Exploring the Perceptions of Women from Under-Resourced South African Communities about Participating in a Low-Carbohydrate High-Fat Nutrition and Health Education Program: A Qualitative Focus Group Study.

Georgina Pujol-Busquets,Kate Larmuth,James Smith,Anna Bach-Faig,Sergi Fàbregues

doi:10.3390/nu12040894

Georgina Pujol-Busquets, Kate Larmuth + Show 3 more

Open Access

https://doi.org/10.3390/nu12040894

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Journal: Nutrients	Publication Date: Mar 25, 2020
Citations: 3	License type: CC BY 4.0

Affiliation: University of Cape Town, Open University of Catalonia

Abstract

Scientific evidence suggests that low-carbohydrate high-fat (LCHF) diets may be effective for managing non-communicable diseases (NCDs). Eat Better South Africa (EBSA) is an organization that runs LCHF nutrition education programs for women from low-income communities. Three focus group discussions (FGDs) were held with 18 women who had taken part in an EBSA program between 2015 and 2017, to explore their perceptions and to identify the facilitators and barriers they faced in implementing and sustaining dietary changes. Thematic analysis of the focus groups was conducted using NVivo 12 software. Women reported that they decided to enroll in the program because they suffered from NCDs. Most women said that the EBSA diet made them feel less hungry, more energetic and they felt that their health had improved. Most women spoke of socioeconomic challenges which made it difficult for them to follow EBSA’s recommendations, such as employment status, safety issues in the community, and lack of support from relatives and doctors. Hence, women felt they needed more support from EBSA after the program. The social determinants that affected these women’s ability to change their health behavior are also NCD risk factors, and these should be assessed to improve the program for other communities.

Highlights

Diet-related non-communicable diseases (NCDs) pose a huge burden in terms of financial cost, morbidity, and mortality [1,2,3]
June 2015 (O15) and women from Atlantis who had taken part in an Eat Better South Africa (EBSA) intervention in June 2016 (A16) or June 2017 (A17). Both communities are in the Western Cape Province of South Africa and originated during the Group Areas Act under the Apartheid government [28]
A total of 18 women completed the study by taking part in one of three focus group discussions (FGDs)

Summary

Introduction

Diet-related non-communicable diseases (NCDs) pose a huge burden in terms of financial cost, morbidity, and mortality [1,2,3]. In South Africa there is currently a double burden of infectious diseases and NCDs [4]. NCDs in South Africa contribute an estimated 43% of total deaths for all ages and both sexes [5]. There is much clinical evidence that dietary carbohydrate restriction, and sugar restriction, can improve markers of metabolic health, including obesity, hyperlipidaemia and hyperglycaemia [7,8,9]. Current guidelines for a healthy diet in South Africa recommend carbohydrate intake to be 45–65% of calories and fat intake to be 20–35% of calories [10]. Low-carbohydrate diets usually include 5–26% of carbohydrate (20–130 grams/day of carbohydrates) and fat intake is often 40–70% of calories [11,12]

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Discussion

Conclusion