09 Apr Poor and hungry – Study reveals how little we know about what people eat in SA

Hunger and nutritional issues are recognised as a major hurdle in the development of South African society. Yet, while millions of South Africans are suffering the effects of hunger and malnutrition, a newly-published scoping study, initiated and funded by the Water Research Commission (WRC), reports that we do not know enough about household food intake, which could hamper intervention efforts.

In South Africa, poor rural households are particularly vulnerable to hunger and malnutrition (including overnutrition and undernutrition). The current economic climate and rising food prices are making it difficult for people to achieve a balanced diet. Healthy food seems to be unaffordable for many South Africans and, even more alarming, it appears that, in general, nutrient-rich foods tend to have sharper price rises relative to less nutritious foods.

The study was undertaken by a multidisciplinary team from the departments of human nutrition and plant production & soil science at the University of Pretoria (UP), the Nutritional Intervention Research Unit at the Medical Research Council (MRC) and the Human Sciences Research Council.

“We need to understand people’s current practices related to food – including the food environment,” say project team members, Dr Friede Wenhold of UP’s Department of Human Nutrition, and Dr Mieke Faber of the MRC Nutritional Intervention Research Unit, explaining the rationale for the study. “People get their food from various sources and for different reasons. We cannot impose foods or food practices on people.”

To cope with current economic conditions, vulnerable communities employ various mechanisms, including decreasing their consumption of non-staple foods, such as meats, dairy, fruit and vegetables. This, in turn, increases their risk for micronutrient malnutrition where the body lacks the required vitamins and minerals it requires to function healthily.

One way of improving household food and nutrition security, particularly among the rural poor, is to promote home production of nutrient-rich foods. While many poor residents living in rural areas have access to land and water resource for productive use, indications are that food produced at household level currently makes an insignificant contribution to the diet of rural households. In addition, while information is available on what people should be eating on nutrient level, little is known about what people are actually eating.

It has been recognised that the home-production of specific foods among rural communities should be based on scientific evidence, taking not only current best practice in agriculture and human nutrition into account, but also the socio-cultural context within which the interventions are to take place. Internationally it is accepted that better understanding of the links between agriculture, nutrition and health is a high priority, explains Dr Gerhard Backeberg, WRC Executive Manager: Water Utilisation in Agriculture. “Before researching water use and nutritional productivity of crops, it is essential to know what food is consumed by poor people; what the nutrient content is of these food products; and which of these foods can be can be produced by household members, either in homestead gardens or communal croplands.”

Since malnutrition is the result of many factors, the study took a multidisciplinary approach, including human nutrition, social anthropology and agronomy perspectives. “One plus one is more than two, particularly when each one comes from a different perspective,” say Drs Wenhold and Faber.

While several food- and nutrition-related studies have been undertaken in South Africa, particularly at a community and provincial level, the project team found that the available information cannot be taken as being representative of the food intake of ‘rural poor South Africans’. National studies are rare and did not generally distinguish between rural and urban poor, with food data in smaller studies often not comparable.

According to the final study report, the absence of a national food and nutrition surveillance system makes it difficult to identify periods of food shortages related to factors such as seasonality, periods prior to pay-out of social grants and shocks at household level (such as funeral costs or the migration of an income earner), all of which have been shown to impact on household food security. The vast majority of studies focus on infants and children.

The reasons for food intake are determined by a range of factors. These include individual, household, cultural and ethnic group preferences, location, season, income and affordability, historical factors, knowledge and education, and social networks. An understanding of the reasons for food choices is important as these factors influence the food and nutrition security of households and individuals.

The project team found that the reasons for food intake were not considered in many studies. None of the national food surveys reviewed considered seasonal difference in food availability and accessibility and how this may impact on food choices. In addition, despite the importance of basic services factors such as access to basic water, sanitation and healthcare were not generally considered in any detail in the studies reviewed.

While general trends have become apparent, there seems to be insufficient available evidence to compile a basket of contemporary food intake of poor households in rural areas of South Africa.

“The major finding of this scoping study is that we do not know what poor people are eating and where they are sourcing their food,” notes Dr Backeberg. “The problem is therefore that informed advice and intervention on a balanced diet with a variety or diversity of foods cannot be undertaken. This means that much more attention must be given to the type of food consumed (which is the source for e.g. carbohydrates, protein and vitamin) and what the best available, most affordable and acceptable source of that food is.”

Although not conclusive, it seems that most poor people are buying and not growing the food that they are eating. At the same time it is of major concern that available natural resources (water, soil, plants, etc.) are under-utilised. This despite the fact that at least 40% of the population (i.e. 20 million people of which approximately 70% live in rural villages) are hungry and under-nourished.

“More research is required to obtain knowledge, in other words, information that is useful for decisions and actions, on how incentives can be improved and capabilities strengthened. It is absolutely essential that poor people gain secure access to available resources and have practical skills for beneficial food production,” says Dr Backeberg.

As a result of the high percentages of food purchasing in poor, rural areas, food intake is mainly related to cost and availability. Food prices were found to be higher in rural than in urban areas while wages were lower in rural areas. As a result the regularity of which food products are purchased largely depends on income quantity and frequency. For example, studies of inland villages in the Eastern Cape found children only consumed meat once a month at the time of the monthly pension pay-out.

In addition, variety is generally less in rural areas, even within supermarket chains, and many rural consumers are heavily reliant on general dealers, spaza shops and what they can purchase from local informal markets, hawkers and producers. Access to electricity and refrigerators is also a factor when it comes to storing food.

At the national level, South Africans’ main food-related purchases are maize, wheat, bread, and salt. Key micronutrients generally lacking in the diet of rural poor people are Vitamin A, iron and zinc.

Only in some studies was it found that food sources are sourced from the wild. In Limpopo, intakes from green leafy vegetables appear to be higher than the other provinces. In addition, while many households owned livestock, it was not a major source of food for household consumption.

Consumption of non-home prepared foods seems to be on the rise in line with international trends. Away-from-home consumptions include school tuck shops, formal or informal street vendors and fast food establishments as well as food eaten at community gatherings, for example at funerals. Feeding schemes may also be a source of food. Overall, these outside foods seem to be less nutritious (i.e. high in sugar and/or fat) thereby contributing to levels of overnutrition.

For more on the study: Contact: Dr Gerhard Backeberg: Email: [email protected], tel: 012 330 0340 , cell : 082 376 0845 .

To order the report, Water use and nutrient content of crop and animal food products for improved household security: A scoping study (Report No. TT 537/12) contact Publications at Tel: (012) 330-0340; Fax: (012) 331-2565; Email: [email protected] or Download a free copy of the study here: http://www.wrc.org.za/Pages/KnowledgeHub.aspx.