South Africa has experienced a significant shift in its nutritional landscape over the past three decades, characterized by the simultaneous presence of undernutrition, hidden hunger, and overweight or obesity. This paradoxical burden of malnutrition, as revealed by the National Food and Nutrition Security Survey, is largely attributed to nutrient-poor diets and socioeconomic factors.
The survey, the first comprehensive nationwide study on food and nutrition since 1994, was conducted by the Human Sciences Research Council on behalf of the Department of Agriculture, Land Reform and Rural Development. Data collected from more than 34,500 households between 2021 and 2023 showed that almost half of the adult population in South Africa is either overweight or obese.
Despite the country having sufficient food through domestic production and imports, many families and individuals continue to face hunger due to high unemployment rates. Relying on social grants to purchase basic food items, these families often resort to buying food with little nutritional value to avoid hunger, contributing to the rise in overweight and obesity rates.
The survey also highlighted gender and age disparities in obesity prevalence. More than two-thirds (67.9%) of females were found to be either overweight or obese, with higher incidences of obesity among women compared to men. Adults aged 35 to 64 years had a significantly higher prevalence of obesity than younger age groups, possibly due to differences in metabolism and activity levels.
Interestingly, KwaZulu-Natal reported a higher prevalence of obesity (39.4%) compared to other provinces, prompting the need for further research to explore potential cultural factors behind this finding.
The survey period coincided with the latter stages of the Covid-19 pandemic, and focus group discussions were conducted in all districts where data was collected to assess the pandemic's impact. The findings revealed that the government's swift response through various relief programs significantly reduced families' exposure to extreme poverty and food insecurity during this challenging time.
Obesity is not just a South African issue, but a global problem. A recent study by the Lancet showed that in 2022, more than 1 billion people worldwide were living with obesity, with rates among adults more than doubling and rates among children and adolescents quadrupling since 1990.
To address malnutrition in South Africa, the Human Sciences Research Council recommended focusing on areas with high levels of malnutrition, encouraging families to produce their own food to supplement social grants, investing in strategically located food banks, helping extremely poor households survive seasonal hunger, and launching educational campaigns on the benefits of consuming nutrient-rich foods and dietary diversity.
As South Africa grapples with the paradoxical burden of malnutrition, it is crucial to recognize that poverty and poor nutrition are at the heart of the overweight and obesity epidemic. Addressing these underlying issues through targeted interventions and policies will be essential in combating this growing public health concern and ensuring a healthier future for all South Africans.
