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For many South Africans, deciding what to eat comes down to what they can afford rather than what is healthy
This is according to a new study by researchers at the University of the Western Cape (UWC), published in the South African Journal of Clinical Nutrition, which examined the factors influencing food choices among adults in Worcester in the Western Cape, Stutterheim in the Eastern Cape and Esikhawini in KwaZulu-Natal
The research found that although many people understood the benefits of healthy eating, financial pressures and household circumstances were the strongest influences on what they bought and consumed
The study, led by Dr Nazeeia Sayed, a lecturer in dietetics and nutrition at UWC, and Prof Rina Swart, head of the university’s department of dietetics and nutrition, involved discussions with nearly 70 participants, most of whom were unemployed or relied on social grants
Researchers found that health was considered when buying food, but was seldom the deciding factor. Instead, participants weighed the nutritional value of food against its price, convenience and the availability of products at nearby retailers
“In our household, we do not just buy food. Rather, we check the price of each food item first to see how much it costs,” one participant said
Family preferences also played a significant role in food purchasing decisions. Many participants said they prioritised buying foods that would satisfy everyone in the household and provide filling meals, rather than choosing healthier options. Children’s and partners’ preferences frequently influenced what was served
Participants generally recognised whole grains, fruit, vegetables, legumes, lean proteins and minimally processed foods as healthy choices, while processed foods, fried foods, sugary drinks, refined carbohydrates and foods high in fat and salt were widely viewed as unhealthy
In our household, we do not just buy food. Rather, we check the price of each food item first to see how much it costs
However, researchers found that healthy foods were not always practical choices. Some participants said they avoided foods such as green leafy vegetables, legumes and chicken livers because they did not know how to prepare them in ways that were appealing
Special offers and promotions also influenced shopping habits, with participants describing them as an important way to stretch limited household budgets
“We watch the specials, we live on specials. We compare them monthly or weekly, depending on what our income is,” another participant said
The study found that home-cooked meals were generally regarded as more affordable than ready-made food, while shopping at stores closer to home or work helped reduce transport costs
Items considered non-essential, such as yoghurt and other snack foods, were often left off shopping lists in favour of staple foods such as flour. Participants also considered shelf life when making purchases, preferring products that would last longer
Spaza shops were viewed as both helpful and problematic. While they offered convenience and, in some cases, food on credit, participants also raised concerns about the freshness and expiry dates of some products
Although the researchers said the findings could not necessarily be applied to all South African communities, they believed the study provided valuable insight into how urban households made food choices and could help shape future public health nutrition policies
They concluded that creating healthier food environments would require collaboration between government, retailers, industry and other stakeholders
“Unless we start to work together to be innovative, the battle to improve our food system will be made more difficult. It can no longer be ‘business as usual’ if we want to see healthier food baskets; we need disruption through the promotion of healthier foods and less promotion of unhealthy foods,” the researchers said
They added that retail initiatives should be part of broader public health efforts aimed at improving access to healthier food choices for South Africans


