1. The meaning of food and the contexts in which food is used: Experiences from a population residing in a black township in South Africa. RESEARCHERS Thandi Puoane, Princess Mantwa, Krisela Steyn, Debra Jackson,

2. MOTIVATION FOR THE STUDY In South Africa a complex picture relating to nutritional status of the population exist In South Africa a complex picture relating to nutritional status of the population exist Under nutrition in children and obesity in adults Under nutrition in children and obesity in adults Obesity is increasingly becoming a serious public health problem among black women in South Africa. Obesity is increasingly becoming a serious public health problem among black women in South Africa.

3. MOTIVATION FOR THE STUDY In 1998 35.7% of African urban women were overweight (BMI 25-29.9) and obese (BMI > 30) respectively In 1998 35.7% of African urban women were overweight (BMI 25-29.9) and obese (BMI > 30) respectively  With urbanisation, diet change to high fat and low carbohydrate  Food plays an important role in the culture of the black African population

4. MOTIVATION FOR THE STUDY  Studies show that the more urbanised the black communities the higher the rate of obesity and the less prudent their diets become.  Lacking in the literature is the information on socio-cultural factors which influence eating behaviours of the black African population

5. OBJECTIVES To explore perceptions of black Africans residing in a black township of Cape Town about the meaning of food, since understanding of the context in which food is used will be the basis for planning culturally sensitive intervention for modifying eating behaviours. To explore perceptions of black Africans residing in a black township of Cape Town about the meaning of food, since understanding of the context in which food is used will be the basis for planning culturally sensitive intervention for modifying eating behaviours.

6. METHODS Qualitative, exploratory research design

7. METHODS Participants were part of the SACLA study, a cross-sectional study designed to collect information on the prevalence and the risk factors for cardiovascular Participants were part of the SACLA study, a cross-sectional study designed to collect information on the prevalence and the risk factors for cardiovascular diseases in a black township, South Africa diseases in a black township, South Africa

8. METHODS METHODS  Purposive sampling to select 32 men and women  6 participants for in-depth interviews  26 for focus group discussions

9. METHODS Subjects were selected based on their responses to the question “I eat whenever food is available” Subjects were selected based on their responses to the question “I eat whenever food is available” 9 men, 12 women who responded positively, 11 women who responded negatively 9 men, 12 women who responded positively, 11 women who responded negatively

10. DATA COLLECTION In-depth interviews with each of the six participants In-depth interviews with each of the six participants Focus group discussions of 8-10 men and women grouped by sex Focus group discussions of 8-10 men and women grouped by sex “what does food mean to you, and for what purposes is food used in your family and in your community? “what does food mean to you, and for what purposes is food used in your family and in your community?

11. DATA ANALYSES Data was content analysed by 2 researchers Data was content analysed by 2 researchers Themes that emerge were summarised and illustrated with direct quotes from the focus groups. Themes that emerge were summarised and illustrated with direct quotes from the focus groups.

12. THE MEANING OF FOOD IN RELATION TO HEALTH THE MEANING OF FOOD IN RELATION TO HEALTH “Food is important because it keeps us alive. There are food with energy and vitamins and body building food. Don’t eat only starch, you must combine it with meat and vegetables” “Food is important because it keeps us alive. There are food with energy and vitamins and body building food. Don’t eat only starch, you must combine it with meat and vegetables” “ If you do not eat body building foods you become sick with diseases like tuberculosis and malnutrition” “ If you do not eat body building foods you become sick with diseases like tuberculosis and malnutrition”

13. THE RELATIONSHIP OF FOOD TO THE BODY “ A person who eats well looks fresh (plump) and happy” “ A person who eats well looks fresh (plump) and happy” “ A person who does not eat well becomes thin and looks unhappy” “ A person who does not eat well becomes thin and looks unhappy”

14. THE SOCIAL MEANING OF FOOD THE SOCIAL MEANING OF FOOD Food is used in cultural events. Traditionally, food consumption in these ceremonies differs Food is used in cultural events. Traditionally, food consumption in these ceremonies differs “When there are bad news, we drink black tea, meat is not consumed during this time, it is usually cooked on the day of burial”. “When there are bad news, we drink black tea, meat is not consumed during this time, it is usually cooked on the day of burial”.

15. VALUES ATTACHED TO FOOD Food shows love, acceptance and humanity (ubuntu). Food shows love, acceptance and humanity (ubuntu). “ If you visit a person’s house and not given food, you feel you are not welcomed” “ If you visit a person’s house and not given food, you feel you are not welcomed”  Eating large portions of food send a message that one can afford to maintain herself

16. VALUES ATTACHED TO FOOD If food is available people should eat as much as they can. Food is not measured. If food is available people should eat as much as they can. Food is not measured. People should share food with other people People should share food with other people “Meat consumption on a daily basis is associated with a high socioeconomic status “Meat consumption on a daily basis is associated with a high socioeconomic status

17. HOW VALUES ABOUT FOOD HAVE CHANGED The food has lost its value due to adoption of western culture The food has lost its value due to adoption of western culture “In the real sense food is becoming less important nowadays, look at this example when the wife says, if we are not getting that hi-fi set,I would rather starve because the stomach has no thank you, do you hear that”. “In the real sense food is becoming less important nowadays, look at this example when the wife says, if we are not getting that hi-fi set,I would rather starve because the stomach has no thank you, do you hear that”.

18. HOW VALUES ABOUT FOOD HAVE CHANGED Consumption of foods such as samp (corn), beans, greens, and root plants is associated with poverty. Consumption of foods such as samp (corn), beans, greens, and root plants is associated with poverty. Once people move to the city, their expenses increase, leaving them with little money for food. They resort to cheap unhealthy foods, such as tripe, chicken skins, and pig’s feet. Once people move to the city, their expenses increase, leaving them with little money for food. They resort to cheap unhealthy foods, such as tripe, chicken skins, and pig’s feet.

19. CONCLUSIONS This study shows that for effective behaviour modification psychological, and socio-cultural factors should also be taken into consideration. This study shows that for effective behaviour modification psychological, and socio-cultural factors should also be taken into consideration. This study provides us with useful information, which can be used to develop messages to influence behavior modification. This study provides us with useful information, which can be used to develop messages to influence behavior modification.

20. RECOMMENDATIONS  People should be taught that they do not need to prove to other people that they can afford by using food because this lead to obesity-and CVD  Media should be encouraged to used recipes which includes locally available foods  Budgeting skills should be taught in all schools to children