If obesity in South African children continues to increase at the current rate, 3.91 million school children will be overweight or obese by 2025. On world Obesity Day, the Heart and Stroke Foundation South Africa (HSF), together with the World Obesity Federation, calls for decisive action from government, private sector and parents.
11 October, 2016 was World Obesity Day and the theme was Ending Childhood Obesity: Act today for a healthier future. HSF supports the World Obesity Federation (WOF) in the initiative to stimulate and support practical actions to address obesity.
The population group that is most vulnerable to this ‘obesogenic’ environment is children. Both children of overweight parents and children subjected to malnutrition during pregnancy or infancy are likely to become obese later in life. Children are brought up in an era of energy dense foods, increasing screen time and sedentary behaviour. The World Health Organisation (WHO) reports the fastest growth of obesity in the African region, where childhood overweight and obesity has more than doubled from 1990 to 2013 1.
Childhood obesity in SA - our girls at greatest risk
According to the most recent national survey, 14.2% of primary school children are already overweight 2. This prevalence is highest at 30% in girls living in urban areas. Being overweight as an infant increases the risk of being overweight as a child, which in turn increases the risk of being overweight as an adolescent and adult. Results from the Birth to Twenty study in Soweto recently showed that girls who were obese between the ages of 4 – 6 years, were 42 times more likely to be obese as teenagers compared to their normal-weight peers! 3 Clearly interventions should already be addressed at infants and toddlers.
Cultural beliefs and poor knowledge of the consequences of obesity lulls many parents into inaction. Childhood obesity is not prevented, recognized or treated adequately. New figures from the World Obesity Federation estimate that by 2025, 3.91 million South African school children will be overweight or obese. This will result in 123 000 children with impaired glucose tolerance, 68 000 with overt diabetes, 460 000 with high blood pressure, and 637 000 with first stage fatty liver disease 4.
The global action plan
The complexity of the obesity epidemic is often cited to explain the little success in turning the tide and perhaps as an excuse not to make the changes we know are necessary. The 2016 WHO Report on Ending Childhood Obesity clearly outlines a comprehensive action plan. Recommendations include addressing norms, treating children who are already obese, promoting intake of healthy foods and physical activity, improved preconception and pregnancy care, healthier school environments, and curbing the marketing of unhealthy foods.
The South African Department of Health have incorporated these guidelines in their own Strategy for the prevention and control in South Africa of obesity framework. Childhood obesity is singled out within this strategy as a specific area of focus, “given the large perceived benefit the interventions may yield”.
We can end obesity if we act now
Obesity is not a complex problem, for we have the tools to address it. We can end the childhood obesity epidemic if we act together. The President of the World Obesity Federation, Professor Ian Caterson, calls for decisive action “If governments hope to achieve the WHO target of keeping child obesity at 2010 levels, then the time to act is now.”
In the National Obesity Strategic Framework, Deputy Minister of Health Dr Joe Phaalhla writes “…It is our responsibility to empower people to make informed decisions and to ensure that they have access to healthy food by raising awareness and increasing the availability of effective initiatives and interventions.”
The Government has shown intent by announcing tax on sugar-sweetened beverages, strategies to increase school sport, and draft legislation to restrict the advertising of unhealthy foods to children. Swift and effective implementation of these policies are vital.
Professor Caterson from the WOF urges governments to act “Introducing tough regulations to protect children from the marketing of unhealthy food, ensuring schools promote healthy eating and physical activity, strengthening planning and building rules to provide safe neighbourhoods, and monitoring the impact of these policies.”
Private sector and in particular the food industry
There is no singular solution for obesity, and involvement of all sectors is needed. Food industry and especially fast food restaurants - still largely unregulated - needs to become part of the solution by producing healthier products and meals that are lower in added sugar, salt and fat, and by partnering with government and civil society to make healthy food choices more affordable. Collective advertising spend on unhealthy foods and meals are staggering, overpowering education efforts by government and NGOs. The HSFSA calls on the food industry to realise the vital role they play in South Africa’s obesity epidemic. It is time to make a choice to either help or hinder- practicing responsible marketing of foods aimed at children is a good place to start.
Parents and caregivers
Professor Pamela Naidoo, CEO of the HSFSA implores primary caregivers “Parents have the single biggest influence over their children’s risk of obesity. Mothers should aim for a normal weight before pregnancy, appropriate weight gain during pregnancy, and exclusive breastfeeding for the first six months. Parents should introduce healthy eating habits from six months onwards and lead by example to create an active lifestyle for the whole family.”
Prof. Naidoo concludes “The HSFSA will continue its efforts to advocate for a healthier environment and create public awareness to prevent obesity as a major risk factor for heart diseases and strokes”. The Heart Mark is one such tool used to make it easier for consumers to make the healthier choice when faced with a variety of options at the supermarket. It helps consumers to identify healthier products that contain less added sugar, salt, and unhealthy fats, and more fibre compared to other similar products.
Another initiative parents can advocate for within the schools their children attend is the Tuck Shop Programme, run by the HSFSA. The programme is free and offered to schools around the country. The programme aims to help schools offer healthier food options to their learners, enabling children to make healthier food choices. Schools are guided through the process of adapting their existing food offerings in a manner that is cost-effective and practical. For more information, call 08601 HEART.
Heart and Stroke Foundation South Africa
Public Relations and Communications Officer
World Obesity Federation:
Professor Ian Caterson, President, World Obesity Federation.
Dr Tim Lobstein, Policy Director, World Obesity Federation.
For more information:
Twitter: @worldobesity #WorldObesityDay
- World Health Organization. Facts and figures on childhood obesity. http://www.who.int/end-childhood-obesity/facts/en/
- National Department of Health. Strategy for the prevention and control in South Africa of obesity. 2016. https://www.health-e.org.za/wp-content/uploads/2015/12/National-Strategy-for-prevention-and-Control-of-Obesity-4-August-latest.pdf
- World Health organisation. Report of the commission on ending childhood obesity. 2016. http://apps.who.int/iris/bitstream/10665/204176/1/9789241510066_eng.pdf?ua=1
- Lobstein T, Jackson-Leach R. Planning for the worst: estimates of obesity and comorbidities in school-age children in 2025. Pediatric Obesity 2016; 11 (5): 321–5. DOI: 10.1111/ijpo.12185
- Lundeen EA, Norris SA, Adair LS, Richter LM, Stein AD. Sex differences in obesity incidence: 20-year prospective cohort in South Africa. Pediatr Obes. 2016; 11(1):75-80
- Shisana O, Labadarios D, Rehle T, Simbayi L, Zuma K, Dhansay A, Reddy P, Parker W, Hoosain E, Naidoo P, Hongoro C, Mchiza Z, Steyn NP, Dwane N, Makoae M, Maluleke T, Ramlagan S, Zungu N, Evans MG, Jacobs L, Faber M, & the SANHANES-1 Team (2014) South African National Health and Nutrition Examination Survey (SANHANES-1): 2014 Edition. Cape Town: HSRC Press
- This article was first published in the HSF website.
Photo Courtesy: hsph.harvard