Background: Despite the strong commitment at both national and international levels to eradicate hunger and achieve household food security, by 2030 food insecurity remains a public health problem. South Africa is amongst the countries with the highest rate of income inequality in the world and extremely high levels of absolute poverty. The Gini coefficient in South Africa is estimated at 0.68 Although South Africa may be food secure at a national level, large numbers of households within the country are food insecure approximately 52% of the rural households in Limpopo Province of South Africa were considered severely food insecure. It has been noted that the majority of households in South African informal settlements and rural areas were moderately or severely food insecure due to lack of access to food which was directly related to income. Rural areas have assets that can be explored to support households. The adult population above 18 years in South Africa make up 78% of the 5.9 million population with about 40% living in rural areas, this study explored household food insecurity in adults in rural environments. The current study aimed to explore the socioeconomic and dietary determinants of household food insecurity among the adult population in the Limpopo Province. Methods: A cross-sectional survey design was used, and data were collected using a validated pre-tested questionnaire. The participants were recruited from households in Limpopo province. Multiple linear regression was computed to explore the influence of socioeconomic and dietary practices on food insecurity. Results: The study included 699 randomly selected participants of which the majority earned a monthly income ≤ 3000 ZAR, and 31.8% experiencing hunger in the past 30 days at the time of study. The dietary practices of the participants were found to be associated with household food insecurity. The study found that large family size, being female in South Africa, low household income and low rate of regular breakfast intake were significant determinants of household food insecurity (p < 0.05). Conclusion: In summary, most of the households were poor and approximately one-third were food insecure. The implementation of sustainable employment policies, and food-based approaches and targeting rural household food production could significantly reduce food insecurity in the rural area.

Food insecurity, obesity and hypertension remain major public health issues related to nutrition in South Africa. The purpose of this study was to determine household food security and the health risk of the adult population in the Limpopo Province using cross-sectional designs. A stratified random sampling method was used to recruit adults aged 18 to 65 years in the Limpopo Province of South Africa. Data were collected using a validated, structured questionnaire. All data were analysed using SPSS version 25.0. The study included 640 participants with an average age of 36.2±17.6 years and a household size of five persons; 74.5% of participants fell in the low monthly income bracket (≤ZAR3000). The mean dietary diversity score was 3.99 (CI: 2.79–5.19). The prevalence of food insecurity was 31.3%, obesity 35.2% and hypertension 32.3%. Being a woman, older and married significantly positively influenced obesity and hypertension. Also, a healthy eating lifestyle such as high dietary diversity was found to positively influence obesity status, while daily eating of fruit and vegetables positively significantly influenced the hypertension status of participants (p<0.05). Food insecurity, obesity and hypertension rates remain high among adults in the Limpopo Province of South Africa with consumption of a diet low in dietary variety. Aged and married women were more likely to be obese and hypertensive, while daily fruit and vegetable intake were found to be a protective factor. Educational and nutritional intervention should be designed and geared towards promoting fruit and vegetable intake in the community.Significance: Households had a diet low in dietary variety, with dietary diversity revealed as a determinant of health risk. Dietary diversity is inversely correlated with household food security. The findings also identified household determinants of obesity and hypertension, which are major public health issues in South Africa.

Background. Salt iodisation is considered the most effective long-term public health intervention for achieving optimal iodine nutrition. Effective salt iodisation is a prerequisite for the sustainable elimination of iodine deficiency disorders. The aim of this study was to determine iodine concentration of salt used for the National School Nutrition Program (NSNP). Methods. A cross-sectional study was conducted in 359 food handlers from Vhembe and Mopani districts of Limpopo Province, South Africa. The questionnaire was administered to solicit data on demographic information, general questions on salt fortification, and iodine nutrition knowledge. After the interviews, two tablespoons of salt used for the NSNP food preparation was collected from 318 schools in small zip-lock plastic bags. The salt samples were coded and stored at room temperature and protected from light and moisture until the time of analysis. Salt iodine concentrations were determined at the North-West University (NWU) in Potchefstroom by means of the iCheck test method. Results. The median iodine concentration of both Mopani (31.65ppm) and Vhembe (32.56ppm) districts signified adequate iodine levels. Of 318 salt samples, 113 (71) samples in Mopani and 104 (65) in Vhembe had an iodine concentration of 1564ppm. A few (6) food handlers in Mopani and almost half (45.9) in Vhembe could correctly identify iodated salt as the main source of iodine. Almost half of the food handlers () in Mopani and 36.5 in Vhembe did not know which part of body needs iodine for functioning. Conclusion. More than 20 years after the implementation of the USI program, the result of the study shows that the international goal of 90 coverage is still far from being realised.

Background: Home-based care is provided to clients in their homes to promote and maintain good health, hygiene and nutrition. Objective: This study assessed nutrition knowledge and care practices of home-based caregivers in Vhembe District, South Africa. Methods: The design was cross sectional, descriptive and exploratory using quantitative and qualitative approaches. Multistage sampling was used, with convenient selection of two municipalities from four, eight home-based care agencies randomly selected from 96 agencies, 128 caregivers conveniently selected for interviews, 92 caregivers selected for focus group discussions and 28 caregivers selected for observation during home visits. Demographic characteristics, nutrition knowledge and care practices were evaluated using questionnaires, interview guides and observational checklists. Data were analysed using SPSS 22 and thematic analysis for qualitative data. Results: caregivers (99.2%) were women, 68.7% had secondary education and all had received 59-day training and 64.1% had six to ten years of home-based care experience. Only 0.8% had adequate nutrition knowledge, 45.3% satisfactory knowledge and 53.9% limited to no knowledge. Most care practices reported during the focus group discussions were not observed during home visits. Conclusion: Nutrition knowledge and care practices of HBC in Vhembe District were found to be inadequate. The nutrition content in the training package should be improved.

The increased prevalence of obesity is due to a decreased level of physical activity and increased intake of fast food. Furthermore, obesity among children and adolescent is a risk factor for life-threatening conditions including cardiovascular diseases (CVD), Cardio-metabolic disorders, type 2 diabetes mellitus, hypertension, cancer and reproductive disorders. The aim of this study is to describe the determinants of obesity. A cross-sectional study was conducted on a total of 377 adolescents aged 13 to 20 years from 16 secondary schools in Thulamela Municipality, Vhembe District Limpopo Province, South Africa. Information about socio-demographic characteristics, household income, disease family history, and level of education of parents was obtained using a self-administered questionnaire. Anthropometric measurements such as weight, height and waist circumference were taken by trained field workers and body mass index (BMI), and the waist-hip ratio were determined. Biochemical measurements and clinical assessment were done by a professional nurse following standard procedures. The prevalence of obesity is 22.2% in males and 32.6% in females by abdominal obesity by (waist circumference), whilst 11.1% (males) and 28.3% (females) by waist to hip ratio (WHR). Gender (β=0.32, p=0.018, 95%CI); age (β=1.28, p=0.015, 95%CI); source of income (β=3.25, p=0.008, 95%CI) and systolic blood pressure (β=1.04, p=0.01, 95%CI) were associated with obesity. Overweight and obesity were more prevalent in females than in males in Thulamela municipality. There is a need to bring up children and adolescents in a health-promoting environment in an effort to reverse and stop the increasing trend of overweight and obesity.

Background. Both iodine deficiency and excess may affect lactating women and their infants. In Limpopo Province, South Africa (SA), there are no data on the iodine status of individuals in these vulnerable groups.Objective. To determine the iodine status, including breastmilk iodine content, of lactating mothers and their infants aged 0 - 6 months in Vhembe and Mopani districts, Limpopo, SA.Methods. A cross-sectional descriptive study in the quantitative domain was undertaken in Vhembe and Mopani districts. Mother-infant pairs were randomly selected. Breastmilk iodine content (BMIC), urinary iodine content (UIC) of infants, UIC of mothers, household (HH) salt iodine content (SIC) and water iodine content (WIC). The iodine nutrition knowledge of mothers was determined.Results. The median (interquartile range (IQR)) of BMIC among lactating mothers in Vhembe and Mopani was 102 (62 - 179.7) μg/Land 150.4 (89.4 - 201.7) μg/L, respectively. The median (IQR) UIC of mothers in Vhembe and Mopani was 96.3 (54.8 - 154.8) μg/L and137.9 (72 - 212.4) μg/L, respectively. The median UIC of infants was 217.7 (107.1 - 409.9) and 339.8 (162.9 - 490.3) μg/L in Vhembe andMopani, respectively. There was a significant difference between SIC of coarse and fine salt in both districts. Lactating mothers in both areas had limited iodine nutrition knowledge.Conclusion. The results suggest that iodised salt is a major contributor to iodine status in lactating mothers and their infants. Our results also show that the salt iodisation programme in SA supplies sufficient iodine for children, women of reproductive age, lactating mothers and breastfed infants.