An increase in the consumption of unhealthy food and a lack of physical activity are to blame for increasing obesity in South African women of childbearing age, according to a study by University of Cape Town (UCT) doctoral student Mweete Debra Nglazi.
Nglazi used nationally representative data from the 2008 - 2017 National Income Dynamics Study, 1998 and 2016 South African Demographic and Health Surveys, and 2005/06 and 2010/11 Income and Expenditure Surveys, to assess the prevalence of overweight and obesity changes between 1998 to 2017 for non-pregnant women aged 15 to 49 years in South Africa. She also examined the determinants of overweight and obesity.
The ratios of overweight or obese persons have increased from 24.7 to 35.2 % and 51.3 to 60.0 %, respectively, according to the study, published in the journal BMC Public Health. Nglazi asserts that older women continue to have greater rates of obesity and overweight than younger women.
In 1998, women with no primary education and those with secondary education had a higher overweight and obesity prevalence than those with tertiary education. But this pattern was reversed in 2017.
Nglazi noted that compared to women from less affluent socio-economic origins, women from wealthier backgrounds tended to have greater prevalence rates of overweight and obesity.
"The prevalence of overweight and obesity among most women in 2017 was significantly higher than the estimate in 1998. Significant predictors of overweight and obesity included increased age, self-identification with the Black African population group, higher educational attainment, living in an urban area, and wealth. Being overweight or obese was found to be inversely related to smoking "stated Nglazi.
South Africa is undergoing a nutrition transition, characterised by an increasing prevalence of overweight and obesity. The finding that overweight and obesity increased over time could be due to rapid economic development since the new democracy in 1994, urbanisation, and increased female labour force participation.
"Working women tend to have low-energy jobs, and mobility is less energy-intensive because of shorter commutes and the use of motorised transportation. Time constraint is a challenge for many women in preparing healthy meals because of long working hours and having greater access to processed foods," she highlights.
Other studies have confirmed that African countries were undergoing increasingly rapid urbanization, globalization of the food markets and economic and human development. These are associated with lifestyle changes such as increased sedentary behaviours, physical inactivity and increased consumption of the ‘Westernized diets’.
"Those with higher education tend to have less energy-demanding jobs, be more physically inactive, and have sedentary lifestyles. By contrast, we found that in 1998, the odds of being overweight and obese was lower in women with a tertiary education compared to those with no primary school education.”
In 1998 and 2017, the study found that women residing in urban areas had higher odds of being overweight or obese than those who resided in rural areas.
Dr. Andre Pascal Kengne, director of the Non-Communicable Diseases Research Unit of the South African Medical Research Council in Cape Town, agrees that poverty is a contributing factor to lower rates of obesity among women in rural areas.
"Life in rural Africa has largely remained physical, mostly agricultural and manual labour, involving manual work and agriculture. The simple act of collecting water is demanding."
Additionally, according to Kengne, there is limited access for vehicles and buses and the roads are completely undeveloped in rural areas, and so, "people tend to walk."
Furthermore, due to certain sociocultural practices that influence food choices, dietary intakes, and physical activity the perception of overweight/obesity is seen as an indicator of beauty, good health and wealth, particularly among women who tend to be more sedentary compared to men.
Clearly, South Africa needs urgent public health attention due to the rising trend of overweight and obesity among women of reproductive age.