Africa faces obe­sity prob­lem

By 2050, 60% of ur­ban pop­u­la­tion will be obese adding to growing list of life­style health prob­lems and largely fu­eled by poor nu­tri­tion

The New Age (Western Cape) - - Opinion & Analysis - DICKSON AMUGSI Dickson Amugsi, as­so­ciate re­search sci­en­tist, African Pop­u­la­tion and Health Re­search Cen­tre. Mwangi Chege, pol­icy en­gage­ment man­ager at APHRC con­trib­uted to this ar­ti­cle

RAPID ur­ban­i­sa­tion and as­so­ci­ated changes in peo­ple’s life­style means Africa faces a growing obe­sity prob­lem. Across the con­ti­nent the share of the ur­ban pop­u­la­tion is pro­jected to in­crease to 50% by 2030 and 60% by 2050.

In­creased ur­ban­i­sa­tion is as­so­ci­ated with life­style changes such as de­creased phys­i­cal ac­tiv­ity. This is of­ten ac­com­pa­nied by in­creased in­take of high caloric fast foods and sugar-sweet­ened bev­er­ages. This com­bi­na­tion has con­trib­uted to the ris­ing bur­den of obe­sity in towns and cities in de­vel­op­ing coun­tries.

Obe­sity is a se­ri­ous pub­lic health prob­lem be­cause it sig­nif­i­cantly in­creases the risk of chronic dis­eases such as car­dio­vas­cu­lar dis­ease, type-2 di­a­betes, hyper­ten­sion, coro­nary heart dis­eases and cer­tain can­cers. It also puts con­sid­er­able strain on health­care and so­cial re­sources. Why obe­sity is a prob­lem A per­son is con­sid­ered to be obese if they weigh more than 20% over their ideal weight. It is more pre­cisely de­fined as body mass in­dex of 30 or more.

For women of re­pro­duc­tive age, the con­se­quences of be­ing obese are more se­ri­ous. Stud­ies have shown that ma­ter­nal obe­sity is bad for both the mother and un­born child. It can lead to higher rates of mis­car­riage, still­births and con­gen­i­tal anom­alies.

Obe­sity can also re­sult in ges­ta­tional di­a­betes, which is marked by high blood sugar lev­els dur­ing preg­nancy. These usu­ally dis­ap­pear af­ter delivery. An­other in­her­ent risk is pre­eclamp­sia, a con­di­tion that af­fects some preg­nant women and usu­ally sets in 20 weeks into preg­nancy.

Obe­sity dur­ing preg­nancy can also af­fect health later for both mother and child, in­clud­ing in­creased risk of heart dis­ease, hyper­ten­sion and di­a­betes. Chil­dren of obese moth­ers also have a risk of fu­ture obe­sity.

And obe­sity is as­so­ci­ated with de­creased con­tra­cep­tive ef­fi­cacy and also im­pacts neg­a­tively on nor­mal vagi­nal delivery. Obe­sity in Africa To un­der­stand the scale of the obe­sity prob­lem in Africa, we an­a­lysed de­mo­graphic and health sur­vey data from 24 African coun­tries over 25 years. Such data are col­lected ev­ery five years in the de­vel­op­ing coun­tries. We found that not only was obe­sity on the rise, but that it is high among ur­ban African women aged 15 to 49 years.

The anal­y­sis shows in­creases in obe­sity lev­els in all 24 coun­tries over the 25 year pe­riod. The in­creases were statistically sig­nif­i­cant in 17 coun­tries. Based on the lat­est sur­veys we found that four coun­tries had an obe­sity preva­lence that was above 20% while the rest ranged be­tween 10% and 19% among ur­ban women of re­pro­duc­tive age in the coun­tries stud­ied. Com­par­ing these data with ear­lier sur­veys it is clear that obe­sity lev­els among ur­ban women have wors­ened in the past twoand-a-half decades.

Our study found sig­nif­i­cant dif­fer­ences be­tween African coun­tries. In the lat­est sur­vey Egypt has the high­est preva­lence of obe­sity by far. Two out of ev­ery five Egyp­tians (39%) are obese, fol­lowed by Ghana at 22%.

Egypt and Ghana also ex­pe­ri­enced a sig­nif­i­cant in­crease in obe­sity over the past 25 years, from 34% to 39% (13% in­crease) in Egypt and 8% to 22% in Ghana (65% in­crease). The in­crease in obe­sity dou­bled in Kenya, Benin, Niger, Rwanda, Ivory Coast and Uganda, while Zam­bia, Burk­ina Faso, Mali, Malawi and Tan­za­nia ex­pe­ri­enced a three-fold in­crease.

While the preva­lence of obe­sity in these coun­tries is lower than Egypt’s or Ghana’s, the rate of ac­cel­er­a­tion is alarm­ing. Should these trends per­sist, obe­sity lev­els in these coun­tries may reach the lev­els of those in Egypt and Ghana. Pol­icy in­ter­ven­tions Given the mag­ni­tude of the in­crease in obe­sity lev­els among ur­ban women in the coun­tries stud­ied, we ar­gue strongly that gov­ern­ments should take ur­gent steps to address the prob­lem.

There is a di­rect link be­tween obe­sity and the rise in non­com­mu­ni­ca­ble dis­eases. Ad­dress­ing obe­sity will be an im­por­tant step to­wards curb­ing the surge of life­style dis­eases that the con­ti­nent is ex­pe­ri­enc­ing. It’s es­ti­mated that their toll is likely to sur­pass in­fec­tious dis­eases by 2030.

This calls for de­lib­er­ate poli­cies and in­ter­ven­tions geared to en­cour­ag­ing peo­ple liv­ing in ur­ban ar­eas to adopt healthy di­ets, in­crease phys­i­cal ac­tiv­ity and re­duce weight.

Strate­gies should in­clude pol­icy in­ter­ven­tions to address over-con­sump­tion of un­healthy di­ets. This may in­clude fis­cal food poli­cies, manda­tory nu­tri­tion pan­els on the for­mu­la­tion and re­for­mu­la­tion of man­u­fac­tured foods, im­ple­men­ta­tion of food and nu­tri­tion la­belling, re­strict­ing mar­ket­ing and advertising bans of un­healthy foods and mak­ing healthy food ac­ces­si­ble.

Greater phys­i­cal ac­tiv­ity can be en­cour­aged through ur­ban plan­ning, trans­port and or­gan­i­sa­tional poli­cies cou­pled with the pro­vi­sion of fa­cil­i­ties such as pub­lic parks. Such in­ter­ven­tions have been ap­plied in de­vel­oped coun­tries with some mea­sure of suc­cess. – the­con­ver­sa­


GROWING PROB­LEM: Obe­sity can lead to car­dio­vas­cu­lar dis­ease, type-2 di­a­betes, hyper­ten­sion, coro­nary heart dis­eases and cer­tain can­cers and puts con­sid­er­able strain on health­care and so­cial re­sources.

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