Food Preferences and Nutritional Adequacy in Urban Informal Settlements: A Cross-Sectional Study.

Background and Aims: Urban informal settlements often face challenges related to food insecurity and poor nutritional adequacy. This study examines food preferences and dietary diversity among households in informal settlements in Tshwane (Pretoria), Gauteng, South Africa. Methods: A cross-sectional survey was conducted with 367 households. The Household Dietary Diversity Score (HDDS) was used to measure the diversity of foods consumed over a 24-h recall period. The Principal Component Analysis (PCA) was employed to identify major dietary patterns based on the consumption of different food groups. Results: The Household Dietary Diversity Score (HDDS) indicated increased food group consumption across dietary diversity quintiles (based on the number of food groups consumed), with 78.4% of households in the highest quintile consuming six or more food groups. Informal dwelling residents consumed more diverse diets than those living in brick houses. The most commonly consumed food groups included grains, vegetables, and fruits, though protein intake was generally inadequate. with less than half of households consuming eggs (44.4%) or fish (33.8%) during the recall period PCA identified three dietary patterns: (1) a protein- and staple-rich diet, with high factor loadings for cereals (0.584), fruits (0.652), processed meats (0.836), eggs (0.814), fish (0.480), and legumes (0.570); (2) a high-fat, high-sugar diet; characterised by high loadings for oils and fats, spreads, sugar, sugar confections, milk products, and sweetened beverages; and (3) a fibre-rich, vegetable-based diet, with high loadings for bread (0.546), pumpkin (0.761), tubers (0.615), and leafy greens (0.710). Conclusion: While dietary diversity appears relatively high in these informal settlements, the low protein intake raises nutritional concerns. Strategies to improve household nutrition should include promoting urban agriculture, increasing access to fortified foods, regulating the marketing of unhealthy foods, and strengthening informal food markets. Community-based initiatives such as food storage systems, cooperatives, community kitchens, and gardens are also essential to improving dietary quality and food security in urban low-income contexts. Based on the observed dominance of starch-based diets and inadequate protein consumption, policy responses should prioritise improved access to affordable protein-rich foods, support informal food markets, and promote community-based food production initiatives.