What are the people in South African townships really eating?

Towards the end of last year, The Noakes Foundation facilitated research that was done by two undergraduate students from the Netherlands who wanted to study the perceptions around the dietary habits, as well as the dietary intake of people living in South African township communities who have type 2 diabetes (T2D).

Localising information & research population:

  • Who were the research participants: 9 black females, older than 18
  • Where was the study location: Delft, Cape Town
  • Diabetes diagnosis: type 2

During the research process, the following questions were discussed:

  1. What are the perceptions regarding dietary habits of the sample of adult residents in Delft with type 2 diabetes?
  2. What is the dietary intake of the sample in relation to carbohydrates and what are the most common carbohydrate rich products?
  3. How can the carbohydrate rich daily menu be replaced by a Low Carb High Fat daily menu and adapted to the dietary habits of the residents of Delft?

The answers to these questions are reliant on access to money, cultural norms and situational circumstance that influence the eating patterns of the participants and their community. Answering the first question revealed the importance of these factors in determining perceptions around dietary habits of participants:

  • Affordability: research participants indicated that their food-buying patterns are reliant on what they can afford and not if the food itself is healthy. One participant said: “[we] are very poor, so there is no room for: I like this I don’t like that”, it comes down to what we can afford”. Another said, “if [we] can afford it then we will eat it.”
  • Attitude towards nutrition and health: having enough to eat was seen as central rather than the food item or choice: “[we] just eat, as long as [we] get full”. Sweetness was the exception: participants acknowledged that sweet food is bad for their diabetes. This indicates that education around other foods that play a role in health and diabetes is required.
    Participants weren’t fussy, saying, “we like everything”, which is encouraging, as it may aid acceptance of interventions that require changes to diet choices. Favourite, or accessible, foods included rice and pap (mielie meal).
  • Social environment: women in these communities are typically the ones who prepare food for their families, which they eat together. One research participant noted that she does not eat the food prescribed by the clinic as catering for the needs of her family takes precedence over her own needs. Also, eating as a family or in company was linked to less discretion: “I eat more careful when I am alone, I will eat everything in company with others”. Another social situation that was found to mostly interfere with health eating in this group was “special occasions”, such as birthdays and Christmas: times to enjoy, indulge and eat a lot of sugary and other unhealthy foods. However, Sundays are special family days of increased dietary diversity.

In response to the second question of this study, below is a typical meal diary of the research participants eating habits.

Under dinner:

  • 2 pieces of chicken breast refers to 2 pieces of a chicken breast and not 2 whole chicken breasts.
  • 1 serving spoon of mixed vegetables is 1 teaspoon of mixed vegetables.

From this, the researchers were able to ascertain that the dietary intake was as follows:

  1. High intake of saturated fat at approximately 14 to 47 grams
  2. Low intake of fibre at approximately 9 to 33 grams and,
  3. An extremely high intake of carbohydrates at approximately 226 to 312.


Heba pap is an alternate pap, co-created by Eat Better South Africa and Banting Blvd, that is affordable for people such as the research participants but is not as high in carbohydrate intake as normal “pap”. Find out more about EBSA here: https://thenoakesfoundation.org/eat-better-south-africa

While Heba pap is seen as well priced, for people living in townships, it can still be out of their budget. Part of Eat better South Africa’s mission is to make Heba pap an integrated food staple within these communities in an attempt to combat poor eating patterns. We do this through various outreach community programmes, specifically in the under-served communities, to educate people on healthy and wholesome eating and create awareness around the importance of proper nutrition. Eat Better South Africa is committed to working on and collaborating with brands who strive to offer quality and healthy products.

Eat Better South Africa is in the process of conducting further research into the health benefits of implementing affordable LCHF diet solutions into under-resourced communities, in collaboration with UCT.

The Noakes Foundation’s Registered Dietitian, Tamzyn Murphy concludes: “fat plays an important role in fullness, and carbohydrate intake largely determines blood glucose concentrations and insulin resistance in insulin resistant conditions, like T2D. These nutrients are also the main contributors to energy (calorie intake). The participants’ intake of fat and carbohydrate is more in line with conventional recommendations, than with LCHF recommendations. Therefore, it would be interesting to see how changing these nutrients to be more in line with LCHF recommendations, would change fullness, blood glucose control, and energy intake. Eat Better South Africa’s community interventions and our recent UCT research into T2D indicate that LCHF induces beneficial changes in all three of these.”
Tamzyn Murphy (RD) suggests that the following replacements to some of the most commonly consumed carbohydrate sources in the participants’ diets, as well as affordable high-fat food additions, to convert it from a diet high in carbohydrate and moderate in fat, to low in carbohydrate and high in fat:

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Please note, the research findings are based on a small segment of the population and should not be regarded as factual information. Furthermore, the information in this study was done by ammeter researchers who endeavoured to complete their thesis paper, The Noakes Foundation does not credit the research represented here.

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