October was World Food Day, and I hope that all of us who have enough to eat celebrated
and gave thanks. Those of us who are well-nourished should spare a thought for
the millions who “go to bed hungry every night”.
people what they believe are the biggest nutritional issues in South Africa, and
the yuppies will probably mention things like obesity, Banting and carbs. I
was, therefore, heartened by a recent article on Prof David Sanders, published
in MedicalBrief, entitled “SA’s real nutrition problems ‘Not Carbs vs.
Fats’”. The article emphasises that instead of worrying about the 2 grains of
sugar in diet cold drinks, we should be improving the diets of our children,
and the first thing all our children should be given is mother’s milk.
Read: Breast milk reduces infections
is a paediatrician and emeritus professor at the University of the Western Cape
and is a highly respected scientist in the fields of child health and
nutrition. Prof Sanders lists the most important problems we face in South
Africa as low birth weight, malnutrition, obesity and the diseases that follow,
such as diabetes, cancer and heart disease.
points out that the most recent data obtained from the SA National Health &
Nutrition Examination Survey (SANHANES) shows that 28% of our nation’s
households were at risk of hunger and 26% actually suffered from hunger in
2012. It is probable that this figure has grown in the past 3 years.
mean that by now, 30% or more of our population do not have enough food to eat.
It also makes sense that these people also do not obtain the nutrients they
need to grow, develop and remain healthy.
Read: Good nutrition on a tight budget
in any society should always be priority number one because they are our
future. The SANHANES 2012 data showed that 27% of our children under the age of
3 years suffer from under-nutrition which causes stunting, and 6% of the
under-14s were underweight. Along with this malnutrition, caused by a lack of
kilojoules, macro- and micronutrients, 19% of children between 2 and 5 years
were overweight and 5% were classified as obese.
contrast between starvation and malnutrition and obesity in our children should
be our first priority – and will certainly not be addressed by unbalanced fad
diets. The majority of affected households also do not have the means to follow
fad diets, which differ greatly from the traditional diets of our indigenous
populations. These traditional diets were based on high-fibre starches
(sorghum, millet, unsifted maize meal) as staples, fermented milk, modest
quantities of lean meat, vegetables, veld fruits and nuts.
One of the
primary factors that lead to these childhood problems, is the fact that too
many babies are born prematurely or with a low birth weight. Prof Sanders lists
the following causes:
nutrient intake of the mother before conception and during pregnancy. Mothers who lack a diet which provides adequate energy, protein of plant and animal
origin, high-fibre, minimally processed, low-GI carbohydrates, healthy mono-
and polyunsaturated fats, as well as the essential fatty acids omega-3 and
omega-6, and micronutrients like vitamins, minerals and phytonutrients tend to have
small, underweight babies that are often born before term. Low birth weight and
premature birth are factors that can hamper a child’s future growth and
women who have to do hard physical labour on an energy-deficient diet are not
able to channel sufficient energy to their unborn babies to fuel adequate
abuse (alcohol, drugs and smoking) can retard foetal growth and result in low birth weight, as well as foetal alcohol
syndrome, and foetal addiction and withdrawal symptoms.
sexually transmitted diseases and tuberculosis can all affect foetal growth and
disadvantage a child from birth.
anaemia is linked to an increase in low birth weight and 23% of South African
women were found to be suffering from anaemia according to the 2012 SANHANES
reports of infant deaths in South African hospitals illustrate how dangerous
premature birth and low birth weights are. Last Sunday, Ahmed Areff of News24
reported that the Free State Health Department had issued a statement that an
investigation into the deaths of 5 neonates at the Bongani Hospital in Welkom
had found that “four had low birth weights and died from pulmonary haemorrhage,
which is bleeding in the lungs and one baby died from birth asphyxia”.
describes how the vicious cycle of under-nourishment and nutrient deprivation
continues because low birth weight babies are not strong enough to suck
strongly and therefore cannot breastfeed properly. These babies do not receive
adequate nourishment at the breast and may not receive invaluable protective
antibodies from their mothers’ milk. Consequently they tend to be more
susceptible to infections. If these children survive infancy they are more
inclined to become undernourished and stunted children.
Read: Mother's milk a miracle medicine for mom and baby
has the lowest breastfeeding rate in the world, which means those children who
need them most, are once again deprived of vital nutrients for the first year
of their lives.
If there is
a solution to this problem then it is education to encourage mothers to
exclusively breastfeed their babies for the first 6 months of life, and then to
add high-energy foods such as oils and peanut butter, as well as proteins like
sour milk and legumes (dry beans and lentils) to the weaning diet. Education
should also concentrate on teaching mothers who do most of the shopping and
receive child support grants to select foods that give them and their families
the most nourishment at the lowest cost.
Read: Am I healthy for breastfeeding?
This kind of
education should start at schools because many of the mothers who have low birth
weight babies are undernourished teenagers who have not yet finished growing
World Food Day and spare a thought for the millions of young women and their
babies who struggle to survive and also keep in mind never to deprive your own
children of breastmilk, breastfeeding and a balanced diet.
The state of hunger in South Africa
Breastfeeding is best
PSFA addresses hunger in schools
Dr Ingrid van Heerden is a registered dietician and holds a doctoral degree in Nutrition and Biochemistry. She believes that "we are what we eat" and offers free nutrition and weight loss advice via her DietDoc service on Health24.com. Read more of her articles.