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
For the success of both these initiatives in public health terms, consumers
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.
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
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).
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.
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
3. 1 don't take any notice of health information as it is only marketing
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.
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.||