The stream of media coverage about diets may suggest that the majority of South Africans are pre-occupied with the latest food fads. But what people choose to eat is more often dictated by class and their purses than clinical decisions about what is good for them.
Malnutrition, diabetes, hypertension and cancer are feasting increasingly on South Africa’s poor as a result of eating unhealthy energy dense food. More often than not, this is all they can afford.
Yet 14 million people, that is one in four, go to bed hungry in South Africa every day. Another 15 million are on the verge of joining the ranks of the chronically hungry.
Research shows that 40% of South Africans are suffering from malnutrition. Although the food they eat has the recommended 2000 daily calories, it does not provide sufficient nutrients to sustain health. Insufficient nutrition results in both under and over-nutrition, micro-nutrient deficiencies such as iron and vitamin A, low blood pressure and stunted growth.
Indications are that unless we tackle the underlying causes of unhealthy eating habits, the situation will only get worse.
When choice is not an option
The reality is that poor people are more concerned with filling stomachs and feeding their families than monitoring what they eat.
The challenge is that for many people, the choice is not theirs. The diet of poor people is limited: high in calories and low in nutrition value. These choices are exacerbated by high food prices and accessibility. Both drive people towards food with high fat and sugar content.
Higher food prices pose a particular challenge to vulnerable groups. The cost of food has in some instances almost doubled in rural settings compared to cities.
This means that people often purchase less expensive foods that are more filling. These are invariably energy-dense foods that contain high quantities of fat, sugar and starch such as fast foods, snacks and desserts.
The availability of food, particularly fresh vegetables, also determines the choices people make. Unhealthy food such as chicken skin and fat are more likely to be sold in supermarkets that poor South African have easy access to.
Healthy food, on the contrary, is markedly more expensive and is more easily available in cities or at big supermarkets.
Getting the right mix of food
The South African National Department of Health has developed dietary guidelines designed to help people make healthy food choices. This in turn helps prevent nutrition related diseases.
The problem is that 12 years after the dietary guidelines were created, very few people know about them. This lack of awareness stems from the South African Department of Health’s challenges with its implementation and because it is more focused on curative health than preventative health.
As a result the majority of South Africans are unable to monitor their diet or make healthy food choices. Even those who are aware of the guidelines are constrained by high food prices and growing inflation.
The meaning behind a meal
Food plays an important part of our lives. Our bodies need food to fulfil several functions. It provides energy for daily activities and protects the body against diseases.
We eat because our bodies need nutrients - the vitamins and minerals in fruit and vegetables - which are necessary for stimulating growth and maintaining life. There are also essential nutrients like carbohydrates, fats, and proteins which are needed daily. Problems arise when these form the bulk of someone’s diet.
To satisfy hunger, larger portions of unhealthy food are often consumed. This invariably leads to obesity which in turn puts people at risk of developing diseases such as diabetes, hypertension and some cancers.
Filling the gaps needed for healthier choices
The government has a number of responsibilities it needs to fulfil. The first is to educate people about what’s good for them and what isn’t. A useful first step would be to popularise the guidelines it set 12 years ago.
It also as a duty to make healthy food affordable and easily accessible across South Africa, particularly its rural areas.
It is time that the right environment was created so that people can begin to make healthy food choices rather than having to worry about how they will feed their families.
Thandi Puoane receives funding from the National Research Foundation.
Authors: The Conversation