Dietary adjustments that consumers in the professional sector in the City of Cape Town are likely to make, in order to enhance their phytochemical intake

Abstract

The prevalence of nutrition-related chronic diseases of lifestyle (CDL) is escalating in South Africa (SA). Studies suggest that poor nutrition plays a major role in the aetiology of these diseases. Phytochemicals present in plant foods, namely fruit, vegetables, whole grains and tea, may prevent the onset of CDL. Most South African diets appear to be deficient of these plant foods. Achieving enhanced phytochemical intake amongst South Africans may therefore have to be supported in other ways. The objectives of this research were to determine whether consumers in the professional sector in the City of Cape Town would be (i) likely to consume proficient home-cooked category prepared dishes and (ii) purchase and consume commercially manufactured category prepared dishes for enhanced phytochemical intake and, if so, (iii) which dietary source adjustment category/categories and (iv) food vehicle category/categories they would be likely to consume, and (v) who would be likely to consume them. After obtaining ethical approval, a survey was conducted amongst 184 white collar workers (87% response rate) representing the professional sector (professional, technician and associate professional) occupational groups. The respondents were approached for voluntary participation based on their occupation and age, representing adulthood to the elderly life stage as a risk factor for the development of lifestyle diseases. A pilot-tested questionnaire was used to obtain information regarding the respondents awareness of phytochemicals, whether or not they were involved in the preparation of food at home, their degree of ‘likelihood’ to consume proficient home-cooked and commercially manufactured category prepared dishes for enhanced phytochemical intake, their current daily intake of fruit, vegetables, whole grains and tea, and demographic, health and lifestyle information. The frequencies of the respondents’ consumption of phytochemical-rich dietary sources pertaining to the stages of change model were assessed using Pearson’s chi-squared analysis to determine significant associations/differences (p < 0.05) between the data sets. The repeated measure analysis of variance (ANOVA) on Bonferroni correction was used to assess the ‘likeliness’ scale (from ‘extremely unlikely’ as ‘1’ to ‘extremely likely’ as ‘5’) for the household and commercial dietary source adjustment and food vehicle categories. The respondents were mostly female (58.7%), 31 to 44 years of age (67.9%) and of White ethnicity (72.3%). The majority (61.5%) had obtained grade 12 and a diploma (29.4%) or a degree (32.1%). Almost half were married or living together with children (48.9%) and were English (48.9%) or Afrikaans (47.3%) speaking. The majority of respondents were non-smokers (69%), and approximately half (54.4%) consumed alcohol less than three times per week (54.4%). About fifty percent used dietary supplements (50.5%) and exercised (59.2%) regularly.

A small percentage of the respondents were obese (7.6%), had diabetes mellitus (4.4%) or cardiovascular disease (CVD) and cancer (2.2% or four respondents each). Cancer was most prevalent (36.4%) within the respondents’ family, followed by diabetes mellitus (29.9%), CVD (26.6%) and obesity (7.6%). The majority (77.7%) were not aware of phytochemicals and about half (55.4%) could not indicate the role these compounds play in the human diet. Half of the respondents consumed the recommended two to four servings of fruit daily, very few (10.9%) consumed the recommended three to five servings of vegetables daily, only about 10% (9.2% or 17 respondents) consumed the recommended three servings of whole grains daily, and about a third (36.4%) consumed two to three cups of tea daily. The respondents who considered phytochemicals to be very necessary to support health were more likely to consume rooibos herbal tea added to category prepared dishes than those who considered phytochemicals to be necessary to support health (p < 0.05) and those who did not know the role phytochemicals played in the diet (p < 0.05). The likelihood to consume category prepared dishes with added vegetables and added fruit respectively was lower (p < 0.05) amongst those respondents who consumed none to one serving of vegetables daily than amongst those who consumed two to four servings of vegetables daily. The respondents who did not consume tea were less likely to consume category prepared dishes with added rooibos herbal tea than those who consumed one cup (p < 0.05) or two to three cups (p < 0.001) daily. Furthermore, the respondents who did not consume tea were also less likely to consume category prepared dishes with added herbs than those who consumed one cup (p < 0.05), two to three cups (p < 0.001) or four to six cups (p < 0.05) daily. The likelihood to consume category prepared dishes with fruit additions was lower amongst those respondents who did not consume tea than amongst those who consumed two to three cups (p < 0.05) or four to six cups (p < 0.05) daily. The respondents were more likely (p < 0.05) to consume herb, vegetable and fruit additions respectively than rooibos herbal tea addition, and more likely to consume vegetable additions than herb (p < 0.05) or fruit (p < 0.001) additions as dietary source adjustment options. Furthermore, vegetable additions to category prepared dishes were more likely to be consumed by the respondents than fruit additions (p < 0.001), and starch-based dishes more likely to be consumed than vegetable-based dishes (p < 0.001) or fruit-based dishes (p < 0.05) for the addition of rooibos herbal tea. The respondents were likely to consume the food vehicle categories egg and chicken for added herbs in comparison to other starch (p < 0.05) and vegetables (p < 0.001) respectively. Chicken was a likely option over pasta for added broccoli (p < 0.05). Crêpe was a likely option over compote for added mixed berries (p < 0.001). Potato was a likely option over vegetables (p < 0.05) as well as other starch over vegetables (p < 0.05)

for added herbs. Carrot salad with raisins was a likely option above carrot salad with raisins and parsley (p < 0.05). Poached pear in red grape juice was a likely option over poached pear in rooibos herbal tea (p < 0.001). Tomato (p < 0.001) and broccoli (p < 0.05) were more likely to be consumed than spinach, while spinach (p < 0.05) and roasted butternut (p < 0.05) respectively were likely options over onion as vegetables added to a quiche. Onion was a less likely option over broccoli (p < 0.001), tomato (p < 0.001) and roasted butternut (p < 0.001) as respective vegetables in a soup. Tomato soup was a likely option over tomato soup with rooibos herbal tea (p < 0.001). Roasted butternut soup was a likely option over butternut and orange soup (p < 0.001) and butternut and rosemary soup (p < 0.001). Berries as fruit addition were a likely option over pome fruit as pear (p < 0.05) and citrus fruit (p < 0.001), and furthermore citrus fruit over pome fruit as pear (p < 0.05). Raw apple with its skin on was a more likely option over chicken breast salad with apple pieces (p < 0.001), and chicken breast salad with apple a likely option over chicken and apple casserole (p < 0.001). Parsley was a likely option over basil (p < 0.001), and mixed herbs (p < 0.001) and rosemary (p < 0.001) respectively were likely options over basil as herb addition. Commercially manufactured category prepared dishes likely to be purchased and consumed by the respondents included category prepared dishes with added fibre more than added herbs (p < 0.05), fruit (p < 0.001), vegetables (p < 0.001) or tea (p < 0.001), and added herbs than added vegetables (p < 0.05) or tea (p < 0.05). Pizza/pasta was a likely option over beverages (p < 0.05), grains/bake (p < 0.001) and dairy (p < 0.001) respectively, and baked goods than grains/bake (p < 0.001), dairy (p < 0.001) and beverages (p < 0.05) respectively as food vehicles. A baked dish with added fibre was more likely to be consumed than with added fruit (p < 0.001), tea (p < 0.001) or vegetables (p < 0.001), and added fruit more likely to be consumed than added vegetables (p < 0.05). Pasta incorporating vegetables was a more likely option than pasta incorporating fruit (p < 0.001). Shortbread with added fruit was a likely option over added herbs (p < 0.05), and a muffin with bran (p < 0.001) or blueberries (p < 0.001) a likely option over a muffin with spinach. Fruit juice incorporating rooibos herbal tea (p < 0.001) or herbs (p < 0.001) were likely options over fibre incorporation. The female respondents were more likely to consume category prepared dishes with added fruit than the male respondents (p < 0.05), while the older respondents (55 to 64 years) were more likely to consume category prepared dishes with added herbs than the younger respondents (31 to 44 years) (p < 0.05). The older respondents were also more likely to consume category prepared dishes with fruit additions than the younger respondents aged 31 to 44 (p < 0.05) and 45 to 54 (p < 0.05) respectively. The respondents involved in the preparation of food at home were more likely to consume category prepared dishes with the addition of rooibos herbal tea (p < 0.05), herbs (p < 0.05) and fruit (p < 0.05) respectively than those who were not involved in preparing food at home.