Rose Gallo

BHAN 322 Research Paper

Necessity of Nutrition Education in South Africa

Both children and adults of South Africa have been plagued with severe health problems

including, HIV/AIDs, tuberculosis, and heart disease. While none of these can be completely

cured with nutrition, an education about healthy lifestyles can greatly prevent or slow the

progression of a disease. In South Africa, nutrition education and intervention have very slowly

started to be acknowledged as a vital part of illness prevention. However, it will take many more

concrete efforts to evaluate the country’s levels of health and work to implement programs that

can teach adults and children the importance of a healthy lifestyle.

The lack of nutrition education in South Africa has given rise to inaccurate information

about what foods to consume as well as created a malnutrition issue across the country. Around a

third of preventable deaths around the world can be attributed to malnutrition.1 Malnutrition

stems from a lack of resources, poverty, illness, stress, and finally, lack of education.(2) Nutrition

education has been so poorly prioritized in the world that about 200 million children under five

years old are unable to fully develop due to lack of nutritional care.(1) The Integrated Nutrition

Programme (INP) of the Western Cape province describes the malnutrition problem as a “silent

epidemic,” as about 30% of South African children fail to fully develop due to poor nutrition.(2)

Those that poorly develop are greatly underserved in the nation and unable to live a fully

productive life. Ignorance regarding nutrition can also contribute to poor health which can

weaken the immune system. Diseases prevalent in South Africa, such as HIV/AIDS and

tuberculosis, greatly increase in severity without proper nutritive care.(3) It has been estimated
that about 30% of deaths in children can be attributed to lack of nutrition and a consequential

poor immune system. (3)

In response to the great increase in malnutrition, the South African government has made

some concrete efforts to aid the population. In 2003, vitamins and minerals began being added to

flour in order to increase consumption.(4) Salt began to be regulated as iodized in order to

provide iodine to individuals.(4) In response to poor folic acid intake of mothers and newborns,

folic acid began to be fortified in various foods, greatly decreasing the number of birth defects.(4)

Fortifying foods has made a huge impact on the health of South Africans. However, a large part

of the widespread malnutrition issue still has to do with education and daily health practices. For

various reasons, almost 75% of South African mothers provide their newborns with formula or a

mixed diet, rather than solely breast milk.(4) Without the nutrients found solely in breast milk,

babies are susceptible to a high risk of illness, growth defects, and malnutrition.(4) Nutritive

education, particularly for mothers, would greatly assist the quality of health of both mothers and

their newborns.

Another large issue leading to malnutrition in South Africa is food security. The high

poverty and lack of resources in the country often lead families to spend their incomes on the

cheapest, and often more unhealthy foods available to them.(5) In a 2017 article by the South

Africa Times, it was found that “most poor families are spending up to 40% of their incomes on

food, and most of the energy they are getting was from cheap foods that are high in

carbohydrates.” (5) While a large part of choices that lead to poor diet can be made based on

availability and cost, education can greatly increase a person’s ability to make alternative and

healthier choices based on what is available to them. It is almost impossible to reverse

malnutrition once the severe debilitating effects have taken their toll. However, through an
increase in proper nutrition education widespread throughout the country, malnutrition can be

greatly decreased and the information can be passed on to future generations.

Throughout South Africa, there are some nutritional guidance references currently

available to the public. However, the large number of malnourished individuals in the country

indicates that these guidelines are not fully utilized or understood. Only through proper nutrition

education can the vital information of these references be fully understood. One example of

these reference manuals includes the Food Based Dietary Guidelines, created in 2003 by the

Nutrition Society of South Africa, Department of Health, Medical Research Council, and other

organizations.(6) The target population of these guidelines are individuals 5 years of age and

older.(6) The guideline is helpful in that it identifies the various food groups that should be eaten

in a balanced manner. These include starches, fruits and vegetables, beans and legumes, protein

foods, dairy, fat and oil, and water.(6) A flaw of the guideline though in comparison to the US

Dietary Guidelines is that it does not identify which foods to limit. Such foods include those high

in saturated and trans fats, salt, and/or sugar.(6) Without such knowledge, individuals using these

guidelines as a reference for their own daily habits can easily contribute to their own weight gain,

onset of diabetes, or heart disease unknowingly.

It has been proven through various research studies that implementation of nutrition

education programs works and can greatly increase quality of life for the affected individuals.

Between 1992 and 1995, the Nutrition Education Intervention Programme (NEIP) was

established that worked with lower income communities across South Africa.(7) For two years,

the program gave “a nutrition education and food aid programme…to one urban and three rural

areas.” (7) One of the rural areas acted as a control group, meaning it was not given any nutrition

education in order to compare it to the implementation programs of the other three

communities. The researchers evaluated the roughly 600 respondents’ nutrition education and

practices before implementing the program.(7) The results of the intervention showed great

success. Those who received the nutrition education program in rural areas increased their

knowledge of healthy eating by 42.2-52.6%.(7) People of these households began including more

varied food groups in their meals and maintaining a healthy balance of foods. There was a

significant increase in the daily consumption of milk as well.(7) The overall results of the study

evidenced that nutrition education programs can alter dietary choices and habits on a daily basis

in low income areas. Particularly, education programs in a community environment have a

substantial impact on the behaviors of those participating in the program.

In a study done by the Department of Basic Education, DBE, a nutrition implementation

program was found to greatly increase the nutritional knowledge of students and begin to make

changes to decrease malnourishment of the country.(8) The Department recognized that poor

nutrition understanding is a main contributing factor to the undernourishment of so many

children in the country. Poor nutrition knowledge could stem from either a lack of education or

incorrect societal beliefs about certain foods or habits. In response, the DBE tactfully initiated

the implementation of the Nutrition Education Program (NEP) in 45 selected schools.(8) Doing

so allowed students to be reinforced on a daily basis of the importance of a healthy lifestyle, as

well as gain reassurance from their peers in their habits. Additionally, learning this vital

information at a young age encourages a healthier population growing up. Before implementation

of the program, the educators were assessed with a questionnaire to evaluate their prior nutrition

knowledge. One of the most important findings of this study was that many educators were

found to have an average or below average understanding of a healthy diet. Through

implementation of an NEP, their knowledge can be greatly increased and effectively be passed on

to students.

Across the country of South Africa, malnutrition continues to be one of the highest risks

of illness and disability. Without proper nutritive care and education, mothers cannot properly

birth or raise healthy children. The children then develop incorrect knowledge about how to live

a balanced lifestyle, and the cycle continues. Although the country provides some guidelines and

material on how to maintain a healthy diet, very little information emphasizes why nutrition is so

important. It has been proven that providing such education influences both children and adults,

and results in changed daily habits. In order to combat illness, poverty, and low amount of

resources, as well as create a healthier South African population, nutrition education must gain

status as a priority in schools and government. Without desire and concrete action to achieve a

healthy population, the quality of life for all South Africans will continue to remain the same, or

worse, decline.