Modern vs traditional indigenous diet preference in Gauteng region, South Africa: A public health concern?

The prevalence of non-communicable diseases still represents a public health concern in South Africa, of which eating habits are some of the main risk factors. A modern diet consisting of the consumption of highly processed foods high in fat, salt and caloric sweeteners and low in fibre is recognised as unhealthy. This study was conducted to assess the penchant of the population for these types of foods rather than traditional indigenous foods known to be healthier. This research was undertaken in the Gauteng region, which is the most urbanized province in the country. This study consisted of a quantitative research survey conducted in 2019 with 1527 participants (Asians, Black, Coloured, Indians and White) aged 18 and above who had lived in the province for at least two years. The results revealed that 30-40 % were neutral on the issue. Despite half (54.4 %) indicating that it was good to mix traditional and modern foods, a clear preference for modern food was noticed for 35.7 % of respondents, with 32.2 % reporting not being concerned that traditional foods have been replaced by modern foods. The traditional indigenous food consumption (TIFC) appeared to depend on monthly total household income, residential area, and settlement category. Participants with specific economic comfort consumed less. Race and number of people in the participants' households also significantly affected the TIFC (p < 0.05). Participants of white ethnicity and those living in a household of a maximum of 02 people displayed the lowest TIFC. In comparison to those who strongly disagree, participants with a neutral opinion about the idea of mixing eating habits were also the most neutral concerning preference for a modern diet (OR: 10.95, 95 % CI 7.00-17.12) and nutrition transition (OR: 14.66, 95 % CI 9.09-23.64). Sensitisation about healthy eating habits among the identified at-risk and target groups is undoubtedly a need in the region to avoid a resurgence of modern diet-related diseases.

Processed food consumption and risk of non-communicable diseases (NCDs) in South Africa: evidence from Demographic and Health Survey (DHS) VII.

We aimed to analyse the association between processed food consumption and the risk of non-communicable diseases (NCDs) in South Africa. In this empirical study, we analysed nationally representative secondary data obtained from the South African Demographic and Health Survey (SADHS) VII. The survey included 13,288 occupied households, of which 11,083 were interviewed. In the interviewed households, 12,717 eligible adults aged 15 and older were identified and 10,336 were successfully interviewed. The study included four processed food groups (i.e. fried foods, takeaway foods/fast foods, salty snacks/packed chips, and processed meats) and eight NCDs (i.e. hypertension, cardiac arrest, cancer, stroke, hypercholesterolaemia, diabetes, chronic bronchitis, and asthma). As per the logistic regression results following adjustment, none of the disease states showed association with all four processed food groups. However, at least three processed food groups showed a significant positive association with hypertension, cardiac arrest, and diabetes. Two processed food groups showed significant positive association with stroke, and chronic bronchitis; one with hypercholesterolaemia and asthma; and cancer was not associated with any food groups. Processed meat and salted snacks/packed chips were each associated with five chronic conditions. In summary, we found that the consumption of any of the processed food groups increased the risk of NCDs in the South African population. Enabling policy and regulatory efforts in the production and distribution of processed foods, combined with improved awareness among the population need to be prioritised for immediate action. Facilitating the populations to choose traditional healthy diets would be a sustainable strategy for the prevention of NCDs.

Knowledge, Perception and Consumption of Indigenous Foods in Gauteng Region, South Africa.

Urbanisation in South Africa has led to a nutritional transition from traditional diets (mainly based on indigenous foods) to a Western diet. Currently, the country is one of the most concerned about the prevalence of associated malnutrition and non-communicable diseases. One should, therefore, question the position of indigenous foods (IFs) in the population's eating habits since their nutritional and health value is known. This study aimed to collect updated data on South Africans' true awareness and consumption of indigenous foods, especially in the Gauteng region (the most urbanised province of the country). A quantitative cross-sectional research survey was conducted (n = 746). Among a list of 18 IFs, grain sorghum 32.4% (n = 242), marula 32% (n = 239), pearl millet 21.7% (n = 162), amadumbe 19.3% (n = 144) and cowpea 18.6% (n = 139) were the best known. However, the study noticed a maximum consumption of 19.3% (grain sorghum). Overall, this consumption was seasonal, and its level was significantly defined by race (p < 0.05). Black people consume more IFs compared to coloured people, Indian people and white people. Participants mostly consumed these foods for nutritional and health reasons and pointed out the problem of availability. "Poor image" was rated the lowest by all races (black 5.8%, coloured 4.2%, Indian 7.0% and white 4.1%) regarding the reasons for no or low consumption of IFs. Whatever the race, the desire to increase IF consumption was positive. The promotion of their integration into South African diets should, therefore, be considered as an intervention strategy.

Auditing causality of the multiple-burden of malnutrition in India and South Africa: a critical need for directions.

Developing economies are shaped by the current predicament of urbanisation and its impact on health is inevitable. In the post-pandemic times, India and South Africa witnessed a GDP growth rate of about 1·7 % and 1·9 %, respectively, while the developed economies like Europe and the USA have bounced back with more than 2 % GDP. The similarities and differences between India and South Africa provide potential candidates to study nutrition transition with the elements of urbanisation. In both countries, increased access to convenience foods is a consequence of the rapid expansion of small and medium enterprises, open international markets and expanding food supply chains. Also, there has been significant acculturation and people have moved away from traditional diets in these two countries. A spate of similar changes in the food environment is a telling sign of serious ill-health consequences in both countries. Generating evidence on causality is fundamental to informing policy. India and South Africa qualify as potential candidates to study the multiple burdens of malnutrition. Collaborating with different disciplines such as data sciences and capacitating analytic skills are key to progress in this direction.

Evaluation of nutritional and functional properties of anatomical parts of two sorghum (Sorghum bicolor) varieties.

Compositional differences exist among grain varieties as well as in the content of respective fractions. The proximate composition, amino acids, mineral contents, and functional properties of white and brown sorghum and its anatomical parts (dehulled and bran) were studied. The results showed that the bran had higher crude protein, crude fat, crude fibre, and ash contents for both sorghum varieties than the whole grain and dehulled samples. Likewise, significantly (p ≤ 0.05) higher essential and non-essential amino acids and minerals, particularly calcium, zinc, potassium were recorded for the bran samples compared to the whole grains or dehulled ones. With regard to the functional properties, the hydration capacity, hydration index, water, and oil absorption capacities of the dehulled samples were significantly (p ≤ 0.05) lower than the other investigated samples, except for bulk density, which was significantly (p ≤ 0.05) higher. In contrast, none of the swelling capacities differed significantly in any of the samples. In conclusion, sorghum bran has significant potential in the food industry and could be an excellent material for formulating high-fibre foods and serving as a nutritionally-rich food ingredient.

The role of nutrition knowledge in dietary adjustments during COVID-19 pandemic.

Knowledge/awareness significantly influences people's dietary choices, lifestyle, and inadvertently their health outcomes; hence it is imperative that people have correct information with regards to food and health. This study was undertaken to establish the role of nutrition knowledge on dietary choices and habits of people in Calabar, especially after the hard COVID-19 lockdown, and to ascertain if there was any positive or negative effect on the lifestyle of the people. It consisted of a cross-sectional survey in Calabar, Cross River State - Nigeria. An online questionnaire was prepared after sample size determination and its content validated. The questionnaire was designed to obtain data on the socio-economic status, participants' lifestyle, and changes in dietary intake/health before and during the COVID-19 lockdown, while the questionnaire link was in circulation for 6 weeks (April/May 2021). Descriptive statistics was used to define the proportion of responses for each question and Pearson's correlation was used to check for association between variables. Most participants were undergraduates depending on parents/sponsors. Financial decline appeared to have contributed to a post lockdown decrease in food consumption. Many (82.6%) respondents recorded high nutrition knowledge scores (NKS) and 83.1% of the respondents had high health scores. The results show that NKS influenced the kind of foods the respondents consumed frequently and there was a positive correlation between NKS consumption of fruits/vegetables. NKS had effect on their access to healthy foods and it varied significantly with respondent's total health score. No association existed between NKS and the reason for skipping meal - 'lack of time to prepare meals'. Nutrition knowledge and proper awareness, contributed significantly in dietary choices (regardless of limited resources), thus ensuring adequate nutrition and reduced health problems (most respondents recorded high health scores) during a pandemic. This study affirms the effectiveness of adequate nutrition education and awareness in ensuring healthy dietary choices, promoting optimal health, and reducing risks of diseases.

COVID-19 preventives consumed in South Africa versus other Sub-Saharan African countries.

Background: The current coronavirus disease 2019 (COVID-19) pandemic has been of global concern as it has affected the health of many and the economies of nations. In order to strengthen the immune system against COVID-19, certain plant-source foods were consumed. Aim: This study was designed to identify and compare various special foods and drinks consumed to prevent COVID-19 during the lockdown in various sub-Saharan countries in comparison to South Africa (SA), as well as highlighting some current dietary recommendations. Setting: Online cross-sectional survey in six African countries, namely South Africa, Cameroon, Nigeria, Ghana, Ethiopia and Kenya. Methods: After sample size determination, an online questionnaire was designed and content validated. The survey link was pretested on 25 people and then circulated for 6 weeks during total lockdown. The proportion of responses for each question were reported using descriptive statistics. Results: Half of the 817 participants surveyed were not consuming anything special for COVID-19 prevention. South Africans mostly reported the consumption of supplements or conventional medicines (mainly vitamin C and zinc) while for other countries, a variety of natural foods and drinks were mentioned - some having already proved helpful in boosting immune systems. They included infusions of spices with or without honey, fruits and vegetables, medicinal drinks and local beverages. Conclusion: Programmes and campaigns designed to increase awareness of dietary measures for COVID-19 prevention have proved beneficial and should be promoted. Analytical evaluation of the nutritional and health benefits and antiviral potentials of the identified special foods would help in determining which foods to prioritise and promote in the fight against COVID-19. Contribution: This study shows the possibility of finding dietary solutions for managing the pandemic and 'preventive' potentials of certain plant substances.

Socio-demographic and economic determinants of household expenditure on eating out in India - Evidence from India Human Development Survey (IHDS) II.

Background: 'Eating out (EO)' has witnessed a significant increase across nations and in India. Understanding food behaviour from an economic standpoint is essential to recognize food systems and nutrition transition. Aim: Our work compared the macro-data on per capita income and gross state domestic product from India with household expenditure on eating out. Using the India Human Development Survey II micro-data we studied the socio-demographic and economic determinants of household expenditure on eating out. Methods: The study design is a secondary data analysis of India Human Development Survey II from a sample of N = 42,152 households. It included socio-demographic and economic predictors, such as religion, caste, residence, migration for work, education, number of household members, income source, total annual income, consumption expenditure and poverty status. Results: No consistent trends emerged in the macroeconomic comparisons using gross state domestic product and per capita income. Results of logistic regression showed that the reserved caste categories OBC [COR 1.2 (1.1-1.2)] and SC/ST/Others [COR 1.1 (1-1.1)], household heads education up to secondary [COR 0.4 (0.4-0.5)] and higher secondary and above [COR 0.7 (0.6-0.8)], urban place of residence [COR 0.55 (0.53-0.58)], organised sector [COR 0.7 (0.6-0.7)] as the income source, higher annual income [COR 0.52 (0.50-0.54)], higher annual consumption expenditure [COR 0.44 (0.42-0.46)] and above poverty line [COR 2.1 (1.9-2.2)] were significantly positively associated with expenditure on eating out (p = <0.05). All these variables stayed significant in the multinomial regression model as well. Conclusion: This analysis confirms the increase in household income along with other demographics, increases the frequency of eating out. However, such trends remained inconsistent in macroeconomic assessments using gross state domestic product and per capita income.

Pooled prevalence of food away from home (FAFH) and associated non-communicable disease (NCD) markers: a systematic review and meta-analysis.

BACKGROUND: Food away from home (FAFH) is an 'eating behavior' widely practiced across nations, more common in developed nations. Likewise, in developing countries an increase of close to 50% indicates an upsurge in FAFH consumption. While various indices and tools are used to assess diet quality, diversity, or healthy eating, FAFH is less utilized to study dietary behaviors and the associated disease risk. OBJECTIVE: To calculate the pooled estimate of FAFH and identify the associated non-communicable disease (NCD) markers. DESIGN: Systematic review and meta-analysis. METHODS: Independent electronic searches were conducted across 6 databases: Medline, Web of Science, Scopus, Cochrane library, Ingenta, and CAB direct. Observational studies investigating the association between FAFH and NCD markers published between the year 2011 and 2021 were eligible for inclusion. Studies that included overweight or obese participants, pregnant women, or those under institutional care at baseline were excluded. The guidelines for reporting meta-analysis of observational studies in epidemiology were adhered to in the preparation of this systematic review. RESULTS: The random effects combined estimate for the overall prevalence of FAFH was 39.96% (95% CI 29.97-53.29). High heterogeneity (τ2 = 0.63, I2 = 100%) and high risk of bias were observed among the selected studies. The test for overall effect was observed to be z = 25.11 (p < 0.001). Eleven out of fourteen studies showed a positive association between FAFH and anthropometric changes. Twelve out of seventeen studies showed a positive association between FAFH and cardiovascular disease (CVD) biomarkers. CONCLUSION: Our work confirms FAFH as an evolving dietary behavior in both developing and developed countries, emphasizing the lack of representation from low-income countries. The association of FAFH with obesity and non-communicable disease risk is reinforced by our analyses. These findings should enable policy decisions to meet the rising demand of FAFH with healthier options to prevent the risk of NCD.

Effect of the coronavirus pandemic on nutrition and health of adults in Calabar, Nigeria: A post-lockdown analysis.

Background: The food security and nutrition of millions of people around the world is currently being threatened by the coronavirus disease 2019 (COVID-19) pandemic, an evolving health crisis. Aim: To evaluate the effect of the COVID-19 pandemic on nutrition and health of adults in Calabar, especially after the hard lockdown. Setting: Online cross-sectional survey in Calabar, Nigeria. Method: After sample size determination, an online questionnaire was designed, content-validated by nutrition experts and piloted on 20 respondents. The questionnaire link was circulated for 6 weeks (April-May, 2021). The questionnaire was structured to gather socio-economic data, lifestyles of the participants (especially younger adults) and changes in dietary intake and health. Descriptive statistics and Pearson's correlation were used to define the proportion of responses for each question and check for association. Results: No glaring nutrition or health problems was observed in the surveyed population (385 respondents), but many (50%) earned very low monthly income (< 50 000 naira). A drop in finances seemed to have indirectly caused a decrease in food consumption post-lockdown. A strong association between age and health risks was observed; similarly, alcohol intake was significantly affected by income and age. Conclusion: The pandemic caused many changes in people's dietary habits and lifestyles, including financial setbacks. Apparently, education and proper enlightenment play a major role in food choices (despite limited resources), thus ensuring adequate nutrition and reducing health risks in the face of a pandemic. Contribution: This study has affirmed the efficacy of nutrition education and proper awareness in ensuring healthy dietary choices, optimal health and reduced risks of diseases.

Food safety behavioural changes among the population in Sub-Saharan Africa during the COVID-19 first wave.

Sub-Saharan Africa (SSA) is known as a region that is highly affected by foodborne illnesses; and like the rest of the world, SSA is also deeply concerned about the COVID-19 pandemic. Despite the risk of infection by the SARS-CoV-2 coronavirus from food products and food packaging being thought to be very low, it does not exclude possibilities of cross-contamination. This study aimed at assessing that risk based on the population's key food safety Knowledge, Attitude, and Practices (KAP) that might be considered important to limit eventual virus propagation. A cross-sectional study consisting of an online survey was carried out between June and July 2020 (during the first wave of COVID-19 in the region). This study was targeted at Sub-Saharan Africans aged at least 18, and 817 participants from 5 developing countries (Cameroon, Ethiopia, Ghana, Kenya, and Nigeria) and South Africa (a middle-income country) were recorded. Most of the respondents appeared to be aware of COVID-19, its symptoms, and the protective measures. The awareness of the pandemic led to a reduction in street foods consumption, a rise in the preference for cooked foods, and a greater awareness of hygiene during food preparation and washing of fruits and vegetables before eating. Females appeared to be more knowledgeable on food safety KAP. Globally, higher KAP scores were revealed as the respondents were mature (age, employment, marital status, household, monthly income) and they were able to make responsible choices. Though the risk of the spread of COVID-19 through food contamination appears limited, efforts need to be made to sensitize the public (especially the most exposed communities) about the challenge behind food safety.

Protein Quality Evaluation of Some Commonly Consumed Bird Egg Varieties Using Amino Acid Scores.

Objective: Food proteins provide amino acids (AAs) and serve as building blocks of all vital organs, muscles, hormones, and biological fluids such as blood. Eggs are known as a good source of protein. This study compared the protein quality of bird eggs (raw and boiled), using their AA scores since some individuals consume raw eggs for various reasons. Research Methods. Eggs studied were exotic chicken, local chicken, turkey, quail, and guinea fowl eggs. The eggs were shelled and their contents (boiled and raw) lyophilized. The standard AOAC method (Kjeldahl) was used to determine protein content, while the amino acid composition was measured using an AA analyzer. The total AA scores were calculated based on the whole hen's egg AA profiles. Statistical significance was accepted at p < 0.05. Results: The Guinea fowl egg had the highest total amino acid score (TAAS) of 0.92. The other scores ranged as follows: 0.82 (quail) >0.81 (turkey) >0.75 (exotic chicken), and the lowest score was 0.65 (local chicken). The least scores were phenylalanine: 0.34 (exotic chicken), phenylalanine and serine: 0.36 (local chicken), leucine and aspartic acid: 0.41 (turkey), methionine: 0.31 (quail), and glutamic acid: 0.33 (guinea fowl). Also, guinea fowl egg had the highest total essential amino acid (TEAA) (49.6 g/100 g protein), i.e., % TEAA (55.1%), while exotic chicken egg had the lowest (41.1%), but the highest % NEAA (58.9%). Conclusion: Guinea fowl eggs had the highest EAA and TAA content. Its consumption should particularly be encouraged for children as this can significantly reduce the risk of protein-energy malnutrition and prevent protein deficiencies.

3D food printing improves color profile and structural properties of the derived novel whole-grain sourdough and malt biscuits.

Presentation of foods is essential to promote the acceptance of diversified and novel products. This study examined the color profile, browning index (BI), and structural properties of 3D-printed and traditional biscuits from whole-grain (WG) sourdough and germinated flours. The processed flours and composite/multigrain flours comprising cowpea sourdough (CS) and quinoa malt (QM) were used to prepare the snacks, and their structural characteristics were determined. Compared with the traditional biscuits, the 3D-printed biscuits showed considerable distinction in terms of consistent structural design and color intensities. The in-barrel shearing effect on dough biopolymers, automated printing of replicated dough strands in layers, and expansion during baking might have caused the biscuits' structural differences. The composite biscuit formulations had a proportional share of CS and QM characteristics. The 80% CS and 20% QM printed biscuit had a low redness and BI, increased cell volume, average cell area, and total concavity. The 60% CS and 40% QM printed snack showed improved lightness and yellowness, increased average cell elongation, and less hardness. The 3D-printed composite biscuits may be recommended based on their unique structural characteristics. Such attributes can enhance the acceptability of printed foods and reinvent locally prepared meals as trendy, sustainable, and functional foods.

Trends in functional food development with three-dimensional (3D) food printing technology: prospects for value-added traditionally processed food products.

One of the recent, innovative, and digital food revolutions gradually gaining acceptance is three-dimensional food printing (3DFP), an additive technique used to develop products, with the possibility of obtaining foods with complex geometries. Recent interest in this technology has opened the possibilities of complementing existing processes with 3DFP for better value addition. Fermentation and malting are age-long traditional food processes known to improve food value, functionality, and beneficial health constituents. Several studies have demonstrated the applicability of 3D printing to manufacture varieties of food constructs, especially cereal-based, from root and tubers, fruit and vegetables as well as milk and milk products, with potential for much more value-added products. This review discusses the extrusion-based 3D printing of foods and the major factors affecting the process development of successful edible 3D structures. Though some novel food products have emanated from 3DFP, considering the beneficial effects of traditional food processes, particularly fermentation and malting in food, concerted efforts should also be directed toward developing 3D products using substrates from these conventional techniques. Such experimental findings will significantly promote the availability of minimally processed, affordable, and convenient meals customized in complex geometric structures with enhanced functional and nutritional values.

COVID-19 preventives consumed in South Africa versus other Sub-Saharan African countries

Background: The current coronavirus disease 2019 (COVID-19) pandemic has been of global concern as it has affected the health of many and the economies of nations. In order to strengthen the immune system against COVID-19, certain plant-source foods were consumed. Aim: This study was designed to identify and compare various special foods and drinks consumed to prevent COVID-19 during the lockdown in various sub-Saharan countries in comparison to South Africa (SA), as well as highlighting some current dietary recommendations. Setting: Online cross-sectional survey in six African countries, namely South Africa, Cameroon, Nigeria, Ghana, Ethiopia and Kenya. Methods: After sample size determination, an online questionnaire was designed and content validated. The survey link was pretested on 25 people and then circulated for 6 weeks during total lockdown. The proportion of responses for each question were reported using descriptive statistics. Results: Half of the 817 participants surveyed were not consuming anything special for COVID-19 prevention. South Africans mostly reported the consumption of supplements or conventional medicines (mainly vitamin C and zinc) while for other countries, a variety of natural foods and drinks were mentioned ­ some having already proved helpful in boosting immune systems. They included infusions of spices with or without honey, fruits and vegetables, medicinal drinks and local beverages. Conclusion: Programmes and campaigns designed to increase awareness of dietary measures for COVID-19 prevention have proved beneficial and should be promoted. Analytical evaluation of the nutritional and health benefits and antiviral potentials of the identified special foods would help in determining which foods to prioritise and promote in the fight against COVID-19. Contribution: This study shows the possibility of finding dietary solutions for managing the pandemic and 'preventive' potentials of certain plant substances.

Fermented Edible Insects for Promoting Food Security in Africa.

Efforts to attain sustainable nutritional diets in sub-Saharan Africa (SSA) are still below par. The continent is envisaged to face more impending food crises. This review presents an overview of common edible insects in Africa, their nutritional composition, health benefits and utilization in connection with fermentation to enrich the inherent composition of insect-based products and offer foods related to existing and generally preferred culinary practice. Attempts to explore fermentation treatments involving insects showed fermentation affected secondary metabolites to induce antimicrobial, nutritional and therapeutic properties. Available value-added fermented edible insect products like paste, powder, sauces, and insect containing fermented foods have been developed with potential for more. Novel fermented edible insect-based products could effectively fit in the continent's food mix and therefore mitigate ongoing food insecurity, as well as to balance nutrition with health risk concerns limiting edible insects' product acceptability in SSA.