This change is linked to urbanisation, economic challenges, and a lack of knowledge about the nutritional value of traditional foods.
Her study developed a solution to help people return to healthier, traditional diets.
A Ghanaian-born South African, Dr Nketiah completed her BSc in Dietetics at Stellenbosch University before moving to Nelson Mandela University for her MSc and PhD. The Department of Human Nutrition and Dietetics started with a class of first year BSc Dietetics students only 13 years ago, and this is its first doctorate.
Now a lecturer at Nelson Mandela University, Nketiah formerly worked as a community nutrition dietician at the Department of Health.
She became aware of various nutritional challenges causing illness and disease, and said the study had “deep personal and professional significance”.
"On a personal level, it reflects my commitment to addressing public health challenges that are close to home, particularly those affecting marginalised communities," she said. "Professionally, it represents a meaningful contribution to the field of nutrition and dietetics, providing insights into how we can bridge the gap between traditional diets and modern nutritional needs."
Her research focused on nearly 250 Xhosa-speaking participants and revealed that traditional food knowledge was being lost as people moved to cities or had less access to healthy food options.
Dr Nketiah educated participants on the nutritional benefits of traditional foods such as sorghum, amadumbi, num num and wild leafy greens.
“Nutrition transition is when people change the way they eat, moving from traditional, healthy foods like fruits, vegetables and grains to more processed foods like fast food, sweets and sugary drinks," Dr Nketiah explained.
“This often happens when people move to cities or have more money to spend. However, these changes can lead to health problems like gaining too much weight or illnesses like diabetes and heart disease.”
Through a series of workshops, study participants learned how to incorporate indigenous foods back into their diets. They also received a manual with pictures of the various plants, plus training on how to grow their own food.
"We tried to make it special on the day and asked the participants to come dressed up in their traditional attire, so we could bring the message that it is really important for us to go back to our roots,” Dr Nketiah said.
“These traditions also bring families and communities closer together.”
The results were impressive. After three months, many participants reported eating more fruits and vegetables.
“A lot of them said they started growing their own foods, and incorporated some of the indigenous fruit and vegetables, such as the leaves, into their diet,” she said.
“Most of my participants would only have sorghum during traditional rituals, where they would consume it in the form of African beer. But you can also use it to make porridge, and have it as a cereal in the morning for breakfast instead of mealie pap.
“Sorghum is very high in fibre, and in nutrients and it's unfortunate that we're moving away from it towards maize as that comes with its own problems, especially when it is refined.”
Follow-up calls to the participants highlighted that the dietary changes led to improvements in blood pressure, blood sugar levels and overall wellbeing.
“Literally all of the responses were really good: a lot had noticed the benefits in their lives,” Dr Nketiah said.
“There was a young girl, for example, who said her skin looked much better because she was eating healthily and drinking more water instead of cool drinks."
The Mandela University research is particularly significant given South Africa’s rising rates of chronic diseases like diabetes and hypertension.
It was supervised by Professor Annelie Gresse, head of the University’s Department of Human Nutrition and Dietetics.
“Vera’s work is a giant step towards bringing back indigenous food knowledge and use in our modern day homes,” said Prof Gresse. “As an African university, the topic is also so important to us. We do not want the rich traditional food knowledge and food culture to get lost during the nutrition transition into a Westernised diet.”
The study also revealed challenges in accessing healthy foods.
“Living in the city makes it a bit complicated. Participants would say that they would like to grow food but they don’t have land,” Dr Nketiah said.
She therefore taught participants how to use containers, such as old tyres, basins or buckets, to grow food in small spaces.
Dr Nketiah now hopes to expand on her findings and publish them in a high-impact journal to reach a broader audience.
Her doctorate is not her only “baby” for 2024: Dr Nketiah has a two-month old daughter.
“During the last stages of my pregnancy, I was analysing data and writing my thesis,” she said. “This was no small task, but I had incredible support. My husband was a constant reminder for me to rest and pace myself when I pushed too hard.
“Prof Gresse also checked in regularly, not just about my research but also about my pregnancy, which made me feel personally cared for.”
With a growing commitment to nutrition research and teaching, Dr Nketiah now plans to pass on her knowledge to the next generation of dietetics students.
"My long-term goal is to supervise Master's students to help them develop a love for research, and to foster a culture of research excellence.”
Dr Vera Nketiah with her supervisor, Professor Annelie Gresse, at Nelson Mandela University's summer graduation.