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Optimizing Micronutrient Intake of Lactating Women in Kwazulu-Natal, South Africa, Through Increased Wild Edible Plant Consumption

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Optimizing Micronutrient Intake of Lactating Women in Kwazulu-Natal, South Africa, Through Increased Wild Edible Plant Consumption OPTIMIZING MICRONUTRIENT INTAKE OF LACTATING WOMEN IN KWAZULU-NATAL, SOUTH AFRICA, THROUGH INCREASED WILD EDIBLE PLANT CONSUMPTION A Thesis Presented to the Faculty of California Polytechnic State University, San Luis Obispo In Partial Fulfillment of the Requirements for the Degree Master of Science in Agriculture, Food Science and Nutrition Specialization By Kerry Pearson June 2011 ©2011 Kerry Pearson ALL RIGHTS RESERVED ii COMMITTEE MEMBERSHIP TITLE: OPTIMIZING MICRONUTRIENT INTAKE OF LACTATING WOMEN IN KWAZULU-NATAL, SOUTH AFRICA, THROUGH INCREASED WILD EDIBLE PLANT CONSUMPTION AUTHOR: Kerry Pearson DATE SUBMITTED: June 2011 COMMITTEE CHAIR: Peggy Papathakis, Ph.D. Food Science and Nutrition COMMITTEE MEMBER: Lisa Nicholson, Ph.D. Food Science and Nutrition COMMITTEE MEMBER: Dawn Neill, Ph.D. Social Sciences iii 0B ABSTRACT OPTIMIZING MICRONUTRIENT INTAKE OF LACTATING WOMEN IN KWAZULU-NATAL, SOUTH AFRICA, THROUGH INCREASED WILD EDIBLE PLANT CONSUMPTION Kerry Pearson Micronutrient consumption in KwaZulu-Natal, South Africa, is insufficient to meet the needs of lactating women. Inadequate intake negatively impacts the health of both the mother and infant. Increasing consumption of wild edible plants has been recommended to combat these deficiencies, but information has not yet been provided on which types of wild plants should be eaten or in what quantity. The objective of this study was to determine the optimal mixture of wild edible plants that needs to be consumed to meet the micronutrient needs of lactating women in rural KwaZulu-Natal, South Africa. This was done by creating optimization models using linear programming. Components of these models included identifying gaps between current micronutrient intake and recommended intake levels and the creation of composite nutrient profiles for groups of wild edible plants available in KwaZulu-Natal. One model calculated the optimum amount of wild edible plants that would need to be consumed in addition to the current diet to meet micronutrient recommendations. A second semi-isocaloric model calculated the optimum amount of wild edible plants that would need to be consumed if half the additional calories would replace an equivalent number of calories of the main staple food, maize. A combination of 250g leafy vegetables and 349g fruit, replacing 54g iv of maize meal, was determined to be the best model. This mixture will meet the micronutrient needs of 50% of lactating women and would add only 192 calories to the diet. The same blend will meet the needs of 75% of women for all nutrients except calcium, zinc, thiamin, and riboflavin. It is hoped that increased use of wild plants will also increase physical activity and make the consumption of high quality animal products more economically feasible. Understanding forces that have brought about current dietary patterns in this population and working in tandem with other nutrition intervention programs will be the best way to successfully implement these goals. More complete information is needed on the nutrient profiles of wild edible plants in South Africa and on how anti-nutrients in these plants effects bioavailability of nutrients and the health of the consumer. Despite these limitations, it is clear that a reasonable increase in wild edible plant consumption can have a tremendous positive impact on micronutrient consumption of lactating women in KwaZulu-Natal, South Africa. v 1B ACKNOWLEDGEMENTS Much thanks to my graduate committee, who supported me in all my crazy ideas, but were never afraid to tell me I was wrong. And a huge thanks to my parents for feeding me and letting me live at home. I couldn’t have done it without you. vi 2B TABLE OF CONTENTS Page LIST OF TABLES ............................................................................................................. ix LIST OF FIGURES ........................................................................................................... xi CHAPTER 1: INTRODUCTION ....................................................................................... 1 CHAPTER 2: REVIEW OF LITERATURE ...................................................................... 3 2.1 Nutrition Transition .................................................................................................. 4 2.2 Diet Related Health Problems in South Africa ....................................................... 12 2.2.1 Infectious Disease and Nutrition ...................................................................... 13 2.2.2 HIV/AIDS and Nutrition .................................................................................. 14 2.2.3 Chronic Disease and Nutrition ......................................................................... 16 2.3 Intervention Programs ............................................................................................. 18 2.3.1 Supplementation .............................................................................................. 19 2.3.2 Fortification ...................................................................................................... 20 2.3.3 Food aid ........................................................................................................... 21 2.3.4 Home and community gardens ........................................................................ 22 2.4 Consumption of Wild Edible Plants ....................................................................... 23 2.4.1 General use of wild edible plants ..................................................................... 24 2.4.2 Wild edible plants in KwaZulu-Natal, South Africa........................................ 26 2.4.3 Reasons for declining consumption ................................................................. 29 2.4.4 Suggestions for encouraging use ..................................................................... 30 2.5 Modeling Methods .................................................................................................. 31 2.5.1 Dietary Assessment .......................................................................................... 32 2.5.2 Seasonality ....................................................................................................... 33 2.5.3 Food group composites .................................................................................... 34 2.5.4 Linear programming ........................................................................................ 35 2.6 Conclusion .............................................................................................................. 36 CHAPTER 3: MATERIALS AND METHODS .............................................................. 38 3.1 Objective ............................................................................................................. 38 3.2 Subjects ............................................................................................................... 38 vii 3.3 Diet ...................................................................................................................... 40 3.4 Nutrient profiles of wild edible plants ................................................................ 42 3.5 Optimizing intake ................................................................................................ 44 CHAPTER 4: RESULTS .................................................................................................. 49 4.1 Diet ...................................................................................................................... 49 4.2 Nutrient profile of wild edible plants .................................................................. 50 4.3 Optimizing intake ................................................................................................ 51 CHAPTER 5: DISCUSSION ............................................................................................ 55 CHAPTER 6: CONCLUSION ......................................................................................... 63 REFERENCES ................................................................................................................. 65 Appendix A: The Nutrition Transition in KwaZulu-Natal, South Africa ......................... 77 Appendix B: Wild Fruits and Vegetables of KwaZulu-Natal, South Africa .................. 126 Appendix C: Nutrient Profiles of Wild Edible Plants ..................................................... 140 viii 3B LIST OF TABLES Page Table 2-1. Summary of nutrition transitions and influencing factors in KwaZulu-Natal, South Africa ............................................................................................. 7 Table 2-2. Comparison of nutrient composition per 100g of cooked wild and conventional green leafy vegetables ................................................................................. 29 Table 2-3. Ideas for supporting indigenous food systems ............................................... 30 Table 3-1. Baseline characteristics of breastfeeding mothers .......................................... 39 Table 3-2. Average pre-fortification intakes of fortified nutrients for all women (n=142) compared to intakes of the sub-sample with records both before and after fortification (n=34) ........................................................................................................... 41 Table 3-3. Average difference in fortified nutrient intake following fortification of maize and wheat products ................................................................................................
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