Updated 18 May 2015

Many South Africans can't afford a healthy diet

South Africans are being urged to follow a healthy diet to avoid high blood pressure, but for many it simply isn't affordable.

The Heart and Stroke Foundation has urged South Africans to check their blood pressure readings and follow a healthy diet – but poverty and the high food prices put a healthy diet out of reach of many people in the country.

In 2013 the Mpumalanga pensioner Elsie Malaza suffered a serious stroke that left her unable to speak and partially paralysed.

She also has diabetes and hypertension, or high-blood pressure – a common risk factor for stroke.

As the globe marked World Hypertension Day, an estimated 11 million South Africans live with hypertension.

Determined to regain her health, Malaza goes for regular check ups and takes her medication diligently, but worries that the food she eats might be putting her at risk for another stroke.

Read: Get your blood pressure tested on World Hypertension Day

“The nurses told me to follow the correct diet to help control my conditions, but I’m a pensioner and I usually buy food that will last the whole month and that excludes fresh vegetables and fruits,” Malaza told Health-e News.

More than half of all South Africans are at risk of hunger, according to the South African National Health and Nutrition Examination Survey for 2012.

A healthy diet is an important part of hypertension management, and people with high blood pressure should be particularly wary of the amount of salt they eat, warns the Heart and Stroke Foundation.

“Be aware of how much salt is in foods and limit your intake of very salty products like boerewors, polony, stock cubes and soup powders,” said the foundation in a recent statement.

But these are exactly the products cash-strapped South Africans reach for to spice up bland diets, consisting mainly of mealie meal, bread or rice, according to Prof David Sanders from the University of the Western Cape’s School of Public Health.

According to him, energy-dense, salty foods such as white bread, biscuits and processed meats are much cheaper than healthy food. 

A 2012 study by Sanders and colleagues published in the medical journal PLOS Medicine found that healthier foods cost South Africans between 10 and 60 percent more than less healthy options when compared by weight.

In terms of calories, the study found that consumers pay up to 110% more for healthy foods.

These dietary trends are also linked to another important risk factors for hypertension: overweight and obesity. Despite high levels of food insecurity, South Africa is one of the 20 fattest countries in the world with seven out of every 10 women, and three out every 10 men being overweight or obese.

Other risk factors for hypertension include smoking, harmful use of alcohol, and inactivity.

Read: Salty snacks tied to higher blood pressure in kids

Eating for a healthy blood pressure

Stellenbosch University’s Nutrition Information Centre recommends following this dietary checklist for a healthy blood pressure:

- Eat at least 6-8 servings of vegetables and fruit each day.

- Eat natural, unprocessed and homemade foods more often.

- Choose lower sodium, high-fibre cereals, breads, bakery products and snacks.

- Choose 2-3 servings of low-fat milk products or alternatives each day.

- Use less salt at the table and in cooking and baking.

- Cut back on the amount of  sauces and dressings added to food.

- Choose low-fat, high-fibre, lower sodium snack foods.

- Avoid processed meat such as polony and deli meat. Have leftover cooked meat or chicken instead.

- Check food labels and buy lower sodium foods.

- Eat more beans, peas and lentils.

- Eat a handful of unsalted nuts or seeds several times each week.

- Eat fewer take-away meals.

- Watch portion sizes, eat slowly and enjoy every bite.

Read more:

Salt is killing South Africans

Regularly salting foods heightens death by 50% 

Salt: the slow, silent killer

Source: Nutrition Information Centre at Stellenbosch University

Image: Big hamburger, french fries from Shutterstock


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Dr Jacomien de Villiers qualified as a specialist physician at the University of Pretoria in 1995. She worked at various clinics at the Department of Internal Medicine, Steve Biko Hospital, these include General Internal Medicine, Hypertension, Diabetes and Cardiology. She has run a private practice since 2001, as well as a consultant post at the Endocrine Clinic of Steve Biko Hospital.

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