Dietary diversity and adequacy of women caregivers in a peri-urban informal settlement in South Africa.

OBJECTIVE: Simple measures reflecting dietary quality are preferred for assessment of dietary intakes in low-income communities, e.g. dietary diversity that reflects a healthy, varied, nutritious diet, associated with nutrient adequacy. A strong association between household income and food access suggests dietary diversity assessment as one of the indicators of household food security. The aim of this study was to assess the food security situation of black women in an informal settlement by exploring their food access capabilities through dietary diversity measures and the coping strategies they employ to cope with poverty and hunger.

METHODS: A randomly selected sample of black women living in an informal settlement completed a pretested socio-demographic questionnaire (socio-economic circumstances) and validated questionnaires (1-wk quantified food frequency questionnaire: diversity measures; 24-h recall: nutrient intake; Cornell Hunger Scale: coping strategies). Food variety scores and food group diversity scores were calculated from frequency analyses for all foods and food groups. Nutrient adequacy ratios for various nutrients and the mean adequacy ratio for their diet were calculated. Relationships between dietary diversity and nutritional adequacy were investigated with Pearson correlations. Food variety score cut points were tested for sensitivity and specificity against nutritional adequacy.

RESULTS: Intakes were deficient for all nutrients except carbohydrates. Individual mean ± SD nutrient adequacy ratios ranging between 0.15 ± 0.18 and 0.95 ± 0.19 confirmed the poor dietary quality. Zero to 40 individual foods were consumed, but the mean ± SD food variety score was only 3.17 ± 1.21, indicating low food diversity, as did the low dietary diversity score (2.82 ± 0.99) using 0 to 6 food groups.

CONCLUSIONS: Limited food access and food variety in poor households resulted in inadequate nutrient intakes (low nutrient adequacy ratios), confirmed by poor dietary diversity (food variety score and food group diversity score). Dietary diversity assessment can successfully replace traditional dietary assessment tools in poverty-stricken or low-income communities where quick assessments are often required to assess the greatest need.