August's dietary intake is primarily composed of starchy foods, particularly "pap", which is an affordable high-density maize porridge that contains refined carbohydrates and is fortified with essential micronutrients. August also has a preference for dairy products, and typically combines pap with milk or Amazi, a fermented milk product. Additionally, August consumes "mageu", a fermented thin maize porridge, as a snack. August favors chicken over red meat and consumes 60 g once a week. He enjoys vegetables including spinach and cabbage, and pumpkin (on Sundays). Additionally, he consumes apples and/or bananas twice a week. For the past three to four weeks, August has been consuming only 75% of his regular meals.
| Breakfast |
1 cup Morvite (quick Instant Sorghum Porridge with water) 1 mug Five Roses tea (Black/Ceylon) 2 tsp white sugar 2 tsp Cremora coffee creamer |
| Morning Snack |
0-1 apple/banana 1 Marie biscuit |
| Lunch |
1 cup stiff maize porridge (pap) ACE, IWISA, White Star Super Maize Meal (which is not instant and takes approximately 1 hour to cook on a paraffin stove or using electricity). 1 cup full-cream Amasi (fermented, sour milk) Seven colours - 1 cup of cooked carrots, pumpkin, beetroot salad, canned sugar bean salad, spinach, potato mayo salad 1/3 cup white rice and 2 tsp of Six Gun spice |
| Afternoon Snack |
1 cup mageu 1 mug Five Roses tea (Black/Ceylon) 2 tsp white sugar 2 tsp Cremora |
| Evening Meal |
1 cup stiff maize porridge (Pap) 1 cup full-cream milk 1 cup fried cabbage/marogo (wild spinach) with 1 tsp of onion fried with 15 mL (½ fl ounce) sunflower oil |
| Evening Snack | 1 glass of Wild Island Cool drink (cordial mixed with water) |
Note — foods are reported as cooked weight, edible serving unless otherwise advised.
| Starchy Foods |
Maize/sorghum porridge 3 times daily Marie biscuit daily |
| Fruit | Apples, bananas 2-3 per week |
| Vegetables (low starch) | Daily |
| Dairy/Alternatives | 3 serves daily |
| Meat/Alternatives | Chicken once weekly (60 g) |
| Fats/Oils | 2-4 tsp daily |
| Sweets and Alternative Carbohydrates | |
| Beverages |
Sweet cordial daily 2 cups tea with sugar daily |
| Other | 50 g potato chips once/week |
| Type | Nil |
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Energy deficit risk: He’s eaten only 75% of usual intake for 3–4 weeks, with recent weight loss history → high risk for inadequate kcal to halt loss and support recovery.
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Protein shortfall: Daily protein appears low (dairy most days; meat just ~60 g once/week). For ~59 kg, clinical targets are ~71–89 g/day (1.2–1.5 g/kg). Current pattern likely under this—risk for loss of lean mass. Raises concern regarding iron intake.
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High refined starch / added sugars: Pattern dominated by maize porridges, tea with sugar, cordial, and sweets → higher glycaemic load, low satiety, limited micronutrient density per kcal.
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Micronutrient concerns: Limited variety of iron/zinc-rich foods; fruit only 2–3×/week. Fortified maize helps energy intake. Query fortification
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Fluid/beverage pattern: Regular cordial and tea; unclear water intake and food safety practices (important in HIV).
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Affordability & access: Staples (pap, mageu, amasi) reflect cost and convenience; interventions must be budget-sensitive and culturally aligned.
Targeted Questions & Data to Collect
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Quantify portions & frequency: Typical cup sizes for pap, amasi, mageu; teaspoons of sugar/creamer per day; cordial dilution; portion of vegetables; any beans/eggs/peanut butter use.
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Protein distribution: Sources at each meal/snack (milk/amasi volume, eggs/legumes frequency), and feasible, low-cost options (e.g., beans, lentils, chicken livers, eggs, peanut butter).
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Added sugar load: Number of sweetened teas, cordial glasses, sweets/day → estimate total teaspoons sugar.
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Fruit & veg variety: Weekly counts, colours, and affordability barriers
Please use the link below to view a selection of foods that are culturally specific:
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Morvite: a porridge-like breakfast cereal made from sorghum meal, soy, and fortified with vitamins and minerals.
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Pap: a staple food in Southern Africa made from maize meal and water, similar to polenta or grits.
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Amasi: a traditional South African fermented milk product with a tangy taste and a texture similar to thick yogurt.
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Mageu: a non-alcoholic fermented drink made from maize, often enjoyed as a refreshing beverage or snack.
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Creamer: a dairy-based product added to coffee or tea as a sweetener and to enhance flavour.
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Wild Island Cool drink: a popular South African fruit-flavored drink, often enjoyed as a refreshing beverage.
