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A nation of the hungry and obese

Cape Town - South Africa is heading for a health disaster: more than half the population is living in hunger or at risk of it, while a large percentage of the rest are obese or at risk of developing poor lifestyle-related illnesses.

And more people in their twenties are prone to diabetes, high blood pressure and cholesterol. 

Researcher Melissa Oldham told the UK Congress on Obesity that 'fat blindness' was more likely the more fat friends someone had. Photo: Candice Chaplin. Credit: INDEPENDENT NEWSPAPERS

These are some of the startling findings of an extensive health and nutrition study conducted by the Human Sciences Research Council and Medical Research Council.

Details of the South African National Health and Nutritional and Examination Survey are given in a 400-page report.

The survey was undertaken to verify the health and nutritional status of the nation, looking at food security and dietary intake, among other factors.

It also investigated perceptions of health and health-care services, and behavioural and social determinants of health and nutrition such as smoking, diet and physical inactivity.

About 25 500 people were interviewed. Of these, 12 000 had physical examinations and were screened by medical practitioners, while 8 000 participants provided blood samples for biomarker testing (used to screen for or monitor disease).

Speaking at the release of the report in Pretoria on Tuesday, the Human Sciences Research Council’s Professor Demetre Labadarios said 45.6 percent of the population was food secure.

The council defines food security as access to food by all members of a household at all times – enough food for an active and healthy life.

A household is classified as being food secure, as being at risk of hunger, or as experiencing hunger.

Labadarios said: “Regarding food insecurity, which is those who experience hunger, one out of four households experience hunger.

“The Western Cape, Gauteng, and the Northern Cape have low levels of food insecurity in comparison with other provinces.”

Labadarios said that while 26 percent of the population experienced hunger, 28.6 percent were living at risk of being hungry.

The proportion of citizens living “at the risk of hunger” had risen from 25 percent in the previous survey in 2008.

According to the 2012 study, the Eastern Cape, followed by Limpopo, had the highest numbers of citizens experiencing food insecurity.

Food security was highest in the Western Cape.

Two out of five people, or 40 percent, reported that their diets were poor, while 18.3 percent consumed a high fat diet and 20 percent a high sugar diet.

About 26 percent of the population ate fruit and vegetables regularly, while 48 percent ate out regularly.

While more females (about 55 percent) did grocery shopping compared with only 27 percent of men, only 14 percent took health into consideration when buying food, with 65 percent influenced by the price of the food item, followed by taste and the food’s shelf life.

The study also showed that South Africans were developing lifestyle diseases from a young age, with diabetes, high blood pressure and cholesterol starting to peak from as early as 25.

Indians had more cholesterol than any other race group, while 61 percent of those aged 45 and above were pre-diabetic.

The survey found that women were the most inactive and unhealthiest group, with 45 percent deemed inactive, compared with 28 percent of men.

Most women were overweight or obese, with almost 60 percent in the obesity category.

While 12 percent of men had anaemia, almost double the number of women did – 22 percent.

Women of reproductive age were worse off, with the prevalence of anaemia at more than 23 percent and of vitamin A deficiency at 13.3 percent.

Almost 80 percent of women had a waist circumference of more than the 80cm that is regarded as the cut-off point for obesity. Six out of 10 had waist circumferences greater than 88cm – putting them at even greater risk of diabetes and cardiovascular diseases.

Nearly two thirds of the population (about 62 percent of men and 66 percent of females) believed they ate and drank healthily and that there was no need for a lifestyle change.

About 70 percent of the males surveyed were happy with their weight, compared with 63 percent of women.

South Africans also seemed comfortable with their large waistlines, with 88 percent indicating that they regarded their ideal body image as “fat”. More females – about 15 percent – attempted to lose weight than males (8 percent).

Smoking and alcohol abuse remained substantial.

About 16 percent of the respondents smoked every day.

The Western Cape, with 34 percent, had the highest proportion of smokers or people regularly exposed to smoking.

The percentage of coloured people who smoked was twice the national average of 16.5 percent.

Alcohol use also remained prevalent, with 31 percent of males drinking regularly, compared with 10 percent of females.

Of the households that consumed alcohol, 61 percent did not perceive this as alcohol misuse and 29 percent did not consider alcohol abuse a problem.

Human Sciences Research Council chief executive

Professor Olive Shisana said it was clear that “South Africa is heading for a disaster”, judging by the high percentage of people living with chronic diseases, with “overweight and obesity being strong risk factors for these diseases”.

Shisana also raised concerns about tobacco use, saying although the rate of smoking had declined over the past two decades, the threat remained “substantial”.

“In view of the evidence that the profile of South Africans who smoke remains a large risk factor in non-communicable diseases, new regulations should be implemented and their impact monitored in the next survey,” she said.

Health Minister Aaron Motsoaledi has said if drastic action is not taken to reverse the rise of lifestyle diseases, particularly in those who are pre-diabetic and pre-hypertensive, the health budget will become so overstretched “it won’t be able to meet the country’s health needs”. – Additional reporting by Sapa

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