The results of this survey showed that street food and fast food consumption are commonly consumed in all provinces of South Africa and consequently contribute to dietary intake, particularly those who consume it frequently. A recent pilot survey  in deep rural villages in Mpumalanga showed similar trends, with the sale of street foods being a very common occurrence even in these very rural and remote areas.
The increasing use of fast foods, and more recently street foods, pose many questions for public health advocates. Should nutritionists condemn the use of street foods in a country which is undergoing a rapid transition from consumption of traditional foods to more commercially available, ready-to-eat foods? How do these foods "fit" into the food-based dietary guidelines  which health professionals in South Africa promote? Apart from fruit, which was found to be a popular street food choice, the remaining items would not be nutritionally recommended by nutritionists and would not feature on the list of food-based dietary guidelines. However, the reality lies in the fact that street foods are generally very affordable [2, 17] and have a high energy density. As such they are very appealing to poor people who need to reduce their hunger as cheaply as possible.
In this study, apart from the documentation of food items selected, we have little information on the most commonly consumed "cooked" fast foods and street foods in terms of their nutritional value or portion sizes. One of the limitations of the present study was that cooked foods were not individually identified and due to the nature of the study, portion sizes could not be calculated. This appears to be a large gap in the nutrition knowledge that we have on the dietary intake of adults in South Africa and motivates for the importance of a national food consumption survey in the adult population. The pilot study undertaken in Mpumalanga  showed that items most commonly available for sale in those areas were fried potato chips, vetkoek (fried dumplings made from wheat flour) and kotas (a quarter loaf of white bread filled with fried potato chips, and numerous processed meat or cheese). The fried chips and vetkoek yielded on average between 943 and 5552 kJ and between 11-64 g fat, being high in energy and in fat.
Another aspect of critical importance in the discussion around the relative merits of fast food consumption are the negative nutritional outcomes [19–24] associated with its use; while there are limited data in this regard in relation to the consumption of street foods. One of the negative aspects relates to the association of fast food consumption with overweight and obesity, both of which are very high in South African women (73% have a BMI > = 25). The high prevalence of fast food and street food intake, particularly intake of soft drinks is of some concern because of the recent flurry of studies documenting the positive relationship between soft drink consumption and obesity in children and adolescents [25–30]. In South Africa, as in many other African countries, there is little information regarding the extent to which use of street foods or fast foods contribute to this problem. However, based on the results from the Mpumalanga study  and the Soweto study , one can only assume that similar findings will prevail in many other areas. This is certainly an aspect that should be investigated in a future research agenda and is currently receiving attention in the development of a protocol for a national nutrition study in South Africa. Another limitation of the present study was the fact that types of fast foods consumed were not recorded.
The present study showed that socio-economic status played an extremely important role in the consumption of both fast foods and street foods, particularly in relation to fast food intake. Fast food intake was much higher in the highest LSM compared with the low LSM, while those in the middle category were the highest consumers of street foods. The importance of socio-economic status was further illustrated by the findings of the logistic regression. People who were employed, and additionally possessed major household appliances had a higher intake of fast foods; reflecting the effects of westernization of diet in Africa. This was also the case for street foods, however, to a lesser degree, most probably because street foods were less expensive and there was less variety in the items sold.
Furthermore, another aspect of street foods that requires consideration is the convenience aspect. People who live far from their place of employment, as is the case around the big cities, and have to travel long distances may be in a situation where it is difficult for them to have regular meals at home. In such cases a source of food already prepared, immediately accessible, and at low cost will meet their immediate needs. It is also necessary to consider the finding that those having a frequent intake of fast foods had a significantly higher dietary diversity than those who did not, while those who had a frequent street food intake had a significantly lower dietary diversity than those who seldom consumed street foods. This implies that there was less diversity in the diet of those purchasing street foods more frequently and hence can be considered a serious disadvantage in terms of food security . Street food should therefore be seriously investigated from a policy point of view in terms of their potential impact on food security.
The last aspect of street food that has to be mentioned is one on food hygiene and safety, due to the large numbers of people who purchase such foods and the possible health risks involved. Microbial studies conducted on street foods in both Bloemfontein and Johannesburg have found that the safety of street foods was better than expected in these two urban areas studied [31–33]. Two critical points were identified as ensuring best safety of foods including cooking at temperatures over 65 degrees C and having short holding times. The practices studied in Johannesburg indicated that vendors bought food from retailers early every day; prepared the food in sufficient quantities for that day and gave away or took home the leftovers. This practice is thought to have contributed to the reasonably safe microbial content of the street foods examined but may have had ramifications for the families at home who most probably eat the left-overs. Von Holy et al. have stressed the importance of a need for running water and toilets in areas where street vendors operate ; however, there does not appear to be national data on the food safety aspects of such enterprises. We would like to recommend that this aspect is given serious consideration when the next national survey is planned since the extent of street food consumption in RSA certainly warrants this.
Lastly, the consumption of street food provides employment for a large sector of the population  and there may be ways and means by which this practice can be encouraged if vendors sell healthier food items; such as fresh fruit, dry fruit, nuts, and vegetables such as roasted maize cobs. Since the sale of street food is likely to increase, consideration should be given to ways and means that the practice can be done in a healthy and safe manner. This is particularly relevant in schools in poorer areas where at times numerous vendors sell their products to children at break periods . The bulk of these items are energy-dense and high in fat, already laying a foundation for the type of diet which one wishes to avoid in countries which are undergoing the nutrition transition.
In conclusion, a large percentage of the population purchases fast foods and street foods. This is of some concern when one notes the high prevalence of soft drinks, high fat and energy-dense foods consumed, particularly in terms of pre-disposition to obesity, and related chronic diseases. These findings need to be taken into consideration when evaluating and planning dietary patterns and nutritional adequacy of population diets and health promotion intervention programs.