Associations among Food Systems, Food Environments, Food Choices, Food Security, and Nutrition Transition in Limpopo Province, South Africa: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Target Population, Sample Size Calculation, and Sampling Technique
2.3. Data Collection Tool and Procedure
2.4. Ethical Clearance
2.5. Data Analysis
3. Results
3.1. Socio-Demographic Information and Biophysical Environment
3.2. Food Systems Assessment
3.3. Food Environment Assessment
3.4. Food Choices
3.5. Household Food Security Status
3.6. Nutritional Status and Health Risk
3.6.1. Anthropometric Indicators of the Respondents
3.6.2. Biochemical Indicators of the Respondents
3.6.3. Clinical Indicators of Respondents
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Interpretation | Classifications (kg/m2) |
---|---|
Underweight | <18.5 |
Normal | 18.5–24.99 |
Overweight | 25–29.99 |
Obese class 1 | 30–34.99 |
Obese class 2 | 35–39.99 |
Obese class 3 | >40 |
Categories | Frequency (n) | Percentage (%) | p Values |
---|---|---|---|
Age (years) * | |||
18–35 | 210 | 49.2 | |
36–55 | 156 | 36.5 | <0.001 |
>55 | 61 | 14.3 | |
Marital Status | |||
Single | 248 | 57.8 | |
Married | 119 | 27.7 | <0.001 |
Divorced | 13 | 3.0 | |
Widowed | 25 | 5.8 | |
Cohabitation | 22 | 5.1 | |
Other | 2 | 0.5 | |
Gender | |||
Female | 345 | 80.4 | <0.001 |
Male | 84 | 19.6 | |
Education | |||
Never attended school | 21 | 4.9 | |
Primary education (grade 1–7) | 26 | 6.1 | |
Secondary education (grade 8–12) | 232 | 54.1 | <0.001 |
Tertiary education (degree, diploma, etc.) | 146 | 34.0 | |
Other | 4 | 0.9 |
Usage | No of Days | |||||||
---|---|---|---|---|---|---|---|---|
Behaviours | % (n) | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
Rely on less preferred and less expensive foods | 31.3 (134) | 4.7 (20) | 8.4 (36) | 5.1 (22) | 2.8 (12) | 2.1 (9) | 0.7 (3) | 7.5 (32) |
Reduce portion sizes | 23.1 (99) | 4.7 (20) | 6.3 (27) | 4.0 (17) | 3.5 (15) | 0.2 (1) | 0.0 (0) | 4.4 (19) |
Limit portion size at mealtimes | 22.4 (96) | 4.0 (17) | 6.8 (29) | 3.7 (16) | 2.8 (12) | 0.9 (4) | 0.0 (0) | 4.2 (18) |
Borrow food, or rely on help from a friend or relative | 18.0 (80) | 8.4 (36) | 4.4 (19) | 2.1 (9) | 1.4 (6) | 0.5 (2) | 0.0 (0) | 1.2 (5) |
Reduce the number of meals eaten in a day | 17.7 (76) | 4.7 (20) | 6.3 (27) | 2.1 (9) | 0.9 (4) | 0.9 (4) | 0.2 (1) | 2.6 (11) |
Not having enough food or money to buy food | 15.1 (65) | 3.7 (16) | 3.5 (15) | 3.3 (14) | 1.4 (6) | 0.2 (1) | 0.0 (0) | 3.0 (13) |
Purchase food on credit | 13.7 (59) | 6.8 (29) | 3.0 (13) | 1.6 (7) | 1.2 (5) | 0.2 (1) | 0.2 (1) | 0.7 (3) |
Skip meals | 13.6 (59) | 3.7 (16) | 5.1 (22) | 2.1 (9) | 0.9 (4) | 0.0 (0) | 0.2 (1) | 1.6 (7) |
Borrow money to buy food from neighbours | 12.6 (54) | 7.5 (32) | 2.6 (11) | 0.9 (4) | 0.2 (1) | 0.9 (4) | 0.0 (0) | 0.5 (2) |
Take other measures | 13.3 (51) | 4.0 (17) | 2.7 (11) | 3.7 (10) | 0.6 (3) | 0.2 (1) | 0.0 (0) | 2.1 (9) |
Drink tea only | 11.3 (48) | 2.6 (11) | 4.7 (20) | 1.9 (8) | 0.2 (1) | 1.9 (8) | 0.0 (0) | 0.0 (0) |
Restrict consumption by adults in order for small children to eat | 7.4 (32) | 2.8 (12) | 2.3 (10) | 1.2 (5) | 0.2 (1) | 0.0 (0) | 0.0 (0) | 0.9 (4) |
Borrow food from neighbours | 6.9 (29) | 1.9 (8) | 2.6 (11) | 0.7 (3) | 0.7 (3) | 0.5 (2) | 0.0 (0) | 0.5 (2) |
Sleep without food | 5.5 (24) | 3.0 (13) | 0.9 (4) | 1.2 (5) | 0.0 (0) | 0.2 (1) | 0.0 (0) | 0.2 (1) |
Send household members to beg | 5.1 (22) | 1.4 (6) | 1.6 (7) | 1.2 (5) | 0.2 (1) | 0.5 (2) | 0.2 (1) | 0.0 (0) |
Send children to neighbours or relatives | 5.1 (22) | 2.1 (9) | 1.9 (8) | 0.5 (2) | 0.2 (1) | 0.2 (1) | 0.0 (0) | 0.2 (1) |
Send household members to eat elsewhere | 4.4 (19) | 1.2 (5) | 1.9 (8) | 0.2 (1) | 0.2 (1) | 0.0 (0) | 0.0 (0) | 0.9 (4) |
Feed female members of HH at the expense of male members | 2.5 (11) | 1.4 (6) | 0.5 (2) | 0.2 (1) | 0.0 (0) | 0.2 (1) | 0.0 (0) | 0.2 (1) |
Exchange sorghum/green mealies for white mealie meals from local shops or mobile vendors | 2.5 (11) | 1.4 (6) | 0.9 (4) | 0.0 (0) | 0.0 (0) | 0.0 (0) | 0.0 (0) | 0.2 (1) |
Sell traditional beer and buy food with profit | 2.3 (10) | 0.7 (3) | 1.4 (6) | 0.2 (1) | 0.0 (0) | 0.0 (0) | 0.0 (0) | 0.0 (0) |
Gather wild food, hunt, or harvest immature crops | 2.1 (9) | 1.4 (6) | 0.5 (2) | 0.0 (0) | 0.0 (0) | 0.0 (0) | 0.0 (0) | 0.2 (1) |
Consume seed stock held for next season | 2.1 (9) | 0.9 (4) | 0.5 (2) | 0.5 (2) | 0.0 (0) | 0.0 (0) | 0.0 (0) | 0.2 (1) |
Feed working members of HH at the expense of non-working members | 2.1 (9) | 1.2 (5) | 0.5 (2) | 0.2 (1) | 0.2 (1) | 0.0 (0) | 0.0 (0) | 0.0 (0) |
Feed adult members of HH at the expense of children members | 2.1 (9) | 0.5 (2) | 0.2 (1) | 1.2 (5) | 0.2 (1) | 0.0 (0) | 0.0 (0) | 0.0 (0) |
Feed male members of HH at the expense of female members | 2.1 (9) | 0.0 (0) | 0.5 (2) | 0.2 (1) | 1.4 (6) | 0.0 (0) | 0.0 (0) | 0.0 (0) |
Food Security Characteristics | % |
---|---|
HFIAS domains | |
Anxiety and uncertainty over food | 45.2 |
Insufficient food quality | 40.2 |
Insufficient food intake | 46.0 |
HFIAS conditions | |
Worrying about food intake | 43.7 |
Not able to eat preferred food | 40.6 |
Limited variety of food | 39.5 |
Eating unwanted foods | 38.9 |
Eating smaller meals | 33.1 |
Eating fewer meals | 26.8 |
No food in the house | 15.6 |
Sleeping hungry | 8.2 |
The whole day and night without food | 6.5 |
HFIAS categories | |
Food secure | 46.0 |
Mildly food insecure | 23.8 |
Moderately food insecure | 26.3 |
Severe food insecurity | 4.0 |
Variables | Bivariate | Multivariate | |||||
---|---|---|---|---|---|---|---|
Characteristics | N | HFI (%) | OR (CI) | p Value | AOR (CI) | p Value | |
Gender | Male | 345 | 82.83 | 0.716 (0.444–1.155) | 0.181 | 1.048 (0.561–1.957) | 0.884 |
Female | 84 | 1.17 | |||||
Education | Illiterate | 21 | 5.15 | 0.886 (0.365–2.150) | 0.826 | 0.827 (0.259–2.642) | 0.748 |
Literate | 408 | 94.85 | |||||
Farm ownership | Yes | 29 | 7.30 | 0.829 (.386–1.780) | 0.702 | 0.987 (0.410–2.379) | 0.977 |
No | 400 | 92.70 | |||||
Field ownership | Yes | 60 | 12.45 | 1.322 (0.765–2.282) | 0.331 | 1.709 (0.866–3.374) | 0.122 |
No | 369 | 87.55 | |||||
Home garden ownership | Yes | 256 | 63.95 | 0.685 (0.465–1.011) | 0.035 | 0.670 (0.405–1.110) | 0.120 |
No | 172 | 36.05 | |||||
DDS | Poor dietary intake | 240 | 53.65 | 1.227 (0.836–1.800) | 0.329 | 1.370 (0.841–2.233) | 0.206 |
Good dietary intake | 189 | 46.35 | |||||
Nutritional knowledge | Yes | 363 | 81.97 | 1.576 (0.916–2.710) | 0.064 | ||
No | 66 | 18.03 | |||||
BMI | ≤Normal | 20 | 5.15 | 0.773 (0.309–1.931) | 0.651 | 0.788 (0.269–2.309) | 0.664 |
>Normal | 406 | 93.56 |
Variables | % | Mean | Std. Deviation | p Value |
---|---|---|---|---|
Random blood glucose (mmol/L) | 9.7386 | 3.4863 | <0.001 | |
Normal (<11.1) | 67.5 | |||
Diabetes (>11.1) | 32.5 | |||
Total blood cholesterol (mmol/L) | 3.6893 | 0.7421 | <0.001 | |
Normal (<5.0) | 93.2 | |||
At risk (<7.5) | 6.8 |
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Nedzingahe, V.; Tambe, B.A.; Zuma, M.K.; Mbhenyane, X.G. Associations among Food Systems, Food Environments, Food Choices, Food Security, and Nutrition Transition in Limpopo Province, South Africa: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2023, 20, 6557. https://doi.org/10.3390/ijerph20166557
Nedzingahe V, Tambe BA, Zuma MK, Mbhenyane XG. Associations among Food Systems, Food Environments, Food Choices, Food Security, and Nutrition Transition in Limpopo Province, South Africa: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2023; 20(16):6557. https://doi.org/10.3390/ijerph20166557
Chicago/Turabian StyleNedzingahe, Vhushavhelo, Betrand Ayuk Tambe, Mthokozisi Kwazi Zuma, and Xikombiso Gertrude Mbhenyane. 2023. "Associations among Food Systems, Food Environments, Food Choices, Food Security, and Nutrition Transition in Limpopo Province, South Africa: A Cross-Sectional Study" International Journal of Environmental Research and Public Health 20, no. 16: 6557. https://doi.org/10.3390/ijerph20166557