Seasonal cycles in food purchases and changes in BMI among South Africans participating in a health promotion programme.

OBJECTIVE
Improving diet quality is a key factor for promoting population health. Social norms can support or undermine these efforts. The present study aimed to investigate the relationship between seasonal variation in food purchases and BMI.

DESIGN
The study population comprises members of a South African health promotion programme. Data come from scanner data of food purchases by 400 000 enrolled households at supermarkets and repeated individual surveys (about 500 000 participants) between 2009 and 2013.

RESULTS
Members in the health promotion programme spent 16·7 % of total food expenditure on nutritionally undesirable foods (sugar-sweetened beverages, candy, ice cream, etc.) and 24·7 % on healthy foods (fruit/vegetables, whole grains, non-fat dairy, etc.). Fruits and vegetables accounted for 13·5 % of purchases (half of all healthy food spending). Yet there were pronounced seasonal variations, with December being the peak month for unhealthy food purchases, which were 40 % higher than in January. This holiday peak was associated with short-term weight gain, but average body mass did not revert to pre-holiday levels. From 2009 to 2013, respondents gained about 0·13 BMI units per year (0·43 kg for men, 0·30 for women). From November to January alone, the increase was 0·1 BMI units for men (0·35 kg) and 0·8 BMI units for women (0·20 kg).

CONCLUSIONS
Purchases of nutritionally undesirable foods peak in December and are accompanied by weight gain from November to January. Despite weight loss after January, the November to January weight gain accounts for 60-70 % of the annual gain.