The tuck shop purchasing practices of grade 4 learners at selected primary schools in Pietermar[it]zburg, South Africa.

Abstract

Aim: To determine whether the tuck shop purchasing habits of Grade 4 learners were contributing towards the development of childhood overweight and obesity. Objectives: To assess the nutritional quality of the food and beverages available for learners to purchase; items regularly purchased from the tuck shop as well as factors influencing the learner’s decision to purchase these items; the anthropometric and socio-demographic characteristics of grade 4 learners as well as their nutrition knowledge related to the tuck shop items purchased. Method: A survey administered to 11 tuck shop managers, a questionnaire administered to 311 Grade 4 learners and two single-sex focus groups of 5 learners each were conducted. Results: Fifty six percent of the sample were female (n=173) and 44% were male (n=138). Twenty seven percent of the study sample was overweight (n = 83) and 27% were obese (n = 85). Eighty six percent of learners (n = 266) claimed to buy from their school tuck shop. Twenty two percent of learners purchased from their tuck shop at least three times per week (n =58). Learners who purchased from the tuck shop had a significantly higher BMI than those who did not (p = 0.020). Learners who purchased from the tuck shop spent on average R8,38 per day with a minimum of R1 and a maximum of R40 (standard deviation R5.39). The most popular reasons for visiting the tuck shop included “this is my favourite thing to eat or drink” (66.5%, n = 177) and “I only have enough money to buy this item” (47.0%, n = 125). Savoury pies were the most popular "lunch" item for all learners for both food breaks (45%, n = 5 schools and 27.3%, n = 3 schools) selling the most number of units (43) per day at eight of the eleven schools (72.7%). Iced popsicles were sold at almost every school, ranked as the cheapest beverage and also sold the most number of units (40.7). Healthy beverages sold included canned fruit juice and water, while healthy snacks consisted of dried fruit, fruit salad, bananas, yoghurt and health muffins. The average healthy snack contained almost half the kilojoules of its unhealthy counterpart (465kJ vs 806kJ). Nutritional analyses of the healthy lunch options revealed total fat contents that exceeded the DRI and South African recommended limit. Perceived barriers to stocking healthy items included cost and refrigeration restrictions. The average score for the food groups was only 33% indicating that learners were not familiar with the Food Based Dietary Guidelines (FBDG). Further analyses showed that the total knowledge scores of those learners that reported to buy from the tuck shop frequently, was significantly lower when compared to the total knowledge scores of those learners who bought from the tuck shop less frequently (13.0 ± 3.9 and 11.6 ± 3.1, respectively; p < 0.05). Logistic regression analysis confirmed that the total knowledge of a learner could be used to predict whether he or she is more likely to make purchases from the tuck shop (significance = 0.017). Focus group results revealed that learners are aware of “healthy” and “unhealthy” tuck shop items. Most learners stated that they would continue to purchase items from their tuck shop if all “unhealthy” items were removed. Conclusion: Primary school tuck shops of well resourced schools in Pietermaritzburg are contributing to childhood overweight and obesity through a combination of factors. These include the poor nutritional quality of the items stocked at the tuck shop as well as the poor tuck shop purchasing practices. Much consultation is required amongst dieticians, school principals and privatised tuck shop managers to overcome barriers to stocking healthy items. School management and government have an important role to play in imposing restrictions on the sale of unhealthy items; along with improving the quality of the nutrition education curriculum to ensure that learners are able to translate their knowledge into healthier purchasing practices.