A narrative review of the implementation and monitoring of the food-based dietary guidelines within the healthcare sector in South Africa

Background Food-based dietary guidelines (FBDGs) are a public health nutrition intervention that plays a crucial role in promoting healthy eating habits and preventing nutrition-related diseases in the population. Objectives To synthesise evidence on the implementation and monitoring of FBDGs with respect to nutrition education in healthcare settings and the influence on dietary patterns and behaviour in South Africa (SA). Design and settings A narrative review was conducted. A comprehensive search strategy was used to identify relevant literature tailored to Africa-Wide Information, CINAHL, MEDLINE via EBSCOHOST, PubMed and ScienceDirect. The selection criteria were based on the Population, Intervention, Control, Outcome and Time (PICOT) framework. The search was focused on SA (97 literature). After removing 43 duplicates, a total of 54 research articles were screened. In the data extraction phase, six articles and six reports were selected. The results of these studies were compared and narratively described in relation to the objectives. Results and discussion The review revealed a few studies focusing on the implementation and monitoring of FBDGs in SA. Despite improved dissemination of FBDGs, gaps posed by the lack of monitoring persist. After nearly 25 years of SA adopting FBDGs, and more than 10 years of adopting a revised version of FBDGs, the implementation and impact of FBDGs remain uneven and under-evaluated. There is a notable lack of a standardised FBDGs monitoring tool and reporting. Conclusion and implications Given the identified gaps in both implementation and monitoring, there is a need for a structured and context-specific monitoring framework that integrates clear indicators, standardised data collection systems, and accountability mechanisms within the South African health sector.