This research study investigates the feasibility, acceptance, and effectiveness of a digital Diabetes and Diabetes Risk Reversal Program (DRP) within a South African medical scheme setting. Designed as a pilot study, it targets individuals who have been diagnosed with Type 2 Diabetes (T2D). The program is delivered digitally and incorporates therapeutic carbohydrate restriction (TCR) alongside a broader biopsychosocial approach to chronic disease management. This intervention aims to empower patients through education, individualized coaching, and lifestyle change, aligning with modern, patient-centred care models.

The study will be implemented using a pre-test/post-test method over six months. A total of 100 participants, recruited from the member base of a partnering medical scheme, will be selected based on strict inclusion and exclusion criteria. Participants will receive access to a digital platform offering structured weekly educational content on diet and lifestyle, individual coaching from registered dieticians, and optional group coaching sessions. In the first three months, the focus will be on implementing dietary changes through carbohydrate restriction. The subsequent three months will address lifestyle factors such as physical activity, stress management, sleep quality, and emotional well-being. Data will be collected at baseline, mid-point, and end of the study using medical assessments, pathology tests, and validated self-report questionnaires. Participants will also self-monitor key health indicators and report them to their dieticians. Their engagement with the digital content will be tracked to assess both adherence and overall program acceptance.

This research is of significant importance in the context of South Africa’s escalating diabetes burden. Managing diabetes places immense pressure on the healthcare system and accounts for a substantial portion of national health expenditure. Given that lifestyle behaviours influence the vast majority of outcomes for noncommunicable diseases like diabetes, a scalable and cost-effective intervention such as this digital DRP has the potential to improve health outcomes while alleviating the financial burden on the healthcare system. Furthermore, this pilot study will inform whether such an intervention, proven effective in high-income settings like Denmark and the USA, is viable and culturally appropriate for broader implementation in the South African context. If successful, the program could revolutionize chronic disease management through digital health, saving lives and resources alike.

This study explores the impact of a low-carbohydrate dietary intervention on metabolic and thyroid health among women diagnosed with hypothyroidism in South Africa. Employing a mixed-methods approach, the research combines quantitative measurements—such as changes in weight, glycemic control (HbA1c), and thyroid function (TSH, T3, T4)—with qualitative reflections from participants on their experiences throughout the intervention. The aim was to understand not only the physiological effects of dietary change but also the emotional, social, and practical challenges participants faced while implementing and sustaining the dietary modifications. The findings reveal promising outcomes in terms of weight loss and emotional empowerment, though variability was observed in thyroid function and glycemic markers, suggesting the need for more personalized approaches.

Implemented over a three-month period, the study involved South African women with diagnosed hypothyroidism who followed a structured low-carbohydrate dietary plan. Dietary information was

provided by the Nutrition Network. Quantitative results showed statistically significant weight loss and changes in certain thyroid markers, particularly a notable decrease in T3 levels. While reductions in HbA1c were not statistically significant, individual improvements were observed. Qualitatively, participants described growing confidence in navigating dietary changes, a sense of empowerment from metabolic improvements, and challenges related to social and environmental factors such as access to appropriate food choices. This integration of clinical and experiential data provided a nuanced understanding of the intervention’s impact, highlighting the importance of combining nutritional strategies with psychosocial support.

This research is significant as it addresses an often overlooked chronic condition in the South African context, particularly among women in under-resourced communities who face diagnostic, financial, and logistical barriers in accessing consistent treatment. The study emphasizes that nutritional interventions, particularly low-carbohydrate diets, may serve as effective, non-invasive strategies to support metabolic and thyroid health, even in resource-constrained settings. Moreover, by including participant narratives, the research offers critical insight into real-world barriers to adherence and sustainability, reinforcing the value of holistic, patient-centered approaches in chronic disease management.

Importantly, additional funding has now been secured to conduct follow-up assessments with study participants. This will allow researchers to evaluate the long-term efficacy and sustainability of the intervention and provide more robust evidence on whether the observed short-term benefits are maintained over time. These follow-up insights will be vital for informing future policy recommendations and the potential integration of such dietary interventions into broader healthcare strategies for managing hypothyroidism and related chronic conditions.

This research study investigates the perceptions, dietary habits, and nutritional knowledge surrounding pork consumption among strength and endurance athletes in South Africa. It is designed as a two-phase mixed-methods study aimed at understanding both the existing beliefs athletes and their support teams hold about pork, and the potential for nutritional education to shift these perceptions and influence dietary behaviour. The study specifically explores whether targeted education can increase pork consumption among athletes, while also assessing any resultant health outcomes such as changes in body composition, metabolic markers, and performance-related perceptions.

The first phase of the study, currently nearing completion, involves qualitative data collection through focus group discussions and one-on-one interviews with 40 athletes—20 endurance athletes and 20 strength-trained athletes—as well as 10 coaches. This phase explores a wide range of themes including current dietary practices, sources of nutrition information, beliefs about pork and saturated fat, cooking habits, supplement use, training regimens, and long-term health concerns. These qualitative insights are currently undergoing analysis, which marks the conclusion of phase 1.

In phase two, all original participants will be invited to join a six-week dietary intervention focused on increasing pork consumption. This will be preceded by a science-based nutritional education session, tailored to address misconceptions identified during phase one. Participants will receive dietary plans to integrate various pork products into their diets, aligned with their athletic goals. Pre- and post-intervention assessments will measure fasting blood glucose, HbA1c, lipid profiles, inflammatory markers, body composition, and blood pressure. Participants will also complete diet journals, meet regularly with a dietician, and take part in post-intervention focus groups to reflect on changes in health, training, and attitudes toward pork.

The significance of this research lies in its potential to challenge long-standing myths about pork, particularly in relation to fat content and health perceptions. It aims to deliver actionable insights to the South African pork industry by expanding consumer understanding and potentially opening new markets within the health-conscious athletic community. It also provides a replicable model for consumer education that could be applied across different population groups.

This research proposal explores the effectiveness of the Eat Better South Africa (EBSA) community-based nutrition education program in improving physical and mental health outcomes among individuals living with Type 2 Diabetes (T2D) and those at risk of developing it,

particularly in the under-resourced community of Dunoon, Cape Town. The study follows a two-phase mixed-methods approach and aims to generate evidence on how lifestyle changes—focusing primarily on therapeutic carbohydrate restriction and reduction of ultra-processed foods—can influence metabolic, immune, and psychosocial health, especially in individuals managing multiple chronic conditions such as HIV and tuberculosis (TB) alongside diabetes.

The first phase of the study focuses on engaging healthcare providers at the Dunoon Community Health Centre (CHC). These practitioners are equipped with continuous glucose monitors (CGMs) for a two-week period to gain firsthand experience of how daily lifestyle factors influence blood glucose levels. Their perceptions and experiences are then explored through focus group discussions, where they also provide recommendations for adapting the EBSA program to better meet the needs of patients facing multiple co-morbidities. This phase serves not only to gather qualitative insights into current healthcare challenges but also to bridge the gap between clinical practice and patient-centred lifestyle interventions. This component of the research is currently being concluded, with qualitative data now under analysis.

In the upcoming second phase, these insights will inform the implementation of an enhanced 6-week EBSA intervention with 50 participants from the Dunoon CHC diagnosed with or at risk for T2D, many of whom are also living with HIV or TB. Participants will attend weekly education sessions focused on making accessible, sustainable dietary changes with the support of trained EBSA community coaches. Alongside this, they will receive regular health monitoring, including assessments of blood glucose, insulin resistance, cholesterol, blood pressure, and body composition, as well as comprehensive questionnaires capturing food intake, medication adherence, mental health, quality of life, and self-efficacy. Focus group discussions will also be held before and after the intervention, and again at 12 months, to explore participants’ experiences, behaviour changes, and ongoing challenges.

This study holds significant public health relevance in South Africa, where the dual burden of communicable and non-communicable diseases, particularly in low-income communities, places enormous strain on healthcare resources. By investigating how a grassroots nutrition education program can support better management of diabetes and associated comorbidities, the research aims to inform scalable solutions that are culturally and economically appropriate. The program’s focus on community empowerment, education, and support aligns with growing calls for holistic, preventative models of chronic disease care.