CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 5, June 2012
AFRICA
247
in low-income groups. Largely unrefined carbohydrate-rich
foods are excellent sources of dietary fibre and provide several
important vitamins and minerals.
33
It is also recommended that
in a healthy, balanced diet, protective against chronic diseases
of lifestyle, at least 55% of the total energy (%E) should be
provided by a variety of carbohydrate-rich foods, with around
30%E provided by fat and 15%E by protein. To provide at least
55%E in an 8 500 kJ diet, at least 275 g carbohydrate should be
consumed daily.
32
Demographic and clinical data
At the time the QFFQ was administered, body mass was
measured with an electronic digital scale, measuring up to 200
kg in graduations of 0.1 kg (Seca 767), and body height was
taken with a telescopic measuring rod (Seca 220) attached to
the scale, to the nearest 1 mm. Data on the clinical [including
left ventricular ejection fraction, New York Heart Association
(NYHA) functional class and concurrent diagnoses] and socio-
demographic profile (including age, gender and educational
status) were collected prospectively.
Statistical analyses
Datawere analysed usingSPSS forWindows version 14.0.1 (SPSS
Inc, Chicago, Illinois). Normally and non-normally distributed
continuous data are given as the mean (standard deviation: SD)
and median (interquartile range: IQR), respectively. Categorical
data are presented as counts and percentages. Proportional
data were compared via the Chi-squared test while all nutrient
data were compared via the Mann Whitney U-test according
to gender, and actual versus recommended dietary intake.
Significance has been accepted as
p
<
0.05 (two-tailed).
Results
The demographic and clinical profile of the study cohort is
shown in Table 1. Reflective of the overall Heart of Soweto
study cohort, there were more women (56%) than men. Women
were slightly, but not significantly younger than the men and the
entire HF cohort was typically two decades younger than that
seen in high-income countries. Hypertension and obesity were
highly prevalent in both genders. Concurrent diabetes was also
common, particularly in men. The majority of patients had left
ventricular systolic dysfunction (LVEF
<
45%) and symptoms
of exercise intolerance and dyspnoea indicative of NYHA
functional class II or III.
The daily food consumption of the cohort as measured by the
QFFQ according to gender is shown in Table 2. Significantly,
more women (79%) than men (65%) reported eating brown or
wholemeal bread, 75% of women and 48% of men consumed
sweets and chocolates, processed meat were eaten by 89% of
women and 78% of men, and packet soup was consumed by
TABLE 1. DEMOGRAPHICAND CLINICAL
PROFILE OF THE STUDY COHORT
Socio-demographic profile
Men
n
=
22 (%)
Women
n
=
28 (%)
Mean age (years)
1
51
±
12
47
±
18
No education
1 (4.5)
4 (14)
1–5 years’ education
5 (23)
7 (25)
6–10 years’ education
15 (68)
16 (57)
Post-matriculation qualifications
1 (4.5)
1 (3.6)
Risk profile
Body mass index (kg/m
2
)
1
25.2
±
4.8
26.5
±
6.4
Hypertension
14 (65)
18 (65)
Diabetes
2 (10)
2 (7.6)
Heart failure profile
NYHA class II
11 (50)
12 (43)
NYHA class III
4 (19)
9 (32)
NYHA class IV
0 (0)
1 (3.6)
Left ventricular ejection fraction
1
37.3
±
9.1% 36.4
±
13.4%
1
Data are given as mean
±
SD or as number (%).
TABLE 2. DAILY FOOD CONSUMPTION OF HF PATIENTS
ACCORDINGTO
THE QUANTITATIVE FOOD FREQUENCY QUESTIONNAIRE
Men (
n
=
22)
Women (
n
=
28)
Foods/food groups
Propor-
tion
(%)
Median
daily intake
(interquartile
range)
Propor-
tion
(%)
Median
daily intake
(interquartile
range)
Maize meal (g)
91 516 (200–750)
93 424 (140–688)
Mabella (g)
1
52
78 (25–64)
57 111 (55–136)
Oats (g)
26 88 (55–107)
32 80 (50–100)
Potatoes (g)
78
76 (28–91)
86* 59 (28–89)
White bread (g)
22
88 (50–60)
29
73 (38–98)
Brown/wholegrain
bread (g)
65 102 (43–120) 79*** 87 (60–113)
Cereals: refined (g)
13
13 (13–15)
14
7 (4–10)
Cereals:
wholegrain (g)
22
29 (25–30)
21
17 (9–15)
Mageu (ml)
2
30 208 (43–321)
39
64 (16–71)
Added sugar (g)
74
15 (10–15)
75
16 (10–20)
Sweets and
chocolates (g)
48
19 (7–30)
75*** 11 (3–12)
Cakes and biscuits (g)
48
45(15–25)
57
7(5–10)*
Cold drinks
(sweetened) (ml)
65 439 (71–670)
54* 310 (85–400)
Meat, chicken, fish,
eggs (g)
100 150 (105–190)
100 127 (83–168)
Milk and milk
products (ml)
87 262 (129–370) 93* 113 (58-145)*
Legumes (g)
43
18 (10–24)
43
18 (9–28)
Fruit (fresh) (g)
100 174 (150–160) 100 147 (40–160)
Vegetables (fresh) (g)
100 76 (40–103)
100 78 (50–91)
Margarine on
bread (g)
83
15 (7–20)
75
16 (10–20)
Salt added to cooked
food (g)
91
2 (2–2)
75***
2 (2–2)
Salted snacks (g)
74
15 (4–22)
61** 15 (2–17)
Take-away foods (g)
48
23 (10–15)
32*** 16 (10–25)
Sauces and
condiments
57
7 (2–10)
64
4 (2–5)
Stock cubes
4
1 (1–1)
18***
1 (1–2)
Packet soup
43
3 (1–5)
57**
2 (1–2)
Processed meat
78
35 (8–54)
89** 26 (8–35)
1
Unrefined porridge made from sorghum;
2
Dried and broken corn kernels;
3
A carbohydrate-rich drink made from fermented mealie (maize) meal and
malt.
Significant difference between men and women, *
p
<
0.05, **
p
<
0.01,
***
p
<
0.001.
