South African Journal of Clinical Nutrition

When foods are not equal: implications for nutrition policy and practice

M Wicks — Fri, 20 Mar 2026 07:28:17 +0000

none

The self-reported influence of social media on food choices of young adults at a tertiary institution in South Africa

M Kreft, C Lombard, N Koen — Fri, 20 Mar 2026 12:53:19 +0000

Objective: The accuracy of user-generated content on social media (SM) is unclear, raising concerns about misinformation and the influence of marketing on food choices. This study aimed to determine the self-reported influence of SM use on food choices through investigating different types on nutrition information, sources of influence and platform usage.
Design: A cross-sectional descriptive study with an analytical component was conducted by a self-administered electronic survey (n = 1 434).
Setting: Tertiary institution in Western Cape, South Africa.
Participants: 1 434 registered undergraduate and postgraduate students aged 18–35 years, who were SM users.
Results: The majority (64%) used SM for health and nutrition-related content, with 89% of participants reporting it influenced their food choices. Females (70%, n = 693) were more likely than males (52%, n = 228) to use social media for nutrition information (p <0.0001). Daily engagement was highest on Instagram (64%). Participants rated their level of influence of SM on their food choices for diets, supplements, food products and recipes; using a four-point Likert scale (no influence, slight influence, moderate influence, high influence). Participants mostly reported ‘no influence’ of diets (41%) and supplements (49%) on food choices, while a ‘slight’ level of influence was reported for food products (46%) and recipes (44%). The majority (61%) reported trying to convince others to try food products, supplements, recipes or diet trends seen on SM.
Conclusion: SM was used to access nutrition-related content and had a self-reported impact on food choices. Food products, recipes, and friends and family were most influential.

Keywords: food choices, misinformation, nutrition, public health, social media

Requirement for front-of-pack warning labels in South African porridges and cereals varies depending on preparation method and grain type

M K Mamabolo, N Sibiya, M Mosana, F N Cokile, Z Mkandla, S Dlamini, S N Dlamini — Fri, 20 Mar 2026 13:50:14 +0000

Objectives: To determine the proportion of breakfast products requiring front-of-pack labels (FOPLs) according to R.3337 regulations and to compare nutritional content and FOPL requirements across grain types (modern grains, oats, and other ancient grains) and preparation method (ready-to-eat, instant, and cooking required).
Design: A cross-sectional analysis of 271 products from leading South African supermarkets was conducted. Nutrient values per 100 g, including total energy, protein, carbohydrates, fats, dietary fibre, and sodium, were extracted from nutritional information tables. Ingredient lists identified grain types. Products were assessed against R.3337 FOPL thresholds for sugar, saturated fat, sodium, and artificial sweeteners.
Setting: Products available from March to July 2024 were identified through online shopping platforms, supplemented by instore visits where necessary.
Results: Breakfast products requiring cooking exhibited superior nutrient profiles (including higher protein and dietary fibre, and lower total sugar and sodium) compared with instant and/or ready-to-eat options (p < 0.010). Products containing ancient grains, particularly oats, showed more favourable nutritional profiles than those with modern grains (p < 0.050). While 73.5% of products required FOPLs, this varied by preparation method: 75.2% for ready-to-eat, 83.5% for instant, and none for cookingrequired products. Similarly, FOPL requirements varied by grain type, with 50.0% of oat-based products requiring FOPLs compared with 81.9% of modern grain products and 75.4% of products containing other ancient grains.
Conclusions: Most porridges and cereals in South Africa required FOPLs due to high sugar, saturated fat, salt, and artificial sweeteners. However, products requiring cooking and those containing oats were less likely to need these warning labels.

Keywords: breakfast products, front-of-pack warning labels, grains, nutrient density

Drivers of food choice in three urban communities in South Africa

N Sayed, E C Swart — Wed, 25 Mar 2026 07:09:44 +0000

Background: With South Africa’s high burden of disease, increasing attention has been given to improving food environments to facilitate healthier food access. An understanding of the main drivers of food choice and barriers in consuming healthier foods can assist in the formulation of nudge strategies to improve the quality of diets consumed.
Objectives: To explore the drivers of food choice among adults in three urban communities in South Africa.
Design: Qualitative descriptive phenomenological study using focus-group discussions.
Setting: Three urban sites in the Eastern Cape, KwaZulu Natal, and Western Cape provinces in South Africa.
Subjects: Adults (male and female, 21 to 59 years of age).
Outcome measures: Self-administered sociodemographic questionnaire and focus-group discussions.
Findings: Nine focus groups with 68 participants were completed. Financial considerations, household/family factors, and shop/food retail factors were the key drivers of food choice identified. Health considerations were present, but not prevalent. Enablers of healthy food consumption included: cost, recognised health/nutrition benefits, and good taste. Barriers were unavailability, unknown preparation, beliefs, and disliked taste.
Conclusions: This study found that financial considerations, household/family factors, and the retail food environment were key influences on food choice in three urban South African communities. The research contributes to qualitative evidence on consumer perspectives in urban contexts. Recommendations include exploring retail interventions and pricing strategies to improve access to healthy foods. The study limitations include limited transferability beyond the study sites, but findings remain valuable for guiding future research and public health nutrition policy.

Keywords: barriers, enablers, food choice, healthy food, South Africa

The perceptions of South African dietetic and nutrition professionals on sponsorship and funding of scientific education opportunities by Big Food

T K Scorgie, J Badham, L M du Plessis — Wed, 25 Mar 2026 09:18:23 +0000

Objective: To determine the perceptions of South African dietetic and nutrition professionals on sponsorship and funding of scientific education opportunities by Big Food.
Setting: South Africa.
Subjects and methods: Members of the Association for Dietetics in South Africa (ADSA), the Nutrition Society of South Africa (NSSA), and the Dietetics-Nutrition is a Profession (DIP) groups (excluding students) were invited to participate in an online survey using census and snowball sampling (n = 118). The survey used a Likert scale to record responses to experience and perception questions and included a brief demographic section. Additionally, dietetic/nutrition professionals were recruited for semi-structured interviews (n = 10) using purposive sampling. An interview guide with open-ended and probing questions, where necessary, was used.
Results: Perceptions of dietetic and nutrition professionals regarding Big Food sponsorship of scientific education opportunities varied. The majority (88%; n = 104) felt collaboration should be encouraged, particularly to improve the nutritional content of unhealthy products. Others expressed hesitance and strong disagreement, citing real or perceived conflict of interest (COI) and concerns regarding the scientific credibility of research presented. There was consensus from 90% of participants (n = 106) on the need for clear guidelines defining acceptable sponsorship and funding, including transparency and disclosure. Upholding and adhering to professional ethical standards should also remain a priority for dietetic and nutrition professionals, as emphasised by participants during the semi-structured interviews.
Conclusion: The research indicates diverse perceptions among South African dietetic and nutrition professionals on the sponsorship and funding of scientific education opportunities by Big Food, emphasising the complex nature of interactions with multinationals. The importance of establishing consensus guidelines on collaborations that adhere to professional ethical standards was underscored.

Keywords: Big Food, conflict of interest, dietetic and nutrition professionals, scientific education opportunities

Size does matter: clinical outcomes of percutaneous endoscopic gastrostomy (PEG) placement in a South African tertiary endoscopy unit

D M Mutura, G Chinnery, T Cohen, B Gibson, M Setshedi, M F Scriba — Wed, 25 Mar 2026 09:56:47 +0000

Background: Enteral access is considered the most physiological and beneficial feeding route. Percutaneous endoscopic gastrostomy (PEG) is widely used for enteral feeding in patients with functional gastrointestinal systems, but who are unable to maintain sufficient oral intake to meet daily nutritional and metabolic needs. PEG-related complications can be significant, but reported rates are variable.
Aim: To investigate the use, complications, and outcomes associated with PEG insertion in a South African tertiary-level centre.
Methods: Retrospective study including all patients who underwent PEG insertion at the Groote Schuur Hospital Gastroenterology Unit between March 2018 and June 2023. Variables obtained included patient demographics, comorbidities, PEG insertion details, and complications.
Results: A total of 149 patients undergoing 158 PEG-insertion procedures were included with a median age of 54 years (IQR: 38–64) with the majority being male (91; 61.1%). The most common indication for PEG insertion was cerebrovascular accident (CVA) at 25.5%. PEG-related complications were divided into three: insertion-related, early (within 30 days of insertion), and late (after 30 days of insertion) and observed in 64 patients (43.0%). The only factor found to be associated with an increased early complication rate was the size of the PEG, with 24Fr tubes having a higher complication rate compared with smaller tubes (25.5% vs. 3.7%, p < 0.001).
Conclusions: Local indications and high complication rates of PEG placement are highlighted, advocating for the judicial placement of PEGs. Early complications are notably higher with increased diameter tubing, and it is recommended that the use of 24Fr tubes be avoided if possible.

Keywords: complication rate, enteral feeding, outcomes, percutaneous endoscopic gastrostomy

Describing the triple burden of malnutrition in adolescents in rural and urban South Africa

Tue, 31 Mar 2026 08:38:41 +0000

Objectives: To describe the triple burden of malnutrition among a large, school-going sample of adolescents in rural Agincourt and urban Soweto, South Africa.
Design: Cross-sectional study.
Setting: Schools and community centres across rural Agincourt and urban Soweto, South Africa.
Subjects: 12 644 adolescents (mean age 15.5 years; 62% girls; 70.7% rural).
Measures: International Obesity Task Force cut-offs were used to calculate the prevalence of underweight, healthy weight, overweight, and obesity. Haemoglobin levels were measured in Soweto to assess the prevalence of anaemia.
Results: This large, population-based study reveals a high burden of malnutrition, with 34.9% of adolescents either underweight, overweight, or obese. Underweight prevalence was 14.3%, with relatively uniform distribution across sex and setting. Overweight and obesity were notably more prevalent in urban girls (32.3% and 7.0%, respectively), nearly doubling the rates observed in their rural peers (17.4% and 5.8%), and substantially higher than urban and rural boys (all < 6%). Boys consistently exhibited lower body fat percentage and fat mass index compared with girls across both settings. In a subsample of urban adolescents with haemoglobin data, anaemia was common, particularly in girls (31.6% vs. 10.2% in boys).
Conclusions: These findings highlight the complexity of the burden of malnutrition in adolescence, including both under- and over-nutrition with overlapping micronutrient deficiencies.

Keywords: adolescents, anaemia, malnutrition, obesity, overweight, rural, South Africa, underweight, urban

Smartphone-based dietary assessment of food away from home and the risk of non-communicable diseases among young working adults in Johannesburg, South Africa

S Godbharle, H Kesa, A Jeyakumar — Tue, 31 Mar 2026 08:50:12 +0000

Background: The rising consumption of food away from home (FAFH) among young working adults is a growing public health concern, particularly due to its association with non-communicable diseases (NCDs).
Objective: This study employed ‘FoodLog’, a validated smartphone-based dietary tracking application, to investigate the determinants of FAFH consumption and its relationship with NCD risk among young adults.
Design: Case-control study.
Setting: Johannesburg, South Africa.
Subjects: The analysis included 442 employed adults aged 25–45 years. Cases (146) were defined as individuals with selfreported NCDs, while controls (296) had no NCDs.
Outcome measures: The primary outcome measures were the identification of determinants of FAFH consumption and the assessment of its association with NCD risk, using multivariate logistic regression models.
Results: Multivariate analysis revealed that 33% of participants consumed FAFH in the week before the survey. Significant associations were found between FAFH consumption and female gender (AOR = 1.52, CI: 1.01–2.30), higher education (AOR = 2.05, CI: 1.16–3.61), physical inactivity (AOR = 2.44, CI: 1.56–3.79), and low vegetable intake (AOR = 1.33, CI: 1.09–1.57). Additionally, NCDs were more prevalent among individuals reporting alcohol use, non-vegetarian diets, and frequent FAFH consumption. FAFH consumers were 1.12 times more likely to report NCDs than non-consumers (AOR = 1.12, 95% CI: 1.01–1.61).
Conclusion: These findings underscore the utility of mobile dietary assessment tools in capturing nuanced eating behaviours and highlight the need for targeted interventions addressing both individual choices and the urban food environment to reduce NCD risk.

Keywords: dietary habits, food away from home, mHealth, non-communicable diseases, South Africa, young adults

Nutritional management of a patient with a small bowel neuroendocrine tumour and obstruction: a South African case study

KE Drake — Tue, 31 Mar 2026 08:54:50 +0000

Small bowel neuroendocrine tumours (SBNETs) arise from enterochromaffin cells, most commonly in the terminal ileum. Functional tumours may secrete hormones, which can lead to carcinoid syndrome, whereas non-functional tumours often present later with symptoms of mechanical obstruction. Malnutrition is common in patients with gastroenteropancreatic neuroendocrine tumours (GEP-NETs) which includes SBNETs, and is worsened by tumour burden, medical therapies, hormonal activity, surgery, and postoperative catabolism.
A 55-year-old male presented with abdominal disomfort, early satiety, vomiting, and unintentional weight loss. Imaging revealed a small bowel mass with biochemistry tests indicating a neuroendocrine tumour (NET). Preoperative nutritional assessment revealed severe malnutrition, prompting the initiation of parenteral nutrition prior to abdominal surgery. Throughout the preoperative and postoperative period, targeted nutritional intervention contributed to improvements in fluid balance, maintenance of skeletal muscle, and an increased phase angle, all reflecting an overall improvement in the patient’s nutritional status. Malnutrition in patients with NETs is multifactorial, and early identification, targeted nutritional support, and structured followup are essential to optimise recovery and long-term outcomes in this population.

Keywords: bioelectrical impedance, body composition, bowel obstruction, dietetics, hepatobiliary, neuroendocrine tumour, nutrition support, oncology, phase angle, surgery

Comments on ‘Preliminary dietary recommendations for adult spinal cord-injured endurance hand cyclists’

A Sharma, V Vadhithala, A Kumar, S Verma, SN Katkuri — Tue, 31 Mar 2026 09:28:40 +0000

none

Response to ‘Comments on “Preliminary dietary recommendations for adult spinal cord-injured endurance hand cyclists”’ by Sharma et al.

RE Gordon — Tue, 31 Mar 2026 09:35:11 +0000

none

Activity 192

NISC (Pty) Ltd — Tue, 31 Mar 2026 08:30:23 +0000

Activity 192 in pdf format. Please visit https://www.mpconsulting.co.za to complete this activity for CEUs.

Activity 193

NISC (Pty) Ltd — Tue, 31 Mar 2026 08:32:07 +0000

Activity 193 in pdf format. Please visit https://www.mpconsulting.co.za to complete this activity for CEUs.

ADSA News

NISC (Pty) Ltd — Thu, 19 Mar 2026 14:05:45 +0000

NSSA News

NISC (Pty) Ltd — Thu, 19 Mar 2026 14:04:39 +0000

SASPEN News

NISC (Pty) Ltd — Thu, 19 Mar 2026 14:21:12 +0000