Urbanisation and cariogenic food habits among 4-24-month-old black South African children in rural and urban areas.

OBJECTIVE To determine if social class, education level and group environment (rural and urban) influence particular food habits commonly associated with dental caries incidence among 4-24-month-old black South African children. DESIGN, SETTING AND SUBJECTS Information was collected by trained interviewers using a food-frequency questionnaire from mothers of children in two areas in South Africa: Ndunakazi, a rural area in KwaZulu/Natal (n = 105) and two urban areas in Gauteng - Soweto (low to middle socio-economic area) (n = 100) and the northern suburbs of Johannesburg and Sandton (middle to upper socio-economic area) (n = 101). Education level and occupation of the parents, which define social class, were also recorded. A linear logistic (Proc Catmod) analysis tested social class, education level and group environment as the independent variables and the food habits as the dependent variables. RESULTS Group environment was significantly associated with nine of the 18 food habits investigated. More urban than rural mothers added sugar to their child's comforter. More mothers in urban Soweto than in urban Johannesburg were still breast-feeding their infants at 24 months. More rural than urban mothers were giving 'mutis' (common and traditional medicines). Together with group environment, education level was significantly associated with giving of 'mutis' and the frequency of giving them. Social class was significantly associated with the frequency of breast-feeding and when the child was breast-fed. Mothers from the upper social class breast-fed less frequently than mothers from the lower class. CONCLUSION The study showed a strong influence of rural/urban environment on specific cariogenic food habits among young black South African children, enabling the development and implementation of a nutrition strategy.