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The nutritional status of black adults in rural districts of Natal and Kwazulu.

A nutritional field survey was undertaken in 11 rural districts of Kwazulu. Standard anthropometric measurements (weight, height, triceps skinfold thickness, mid-arm circumference) were taken from 1 725 adults (616 males, 1 109 females), including 337 old-age pensioners, and a recall dietary intake questionnaire was completed by 297 male and 572 female Zulus. Mean body weights (+/- SD) were 95 +/- 10% of ideal for males and 118 +/- 15% for females. Consequently 39% of the male sample was undernourished (i.e. less than 80% ideal weight) and 17% of the female group obese (greater than 140% ideal weight). Undernutrition was significantly more common in old-age pensioners, with 73% of males and 23% of females being below 80% of the standard for body weight. Diet consisted mainly of refined maize meal (putu) 2-3 times per day. Meat and fresh milk were rarely taken, the average intake frequency for men being once a week and for women once a fortnight. Vegetable intake was seasonal, wild spinach and cabbage being consumed daily only during the summer rainfall months. Average fibre intake was therefore surprisingly low at approximately 10 g/d per individual. In conclusion, although poor socio-economic conditions are the root cause of most of the malnutrition problems observed, basic nutritional education can at least partially help by advising the population of the importance of a varied diet and the problems associated with obesity. More use of legumes, eggs, milk and fish products should significantly improve the diet. The reasons for the particularly high incidence of malnutrition among the elderly need further investigation.