Dietary intake of Senegalese adults

  • Cheryl AM Anderson1Email author,

    Affiliated with

    • Scarlett Bellamy2,

      Affiliated with

      • Mindy Figures2,

        Affiliated with

        • Charnita Zeigler-Johnson2,

          Affiliated with

          • Mohamed Jalloh3,

            Affiliated with

            • Elaine Spangler2,

              Affiliated with

              • Margerie Coomes2,

                Affiliated with

                • Serigne Gueye3 and

                  Affiliated with

                  • Timothy R Rebbeck2

                    Affiliated with

                    Nutrition Journal20109:7

                    DOI: 10.1186/1475-2891-9-7

                    Received: 30 July 2009

                    Accepted: 18 February 2010

                    Published: 18 February 2010

                    Abstract

                    The aim of this work is to identify major food sources and dietary constituents of Senegalese adults. We conducted a cross-sectional study, using a single 24-hour dietary recall interview. Foods were classified into food groups based on similarities in nutrient content or use. Food groups included foods consumed individually, or as part of food mixtures such as stews, soups, or sandwiches. Median consumption (amount/day) of each food was determined and examined by relevant subgroups. Participants were 50 healthy Senegalese men, aged 20-62 years recruited at the Hôpital Général de Grand Yoff in Dakar, Senegal and from Sendou village, a rural area outside Dakar. A total of 90 foods and beverages were identified and classified into 11 groups. Sixty-five percent of foods identified could be classified as meats, grains, or fruits/vegetables. Fruits and vegetables comprised 42% (38/90) of all foods; meats 12% (11/90); and grains 11% (10/90). Sauces (6%, 5/90), sweets (4%, 4/90), and desserts (4%, 4/90) were also reported. The most common fruits/vegetables reported were potato, carrot, mango, and lettuce; commonly reported grains were bread and rice; and commonly reported meats were fish, beef, and ox. There were no differences in reported daily intake of each food by age, ethnicity, education, or residence. Most foods reported were traditional to the Senegalese diet, despite the increasing availability of Western foods in Senegal.

                    Findings

                    Diet-related diseases and conditions such as certain cancers, cardiovascular disease, hypertension, and diabetes are prevalent worldwide. Research on the role of diet in disease prevention is strongly linked to the conduct of precise dietary assessment in populations. Critical elements of dietary assessment include knowledge of the type, frequency, and amount of foods consumed; as well as the expected diversity in dietary intake patterns of a study population. Given the high prevalence of diet related disorders in populations, dietary assessment efforts are needed for the conduct of nutritional epidemiological studies and for treating diet related diseases and conditions. In Senegal, little is known about the modern diet of adults as most studies of nutrition in this population have focused on malnutrition and growth retardation in childhood [16].

                    The lack of nutritional epidemiological studies in Senegal is related to lack of standardized dietary assessment tools. The creation of these tools may have been hindered by a hypothesized low variability in dietary intake for foods or food groups that are associated with chronic diseases. However, there are no empirical data to support this notion. In fact, it is possible that there has been an epidemiologic transition [7] and an accompanying nutrition transition [8] resulting from an increase in non-traditional lifestyles and a concomitant increase in intake of non-traditional foods by Senegalese. This would result in greater heterogeneity of intake in the modern diet, and it has been predicted that a dramatic shift in causes of mortality from nutrition-related chronic diseases will occur in developing countries, including the Sub-Sahara [9]. Therefore, the primary objective of this study was to describe the Senegalese diet. Although we are unable to examine diet-disease relationships in this study, this work will serve as a prelude to a more formal examination of dietary influences on the health of Senegalese.

                    Participants were healthy, Senegalese men aged 20-62 years (n = 50) who were recruited at the Hôpital Général de Grand Yoff (but were not hospitalized) in Dakar, Senegal (n = 40) and from Sendou village - a neighboring rural area (n = 10). In general, a convenience sample was used and recruitment was conducted by a combination of physician referral and word of mouth. All study procedures were approved by the University of Pennsylvania Institutional Review Board and by the Commission Ethique et Evaluation (IRB) at Hôpital Général de Grand Yoff under FWA 00002772.

                    Participants agreed to in-person interviews and signed an informed consent form. Food intake data were collected by a trained interviewer during a single 24-hour dietary recall interview. Interviews were conducted with the assistance of a native Senegalese physician and translator. As is typical in the 24-hour recall interview, participants were asked to remember and report all food and beverage items consumed in the previous 24 hours. The interviewer probed in detail about each food and beverage item reported. Participants were asked details about the name, place and time of consumption of the meal, method of preparation, amount consumed, condiments added, recipes, brand names or name of menu items for restaurants, take-out foods, or other foods eaten outside of the home. During the interview, participants were shown visual aids to assist them in estimating amount consumed. Demographic information such as age, tribal affiliation, education, residence, marital status, as well as health behaviors, medical history, and family history were also collected.

                    There were two primary analytic goals: 1) Identify and classify foods consumed into broad categories. Categories were primarily defined by traditional Western food groups; and 2) descriptively summarize the amount consumed of the most frequently reported foods. Frequencies and percentages were calculated in order to determine the most popular foods consumed. The median and interquartile ranges (IQR) for daily intake are presented for the top 25% of food items reported in each food group. For example, if there were 11 foods reported in a food group, the median daily consumption for the top 3 foods was presented. We compared median daily consumption by age, residence, and tribal affiliation using non-parametric Wilcoxon tests. All analyses were performed using SAS version 9.1 or higher.

                    Characteristics of study participants are shown in Table 1. Mean age was 31 years, body mass index was 22.7 kg/m2, and the men represented various ethnic/tribal backgrounds. Most (64%) were married and had at least some college education (40%).
                    Table 1

                    Characteristics (mean and range) of study participants

                    Variable

                    Mean (range)

                    Age (yrs)

                    31.0 (20.0, 62.0)

                    Body Mass Index (kg/m2)

                    22.7 (17.8, 31.3)

                     

                    Freq (%)

                    Prepare own meals

                    3 (6)

                    Live in urban area

                    40 (80)

                    Married

                    32 (64)

                    Ever smoked

                    16 (32)

                    Education

                     

                       Primary/illiterate (includes Coranic School education)

                    14 (28)

                       First half of secondary school

                    5 (10)

                       Last half of secondary school

                    11 (22)

                       College education

                    20 (40)

                    Ethnicity (Maternal)

                     

                       Arab

                    1 (2)

                       Diolas

                    4 (8)

                       Mandingues

                    6 (12)

                       Mencayne

                    1 (2)

                       Pulaar

                    12 (24)

                       Sereer

                    11 (22)

                       Soninke

                    1 (2)

                       Wolof

                    14 (28)

                    Ethnicity (Paternal)

                     

                       Arab

                    1 (2)

                       Diolas

                    4 (8)

                       Mandingues

                    4 (8)

                       Mencayne

                    1 (2)

                       Pulaar

                    13 (26)

                       Sereer

                    10 (20)

                       Soninke

                    1 (2)

                       Wolof

                    16 (32)

                    There were 90 unique foods and beverages reported by study participants (Table 2). These foods could be classified into 11 distinct categories: meat and meat alternatives; milk/dairy products; grains; fruits and fruit juices; vegetables and vegetable juices; sweets/sweeteners; sauces; fats; condiments/spices; desserts; and beverages (not fruit/vegetable based). The majority (65%) of foods identified could be classified as meats, grains, or fruits/vegetables. Fruits and vegetables comprised 42% (38/90) of all foods; meats 12% (11/90); and grains 11% (10/90). Sauces (6%, 5/90), sweets (4%, 4/90), and desserts (4%, 4/90) were also reported.
                    Table 2

                    Classification of foods reported (n = 90) by Senegalese men in the 24-hour recall interview

                    Meat/Poultry/Fish/Meat Alternatives (n = 11):

                    Grains (n = 10):

                    Fruits and Fruit Juices (n = 17):

                       Fish (Thiouf, Codfish, Yaboy)

                       Bread

                    Fruits (n-12)

                       Beef/Cow

                       Porridge

                       Mango

                       Sausage

                       Cereal paste/millet

                       Coconut

                       Chicken

                       Flour/baking ingredientsb

                       Cola nut

                       Ox

                       Fataya (pound wheat)

                       Banana

                       Goat

                       White rice

                       Raisins

                       Sheep

                       Couscous

                       Papaya

                       Pork

                       Pita Bread

                       Pear

                       Eggs/Omeleta

                       Pasta/macaroni

                       Watermelon

                       Chickpeas

                       Spaghetti

                       Apple

                       Peanuts

                     

                       Grapes

                      

                       Sapoti

                      

                       Maad bi

                    Milk/Dairy Products (n = 4):

                     

                    Fruit Juices (n = 5)

                       Powdered mik

                     

                       Quinquiliba juice

                       Liquid milk

                     

                       Monkey bread juice

                       Cheese

                     

                       Guava juice

                       Yogurt

                     

                       Pineapple juice

                      

                       Orange juice

                    Vegetables and Vegetable Juices (n = 21):

                    Sweets/Sweeteners (n = 4):

                    Desserts (n = 4):

                    Vegetables (n = 19)

                       Sugar

                       Cake

                       Tomato

                       Honey

                       Chocolate croissant

                       Lettuce

                       Chocolate

                       Milk flavored biscuit

                       Carrot

                       Cocoa powder

                       Hard mint candy

                       Cabbage

                      

                       Corn

                    Sauces (n = 5):

                     

                       Eggplant

                       Bissap paste/sauce

                    Beverages (not fruit/veg) (n = 7):

                       Okra

                       (hibiscus)

                       Water

                       Garlic

                       Lemon sauce

                       Tea

                       Onion

                       Red pepper powder/sauce

                       Coffee

                       Potato

                       Peanut paste/sauce

                       Soda

                       Turnip

                       Sauce

                       Fanta

                       Cucumber

                     

                       Beer

                       Green bean

                    Fats (n = 3):

                       Red wine

                       Green pepper

                       Butter

                     

                       Green pea

                       Mayonnaise

                     

                       Petit pois

                       Oil

                     

                       Broccoli

                      

                       Green olive

                    Condiments/Spices (n = 4):

                     

                       Cowpeas

                       Salt

                     

                    Vegetable Juices (n = 2)

                       Black pepper

                     

                       Root juice

                       Mustard

                     

                       Ginger juice

                       Ketchup

                     

                    aExcludes eggs found in cakes, breads, mayonnaise, pasta, etc.

                    bIncludes flour, cornmeal and yeast disaggregated from recipes for items like pizza and fataya

                    Table 3 shows the most commonly consumed foods with "common" defined as ranking in the top 25% of all foods consumed in the category. For example, the top 3 meats out of a total of 12 meats are shown. The most commonly reported (median daily intake) meats were fish (1.17 oz/d), beef (2.61 oz/d), and ox (2.00 oz/d); milk/dairy product was cheese (0.38 oz/d); grains were bread (18.07 in3/d) and rice (0.75 cup/d); fruits were mango (1.00 whole fruit/d) and orange juice (1.25 cup/d); vegetables were potato (0.5 cup/d), carrot (0.33 cup/d), lettuce (0.65 cup/d) and tomato (0.06 cup/d); and beverages were water (5.09 cups/d), coffee (0.06 cups/d), and tea (0.56 cups/d). Other foods commonly reported were sugar (0.71 tbsp/d), sauce/peanut paste (4.43 tbsp/d), and butter (0.71 tbsp/d). Although consumption of tomato and carrot were commonly reported, they were consumed as a part of mixed dishes resulting in a low median daily intake. Bread was most commonly reported as baguette and is shown in the measure of inches cubed. Water was the only food item reported having been consumed by 100% of the men interviewed. Reporting of condiments, spices, and desserts was low overall. There were no statistically significant differences in consumption of each food by tribal affiliation, education, smoking status, urban/rural residence, BMI or age (data not shown).
                    Table 3

                    Daily intake (median and interquartile range (IQR)) of the most commonly consumed foods (top 25%) by Senegalese men (n = 50), by food category.

                    Food category

                    N (%)

                    Daily Intake (Median (IQR))

                    Meats/Meat Alternatives (n = 11)

                      

                    Fish (oz)

                    29 (58)

                    1.17 (0.33, 4.00)

                    Beef (oz)

                    18 (36)

                    2.61 (2.00, 3.00)

                    Ox (oz)

                    15 (30)

                    2.00 (2.00, 4.00)

                    Milk/Dairy Products (n = 4)

                      

                    Cheese (oz)

                    6 (12)

                    0.38 (0.17,0.50)

                    Grains (n = 10)

                      

                    Bread (in3)

                    45 (90)

                    18.07 (13.30, 26.60)

                    Rice (cup)

                    32 (64)

                    0.75 (0.50, 1.50)

                    Fruits and Fruit Juices (n = 17)

                      

                    Mango (#)

                    9 (18)

                    1.00 (1.00, 1.00)

                    Orange Juice (cup)

                    5 (10)

                    1.25 (1.00, 2.18)

                    Pineapple Juice (cup)

                    4 (8)

                    0.65 (0.30, 1.90)

                    Banana (#)

                    4 (8)

                    1.00 (0.75, 2.25)

                    Pear (#)

                    4 (8)

                    0.75 (0.50, 1.00)

                    Vegetables and Vegetable Juices

                    (n = 21)

                      

                    Potato (cup)

                    18 (36)

                    0.50 (0.25, 0.75)

                    Carrot (cup)

                    16 (46)

                    0.33 (0.14, 1.27)

                    Lettuce (cup)

                    7 (14)

                    0.65 (0.22, 0.73)

                    Tomato (cup)

                    5 (10)

                    0.06 (0.06, 0.06)

                    Sweets/Sweeteners (n = 4)

                      

                    Sugar (tablespoon)

                    13 (26)

                    0.71 (0.53, 1.06)

                    Sauces (n = 4)

                      

                    Sauce/Peanut Paste

                    (tablespoon)

                    31 (62)

                    4.43 (2.00, 11.08)

                    Fats (n = 3)

                      

                    Butter (tablespoon)

                    13 (26)

                    0.71 (0.71, 1.41)

                    Condiments/Spices (n = 4)

                      

                    Ketchup (tablespoon)

                    1(2)

                    2.00 (2.00, 2.00)

                    Mustard (ounces)

                    1(2)

                    1.00 (1.00, 1.00)

                    Desserts (n = 4)

                      

                    Milk Biscuit (pieces)

                    2(4)

                    0.64 (0.30, 1.00)

                    Candy (pieces)

                    2(4)

                    3.00 (1.00, 5.00)

                    Beverages (not fruit/vegetable) (n = 7)

                      

                    Water (cup)

                    50 (100)

                    5.09 (3.19, 6.13)

                    Coffee (cup)

                    29 (58)

                    0.06 (0.06, 0.09)

                    Tea (cup)

                    27 (54)

                    0.56 (0.19, 0.56)

                    Even though our study sample represents a relatively educated group, with 40% having at least some college education, we report that traditional foods are still commonly consumed in the Senegalese diet. Of the foods reported, the majority were fruits and vegetables. The World Health Organization's Global Strategy on Diet, Physical Activity and Health emphasizes the need to increase intake of fruits and vegetables while limiting refined sugars, saturated fat, and sodium [10]. In 2006, Holdsworth and colleagues reported that Senegalese women had reasonably good knowledge of how diet affects non-communicable diseases [11]. However, Holdsworth et al reported poor knowledge of the benefits of eating fruit and vegetables for the prevention of certain cancers. Although men were omitted from Holdsworth's study, our data suggest that despite a lack of health knowledge, Senegalese adults are meeting current WHO recommendation to consume at least 5 servings of fruits and vegetables. Each meal typically contained fruits and vegetables, either consumed alone or as a part of mixed dishes such as stews and soups. Many different types of grains were reported such as fataya, millet, and couscous but the most commonly reported grains (bread and rice) are foods that are also commonly consumed in the US/Western diet. The impact of these similarities requires further investigation. Snack products were not reported but sodas were. Beef and ox were commonly reported meats but the daily median portion size was much below US recommended serving sizes (i.e., 3-4 oz of meat/svg). The majority of foods reported in this study were primarily native to Senegal, and typical of the Senegalese diet.

                    A limitation of this work was the small sample size. Although we suspected intake would vary by demographic characteristics, it did not, and this may in part have been due to the low power to detect statistically significant differences in this sample set. We did not see differences when data were stratified by rural and urban residence. Also, most of the men in our sample had meals prepared by others and clarification by the meal preparer was sought when necessary. We were only able to conduct one 24 hr dietary recall interview. Multiple interviews or alternative measures of diet such as food frequency questionnaires were not feasible but could have given us more information about variability in dietary intake. Future studies may benefit from both a larger sample size and additional measures of food intake. The strengths of this study include the use of a trained interviewer to conduct the 24 hour dietary recall interview. We included an overall well-educated sample from a culture that values honesty and who were likely to have recalled their diets accurately. Additionally, the sample had variability in participant age with a range from 20 to 62 years.

                    The role of diet and nutrition in the prevention of chronic diseases such as cancer and cardiovascular disease in the Senegalese population is understudied. This work provides an important first step in characterizing the diet of Senegalese. While data from this study cannot be used to directly compare the Senegalese diet to the American diet, we see that characteristics of a Western diet are present in Senegal. In the US, Black populations reportedly have lower intake of fruits, vegetables, and whole grains, and higher intake of meats, and a less healthy diet overall than other racial/ethnic groups [12, 13]. The Senegalese diet has more fruits and vegetables, and less meat than has been documented in the typical African American diet. Additional research is needed for more precise, standardized, dietary assessment, and to assess the variability in dietary intake for foods or food groups that are associated with chronic diseases. These efforts will further our understanding of the role of diet in the etiology and prevention of diet-related diseases.

                    Declarations

                    Acknowledgements

                    This study was funded, in part, by the National Cancer Institute grant # R01-CA08574. The funding body had no role in the study design, data collection, analysis, interpretation of the data, writing of the manuscript, or the decision to submit the manuscript for publication.

                    Authors’ Affiliations

                    (1)
                    Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Welch Center for Prevention, Epidemiology and Clinical Research
                    (2)
                    Department of Biostatistics and Epidemiology, University of Pennsylvania, School of Medicine, Center for Clinical Epidemiology and Biostatistics
                    (3)
                    University Cheikh Ante Diop Dakar, Hôpital Général de Grand Yoff

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                    Copyright

                    © Anderson et al. 2010

                    This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://​creativecommons.​org/​licenses/​by/​2.​0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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