‘Nutrition transition’ is making us fat

INLSA

433 22/05/2012 Bataung Matsau (white track jacket) lost 28 kilograms in 2011 in an effort to relieve his hypertension, but people incorrectly assumed his weight loss was due to HIV, with Sam Ndlovu a community activist who wants to help Pimville get healthier through a community garden. Picture: Motshwari Mofokeng

CORINNE CHIN

corinne.chin@inl.co.za

Last year, Bataung Matsau lost nearly 28kg. The Pimville, Soweto, resident began running, cycling and following a healthy diet and went from 96.4kg to 68.8kg.

But instead of congratulating him, his neighbours were wary.

“People would ask: ‘Are you okay?’ People would ask my friends: ‘Is Matsau all right?’” he says.

They assumed, wrongly, that his dramatic weight loss was caused by HIV.

fat people weight gain slimming dieting

Ex-QDMS

Matsau has learnt to ignore this stigma, but it seems that others would rather risk their long-term health than face the rumours.

“People are afraid to lose weight because they may end up being labelled Aids sufferers. But it seems acceptable to suffer from hypertension,” Matsau says. “They don’t realise that with high blood pressure, you may not wake up the next day.”

In addition to hypertension, being overweight contributes to chronic illness such as cardiovascular disease, stroke, cancer and type 2 diabetes.

Yet according to a 2010 study, 78 percent of obese and 52 percent of morbidly obese South Africans consider themselves healthy. Given that most adults in SA are too heavy – 61 percent are overweight or obese – this attitude becomes even more alarming.

So why aren’t more people scrambling to shed excess weight?

SA’s obesity rates are rapidly gaining on industrialised superpowers such as the US and the UK.

Obesity is no longer a rich man’s problem. While it was once considered a luxury to spend money on overeating, it is now considered a luxury to spend money – and time – on losing weight. Fat wallets help make skinny people.

“I used to think, people with money, they can worry about weight loss. In the township, why would I want to get skinny? People will think I’m poor,” Matsau says.

“Being poor is already a forced diet. And if you exercise, you’re wasting all of that energy. We need to harness it.”

Socio-economic barriers to weight loss are pervasive. Gym memberships are too expensive and inconvenient for many.

Doctor’s visits can also incur costs, so unhealthy people may avoid check-ups altogether.

Beryl Chaka, a diabetic, was prescribed a healthy diet by her doctors. She does not follow it because the recommended foods are too expensive, she says.

When magwinyas (fat cakes) sell for only a rand at every corner, it is no surprise that nutritious foods don’t provide enough bang for the buck.

Cheap and ubiquitous fast food is a classic side effect of rapid urbanisation.

This phenomenon has been dubbed the “nutrition transition” by public health experts.

Many countries in political transition have moved from hunger straight to obesity, with significant overlap – obese people are often simultaneously malnourished because of poor diets full of empty calories.

A 2008 study revealed that 84 percent of elderly women in Sharpeville were obese despite being chronically food insecure, according to an African Food Security Urban Network report.

As more people move into urban areas, work faraway jobs and make more money, they opt for convenience over nutrition.

“The parents don’t cook for kids. They give them money to buy food,” says cobbler Jimmy Nyambi.

Nyambi’s children dislike the cabbage and spinach he boils for dinner.

“Generally, people don’t like to eat healthy food. Junk food seems to be tastier,” Matsau says. “The other morning, I saw a guy going to buy a kota.”

Kotas – quarter-loaves of white bread filled with processed food such as chips, cheese and polony – can be purchased for as little as R8. Fast food chains are also growing in popularity, and the “brand names” attract diners.

To top it off, urbanisation diminishes physical activity.

“People take a taxi (from Pimville) to Maponya Mall,” Nyambi says. “You can go to Maponya with your feet.”

Junk food is becoming more prevalent, and in turn, healthy options are being pushed out.

“On every corner, you’ll find a kota. But for nutritious food, you have to walk far. There are no fruit shops around,” Matsau says.

Matsau believes he lives in a food desert: an area where fresh produce is scarce, with grocery stores few and far between. To get to the closest grocery store, he cannot walk; he must take a taxi.

“You end up spending more on transport than on food,” says community activist Sam Ndlovu.

Matsau adds: “There are people who sell fruits on the corner, but they’re perishable. So you won’t find anyone selling the whole range (of produce).”

Ndlovu believes people need to tackle this problem.

“We as Africans are afraid of going back to our roots. When we buy spinach, we put on fat and a lot of salt,” Ndlovu says.

He wants to take an unused patch of land in Pimville Zone 4 and turn it into a community garden, allowing residents to grow their own fresh vegetables. He has been in discussions with authorities.

However, there are many obstacles to overcome before his vision of this oasis can become a reality.

“If you start a garden here, it’s not properly fenced. You do the labour but other people will take the food,” Matsau says.

For now, promoting education is Ndlovu’s priority.

“I think most people are afraid of going to check-ups. They think they are going to get negative results,” Ndlovu says. “We must (take) time to educate the community.”

Even educating one small community can make a difference to the country as a whole.

“There are other people who will have high blood pressure or diabetes, whether they exercise or not; it’s genetic,” Matsau says.

“But queues of unhealthy young (overweight) people are clogging up the health system.”