Marinka
Marinka
Marinka
Ethnomedicine
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doi:10.1186/1746-4269-9-78
ISSN
Article type
1746-4269
Research
Submission date
18 July 2013
Acceptance date
7 November 2013
Publication date
25 November 2013
Article URL
http://www.ethnobiomed.com/content/9/1/78
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Centre of Excellence for Nutrition (CEN); Faculty of Health Sciences, NorthWest University, Potchefstroom Campus, Private Bag 6001, Potchefstroom
2520, South Africa
3
Abstract
Background
The dietary shift from indigenous and traditional plants (ITPs) to cash crops and exotic plant
food sources increases the risk of malnutrition and other nutrition-related non-communicable
diseases, especially in poor rural communities. Farm communities in South Africa have been
associated with poor nutritional status and extreme poverty. ITPs have been found to be
affordable sources of several micronutrients. However, knowledge of and the use of these
plants are declining, and little is known about the childs acceptance of dishes prepared with
ITPs. This knowledge can be used to improve the general acceptance of ITPs. This study
aimed to gain insight into parents knowledge and perceptions and their use of ITPs in a
farming community in the North West Province and to assess childrens acceptance of and
preference for dishes made with African leafy vegetables (ALVs) and Swiss chard.
Methods
Parents (n = 29) responsible for food preparation for children in grade 2 to 4 in two schools
were purposively selected for four focus group discussions. A sensory evaluation assessed the
childrens (n = 98) acceptance of, preference for and intended consumption of dishes made
with leafy vegetables. The dishes were made of Amaranthus spp., Cleome gynandra,
Cucurbita maxima, Vigna unguiculata and Beta vulgaris.
Results
Parents mentioned 30 edible ITPs during the focus group discussions. Parents had knowledge
of available ITPs and their use as food. Location, seasonal variation and rainfall affected the
availability of and access to ITPs. Sun-dried ITPs were stored in sacks for later use. ITPs
were perceived as healthy, affordable and delicious, hence acceptable to the parents. The
children also evaluated the dishes made with ALVs as acceptable in terms of colour, smell
and taste. Swiss chard was preferred, most likely because of the childrens exposure to this
vegetable. Children indicated that they would like to eat these leafy vegetables twice a week.
Conclusion
These results look promising for the promotion of ITPs as a strategy to reduce malnutrition in
rural farm communities and for potential inclusion of these micronutrient-rich ALVs in
school feeding programmes to improve the nutritional status of children.
Keywords
Indigenous plants, Traditional plants, African leafy vegetables, Knowledge, Perception, Use,
Sensory evaluation, Parents, Primary school children, South Africa
Background
Over millennia, indigenous and traditional plants (ITPs) have been the main source of food
for many rural communities. However, colonial economies and post-independence
development schemes placed greater emphasis on the production and consumption of cash
crops, introduced foods that led to the displacement of indigenous food crops and caused
subsequent changes in the diet of African people [1]. Their food patterns reflected an
increasing intake of a limited number of domesticated plant staples, while intake of the edible
wild plant species that once sustained health and nutritional status was reduced [2]. It is
evident that urbanisation has contributed to a decline in knowledge of the usefulness of ITPs,
hence the reduction in the consumption of these foods. This dietary change, especially in poor
rural communities, put people at risk of malnutrition and other nutrition-related noncommunicable diseases. According to the United Nations Childrens Fund conceptual
framework on malnutrition, the underlying causes of malnutrition and death in children are
poor household food security, inadequate maternal and child care, insufficient health services
and an unhealthy environment or lack of education and information [3]. The South African
National Food Consumption survey of 1999 showed that a large number of children had
inadequate intake of energy, vitamin A, vitamin C, thiamine, riboflavin, niacin, vitamin B6,
vitamin B12, folic acid and zinc [4]. It also showed that rural children were worse off than
those who lived in urban areas. Lemke stated that in South Africa, with regard to socioeconomic status, health status, household nutrition security and education, farm worker
households tended to be most vulnerable among all groups [5]. ITPs can play an important
part in alleviating hunger and malnutrition. They are important sources of micronutrients,
including vitamins A and C, iron and other nutrients, and are sometimes better nutritional
sources than modern vegetables [6]. Modernisation of South African rural communities has
led to people perceiving ITPs as inferior. Faber et al. reported that African leafy vegetables
(ALVs) were often regarded as a poor peoples food in South Africa [7]. Labels such as
backward knowledge have been linked to traditional vegetables and associated knowledge,
thus discouraging the youth from learning about them [8,9].
Knowledge of the use of indigenous plants needs urgent scientific investigation and
documentation before it is irreversibly lost to future generations [6]. Several studies in South
Africa have reported a decline in the use of ITPs [10-12]. However, Shackleton reported the
frequent use of wild edible herbs among rural communities [13]. Faber et al. [7] concluded
that availability and access to nutrition-related uses of ALVs are content-specific, with interand intra-provincial rural/urban differences. Different communities may have different
perceptions and beliefs about the ITPs that grow in their area and this affects the consumption
and use of the plants. Sensory characteristics of food, such as appearance, smell, texture and
taste, also play an important role in peoples decision to consume a particular food. Research
on the acceptability of food is needed to determine the impact of taste and preference on
dietary intake patterns of consumers that can be used to improve the general acceptance of
ITP foods [14].
As information collected during small studies within a specific area cannot be generalised to
the entire South African population, the objectives of this contextual study were to gain
insight into the parent [1] s knowledge and perceptions of and their use of ITPs in a farming
community in the North West Province and to assess childrens acceptance of and preference
for dishes made with ALVs and Swiss chard.
Methodology
Research design
The study was conducted in two phases. The first phase used a qualitative interpretive
description approach [15] to explore and describe parents knowledge and perceptions and
their use of ITPs. Household socio-demographic characteristics were also obtained from these
parents. The second phase used a quantitative cross-sectional approach in the form of sensory
evaluation to assess childrens acceptance of and preference for dishes made with ALVs and
Swiss chard.
Setting
The North West Province of South Africa is approximately 116 320 square kilometers in area
and almost all its rainfall occurs in the summer months between October and April. Average
rainfall of 539 mm per annum decreases from east to west. There is a short growing season
for frost-sensitive crops between October (last cold) and the end of April (first frost). Regular
droughts occur in this province. Sixty percent of the provinces 3.2 million inhabitants live in
rural areas [16,17]. According to the North West Province State of the Environment Report in
2002, mining and agriculture, including both crop cultivation and livestock production
systems, were the two most important economic sectors. In the same year, the estimated
unemployment rate was 38% and approximately a third of the population was illiterate [17].
According to Cloete et al., 53% of the population lives in poverty and 41% is economically
dependent on social funding from government [18]. The current study was conducted within
the infrastructure of two farm primary schools in a rural area approximately 50 kilometres
from Potchefstroom in the southeastern part of the North West Province (Figure 1). The
main farming activities in this area include maize, sunflower and chicken farming. Both these
primary schools were located in similar farm surroundings (with only very small shops, socalled tuck shops) and were fully sponsored by the South African Department of Education
and by the farm owners themselves. One school was situated approximately 25 kilometres
from an urban area with markets and grocery stores, the other school approximately 35
kilometres from such an area. Schools were chosen as entry point because they are closely
linked to the community.
Figure 1 Map indicating the study site in the North West Province of South Africa
(adapted from 17).
Ethical considerations
Ethical approval was granted by the Ethics Committee of the North-West University (NWU00033-09-A1). Permission to conduct the study was granted by the Department of Education
of the North West Province (Dr Kenneth Kaunda district) and the school governing bodies of
the two schools. Several parent meetings, in the preferred language of the parents, were held
at the school premises to explain the purpose and procedures of the study, and to answer any
questions that the parents had. Potential participants were invited to participate in the study
and were asked to sign an informed consent form (illiterate people made a cross in front of a
witness) agreeing that they themselves and their children would participate in the study. Only
children who obtained parental consent and gave assent for the study were included. Potential
participating parents were assured of data confidentiality and that the data would be used for
the sole purpose of the study. Participation was voluntary and the participants could withdraw
at any time without any consequences.
focus group meeting, the prospective participant was verbally informed about the research
again and invited to participate. If the prospective participant indicated not being available for
the focus group, a different parent was asked to participate. Although eight parents were
invited to participate per focus group, only one focus group consisted of eight participants.
The other three focus groups had seven participants each. Repetition in knowledge and
themes was noted after the third focus group discussion. The fourth focus group discussion
did not provide any significant new information, therefore no more parents were selected to
participate.
Data collection
Household socio-demographic characteristics data for the 29 parents participating in the
focus group discussions was collected by means of a structured questionnaire prior to the
focus group discussions.
The focus group discussions were held in a classroom at the two schools during school
holidays. The school environment was chosen in order to make participants feel that they
were in an environment to which they were already used. Transport was provided to get to
the schools. All participants received refreshments before and after the focus group
discussions and were given a small monetary incentive for their participation. Participants
were seated in a circle. This allowed them to see one another during the discussions and it
also encouraged a sense of group atmosphere and bonding. All focus groups were conducted
in the local language (Setswana), audio-recorded and transcribed verbatim. Each focus group
was conducted by an interviewer and an assistant moderator, responsible for operating the
tape, making observations and taking notes. A photo atlas from the South African
Agricultural Research Council with pictures of ITPs [20] was used to assist participants to
identify the ITPs and to connect the common names of the plants to their botanical names.
All botanical names used in this manuscript have been verified with the International Plant
Names Index and the World Checklist of Selected Plant Families [21,22].
The focus groups followed a semi-structured format to ensure accuracy in topics covered
across the different groups and still permit a certain level of flexibility within the group [23].
A discussion guide with six open-ended questions was designed to collect data on the
knowledge and use of ITPs. The interview guide was discussed with other experts in the
field, adjusted and pilot tested [24]. The following open-ended questions were included:
1.
2.
3.
4.
5.
6.
Can you tell me more about the indigenous and traditional plants in your
community/surroundings?
You have mentioned all these plants; let us talk about where you get them.
These plants, how do you use them?
These plants, how and why do you store them?
Please tell me more about the beliefs about these plants?
Please tell me more about your feelings and your views regarding these plants?
inhabitants of a region. In describing the results of the focus groups, it was important to
contextualize the term knowledge and use. Gadgil et al. defined knowledge as an
outcome of model-making about the functioning of the natural world. They further defined
indigenous knowledge as a cumulative body of knowledge and beliefs handed down through
generations by cultural transmission about survival and the relationship of beings (including
humans) with one another and their environment [25]. This definition of knowledge was
adapted to this study. In this context, parents were considered to be knowledgeable if they
could express or give any form of relevant information related to the topic of study. The term
use in this context referred to the purposes the ITPs served in the community and the
processes that were involved in preparation to serve their purpose.
Data analysis
Household socio-demographic characteristics data was analysed by means of descriptive
statistics using the IBM Statistical Package for Social Sciences (IBM SPSS 20.0 for
Windows). A quality check was carried out on the transcribed data of the focus groups by a
research assistant who was fluent in both English and Setswana, to ensure that the discussion
was correctly translated without the original meaning being lost in translation. The notes
taken during the focus group discussion by the assistant moderator were used to complement
the rich data. The transcripts were coded and analysed with Atlas.ti 6 computer software,
using the framework approach as described by Rabiee [26]. The coding of the transcripts was
done independently by two researchers (MvdH and JO). After the second focus group no new
codes were added. Differences between researchers were minimal and consensus was easily
reached.
Trustworthiness
The principle of trustworthiness was adhered to using the approach of Guba (in [27]). The
pilot study and the focus groups ensured prolonged engagement (truth value) with the
participants in this study. Truth value was further increased through triangulation of
investigators and sources. Applicability was ensured by conducting multiple focus groups,
using a detailed interview guide, encouraging participants to share their knowledge, the
saturation of data and a dense description of the methodology. Transferability was obtained
through purposive sampling and using direct quotations when presenting findings. The
establishment of an audit trial for stepwise replication of the research was possible and a cocoder was used during data analysis, ensuring consistency and neutrality.
ingredients were the same. These included tomatoes, onions, salt and vegetable oil. The
ALVs selected for this study and the recipe for the dishes were based on the results of
previous studies in the North West Province [28,29]. Sufficient samples of the five dishes
were prepared, transported to the study site and heated in a microwave oven in a standardized
manner. Each sample (numbered with three-digit random numbers) was served on a small,
white plate accompanied by a small spoon.
Table 1 Leafy vegetables used in dishes tested in sensory evaluation
Leafy vegetables used in dish
Common name
ALV: Amaranthus cruentus L. (100%)
Amaranth
ALV: Amaranthus cruentus L. (80%) and Cleome gynandra L.
Amaranth and
(20%)
spiderplant
ALV: Amaranthus cruentus L. (80%) and Cucurbita maxima
Amaranth and pumpkin
Lam.(20%)
ALV: Amaranthus cruentus L. (80%) and Vigna unguiculata (L.)
Amaranth and cowpea
Walp (20%)
Conventional vegetable: Beta vulgaris L.
Swiss chard
Score sheet
The procedure for sensory evaluation and the score sheet were standardised during a pilot
study conducted in one of the schools. The 10 randomly selected children (M/F: 5/5; 710
years) participating in the pilot study were excluded from participation in the sensory
evaluation. Chen et al. (1996) and Kroll (1990), both cited by Guinard [31], recommend
using hedonic scales with verbal anchors. The score sheet used a five-point ordinal scale,
ranging from super good (value = 5) to super bad (value = 1) (see Figure 2). The five-point
ordinal scale has an equal number of positive and negative categories and is often used in
consumer studies accommodating different language groups [32]. To avoid potential
comprehension problems the five-point ordinal scale was explained by the facilitator using
visual stimuli [31] in the form of a large lollipop (super good) and cod liver oil (super bad).
The score sheet also included a question on a potential preferred sample and a seven-point
food action rating scale to score consumption intent relating to each sample. This was done
by asking how many times per week the participant was willing to eat leafy vegetables [29].
From the pilot study it was evident that the participants understood the score sheet used.
Figure 2 Five-point ordinal scale used for sensory evaluation (adapted from 30).
Data analysis
Each verbal anchor used in the sensory evaluation was allocated a value ranging from super
good (value = 5) to super bad (value = 1). Mean values for the different attributes were
calculated. Data was found not to be normally distributed, therefore the Kruskal-Wallis,
MannWhitney U test and chi-square test for independence were performed using the IBM
Statistical Package for Social Sciences (IBM SPSS 20.0 for Windows), controlling for Type 1
error across tests by using the Bonferroni approach. A p-value of <0.05 was regarded as
significant.
Median
Range
3.0
2.0
0.0
3.0
1-7
0-5
0-2
1-7
Direct quotations from participants were included in the description of the findings in order to
give a richer description of the context. Results of the focus groups in general showed that the
participants appeared to be knowledgeable on various edible ITPs in their surroundings in
terms of their use.
Edible ITPs
The themes that emerged from the data with regard to the edible ITPs included availability
and access, preservation and storage, preparation and perceptions, including beliefs and
feelings.
Table 3 shows the edible ITPs identified by the participants. The most commonly used edible
plants were Amaranthus spp., commonly known as thepe, and Chenopodium album,
commonly known as senkgampapa. The parts of the plants that were mostly consumed were
the leaves. Participants referred to the leafy vegetables as morogo or wild spinach.
Vorster et al. reported that ITPs are still perceived as weeds by research and extension
personnel who criticize farmers for not keeping them under control [9]. Farmers and research
and extension personnel should thus be informed of the importance of these plants.
Participants indicated that the seasonal availability of most ITPs affected the frequency of
consumption. In addition, drought periods affect their availability as well. Ways of improving
the availability of ITPs during off-season and drought periods include using recycled water
[9] and collection of seeds of ITPs. Collection of seeds is not the current practice in rural
communities, where people rely on the plants self-sowing abilities of ITPs [35].
add more vegetables to it when you pour out the water that is when you
lose all the vitamins. If you fry it until it is golden, you will lose all the
nutrients and it will not be healthy for you you must time it properly so that
you do not overcook it and lose all the nutrients.
We wash it, put it in a pot, and boil it for maybe 30 minutes my
grandmother believed that you would drain out the vitamins. (The water was
not drained.)
It tends to be very bitter, so you have to drain it yes, it also has vitamins.
Draining and discarding the water used in cooking vegetables are likely to cause the loss of
water-soluble vitamins such as vitamin B complex and vitamin C [34]. It is therefore
important to educate this population on cooking methods that retain most of the nutritional
value of the ITPs.
and improving household food security in resource-poor households [34,39]. Matenge et al.
showed that consumption of these foods could be increased through education, increased
availability, marketing and gradual introduction to ITPs [29]. This, combined with a positive
attitude to ITPs, could benefit the promotion of ITPs. The concept of affordability should be
avoided or used carefully in marketing strategies, as some ethnic groups/cultures associate
these foods with poverty [7].
Transfer of knowledge
Several methods for preservation and storage had been passed on through generations, thus
indicating transfer of knowledge from one generation to another:
Back then, our mothers used to dry them and save them for the future.
In describing the cooking methods used for the various leafy ITPs, participants also indicated
that there was transfer of knowledge through generations and hence the practice had not
faded away completely:
I drain the water. Back home, my grandmother used to drain the water and
then add peanuts and some oil. My grandmother believed they add[ed] flavour
to the wild spinach and that peanuts were nutritious.
It is evident that the older generation in this population was seen as custodians of knowledge
related to ITPs, and they passed their knowledge on in the hope that it would be transferred
and not lost through generations. This finding was similar to the findings of a study
conducted by Shava in the Eastern Cape, who found the younger generation to have extensive
knowledge of ITPs in their surroundings, probably because of the close relationship they had
with the elderly people in their community [40].
The focus groups were female-dominated, usually including only one male, and as a result
females tended to dominate the discussions. However, the facilitator was able to insist on
male participation regularly, and as a result, the males were able to describe their knowledge
as well, thus avoiding bias. At times, some male participants were hesitant to make comments
because they associated some aspects of the discussions with female roles, for example,
cooking of food or the use of ITPs in the household. At times the older participants tended to
hold back as the younger participants dominated the discussions. One elderly woman said: I
just dont understand see the younger ones are managing well on their own with the
information. The group facilitator was able to bridge these gaps and get the older
participants more involved in the discussions as they went along. McLafferty stated that there
are several ways of creating homogeneity in focus groups. In explorative studies
homogeneity can also be classified according to status, class, occupation and other
characteristics instead of gender and age [41]. The homogeneity between the participants in
the focus groups was based on their role as parents of children and the person involved in
food preparation, since the main focus of this study was on knowledge and usage of ITPs. For
future studies, it may be more appropriate to separate the focus group participants by age and
gender.
Table 5 Sensory evaluation scores (mean SD) for different dishes made with leafy
vegetables
N Colour
Smell
Taste
Overall
Dish
a
a
a
100% Amaranth
77 3.83 1.13 3.66 1.22 3.53 1.34 3.82 1.44a
80% Amaranth + 20% Cowpea
80 4.05 0.98a 3.95 1.02a 3.50 1.45a 3.71 1.35a
80% Amaranth + 20% Pumpkin 79 3.85 1.16a 3.65 1.25a 3.33 1.47a 3.57 1.47a
80% Amaranth + 20% Spiderplant 78 3.83 1.19a 3.85 1.17a 3.31 1.41a 3.59 1.48a
100% Swiss chard
78 4.21 0.93a 4.33 0.94b 4.26 1.19b 4.38 1.13b
Score: five-point ordinal scale ranging from 5 (super good) to 1 (super bad). Dishes with
different superscript differed statistically significant (p < 0.005).
The dish made with Swiss chard was included as a reference dish, as it was expected that
children would be exposed to this vegetable more often at home and at school via the daily
cooked school meal. This was evident in the preference for the dish made with Swiss chard
with regard to smell and taste. Although the dish made with Swiss chard was preferred, the
four dishes made with ALVs were found to be of acceptable colour, smell and taste. These
results are promising for the inclusion of ALVs in childrens diet, particularly as Michicich et
al. found a positive correlation between liking and consumption [42]. Therefore, ALVs might
be successfully introduced into a school nutrition programme that has a limited budget per
school meal. Developing a range of recipes with different ingredients, as mentioned in the
focus group discussions, will add variety to the flavours of the dishes. ALVs have been
advocated as excellent sources of several micronutrients [6,7] and could potentially address
co-existing multiple micronutrient deficiencies in individuals. Edible ITPs can add variety to
the diets of people, especially those who do not have easy and regular access to markets or
other fresh produce.
Conclusion
This study indicated that there was not only a wealth of knowledge on various edible ITPs
and their use in this farm community, but traditionally prepared ALV dishes were also
sensorily acceptable to children. Edible ITPs were usually found growing on farms and fields
among cultivated crops, and their availability and accessibility were influenced by seasonality
and environmental conditions. Drying and storage methods for use during off-season periods
should be optimized to minimize nutrient losses. Edible ITPs were perceived as rich sources
of health-promoting nutrients and an affordable source of food and were appreciated for their
taste. Knowledge about edible ITPs was transferred from one generation to another. The
positive perceptions and knowledge of ITPs of the parents, and the childrens acceptance of
the taste of dishes made with ALVs indicate great potential for the promotion of ITPs as a
strategy for improved child nutrition. It also looks promising for future use of edible ITPs in,
for example, school feeding programmes. The researchers will be investigating the effect of
these ALVs as part of the school meal on the nutritional status of children. Results of this
study to date strongly indicate that compliance in the intervention study will be high.
Abbreviations
ALVs, African leafy vegetables; ITPs, Indigenous and traditional plants
Competing interests
The authors declare that they have no competing interests.
Authors contributions
MvdH: design; acquisition of data; analysis and interpretation of data; drafting the
manuscript. JO: acquisition of data; analysis and interpretation of data; drafting the
manuscript. MG: design; critical revision of manuscript for intellectual content. AK: critical
revision of manuscript for intellectual content. MF: design; critical revision of manuscript for
intellectual content. CMS: design; critical revision of manuscript for intellectual content. All
authors read and approved the final manuscript.
Authors information
MvdH is currently a PhD student in Nutrition at the Centre of Excellence for Nutrition (CEN)
at the North-West University, South Africa. She is studying the effect of African leafy
vegetables on the alleviation of micronutrient deficiencies in school children residing in the
North West Province of South Africa. She is also the research co-ordinator for the South
African leg of the Biodiversity study at Africa Unit for Transdisciplinary Health Research
(AUTHeR) at the same university. This transdisciplinary research aims to increase
agricultural biodiversity to improve nutritional and health status , as well as livelihoods and
to establish more sustainable production systems in the North West Province of South Africa.
JO is currently a PhD student in Nutrition at the CEN at the North-West University, South
Africa. Her PhD research is focused on iodine nutrition in mothers and their infants in the
North West Province, South Africa. She has just completed her MSc in Nutrition; her
research focused on the potential contribution of African leafy vegetables to the nutritional
status of school children residing in the North West Province of South Africa.
MG is a professor and senior researcher in the AUTHeR in the Faculty of Health Sciences of
the North-West University, South Africa. She holds an MCur and a PhD in Psychiatric
Nursing. She is an acknowledged researcher and has published extensively in national and
international scientific journals and presented her research findings at many national and
international conferences. Her research over the past few years has mainly focused on the
quality of life of people living with HIV and AIDS and HIV stigma reduction on a
community base. She is a South African nationally rated researcher and an inducted member
of the International Nurses Hall of Fame.
MF is a chief specialist scientist at the Medical Research Council and an extra-ordinary
professor at the University of the Western Cape as well as the University of Pretoria , South
Africa. She is an acknowledged researcher and her research over the past few years has
mainly focused on food-based approaches to address micronutrient malnutrition in children,
particularly in rural areas. Her research also covers aspects of food security and indigenous
foods.
CMS is a professor in nutrition and senior scientist in the CEN, North-West University, South
Africa. He is currently the president of the Nutrition Society of South Africa. He is a wellrecognised researcher and has an interest in the role of essential fatty acids in health and
disease, and the interactions between iron and essential fatty acids in cognitive development.
His research mostly targets vulnerable children residing in low socio-economic areas.
Acknowledgements
The authors would like to thank to the parents and their children for their contribution. Dr
Eva Manyedi is thanked for her contribution in facilitating the focus group discussions.
Mashudu Ramabulana, Mashudu Nndanduleni, and Martin Smit are thanked for their
contribution in naming the identified plants. Professor Magdalena J.C. Bosman and Dr
Annalien Dalton are thanked for their advice on the sensory evaluation. This research was
supported by a grant from the Program to Support Pro-poor Policy Development (PSPPD), a
partnership between the Presidency of South Africa and the European Union.
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