An investigation of the factors influencing food choices of mothers of children attending primary schools in the Metro North Education District of Western Cape Province, South Africa.

Thesis (MNutr)--Stellenbosch University, 2015.ENGLISH SUMMARY : Introduction: Adequate nutrition during childhood is essential for optimal growth, development, health and well-being. The growing epidemic of childhood obesity is a major public health problem. In South Africa, almost one fifth of children under the age of twelve are overweight or obese. Childhood obesity, a risk factor for non-communicable diseases, often leads to adult obesity. Younger children are dependent on their parents for the food they have access to. Unhealthy food choices made by mothers can impact negatively on child health and may lead to establishing unhealthy eating behaviour that persists into adulthood. Making food choices is a complex process influenced by many factors. Objectives: To determine 1) the factors that influence food choices of mothers with primary school children 2) the knowledge, attitude and practices of mothers regarding healthy and unhealthy food 3) the impact that employment status and socio-economic backgrounds have on these factors and 4) to investigate barriers to purchasing healthy food. Design: An observational, cross sectional, descriptive study with an analytical component. Methods: Mothers (n=476) were recruited from three randomly selected schools, each representing a different national quintile. Self-administered questionnaires were used to collect data about the demographics, knowledge, attitude and practices of mothers. Six focus group discussions were conducted with working and non-working mothers (n=37) from the three schools to investigate barriers to healthy eating. Results: The mean nutrition knowledge score for the group was 68.6%. Nutrition knowledge was significantly (p<0.05) lower in mothers from the lower quintile school (64%). Mothers from the higher quintile school were more concerned with healthy eating and more aware of the role they play in shaping a child‟s eating habits compared to mothers from the lower quintile school (p<0.05). Mothers from the lower quintile school practiced unhealthier food preparation methods such as using oil and sugar frequently in meal preparation (p<0.05). The most important factors that influenced food purchases for the whole group were cost (60%), nutritional value (37%) and a lack of time (29%). Time constraints resulted in working mothers buying more take aways and convenient foods (p<0.05) compared to non-working mothers. Barriers identified during the focus group discussion were employment status, family preference, the school environment and mixed messages from the media. Magazines and health professionals were identified as the sources most often used by all participants for nutrition information (62% and 44%). Conclusion: Nutrition education should remain a priority, especially among lower socio-economic groups. Nutrition education campaigns should not only focus on nutrition knowledge but should include the long term negative impact that mother‟s unhealthy food choices have on their children. Policy makers should monitor the gap between rising prices of healthy food and the promotion of unhealthy food. The food industry should act on their responsibility towards consumer health. A need for healthier convenience foods exists in order to support working mothers in making healthier food choices. Mothers need support with practical application of their existing nutrition knowledge and nutrition related health messages.AFRIKAANSE OPSOMMING : Inleiding: Voldoende voeding tydens die kinderjare is essensieel vir optimale groei, ontwikkeling, gesondheid en welstand. Die toenemend groeiende epidemie van vetsugtigheid onder kinders is „n massiewe publieke gesondheidsprobleem. Ongeveer een vyfde van Suid-Afrikaanse kinders jonger as twaalf jaar is oorgewig of vetsugtig. Kindervetsugtigheid, „n risiko vir nie-oordraagbare siektes, lei meesal na volwasse vetsugtigheid. Jong kinders is afhanklik van hul ouers vir die voedsel waartoe hulle toegang het. Ongesonde voedselkeuses deur moeders kan „n negatiewe impak hê op kindergesondheid wat daartoe kan lei dat ongesonde eetgewoontes gevestig word, wat volgehou word as volwassene. Die proses om voedselkeuses uit te oefen is kompleks en word deur verskeie faktore beïnvloed. Doelwitte: Om te bepaal 1) wat die faktore is wat die voedselkeuses van moeders met laerskoolkinders beïnvloed 2) wat die kennis, houding en gewoontes van moeders aangaande gesonde en ongesonde voedsel is 3) wat die impak van werkstatus en sosio-ekonomiese agtergrond is op die faktore en 4) om hindernisse te ondersoek wat die aankoop van gesonde voedsel beïnvloed. Studieontwerp: „n Beskrywende, dwarsdeursnitstudie met „n analitiese komponent. Metode: Moeders (n=476) by drie ewekansig geselekteerde skole, wat elkeen „n verskillende nasionale kwintiel verteenwoordig was gekies. Self-geadministreerde vraelyste was gebruik om data in te samel aangaande die demografie, kennis, houding en gewoontes van moeders. Ses fokusgroepbesprekings was gehou met werkende en nie-werkende moeders (n=37) van die drie skole om hindernisse t.o.v. gesonde eetgewoontes te ondersoek. Resultate: Die gemiddelde voedingkennis van die hele groep was 68.6%. Voedingkennis was beduidend (p<0.05) laer in die laer kwintiel skool (64%). Moeders by die hoër kwintiel skool was meer besorg daaroor om gesond te eet en meer bewus van hul rol in die vorming van „n kind se eetgewoontes, in vergelyking met moeders van die laer kwintiel skool (p<0.05). Moeders by die laer kwintiel skool het meer ongesonde voedselvoorbereidingsmetodes gebruik, byvoorbeeld die gereelde gebruik van olie en suiker tydens maaltyd voorbereiding (p<0.05). Die belangrikste faktore wat voedselaankope beïnvloed het vir die hele groep was prys (60%), nutrisionele voedingswaarde (37%) en gebrek aan tyd (29%). Werkende moeders se gebrek aan tyd het gelei tot meer gereelde aankope van wegneemetes en geriefsvoedsel (p