Hidden nutrition crisis observed in South Africa: People are eating, but not receiving necessary nutrients
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Hidden nutrition crisis observed in South Africa: People are eating, but not receiving necessary nutrients

South Africa is facing a dual challenge: food poverty and diet-related diseases. Households struggle with limited access to diverse and nutritious food, while diabetes and other non-communicable diseases continue to rise.

As part of National Nutrition Week, running from October 9th to 15th, statistics reveal a serious public health issue, indicating that people may consume enough food to feel full, yet lack vital nutrients for healthy development and long-term well-being.

According to the latest mortality data from Statistics South Africa (Stats SA), diabetes mellitus accounted for 6.1% of registered deaths in 2024, an increase from 5.8% in 2023. It became the leading cause of death among individuals aged 45 to 64, comprising 7.9% of deaths in this age group.

The International Diabetes Federation estimates that 2.32 million South African adults aged 20 to 79 suffered from diabetes in 2024, corresponding to a prevalence of 7.2%. Meanwhile, UNICEF reports that 23% of children under five in South Africa suffer from severe child food poverty. The organization's latest data also shows that in 2022, 21% of children and adolescents aged five to 19 were overweight.

Dietitian Zeenat Simjee notes that financial and practical pressures often dictate family diets, with the priority being ensuring sufficient food for all meals rather than achieving nutritional diversity. She explains: 'When household budgets are under pressure, the first reaction is not always the healthiest diet, but rather the choice of products that guarantees enough food to sustain the household, stretch across several meals, and is easier to prepare.'

Simjee emphasizes that meals built predominantly on staple foods can provide necessary energy but may lack sufficient protein, fiber, and essential micronutrients, including iron, zinc, calcium, vitamin A, and folate. She concludes: 'Thus, a meal can provide satiety but be nutritionally inadequate.'

The expert warns that the consequences can be particularly severe for children, as their bodies and brains require adequate nutrients for healthy development. The first 1000 days, from pregnancy to the child's second birthday, are especially critical, as nutrient deficiencies during this period can have long-term effects.

In Simjee's view, South Africa is grappling with a triple burden of malnutrition, where undernutrition and micronutrient deficiencies coexist with overweight, obesity, and diet-related diseases. However, she clarifies that the link between diet and chronic diseases is not about blaming individual foods; the concern lies with the overall dietary pattern, where energy-dense foods rich in refined carbohydrates, added sugars, saturated fats, or sodium constantly displace more nutrient-rich options.

The Ministry of Health has acknowledged that access to affordable, nutritious, and diverse food is a crucial health factor closely linked to preventing non-communicable diseases. A representative from the Department, Foster Mohale, stated that the National Strategic Plan for the Prevention and Control of Non-Communicable Diseases for 2022–2027 identified unhealthy diets as one of the five main modifiable risk factors.

Mohale added that the department views food accessibility and the availability of healthier options as issues beyond individual choice. Measures taken by the department include regulating sodium reduction, controlling industrially produced trans fats, food fortification, nutrition education, and steps to improve the food environment. It was noted, however, that education alone is insufficient to overcome structural barriers affecting what people eat. Foster also announced the upcoming 2022 National Dietary Intake Survey, which is expected to provide updated data on dietary patterns, nutrient intake, and nutritional status across different socioeconomic groups.

Dr. Karen Heath, a senior researcher at The Noakes Foundation, believes that National Nutrition Week should not turn into a list of instructions addressed to individuals. She argues: 'National Nutrition Week cannot be reduced to a list of rules for individuals. The data points to a much more complex challenge: making nutritious choices more accessible and affordable, helping people interpret reliable information, and taking chronic disease prevention seriously.'

The Foundation will host a World Nutrition Summit in Cape Town from October 14th to 16th, gathering South African and international participants to discuss nutrition research, clinical practice, prevention, and nutrition environments. Professor Tim Noakes stated that scientific debate is necessary to improve health outcomes, emphasizing that 'Scientific progress depends on asking difficult questions and being willing to change one's mind.'

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Cost of living crisis forces South African shoppers to rethink spending
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Cost of living crisis forces South African shoppers to rethink spending

Amid the cost of living crisis, residents of South Africa are becoming more meticulous about every purchase in grocery stores, as rising food prices, debt repayments, and other household expenses place significant pressure on already strained budgets.

Consumers in South Africa are exercising greater caution in spending, forced to analyze everything from food prices to debt repayment. For many shoppers, the familiar brand on the supermarket shelf is no longer an automatic choice. The popularity of private label goods is growing, as consumers compare prices, question the justification for premium brand prices, and seek ways to stretch limited family income.

Neil Ruets, CEO of Debt Rescue, noted that this reflects a broader shift in household financial management. He stated: 'At Debt Rescue, we see this as part of a wider change in how households manage money: buyers are paying much closer attention to what they are buying, what they truly need, and whether the price they are paying can be justified within their monthly budget.'

The increasing demand for private label goods is one sign of this shift. According to NielsenIQ data cited in a recent industry analysis, private label sales in South Africa reached 53.5 billion rand in the first half of 2026. Ruets added that from a consumer finance perspective, this trend indicates that purchasing decisions are becoming less automatic.

He emphasized: 'Loyalty to established brands can still matter, but when household finances are constrained, consumers have a stronger financial incentive to compare alternatives and decide if the cost of a particular product remains affordable.'

Households under growing pressure

This shift occurs against a backdrop of a difficult economic situation characterized by inflationary pressure, high interest rates, weak economic growth, and persistently high unemployment, which continues to negatively affect household finances. The latest PMBEJD Household Affordability Index revealed the pressure consumers are facing. In September, the average cost of a food basket was 5488.06 rand, which is 108.64 rand, or 2% year-on-year, higher.

Of the 44 main products tracked, 21 increased their price during the month. For families already incurring costs for housing, transport, electricity, insurance, debt repayment, and food on the same income level, even small savings can become substantial over a month. Thus, choosing the retailer's own product instead of the familiar branded alternative is one way consumers are trying to control daily spending.

However, Ruets cautioned against interpreting this shift as merely evidence of increased consumer financial discipline. He warned: 'It is important to understand that this does not mean consumers will automatically choose the cheapest item in their entire shopping basket.' Households often save in areas where they are comfortable, continuing to spend on items they deem important. Ruets concluded: 'The level of consideration put into these choices has changed.'

Private label gains ground

Tony Man Gavin, Managing Director of Encore, a wholly-owned private label business of SPAR South Africa, reported that shoppers are increasingly focusing on value rather than just price. Man Gavin stated: 'South African shoppers are not just becoming more price-sensitive. They are becoming more value-sensitive.'

NielsenIQ data showed that private label sales grew by 1.9% year-on-year in the first half of 2026, highlighting the growing role of retailer brands in food baskets. Ruets noted that this trend is important because it demonstrates that consumers are actively re-evaluating established purchasing habits. He added: 'There is something encouraging about consumers actively comparing prices and looking for ways to cut unnecessary expenses. However, we must also be careful not to interpret all this behavior solely as improved purchasing discipline.'

For many households, the heightened focus on spending is due to necessity. Ruets noted that Debt Rescue's concern was particularly focused on families who had already significantly cut their spending. He explained: 'There comes a point where switching brands, buying on sale, and cutting non-essential expenses can no longer compensate for the constant gap between household income and monthly financial obligations.'

'When a consumer has already significantly reduced spending and still cannot comfortably cover basic necessities and debt repayment, the problem goes beyond finding extra savings in the supermarket. It may indicate deeper financial difficulties,' Ruets continued. For such households, the rise in private label sales offers only limited relief from broader financial pressure. Nevertheless, Ruets believes this trend provides valuable insight into the decisions being made by South African households striving to stay within increasingly tight budgets.

He concluded by saying: 'Consumers are becoming more selective and more willing to reconsider established purchasing habits while trying to keep essential expenses within increasingly limited budgets.' The problem for households is that there is a finite amount of expenses that can be cut. Thus, as consumers become more strategic in their purchases, the growing reliance on cheaper alternatives is not just a story of changing consumer preferences, but also a reflection of the financial pressure faced by millions of South African households.

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