Globally, anxiety and depression is the third leading cause of disease burden for women 14 to 44 years of age. The World Health Organisation reports that 15 to 57% of women in developing countries experience symptoms of depression. Maternal mental illness has a negative impact on infant and young child (IYC) growth, development and care, having serious health implications in terms of physical, cognitive and emotional well-being during crucial stages of the life span, such as the first 1000 days and early childhood. Various studies conducted in both developed and developing countries, have shown that maternal depression is associated with negative health outcomes such as: low birth weight, developmental delay, incomplete immunisation schedules, acute or chronic diarrhoea, somatic symptoms, disrupted sleep patterns and child abuse, as well as psychiatric and neurobehavioural disorders. In addition, maternal depression impairs IYC care practices related to breastfeeding, health care, safety and development. It also contributes to inadequate nutrition during pregnancy as well as that of offspring during infancy and childhood, resulting in suboptimal brain development and inadequate growth. Infants with depressed mothers are not only vulnerable to becoming underweight, but also being stunted.

In South Africa, the nutrition transition has led to unhealthy diets lacking variety, contributing to the rise in overweight, obesity and diet-related noncommunicable diseases. Using baseline screening data of the South African Diabetes Prevention Programme (SA-DPP) study, this study aims to determine the relationship of dietary diversity (DD) with nutritional status, cardiometabolic risk factors and food choices of adults at risk of type 2 diabetes in resource-poor communities around Cape Town. Data of 693 adults, 25–65 years old were analysed. This included socio-demographic information, anthropometric measurements, biochemical assessments, food groups consumed the previous day and consumption frequency of certain foods to reflect food choices. The Minimum Dietary Diversity for Women (MDD-W) indicator was calculated; 70.4% of participants had low DD (<5 food groups). Low DD was associated with elevated serum triglycerides [AOR: 1.49, 95% CI (1.03, 2.15) p = 0.036]. The DD score was positively correlated (although weak) with the unhealthy food score (r = 0.191, p = 0.050) and sugary food score (r = 0.139, p < 0.01). Study participants at risk of diabetes consumed a diet low in DD; however, DD was not associated with nutritional status or cardiometabolic risk factors except for serum triglycerides.

IntroductionThe local retail food environment influences dietary patterns and food choices, as suggested in the literature. The lack of access to healthy food within this environment may result in unhealthy food choices which may lead to obesity and the development of non-communicable diseases. Evidence suggests that resource-poor communities may have unhealthy food environments, therefore, preventing residents from making healthy food choices. A systematic scoping review will be conducted to provide an overview of the evidence on adult food choices in association with the local retail food environment and food access in resource-poor communities.Methods and analysisThis protocol for the scoping review was developed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines and the framework process by Arksey and O’Malley. Observational studies, published from July 2005 to January 2021, will be searched and screened. Keywords and medical subject headings (MeSH) terms will be used to search several multidisciplinary databases. Two independent reviewers will screen identified articles using the selection criteria and extract data using the PRISMA-ScR checklist. Descriptive numerical and thematic analysis will be performed to evaluate and categorise quantitative and qualitative data.Ethics and disseminationEthical approval will not be required for the review, as data from published studies will be used. The results of this scoping review will form part of a PhD thesis that will be submitted to the University of the Western Cape, South Africa. The review findings will also be presented at conferences and published in a peer-reviewed journal.Open science framework registration numberhttps://osf.io/shf93.