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14 October 2022 | Story Prof Johan van Niekerk, Dr Ismari van der Merwe, and Ms Elzmarie Oosthuizen | Photo Supplied
Sustainable food
World Food Day is celebrated annually on 16 October to promote global awareness and action to uplift those who suffer from hunger and to highlight the need to ensure access to healthy diets for all.

Opinion article by Prof Johan van Niekerk, Dr Ismari van der Merwe, and Ms Elzmarie Oosthuizen, Department of Sustainable Food Systems and Development, University of the Free State.



World Food Day is celebrated annually on 16 October to promote global awareness and action to uplift those who suffer from hunger and to highlight the need to ensure access to healthy diets for all. However, in 2022 we are faced with an ongoing pandemic, conflict, global warming, rising prices, and international tensions. All these factors are affecting global food security. Educators have an enormous task to help students develop skills to help build a sustainable world where everyone has regular access to nutritious food. 

Although we have progressed towards building a better world, many people have been left behind – people who cannot benefit from human development, innovation, or economic growth. Millions of people worldwide cannot afford a healthy diet, putting them at high risk of food insecurity and malnutrition. But ending hunger is not only about supply. Enough food is produced today to feed everyone on the planet. The problem is access and availability of nutritious food. People worldwide are suffering from the domino effects of challenges that know no borders.

Students have insufficient balance for food

South Africa has seen a significant expansion of student enrolment in the higher education system, with nearly one million students attending one of the 26 public universities. The number of students in South Africa's higher education system is far below other middle-income developing countries. Therefore, the government aims to increase university enrolment to 1,5 million by 2030. However, the cost of attending university greatly exceeds the financial means of most students. 
Students must divide their budget between rent, tuition, utilities, and the remaining insufficient balance for food, which ultimately increases their food insecurity risk.
Moreover, the transition of school learners to university students is more complicated than foreseen since lifestyle changes have health implications, where the excitement is combined with stress from pressure to perform well academically in a competitive environment. Research has found that first-year students are exceptionally prone to food insecurity. They have newfound independence and are still learning to cope with the milieu away from home. A study on the Bloemfontein Campus by the Department of Nutrition and Dietetics indicated that students experience considerable problems in managing their tasks, time, and finances. The challenge of reduced social support results in lengthy emotional and physical separation from family and friends, which influences standard eating patterns. The students have poor nutritional knowledge, limited earning potential, and a lack of budgeting skills and resources for healthy food preparation. Finally, sociocultural diversity is another factor to consider. It influences students' food patterns, while the total student population of the UFS, about 37 800 full-time students, reflects a rich sociocultural diversity. 

Intake of vegetables, fruit, and protein among students is minimal

When required to earn a degree, food insecurity represents a short period of time, but it can precipitate poor lifelong health behaviour and increased risks of chronic diseases. Prolonged exposure may contribute to the development of obesity. The research found food insecurity is related to poor mental health and academic performance. Students endorse increased rates of depression and anxiety, decreased concentration, and low concentration marks. It leads to lower academic achievement and undermines the goals of tertiary education. The importance of studying the aspects related to students' sustainable food consumption behaviour lies in the fact that, at this age, they begin to develop specific consumption patterns that will have long-term effects.

The average of current first-year students forms part of Generation Zoomers (ages 19-22 years). Generation Zoomers (Gen Z) grew up in specific circumstances, known as the first truly digital natives. They grew up living, working, and socialising with the internet and social media. This generation's economic circumstances are more constrained. The latter is partly due to the rise in university tuition fees. Gen Z forms part of diverse communities seen as networked young citizens, but growing social inequalities often limit their opportunities. This generation is labelled as the stay-at-home generation, with indoor and online socialising on the rise. 

During a study by the Department of Sustainable Food Systems and Development on the South Campus of the UFS (student population – ages 19-22 years), we found that the intake of vegetables, fruit, and protein among our students is minimal and will lead to deficiencies. At the same time, rice and pasta are part of their everyday diet. Money to buy these foods is still an immense problem. Students indicated that they would prefer healthy foods when they had the resources to afford it.

No Student Hungry initiative

Gender and student consumption patterns showed that breakfast consumption decreased, with male students consuming breakfast more regularly than females. The results indicated that students preferred soft drinks (energy) and water (available). They argued that the high consumption of fast food is due to its wide availability and accessibility in commercial and informal outlets. The informal vendors make fast food more available and accessible to low-budget student groups due to the lower food prices. The unhealthy consumption movement is driven by aggressive advertising practices and lower costs. 

Students consume more saturated fat snacks, refined carbohydrates, sweetened carbonated beverages, and diets that are short in polyunsaturated fatty acids (PUFAs) and fibres. Researchers indicated that these unhealthy diets and the increasingly sedentary lives of students could lead to non-communicable diseases such as type 2 diabetes mellitus and heart disease.

Currently, the department forms part of the NO STUDENT HUNGRY (NSH) initiative by establishing vegetable tunnels on campus. It remains an indispensable objective of the department, though, to increase the proportion of university students who receive information on unhealthy dietary patterns; however, nutrition knowledge has only moderate effects on students' attitudes and behaviours. Therefore, we use our Food Security modules as an effective strategy to educate our student community on sustainable food systems by ensuring skills development. Teaching contextual skills (e.g., how to plan and prepare nutritious meals within time and financial constraints) could address this unhealthy behaviour of the UFS students and work towards the sustainable development goal of NO HUNGER in 2030

News Archive

Heart diseases a time bomb in Africa, says UFS expert
2010-05-17

 Prof. Francis Smit

There are a lot of cardiac problems in Africa. Sub-Saharan Africa is home to the largest population of rheumatic heart disease patients in the world and therefore hosts the largest rheumatic heart valve population in the world. They are more than one million, compared to 33 000 in the whole of the industrialised world, says Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the Faculty of Health Sciences at the University of the Free State (UFS).

He delivered an inaugural lecture on the topic Cardiothoracic Surgery: Complex simplicity, or simple complexity?

“We are also sitting on a time bomb of ischemic heart disease with the WHO (World Health Organisation) estimating that CAD (coronary artery disease) will become the number-one killer in our region by 2020. HIV/Aids is expected to go down to number 7.”

Very little is done about it. There is neither a clear nor coordinated programme to address this expected epidemic and CAD is regarded as an expensive disease, confined to Caucasians in the industrialised world. “We are ignoring alarming statistics about incidences of adult obesity, diabetes and endemic hypertension in our black population and a rising incidence of coronary artery interventions and incidents in our indigenous population,” Prof. Smit says.

Outside South Africa – with 44 units – very few units (about seven) perform low volumes of basic cardiac surgery. The South African units at all academic institutions are under severe threat and about 70% of cardiac procedures are performed in the private sector.

He says the main challenge in Africa has become sustainability, which needs to be addressed through education. Cardiothoracic surgery must become part of everyday surgery in Africa through alternative education programmes. That will make this specialty relevant at all levels of healthcare and it must be involved in resource allocation to medicine in general and cardiothoracic surgery specifically.

The African surgeon should make the maximum impact at the lowest possible cost to as many people in a society as possible. “Our training in fields like intensive care and insight into pulmonology, gastroenterology and cardiology give us the possibility of expanding our roles in African medicine. We must also remember that we are trained physicians as well.

“Should people die or suffer tremendously while we can train a group of surgical specialists or retraining general surgeons to expand our impact on cardiothoracic disease in Africa using available technology maybe more creatively? We have made great progress in establishing an African School for Cardiothoracic Surgery.”

Prof. Smit also highlighted the role of the annual Hannes Meyer National Registrar Symposium that culminated in having an eight-strong international panel sponsored by the ICC of EACTS to present a scientific course as well as advanced surgical techniques in conjunction with the Hannes Meyer Symposium in 2010.

Prof. Smit says South Africa is fast becoming the driving force in cardiothoracic surgery in Africa. South Africa is the only country that has the knowledge, technology and skills base to act as the springboard for the development of cardiothoracic surgery in Africa.

South Africa, however, is experiencing its own problems. Mortality has doubled in the years from 1997 to 2005 and half the population in the Free State dies between 40 to 44 years of age.

“If we do not need health professionals to determine the quality and quantity of service delivery to the population and do not want to involve them in this process, we can get rid of them, but then the political leaders making that decision must accept responsibility for the clinical outcomes and life expectancies of their fellow citizens.

“We surely cannot expect to impose the same medical legal principles on professionals working in unsafe hospitals and who have complained and made authorities aware of these conditions than upon those working in functional institutions. Either fixes the institutions or indemnifies medical personnel working in these conditions and defends the decision publicly.

“Why do I have to choose the three out of four patients that cannot have a lifesaving operation and will have to die on their own while the system pretends to deliver treatment to all?”

Prof. Smit says developing a service package with guidelines in the public domain will go a long way towards addressing this issue. It is also about time that we have to admit that things are simply not the same. Standards are deteriorating and training outcomes are or will be affected.

The people who make decisions that affect healthcare service delivery and outcomes, the quality of training platforms and research, in a word, the future of South African medicine, firstly need rules and boundaries. He also suggested that maybe the government should develop health policy in the public domain and then outsource healthcare delivery to people who can actually deliver including thousands of experts employed but ignored by the State at present.

“It is time that we all have to accept our responsibilities at all levels… and act decisively on matters that will determine the quality and quantity of medical care for this and future generations in South Africa and Africa. Time is running out,” Prof. Smit says.
 

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