Food intake, socio-economic factors and health status of free-living, white residents living in an elderly residential facility in Morningside, Durban

Abstract

Food intake patterns, socio-economic factors, health and nutritional status of free-living, white residents living in an elderly residential facility in Morningside, Durban. RATIONALE AND OBJECTIVE The objective of the study was to conduct an analysis of elderly people living in Morningside, Durban, KwaZulu-Natal, South Africa. The research focused on the socio-economic status, the dietary intake, the nutritional status and the health status of this community. METHODOLOGY The sample comprised 150 (125 women and 25 men) randomly selected white residents, residing in an elderly care facility located within ward 27 of Durban. The methods used for assessment included a socio-demographic questionnaire which determined their socioeconomic status. A 24-Hour recall questionnaire and a food frequency questionnaire were used to determine dietary intake, while anthropometric measurements were conducted to determine their nutritional status. A health questionnaire was used to determine the health status of the participants. Trained field workers and nurses assisted in the data collection and food consumption data was captured and analysed by a qualified dietician using the Food Finder version 3.0 computer software program. Descriptive statistics (frequencies, means, standard deviations and confidence intervals) were determined with the assistance of a bio-statistician. Socio-demographic and health data were captured onto an Excel ® spreadsheet by the researcher. These questionnaires were analysed using the Statistical Package for Social Sciences (SPSS) for Windows version 17, 0 software program. RESULTS The results indicated that most participants were not financially secure. Many of the participants were widowed and lived alone. A number of the participants relied on their pensions (31.3%, n=32) and very few had a job or any other source of income (6.7%, n=10). Most of the participants said that there was always enough money for food (80.0%, n=120). The BMI results showed that 39.3% (n=59) of the participants were obese. This was mostly observed in the women, where 40.8% (n=51) were obese. This can be linked to the high consumption of a carbohydrate-based diet and a lack of dietary diversity as well as possible lack of physical exercise; 35.3% (n=53) of men and women were of normal weight The nutrient analysis of the 24-Hour recall showed that there was a nutrient deficiency in energy, dietary fibre, calcium, iodine, phosphorus, magnesium and vitamin D. The total fat intake was slightly higher than the recommended intake by the WHO (15-30.0%), with men obtaining 32.4% and women obtaining 32.6% of energy from fat. Carbohydrates and dietary fibre contributed 48.1% for men and 49.3% for women of the daily energy needs for the group, slightly below the recommended 55-75.0%. The protein contribution to total energy intake was above the recommendation of 10-15.0% for both men and women. The men had an intake of 19.5% and the women had an intake of 17.9%. This shows that the average person ate a balanced diet in terms of macronutrients intake. Carbohydrates were the main source of food with the average amount consumed within the group being 152.7 g per day. This was above the recommended amount for this age group, which is 100 g per day. The most consumed sources of carbohydrates were bread or rolls, breakfast cereals, rice, potatoes and pasta. This could be due to the fact the residents received free bread from the facility every week. This bread was donated by a local bakery. These results indicated that the participants consumed a variety of foods but not in sufficient amounts needed to meet the daily recommended requirements. The fruit and vegetable consumption was high, with a mean intake of 219.7 g per person, but this is less than the amount needed to meet the recommendations for this age group. Consumption of dairy products was high, with the per capita intake for one day being 303.2 g for the group. This means that the average person consumed 303.2 g of dairy products a day. The main sources of dairy products consumed were milk, cheese, margarine and yoghurt. These high amounts are required for this age group due to weakening bones and the risk of osteoporosis; however, this rate of dairy consumption did not meet the calcium requirements for this age group. Health factors that were self-reported by the elderly included issues with the skeleton (47.3%, n=71), sensory organs (49.3%, n=74), and the heart or circulation (29.3%, n=44). Many reported suffering from other illnesses (42.6%, n=64) such as diabetes and high cholesterol CONCLUSION The results show that the community did not face poverty, food insecurity or any adverse social factors such as lack of money or food choices. There was a relatively high number of obese participants (39.3%); therefore these participants were classified as malnourished. There needs to be a nutritional intervention aimed at changing the food-purchasing choices of the elderly, and placing emphasis on healthier food preparation and reducing the high level of carbohydrate intake as well as encouraging physical activity.