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.

Background: There is strong evidence that exclusive breastfeeding (EBF) in the first 6 months of life reduces the risk of diseases in infancy and in later life. Objective: To understand the maternal reasoning that influences optimum infant feeding practices of caregivers in semirural communities of Limpopo province. Methods: Nested qualitative study among mothers in an ongoing birth cohort study was conducted; structured and semi-structured interviews were used to collect data. Data from 234 infants after 6 months of follow-up was included for quantitative analysis. Four focus discussion groups comprising 7 to 10 caregivers were used to obtain perception of mothers on breastfeeding. A semi-structured interview guide was used to stimulate discussions. Thematic content analyses were conducted to identify the main themes that influence breastfeeding practices of caregivers. Results: Over 90% of the caregivers initiated breastfeeding after delivery. However, less than 1% of mothers practiced EBF by 3 months, and none of the children were exclusively breastfed for up to 6 months. All caregivers introduced non–breast milk liquids and solids by the second month of child’s life. Common reasons for introducing non–breast milk foods included insufficiency of breast milk production, going back to work or school, and influence by elderly women (mothers/mothers-in-law) and church members. Conclusion: Exclusive breastfeeding was not practiced in this community due to cultural and religious beliefs and misinformation. The involvement of elderly women and church members in infant feeding education and promotion programs and the dissemination of breastfeeding information through mobile phones to younger mothers are recommended.

Effect of a nutrition education programme on nutritional status of children aged 3 - 5 years in Limpopo Province, South Africa

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: Dietary patterns provide comprehensive information about the food consumption habits within a population and how an individual’s dietary pattern may change with age. Aim: To evaluate the nutritional status and dietary patterns of the elderly in Thulamela municipality of Vhembe district, Limpopo province. Setting: Study was conducted in Thulamela municipality of Vhembe district, Limpopo province. Methods: This study included 300 elderly people recruited from Thulamela municipality of Vhembe district, Limpopo province. The municipality was randomly selected, and convenience sampling was used to choose elderly people. Body weight and height were measured using standard techniques. Body mass index (BMI) was determined and classified using BMI categories. Data on dietary patterns and dietary intake were collected using a food frequency questionnaire. Results: A total of 300 elderly people from villages participated in the study. About 38.6% of elderly people had a primary education, while 28.1% had a secondary education. The prevalence of underweight, overweight and obesity was 2.0%, 34.0% and 17.0%, respectively. Less than half of the elderly people did not meet the reference intake of energy (p = 0.023). More than half of the elderly people did not meet the reference intake of protein, iron, zinc, potassium, calcium and vitamins B1, B12 and C. It was found that 13.7% of the elderly skipped breakfast every day. About 19.6% of the elderly ate supper sometimes, while 13.7% did not eat supper. Conclusion: The findings of the study revealed that most of the participants ate three main meals a day, with a minority skipping either breakfast or dinner or eating in between meals. The prevalence of underweight was low and that of overweight and obesity was high. Contribution: Poor food choices and physiological changes may reduce the inclusion of food rich in minerals and vitamins in the elderly’s diets and prompt the prevalence of malnutrition.

Background: Micronutrient deficiency continues to be a major public health problem affecting infants and young children under 5 years of age worldwide.Aim: The study aims to investigate feeding practices and micronutrient status of children aged 0–36 months.Setting: The study was conducted at government clinics located in Thulamela Municipality, which is one of the local municipalities in Vhembe District, Limpopo province.Methods: A cross-sectional survey was conducted. A total of 250 mothers with children aged 0–36 months were enrolled. A structured questionnaire was used to interview the mothers. Biochemical measurements of children were assessed using standard procedures.Results: Only 7.6% of children were exclusively breastfed for 6 months. Majority (87.5%) of the children were introduced to complementary foods before 6 months and 98.8% of the children had a low dietary diversity score of less than four, while 9.2% had a dietary diversity score of more than four. The prevalence of vitamin A deficiency, anaemia and iron deficiency was 21.7%, 53.6% and 13.1%, respectively. For mothers who initiated breastfeeding immediately after delivery, the odds of children having low ferritin were 0.11 times, as compared to children who were initiated breastfeeding a day after delivery (odds ratio = 0.11; 95% confidence interval = 0.015–0.812).Conclusion: Most of the children were introduced to complementary foods earlier than 6 months of age. Infant feeding practices were associated with micronutrients status.Contribution: The study contributes to the body of literature on feeding practices and the micronutrient status of children.