Exploring the Perceptions of Women from Under-Resourced South African Communities about Participating in a Low-Carbohydrate High-Fat Nutrition and Health Education Program: A Qualitative Focus Group Study

Abstract

Scientific evidence suggests that low-carbohydrate high-fat (LCHF) diets may be effective for managing non-communicable diseases (NCDs). Eat Better South Africa (EBSA) is an organization that runs LCHF nutrition education programs for women from low-income communities. Three focus group discussions (FGDs) were held with 18 women who had taken part in an EBSA program between 2015 and 2017, to explore their perceptions and to identify the facilitators and barriers they faced in implementing and sustaining dietary changes. Thematic analysis of the focus groups was conducted using NVivo 12 software. Women reported that they decided to enroll in the program because they suffered from NCDs. Most women said that the EBSA diet made them feel less hungry, more energetic and they felt that their health had improved. Most women spoke of socioeconomic challenges which made it difficult for them to follow EBSA’s recommendations, such as employment status, safety issues in the community, and lack of support from relatives and doctors. Hence, women felt they needed more support from EBSA after the program. The social determinants that affected these women’s ability to change their health behavior are also NCD risk factors, and these should be assessed to improve the program for other communities.

Social Influence on Fad Diet Use: A Systematic Literature Review

“…Additionally, after completing the JBI critical appraisal on the remaining articles, the reviewers determined all studies had low to moderate risk of bias and decided to move forward with the eligible studies (see Appendix B for detailed summary of appraisal results). Therefore, the present review is based on the results of 13 articles: eight cross sectional studies (Allen et al, 2018; Ambwani et al, 2020; Condon et al, 2007; Eisenberg et al, 2005; Grigg et al, 1996; Marquez et al, 2018; Maxwell et al, 2017; Worsley and Skrzypiec, 1997), three qualitative studies (Poirier et al, 2016; Pujol-Busquets et al, 2020; Rydén and Sydner, 2011), one cohort study (Bonaccio et al, 2012), and one non-randomized experimental study (Paxton et al, 2002).…”

“…The sample sizes ranged from 14 participants to 2337 with eight of the studies consisting solely of female participants (e.g. Eisenberg et al, 2005; Pujol-Busquets et al, 2020) and only one study had a majority of male participants (Maxwell et al, 2017). There was a large distribution of mean age ranges among studies.…”

“…Fad diets are categorized due to their short-lived trend, short-term results, and often short-term use; however, social influence is not frequently associated with the termination or short-term adherence to the diet. Results of this review indicate participants may be encouraged by peers to start a fad diet (Pujol-Busquets et al, 2020), but a lack of reinforcement of behaviour and an increased burden on users (e.g. having to cook multiple meals for family; Rydén and Sydner, 2011) may ultimately be the reason for stopping fad diets regardless of individual preference or weight-loss success (Poirier et al, 2016).…”

“…Although these diets have occasionally been used for clinical purposes in certain populations (e.g. to improve glucose metabolism for those at risk for or diagnosed with type 2 diabetes mellitus; D'Souza et al, 2020; Pujol-Busquets et al, 2020), people often utilize fad diets for weight loss (Johnston et al, 2014), stemming from societal and/or peer pressure (Khawandanah and Tewfik, 2016).…”

Alternative Dietary Patterns for Americans: Low-Carbohydrate Diets

“…Qualitative and survey research has shown that adults consuming a low-carbohydrate eating pattern have positive health outcomes such as less hunger, greater energy, and improved health, but that lack of support from family and physicians can be a barrier to adherence [161,162]. Qualitative surveys of healthcare providers reveals that many practitioners have found low-carbohydrate diets to be helpful for their patients and as a consequence, have changed the way they view and practice healthcare [163].…”