Are healthier diets culturally affordable in Africa? evidence from four African countries

In 2023, between 713 and 757 million people experienced hunger globally, with Sub-Saharan Africa facing a prevalence of undernourishment at 20.4%. This study addresses the nutritional challenges affecting vulnerable groups, particularly women and young children, in eight African cities by modelling nutritionally adequate, economically affordable, and culturally acceptable diets. Our goal is to provide optimised diets for future consideration in food based national dietary guidelines for Ethiopia, Kenya, South Africa, and Uganda. We employ a mathematical programming approach to optimise diets, in order to achieve nutrient adequacy with minimal changes to current consumption patterns, under a budget constraint. The results show that nutritionally adequate diets are possible but often require dietary shifts, including increased intake of vegetables, fruits, and legumes, while moderately reducing the intake of cereals and, to a lesser extent, roots and tubers. Affordability remains a key constraint, some cities face larger tradeoffs than others, reflecting different levels of dietary diversity and purchasing power. Our discussion highlights the trade-off between cultural acceptability and economic affordability, suggesting that higher budgets may facilitate easier acceptance of dietary changes. Consequently, a focus on minimising food expenditures alone could compromise diet suitability by neglecting cultural acceptability. Lastly, we recommend a multifaceted policy approach to enhance frameworks for both demand and supply sides to achieve healthier diets.