Beliefs and practices related to label reading and its implications for functional foods in South Africa
Badham, Jane Melissa
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Motivation There is international agreement and recognition that the health status of the worlds' population is a cause for concern and that one of the key risk factors for many of the diseases that are increasing at an alarming rate (heart disease, diabetes, cancer) in both developed and developing countries, is diet. Despite many successes (especially in the areas of the eradication and containment of infectious disease and reduced fertility) and the huge advances in scientific research and technology, that have increased both what is known, and what can be done, for prevention and risk management, we still face what many describe as a crisis. Knowledge it seems is not always adequately reflected in public health practice. The objective of the local (Department of Health, Directorate of Food Control) and international (WHO, Codex Alimentarius) drive towards increased and improved food labelling, is that if consumers have reliable nutrition information available at the point of purchase and if they understand how their diet affects their risk of diseases, they will be able to make risk-reducing food choices. This could ultimately have a significant positive public health impact. The food industry has also expressed an interest through the concept of functional foods (food similar in appearance to conventional food that is intended to be consumed as part of a normal diet, but has been modified to subserve physiological roles beyond the provision of simple nutrient requirements), that albeit in reality financially motivated, could provide consumers with the opportunity to reduce their risks of some diseases through readily available, good-tasting diets rather than through the use of curative measures only. For the success of both these initiatives in public health terms, consumers must: o accept the link between the food that they eat and their health o actively look for and trust the messages communicated be able to correctly process and integrate the information o make a purchasing decision. This highlights the importance of in-depth consumer understanding in order to ensure that regulatory, educational and marketing strategies will affect positive behaviour change and improve health status. Little consumer research has been done in South Africa to assist all those involved (government, industry, researchers, nutrition experts I dietitians, educators) in gaining potentially important insights. Objectives Of South Africa's almost 31 million adults, some 11 million live in the metropolitan areas and so have relative exposure to most media and access to the widest range of available food products. This group is also a microcosm of the larger South Africa - being made up of all races, ages and living standards. The overall objective of this study was to investigate the beliefs and practices of South African metropolitan adults, in relation to the food and health link and the health information contained on food packages in order to consider the implications for functional foods. The study design was focussed on four key variables, namely, gender, race, age and living standard measure (LSM). Methods The study was designed to ensure that the results would be representative of the metropolitan adult (>I6 years) population and that they could be weighted and extrapolated. 2000 adults made up of 1000 Blacks. 640 Whites, 240 Coloureds and 120 Indians, with a 50150 gender split were drawn using a stratified, random (probability) sampling method in order to allow for the legitimate use of the mathematics of probability as well as to avoid interviewer bias. The study group were interviewed, face-to-face, in home, in the preferred language from English, Afrikaans, Xhosa, Zulu, Tswana, North Sotho and South Sotho, by trained field workers. A minimum 20% back-check on each interviewer's work was undertaken to ensure reliability and validity of the data. The field worker used a pre-coded questionnaire that included seventeen food related questions designed by a multidisciplinary team of marketers, dietitians, nutritionists and research specialists. The food questions used a 5-point Likert scale in order to measure attitude. The data was captured (3 questionnaire were excluded due to being incorrectly filled in) and the computer software package STATISTICA@ Release 6, which was used to perform the statistical analysis. The data was data was weighted to represent the total metropolitan population prior to analysis. Quantitative data was statistically analysed in order to generate relevant descriptive statistics, cross tabulations and statistical tests. Results The study considered four variables; gender, race (Black, White, Coloured, Indian), age (16-29, 30-44,45+) and living standards measure (LSM 2-3, LSM 4-6, LSM 7-10), to explored four statements: 1. I believe food can have an effect on my health 2. 1 always look for health information contained on the packaging of food products 3. 1 don't take any notice of health information as it is only marketing hype 4. 1 buy food that claims to contribute to my health. The overall response to the belief that food can have an effect on health was positive (54%). There was no practical significant difference between age groups and genders but there were practical significant differences between Blacks and the other race groups (Blacks having the lowest belief in the food and health link) and between the highest LSM group and the other LSM groups (LSM 7-1 0 had the strongest belief in the link between food and health and this belief decreased with decreasing LSM). Forty-two percent of respondents always look for health information on the packaging of food, but there was no practical significant difference between all the variables, however women were more likely than men to always look for health information on food packaging. Over half the respondents (51%) stated that they look for health information and that it is not only marketing hype. There was a small practical significant difference between the top and the bottom LSM group with LSM 7-10 being less sceptical about the health information on food packaging. 67% buy foods that claim to beneffi their health and there was a small practical significant difference between Blacks and Whites, with more Blacks agreeing that they buy foods that claim to contribute to health. CONCLUSION Findings from this study indicate that adult metropolitan South Africans label reading practices are influenced by a number of factors including attitudes, beliefs and practices and that there are differences based on gender, race, age and LSM which must be considered by regulators in drafting food labelling regulations; the food industry when considering and developing functional foods; and nutrition experts when planning education strategies. Whilst the labelling of foods with health information and the development of function foods might indeed potentially empower consumers to effectively reduce their risk of many chronic diseases, on its own it is not enough. Nutrition education is vital and must be planned giving due consideration to the differences in belief and practices that exist within the different gender, race, age and LSM groups found in South Africa. Food consumption patterns are influenced by consumer attitudes, beliefs, needs, lifestyles and social trends and so more multi-disciplinary research in these fields must be encouraged to find ways to improve nutritional intakes that will lead to improved health for all South Africans.
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