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T T 5 37/12 W Ater U S E an D N U Trie N T C O N Te N T O F Fo O D S Fo R H O U S E H O Ld Fo O D S Ec U Rity

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T T 5 37/12 W Ater U S E an D N U Trie N T C O N Te N T O F Fo O D S Fo R H O U S E H O Ld Fo O D S Ec U Rity TT 537/12 Water use and nutrient content of foods for household food security Water Use and Nutrient Content of Crop and Animal Food Products for Improved Household Food Security: A Scoping Study Report to the WATER RESEARCH COMMISSION by Friede Wenhold (University of Pretoria, Department Human Nutrition) John Annandale (University of Pretoria, Department Plant Production and Soil Science) Mieke Faber (Medical Research Council, Nutritional Intervention Research Unit) Tim Hart (Human Sciences Research Council) WRC Report No. TT 537/12 October 2012 Obtainable from Water Research Commission Private Bag X03 GEZINA, 0031 South Africa [email protected] or download from www.wrc.org.za The publication of this report emanates from a project titled Water Use and Nutrient Contents of Crop and Animal Food Products for Improved Household Food Security: A Scoping Study (WRC Project No. K5/1954) DISCLAIMER This report has been reviewed by the Water Research Commission (WRC) and approved for publication. Approval does not signify that the contents necessarily reflect the views and policies of the WRC, nor does mention of trade names or commercial products constitute endorsement or recommendation for use. ISBN 978-1-4312-0332-1 Printed in the Republic of South Africa © WATER RESEARCH COMMISSION ii EXECUTIVE SUMMARY Many South Africans are affected by malnutrition. This includes overnutrition, with which many adult women present, as well as undernutrition, which is common amongst children. The latter can refer to protein energy malnutrition or micronutrient deficiencies, also called hidden hunger. Previous research has shown that in South Africa the rural poor are disproportionately affected by this double burden of nutrition-related problems. In this vulnerable target group the promotion of home-production of foods that could potentially address their specific nutritional problems, in particular the hidden hunger, appears meaningful. Such interventions should use current food intake and acquisition practices as basis, as well as the reasons for these behaviours. Furthermore, in a country where water may be a limiting factor for home production, the water use efficiency of such crops and animal food products should be known. In order to account for the complexity of the problem, this scoping study was approached from a multidisciplinary perspective, including human nutrition, social anthropology and agronomy, with the intention to also produce an interdisciplinary output. In Chapter 3 of the report the results of a comprehensive literature search conducted to identify studies that included information on food intake of rural poor South Africans are presented. From suitable studies data relevant to this study were extracted into a project-specific template. Quantitatively ranked food intake data from these studies are reported, grouped according to geographical area (province) and study. In KwaZulu-Natal food intake is comprehensively reported at certain sites. For Limpopo Province a number of studies from different sites are available. Food intake in the Eastern Cape, Free State, North West and Western Cape is reflected by a very limited number of studies per province. No quantitative food intake data for rural parts of Mpumalanga, Gauteng and the Northern Cape were identified. The vast majority of studies focused on food intake of individual infants and young children. Non-elderly adults and households were also targeted by a few studies. In the critical discussion of the findings it was noted that available information cannot be taken as being representative of the food intake of “rural poor South Africans”. On the one hand there were limitations in terms of coverage: geographically, and based on ethnicity / culture and stages of the life cycle. Furthermore, most studies were not designed to describe prevalence. Dietary assessment methodologies used by the various studies do not allow unqualified merging of the findings. Whilst certain general trends have become apparent, there seems to be insufficient available evidence to compile a single basket of contemporary food intake of poor households in rural areas of South Africa. The preliminary trend that emerged was that current food intake in this group is cereal-based with low intakes of fruit, vegetables and foods of animal origin. In Limpopo Province intakes from green leafy vegetables appear to be higher than the other provinces, and the Western Cape seems to differ from the other provinces in terms of food intake. Very little information on the sources of the foods consumed by rural South African households was found, resulting in the overall conclusion that there are insufficient data for generalisation. On the national level the National Food Consumption Survey Fortification Baseline (NFCS-FB) of 2005 clearly showed that South Africans buy maize, wheat, bread and salt. Purchasing may also be the major mode of procurement for other foods. There is some evidence of home or community gardens, but iii these do not guarantee an unfailing source of food. Thus for the staple foods purchasing seems to be the most important source, but regarding the foods of which intakes appear to be low (foods of animal origin, fruit and vegetables) and which could potentially be home-produced there is limited evidence of its source, including seasonality. Chapter 4 builds on the above work on food sources and intake by exploring the reasons underlying or governing food consumption trends among rural poor South African households. This part of the study shows that information on the reasons for the foods consumed by rural South Africans is sparse and fragmented, with only one study really focusing on some reasons for contemporary food choices. Some data were found in studies with other research aims. The data gleaned, and drawing heavily on the framework of Viljoen et al. (2005), allowed for the expansion of this framework that can be used to aid further investigation in this topic. The original framework developed by Viljoen et al. (2005) proposed the following four environmental areas as influencing food intake decision making: • Physical environment (Determining Availability and Accessibility) • Economic and political environment (Determining Affordability) • Socio-cultural environment (Determining Acceptance) • Individual environment (Determining Individual Choices) This framework has been expanded during the current study to include the effects of HIV/AIDS and other diseases (including death) on household food choices. These modifications are included in the ‘economic and political environment’ of the framework, because death and disease will first and foremost result in an economic shock for the household and thus negatively affect the economic environment of the household before changes in other environments are felt. Economic factors (available financial resources and assets, labour ability and household size) will be immediately affected. Macro and meso level factors tend to influence the decisions made at micro-level. This includes availability, accessibility, affordability, acceptability and household and individual decision making. The reasons for food intake are determined by a range of factors. These include individual, household, cultural and ethnic group preferences, location, season, income and affordability, historical factors, knowledge and education, and social networks, as well as the impact of HIV/AIDS on individuals and households. Therefore micro-level case studies are the best means of understanding the diversity of reasons for food intake. However, most of the existing micro-level studies mention only one or two aspects that are relevant to understanding the reasons for contemporary food intake, as their primary focus tends to be different. More in-depth micro level case studies are required in order to obtain better information on the topic and especially studies that consider the local context, cultural variation, social networks and attempt to prioritise food choices at different times or during different life experiences. Having said that, it is also important to understand how macro level factors (high prices, food distribution, agricultural support services, climate change, etc.) impact on the micro level context and influence local reasons for food intake. It is also important to understand reasons for food intake in different localities at a national level and this could be done by means of including appropriate questions (based on solid fieldwork) into national surveys. Following a discussion of the principles of the evaluation of dietary quality and an overview of available dietary standards, Chapter 5 outlines the core nutritional problems facing rural South Africans in terms of energy, macro- and micro-nutrient intake as well as dietary diversity and nutrient density. Overall it appears that although several studies have reported low energy intakes, total protein intake was adequate. Gaps in the diet include an inadequate intake of various micronutrients, iv low nutrient density and lack of variety. Based on dietary as well as biochemical indicators, key micronutrients lacking in the diet are vitamin A, iron and zinc, which relates back to low consumption of foods of animal origin, fruit and vegetables. It is stated that no single food can ensure nutritional adequacy and dietary quality. Variety, balance and moderation remain the pillars from a nutritional perspective. In addition, availability, affordability and acceptability are essential for a sustainable solution
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