The impact of dietary habits and nutritional deficiencies in urban African patients living with heart failure in Soweto, South Africa--a review.

In South Africa, rapid urbanisation and epidemiological transition have left the black urban population vulnerable to diseases of lifestyle such as diabetes, high blood pressure, obesity and heart disease, as well as chronic heart failure. This is in part due to the fact that changes in dietary patterns during urbanisation play an important role in the increase of risk factors of these diseases. The South African population is made up of many different ethnic and cultural groups, each with its own way of eating and food choices. The black African population is one such an ethnic group, with its own distinct eating patterns and food choices. The diets of people living in rural areas tend to still be higher in carbohydrates, lower in fat, lower in sugar and higher in fibre, corresponding to the more traditional way of eating. With urbanisation their diet has changed to a more westernised diet with the resultant decrease in carbohydrates and fibre and an increased fat, processed food and salt consumption. Factors that might contribute to this change in dietary patterns include lack of awareness and knowledge around nutritional recommendations for persons suffering from chronic heart failure, urbanisation, socio-economic circumstances, food insecurity and level of education. Nutritional recommendations and intervention programs for the prevention and management of CHF focusing on food that is culturally sensitive and affordable should be implemented.