How DIVERSE are our DIETS?

For many South Africans, particularly those living in rural areas and informal settlements, our diet is simply not diverse enough, find DEMETRE LABADARIOS, NELIA PATRICIA STEYN and JOHANNA NEL.

South Africans, particularly those living in tribal areas and informal settlements, do not eat well. In terms of dietary variety, our meals are not diverse enough, lacking particularly in eggs, legumes and vitamin A-rich fruit and vegetables, which raises serious concerns about the nation’s household food security.

Since no single food contains all nutrients required for optimal health, only a sufficiently diverse diet will be nutritionally adequate. Monotonous diets based mainly on starches are closely associated with food insecurity, while dietary diversity is an outcome measure of food security at the individual or household level. Food security is defined as access by all people at all times to enough food for an active, healthy life.

Stunning in tribal areas

Past nutritional surveys have shown that stunting is most prevalent in tribal areas in Eastern Cape, Northern Cape and Limpopo, where the most commonly consumed foods are maize, tea, sugar and bread – a highly monotonous diet. The diet of many children is low in energy and certain essential micronutrients, and dietary diversity is poor, indicating poor food security.

This study does not evaluate nutrition security or show whether other factors such as access to health care and safe water are adequate. To evaluate nutrition security, these factors also have to be evaluated. However, the findings on dietary variety and, by association, food security, are causes for concern. 

Not enough veggies and fruit

Findings were that variety is low overall and certainly not in line with the guidelines promoted by the Department of Health. It was particularly poor in the low income group and among black people. The most neglected food groups were vitamin A-rich fruit and vegetables, and legumes and nuts.

It is possible that the government’s health messages are either not reaching people or are not understood. Poor people often do not have access to a variety of foods and, unless access is being addressed, knowledge of dietary guidelines will probably have little effect. It also needs to be realised that a greater variety will probably increase costs.

The results indicate that environmental factors are important determinants of household food security, though improving the environment is not necessarily going to lead to better household food security if people do not have access to food. Moreover, nutrition security cannot be achieved without food security, knowledge and skills.

Marketing the message

It is important to discover how effective the marketing of the guidelines are and whether better knowledge will favourably affect households that are food insecure due to lack of access.

There is much evidence for school curriculum-based nutrition education to improve knowledge, self-efficacy and attitudes leading to improved nutritional behaviour. If this is coupled with healthy foods with plenty of variety in the primary school nutrition programme, one would be able to provide both knowledge and access to food. It is also essential that schools reinforce healthy eating behaviour through the types of foods sold at the school.

It is clear that nutrition security of individuals and households is influenced by a myriad factors, particularly those related to the immediate environment. Ideally, South Africa should strive for all households to have access to food, water, sanitation and health care, but this can only happen if economic growth takes place and there are employment opportunities for all.

Authors: Demetre Labadarios, Nelia Patricia Steyn, researchers at the Centre for the Study of Social and Environmental Determinants of Nutrition, Knowledge Systems, HSRC; and Johanna Nel, researcher at the Department of Logistics, University of Stellenbosch.