Knowledge, attitudes and practices of exit-level Health Sciences students at a selected University in Durban, South Africa, towards the consumption of sugar-containing beverages following the introduction of the Sugar Tax in South Africa.

Abstract

Introduction South Africa has the highest prevalence of lifestyle-related diseases, such as diabetes, dental caries, and obesity-related diseases. Many of these diseases are expensive and difficult to treat and place a burden on the healthcare system. If sugar-consumption can be decreased, then the prevalence of these diseases can be reduced, resulting in financial savings and reduced disease burden. Consequently, there will be a reduction in the number of healthcare workers needed, and the costs of delivering healthcare to the population. The sugar tax was implemented in South Africa to directly raise revenue for the State that could be utilised to prevent and treat lifestyle-related diseases and indirectly increase the price of food products containing sugar to reduce sugar consumption. It was envisaged that this reduced sugar consumption would reduce obesity and in diseases that have sugar as a causative agent. Healthcare professionals can play a critical role in advising patients on reducing sugar intake, especially with reduced consumption of sugar-sweetened beverages. Aim and objectives This study aimed to determine the knowledge, attitudes and practices of knowledge, attitudes and practices of exit-level health sciences students at a selected University in Durban, South Africa, towards consuming sugar-containing beverages following the introduction of a sugar tax. Methods Gatekeeper permission was obtained from the Durban University of Technology and final ethical approval from the University of KwaZulu-Natal. Online information sheets about the study were made available to 150 final-year students in the health sciences professions and informed consent was obtained. An online questionnaire was administered to the participants. It included questions around participants sociodemographic profile, knowledge of the sugar tax and SSBs, attitudes towards the sugar tax and SSBs, and perceptions of their practices relating to dietary advice and the sugar tax. Qualitative data were analysed using NVivo, and quantitative data using the Statistical Package for the Social Sciences (SPSS) (version 25) SPSS.

Results The study population consisted of a young population with the mean age being 23.6 years. Most participants (60.4%, n=40, p.101707 – not significant), left the purchasing and food-choice decisions to their parents. Most participants (n=39, 59%) reported that they had changed their SSBs consumption habits. Most (78.2%, n=51) participants were not aware of the sugar tax's purpose and its introduction. Participants were mostly positive 61% (n=40) on their attitudes towards the merit of the implementation of a sugar tax, but 21 participants (32%) had a negative view of this tax, citing reasons such as that “even with an increase of the sugar beverages price, consumption will not decline.” The sugar tax theme is an excessive burden placed on an already over-taxed society. A violation of personal and constitutional rights was reported by 27% (n=18) of the participants who supported the sugar industries anti-sugar tax stance. Only 24% (n=16) believed they had not received sufficient education and training around sugar consumption containing beverages. Participants reported having had minimal training, lacking in-depth knowledge of the current literature about SSBs consumption. Conclusion This study raises several important questions regarding nutritional training among the various cadres of health sciences students at universities and technology universities. According to the results, it appears that there is a need for curriculum reform that would lead to improved training in diet and nutrition advice content. This is so that future health professionals will be more aware of the current trends and practices about diet and nutrition, thus offering their clients/patients holistic health management and treatment course of care. Extensive curriculum reform and redesign should occur, in that extensive training and education be given to all Health Sciences students and future healthcare workers about the ill effects of excessive sugar consumption, and that they are trained in being able to render dietary counselling and advice to their prospective patients.