Does nutrition transition distort food choices and dietary patterns contributing to obesity among black African women? : a case of African women from Pietermaritzburg.

Abstract

Obesity and its attendant nutrition-related non-communicable diseases and other risk factors has long been identified as a serious public health concern globally and locally. Based on those concerns, the author investigated the question: „Does nutrition transition distort food choices and dietary patterns, contributing to the overweight and obesity problem among the Black African women?‟ The nutrition transition is characterised by shifts from traditional diets to highly processed products with long shelf-life and regarded as energy-dense as they tend to have high oil, sugar and salt content, often purchased from supermarkets. Such diets are highly implicated in the global obesity epidemic. The focus was on women from Pietermaritzburg and the surrounding urban and rural communities. Qualitative and quantitative research methods using various research instruments were employed in the survey-based research design to elicit information from the participants. Qualitative methods used were in-depth and focus group interviews. Raw data were collected, computed and analysed. Four hundred and fifty-two women, excluding the pilot study, were interviewed. The participants were between the ages of eighteen and sixty-five years. Research included data from seventy-three women organised into six focus groups, complemented with key informants‟ interviews. The anthropometric data represented by the body mass index, reflected significantly high prevalence of obesity. The waist-to-hip ratios and the waist circumference, both indicators of abdominal obesity, similarly concurred. The socio-demographic information described the sample as homogenous in that they were all of childbearing age and more, oversaw food preparation in their households, of the same race group, culturally and geographically from the rural and urban areas of Pietermaritzburg. The socio-demographics analysed, were: marital status through the female-headed households‟ implied poverty; social grants‟ recipients as suggestive of household poverty; ownership of consumer durables as signifying a community undergoing a nutrition transition. ii The Household Food Insecurity (Access) Scale (HFIAS) measured the access component of food insecurity based on the experience of anxiety about food shortage; the perceptions of insufficient quality and variety of food and insufficient food intake. That was done through a nine occurrence- and frequency-of-occurrence questionnaire. The findings showed incidents of worrying about not having enough, as well as eating a limited variety and foods they really did not want to eat because of insufficient funds. Significantly, there were incidents of not eating any food of any kind because of lack of funds, including experiences of going to bed hungry, as well as going day and night without eating anything because there was not enough food. Those poignantly indicated a possibility of food insecurity at household level. The Household Dietary Diversity Score (HDDS) is a food group dietary diversity indicator assessed through varieties of food-groups consumed. The results revealed limited dietary diversity with monotonous starchy staples consumed and high consumption of oily, sweet and salty food groups implicated in nutrition transition and the obesity epidemic. Focus Groups and key informants seemed oblivious to obesity and venerated it. Overall, the participants seemed to be relatively food and nutrition insecure, concurrently undergoing a nutrition transition, with abundance of highly processed products that seemingly distorted food choices and dietary patterns.