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South African Food-Based Dietary Guidelines ISSN 1607-0658 Food-Based Dietary Guidelines for South Africa S Afr J Clin Nutr 2013;26(3)(Supplement):S1-S164 FBDG-SA 2013 www.sajcn.co.za Developed and sponsored by: Distribution of launch issue sponsored by ISSN 1607-0658 Food-Based Dietary Guidelines for South Africa S Afr J Clin Nutr 2013;26(3)(Supplement):S1-S164 FBDG-SA 2013 www.sajcn.co.za Table of contents Cited as: Vorster HH, Badham JB, Venter CS. An 9. “Drink lots of clean, safe water”: a food-based introduction to the revised food-based dietary guidelines dietary guideline for South Africa Van Graan AE, Bopape M, Phooko D, for South Africa. S Afr J Clin Nutr 2013;26(3):S1-S164 Bourne L, Wright HH ................................................................. S77 Guest Editorial 10. The importance of the quality or type of fat in the diet: a food-based dietary guideline for South Africa • Revised food-based dietary guidelines for South Africa: Smuts CM, Wolmarans P.......................................................... S87 challenges pertaining to their testing, implementation and evaluation 11. Sugar and health: a food-based dietary guideline Vorster HH .................................................................................... S3 for South Africa Temple NJ, Steyn NP .............................................................. S100 Food-Based Dietary Guidelines for South Africa 12. “Use salt and foods high in salt sparingly”: a food-based dietary guideline for South Africa 1. An introduction to the revised food-based dietary Wentzel-Viljoen E, Steyn K, Ketterer E, Charlton KE ............ S105 guidelines for South Africa Vorster HH, Badham JB, Venter CS ........................................... S5 13. “If you drink alcohol, drink sensibly.” Is this 2. “Enjoy a variety of foods”: a food-based dietary guideline still appropriate? guideline for South Africa Jacobs L, Steyn NP................................................................. S114 Steyn NP, Ochse R .................................................................... S13 3. “Be active!” Revisiting the South African food-based Paediatric Food-Based Dietary Guidelines for dietary guideline for activity South Africa Botha Wright HH, Moss SJ, Kolbe-Alexander TL ..................... S18 I. Commitment and capacity for the support of 4. “Make starchy foods part of most meals”: a food-based breastfeeding in South Africa: a paediatric food-based dietary guideline for South Africa dietary guideline Vorster HH .................................................................................. S28 Du Plessis LM, Pereira C ......................................................... S120 5. “Eat dry beans, split peas, lentils and soya regularly”: II. Complementary feeding: a critical window of a food-based dietary guideline for South Africa opportunity from six months onwards Venter CS, Ochse R, Swart R ................................................... S36 Du Plessis LM, Kruger HS, Sweet L ......................................... S129 6. “Eat plenty of vegetables and fruit every day”: a food-based III. Responsive feeding: establishing healthy eating dietary guideline for South Africa behaviour early on in life Naude CE ................................................................................. S46 Harbron J, Booley S, Najaar B, Day CE ................................ S141 7. “Have milk, maas or yoghurt every day”: a food-based dietary guideline for South Africa IV. Oral health and nutrition for children under five years Vorster HH, Wright HH, Wentzel-Viljoen E, Venter CS, of age: a paediatric food-based dietary guideline Vermaak M ............................................................................... S57 Naidoo S ................................................................................. S150 8. “Fish, chicken, lean meat and eggs can be eaten V. Food hygiene and sanitation in infants and young daily”: a food-based dietary guideline for South Africa children: a paediatric food-based dietary guideline Schonfeldt HC, Pretorius B, Hall N .......................................... S66 Bourne LT, Pilime N, Sambo M, Behr A ................................. S156 © SAJCN 2013, www.sajcn.co.za Published under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.5 South Africa License, by Medpharm Publications (Pty) Ltd This work must be cited as follows: Vorster HH, Badham JB, Venter CS. An introduction to the revised food-based dietary guidelines for South Africa. S Afr J Clin Nutr 2013;26(3):S1-S164 Front cover image: Reprinted with permission from the National Department of Health, South Africa Directorate Nutrition Private Bag x 828 Pretoria 0001 Tel: (012) 395-8782 Fax: (012) 395-8802 ISSN 1607-0658 Acknowledgements This guideline has been developed and sponsored by: Distribution of 500 launch copies was co-sponsored by: S Afr J Clin Nutr S2 2013;26(3)(Supplement) Guest Editorial Revised food-based dietary guidelines for South Africa: challenges pertaining to their testing, implementation and evaluation Food-based dietary guidelines (FBDGs) are brief, positive and undernutrition6,8 in segments of the population, while dietary recommendation messages that are used to overweight and obesity, and the consequent risk of NCDs, inform consumers how to choose food and beverage are on the increase.6,7,9 The rapid nutrition transition,7 combinations that will lead to a diet that is adequate, that an outcome of the present economic development, meets nutrient need and that is, at the same time, prudent, urbanisation and modernisation of South African society, for example, which lowers the risk of noncommunicable is a major contributor to this double burden. Therefore, the diseases (NCDs).1 FBDGs are based on the best available challenge is to use the FBDGs to guide undernourished scientific evidence on the relationship between what we and overnourished consumers towards behavioural eat and our health. Furthermore, country-specific FBDGs change that will lead to optimal nutrition. This challenge are influenced by prevailing eating patterns and public dictated the format of the FBDGs, ensuring that they were health problems within the country.1 user friendly to a wide variety of consumers. This special supplement in the current issue of the SAJCN The aim of changed behaviour will only be reached if the publishes the technical support papers which motivate FBDGs are used in nutrition programmes and interventions and explain each of the recently revised South African that are holistic and transdisciplinary, and which take FBDG messages. into account factors that influence dietary choice. These The revisions were executed for the following reasons: factors include which food and beverages are available, affordable and preferred, and are themselves influenced • Firstly, when the South African FBDGs were initially by numerous other factors. Factors relate to poverty and designed and adopted by the Department of Health food insecurity, lack of care, illness, and possibly the as “official” dietary recommendations for South Africa, absence of knowledge among the undernourished about it was advised that they should be revised regularly the best food and beverage choices to make within the to assess if they still reflect the most recent available scientific evidence on the influence of dietary intake confines of a low budget. Clearly, there is a need to help on health and disease.2 consumers adopt better child feeding practices and to choose more adequate diets. • Secondly, the Department of Health, Chief Directorate: Health Promotion and Nutrition, recently developed At the same time, the consequences of overnutrition, the first country-specific food guide for South Africa, associated with a high intake of energy from highly and wanted to ensure that the FBDGs and the food processed, energy-dense, micronutrient-poor, oily and guide were aligned, so that the latter could be used salty take-away convenience foods and beverages, are with confidence to implement the FBDGs in efforts to major contributors to morbidity and mortality in South educate consumers about healthy eating. Africa.9 The many factors leading to this unfortunate • Thirdly, reports from practising dietitians and nutritionists modern eating pattern of a population in economic indicated that some of the FBDGs in the first set, transition probably relate to complicated social, especially the alcohol FBDG,3-4 might be misinterpreted psychological and biological interactions. Clearly, there by consumers. is a need to influence dietary behaviour towards a more • Finally, the Department of Health requested that the prudent diet. 5 existing paediatric FBDGs for South Africa should be The South African FBDGs were developed to address revisited, so that they could become an integral part both dietary adequacy and prudency. When the dietary of the general recommendations for healthy eating. recommendations are followed, the result should be The main purpose of the South African FBDGs, together optimum nutrition, commensurate with optimum physical with the food guide and education material that must and mental development, a lowered risk of NCDs, and be developed based on the technical support papers health and well-being throughout the life course. published in this supplement, is to inform, educate and Therefore, the way in which the FBDGs are used to empower South African consumers to change their eating inform consumers about healthier eating behaviour behaviour. will differ, depending on the needs of the target group. Changed
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