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Where does the black population of South Africa stand on the nutrition transition?

Published online by Cambridge University Press:  22 December 2006

Lesley T Bourne ,
Estelle V Lambert  and
Krisela Steyn
Lesley T Bourne*
Affiliation:
Health and Development Research Group, Medical Research Council (MRC), PO Box 19070, Tygerberg 7505, South Africa
Estelle V Lambert
Affiliation:
MRC/UCT Exercise Science and Sports Medicine Research Unit, University of Cape Town, Sports Science Institute of South Africa
Krisela Steyn
Affiliation:
Chronic Diseases of Lifestyle Unit, Medical Research Council, Tygerberg, South Africa
*
*Corresponding author: Email [email protected]
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Abstract

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Objective:

To review data on selected risk factors related to the emergence of non communicable diseases (NCDs) in the black population of South Africa.

Methods:

Data from existing literature on South African blacks were reviewed with an emphasis placed on changes in diet and the emergence of obesity and related NCDs.

Design:

Review and analysis of secondary data over time relating to diet, physical activity and obesity and relevant to nutrition-related NCDs.

Settings:

Urban, peri-urban and rural areas of South Africa. National prevalence data are also included.

Subjects:

Black adults over the age of 15 years were examined.

Results:

Shifts in dietary intake, to a less prudent pattern, are occurring with apparent increasing momentum, particularly among blacks, who constitute three-quarters of the population. Data have shown that among urban blacks, fat intakes have increased from 16.4% to 26.2% of total energy (a relative increase of 59.7%), while carbohydrate intakes have decreased from 69.3% to 61.7% of total energy (a relative decrease of 10.9%) in the past 50 years. Shifts towards the Western diet are apparent among rural African dwellers as well. The South African Demographic and Health Survey conducted in 1998 revealed that 31.8% of African women (over the age of 15 years) were obese (body mass index (BMI) ≥ 30 kgm−2) and that a further 26.7% were overweight (BMI ≥ 25 to <30 kgm−2). The obesity prevalence among men of the same age was 6.0%, with 19.4% being overweight. The national prevalence of hypertension in blacks was 24.4%, using the cut-off point of 140/90 mmHg. There are limited data on the population's physical activity patterns. However, the effects of the HIV/AIDS epidemic will become increasingly important.

Conclusions:

The increasing emergence of NCDs in black South Africans, compounded by the HIV/AIDS pandemic, presents a complex picture for health workers and policy makers. Increasing emphasis needs to be placed on healthy lifestyles.

Keywords

Black South AfricansDietObesityActivityHypertensionDiabetes
Type
Research Article
Information
Public Health Nutrition , Volume 5 , Issue 1a , February 2002 , pp. 157 - 162
Copyright
Copyright © CABI Publishing 2002

References

1Statistics South Africa. Population Census, 1996: Primary Tables. Report 03-01-17 (1996). Pretoria: Statistics South Africa, 1999.Google Scholar
2Burkitt, DP. Western diseases and their emergence related to diet. S. Afr. Med. J. 1982; 61: 1013–5.Google ScholarPubMed
3Segal, I, Walker, ARP. Low fat intake with falling fibre intake commensurate with rarity of non-infective bowel diseases in blacks in Soweto, Johnannesburg, South Africa. Nutr. Cancer 1986; 8: 185–91.CrossRefGoogle Scholar
4Fox, FW. Diet in the urban locations as indicated by the survey. In: Janisch, M, ed. A Study of African Income and Expenditure in 987 Families in Johannesburg. City of Johannesburg: Department of Non-European and Native Affairs, 1940.Google Scholar
5Du Toit, B. Dietary survey amongst 100 native families in the Payneville Location, Springs. S. Afr. J. Soc. Sci. 1951; 4: 63–73.Google Scholar
6Batson, E. The ethnic differentiation of fat–calorie ratios in household food purchases in Cape Town. J. Soc. Res. 1953; 4: 113–5.Google Scholar
7Bronte-Stewart, B, Keys, A, Brock, JF. Serum cholesterol, diet and coronary heart disease. Lancet 1953; ii: 1103–8.Google Scholar
8Manning, EB, Mann, JI, Sophangisa, E, Truswell, AS. Dietary patterns in urbanised blacks. S. Afr. Med. J. 1971; 48: 488–98.Google Scholar
9Gericke, GJ, Loock, ME, Marzner, L, van der Merwe, CA. Die macronutrientinname en serumlipiedwaardes van swartes met en sonder IHS. J. Diet Home Econ. 1989; 17: 41–6.Google Scholar
10Albertse, EC, Neethling, A, de Villiers, MA. Diet and lifestyle differences between rural and urban Zulu women. S. Afr. J. Food Sci. Nutr. 1990; 2(Suppl. 1.1): 1.Google Scholar
11Walker, ARP, Walker, BF, Walker, AJ. Comparison of nutrient intakes of South African elderly black women in 1969 and 1989. J. Hum. Nutr. Diet. 1992; 5: 169–77.CrossRefGoogle Scholar
12Walker, ARP, Walker, BF. High high-density lipoprotein cholesterol in African children and adults in a population free of coronary heart disease. BMJ 1978; 2: 1336–8.CrossRefGoogle Scholar
13De Villiers, MA. Diet, lifestyle and the prevalence of obesity and hypertension among Zulu women in a remote rural area. MSc thesis, University of Stellenbosch, South Africa, 1988.Google Scholar
14Sivis, N, Mollenze, WF. Nutrient intakes of black inhabitants in Qwa Qwa and Bloemfontein. Unpublished, University of Potchefstroom, 1992.Google Scholar
15Rossouw, LJ. An interracial comparison of atherosclerosis precursors in 11-year-old South African children. MSc thesis, University of Stellenbosch, South Africa, 1990.Google Scholar
16Bourne, LT. Dietary intake in an urban African population in South Africa – with special reference to the nutrition transition. PhD thesis, University of Cape Town, South Africa, 1996.Google Scholar
17Shekelle, RB, Shyrock, A, Mac, M, Paul, O. Diet and serum cholesterol and death from coronary heart disease: The Western Electric Study. N. Engl. J. Med. 1981; 304: 65–70.CrossRefGoogle ScholarPubMed
18Bourne, LT, Langenhoven, ML, Steyn, K, Jooste, PL, Laubscher, JA, Van der Vyfer, E. Nutrient intake in the urban African population of the Cape Peninsula, South Africa. The BRISK study. Cent. Afr. J. Med. 1993; 39: 238–347.Google ScholarPubMed
19Diet Consensus Panel. Dietary recommendations for the prevention of coronary heart disease. S. Afr. Med. J. 1989; 76: 591–2.Google Scholar
20American Heart Association. Dietary guidelines for healthy American adults. Position Statement. Circulation 1988; 77: 721A–4A.Google Scholar
21Food and Nutrition Board, US National Research Council. Recommended Dietary Allowances, 10th ed. Washington, DC: National Academy Press, 1990.Google Scholar
22Bourne, LT, Langenhoven, ML, Steyn, K, Jooste, PL, Nesamvuni, AE, Laubscher, JA. The food and meal pattern in the urban African population of the Cape Peninsula. The BRISK study. Cent. Afr. J. Med. 1994; 40: 140–8.Google ScholarPubMed
23Department of Health Services and Welfare, Administration: House of Assembly. Guide to Healthy Eating. Pretoria: Promedia, 1990.Google Scholar
24Vorster, HH, Jerling, JC, Oosthuizen, W, Becker, P, Wolmarans, P. Nutrient Intakes of South Africans: An Analysis of the Literature. SANSS Group Report to Roche Products, Potchefstroom, 1995; 41.Google Scholar
25Steyn, K, Katzenellenbogen, J, Lombard, CJ, Bourne, LT. Urbanisation and the risk for chronic diseases of lifestyle in the black population of the Cape Peninsula, South Africa. J.Cardiovasc. Risk 1997; 4: 135–42.CrossRefGoogle Scholar
26Walker, ARP. Urbanisation of developing populations: bearing of rise in privilege and the prevalence of diseases of nutritional deficiency and excess. In: Chaves, A, Bourges, H, Basta, S, eds. Proceedings of the 9th International Congress on Nutrition, Mexico. Basel: Karger, 1972; 26–31.Google Scholar
27Steyn, K, Bourne, LT, Jooste, PL, Fourie, J, Rossouw, K, Lombard, C. Anthropometric profile of a black population of the Cape Peninsula in South Africa. East Afr. Med. J. 1998; 75: 35–40.Google Scholar
28Mollentze, WF, Moore, AJ, Steyn, AF, Joubert, G, Steyn, K, Oosthuizen, GM. Coronary heart disease risk factors in a rural and urban Orange Free State population. S. Afr. Med. J. 1995; 85: 90–6.Google Scholar
29Puoane, T, Steyn, K, Bradshaw, D, Lambert, EV, Fourie, J, Laubscher, JA. Anthropometry and obesity in South Africa – the National Demographic and Health Survey, 1998. Int. J. Obes. [in press]. Personal correspondence.Google Scholar
30World Health Organization (WHO). Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on Obesity, Geneva: WHO, 3–5 June 1997.Google Scholar
31Steyn, K, Jooste, PL, Bourne, L, Fourie, JM, Badenhorst, CJ, Bourne, DE. Risk factors for coronary heart disease in the black population of the Cape Peninsula. S. Afr. Med. J. 1991; 79: 480–5.Google ScholarPubMed
32Levitt, NS,Katzenellenbogen, JM, Bradshaw, D, Hoffman, MN, Bonnici, F. The prevalence and risk factors for NIDDM in urban Africans in Cape Town, South Africa. Diabetes Care 1993; 16: 601–7.CrossRefGoogle ScholarPubMed
33Levitt, NS, Steyn, K, Lambert, EV, Fourie, JM, Rossouw, K. Modifiable risk factors for Type 1 diabetes mellitus in a periurban community in South Africa. Diabet. Med. 1999; 16: 1–5.CrossRefGoogle Scholar
34Kruger, HS, Venter, CS, Vorster, HH, et al. Physical inactivity is an important contributing factor to obesity in black women in the North West. S. Afr. Med. J. 1999; 89(4): 463.Google Scholar
35Kolbe, TL, Lambert, EV, Charlton, K, Noakes, TD. Effectiveness of a low intensity, community-based exercise program for older South Africans from previously disadvantaged communities. Med. Sci. Sports Exerc. 1999; 31(Suppl. 5): S185.CrossRefGoogle Scholar
36Steyn, K, Gaziano, TA, Bradshaw, D, Laubscher, JA. Hypertension in South African adults: results from the Demographic and Health Survey. J. Hypertens. [in press].Google Scholar
37Guidelines Subcommittee 1999. World Health Organisation/International Society of Hypertension guidelines for management of hypertension. J. Hypertens. 1999; 17: 151–83.Google Scholar
38Burt, VL, Whelton, P, Rocella, EJ, Brown, C, Cutler, JA, Higgins, M. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988–1991. Hypertension 1995; 25: 305–13.CrossRefGoogle ScholarPubMed
39Fuentes, R, Illmaniemi, N, Laurikainen, E, Tuomilehto, J, Nissinen, A. Hypertension in developing economies: a review of population based studies carried out from 1980–1988. J. Hypertens. 2000; 18: 521–9.CrossRefGoogle Scholar
40McLarty, DG, Pollitt, C, Swai, ABM. Diabetes in South Africa. Diabet. Med. 1990; 7: 670–84.CrossRefGoogle Scholar
41Goldberg, MD, Marine, N, Ribeiro, F. Prevalence of glycosuria and diabetes among Indians and Bantu. S. Afr. Med. J. 1969; 43: 733–8.Google ScholarPubMed
42Omar, MAK, Seedat, MA, Motala, AA, Dyer, RB, Becker, P. The prevalence of diabetes mellitus and impaired glucose tolerance in a group of urban South African blacks. S. Afr. Med. J. 1993; 83: 641–3.Google Scholar