Methods & data analysis

Food security and related health risk among adults in the Limpopo Province of South Africa
adults CRISPR health risk determinants household food insecurity HypertensionObesity public health South Africa


The design was a cross-sectional, correlational study that surveyed households in the Limpopo Province of South Africa. The sample size was calculated from a population of 1 537 483 using Slovin’s formula with 95% confidence level and 5% margin of error, which yielded a sample size of 385 from three of the six districts. A higher number was targeted to control for attrition and withdrawals. Stratified random sampling was used to recruit 640 adults (men and women) aged between 18 and 65 years. Data were collected using a validated questionnaire. The questionnaire consisted of five main sections namely: demographic data (gender, age, marital status, level of education, family size and household income), dietary patterns, household food security (determined using the 24-hour qualitative recall, hunger scale and food inventory), physical activity patterns and anthropometric measurements, specifically body mass index (BMI)/obesity and blood pressure. The 24-hour recall, hunger scale and food inventory were used to assess consumption and availability of foods in a household. The prevalence of hunger was measured using a hunger scale questionnaire adapted from the World Health Organization (WHO) standardised tool used in the South African National Food Consumption Survey of 1999.17 The physical activity patterns were assessed by asking questions that addressed sedentary lifestyle and physical exercise practice. BMI and blood pressure were evaluated using both self-reported and clinical measurements. Weight and height were measured thrice using a calibrated electronic scale and stadiometer, respectively, and an average was computed. BMI was calculated from the weight and height measurements (weight in kg/height in metres squared). Systolic and diastolic blood pressures were measured in triplicate in a seated position with 5-min intervals between repeat measurements. Clinical evidence of hypertension was established to be either a measured systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) >90 mmHg. The self-reported use of antihypertensive medication was also considered.

Ethical consideration

This study was approved by the higher degree and ethics committee of the University of Venda (SHS/08/NUT/003). Permission was also obtained from the chiefs or local councillors. The participants signed a consent form after the study purpose was explained to them. The research adhered to the principles of the Declaration of Helsinki.

Data analysis

Data were analysed using SPSS version 25.0. Descriptive statistics were used to depict overall food security, obesity and hypertension status. Chi-square tests were used to examine associations between these outcome variables (obesity and hypertension status) and independent variables (socio-demographic characteristics, food insecurity and physical activity). The relationship between the participants’ BMI and systolic pressure, dietary diversity score (DDS) and obesity and other variables were investigated using Pearson’s correlation coefficient. The association between participants’ socio-demographic parameters and DDS of ≤4 food groups was done using logistic regression analysis. Probability (p) values less than 0.05 were considered statistically significant.

Article TitleFood security and related health risk among adults in the Limpopo Province of South Africa


Food insecurity, obesity and hypertension remain major public health issues related to nutrition in South Africa. The purpose of this study was to determine household food security and the health risk of the adult population in the Limpopo Province using cross-sectional designs. A stratified random sampling method was used to recruit adults aged 18 to 65 years in the Limpopo Province of South Africa. Data were collected using a validated, structured questionnaire. All data were analysed using SPSS version 25.0. The study included 640 participants with an average age of 36.2±17.6 years and a household size of five persons; 74.5% of participants fell in the low monthly income bracket (≤ZAR3000). The mean dietary diversity score was 3.99 (CI: 2.79–5.19). The prevalence of food insecurity was 31.3%, obesity 35.2% and hypertension 32.3%. Being a woman, older and married significantly positively influenced obesity and hypertension. Also, a healthy eating lifestyle such as high dietary diversity was found to positively influence obesity status, while daily eating of fruit and vegetables positively significantly influenced the hypertension status of participants (p

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