In the past, overweight people were believed to be the healthiest, more likely to have resistance to diseases and infections (Ebbeling et al, 2002). Some decades ago, the increase in non-communicable diseases associated with overweight and obesity has arguably become a public health problem in developed countries and more recently in under developed countries; with 8 million overweight people living in developed countries and 53 million living in developing countries (WHO, 2012). This essay will try to discuss overweight and obesity in South Africa, the public health challenges and how the country is tackling the issue.
Overweight and obesity can be defined as a body mass index (BMI) of an individual greater than or equal to 25kg/m2 and greater or equal to 30 kg/m2 respectively (WHO, 2012). Overweight and obesity has been highlighted to be one of the causes of recent increase in non-communicable diseases, accounting for about 1. 4 million people worldwide (Ebbeling et al. , 2002). South Africa is a Sub-Sahara African country and has a population of 50,132,817 people. In South Africa, over-nutrition can be said to be high with overweight and obese accounting for 65. 4% and 31. 3% respectively of the total population (WHO, 2011).
About 29% of men and 56% of women have body mass index (BMI >25) for overweight and (BMI>30) for obesity. Despite the country focusing on underweight and infectious diseases, the increase in non-communicable diseases due to over nutrition has created a double burden of disease which increases public health challenges (Kruger et al. , 2005). In South Africa, the public health challenges associated with overweight and obesity are increase in non-communicable diseases. And theses non-communicable diseases and their prevalence are 3% for diabetes, 21% for hypertension, 7% for cancer and 16. 5% for mental illness (Kruger et al. , 2005).
However despite this prevalence, few epidemiological studies of the association between obesity and non-communicable diseases have been carried out in South Africa (Goedecke et al. , 2005). The determinants associated with obesity other than genetic factors are; socio-cultural factor, education, dietary intake and physical activity. Highlighting socio-cultural factor, studies have shown that cultural background influences black South Africa women to gain weight which symbolises wealth, happiness, good health and free from HIV/AIDS (Clark et al. , 1999). 56. 6% of South African females are overweight, but 22% perceive themselves as overweight.
Studies have shown that most women with this negative perception had low level of education (Bradshaw et al. , 2002). Due to urbanization, a change in diet from the local homemade meal to high calories meals sold by fast foods have been observed, thus contributing to increase in the prevalence of overweight and obesity (Department of Health, 2011). Lack of physical activity has also been implicated, a study carried out in Cape Town, found children with higher television viewing and less physical activity had a higher BMI when compared to children that were physically active (Charlton et al., 2000).
Some efforts have been made to tackle overweight and obesity in South Africa, though with variable outcomes. The South African government carried out a national survey in 1998 and it was repeated in 2003. Findings from the survey prompted the Department of health after series of consultations, to set up the Directorate, Chronic Disease, Disabilities and Geriatrics, to prevent and monitor non-communicable diseases. Then in 2004, the Directorate of Health Promotions was launch, which was aimed at promoting healthy life styles and highlighting risky behaviours.
The Department of Education in collaboration with the private sector launched an awareness programme called “Vuka-South Africa’. Its objectives are to promote physical activity and maintain optimum weight particularly among the youths (Goedecke et al. , 2005). Despite all these initiatives, increase in prevalence of overweight and obesity together with non-communicable diseases have been recorded. And trends of some non-communicable disease risk factor are still on the rise.
For example, the mean systolic blood pressure of men and women in the year 2000 was 129mmhg and 127mmhg respectively; and in 2008, an increase of 133mmhg and 129mmhg was recorded for men and women respectively. An increase in BMI over time was also recorded. In 2000, the mean BMI for men and women was 23kg/m2 and 27kg/m2 respectively and in 2008, the mean BMI was 27kg/m2 and 30 kg/m2(WHO, 2011). These initiatives have been implemented with some measure of success in the private sector, but the same cannot be ascertained in the public sector (jacke, 2012).
The South African government have tried to reduce the prevalence of obesity by creating polices and guideline; however, due to the high prevalence of obesity, the need to address these huge burden of disease cannot be argued. There is the need for the government, communities, the media and other stake holders to work together to address overweight and obesity. This public health crises also demands more research into the association between obesity and non-communicable diseases with a multi-sectoral approach between the diverse populations with different cultural background.
And also research should be carried out into pharmacological approaches, for treatment and prevention of overweight and obesity. And finally, there is the need for the South African government to prioritise monitoring and evaluation of the existing policies and interventions. Tackling overweight and obesity, reduces public health challenges and in turn reduces the prevalence of non-communicable diseases. Communities, governments, the media and the food industry need to work together to modify the environment so that it is less conducive to weight gain and to create a supportive environment using a multisectoral approach, including antipoverty measures, food production strategies, water, sanitation and proper housing.
Strategies should include consumer education, appropriate food labelling, nutritional and physical activity education, as 1. Interventions should focus on education and address environmental and social factors to promote and support behaviour change. 2. Increased physical activity. 3. Sustainability of programmes is crucial to ensure positive change in diet, activity and obesity levels over time. 4. Political support, intersectoral collaboration and community participation are essential for success. 5.
Local actions within the context of national initiatives allow programmes to meet needs, expectations and opportunities. 10. Programmes should be properly monitored, evaluated and documented to ensure dissemination and transfer of experience. And all these pose challenges to public health.
Taking action to address overweight and obesity in Nevada communities will have tremendous, positive public health effects, therefore reducing public health challenges and in turn reducing the prevalence NCDs.
http://journals. cambridge. org/download. php? file=%2F73825_601959B71BFE7BDB5E771D14624652B2_journals__PHN_PHN8_05_S1368980005000686a.
pdf&cover=Y&code=71bd78d1ca0ae363a52396b9fb4b0cce http://www. mrc. ac. za/chronic/cdlchapter7. pdf http://www. ncbi. nlm. nih. gov/pmc/articles/PMC2905575/ http://epirev. oxfordjournals. org/content/29/1/62. full http://www. who. int/dietphysicalactivity/childhood/en/ http://wiredspace. wits. ac. za/bitstream/handle/10539/8792/AmyFairbrother_ResearchReport_FinalSubmission. pdf? sequence=1 http://www. allhealth. org/briefingmaterials/lancetobesityrev-393. pdf http://www. who. int/nmh/countries/zaf_en. pdf http://www. who. int/nmh/countries/zaf_en. pdf http://www. who. int/nmh/countries/zaf_en. pdf http://journals. cambridge. org/download.
php? file=%2F91034_4C8032CCD6554E299E9E1DB7C0BB0961_journals__PHN_PHN8_05_S1368980005000686a. pdf&cover=Y&code=9d82e7b192bb86d4f111c69b82140018 http://www. who. int/mediacentre/factsheets/fs311/en/index. html http://www. mrc. ac. za/chronic/cdl1995-2005. pdf http://www. ajol. info/index. php/jemdsa/article/viewFile/34693/24857 http://www. doh. gov. za/docs/reports/2012/epicomments3. pdf http://www. globalpa. org. uk/downloads/healthy-active-kids-report-2010. pdf http://orgs. bloomu. edu/gasi/2012%20Proceedings%20PDFs/StaggersImpact%20of%20Globalization%20on%20the%20Prevalence%20of%20Obesity%20GASI%20Proceedings%20Submission. pdf.