We're overweight, unfit, unhealthy - and in denial

In a recent national health survey measuring the health of the nation, it was found that 74% of South Africans think their fellow citizens are overweight, while only 34% of people considered themselves as overweight or obese[24]. The national health survey*, which was released in Johannesburg yesterday, 8 September 2010, was commissioned by global research-based healthcare company, GlaxoSmithKline (GSK) and conducted by independent marketing insight consultancy, Added Value.

The survey found that 61%, or nearly two in every three South Africans are overweight, obese or morbidly obese [7]. These figures on the growing size of our population are similar to those of the Medical Research Council (MRC), which also conducted a study in 2003 on overweight and obesity in South Africa. The MRC report found that 56% of women and 29% of men are overweight [65]. Nearly 10% of men and 24% of women have a Body Mass Index (BMI) of more than 30 [68].

Think you're healthy? Think again

The GSK national health survey also found that South Africans believe they are healthy, even when they are overweight and obese:
• 78% of obese people think they are somewhat healthy/very healthy [5];
• 52% of morbidly obese people think they are somewhat healthy or very healthy [6];
• 42% have no health concerns[46]; and
• Only 47% recognise that exercise/physical fitness is critical[47].

GSK recently commissioned the national consumer health survey to assess certain facts about our nation as they relate to general health and wellness, lifestyle, family, nutritional understanding, local socio-political impact and psychological barriers to achieving better health. Jonathan Girling, vice president, Consumer Healthcare at GSK, says the aim of the survey was "to measure how healthy South Africans are as a nation".

"As a new entrant into the weight loss category in South Africa, the decision to embark on a National Health Survey was essential for us," says Girling. "Not only has it given us insight into the attitudes and behaviours of people on health matters, but a broader context to the overweight and obesity epidemic we're facing as a nation."

The GSK national health survey also found:

• 60% of obese (and 62% of morbidly obese) people consider themselves as only being overweight [39];
• 49% of South Africans don't exercise [26]; and
• 71% of them have never been on diet [24].

Lifestyle, food, poverty and demographics play a role in the weight of the nation, the survey reveals. Capetonians are the worst affected with 72% of them overweight, followed by people living in Pretoria (68%), Johannesburg (59%) and Durban (52%) [52].

A total of 65% of people interviewed have the perception that healthy food is more expensive than unhealthy food [17]. However, people consider the food they buy as being healthy and most people claim to shop for healthy food 52% of the time [42].

The "denialism" continues when it comes to food labels: 66% understand food labels but only 33% consult them [43].

Heart attacks claim three South Africans an hour

At least 60 South Africans (three people every hour) die from heart attacks and strokes every day, according to the MRC [69]. In a 2003 WHO report, statistics further confirm that overweight and obesity pose a major risk for chronic diseases, including type2 Diabetes, cardiovascular disease (CVD), hypertension and stroke and certain forms of cancer [72]. Additional data from the MRC taken from participants in the age group 60-69 years indicates that a normal mid-life BMI has significant health benefits [71].

Dr Jeff King, a leading Johannesburg-based cardiologist, calls for a proactive approach to leading a healthy life by watching your weight, eating a balanced diet and maintaining a regular exercise programme.

"Obesity is a major factor of cardiovascular disease. Excess weight puts pressure on the heart and increases blood pressure," King says. He warns that the heavier you become, the lower you drive your life expectancy. "In five to 15 years an obese person will develop type2 diabetes. Smoking increases the risk of cardiovascular disease even more because it doesn't allow protection from blood clotting. Clotting causes blocked arteries that will result in a stroke or heart attack."

Our children too, are at risk

But it's not only adults who are obese. 17% of South Africa's children aged one to nine years are obese [70]. This is further backed up by research from the GSK national health survey which found that 23% of people don't know what their children eat during the day [18].

"Healthy foods, healthy eating habits and exercise should be promoted to children through special education and awareness campaigns in schools," says registered dietician Celynn Erasmus. "Unhealthier choices seem more convenient and readily available, especially for people on the run. More ventures to promote healthier food choices should be encouraged and supported by the government and South African business."

The survey also reveals that in the tough economic climate:

• 39% of South Africans look at cost when purchasing food [48];
• 87% eat a home cooked dinner [49]; and
• 46% feel obesity will impact South Africa economically [50].

For years anecdotal evidence has been building up to show that South Africans have serious problems with being overweight, obese and morbidly obese. Now there is hard empirical evidence that proves beyond doubt that we are already facing an epidemic and denying these facts could result in severe economic and social repercussions.

[65] Stein, Krisela. MRC Report; Heart Disease in South Africa; Dept. of Medicine, University of Cape Town & Chronic Diseases of Lifestyle Unit, at the medical research council. Pg 17

[66] Goedecke Julia H. et al. Chronic Diseases of Lifestyle in South Africa since 1995-2005. Obesity in South Africa (Ch 7, pg 66)

[67] Goedecke Julia H. et al. Chronic Diseases of Lifestyle in South Africa since 1995-2005. Obesity in South Africa (Ch 7, pg 66)

[68] SADHS; The South African Demographic and Health Survey, 2003: Ch. V; Adult Health, pg 25-26

[69] Stein, Krisela. MRC Report; Heart Disease in South Africa; Dept. of Medicine, University of Cape Town & Chronic Diseases of Lifestyle Unit, at the medical research council. Pg 2

[70] Goedecke Julia H. et al. Chronic Diseases of Lifestyle in South Africa since 1995-2005. Obesity in South Africa (Ch 7, pg 66)

[71] Stein, Krisela. MRC Report; Heart Disease in South Africa; Dept. of Medicine, University of Cape Town & Chronic Diseases of Lifestyle Unit, at the medical research council. Pg 18

[72] WHO. Fact Sheet; Obesity and overweight. 2003. Available from: http://www.who.int/topics/obesity/en/ (Last accessed 17 December).

* A sample size of 500 respondents was chosen for the GSK national health survey. Based on a total population of 32 million adults, the confidence interval is thus 4.38 at a 95% confidence level.

Face-to-face interviews were conducted amongst 500 LSM 4-10 male and female respondents in major metropolitan areas: Gauteng (Johannesburg and Pretoria), Cape Town and Durban.

Quota controls were imposed on age, race, gender, LSM and region to ensure a representative spread amongst the urban population that was deemed appropriate for this target market. The fieldwork for this study was conducted by Catalyst Research & Strategy.

Notes:

GlaxoSmithKline is one of the world's leading research-based healthcare companies and is committed to improving the quality of human life by enabling people to do more, feel better and live longer. For further information please visit www.gsk.com.

Added Value, www.added-value.com, provides consultancy on brand development and marketing insight for iconic brands around the world. In South Africa, they've worked with a wide range of both local and international brands, including Old Mutual, Southern Sun, SABMiller, Nestlé, Unilever, Kimberly Clark and Nedbank.

Glossary

BMI - Body Mass Index defined as the weight in Kilograms divided by the square of the height in metres (kg/m2). [1]

Overweight - A BMI over 25 kg/m2 is defined as overweight [1]

Obese - A BMI of over 30 kg/m2 as obese [1]

Morbidly Obese - A BMI of over 35 kg/m2 as Morbidly obese [1]

Cardiovascular disease - Any abnormal condition characterised by dysfunction of the heart and the blood vessels. [2]
Co-morbidities - Two or more co-existing medical conditions or unrelated disease processes. [3]

Type II diabetes - A complex disorder of carbohydrate, fat and protein metabolism that is primarily a result of a deficiency or complete lack of insulin secretion by the beta cells of the pancreas or resistance to insulin. [4]

Hypertension - A common disorder that is a known cardiovascular disease risk factor. Hypertension is characterized by elevated blood pressure over the normal values of 120/80mm Hg in an adult over 18 years of age. [5]

Stroke (cerebrovascular accident) - Pertaining to the vascular system and blood supply of the brain. An abnormal condition of the brain characterized by occlusion of an embolus, thrombus, or cerebrovascular haemorrhage or vasospasm, resulting in ischemia of the brain tissues normally perfused by the damaged vessels. [6]

1 - WHO Fact Sheet; Obesity and overweight. 2003. Available from: www.who.int/dietphysicalactivity/publications/facts/obesity/en/ (Last accessed 17 December).
2 - Mosby's medical dictionary, 7th Edition, 2006, pg 312
3 - Mosby's medical dictionary, 7th Edition, 2006, pg 426
4 - Mosby's medical dictionary, 7th Edition, 2006, pg 548
5 - Mosby's medical dictionary, 7th Edition, 2006, pg 923
6 - Mosby's medical dictionary, 7th Edition, 2006, pg 343

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