Counting The Cost Of Calories

Given the popular portrayal of Africa as a starving continent, and the ongoing scourge of poverty that disproportionately affects its citizens, it often comes as a surprise to discover that one of the fastest-growing concerns among health professionals in Africa is obesity.

According to the World Health Organisation, some 10.3 million children (or 6.1%) on the continent are technically obese, as a result of urbanisation, reducing exercise, and increased access to and reliance on sugary and fatty foods. Last year researchers from the University of the Witwatersrand calculated that “non-communicable lifestyle diseases” such as diabetes and heart disease now account for almost as many deaths as AIDS/HIV ion South Africa.

The issue affects women disproportionately, too. While obesity levels in South Africa’s male population is still below those in the UK and the USA, it is steadily climbing, according the South African Heart Foundation (SAHF). But the prevalence of obesity in adult females is already 42% higher than that in the USA, and double that of the UK.

“Obesity figures in both of these countries are plateauing, while ours are still increasing,” says SAHF head Gabriel Eksteen.

Eksteen says that, over time, the eating habits, food supply types and the country’s culture have contributed significantly to this problem – and it’s far from restricted to the middle classes. Low-cost food is often highly processed and loaded with sugars.

“The causes are cumulative and underpinned by an obesogenic environment – an environment that makes it easy to become overweight,” adds Eksteen. “Our modern food supply is energy-dense, portions are too big, and highly processed foods are both moreish and cheap.

“Activity levels are declining and sitting time increasing. Finally, the overwhelming majority of the South African population indicates their ideal body weight as ‘fat’,” he says.

Something clearly needs to be done. But is it possible, with the country teetering on junk bond status, to make healthier food more affordable?

“Food prices will continue to rise, but both austerity and prosperity cause poor food choices. The solution should address two issues: help consumers to spend their food budget wisely, and make healthy foods more affordable,” suggests Eksteen.

One potential solution is to increase the cost of consumables that have large amounts of added sugar – which will happen later this year when the so-called “sugar tax” on soft drinks comes into effect. The rate of the tax will be 2.29c per gram of natural or added sugar.

This could be a good thing, as there are noticeably fewer low-sugar drinks in South African supermarkets and spaza stores than are available in their European counterparts. But the tax has caused outrage among the food industry, which predicts job losses and economic catastrophe. Worse for the government, however, is the fact that a recent report by McKinsey suggested that sugar taxes have no observable effect in reducing obesity levels or changing buying habits.

Eksteen says making healthier foods more affordable is possible through combined industry and government action, but also needs to be driven by consumer demand.

“Habits are difficult to break, once established, particularly when there are socio-economic barriers,” he notes. “Few obesity treatment programmes are available, and, even when available, have varying success.”

It’s paramount that healthy eating habits are learned from a young age, he concludes. Mothers need support in monitoring healthy growth of their babies, and supporting healthy feeding practices is a key strategy in addressing the problem as early as possible.