SA suffers double burden of malnutrition and obesity

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Unless we act now, by 2025 almost 4m South African children will be overweight or obese and more than 600,000 will be suffering of related diseases, reports Health-e News.

But, says a Health-e News report, ending the epidemic in the country is much more complicated than simply getting the nation’s children to lose weight.

“I received a call from a colleague working in a local hospital a few weeks ago to tell me he had a type 2 diabetic patient – which is not unusual – except that this patient was an adolescent, a child,” says Professor David Sanders from the University of the Western Cape. “We used to only see this disease in adults and in middle-age which is why it used to be called adult-onset diabetes – but now that term has become completely irrelevant.”

Sanders, an expert on paediatric nutrition issues, says that because of the explosion in chronic diseases of lifestyle, called non-communicable diseases (NCDs), “we as clinicians are having to change the way we treat patients”.

“We now see paediatric practitioners having to become competent in picking these conditions up as well as treating them. We have to face facts: NCDs in children, especially diabetes, can’t be classified as ‘rare’ anymore,” he says.

The report says according to data from the South African National Health and Nutrition Examination Survey, among girls aged between two and fourteen years, 16.5% are overweight while 7.1% are classified as obese. Although lower, rates in boys are also high: more than one in ten male children in the same age group are overweight while 4.7% are obese.

But findings from that same survey indicated that under-nutrition is also high. More than a quarter of South African households (26%) experienced hunger in 2012. Almost a third (27%) of children younger than three are stunted (too short for their age), while 6% of those under fourteen are underweight.

But how can these seemingly diametrically opposed scenarios be occurring at the same time? Termed the double burden of undernutrition and overweight and obesity, it is an increasing problem on the continent, and Sanders says, South Africa is the perfect case study.

We are living in an environment where a malnourished child and an obese child can be found living under the same roof, and many aren’t even aware there is a problem.”
He says that nutritional deficiencies and obesity can work together in complex ways to worsen the problem.

“There is evidence that under-nutrition in foetal life, related to low birth weight, can predispose a person to becoming over-weight as they grow,” he says.

“The obesity situation is a little bit like where we were with HIV 20 years ago,” says Professor Tess van der Merwe, president of the South African Society for Surgery, Obesity and Metabolism.

“One of the biggest differences is there is no pill or drug we can take to prevent or treat obesity and consequently we don’t have Big Pharma to pour money into the response.” She believes that if we don’t “wake up” and “act urgently”, obesity’s impact on South African lives will overtake that of HIV – a trauma from which the country is still recovering.

According to Van der Merwe, obesity, and its related conditions like diabetes, heart disease and cancer, is already costing the country R23bn a year. “And with a growing population of overweight children adding to the pool, it doesn’t matter if you’re looking at the private or public health sectors, it is just far too costly to sustain.”

Health-e News material

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