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Facilitators and barriers to the consumption of traditional foods among adults in Zimbabwe

Facilitators and barriers to the consumption of traditional foods among adults in Zimbabwe Background: Traditional foods have superior nutritional composition; however, they are largely absent from the Zimbabwean diet. Objective: To identify barriers and facilitators to the consumption of traditional foods among adults aged 18–69 years in Zimbabwe. Methods: An online-based cross-sectional survey was conducted among adults aged 18–69 years in Zimbabwe. The questionnaire was based on a socio-ecological model designed to assess barriers and facilitators at the individual, interpersonal, community, and national levels. Data were analysed using Microsoft Excel and SPSS version 20 software package. The level of significance was set at p < 0.05. Ethical approval was obtained from the Medical Research Coun- cil of Zimbabwe (MRCZ/B/1931). Results: The study enrolled 440 participants. Traditional food consumption was low in this population with only 9.3% consuming these foods daily. At the individual level, 44.4% of study participants mentioned their consumption of traditional foods is facilitated by generational factors, while the most important barrier at this level was the inconven- ience in accessing and preparing traditional foods (33.2%). At the community and national levels, the most important facilitator was family members (26.2%) and lack of environmental contaminants (38.9%), respectively, while most important barrier at the community and national levels was their residential location or residence (31.8%) and aggres- sive marketing of processed foods (47.8%), respectively. Conclusions: Consumption of traditional foods was low in general. Generational factors, family contribution, and food safety impact the consumption of traditional foods among adults in Zimbabwe. The food environment, particu- larly commercial advertising of alternative foods, is a deterrent. Therefore, interventions to promote the consumption of traditional foods must take into account these factors at every stage of the socio-ecological model. Keywords: Traditional food, Indigenous, Facilitators, Barriers, Zimbabwe complex and variable, still four dimensions to their defi - Introduction nition have been established: time, place, know-how, and Traditional and indigenous foods, by definition, include cultural meaning [2]. These cultural foods are passed on all wholesome foods that have social and cultural value from one generation to another [3] and were common in and preference, are accessible, prepared using local natu- societies before the modernisation and industrialisation ral ingredients, and are specific to a region or country [1]. “westernisation” [4]. There is a general surge in the inter - However, the concept of traditional food is very dynamic, est in traditional foods due to the increased awareness of the relationship between diet and non-communicable diseases (NCDs) [5] and communicable diseases like *Correspondence: pchopera@gmail.com Department of Nutrition, Dietetics and Food Sciences, University COVID-19 [6, 7]. of Zimbabwe, Mt Pleasant, PO Box MP 167, Harare, Zimbabwe © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/. Chopera et al. Journal of Ethnic Foods (2022) 9:5 Page 2 of 13 The traditional African diet is mainly plant-based con - lifestyles [9]. In Zimbabwe, there is now an increase sisting of small grains (millet and sorghum), dark green in the consumption of wheat, rice and maize products leafy vegetables, wild fruits, starchy stems, and root at the expense of traditional staple cereals, roots, and tubers. Though largely cereal-based, a few animal source tubers. Indigenous fruits and vegetables have been largely foods were added to the diet such as fish and game meat replaced by exotic fruits and vegetables in the common [8]. In Zimbabwe, traditional foods consist of small grains household [10]. eaten with a variety of boiled or fried wild vegetables, Most traditional foods have been shown to contain seeds, and or game meat (Table  1). The nutrition transi - healthy components such as antioxidants [11, 12]. In tion is characterised by increased consumption of pro- addition, the traditional and indigenous fruits and veg- cessed and energy-dense foods coupled with sedentary etables are usually drought resistant [13]. Subsisting Table 1 List of some common traditional foods in Zimbabwe Food group/type Scientific name English name Shona name Pictures of the foods Cereals Eleucinecoracana Finger millet Rukweza/ njera/ rapoko Pennisetum typhoides Pearl millet Mhunga Sorghum vulgare SorghumMapfunde Leafy Vegetables Phadeolus vulgaris Bean leafMunyemba brassica oleracea va Green vegetables Muriwo sabellica Vigna ungulculata Cowpeas leafMunyemba Tronchunda portugessa Covo Rugare Choper a et al. Journal of Ethnic Foods (2022) 9:5 Page 3 of 13 Table 1 (continued) Food group/type Scientific name English name Shona name Pictures of the foods Brassica juncea Mustard rape (canola) Ndakupuka/ tsunga Wild vegetables Cucurbita maxima Pumpkin leafMutikiti/ muboora Brassica napus Rape leaf Repi Chenopodium album Wild spinach Mubvunzandadya Beta vulgaris Silver spinachmundawarara Gynandropsis gynandra African spider herb Nyevhe/ nyovhi Amaranthus thunbergii Poor man’s spinachBonogwe/ terere Corchorus olitorius Bush okra Derere mainly on traditional diets, therefore, has the potential to Dietary changes over time can be influenced by many solve two problems, i.e.: (1) rising food insecurity due to factors such as geographical, environmental, social, and climate change effects (2) increase in non-communicable economic factors [14]. This may mean that complex diseases (NCDs). interactions such as migration, income, prices, individual Chopera et al. Journal of Ethnic Foods (2022) 9:5 Page 4 of 13 Table 1 (continued) Food group/type Scientific name English name Shona name Pictures of the foods Pulses, seeds, lentils Phasaolus vulgaris BeansKasungunyemba Phasaolus Vulgaris Sugar beans/common Bhinzi/ muchuru kidney beans/pinto beans Vigna unguiculata Cowpeas/black-eyed Nyemba peas Arachis hypogea Groundnuts/peanutNzungu Citruilus lanatus Melon seedsMhodzi dzemagaka Cucurbita maxima Pumpkin seedsMhodzi dzemanhanga Voandzeia subterranea Round Nyimo bean/groundnut Cajanus cajan Pigeon peaNdodzi Citrullus lanatus Watermelon seedsMhodzi wa mubvembe The food names were hugely informed by Gomez [32], the food pictures were obtained from www. google. com Choper a et al. Journal of Ethnic Foods (2022) 9:5 Page 5 of 13 preferences, beliefs, and cultural traditions influence food lesser extent [26]. Considering the rich biodiversity in choices continuously as they don’t remain static over Zimbabwe, communities should be encouraged to con- time. Nutrition transition, as a global event, has caused sume indigenous and traditional foods as part of the die- changes in the quality and quantity of food consumption tary diversification strategy for sustainable nutrition and patterns in many countries, races, social classes, and cul- health. tures. Zimbabwe is no exception. There is evidence that Therefore, this study was designed to assess the pat - nutrition transition comes with a rise in the prevalence terns, facilitators, and barriers to consumption of tradi- of diet-related NCDs such as obesity and type 2 diabetes tional and/or indigenous foods in Zimbabwe utilising mellitus [15]. a socio-ecological approach. The social-ecological Zimbabwe is a country experiencing rapid urbanisa- approach has been used to explore physical activity inter- tion. Furthermore, the country has seen an increase in ventions [27], promote healthy eating in schools [28] trends of diseases such as type 2 diabetes, cancer, and and to understand barriers and facilitators to consump- metabolic syndrome [16]. Zimbabwe’s Human Develop- tion of traditional foods by Gaudin et  al. [29, 30], and ment Index score in 2019 stood at 0.571 ranking it 150 Roudsari et al. [31]. The socio-ecological approach when out of 189 countries [17], while the Gender Inequality applied helps to clarify factors affecting traditional food Index score of Zimbabwe was 0.527, ranked it 129 out of consumption at each level of society and considers the 162 countries in 2019 [17]. Since the year 2000, the coun- complex interplay between individual, interpersonal, try has also registered a decline in some socio-economic community and environmental factors. indicators mainly attributed to economic recession, polit- ical challenges, and persistent climate-induced humani- Methods tarian crises [18] This is a huge threat to household food Study design and setting security and slows progress on the attainment of the Sus- The cross-sectional study utilized an online poll approach tainable Development Goals (SDGs) by 2030. to collect quantitative data from adults 18–69  years in Current climate adaptation strategies include animal Zimbabwe. The Southern African country is landlocked and crop diversification with emphasis on drought-toler - with 10 provinces and 61 administrative districts (Fig. 1). ant crops such as sorghum and millet [13]. These crops The population of Zimbabwe is 13 061 239 million that have largely been replaced by exotic crops were according to the 2012 census (ZIMSTAT) with about 40% part of African traditional diets for ages. Available evi- below the age of 45  years old and a proportion of males dence has shown that the reception or rejection of food and females of 48 and 52 per cent, respectively [33]. is a complex phenomenon, which is ever-changing and According to a 2012 Census report, 99.6% of the popu- variable. Furthermore, this multi-dimensional system is lation is of African origin. Although Zimbabwe has 16 influenced by an individual’s attitude and by individuals official languages, Shona and Ndebele are the main native interacting within a community in different contexts and languages, while English is the formal language widely over different periods [19]. Studies conducted in other used in administration, law, and schools. The literacy rate countries have revealed that personal factors that influ - is 94% [33]. ence eating patterns can include attitudes, beliefs, food preferences, self-efficacy, and biological changes, while Data collection and tools environmental factors can include the immediate social A questionnaire assessing the barriers and facilitators environment such as family, friends, and peer networks, to consumption of traditional foods was administered and other factors such as school, fast food outlets, street using a web-based survey hosted on the Survey monkey vendors, and social and cultural norms [20, 21]. There platform (SurveyMonkey, California, USA). The survey is a dearth of information concerning patterns and rea- language was English. The questions were based on two sons for traditional food consumption in Zimbabwe [22]. ecological models developed by Gaudin et  al. [29]. One The perceptions and attitudes around traditional food model in a series of concentric circles proposes possible consumption in other countries like South Africa are facilitators at the individual, interpersonal, community, well documented and reveal that these foods have been and environment/ national levels. The second model pro - regarded as poor man’s food hence the decreased popu- poses possible barriers at the same levels. The question - larity [23]. The few studies conducted in Zimbabwe have naire was pre-tested in a small group of adults before it looked at reasons for growing them and not consuming was circulated in the following manner; a department them. Traditional foods have been cultivated for subsist- mailing list was obtained and WhatsApp contacts of the ence purposes and to build resilience in local farming same individuals. The individuals were informed that this communities [24, 25] as well as in other African coun- was a pretest. Feedback was solicited on clarity of ques- tries. They also serve commercial purposes albeit to a tions, order of questions, skip patterns, timing, and task Chopera et al. Journal of Ethnic Foods (2022) 9:5 Page 6 of 13 Fig. 1 Map of Zimbabwe with provinces that took part in the survey. Source: https:// www. mappr. co/ polit ical- maps/ zimba bwe/ difficulty. Questions were adapted accordingly and the best described their body size with 1 being thinnest and 9 questionnaire was finalised. The survey tool was distrib - being the heaviest. uted to participants via known institutional mailing lists through partner organizations, and social media plat- Participants and sampling forms mainly WhatsApp, Facebook, and Twitter. Only All adults living in Zimbabwe aged between 18 and one response was allowed per device hence increasing 69 years were eligible for the study. The sample size was the reliability of the data. The questionnaire took approx - calculated using the Cochran formula using α = 0.05 imately 6 min to complete. and 95% significance level and 50% prevalence of tra - ditional foods consumption. A sample size of 384 was determined. After factoring in the non-responders’ rate Body Mass Index (BMI) and Silhouette matching test of 10%, the final sample size was adjusted to 427. A nine figural BMI-SMT (Body Mass Index-Silhouette Matching Test) was used to collect information on per- ceived anthropometry [34]. The participants were asked Ethics to choose one gender-based silhouette that they thought Ethical approval was obtained from the Medi- cal Research Council in Zimbabwe (MRCZ) Choper a et al. Journal of Ethnic Foods (2022) 9:5 Page 7 of 13 (MRCZ/B/1931). Electronic consent was sought from Table 2 Sociodemographic characteristics of the participants study participants through a consent question at the Variable n % beginning of the online questionnaire which asked par- Gender ticipants if they consented to participate in the survey. Male 126 30.7 Female 284 69.3 Data analysis Age category (years) Data were exported to SPSS version 20 (SPSS Inc. Chi- 18–30 190 47.6 cago, IL), coded, and cleaned. The Shapiro–Wilk test was 31–40 144 36.1 used to test for the normality of data. Continuous vari- 41–49 47 11.8 ables with a normal distribution were presented as means 50–69 18 4.5 and standard deviation, while categorical data were pre- Education level sented as frequencies and percentages. The Chi-square Ordinary level 6 1.5 test was used to explore associations between categorical Advanced level 16 3.9 variables and Fisher’s exact test when cell count was less Tertiary level 388 94.6 than 5. The level of significance was set at p < 0.05. Employment status Employed 282 68.9 Results Not employed 127 31.1 Characteristics of participants Residence The web-based survey was stopped in July 2020. A total Urban province 326 62.8 of 440 participants took part in the survey, the majority Rural province 98 37.2 were females (69.3%) and 30.7% were male. Most partici- Religion pants (94.6%) had attended university or tertiary college None 4 1 and 95.6% were Christians. The majority of the partici - Christian 389 95.6 pants (47.7%) were aged between 18 and 30  years with Muslim 1 0.2 the least representation from the age group 50–69  years ATR 4 1.0 (4.5%). The participants’ age ranged from 18 to 69  years Apostolic sect 4 1.0 (M = 32.2, SD = 9.3). Most of the participants (53.8%) Other 5 1.2 were from the capital city Harare (Table 2). ATR African Traditional Religion Traditional food consumption and sociodemographic characteristics Traditional food consumption was low in this popula- facilitating consumption. The most common facilita - tion with only 9.3% consuming these foods daily and tor at the interpersonal level was family (42.5%) mean- 20% never having consumed traditional foods (Table  3). ing traditional foods were part of the family diet due A large proportion of females (71.1%) consumed tradi- to influence from other members such as parents and tional foods daily compared to 28.9% of their male coun- siblings. At the community level, the most common terparts. There was however no significant difference facilitator was the influence of family and elders in the in frequency of consumption across gender (p = 0.05), community (26.2%) meaning the extended community age group (p = 0.89), education level (p = 0.36), resi- was playing a role in influencing individuals by ensur - dential status (p = 0.06), who the respondent lived with ing these foods are present at community and other (p = 0.91), nutritional status (p = 0.83), religion (p = 0.71) gatherings. At the national/environmental level, 38.9% and marital status (p = 0.32). There was a significant selected the reason that the assurance of the absence difference in frequency of consumption and employ - of contaminants such as mercury in traditional foods ment status (p = 0.004) with higher consumption in the would encourage them to eat. Most traditional foods employed group. are not processed commercially but through artisanal methods that are largely unregulated. The government and environmental bodies have a role to play in ensur- Facilitators of traditional food consumption ing that these foods are safe. The most common factor that facilitated traditional food consumption at the individual level was a cross- generational influence (44.4%) (Table  4). This meant Barriers to traditional food consumption that these foods had been successfully handed down The lack of convenience in the preparation of tradi - generations in about a third of the respondents and tional foods resulted in it being the most common bar- the presence of older generations in families was rier to traditional food consumption at the individual Chopera et al. Journal of Ethnic Foods (2022) 9:5 Page 8 of 13 Table 3 Traditional food consumption trends and selected participant characteristics Traditional food consumption frequency n (%) Never Once per month 1–2 times per week > 2 times per week > 3 times per week Daily P value Total 20 (4.9) 123 (30.1) 96 (23.5) 64 (15.6) 68 (16.6) 38 (9.3) Gender Male 4 (20) 41 (33.3) 23 (24) 29 (45.3) 17 (25.4) 11 (28.9) 0.05 female 16 (80) 82 (66.7) 73 (76) 35 (54.7) 50 (74.6) 27 (71.1) Age category in years 18–30 10 (52.6) 54 (44.3) 45 (46.9) 32 (51.6) 29 (46) 19 (54.3) 0.89 31–40 7 (36.8) 50 (41) 38 (39.6) 17 (27.4) 24 (38.1) 8 (22.9) 41–49 1 (5.3) 13 (10.7) 9 (9.4) 9 (14.5) 8 (12.7) 6 (17.1) 50–69 1 (5.3 5 (4.1) 4 (4.2) 4 (6.5) 2 (3.2) 2 (5.7) Education level Ordinary level 0 (0.0) 0 (0.0) 2 (2.1) 2 (3.1) 1 (1.5) 1(2.6) 0.36 Advanced level 1 (5.0) 3 (2.4) 6 (6.3) 3 (4.7) 3 (4.5) 0 (0.0) Tertiary level 19 (95.0) 120 (97.6) 88 (91.7) 88 (91.7) 63 (94.0) 37 (97.4) Employment status Employed 4 (70) 101 (82.1) 61 (63.5) 41 (65.1) 43 (64.2) 20 (52.6) 0.004* Not employed 6 (30) 22 (17.9) 35 (36.5) 22 (34.9) 24 (35.8) 18 (47.4) Province Urban 10 (55.6) 78 (70.9) 52 (58.4) 27 (46.6) 37 (60.7) 23 (65.7) 0.06 Rural 8 (44.4) 32 (29.1) 37 (41.6) 31 (53.4) 24 (39.3) 12 (34.3 Who do you stay with Family 17 (85.0) 105 (85.4) 83 (86.5) 60 (93.8) 61 (89.7) 34 (89.5) 0.91 Friends 0 (0.0) 1 (0.8) 1 (1.0) 0 (0.0) 0 (0.0) 0 (0.0) Alone 3 (15.0) 17 (13.8) 12 (12.5) 4 (6.3) 4 (10.5) 4 (10.5) Nutritional status Underweight 2 (10) 5 (4.1) 3 (3.1) 3 (4.7) 3 (4.4) 0 (0) 0.83 Normal 9 (45) 42 (34.1) 35 (36.5) 26 (40.6) 24 (35.3) 13 (34.2) Overweight 5(25) 56 (45.5) 45 (46.9) 27 (42.2) 35 (51.5) 19 (50) Obesity 4 (20) 20 (16.3) 13 (13.5) 8 (12.5) 6 (8.8) 6 (15.8) Religion None 1 (5.0) 1 (0.8) 1 (1.1) 0 (0.0) 1 (1.5) 0 (0.0) 0.72 Christian 18 (90.0) 117 (95.9) 92 (96.8) 60 (93.8) 63 (95.5) 37 (97.4) Muslim 0 (0.0) 0 (0.0) 0 (0.0) 1 (1.6) 0 (0.0) 0 (0.0) AFR 0 (0.0) 2 (1.6) 0 (0.0) 0 (0.0) 1 (1.5) 1 (2.6) Apostolic sect 0 (0.0) 1 (0.8) 1 (1.1) 2 (3.1) 0 (0.0) 0 (0.0) Other 1 (5.0) 1 (0.8) 1 (1.1) 1 (1.6) 1 (1.5) 0 (0.0) Marital status Single 10 (50.0) 52 (42.3) 45 (47.4) 31 (48.4) 27 (40.3) 25 (65.8) 0.32 Married 10 (50.0) 68 (55.3) 46 (48.4) 31 (48.4) 36 (53.7) 11 (28.9) Divorced 0 (0.0) 1 (0.8) 3 (3.2) 2 (3.1) 2 (3.0) 0 (0.0) Widowed 0 (0.0) 2 (1.6) 1 (1.1) 0 (0.0) 2 (3.0) 2 (5.3) ATR African Traditional Religion p value based on Pearson’s Chi-square test and Fisher’s exact test for cell counts < 5 *Significant at p < 0.05 level (33.2%). Proper preparation requires knowledge and highly prevalent in supermarkets for a variety of techni- skills that are normally passed on from older generations. cal reasons that include extreme levels of the drudgery Furthermore, most preparation methods are lengthy and associated with the current small grain production sys- cumbersome. Small grain products for example are not tems. This also affects availability at the household level. Choper a et al. Journal of Ethnic Foods (2022) 9:5 Page 9 of 13 Table 4 Facilitators and Barriers to traditional food consumption Table 4 (continued) Variable n % Variable n % Absence of government laws and regulations Pro- 84 26.9 Facilitators to traditional food consumption tecting traditional foods Individual level Sustainability not guaranteed 47 15.1 Generational 165 44.4 Environmental contaminants 13 4.2 Lifestyle 88 23.7 Aggressive marketing 149 47.8 Convenience 46 12.4 Absence of pro-traditional foods regional bodies 17 5.4 Preparation skills 19 5.1 Other 2 0.6 Cost 28 7.5 Other 26 7.0 Interpersonal level At the interpersonal level, it was noted that traditional Family influence 149 42.5 food consumption ‘not being a social norm’ was a barrier Peer influence 18 5.1 by 44.2% of the participants. Meaning that eating tradi- Social norms 45 12.8 tional foods was not the standard in and across families. Values 130 37.0 At the community level, the residential location was cited Other 9 2.6 by 31.8% of the respondents as a barrier. This meant that Community level for individuals residing in communities that have neither Family/elder contribution 87 26.2 access to such foods in the shops nor land to cultivate Social norms 42 12.7 these foods, frequent consumption was difficult. At the Community values 82 24.7 environmental level, 47.8% of participants responded to Residential location 50 15.1 the aggressive marketing of other foods as a major bar- Local business 51 15.4 rier to traditional food consumption. The increased vis - Other 20 6.0 ibility of for example fast foods meant traditional foods Environment level are largely ignored in most shopping baskets. This could Government regulations 67 20.9 be indicating the impact of evolving food systems, par- Sustainability 55 17.7 ticularly in urban areas. Adequate marketing 43 13.8 Environmental contaminants 121 38.9 Discussion Other 27 8.6 Traditional food consumption has gradually decreased Barriers to traditional food consumption over the years despite their health benefits. Therefore, Individual level this study set out to investigate the facilitators and bar- Generational 36 9.8 riers to traditional food consumption among adults aged Lifestyle and preferences 63 17.1 18–69 years in Zimbabwe. In this study, traditional food Convenience 122 33.2 consumption was low in this population. Contrary to our Skills of preparation 44 12.0 expectations being employed was positively associated Cost 82 22.3 with the consumption of traditional foods. For exam- Other 21 5.7 ple, due to their busy work schedules, due to “time scar- Interpersonal level city,” we would have expected low consumption among Lack of family influence 48 14.0 the working class [35]. Traditional dishes such as those Lack of peer influence 37 10.8 made from offals or cow hooves take hours to cook to a Not a social norm 152 44.2 softened texture. The processing of millet grains from Interpersonal values 66 19.2 thrashing to winnowing to pounding to make a thick sta- Other 41 11.9 ple called sadza is time-consuming and laborious. If not Community level done properly, the final product will end up with sand Lack of family support 71 21.7 grains thus unpleasant to eat. A study in Canada reported Not a social norm 53 16.2 the contrary that employment acts as both a facilitator Community values 19 5.8 and a barrier to traditional food consumption, rendering Residential location 104 31.8 the effect undetectable [30]. In Northern Quebec, Can - Local businesses not in support 68 20.8 ada employment status was a facilitator to consumption Other 12 3.7 of traditional foods probably due to access to disposable Environment level income [29]. However, on the contrary, parental employ- ment and work-life stress are normally associated with Chopera et al. Journal of Ethnic Foods (2022) 9:5 Page 10 of 13 a less healthy family food environment [36]. Previous Northern Quebec in Canada where non-convenience of studies have reported that urban dwellers are less likely traditional food was among the key barriers to the con- to consume indigenous foods as compared to their coun- sumption of traditional foods [29]. terparts in rural or peri-urban areas. So, the current find - The fact that people associate indigenous, native foods ing is interesting and encouraging within the premises with a long cooking time makes this a key barrier to the of promoting consumption of traditional foods in Zim- consumption of traditional dishes. Therefore, the decline babwe’s urban areas where consumption of traditional in the consumption of traditional foods could in Zim- foods tends to be driven by affordability. Promoting tra - babwe be a result of the failure by the older generations ditional food consumption through nutrition education to pass on the important traditional food preparation “demand creation” should be coupled with measures in and cooking skills and the advent of extensive market- the agriculture sector to conserve and/or cultivate the ing of ultra-processed “fast foods” targeting the younger traditional species. The government of Zimbabwe may generation. Young people are likely to have never been initiate the acquisition and management of germplasm of introduced to certain traditional foods, especially those indigenous and traditional varieties [37]. Therefore, mul - that have not made their way into the food markets. This tisectoral and collaborative research is warranted for the results in a subsequent preference of younger people to conservation of the traditional varieties owing to their fast foods as these tend to have aggressive marketing nutritional benefits. regimes. Still, our current results are encouraging considering that cost or affordability was not cited as a key barrier in Facilitators of traditional food consumption this study. This finding agrees with findings from South We found that the strongest facilitators were (1) cross- Africa that indeed traditional foods are regarded as “poor generational influence, (2) family support system, and man’s foods” [40]. Future studies are recommended to (3) food safety guarantees. A study in Cree in Canada explore the complex mechanisms underlying the decline also reported that individuals aged above 40  years were in the consumption of traditional foods to inform policy likely to consume traditional foods [30] This highlights and programming decisions. Studies have shown that the the importance of cross-generational influence as a facili - transmission of indigenous knowledge across genera- tating factor. In Zimbabwe, the old generation places tions is key in preserving the knowledge, attitudes, prac- more importance on traditional foods as compared to the tices, and perceptions around these foods [41]. In certain younger generation since the old generation grew up in countries and cultures, documentation has been astute rural areas and with an abundance of wild fruit and veg- to preserve the heritage around these foods [41–43]. We etables. The young generation is, therefore, less likely to recommend the same for Zimbabwe traditional foods. consume nutritious indigenous foods due to different Although not significant our results showed that a rela - exposures. These same findings were also reported in tively large fraction (34.2%) of the participants who con- Northern Quebec in Canada that traditional knowledge sumed traditional foods daily were of normal weight as was a key factor influencing traditional food consump - compared to only 15.8% who were obese. Although the tion in a Cree community [29]. Therefore, the current frequency of traditional food consumption might be an findings are important as they reveal that social behav - insufficiently sensitive factor to reveal an association, we iour change interventions aimed at promoting consump- postulate that consumption of traditional foods will likely tion of traditional foods should be built on pre-existing be associated with healthy eating and normal weight. For knowledge and practices, which may be more important example, in the Korean culture, traditional  food is nor- consumption motivators than introduced knowledge mally considered as the first medicine [44]. In addition, [38]. The overarching role of women in the process of studies conducted in South Africa [45] and Ethiopia [46] promoting traditional foods cannot be overemphasised reported that food security and dietary diversification [31, 39]. Therefore, considering the role of women in the can be attained by exploiting indigenous food species. household food choices, it is necessary to target women Therefore, future studies to investigate these associations in order to increase the traditional food consumption are warranted. patterns. The theoretical contribution of the study Barriers to traditional food consumption The ecological model by Gaudin et  al. [29] was used as The strongest barriers were (1) lack of convenience or the main theoretical background for our study. It allowed knowledge on traditional food preparation, (2) location most influencers and barriers to be categorised appropri - of the residential area, and (3) aggressive advertising of ately. This model provides an ideal framework that can processed foods. The same findings were also found in be applied to investigate traditional food consumption Choper a et al. Journal of Ethnic Foods (2022) 9:5 Page 11 of 13 Fig. 2 Framework for design of interventions on possible factors that influence consumption of traditional foods in Zimbabwe. Source: Author’s compilation especially among indigenous and minority populations from the ecological model, the ecological model makes [30]. In our results, the strongest facilitators came from use of concentric circles, however, here we propose a the individual and interpersonal level (generational, fam- different theoretical framework (order of concepts) and ily influence, convenience, and to a less extent skills) strength of influence as emerging from our data analysis (Fig. 2). These will have to be deliberately targeted in any (Fig. 2). Interventions targeted at facilitating uptake must interventions to promote increased consumption of tra- focus on the individual and interpersonal levels. On the ditional foods in this and related settings. These findings contrary, to create an enabling environment to eliminate agree with results reported by Roudsari et al. [31] in their inherent barriers to consumption of traditional foods, study about barriers and facilitators to traditional food interventions should focus on community and environ- choice by Iranian women. The concepts they identified mental levels. This framework can be used to direct pub - as barriers and facilitators were cultural context (custom- lic health nutrition efforts on the most influential level. ary beliefs, family teachings), social motivations (inter- The existing regional or provincial variations in Zimba - est of family members and prioritisation), convenience, bwe’s traditional cuisines should not be ignored in for- skills of food preparation, and religious considerations. mulating sustainable interventions [48]. Our study however did not consider the category of reli- gion. In a study by Blesic et  al. [47], the sensory appeal Limitations of the study was a key motivation for selecting a traditional food. This The major limitation of this study is that we used a self- was not reflected in our study. The authors also identi - administered online questionnaire. The sample size fied motivators such as convenience, price, familiarity, of participants may not be representative of the Zim- mood, and health concerns. These all appear to be facili - babwean population, the results indicated a clear bias tators at the individual level. Based on previous stud- towards individuals who reside in urban areas. However, ies’ theoretical constructs, we submit that religion and the results remain useful considering that this online sur- sensory appeal are strong determinants that should not vey was carried out during the peak of the COVID-19-in- be ignored in setting up interventions to promote tradi- duced lockdown where face-to-face enrolment was not tional food consumption. The strongest barriers in our possible further, the restrictive cost of mobile phone data study were identified at the community and environment could have attributed to the slight bias to the urban pop- levels (Fig.  2). Though we have used the same concepts ulation. In addition, the pandemic and control measures Chopera et al. Journal of Ethnic Foods (2022) 9:5 Page 12 of 13 2. Rocillo-Aquino Z, Cervantes-Escoto F, Leos-Rodríguez JA, Cruz-Delgado made it impossible to take anthropometric measure- D, Espinoza-Ortega A. What is a traditional food? Conceptual evolution ments such as weight, height, and waist circumference. from four dimensions. J Ethn Foods. 2021;8(1):38. https:// doi. org/ 10. 1186/ Although the BMI-SMT technique sufficed, it records s42779- 021- 00113-4. 3. Guerrero L, Guàrdia MD, Xicola J, Verbeke W, Vanhonacker F, Zakowska- what the individuals perceive to be their body size, not Biemans S, et al. Consumer-driven definition of traditional food products what exactly they weigh. It has however been recom- and innovation in traditional foods. A qualitative cross-cultural study. mended as a valid estimate of body perception [34]. Appetite. 2009;52(2):345–54. 4. Oghotomo JE. Impact of westernisation and industrialisation on traditional African and Mediterranean diet pattern and health. Thesis. Conclusions University of Zagreb; 2017. 5. Mihiranie S, Jayasinghe JK, Jayasinghe CVL, Wanasundara JPD. Indigenous Consumption of traditional foods was low in general. The and traditional foods of Sri Lanka. J Ethn Foods. 2020;7(1):42. https:// doi. majority of participants consumed traditional foods at org/ 10. 1186/ s42779- 020- 00075-z. least once a month despite these foods still being abun- 6. Zhou M, Zhang N, Zhang M, Ma G. Culture, eating behavior, and infec- tious disease control and prevention. J Ethn Foods. 2020;7(1):40. dant a scenario reflective of nutrition transition. Gen - 7. Skalkos D, Kosma IS, Vasiliou A, Guine RPF. Consumers’ trust in Greek tradi- erational factors, family contribution, and food safety tional foods in the post COVID-19 era. Sustainability. 2021;13(17):9975. impact the consumption of traditional foods among 8. Muyonga J, Nansereko S, Steenkamp I, Kanensi O. Traditional african foods and their potential to contribute to health and nutrition: In: Explor- adults in Zimbabwe. The time and cost required to pre - ing the nutrition and health benefits of functional foods. IGI Global; 2017. pare these foods largely result in them being abandoned 9. Baker P, Machado P, Santos T, Sievert K, Backholer K, Hadjikakou M, et al. for foreign, faster cooking foods. The food environment, Ultra-processed foods and the nutrition transition: global, regional and national trends, food systems transformations and political economy particularly commercial advertising of alternative foods, drivers. 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J Ethn Foods. 2019;6(1):4. https:// doi. org/ 10. 1186/ support for research data, including large and complex data types s42779- 019- 0003-9. • gold Open Access which fosters wider collaboration and increased citations 45. Rankoana SA. Indigenous plant foods of Dikgale community in South Africa. J Ethn Foods. 2021;8(1):5. https:// doi. org/ 10. 1186/ maximum visibility for your research: over 100M website views per year s42779- 021- 00080-w. 46. Tadesse NS, Beyene GF, Hordofa TB, Hailu AA. Traditional foods and bever- At BMC, research is always in progress. ages in Eastern Tigray of Ethiopia. J Ethn Foods. 2020;7(1):16. https:// doi. Learn more biomedcentral.com/submissions org/ 10. 1186/ s42779- 020- 00050-8. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Ethnic Foods Springer Journals

Facilitators and barriers to the consumption of traditional foods among adults in Zimbabwe

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Abstract

Background: Traditional foods have superior nutritional composition; however, they are largely absent from the Zimbabwean diet. Objective: To identify barriers and facilitators to the consumption of traditional foods among adults aged 18–69 years in Zimbabwe. Methods: An online-based cross-sectional survey was conducted among adults aged 18–69 years in Zimbabwe. The questionnaire was based on a socio-ecological model designed to assess barriers and facilitators at the individual, interpersonal, community, and national levels. Data were analysed using Microsoft Excel and SPSS version 20 software package. The level of significance was set at p < 0.05. Ethical approval was obtained from the Medical Research Coun- cil of Zimbabwe (MRCZ/B/1931). Results: The study enrolled 440 participants. Traditional food consumption was low in this population with only 9.3% consuming these foods daily. At the individual level, 44.4% of study participants mentioned their consumption of traditional foods is facilitated by generational factors, while the most important barrier at this level was the inconven- ience in accessing and preparing traditional foods (33.2%). At the community and national levels, the most important facilitator was family members (26.2%) and lack of environmental contaminants (38.9%), respectively, while most important barrier at the community and national levels was their residential location or residence (31.8%) and aggres- sive marketing of processed foods (47.8%), respectively. Conclusions: Consumption of traditional foods was low in general. Generational factors, family contribution, and food safety impact the consumption of traditional foods among adults in Zimbabwe. The food environment, particu- larly commercial advertising of alternative foods, is a deterrent. Therefore, interventions to promote the consumption of traditional foods must take into account these factors at every stage of the socio-ecological model. Keywords: Traditional food, Indigenous, Facilitators, Barriers, Zimbabwe complex and variable, still four dimensions to their defi - Introduction nition have been established: time, place, know-how, and Traditional and indigenous foods, by definition, include cultural meaning [2]. These cultural foods are passed on all wholesome foods that have social and cultural value from one generation to another [3] and were common in and preference, are accessible, prepared using local natu- societies before the modernisation and industrialisation ral ingredients, and are specific to a region or country [1]. “westernisation” [4]. There is a general surge in the inter - However, the concept of traditional food is very dynamic, est in traditional foods due to the increased awareness of the relationship between diet and non-communicable diseases (NCDs) [5] and communicable diseases like *Correspondence: pchopera@gmail.com Department of Nutrition, Dietetics and Food Sciences, University COVID-19 [6, 7]. of Zimbabwe, Mt Pleasant, PO Box MP 167, Harare, Zimbabwe © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/. Chopera et al. Journal of Ethnic Foods (2022) 9:5 Page 2 of 13 The traditional African diet is mainly plant-based con - lifestyles [9]. In Zimbabwe, there is now an increase sisting of small grains (millet and sorghum), dark green in the consumption of wheat, rice and maize products leafy vegetables, wild fruits, starchy stems, and root at the expense of traditional staple cereals, roots, and tubers. Though largely cereal-based, a few animal source tubers. Indigenous fruits and vegetables have been largely foods were added to the diet such as fish and game meat replaced by exotic fruits and vegetables in the common [8]. In Zimbabwe, traditional foods consist of small grains household [10]. eaten with a variety of boiled or fried wild vegetables, Most traditional foods have been shown to contain seeds, and or game meat (Table  1). The nutrition transi - healthy components such as antioxidants [11, 12]. In tion is characterised by increased consumption of pro- addition, the traditional and indigenous fruits and veg- cessed and energy-dense foods coupled with sedentary etables are usually drought resistant [13]. Subsisting Table 1 List of some common traditional foods in Zimbabwe Food group/type Scientific name English name Shona name Pictures of the foods Cereals Eleucinecoracana Finger millet Rukweza/ njera/ rapoko Pennisetum typhoides Pearl millet Mhunga Sorghum vulgare SorghumMapfunde Leafy Vegetables Phadeolus vulgaris Bean leafMunyemba brassica oleracea va Green vegetables Muriwo sabellica Vigna ungulculata Cowpeas leafMunyemba Tronchunda portugessa Covo Rugare Choper a et al. Journal of Ethnic Foods (2022) 9:5 Page 3 of 13 Table 1 (continued) Food group/type Scientific name English name Shona name Pictures of the foods Brassica juncea Mustard rape (canola) Ndakupuka/ tsunga Wild vegetables Cucurbita maxima Pumpkin leafMutikiti/ muboora Brassica napus Rape leaf Repi Chenopodium album Wild spinach Mubvunzandadya Beta vulgaris Silver spinachmundawarara Gynandropsis gynandra African spider herb Nyevhe/ nyovhi Amaranthus thunbergii Poor man’s spinachBonogwe/ terere Corchorus olitorius Bush okra Derere mainly on traditional diets, therefore, has the potential to Dietary changes over time can be influenced by many solve two problems, i.e.: (1) rising food insecurity due to factors such as geographical, environmental, social, and climate change effects (2) increase in non-communicable economic factors [14]. This may mean that complex diseases (NCDs). interactions such as migration, income, prices, individual Chopera et al. Journal of Ethnic Foods (2022) 9:5 Page 4 of 13 Table 1 (continued) Food group/type Scientific name English name Shona name Pictures of the foods Pulses, seeds, lentils Phasaolus vulgaris BeansKasungunyemba Phasaolus Vulgaris Sugar beans/common Bhinzi/ muchuru kidney beans/pinto beans Vigna unguiculata Cowpeas/black-eyed Nyemba peas Arachis hypogea Groundnuts/peanutNzungu Citruilus lanatus Melon seedsMhodzi dzemagaka Cucurbita maxima Pumpkin seedsMhodzi dzemanhanga Voandzeia subterranea Round Nyimo bean/groundnut Cajanus cajan Pigeon peaNdodzi Citrullus lanatus Watermelon seedsMhodzi wa mubvembe The food names were hugely informed by Gomez [32], the food pictures were obtained from www. google. com Choper a et al. Journal of Ethnic Foods (2022) 9:5 Page 5 of 13 preferences, beliefs, and cultural traditions influence food lesser extent [26]. Considering the rich biodiversity in choices continuously as they don’t remain static over Zimbabwe, communities should be encouraged to con- time. Nutrition transition, as a global event, has caused sume indigenous and traditional foods as part of the die- changes in the quality and quantity of food consumption tary diversification strategy for sustainable nutrition and patterns in many countries, races, social classes, and cul- health. tures. Zimbabwe is no exception. There is evidence that Therefore, this study was designed to assess the pat - nutrition transition comes with a rise in the prevalence terns, facilitators, and barriers to consumption of tradi- of diet-related NCDs such as obesity and type 2 diabetes tional and/or indigenous foods in Zimbabwe utilising mellitus [15]. a socio-ecological approach. The social-ecological Zimbabwe is a country experiencing rapid urbanisa- approach has been used to explore physical activity inter- tion. Furthermore, the country has seen an increase in ventions [27], promote healthy eating in schools [28] trends of diseases such as type 2 diabetes, cancer, and and to understand barriers and facilitators to consump- metabolic syndrome [16]. Zimbabwe’s Human Develop- tion of traditional foods by Gaudin et  al. [29, 30], and ment Index score in 2019 stood at 0.571 ranking it 150 Roudsari et al. [31]. The socio-ecological approach when out of 189 countries [17], while the Gender Inequality applied helps to clarify factors affecting traditional food Index score of Zimbabwe was 0.527, ranked it 129 out of consumption at each level of society and considers the 162 countries in 2019 [17]. Since the year 2000, the coun- complex interplay between individual, interpersonal, try has also registered a decline in some socio-economic community and environmental factors. indicators mainly attributed to economic recession, polit- ical challenges, and persistent climate-induced humani- Methods tarian crises [18] This is a huge threat to household food Study design and setting security and slows progress on the attainment of the Sus- The cross-sectional study utilized an online poll approach tainable Development Goals (SDGs) by 2030. to collect quantitative data from adults 18–69  years in Current climate adaptation strategies include animal Zimbabwe. The Southern African country is landlocked and crop diversification with emphasis on drought-toler - with 10 provinces and 61 administrative districts (Fig. 1). ant crops such as sorghum and millet [13]. These crops The population of Zimbabwe is 13 061 239 million that have largely been replaced by exotic crops were according to the 2012 census (ZIMSTAT) with about 40% part of African traditional diets for ages. Available evi- below the age of 45  years old and a proportion of males dence has shown that the reception or rejection of food and females of 48 and 52 per cent, respectively [33]. is a complex phenomenon, which is ever-changing and According to a 2012 Census report, 99.6% of the popu- variable. Furthermore, this multi-dimensional system is lation is of African origin. Although Zimbabwe has 16 influenced by an individual’s attitude and by individuals official languages, Shona and Ndebele are the main native interacting within a community in different contexts and languages, while English is the formal language widely over different periods [19]. Studies conducted in other used in administration, law, and schools. The literacy rate countries have revealed that personal factors that influ - is 94% [33]. ence eating patterns can include attitudes, beliefs, food preferences, self-efficacy, and biological changes, while Data collection and tools environmental factors can include the immediate social A questionnaire assessing the barriers and facilitators environment such as family, friends, and peer networks, to consumption of traditional foods was administered and other factors such as school, fast food outlets, street using a web-based survey hosted on the Survey monkey vendors, and social and cultural norms [20, 21]. There platform (SurveyMonkey, California, USA). The survey is a dearth of information concerning patterns and rea- language was English. The questions were based on two sons for traditional food consumption in Zimbabwe [22]. ecological models developed by Gaudin et  al. [29]. One The perceptions and attitudes around traditional food model in a series of concentric circles proposes possible consumption in other countries like South Africa are facilitators at the individual, interpersonal, community, well documented and reveal that these foods have been and environment/ national levels. The second model pro - regarded as poor man’s food hence the decreased popu- poses possible barriers at the same levels. The question - larity [23]. The few studies conducted in Zimbabwe have naire was pre-tested in a small group of adults before it looked at reasons for growing them and not consuming was circulated in the following manner; a department them. Traditional foods have been cultivated for subsist- mailing list was obtained and WhatsApp contacts of the ence purposes and to build resilience in local farming same individuals. The individuals were informed that this communities [24, 25] as well as in other African coun- was a pretest. Feedback was solicited on clarity of ques- tries. They also serve commercial purposes albeit to a tions, order of questions, skip patterns, timing, and task Chopera et al. Journal of Ethnic Foods (2022) 9:5 Page 6 of 13 Fig. 1 Map of Zimbabwe with provinces that took part in the survey. Source: https:// www. mappr. co/ polit ical- maps/ zimba bwe/ difficulty. Questions were adapted accordingly and the best described their body size with 1 being thinnest and 9 questionnaire was finalised. The survey tool was distrib - being the heaviest. uted to participants via known institutional mailing lists through partner organizations, and social media plat- Participants and sampling forms mainly WhatsApp, Facebook, and Twitter. Only All adults living in Zimbabwe aged between 18 and one response was allowed per device hence increasing 69 years were eligible for the study. The sample size was the reliability of the data. The questionnaire took approx - calculated using the Cochran formula using α = 0.05 imately 6 min to complete. and 95% significance level and 50% prevalence of tra - ditional foods consumption. A sample size of 384 was determined. After factoring in the non-responders’ rate Body Mass Index (BMI) and Silhouette matching test of 10%, the final sample size was adjusted to 427. A nine figural BMI-SMT (Body Mass Index-Silhouette Matching Test) was used to collect information on per- ceived anthropometry [34]. The participants were asked Ethics to choose one gender-based silhouette that they thought Ethical approval was obtained from the Medi- cal Research Council in Zimbabwe (MRCZ) Choper a et al. Journal of Ethnic Foods (2022) 9:5 Page 7 of 13 (MRCZ/B/1931). Electronic consent was sought from Table 2 Sociodemographic characteristics of the participants study participants through a consent question at the Variable n % beginning of the online questionnaire which asked par- Gender ticipants if they consented to participate in the survey. Male 126 30.7 Female 284 69.3 Data analysis Age category (years) Data were exported to SPSS version 20 (SPSS Inc. Chi- 18–30 190 47.6 cago, IL), coded, and cleaned. The Shapiro–Wilk test was 31–40 144 36.1 used to test for the normality of data. Continuous vari- 41–49 47 11.8 ables with a normal distribution were presented as means 50–69 18 4.5 and standard deviation, while categorical data were pre- Education level sented as frequencies and percentages. The Chi-square Ordinary level 6 1.5 test was used to explore associations between categorical Advanced level 16 3.9 variables and Fisher’s exact test when cell count was less Tertiary level 388 94.6 than 5. The level of significance was set at p < 0.05. Employment status Employed 282 68.9 Results Not employed 127 31.1 Characteristics of participants Residence The web-based survey was stopped in July 2020. A total Urban province 326 62.8 of 440 participants took part in the survey, the majority Rural province 98 37.2 were females (69.3%) and 30.7% were male. Most partici- Religion pants (94.6%) had attended university or tertiary college None 4 1 and 95.6% were Christians. The majority of the partici - Christian 389 95.6 pants (47.7%) were aged between 18 and 30  years with Muslim 1 0.2 the least representation from the age group 50–69  years ATR 4 1.0 (4.5%). The participants’ age ranged from 18 to 69  years Apostolic sect 4 1.0 (M = 32.2, SD = 9.3). Most of the participants (53.8%) Other 5 1.2 were from the capital city Harare (Table 2). ATR African Traditional Religion Traditional food consumption and sociodemographic characteristics Traditional food consumption was low in this popula- facilitating consumption. The most common facilita - tion with only 9.3% consuming these foods daily and tor at the interpersonal level was family (42.5%) mean- 20% never having consumed traditional foods (Table  3). ing traditional foods were part of the family diet due A large proportion of females (71.1%) consumed tradi- to influence from other members such as parents and tional foods daily compared to 28.9% of their male coun- siblings. At the community level, the most common terparts. There was however no significant difference facilitator was the influence of family and elders in the in frequency of consumption across gender (p = 0.05), community (26.2%) meaning the extended community age group (p = 0.89), education level (p = 0.36), resi- was playing a role in influencing individuals by ensur - dential status (p = 0.06), who the respondent lived with ing these foods are present at community and other (p = 0.91), nutritional status (p = 0.83), religion (p = 0.71) gatherings. At the national/environmental level, 38.9% and marital status (p = 0.32). There was a significant selected the reason that the assurance of the absence difference in frequency of consumption and employ - of contaminants such as mercury in traditional foods ment status (p = 0.004) with higher consumption in the would encourage them to eat. Most traditional foods employed group. are not processed commercially but through artisanal methods that are largely unregulated. The government and environmental bodies have a role to play in ensur- Facilitators of traditional food consumption ing that these foods are safe. The most common factor that facilitated traditional food consumption at the individual level was a cross- generational influence (44.4%) (Table  4). This meant Barriers to traditional food consumption that these foods had been successfully handed down The lack of convenience in the preparation of tradi - generations in about a third of the respondents and tional foods resulted in it being the most common bar- the presence of older generations in families was rier to traditional food consumption at the individual Chopera et al. Journal of Ethnic Foods (2022) 9:5 Page 8 of 13 Table 3 Traditional food consumption trends and selected participant characteristics Traditional food consumption frequency n (%) Never Once per month 1–2 times per week > 2 times per week > 3 times per week Daily P value Total 20 (4.9) 123 (30.1) 96 (23.5) 64 (15.6) 68 (16.6) 38 (9.3) Gender Male 4 (20) 41 (33.3) 23 (24) 29 (45.3) 17 (25.4) 11 (28.9) 0.05 female 16 (80) 82 (66.7) 73 (76) 35 (54.7) 50 (74.6) 27 (71.1) Age category in years 18–30 10 (52.6) 54 (44.3) 45 (46.9) 32 (51.6) 29 (46) 19 (54.3) 0.89 31–40 7 (36.8) 50 (41) 38 (39.6) 17 (27.4) 24 (38.1) 8 (22.9) 41–49 1 (5.3) 13 (10.7) 9 (9.4) 9 (14.5) 8 (12.7) 6 (17.1) 50–69 1 (5.3 5 (4.1) 4 (4.2) 4 (6.5) 2 (3.2) 2 (5.7) Education level Ordinary level 0 (0.0) 0 (0.0) 2 (2.1) 2 (3.1) 1 (1.5) 1(2.6) 0.36 Advanced level 1 (5.0) 3 (2.4) 6 (6.3) 3 (4.7) 3 (4.5) 0 (0.0) Tertiary level 19 (95.0) 120 (97.6) 88 (91.7) 88 (91.7) 63 (94.0) 37 (97.4) Employment status Employed 4 (70) 101 (82.1) 61 (63.5) 41 (65.1) 43 (64.2) 20 (52.6) 0.004* Not employed 6 (30) 22 (17.9) 35 (36.5) 22 (34.9) 24 (35.8) 18 (47.4) Province Urban 10 (55.6) 78 (70.9) 52 (58.4) 27 (46.6) 37 (60.7) 23 (65.7) 0.06 Rural 8 (44.4) 32 (29.1) 37 (41.6) 31 (53.4) 24 (39.3) 12 (34.3 Who do you stay with Family 17 (85.0) 105 (85.4) 83 (86.5) 60 (93.8) 61 (89.7) 34 (89.5) 0.91 Friends 0 (0.0) 1 (0.8) 1 (1.0) 0 (0.0) 0 (0.0) 0 (0.0) Alone 3 (15.0) 17 (13.8) 12 (12.5) 4 (6.3) 4 (10.5) 4 (10.5) Nutritional status Underweight 2 (10) 5 (4.1) 3 (3.1) 3 (4.7) 3 (4.4) 0 (0) 0.83 Normal 9 (45) 42 (34.1) 35 (36.5) 26 (40.6) 24 (35.3) 13 (34.2) Overweight 5(25) 56 (45.5) 45 (46.9) 27 (42.2) 35 (51.5) 19 (50) Obesity 4 (20) 20 (16.3) 13 (13.5) 8 (12.5) 6 (8.8) 6 (15.8) Religion None 1 (5.0) 1 (0.8) 1 (1.1) 0 (0.0) 1 (1.5) 0 (0.0) 0.72 Christian 18 (90.0) 117 (95.9) 92 (96.8) 60 (93.8) 63 (95.5) 37 (97.4) Muslim 0 (0.0) 0 (0.0) 0 (0.0) 1 (1.6) 0 (0.0) 0 (0.0) AFR 0 (0.0) 2 (1.6) 0 (0.0) 0 (0.0) 1 (1.5) 1 (2.6) Apostolic sect 0 (0.0) 1 (0.8) 1 (1.1) 2 (3.1) 0 (0.0) 0 (0.0) Other 1 (5.0) 1 (0.8) 1 (1.1) 1 (1.6) 1 (1.5) 0 (0.0) Marital status Single 10 (50.0) 52 (42.3) 45 (47.4) 31 (48.4) 27 (40.3) 25 (65.8) 0.32 Married 10 (50.0) 68 (55.3) 46 (48.4) 31 (48.4) 36 (53.7) 11 (28.9) Divorced 0 (0.0) 1 (0.8) 3 (3.2) 2 (3.1) 2 (3.0) 0 (0.0) Widowed 0 (0.0) 2 (1.6) 1 (1.1) 0 (0.0) 2 (3.0) 2 (5.3) ATR African Traditional Religion p value based on Pearson’s Chi-square test and Fisher’s exact test for cell counts < 5 *Significant at p < 0.05 level (33.2%). Proper preparation requires knowledge and highly prevalent in supermarkets for a variety of techni- skills that are normally passed on from older generations. cal reasons that include extreme levels of the drudgery Furthermore, most preparation methods are lengthy and associated with the current small grain production sys- cumbersome. Small grain products for example are not tems. This also affects availability at the household level. Choper a et al. Journal of Ethnic Foods (2022) 9:5 Page 9 of 13 Table 4 Facilitators and Barriers to traditional food consumption Table 4 (continued) Variable n % Variable n % Absence of government laws and regulations Pro- 84 26.9 Facilitators to traditional food consumption tecting traditional foods Individual level Sustainability not guaranteed 47 15.1 Generational 165 44.4 Environmental contaminants 13 4.2 Lifestyle 88 23.7 Aggressive marketing 149 47.8 Convenience 46 12.4 Absence of pro-traditional foods regional bodies 17 5.4 Preparation skills 19 5.1 Other 2 0.6 Cost 28 7.5 Other 26 7.0 Interpersonal level At the interpersonal level, it was noted that traditional Family influence 149 42.5 food consumption ‘not being a social norm’ was a barrier Peer influence 18 5.1 by 44.2% of the participants. Meaning that eating tradi- Social norms 45 12.8 tional foods was not the standard in and across families. Values 130 37.0 At the community level, the residential location was cited Other 9 2.6 by 31.8% of the respondents as a barrier. This meant that Community level for individuals residing in communities that have neither Family/elder contribution 87 26.2 access to such foods in the shops nor land to cultivate Social norms 42 12.7 these foods, frequent consumption was difficult. At the Community values 82 24.7 environmental level, 47.8% of participants responded to Residential location 50 15.1 the aggressive marketing of other foods as a major bar- Local business 51 15.4 rier to traditional food consumption. The increased vis - Other 20 6.0 ibility of for example fast foods meant traditional foods Environment level are largely ignored in most shopping baskets. This could Government regulations 67 20.9 be indicating the impact of evolving food systems, par- Sustainability 55 17.7 ticularly in urban areas. Adequate marketing 43 13.8 Environmental contaminants 121 38.9 Discussion Other 27 8.6 Traditional food consumption has gradually decreased Barriers to traditional food consumption over the years despite their health benefits. Therefore, Individual level this study set out to investigate the facilitators and bar- Generational 36 9.8 riers to traditional food consumption among adults aged Lifestyle and preferences 63 17.1 18–69 years in Zimbabwe. In this study, traditional food Convenience 122 33.2 consumption was low in this population. Contrary to our Skills of preparation 44 12.0 expectations being employed was positively associated Cost 82 22.3 with the consumption of traditional foods. For exam- Other 21 5.7 ple, due to their busy work schedules, due to “time scar- Interpersonal level city,” we would have expected low consumption among Lack of family influence 48 14.0 the working class [35]. Traditional dishes such as those Lack of peer influence 37 10.8 made from offals or cow hooves take hours to cook to a Not a social norm 152 44.2 softened texture. The processing of millet grains from Interpersonal values 66 19.2 thrashing to winnowing to pounding to make a thick sta- Other 41 11.9 ple called sadza is time-consuming and laborious. If not Community level done properly, the final product will end up with sand Lack of family support 71 21.7 grains thus unpleasant to eat. A study in Canada reported Not a social norm 53 16.2 the contrary that employment acts as both a facilitator Community values 19 5.8 and a barrier to traditional food consumption, rendering Residential location 104 31.8 the effect undetectable [30]. In Northern Quebec, Can - Local businesses not in support 68 20.8 ada employment status was a facilitator to consumption Other 12 3.7 of traditional foods probably due to access to disposable Environment level income [29]. However, on the contrary, parental employ- ment and work-life stress are normally associated with Chopera et al. Journal of Ethnic Foods (2022) 9:5 Page 10 of 13 a less healthy family food environment [36]. Previous Northern Quebec in Canada where non-convenience of studies have reported that urban dwellers are less likely traditional food was among the key barriers to the con- to consume indigenous foods as compared to their coun- sumption of traditional foods [29]. terparts in rural or peri-urban areas. So, the current find - The fact that people associate indigenous, native foods ing is interesting and encouraging within the premises with a long cooking time makes this a key barrier to the of promoting consumption of traditional foods in Zim- consumption of traditional dishes. Therefore, the decline babwe’s urban areas where consumption of traditional in the consumption of traditional foods could in Zim- foods tends to be driven by affordability. Promoting tra - babwe be a result of the failure by the older generations ditional food consumption through nutrition education to pass on the important traditional food preparation “demand creation” should be coupled with measures in and cooking skills and the advent of extensive market- the agriculture sector to conserve and/or cultivate the ing of ultra-processed “fast foods” targeting the younger traditional species. The government of Zimbabwe may generation. Young people are likely to have never been initiate the acquisition and management of germplasm of introduced to certain traditional foods, especially those indigenous and traditional varieties [37]. Therefore, mul - that have not made their way into the food markets. This tisectoral and collaborative research is warranted for the results in a subsequent preference of younger people to conservation of the traditional varieties owing to their fast foods as these tend to have aggressive marketing nutritional benefits. regimes. Still, our current results are encouraging considering that cost or affordability was not cited as a key barrier in Facilitators of traditional food consumption this study. This finding agrees with findings from South We found that the strongest facilitators were (1) cross- Africa that indeed traditional foods are regarded as “poor generational influence, (2) family support system, and man’s foods” [40]. Future studies are recommended to (3) food safety guarantees. A study in Cree in Canada explore the complex mechanisms underlying the decline also reported that individuals aged above 40  years were in the consumption of traditional foods to inform policy likely to consume traditional foods [30] This highlights and programming decisions. Studies have shown that the the importance of cross-generational influence as a facili - transmission of indigenous knowledge across genera- tating factor. In Zimbabwe, the old generation places tions is key in preserving the knowledge, attitudes, prac- more importance on traditional foods as compared to the tices, and perceptions around these foods [41]. In certain younger generation since the old generation grew up in countries and cultures, documentation has been astute rural areas and with an abundance of wild fruit and veg- to preserve the heritage around these foods [41–43]. We etables. The young generation is, therefore, less likely to recommend the same for Zimbabwe traditional foods. consume nutritious indigenous foods due to different Although not significant our results showed that a rela - exposures. These same findings were also reported in tively large fraction (34.2%) of the participants who con- Northern Quebec in Canada that traditional knowledge sumed traditional foods daily were of normal weight as was a key factor influencing traditional food consump - compared to only 15.8% who were obese. Although the tion in a Cree community [29]. Therefore, the current frequency of traditional food consumption might be an findings are important as they reveal that social behav - insufficiently sensitive factor to reveal an association, we iour change interventions aimed at promoting consump- postulate that consumption of traditional foods will likely tion of traditional foods should be built on pre-existing be associated with healthy eating and normal weight. For knowledge and practices, which may be more important example, in the Korean culture, traditional  food is nor- consumption motivators than introduced knowledge mally considered as the first medicine [44]. In addition, [38]. The overarching role of women in the process of studies conducted in South Africa [45] and Ethiopia [46] promoting traditional foods cannot be overemphasised reported that food security and dietary diversification [31, 39]. Therefore, considering the role of women in the can be attained by exploiting indigenous food species. household food choices, it is necessary to target women Therefore, future studies to investigate these associations in order to increase the traditional food consumption are warranted. patterns. The theoretical contribution of the study Barriers to traditional food consumption The ecological model by Gaudin et  al. [29] was used as The strongest barriers were (1) lack of convenience or the main theoretical background for our study. It allowed knowledge on traditional food preparation, (2) location most influencers and barriers to be categorised appropri - of the residential area, and (3) aggressive advertising of ately. This model provides an ideal framework that can processed foods. The same findings were also found in be applied to investigate traditional food consumption Choper a et al. Journal of Ethnic Foods (2022) 9:5 Page 11 of 13 Fig. 2 Framework for design of interventions on possible factors that influence consumption of traditional foods in Zimbabwe. Source: Author’s compilation especially among indigenous and minority populations from the ecological model, the ecological model makes [30]. In our results, the strongest facilitators came from use of concentric circles, however, here we propose a the individual and interpersonal level (generational, fam- different theoretical framework (order of concepts) and ily influence, convenience, and to a less extent skills) strength of influence as emerging from our data analysis (Fig. 2). These will have to be deliberately targeted in any (Fig. 2). Interventions targeted at facilitating uptake must interventions to promote increased consumption of tra- focus on the individual and interpersonal levels. On the ditional foods in this and related settings. These findings contrary, to create an enabling environment to eliminate agree with results reported by Roudsari et al. [31] in their inherent barriers to consumption of traditional foods, study about barriers and facilitators to traditional food interventions should focus on community and environ- choice by Iranian women. The concepts they identified mental levels. This framework can be used to direct pub - as barriers and facilitators were cultural context (custom- lic health nutrition efforts on the most influential level. ary beliefs, family teachings), social motivations (inter- The existing regional or provincial variations in Zimba - est of family members and prioritisation), convenience, bwe’s traditional cuisines should not be ignored in for- skills of food preparation, and religious considerations. mulating sustainable interventions [48]. Our study however did not consider the category of reli- gion. In a study by Blesic et  al. [47], the sensory appeal Limitations of the study was a key motivation for selecting a traditional food. This The major limitation of this study is that we used a self- was not reflected in our study. The authors also identi - administered online questionnaire. The sample size fied motivators such as convenience, price, familiarity, of participants may not be representative of the Zim- mood, and health concerns. These all appear to be facili - babwean population, the results indicated a clear bias tators at the individual level. Based on previous stud- towards individuals who reside in urban areas. However, ies’ theoretical constructs, we submit that religion and the results remain useful considering that this online sur- sensory appeal are strong determinants that should not vey was carried out during the peak of the COVID-19-in- be ignored in setting up interventions to promote tradi- duced lockdown where face-to-face enrolment was not tional food consumption. The strongest barriers in our possible further, the restrictive cost of mobile phone data study were identified at the community and environment could have attributed to the slight bias to the urban pop- levels (Fig.  2). Though we have used the same concepts ulation. In addition, the pandemic and control measures Chopera et al. Journal of Ethnic Foods (2022) 9:5 Page 12 of 13 2. Rocillo-Aquino Z, Cervantes-Escoto F, Leos-Rodríguez JA, Cruz-Delgado made it impossible to take anthropometric measure- D, Espinoza-Ortega A. What is a traditional food? Conceptual evolution ments such as weight, height, and waist circumference. from four dimensions. J Ethn Foods. 2021;8(1):38. https:// doi. org/ 10. 1186/ Although the BMI-SMT technique sufficed, it records s42779- 021- 00113-4. 3. Guerrero L, Guàrdia MD, Xicola J, Verbeke W, Vanhonacker F, Zakowska- what the individuals perceive to be their body size, not Biemans S, et al. 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Journal of Ethnic FoodsSpringer Journals

Published: Feb 19, 2022

Keywords: Traditional food; Indigenous; Facilitators; Barriers; Zimbabwe

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