Community Assessment for a Low-Carbohydrate Nutrition Education Program in South Africa
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Ethical Approval
2.2. Study Settings
2.3. Participants
2.4. Procedures
2.5. Data Analysis
3. Results
3.1. Theme 1: Role within the household
“I am a mother and a wife and the men do not think the way that I think. They do not worry. I always think about what my children and husband are going to eat.” (Ocean View)
“To prepare a complete cooked meal for your children or family is tradition. We grew up with that and that is how your mother taught you.” (Cloetesville)
“Sometimes when the food is not enough, then you have to stretch the food. (…) We make use of potatoes and rice; it is relatively cheap, and we have big families.” (Ocean View)
“I have three men in the house and my children are big and they eat a lot. My husband lost his leg because of sugar. He was the breadwinner, and the problem is that there is no money.” (Ocean View)
“The food that I prepare at home must be fast dishes, because of a person’s working circumstances. Moreover, quick things because it is easy.” (Ocean View)
3.2. Theme 2: Dietary Behaviour
“Mine [diet] consists of bread. In the morning, I will have porridge, such as Jungle Oats and Weet-Bix.” (Ocean View)
“Late in the evening when everyone is sleeping, then you go on a hunting trip to find something to eat, chips or something else that you know is going to make your joints pain or make you sick. I feel that I have a psychological problem.” (Cloetesville)
“I am obsessed with coffee. (…) I drink up to nine cups of coffee a day. I can stay without food for the whole day as long as I have my coffee.” (Ocean View)
3.3. Theme 3: Health Perceptions
“I think that a healthy lifestyle includes that you have to eat healthy every day; you need to exercise and eat a green salad.” (Ocean View)
“It [healthy living] comes down to correct eating habits, enough exercise, to drink enough water and to stay calm.” (Cloetesville)
“For me it is important that you get enough sleep, your stress levels need to decrease, and you have to develop balanced eating habits.” (Ocean View)
“Can I say everything that is white? [laughter] Rice, sugar, potatoes, even mealie meal and sweet potato.” (Cloetesville)
“Too much of one thing is unhealthy. (…) I also think that alcohol plays a role. It is not wrong to drink, but a certain percentage of alcohol can be unhealthy.” (Ocean View)
“At the moment I try to reduce the carbs and sugars, I really try hard. It is tough, but I try because you always go back to your bad habits. I try every day.” (Ocean View)
“The reason that I joined the gym is because I want to eat what I want to eat. If I want to have biryani today, then I will have biryani, because tomorrow I will burn it out in the gym.” (Cloetesville)
3.4. Theme 4: Willingness to Participate in an LCHF Program
“Just one word, healthy lifestyle, healthy eating. That is my mindset change for myself to have a lifestyle change. I want to have a healthy life.” (Ocean View)
“I think everyone sitting here this morning does not really lead a healthy lifestyle. Our eating habits are not healthy, but we try.” (Cloetesville)
“I also think that it will be good for myself, so that I can instil it in my children and especially my husband, who is a diabetic.” (Cloetesville)
“For myself I need to make a dramatic change. Last year they treated me for organ failure, I almost died. (…) Therefore, for me this is important, this time I need it. It worked for my sister. She is still on Banting and she is very healthy.” (Ocean View)
“I also say that the Banting diet is a little bit expensive, and I am not fond of it. According to what I have read, it is a lot of greasy food, because I can now eat bacon and eggs.” (Cloetesville)
“For me it was also shocking. The diet with the amounts of fat that we always think we need to cut out of a diet (…) We always believe what doctors tell us.” (Ocean View)
“Mentally I am not ready to participate in any program. In the past few months, I had a setback where I lost heavily. (…) I was just in the house and I took it out on food, I just wanted to eat everything that I craved. (…) I am still dealing with my losses, so I am not mentally right to participate.” (Ocean View)
“I am not willing to make two dishes; hell, no, it is too expensive. Therefore, if something can work it out, how to keep everyone in the family happy.” (Cloetesville)
4. Discussion
4.1. Weight Loss Is a Major Motivator for Change, but Change Is Often Expensive
4.2. Family Habits and Social Support Are Major Factors in Food Choice
4.3. Environmental Challenges to Health and Wellbeing in This Community
4.4. Current Perceptions of Healthy and Traditional Eating May Influence Adoption
4.5. Intervention Recommendations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | N(%) |
---|---|
EBSA program | |
Ocean View | 6 (10%) |
Cloetesville | 54 (90%) |
Highest level of education completed | |
Primary School | 20 (33.3%) |
High School | 30 (50%) |
Certificate | 4 (6.7%) |
Diploma | 2 (3.3%) |
Degree | 4 (6.7%) |
Work status | |
Unemployed | 47 (78.3%) |
Employed | 13 (21.7%) |
Reported medical conditions | |
High blood pressure | 28 (46.7%) |
High cholesterol | 14 (23.3%) |
Obesity | 4 (6.7%) |
Type 2 Diabetes Mellitus | 7 (11.7%) |
Heart problems | 1 (1.7%) |
Type 1 Diabetes Mellitus | 3 (5%) |
Osteoporosis | 2 (3.3%) |
Arthritis | 4 (6.7%) |
Thyroid | 4 (6.7%) |
Depression | 1 (1.7%) |
None | 18 (30%) |
Themes | Subthemes | Definition of the Themes |
---|---|---|
Theme 1: Role within the household | 1.1 Women’s responsibilities 1.2 Factors influencing shopping | Women’s roles and responsibilities as caregivers. Priorities when shopping for groceries. |
Theme 2: Dietary behaviour | 2.1. Current diet 2.2. Feelings around food | Descriptions of current diets and feelings around foods. |
Theme 3: Health perceptions | 3.1. Healthy and unhealthy lifestyle 3.2. What women do to be healthy | Understanding of being healthy and unhealthy. |
Theme 4: Willingness to participate in a LCHF program | 3.3. Desire to be healthy 4.1. Knowledge of LCHF diets 4.2. Barriers to adhering to dietary recommendations | Willingness to participate in the EBSA program. Socioeconomic challenges to adhering to the diet. |
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Pujol-Busquets, G.; Smith, J.; Fàbregues, S.; Bach-Faig, A.; Larmuth, K. Community Assessment for a Low-Carbohydrate Nutrition Education Program in South Africa. Nutrients 2023, 15, 67. https://doi.org/10.3390/nu15010067
Pujol-Busquets G, Smith J, Fàbregues S, Bach-Faig A, Larmuth K. Community Assessment for a Low-Carbohydrate Nutrition Education Program in South Africa. Nutrients. 2023; 15(1):67. https://doi.org/10.3390/nu15010067
Chicago/Turabian StylePujol-Busquets, Georgina, James Smith, Sergi Fàbregues, Anna Bach-Faig, and Kate Larmuth. 2023. "Community Assessment for a Low-Carbohydrate Nutrition Education Program in South Africa" Nutrients 15, no. 1: 67. https://doi.org/10.3390/nu15010067