Incorporating orange-fleshed sweet potato into the food system as a strategy for improved nutrition: The context of South Africa.

Orange-fleshed sweet potato (OFSP) is considered the single most successful example of biofortification of a staple crop, and presents a feasible option to address vitamin A deficiency. Though initially promoted as part of a crop-based approach focusing on production and consumption at household level, it evolved into small-scale commercial production, predominantly in Sub-Saharan Africa. This paper reviews OFSP initiatives in relation to the South African food environment and food supply systems, also identifying opportunities for scaling out OFSP in a situation where sweet potato is not eaten as a staple. Current per capita consumption of sweet potato is low; the focus is thus on increasing consumption of OFSP, rather than replacing cream-fleshed varieties. For the major OFSP variety, Bophelo, 66g consumption can be sufficient to meet the recommended daily allowance for 1-3year old children (300µRE vitamin A). Despite a national Vitamin A supplementation programme and fortified staple foods in South Africa, 43.6% of children under 5years of age were reported to be vitamin A deficient in 2012, indicating a stronger need to promote the consumption of Vitamin A-rich foods, such as OFSP. To increase availability of and access to OFSP, all aspects of the food supply system need to be considered, including agricultural production, trade, food transformation and food retail and provisioning. Currently, small-scale commercial OFSP producers in South Africa prefer to deliver their produce to local informal markets. To enter the formal market, small-scale producers often have difficulties to meet the high standards of the retailers' centralised procurement system in terms of food quality, quantity and safety. Large retailers may have the power to increase the demand of OFSP, not just by improving availability but also by developing marketing strategies to raise awareness of the health benefits of OFSP. However, currently the largest scope for scaling out is through a number of public sector programmes such as the National School Nutrition Programme, Community Nutrition and Development Centres, Small-holder Farmer programmes and Agriparks. Though the major approach is focused on unprocessed, boiled OFSP, there are unexploited opportunities for processing of OFSP. However, the nutritional quality of products should be a main consideration within the context of the co-existence of undernutrition, overnutrition and micronutrient deficiencies in the country.

Dietary Diversity and Vegetable and Fruit Consumption of Households in a Resource-Poor Peri-Urban South Africa Community Differ by Food Security Status.

Sociodemographic, living standard measure, consumption of vegetables and fruit, and dietary diversity in relation to household food security were assessed. Using a hunger score, households were categorized as food secure (n = 125) or food insecure (n = 273). Food secure respondents had a higher mean dietary diversity score (3.98; 95%CI [3.79, 4.18] versus 3.65; 95% [CI 3.53, 3.77]), were more likely to eat vitamin A-rich foods (OR 1.15; 95% CI [1.05, 1.26]), a more varied diet (DDS ≥ 4, OR 1.90; 95% CI [1.19, 3.13]), and vegetables daily (OR 3.37; 95% CI [2.00, 5.76]). Cost limited daily vegetable/fruit consumption in food insecure households. Respondents with ≥ 8 years of schooling were more likely (OR 2.07; 95% CI [1.22, 3.53]) and households receiving social grants were less likely (OR 0.37; 95% CI [0.19, 0.72]) to be food secure. Results highlight the association between dietary diversity and household food security.