ASW Hlekwane

49274287

Department of Life and Consumer Sciences

Research proposal

Topic: The South African consumers

nutrition knowledge, consumer patterns,
nutrition and food security.
Chapter 1

Introduction

In this modern world people live in a knowledge society, they all believe that knowledge is
power. But the status and role of nutrition knowledge is decidedly uncertain. It leaves a
question that, does nutrition knowledge influence food behaviours? It is usually assumed that
the answer must be in the affirmative. Indeed, most people implicitly accept the simple
knowledge–attitude–practice model. If people know what is good for them then they are likely
to behave in their best interests.

The status and explanatory role of nutrition knowledge is uncertain in public health nutrition.
Much of the uncertainty about this area has been generated by conceptual confusion about
the nature of knowledge and behaviours, and, nutrition knowledge and food behaviours. So,
the paper describes several key concepts in some detail. The main argument is that ‘nutrition
knowledge’ is a necessary but not sufficient factor for changes in consumers’ food behaviours.
Several classes of food behaviours and their causation are discussed. They are influenced by
several environmental and intra-individual factors, including motivations. The interplay
between motivational factors and information processing is important for nutrition promoters
as is the distinction between declarative and procedural knowledge.

Consideration of the domains of nutrition knowledge shows that their utility is likely to be
related to consumers’ and nutritionists’ goals and viewpoints. A brief survey of the recent
literature shows that the evidence for the influence of nutrition knowledge on food behaviours
is mixed. Nevertheless, recent work suggests that nutrition knowledge may play a small but
pivotal role in the adoption of healthier food habits.

According to Gussow and Conteno (1984) nutrition knowledge is knowledge of nutrients and
nutrition. Immediately one can ask ‘so what’? As they observed two decades ago, nutritionists
have scientific needs and interests, so do ‘learners’ (consumers) and so does society. What
the various groups understand by nutrition and nutrients requires careful examination. Food
security can be reflected or positively correlated with dietary diversity (Styen et al. 2006, Ajani
2010, Bernal and Lorenzana 2003) dietary diversity as a food security indicator (Thorne-
Lyman et al. 2010). Historically, global production of food has outpaced demand. However,
this “outpacing” is now slowing due to both supply and demand-issues. People demand more
and diverse food, and on the supply-side, historic yield growth has slowed or plateaued in
recent years. In addition, there is increased competition for land, water and other natural
resources; climate change is also threatening production growth in many areas. Additionally,

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reducing the environmental impact of agriculture, including greenhouse gas emissions, may
in future require new and innovative farming methods.

Food security, as defined by the Food and Agriculture Organization (FAO), occurs when all
people, all the time, have physical, social and economic access to sufficient, safe and
nutritious food that meets their dietary needs and food preferences for an active and healthy
life. Food is the main source of good nutrition and we eat food to supply us with substances
that are referred to as nutrients. Good nutrition involves consuming a variety of foods in
appropriate amounts (Answer, 2006). According to Meludu (2007) and Merck (2007) defined
nutrient as substances in foods that we cannot see with our naked eyes but are needed for
the proper functioning of the body and for good health. The most important aim of any
government of any country is to achieve reasonable level in the standard of living and general
well-being of every individual in such country through self-sufficiency in food production and
consumption without sustainable food security nutrition adequacy cannot be achieved. Food
security is a fundamental concept on elaborated development strategies millennium
development goal (MDG). It has been defined as access of all individuals at any time to
sufficient nourishing food for a healthy and active life through availability of foodstuff, the
quality of the diet, the stability of supplies overtime and space and the access of food produced
at home or purchased (Honfoga and Boom, 2003).

Nutrition Knowledge

According to Gussow and Conteno (1984) Nutrition knowledge is knowledge of nutrients and
nutrition. Most people think that knowledge enables them to distinguish true from false beliefs,
facts from falsehood. So, they often pose questions and count the number of correct answers.
This can be well done (using validated methods)3 or badly done. However, knowledge is not
one-dimensional as tests scores suggest, it is somewhat structured. One might measure
someone’s knowledge of various areas of nutrition and find that they know about some areas
but less about others. Therefore, that could derive profiles of their knowledge. Inside
someone’s mind, however, knowledge (and beliefs) may be more highly structured or
differentiated (Gussow and Conteno,1984). Lack of knowledge of available foods and their
nutritional and health attributes result in inappropriate feeding practices causing malnutrition
and associate problems.

Nutritional knowledge refers to an understanding of the food groups to be eaten most

frequently or the recommended servings from each food group: foods with high fat, sugar and
fibre content; foods with low fat, sugar and fibre content; foods high in vitamin C and beta
carotene; as well as the functions of each nutrient based on the South African Food-Based
Dietary Guidelines and the Food Guide Pyramid. On a scale of between 0 to 100 %,

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individuals total scoring of more than 50 %, are regarded as knowledgeable, while individuals
scoring less than 50 % are regarded as less knowledgeable.

South Africa is a country undergoing epidemiological transition, with communities adopting

unhealthy lifestyles. This includes smoking tobacco products, being physically inactive and
consuming a typical westernised diet, over time leading to the emergence of chronic diseases.
This results in high levels of obesity, hypertension, diabetes and hyperlipidaemia in
communities (Omran, 1971). Based on a secondary analysis of the South African Health and
Demographic survey, Bradshaw and Steyn (2001) noted that obesity and hypertension
emerge as risk factors associated with increasing wealth, while salty food is preferred by the
youngest group of blacks and men living in urban areas. Eldelman and Mandle (1990)
suggested that over-consumption of dietary fats, sugar and salt, and lack of fibre in the diet
may lead to several chronic diseases, including coronary heart disease and some cancers.
According to WHO (1990), the link between diet and chronic diseases such as cancer and
cardiovascular disorders has been well recognised worldwide. Overweight and high serum
cholesterol levels, hypertension, and osteoporosis (i.e. decreased bone mass) increase the
risk of cardiovascular disorders, stroke and bone fracture, respectively (Eldelman and Mandle,
1990). Considering that South Africa is facing an epidemiological transition, particularly among
urban black South Africans, with increases in diet-related non-communicable diseases and
dietary changes, the latter need to be targeted for nutrition education.

Consumers tend to be rather unpredictable and as such are notoriously difficult to understand
(Langford and Schultz, 2006). Further to that consumer’s preferences and values are
complex, often rooted in factors unbeknown to even themselves. It is therefore justified to state
that consumers say one thing and then act in ways that appear contradictory. Dodd et al (1998)
offer a narrow approach in understanding consumer behaviour by referring to the influence of
people on individual behaviour. His view focussed on customer behaviour in fashion retailing.
Hence the theory has limited applications but does offer a useful framework with which to
understand both collective large-scale movements in trends and fashion cycles, as well as the
individual decision-making processes employed in the adoption of a style. The highlight of
examining consumer behaviour in this context is the ability to categorise consumers in terms
of their purchasing behaviour, and that differentiating consumer groups has proven popular in
the search for competitive advantages (Dodd et al, 1998).

Furthermore, Camus (2006) stated the importance of nutrition in dealing with HIV/AIDS as
funding of programmes to ensure adequate nutrition for those with HIV/AIDS is now firmly
acknowledged. This is an important contribution towards goal 6 of the Millennium
Development Goals, but without focus in eliminating hunger and malnutrition many of the

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MDGs will be very difficult to achieve. When there is lack of knowledge, not only of available
foods but of their nutritional and health attributes it results in inappropriate feeding pattern
causing malnutrition which dis-empowers individuals by causing or aggravating illness,
lowering educational attainment and diminishing livelihood skills and options. This makes it
harder for individuals to seize new opportunities in a globalizing world and reduces their
resilience to resist the challenges and shocks it generates.

Nutrition education programmes are designed to improve nutrition knowledge, with the aim of
supporting sound dietary intake within the community or a specific target population (Lee et
al. 2005)). Nutrition education is widespread, with schools, government and health promotion
agencies delivering a range of messages that incorporate a nutrition component (Worsley,
2002). Members of the community in most industrialised countries are exposed to education
about dietary guidelines or core food group intake. Specific education to prevent or manage
lifestyle diseases such as diabetes, CVD or cancer is also widely available (WHO, 2011).
Despite the wide scope of nutrition education initiatives, it is somewhat surprising that
relatively few studies have evaluated the level of nutrition knowledge in the general community
or other specific group samples, and that the impact of nutrition knowledge on dietary intake
is still largely unexplored.

Numerous factors including taste, convenience, food cost or security and cultural or religious
beliefs influence dietary intake (Heaney et al, 2011; Hendrie et al, 2008 and Parmenter et al,
2000). As Parmenter (2000) suggested that factors that are well known to influence nutrition
knowledge include age, sex, level of education and socioeconomic status. Women tend to
have higher levels of nutrition knowledge than men, and this difference has been attributed to
their more dominant role in food purchasing and preparation or a lower interest in nutrition by
men. Worsley (2002) and Wardle (2000) agrees with Parmenter (2000) that the higher levels
of nutrition knowledge have been reported in those with higher education or socio-economic
status and greater levels of nutrition knowledge have been typically found in middle-aged as
opposed to younger or older persons. These demographic factors also influence dietary intake
(Wardle, 2000).

Wardle (2000) also indicated that the specific contribution of nutrition knowledge to the overall
quality of food intake is complex and is influenced by the interaction of many demographic and
environmental factors. However, greater understanding of the relationship between nutrition
knowledge and dietary intake is important as emerging evidence supports a strong link
between low health literacy, poor management of chronic disease and increased health costs
(Eichler et al, 2009 and Vernon et al, 2007). Although nutrition knowledge is one component

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of health literacy, it is a central factor as poor dietary intake is strongly linked to all the major
lifestyle diseases and in industrialised countries, it accounts for most of health costs.

Nutrition misconceptions and difficulty in understanding or comprehending dietary guidelines

or food labels probably vary across populations, sexes and cultures, and a deeper
understanding of this would help to provide education that is targeted and relevant. As a
substantial amount of effort and public funding is directed at nutrition education initiatives, it is
paramount that contemporary, high-quality research is undertaken. This would seem
particularly important for populations with low socio-economic status who are most likely to
have low health literacy and a greater risk of lifestyle disease, and for which the present review
demonstrates that evidence is lacking. Evaluation of nutrition education campaigns is often
restricted to basic awareness of the key messages with less comprehensive assessment of
how such interventions change dietary behaviour (Conteno et al, 2002). A better
understanding of this relationship may assist in the development of more effective community
nutrition education and guide-targeted public health policy and funding.

Conclusion

Knowledge of good eating habits and a healthy lifestyle is not necessarily enough to motivate
health care professionals to practice what they (ought to) preach. Creating an environment
that is supportive of healthy eating habits and an active lifestyle, as well as requiring health
care students to show competence at applying these principles in their own lives, may go a
long way towards achieving this aim. Future research should be directed at finding the most
appropriate ways in which to create such structures for different student populations in
different cultural settings. This would at least empower the future health care professionals to
take charge of their own health, which may increase their efficacy in dealing with nutrition,
health and weight issues in their patients.

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Consumer patterns

The consumer is in the centre of any marketing endeavour. Finding out what the consumers
(individual or organization) need, desire and demand is the starting point of a marketing
approach to gather the necessary input to develop a tailored product or service for the
respective consumers. Buying behaviour is a process which enables an organisation to
understand how consumers select, buy and dispose of goods, services, ideas or experiences
to satisfy their needs and wants (Kotler and Keller 2006: 173). A provider should pay attention
in grasping the activities and influences occurring before, during and after the purchase
(Strydom 2004).

An organisation should pursue detailed research of the elementary processes of the consumer
behaviour (perceptions, learning, attitudes and motivations) to make the right marketing
decisions. Perception is the process through which stimuli are chosen, organized and
interpreted by the human five senses: sight, sound, smell, touch and taste (Cant et al, 2009)
while learning is the process through which a consumer, based on experience, learns how to
buy and use a product or service (Catoiu and Teodorescu, 2004). Attitude is a favourable or
unfavourable behaviour towards an object, an event or a situation (Botha et al. 1997: 94) and
motivation is the process by which consumers are driven or moved to satisfy a need (Sheth et
al, 1999).

Several global trends in food consumer behaviour can be identified as a result of international
demographic developments: an increase in tourism, emergence of global marketing
strategies, rapid dissemination of information through mass media and government attempts
to influence food consumption. Because of the spread of foot-and mouth disease and bovine
spongiform encephalopathy (BSE) in the 1990s, consumers are concerned about the safety
and quality of meat products. This has led to a considerable decrease in red meat consumption
and an increase in the consumption of chicken and pork. According to Armitstead (1998),
consumers are also increasingly aware of food issues and health concerns. The latter
concerns have led to the demand for lean meat.

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References

Worsley A (2002) Nutrition knowledge and food consumption: can nutrition knowledge change
food behaviour? Asia Pac J Clin Nutr 11, S579–S585.

WHO (2011) Framework for Care and Control of Tuberculosis and Diabetes. Geneva: WHO.

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