Malnutrition in Africa

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Addressing Malnutrition In South Africa.
Gary Klugman
South Africa is getting set to embark on a visionary National Food Fortification Program to address nutrient deficiencies. Scientists however, are beginning to question whether the program will actually achieve its objective of redressing nutrient deficiencies in children. Gary Klugman takes a look at the chemistry of the proposed national food fortification program and the anticipated efficaciousness. Get the facts and enter the debate. A national Food Fortification Program concerns EVERYONE.

World Declaration On The Survival, Protection And Development Of Children. The children of the world are innocent, vulnerable and dependent. They are also curious, active and full of hope. Their time should be one of joy and peace, of playing, learning and growing. Their future should be shaped in harmony and co-operation. Their lives should mature, as they broaden their perspectives and gain new experiences.

But for many children, the reality of childhood is altogether different.

What is the Food Fortification Programme?
Food, or the lack of it, is one of the factors affecting the nutritional status of children in South Africa. The Department of Health (DOH) in South Africa are embarking on a multi-faceted program to address malnutrition (nutrient deficiencies), that is rife amongst children aged 1 - 9 years old. One of these is a National Food Fortification Program where it is recommended to fortify wheat, maize flour and retail sugar, three of the five most commonly consumed food vehicles as reported by the National Food Consumption Survey.

The National Food Consumption Survey reported that for South African children as a whole, the average dietary intake of energy, calcium, iron, zinc, selenium, vitamin A, vitamin D, vitamin C, vitamin E, riboflavin, niacin, and vitamin B6 was less than 67% of the Recommended Dietary Allowances (RDA), and in many cases below 50% of the Recommended Dietary Allowances.

(1) Among infants and pre-schoolers, the more prevalent forms of nutrient deficiencies are those of iron, vitamin A, iodine, protein, energy, riboflavin, calcium and zinc. According to international agencies, millions of children suffer from deficiencies of iron, iodine and vitamin A. The incidence of these problems is markedly higher in developing countries; however, infants in industrialized countries are not spared. Iron deficiency has no borders and in industrialized countries approximately 15% of infants consume insufficient amounts of dietary iron.

Consequences and Causes of Malnutrition
Depending on the nutrient and the severity of deficiency, the consequences of malnutrition may include growth stunting, anorexia, susceptibility to infections, behavioral changes, and learning disabilities. The latter may have lifelong effects. For example, research has found that iodine deficiency and iron deficiency anaemia during infancy can cause mental retardation or inferior psychomotor function in childhood, even after the deficiencies have been corrected. The causes of these problems are multifactorial and include poverty, ignorance, faulty feeding practices, infections and infestations, food scarcity, consumption of foods of low nutrient density, and low bioavailability of food nutrients.

Internationally accepted criteria for food fortification programmes In South Africa food choices are limited and the amount of food consumed is relatively low, but for the age group of children 1 - 3 years of age the demand for nutrients is high, thus the fortification of foods has to adhere to internationally recognized principals, when selecting compounds to be used as fortificants:

1. Chemical structure. Physico-chemical characteristics.
2. Absorption mechanisms.
3. Bioavailability established by internationally recognized procedures. 4. Effectiveness as measured by field and clinical trials, using the compound as a supplement or in food fortification. 5....
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