African Obesity
Africans are getting fatter and less fit
    
AFRICA, a continent usually synonymous with hunger, is falling prey to obesity. It’s a trend driven by new lifestyles and old beliefs that big is beautiful.

Ask Nodo Njobo, a plump hairdressing assistant. She is coy about her weight but, like many African women, is proud of her “big bum”. She says she’d like to be slimmer but worries how her friends would react.

“Here, if you lose a lot of weight, people automatically think you have TB or Aids. It’s not like in America and Europe where you go on a diet to lose weight,” Njobo said.

More than one-third of African women and a quarter of men are estimated to be overweight, and the World Health Organisation predicts that will rise to 41% and 30% respectively in the next 10 years.
“We have gone from under-nutrition to over-nutrition without ever having passed healthy nutrition,” said Krisela Steyn, a retired professor with the South African Medical Research Council.

Although the figures are lower than in affluent countries, many experts fear that health systems already stretched by the Aids virus, malaria and poverty-related diseases may snap under the additional burden of heart disease, strokes, cancer and diabetes, conditions linked to obesity.
Worldwide, an estimated 1 billion people are overweight, compared to 800 million who are undernourished.

Ironically, the poorest are often most vulnerable. Children born with low birth weights to malnourished mothers tend to be more at risk of becoming overweight. They are also more prone to obesity as they are fed too much to help them catch up, according to experts at a recent Cape Town conference on chronic disease.

In South Africa, death rates from obesity and diabetes are on the rise. Some 56% of our women are obese or overweight, compared to fewer than 10% who are underweight.

More than 17% of adolescents are overweight. For teenage girls, it’s 25%, according to the Medical Research Council.

The traditional diet is heavy in starch, with foods like mealie meal and white bread being staples. Three spoons of sugar in coffee and tea are the norm. And, as elsewhere in the world, high-fat, high-sugar fast foods, snacks and fizzy drinks are in.

Growing urbanisation has led to less walking and exercise, and televisions has led to a generation of couch potatoes rather than athletes.

Throughout the continent, it is considered rude to refuse food.

“We face a very difficult situation in trying to manage obesity. We are up against social and traditional norms that being fat is a sign that you are wealthy, you are successful, you are happy, that your husband can feed you,” Steyn said.

Njobo comes from a remote rural village where walking was the main means of getting around. She now works in Cape Town and says she doesn’t have time to buy and cook vegetables and lentils so she often grabs convenience foods.

She is too tired to exercise after being on her feet all day and after the long bus ride home. In any case, she wouldn’t dream of jogging in her suburb as it is plagued by crime.

South Africa is not alone. In Cameroon, where the diet is rich in palm oil, cornflower products and red meat, 35% of the population is overweight or obese. Similar rates are found in Gambia and Nigeria, particularly among women, according to figures presented at the recent Oxford Health Alliance conference. These numbers are still far below the industrialised world.

Only about 2.4% of Africans suffered from diabetes, compared with nearly 8% in Europe and North America. But the International Diabetes Federation says Africa’s overburdened health systems are ill-equipped to diagnose the disease and treatment is too expensive for the vast majority of its victims.
The federation cites the example of a diabetes patient in Mali needing to spend more than $21 (R150) on diabetes care a month – more than half the average family’s income.

Poor communities with no electricity or refrigerators face the added problem of how to store insulin. Even in relatively sophisticated cities like Cape Town, the number of diabetes sufferers with amputated feet due to late diagnosis and poor treatment is distressingly high.

“It’s not true that only the rich have problems with obesity and weight,” says Jean-Claude Mbanya, director of Cameroon’s National Obesity Centre. “The poor suffer even more.” – Sapa-AP
Published in City Press 3 December 2006