High consumption of sugar drinks is driving a spike in obesity-related non-communicable diseases to rival HIV, writes Kerry Cullinan.
In a pattern similar to HIV two decades ago, government clinics are being swamped by 40 000 new patients a month suffering from hypertension and diabetes.
By late last year, more than 25 000 new hypertensive patients and more than 15 000 new diabetic patients were being seen every month at public clinics, according to the Health Department’s District Health Information System.
Last week, Statistics SA reported that diabetes became the biggest killer of South African women in 2015, and the second biggest killer overall. Two years previously, diabetes was only the fifth biggest killer.
Non-communicable diseases (NCDs), many related to us being too fat, are responsible for well over half of all deaths (55.5%).
Ironically, the release of the death statistics came a few days after the government backed down from imposing the 20% tax on sugary drinks on April 1 that it had announced in last year’s Budget speech.
South Africans have ballooned into the fattest people in Africa, mostly thanks to a huge rise in sugary drinks consumption. This is driving an epidemic of obesity-related NCDs that is rivalling the HIV epidemic in South Africa.
But a powerful food industry lobby, led by the Beverage Association of SA, threatened mass retrenchments if the 20% tax was passed. The government has since watered down its proposed tax to around 11% and deferred the starting date to an unspecified time in the future.
For almost a decade, Professor Karen Hofman from the Wits School of Public Health has been trying to draw the attention of policy-makers to the explosion of NCDs including diabetes, caused mainly by dietary changes.
For Hofman, it has been like watching a slow motion train crash – except we are speeding towards the crash site.
“Between 2008 and 2013 – a mere five years – cases of Type 2 diabetes increased by almost 70% in the private sector and cases of hypertension increased by one-third,” she says.
The public sector is under huge pressure from existing patients with NCDs that need constant monitoring and government-sponsored medication, as well as more than six million people with HIV.
“This rise in NCDs is impoverishing vulnerable households who have come to see diabetes and high blood pressure as normal by the age of 40,” says Hofman. “Over 15 years (2000-2015), obesity in people aged 54 to 69 has increased by 50%. The public purse is sponsoring drinking sugary drinks, whose effect is only seen later.”
Another person who has been warning the government about the “toxic food environment” for many years is Professor Tim Noakes, who has developed a huge following for his dietary advice.
“Cutting out all sugar and eating a low carbohydrate diet comprising of real foods will stamp out the diabetes epidemic overnight,” says Noakes.
He contends that the government is “controlled by the food industry and will not do anything that might damage the profitability of that industry”.
“But the chickens are finally coming home to roost,” says Noakes. “By allowing the growth of the toxic food environment, the government has helped fuel the diabetes/obesity epidemic that it must now pay for in terms of exponential increases in health care costs. Sooner or later governments will have to act to rid us of the toxic food environment. Or else the nation and its medical services will go bankrupt.”
Makhehla Mosia is one of the new diabetes statistics. After feeling nauseous, thirsty and tired all the time, Mosia went to a doctor and he diagnosed her with Type 2 diabetes.
“I went home and looked at my life. I asked how I could have messed up so badly. I had to face my bad habits of eating junk food and drinking fizzy drinks all the time. Food was my comfort,” says Mosia, who is from QwaQwa in the Free State.
More than 80% of people with Type 2 diabetes are overweight or obese, and the condition is almost entirely preventable, says endocrinologist Dr Sundeep Ruder.
Ruder estimates that 7% of South Africans over 21 have diabetes – 3.85 million people – yet many don’t know it, and are causing permanent damage to their bodies.
Diabetes is when blood sugar (glucose) is abnormally high. Type 1 diabetes is when a person’s body cannot produce insulin, the hormone that processes glucose, and they need to inject themselves with it. With Type 2 diabetes, the body produces insulin but people develop resistance to insulin mostly because they are overweight.
Over time, high levels of glucose in the bloodstream damage the blood vessels, causing strokes, heart attacks, blindness, kidney failure and nerve damage that can lead to amputations.
While individuals like Mosia blame themselves for their poor eating habits, they are vulnerable to a massive marketing machine that tells them that they need junk food, as well as to the addictive effects of sugar.
Coca-Cola spends in excess of R130 million a year in South Africa alone to market its drinks, which have zero nutritional value.
The World Health Organisation’s Margaret Chan describes the obesity epidemic as being “not the failure of willpower but the failure of political will to take on big business”.
WATCH: An interview with Prof. Barry Popkins, an American Endocrinologist speaking about Mexico's sugar tax and what South Africa can learn about the harmful impact of our sweet tooth on our health.