An assessment of the potential contribution of micronutrient-enriched food products available from major food retailers to the micronutrient intake of South African adolescents

Thesis (MScFoodSc)--Stellenbosch University, 2022.

ENGLISH ABSTRACT: Recent global actions have brought attention to health and nutrition issues facing adolescents and the need to address adolescent malnutrition in all its forms. Malnutrition may include under- or overnutrition, and micronutrient deficiencies or excesses. Micronutrient fortification and enrichment of food products can assist in the prevention of micronutrient deficiencies. However, to protect against other forms of malnutrition, the healthfulness or nutritional quality of these food products should also be considered. Micronutrient-enriched food products are available in South Africa. However, limited information is available on the extent of micronutrient-enrichment and the potential of these food products to contribute to adolescent intake of micronutrients without adding to the burden of overnutrition and the risk of multiple non-communicable diseases (NCDs) later in life. This research assignment aims to add to the knowledge base in this area by assessing the potential contribution of micronutrient-enriched food products available in South Africa to the diet of adolescents. A cross-sectional study of the South African micronutrient-enriched packaged food and beverage supply during a three-month period (July to September) in 2021, was used to assess the potential contribution of these food products to the diet of adolescents in terms of micronutrient content and healthfulness. Primary data (involving ingredient lists and nutritional information) was collected online from the main food retailers in South Africa. The micronutrient-enriched food products were tabulated and categorised according to the Nutrient Profile Model for the World Health Organization African Region. A total of 422 food products were found to be enriched with vitamins and/or minerals. The beverage category had the most micronutrient-enriched food products in this study (46%), followed by the breakfast cereals category (24%). Vitamins were most frequently added, led by vitamin A (55% of micronutrient- enriched food products). Minerals were added less frequently, with iron being the most frequently added mineral (26% of micronutrient-enriched food products). The breakfast cereals category had the greatest range of enrichment, with some food products enriched with 13 vitamins (A, B1, B2, B3, B5, B6, B7, B9, B12, C, D, E and K) and eight minerals (calcium, chromium, iron, iodine, magnesium, phosphorus, selenium, and zinc). Micronutrient-enrichment levels varied between the food products, but most of the levels were high enough for South African nutrient content label claims. This indicates that the micronutrient-enriched food products in this study could potentially contribute towards the daily intake of micronutrients by adolescents. However, only 9.5% of the micronutrient-enriched food products are suitable for inclusion in a healthy diet for adolescents, as the rest may contribute towards the burden of overweight and diet-related NCDs. This presents a valuable opportunity to the South African food industry for product reformulation to contribute to the health and nutrition of adolescents.

AFRIKAANSE OPSOMMING: Onlangse wêreldwye aksies het die aandag gevestig op gesondheids - en voedingskwessies wat adolessente in die gesig staar en die behoefte om wanvoeding in al sy vorms aan te spreek. Wanvoeding kan onder- of oorvoeding insluit, sowel as mikronutriënt-tekorte of -oorskotte. Die verryking van voedselprodukte met mikronutriënte kan help om mikronutriënt-tekorte te voorkom. Om adolessente egter te beskerm teen ander vorms van wanvoeding, moet die voedingskwaliteit van hierdie voedselprodukte ook in ag geneem word. Mikronutriënt-verrykte voedselprodukte is beskikbaar in Suid-Afrika. Beperkte inligting is egter beskikbaar oor die omvang van mikronutriënt-verryking, en die potensiaal van hierdie voedselprodukte om by te dra tot adolessente se inname van mikronutriënte, sonder om by te dra tot die las van oorvoeding en die risiko van veelvuldige nie-oordraagbare siektes (NCDs) later in hulle lewens. Hierdie navorsingsopdrag het ten doel om by te dra tot die kennisbasis in hierdie gebied, deur die potensiële bydrae van mikronutriënt- verrykte voedselprodukte wat in Suid-Afrika beskikbaar is, tot adolessente se dieet te evalueer. 'n Deursnitstudie van die Suid-Afrikaanse mikronutriënt-verrykte verpakte voedsel- en nie- alkoholiese drank beskikbaar in ‘n drie-maande periode (Julie – September) in 2021, is gebruik om die potensiële bydrae van hierdie voedselprodukte tot die dieet van adolessente in terme van mikronutriënt- inhoud en gesondheid te evalueer. Primêre data (wat bestanddele en voedingsinligting insluit) is aanlyn van die grootste voedselkleinhandelaars in Suid-Afrika versamel. Die mikronutriënt-verrykte voedselprodukte is gekategoriseer volgens die “Nutrient Profile Model for the World Health Organization African Region”. 422 voedselprodukte was met vitamiene en/of minerale verryk. Die nie-alkoholiese drankkategorie het die meeste mikronutriënt-verrykte voedselprodukte in hierdie studie gehad (46%), gevolg deur die ontbytgraankategorie (24%). Vitamiene is die meeste bygevoeg, gelei deur vitamien A (55% van mikronutriënt-verrykte voedselprodukte). Minerale is minder gereeld bygevoeg, met yster die mees bygevoegde mineraal (26% van mikronutriënt-verrykte voedselprodukte). Die ontbytgraankategorie het die wydste verskeidenheid verryking gehad, met sommige voedselprodukte wat verryk is met 13 vitamiene (A, B1, B2, B3, B5, B6, B7, B9, B12, C, D, E en K) en agt minerale (kalsium, chroom, yster, jodium, magnesium, fosfor, selenium en sink). Mikronutriënt-verrykingsvlakke het gewissel tussen die voedselprodukte, maar meeste van die vlakke was hoog genoeg om mikronutriënt-aansprake te maak op die etikette van Suid- Afrikaanse voedselprodukte. Dit dui daarop dat die mikronutriënt-verrykte voedselprodukte in hierdie studie potensieel kan bydra tot adolessente se daaglikse inname van mikronutriënte. Slegs 9.5% van die mikronutriënt-verrykte voedselprodukte is egter geskik vir insluiting in 'n gesonde dieet vir adolessente, aangesien die res kan bydra tot wanvoeding (oorvoeding) en dieetverwante NCDs. Dit bied 'n waardevolle geleentheid aan die Suid-Afrikaanse voedselbedryf vir produkherformulering om by te dra tot die gesondheid en voedingstatus van adolessente.

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