**1. Introduction and background**

Poverty and hunger related issues have been paramount concern of humanity. Poverty has been identified as a complex problem affecting nearly 700 million people across the globe, of whom 422 million or > 70% live in the world's poorest region—Sub-Saharan Africa [1]. Current estimates by the World Bank are that between 2020 and 2021, the pandemic nature of the severe acute respiratory

syndrome coronavirus 2 (SARS-CoV-2), fondly known as COVID-19 disease which is ravaging the global health and economic system would result in increased extreme poverty by 100 million people with Sub-Saharan Africa accounting for 40 million individuals [1]. Extreme poverty refers to the socio-economic condition of people living below the international poverty line of \$1.90 a day. This population will experience abject poverty in addition to being vulnerable to acute food insecurity, and compromised health lifestyle. It is worth noting that the global concern for food security as a necessity for quality health, dates back to early years of twentieth century post-World Wars (World War I and World War II in 1930s and 1940s, respectively) during which most societies afflicted with non-communicable diseases resulted from several factors including famine which led to their compromised health lifestyle. It was not until 1935, that the first survey report on global nutrition and public health by the League of Nation's Health Division, documented the extent of malnutrition and hunger in the world. The report revealed a critical food shortage in low and middle-income countries [2]. The League of Nations' survey report is fundamental to the present discourse on dietary intake and health implications because it resulted in the Organization's fundamental discussions on action-oriented developmental policies including the need for coordinated nutrition-related policies in several countries [2].

Contemporary episodes of famine and global food insecurity dates back to early 1970s during the world food crisis when food production and consumptions significantly dropped. This prompted the General Assembly of the United Nations to convene the member states to take specific actions to determine the global food challenge using the comprehensive approach of development agenda and international economic operation [3]. The conference, attended by 135 member states from developed and developing countries (including countries in Sub-Saharan Africa) was concluded through the adoption of the following declaration; "Universal Declaration on Eradication of Hunger and Malnutrition" [3]. The participating states were invited within the context of the United Nations Economic and Social Council Resolution [3]. Thenceforth, the issue of food and nutrition security has been prominent on the global development agenda. In other words, the process of eradicating chronic hunger and poverty and the implication on wellbeing has been a priority since the last quarter of the twentieth century.

However, contemporary research on the history of global food security revealed that for much of the twentieth century, food security was broadly viewed through the lenses of accelerating food production as remedy to famine and international food insecurity. Within this context, the equal relation between health and agriculture would enhance the international economies [2]. Such a perspective, also promoted the need for meeting human basic needs through fundamental policy objectives using commercial agriculture as means to economic development [2]. Consequently, between 1950s to 1970, the world recorded an increase in food production (particularly staple food and/or cereal); concurrently, production per capita improved by 50% and 20%, respectively [2]. Research on the history of food security [2] also reveals that, the period between late 1960s to early 197os saw an annual food aid distribution by high income countries such as the United States to middle income and low-income countries, dropping from an estimated 17 million tons to only 7 million tons. By 1972, several regions of the world among them Sub-Sahara Africa witnessed bad climate conditions such as drought that resulted in famine or general food insecurity. As a consequence, the global food production in staple food such as cereal, sharply fell by 30 million tons [2].

While such substantial measures in post-World Wars were undertaken by the international communities, and three decades after the 1970s' Universal Declaration on Eradication of Hunger and Malnutrition, the chronic poverty and

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*Poverty, Compromised Dietary Intake and Health Implications among South Africa's...*

than 780 million people in developing countries were undernourished [5]. Reassuringly, at the dawn of the new millennium (21 century), the past decades of the aforementioned poverty related conditions prompted the United Nations General Assembly to devise eight fundamental goals, of which— eradicating extreme poverty and hunger was set as a priority goal. The Millennium Development Goals (MDGs) were international development goals that resulted from the UN Millennium Summit in 2000 after the adoption of the United Nations Millennium Declaration. These ambitious goals would be achieved by 2015 [6]. However, in 2015, the global report on the state of food insecurity in the world revealed that some 795 million people were undernourished and/or food insecure largely due to poverty [7] of which, >400 million were from Sub-Sahara Africa. This is despite the region's significant progress in reducing extreme poverty from >50% in 1990 to about 41% in 2013 [8]. Thus, the MDGs were preceded by the 17 Sustainable Development Goals that would be implemented from 2016 to 2030 [6]. The Sustainable Development Goals were devised by the United Nations' General Assembly. Expectantly, the process of eradicating extreme poverty and hunger have

undernutrition continued to engulf developing regions such as Sub-Sahara Africa, the Middle East and South Asia. Accordingly, the World Development Report [4] revealed that while Sub-Sahara Africa constituted only 11.1% of the global population, the region had 16.1% of the worlds' chronically impoverished. By 1992, more

The aim of this study is to determine the nexus between poverty and compromised dietary intake, and the implication on health in selected sub-population groups in a developing country, within the socio-economic context of South Africa. The choice of South Africa as a focal point is suitable because of the nation's complex history that traverse 150 years of colonialism and about 50 years (1948–1994) of the oppressive apartheid regime whose white minority rule and its radical racialized policies significantly disadvantaged the country's majority (>90%) mostly people of black ancestry who were left in abject poverty [9]. The scars of the historically unjust policies remain visible as evidenced by the black majority or the historically disadvantaged population [10] being the most vulnerable to socio-economic issues such as poverty, food insecurity and poor health— making the country one of the most unequal societies in the world. Historically disadvantaged simply means South African citizens that live in poverty due to the unjust systematic racism of the apartheid policy or Act 110 of 1983 Constitution of the Republic of South Africa

As a concept, food security was coined in 1970s following the global economic crisis and the subsequent United Nations Conference that aimed to combat the global food insecurity. Although there is no universally accepted definition of food security, one internationally recognized definition is authored by the World Food Programme of the United Nations which posits that "food security exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life" [11]. Within this context, a household or, an individual's ability to obtain sufficient and nutritious food to stay healthy is crucial. The definition of food security was also documented as the principle achievement of the 1996 World Food Summit [2] because it operationalized food security

*DOI: http://dx.doi.org/10.5772/intechopen.96520*

been reprioritized on the SDGs agenda.

that disenfranchised them.

**2. Clarification of concepts**

**2.1 Food security and insecurity**

#### *Poverty, Compromised Dietary Intake and Health Implications among South Africa's... DOI: http://dx.doi.org/10.5772/intechopen.96520*

undernutrition continued to engulf developing regions such as Sub-Sahara Africa, the Middle East and South Asia. Accordingly, the World Development Report [4] revealed that while Sub-Sahara Africa constituted only 11.1% of the global population, the region had 16.1% of the worlds' chronically impoverished. By 1992, more than 780 million people in developing countries were undernourished [5].

Reassuringly, at the dawn of the new millennium (21 century), the past decades of the aforementioned poverty related conditions prompted the United Nations General Assembly to devise eight fundamental goals, of which— eradicating extreme poverty and hunger was set as a priority goal. The Millennium Development Goals (MDGs) were international development goals that resulted from the UN Millennium Summit in 2000 after the adoption of the United Nations Millennium Declaration. These ambitious goals would be achieved by 2015 [6]. However, in 2015, the global report on the state of food insecurity in the world revealed that some 795 million people were undernourished and/or food insecure largely due to poverty [7] of which, >400 million were from Sub-Sahara Africa. This is despite the region's significant progress in reducing extreme poverty from >50% in 1990 to about 41% in 2013 [8]. Thus, the MDGs were preceded by the 17 Sustainable Development Goals that would be implemented from 2016 to 2030 [6]. The Sustainable Development Goals were devised by the United Nations' General Assembly. Expectantly, the process of eradicating extreme poverty and hunger have been reprioritized on the SDGs agenda.

The aim of this study is to determine the nexus between poverty and compromised dietary intake, and the implication on health in selected sub-population groups in a developing country, within the socio-economic context of South Africa. The choice of South Africa as a focal point is suitable because of the nation's complex history that traverse 150 years of colonialism and about 50 years (1948–1994) of the oppressive apartheid regime whose white minority rule and its radical racialized policies significantly disadvantaged the country's majority (>90%) mostly people of black ancestry who were left in abject poverty [9]. The scars of the historically unjust policies remain visible as evidenced by the black majority or the historically disadvantaged population [10] being the most vulnerable to socio-economic issues such as poverty, food insecurity and poor health— making the country one of the most unequal societies in the world. Historically disadvantaged simply means South African citizens that live in poverty due to the unjust systematic racism of the apartheid policy or Act 110 of 1983 Constitution of the Republic of South Africa that disenfranchised them.
