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Determining the Contribution of the National School Nutrition Programme to the Total Nutrient Intake of Mogale City Learners

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Determining the Contribution of the National School Nutrition Programme to the Total Nutrient Intake of Mogale City Learners DETERMINING THE CONTRIBUTION OF THE NATIONAL SCHOOL NUTRITION PROGRAMME TO THE TOTAL NUTRIENT INTAKE OF MOGALE CITY LEARNERS PUMLA KGOMOTSO MONALA Research dissertation submitted in fulfilment of the requirements for the degree Magister Technologiae Food Service Management in the Department of Hospitality, Tourism and PR Management, In the Faculty of Human Sciences, Vaal University of Technology. Vanderbijlpark 2018 Supervisor: Prof. A.A Egal Co-supervisor: Prof. E.G Dicks DECLARATION This work has not been accepted in substance for any degree and is not being concurrently submitted in candidature for any degree Signed ___________________ Date_____________________ STATEMENT 1 This dissertation is being submitted in partial fulfillment of the requirements for the degree of Masters Technology: FOOD SERVICE MANAGEMENT Signed___________________ Date_____________________ STATEMENT 2 This dissertation is the result of my own independent work/investigation, expert where otherwise stated. Other sources are acknowledged by giving explicit references. Signed__________________ Date____________________ STATEMENT 3 I hereby give consent for my dissertation, if accepted, to be available for photocopying and for interlibrary loan, and for the title and summary to be made available to outside organisations. Signed___________________ Date_____________________ ii ACKNOWLEDGEMENTS The financial assistance of the Vaal University of Technology towards this research is hereby acknowledged. Opinions expressed and conclusions arrived at are those of the author and are not necessarily to be attributed to the Vaal University of Technology This study would have not been possible without the strength and the grace from the God Almighty. My gratitude and appreciation is expressed to the following people and organisations; • Professor Abdulkadir Egal, my supervisor. Thanks for your support, patience, advice, encouragement and most importantly for sharing your knowledge with me. • Professor Emmerentia Dicks, my co-supervisor. Our journey has been quite a long one, but through it all, you still managed to shape me academically into the person I am today. Thank you. • Thank you to the Vaal University of Technology CSL Research Team for assistance with data capturing. • A special thank you to the participating school children, the principal, teachers and food handlers. • Thank you to the fieldworkers from the University of South Africa. • A special thank you to my dad, Reverent Parker Monala. • To my partner, Jean Saouchi, Thank you. iii DEDICATION This study is dedicated to my mother, Fezeka and my father, Reverent Parker Monala. Thank you for your undying support. iv ABSTRACT The purpose of this study was to determine the contribution of the National School Nutrition Programme (NSNP) has made on the total nutrient intake of Kagiso learners. This was done by investigating the nutrient intake of school children participating in the NSNP (experimental group) and comparing this to the nutrient intake of learners participating in the tuck-shop or lunch box (control group) from one school. The research methodology was undertaken in two phases, namely phase one; planning and phase two; data collection and analysis. The following measuring methods were applied; socio-demographics, household food insecurity assessment scale, anthropometry measurements, food frequency questionnaires (FFQ), 24-hour recall and the observation of the NSNP during the school lunch breaks. Anthropometry measurements were analysed according to the World Health Organization standards (WHO 2008), socio-demographics, and household food insecurity assessment scale and FFQ were captured on an Excel spreadsheet by the researcher and analysed using the Statistical Package for Social Sciences (SPSS) version 22.0 for descriptive statistics such as frequencies, standard deviations and confidence intervals. An expediency sample of 160 primary school children aged 6-13 years, including girls (n=84) and boys (n=76) and 106 caregivers were recruited into the study. The results showed that majority of caregivers (59%) completed secondary level education, followed by 39% with primary level or college completion (2%). The employment rate in the Kagiso households of the sampled group was low with 20% of caregivers being unemployed. Out of the 76% of the employed caregivers, 26% were permanently employed and 51% were temporarily employed with contract work and piece jobs. The highest monthly income (42%) was between R1000-R3000 and the lowest (38%) was less than R1000 with only R101-R200 to spend on food per week. The food insecurity status of Kagiso learners showed that 44% of school children were food secure, and 56% were food insecure – of these, 29% experienced hunger. Height- for-age, weight-for-age and BMI-for-age were measured for all of the 160 children. The group was categorized as follows; school children participating in the NSNP (n=59) and v children using the tuck-shop foods (n=35) and lunch box (n=66). The nutritional status of Kagiso learners from the sampled group showed that more boys were stunted (13%) and wasted (12%) while of the girls, 30% were at risk of being overweight, with only 2% reported to be overweight. The majority of boys reported to be stunted and wasted were from the NSNP group and the girls reported to be overweight or at risk of being overweight were from the tuck-shop group. Thus, the learners from the lunchbox had optimum growth status when compared to the other two groups. The respondents consumed a mainly high carbohydrate diet with a low consumption of vegetable and fruits. The results from the Food Variety Score (FVS) revealed a low individual mean (2.25±1.57) in the legume and nuts group, followed by a medium individual mean (7.9±2.81) in the fruits and other juices group, 7.16±2.68 in the vegetable group, and lastly, the highest individual mean (9.26±3.04) in the cereal, roots and tubers diversity. The results from the top 20 popular food items ranked as follows; maize meal stiff (1st), maize meal porridge (5th), white rice (6th), white bread (7th) brown bread (9th), potato fries (12th), breakfast cereal (13th) and samp and beans (14th). Cabbage (15th) and pumpkin (20th) were the most popular vegetables and there were no fruits within the top 20 popular list of food items. The Nutrient Adequacy Ratio (NAR) of the NSNP (n=59) meals was below the 1/3 (33.3%) and 30% dietary requirements for lunch meals. This was very evident regarding vitamin A (16.85%), energy kilojoules (23.78%), calcium (18%), folate (26.72%), zinc (15.71%), dietary fiber (25.71%) and iodine (4.65%). Iron (38.98%) was slightly above the 1/3 and 30% dietary intake, but there were a high percentage (61%) of respondents who did not meet the EARs of 5.9mg for iron. The results revealed an inadequate contribution by the NSNP to the nutrient intake of Kagiso learners. The poor intake of folate, vitamin A and dietary fiber in this sampled group is linked to the low consumption of vegetable and fruits. Results from this observational study showed that a majority of respondents do not participate in the NSNP when they do not have their own eating utensils. Respondents also revealed that the NSNP meals caused allergies such as skin rash while some vi mentioned diarrhea as the cause of not eating meals from the NSNP. Hence, a larger percentage (41%) of school children preferred to participate in the lunch box rather than in the NSNP (37%). The high prevalence of inadequate nutrient intake and the poor nutritional status of Kagiso learners in the sampled group, is an indication that strict monitoring of dietary measures needs to be implemented and continuously evaluated to ensure that positive nutritional results are obtained by the NSNP across South Africa. Keywords: school children, NSNP, nutritional status, dietary intake. vii LIST OF TABLES Table 2.1 The impact of nutrition on education. Source from Adu-Afarwuahs et al. (2007:86) and DoBE (2010c). 29 Table 2.2 Fact sheet: South African school feeding programme. Source: Adopted from Case study of the National School Nutrition Programme in South Africa (2013:11). 30 Table 2.3 NSNP meal plan with appropriate portion sizes. Source: Adopted from the Department of Basic Education (2010c). 34 Table 2.4 DRIs of reference for height and weight in children aged 9-13 (NICUS 2007:12). 54 Table 2.5 DRIs for the required energy consumption of girls and boys aged 9-13 (NICUS 2007:18). 54 Table 2.6 Food-based guidelines. Source: Adopted from Vorster et al (2013). 60 Table 3.1 Data collection schedule. 83 Table 4.1 Respondents demographic profile. 89 Table 4.2 Personal profile of caregivers according to gender and age (n=106). 90 Table 4.3 Caregivers living conditions. 91 Table 4.4 Level of education and home language. 91 Table 4.5 Employment and household income status. 93 Table 4.6 Responses of Kagiso learners to the nine HFIAS questions. 97 Table 4.7 The overall distribution of Kagiso learners based on WHO growth indicators (WHO 2003) n=160. 99 Table 4.8 The distribution of learners participating in the NSNP compared to learners participating in the tuck-shop and lunch box based on WHO growth indicators (WHO 2003). 102 Table 4.9 Summary of the food groups as measured by FFQ. 103 Table 4.10 Popular top 20 food items ranked by the mean intake, portion sizes, per capita mean and number of participants measured by 24-hour-recall (n=160). 105 viii Table 4.11 The overall dietary intake of respondents measured by 24-hour recall (n=160). 107 Table 4.12 Contribution of the NSNP to the nutrient mean intake of respondents as measured by the 24-hour recall (n=59) with DRIs. 109 Table 4.13 Comparison of the dietary mean intake from the NSNP meals with the dietary meal intake from the tuck shop and the lunch box meals as measured by 24-hour recall (n=160).
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