely of refined carbohydrates (CHO), high fat and low fibre sources, as confirmed by the excessive consumption of animal protein sources, added fat, sugars and processed food, in detriment of fruit, vegetables, legumes, whole grain starches and dairy. Additionally, only three participants (5.5%) consumed diets with optimal dietary diversity, suggesting a trend of energy-dense foods, high in added sugar and / or fat, like cookies and sugar-sweetened beverages (SSB), taking preference over nutrient-dense sources, such as fruit, vegetables and wholegrain starches.In summary, results from the current study supported reflected trends of nutrition transition, leading to the DBM and thus an increased risk of NCD and NCD's in adulthood. Results highlight the need for nutrition intervention in the form of educational sessions aimed at parents and day care centre personnel, aiming to ensure optimal development and better future health in toddlers from Nelson Mandela Bay.

[发布机构] University of the Free State