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Updated 07 August 2013

Feast and famine in South Africa

While almost half of the population suffers from hunger at times, many South Africans are overweight (most of them women), a new survey has found.

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Despite an increase in obesity in South Africa, more than half of South Africans do not have reliable access to food.

This paradox has been revealed in the results of the first South African National Health and Nutrition Examination Survey (SANHANES-1) released by the Human Sciences Research Council (HSRC) in Pretoria on Tuesday.

The survey, which was conducted in 2012, saw 25 532 individuals complete a questionnaire-based interview; 12 025 participants undergo a physical examination by a medical doctor; and 8 078 participants provide blood samples to test for "biomarkers" of disease.

Overall, a quarter of South Africans surveyed (26%) were experiencing hunger and a further 28.3% were at risk of hunger. Only 45.6% of the population surveyed enjoyed food security (access to enough food at all times).

Food security was highest in the Western Cape and lowest in the Eastern Cape and Limpopo. Though most of the children interviewed said that it was important to start the day with breakfast, a third of them went to school hungry, and more than half did not take a lunchbox to school.

Fat nation

While almost half of the population suffers from hunger at times, a significant number of South Africans is overweight and, most of them are women.

According to the survey, 39.2% of women were overweight, compared to 24.8% in men. When compared to the 2003 South African Demographic and Health Survey (SADHS), the survey shows that obesity increased substantially in females, from 27% in 2003 to 39.2% in 2012.

Further findings include that women had an alarming average Body Mass Index (BMI) of 28.9, while men had a BMI of 23.6. A BMI between 25 and 29.9 indicates that a person is overweight. (Anything over 30 indicates obesity.)

Half of the women surveyed had a waist circumference over 88cm, which puts them at greater risk of lifestyle diseases such as heart disease, diabetes, hypertension, and elevated cholesterol.

Alarmingly, South Africa's preschool children are among the fattest in the world. The survey has found that 22.9% of SA children between two and five years were overweight. That is double the figure of preschool obesity in other African countries such as Morocco, Swaziland, Botswana, and Nigeria (11%) – and the US (12%).

This does not bode well for the future health of our nation.

"It is clear that South Africa is heading for disaster, judging from the high percentage of people living with chronic lifestyle diseases in the country, with overweight and obesity being strong risk factors for these diseases," the HSRC warns.

High blood pressure, cholesterol and diabetes

According to the survey, 10.2% of participants aged 15 years and older had high blood pressure (blood pressure higher than 140/90mmHg), and a further 10.4% were pre-hypertensive (blood pressure between 120-139/80-89mmHg).

When it comes to cholesterol levels, one out of four participants aged 15 years and older had an abnormally high serum total (23.9%) and LDL "bad" cholesterol (28.8%), and one out of two (47.9%) had an abnormally low HDL "good" cholesterol.

Almost one out of five participants (18.4%) had impaired glucose tolerance (IGT), a pre-diabetic state of hyperglycaemia that is associated with insulin resistance and increased risk of cardiovascular pathology. IGT may precede type 2 diabetes by many years.

Diabetes was diagnosed in 9.5% of participants.

Achieving a healthy weight and exercising regularly can play a big role in reducing the risk of these lifestyle diseases. Sadly, however, many South Africans are not only overweight, but also very unfit: 27.9% of men and 45.2% of women who participated in the survey had failed their fitness tests.

Read the full report on the SA National Health and Nutrition Survey.

*The study, compiled by a research consortium comprising the HSRC and the Medical Research Council (MRC), was financed by the national Department of Health and the UK Department for International Development (DFID) and HSRC.


 
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