Obesity: SA sitting on a time bomb

If we keep in mind that, on average, up to 56% of adult women and 29% of adult men in this country are overweight or obese, South Africa is literally sitting on a time bomb of lifestyle diseases.

A recent study drives this point home in dramatic fashion. The study by Joubert et al, published in the South African Medical Journal, shows that a great percentage of incidents of life-threatening disease in this country can be attributed to overweight and obesity.

The staggering statistics are as follows:

• 87% of type 2 diabetes (non-insulin-dependent diabetes)
• 68% of hypertension (high blood pressure)
• 61% of endometrial cancer (cancer of the lining of the uterus)
• 45% of ischaemic stroke
• 38% of ischaemic heart disease (heart attacks)
• 31% of kidney cancer
• 24% of osteoarthritis
• 17% of colon cancer
• 13% of post-menopausal breast cancer

The findings of this study clearly indicate that overweight and obesity can negatively affect the health of our nation. Practically, 90% of type 2 diabetics and more than 60% of stroke and heart disease patients suffer from these diseases as a result of obesity – a situation that needs to be addressed urgently.

Women at risk

As studies have shown that South African women of all population groups are much more prone to overweight and obesity than their male counterparts, the women in this country are at even greater risk of developing the above-mentioned diseases than men.

While, in the past, the incidence of obesity has always been lower in rural areas, this is changing rapidly. Even in the Limpopo province, which has the lowest incidence, up to 44% of women are obese or overweight.

The trend towards urbanisation in our country is progressing at a rapid rate. When previously rural people move to cities, they tend to become less active and eat highly processed, fatty foods that make them gain weight.

The authors of this report state that "The burden in females was approximately double that in males." (Joubert et al, 2007)

It’s a frightening prospect that the women of South Africa are caught in a spiral of ever-increasing weight and are therefore, more and more exposed to diseases such as diabetes, stroke and heart disease.

The bottom line

The conclusion reached by Joubert and her coworkers (2007) is that "excess body weight results in a substantial burden of death, premature death and disability in adults in South Africa."

They go on to say that this "may be expected to grow with continued development." This is indeed a sorry state of affairs.

Possible solutions

In order to curb the epidemic, the authors suggest that the following steps should be implemented:

• Education on making healthy food choices, particularly in schools, the workplace and for health-care providers.
• Clear food labelling of energy content of all packaged foods, including fast foods.
• Healthy advertising that includes standards to limit the advertisement of foods high in refined starches, sugar, saturated fats and trans-fatty acids to children.
• Improving the availability and reducing the cost of healthy foods (for example, a subsidy on fruits and vegetables).
• Improved processing and manufacturing of food (e.g. replacing unhealthy fats with healthy ones).
• Changing the urban environment so that people can do more exercise in a safe environment.

However, the researchers admit that "no country yet has been successful in reversing obesity trends". They attribute this to the complexity of the problem.

What you can do

During Obesity Week which normally falls in October you can also do something about this seemingly insurmountable problem:

• Determine if you, or any member of your family, particularly your children, are overweight or obese (get assistance from your GP or a clinic if you are unsure of how to measure this).
• Do something about your condition:
  • Consult a clinical dietician to help you lose weight (visit the Association for Dietetics in SA Website and click on "Find a Dietician" to find a dietician in your area).
  • Join a sensible weight-reduction programme such as Weigh-Less or Weight Watchers.
  • Start doing as much physical activity as possible (brisk walking, running jogging, swimming, cycling, rowing, skipping, joining a gym or signing up for Walk for Life).

NOTE: The above-mentioned study was carried out by researchers at the Burden of Disease Research Unit and the Chronic Diseases of Lifestyle Unit of the SAMRC, the University of Cape Town Research Unit for Exercise Science and Sports Medicine, and the School of Public Health at the University of the Western Cape. Persons of 30 years and older were included in the study.

Text copyright: Dr I.V. van Heerden
October 2007

Reference: Joubert J et al (2007). Estimating the burden of disease attributable to excess body weight in South Africa in 2000. SAMJ, Vol 97, No 8, 683-690

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