In Africa, “obesity is now also reaching rural areas”

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In Alexandra Township, in the northern suburbs of Johannesburg, in February 2022.

While the Sahel or the Horn of Africa are struggling with food insecurity, overweight and obesity are taking hold in other regions of the continent, particularly in southern Africa. Botswana, Gabon, Eswatini, Lesotho, Mauritius, Namibia, Seychelles, and South Africa eat too much and poorly. To the west and north, two countries are exceptions: Mauritania and, above all, Algeria, which holds the continental record for the number of obese.

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In these ten countries, one in five adults and one in ten children and adolescents could be obese by the end of 2023 if nothing is done to reverse the dynamic, says the World Health Organization (WHO) in an analysis published today. early March. , on the occasion of the world day against this disease. A situation described as ” time bomb ” by the UN agency. Women are twice as affected as men and, as a novelty, “junk food” is also taking hold in rural areas, where industrial products are reaching family kitchens.

The Kenyan Adelheid W. Onyango, a doctor who leads the group in charge of improving the health of populations at the WHO Africa office in Brazzaville, deciphers the sociological changes at the origin of this progression of obesity.

What are the causes of obesity in Africa?

Adelheid W. Onyango They are at once environmental, cultural and medical. Genetics may be partly responsible for the phenomenon, but sedentary lifestyle, lack of mobility and consumption of processed products are the main reasons. The rapid urbanization of recent years has profoundly changed lifestyles. Throughout the continent, the urban middle class is the most affected. The Covid crisis and its lockdowns have not helped.

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Having said that, obesity is also beginning to reach rural areas and that is new. Some studies show an increase in the body mass index (BMI) of rural populations. This is still a very relative increase but, until now, we thought that this phenomenon only affected urban dwellers.

How do you explain it?

In rural areas, consumption habits have changed. The products that are sold in the town have appeared in the towns and have become permanent: sugary drinks of course, but also processed flour, white bread for sandwiches, pasta.

The worrying thing is that the production of local fruits and cereals is declining and sometimes it is more expensive to buy a fruit than a fruity drink like a soda. Culturally, these drinks are replacing fruits.

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Finally, more and more land that was used for subsistence agriculture is used for other crops, considered more profitable, such as tobacco or sugar cane, for example, a process accelerated by the shortage of labor. Climate change also aggravates the decrease in agricultural production that translates into the loss of healthy food.

Why are African women and their children more affected than men?

The issue of being overweight is complex, it is the result of several crossed parameters: eating and drinking is an activity of survival of the body, as well as social, psychological, economic and cultural. On the continent, beauty, success and even good health continue to be embodied by women in very generous ways. Being plump is always an outward sign of wealth.

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For children, the way they play is also changing, with more screens and less life outside. In these adults of tomorrow, the preference for sweetness is established very early, as soon as they give up mother’s milk. The continent is working to promote breastfeeding up to 6 months and even 2 years, but the appearance of formula milk containing sugars, promoted by manufacturers, has changed the situation.

But sugar is not the only culprit. It is all the consumption from food diversification that poses a problem: salt, flavor enhancers, consistency of food that does not allow proper formation of teeth…

Mauritania, a country in the Sahel, is an exception in West Africa. Why ?

Traditions are hard to die. Mauritanian women suffer from overweight and obesity due to the custom of forced feeding. Hitting puberty, and sometimes even earlier, they are literally stuffed with anticipation for an upcoming marriage.

The National Institute of Public Health of Algeria specified in early March that “one in two Algerians and one in three Algerians are overweight.” Why does Algeria stand out so much?

Traditionally, in the Maghreb countries, we eat too much fat and too much sugar. But Algerians are turning more and more to express catering, to the car, even for short trips. Sedentary lifestyle and lack of activity do the rest. It has become a real public health problem.

Are the health authorities of the countries concerned taking the measure of the problem?

Yes, but very often their action is limited, even hampered, by industrial lobbies and the lack of a regulatory framework. We must change the standards, develop new production standards, establish specific taxes. Several countries are working on it, such as Uganda, Kenya and Tanzania at the moment. But manufacturers are rarely inclined to comply with these changes. Furthermore, African consumers are less informed: many products are mislabelled, if at all. The obligation to declare the composition of the products, when it exists, is not necessarily respected and people are not sufficiently educated.

Weights and Measures

The World Health Organization (WHO) has defined the following international reference points:

  • Body mass index or BMI
    Its calculation allows evaluating the corpulence of an individual and therefore the possible risks to their health. The BMI determines whether one is thin, overweight or obese, for example, although this measurement does not give the density of adipose tissue. A normal BMI is between 18.5 and 25.
    BMI is calculated by dividing a person’s weight in kilograms by the square of their height in meters.
  • Over weight A person is considered overweight when their BMI is equal to or greater than 25.
  • Obesity A person is considered obese when their BMI is equal to or greater than 30.
  • for adultsObesity is considered moderate from 30 to 35, severe from 30 to 40, and morbid beyond 40.
  • For children and adolescentsage must be taken into account to define overweight and obesity.
  • Non-communicable diseases Overweight and obesity favor the development of certain pathologies: cardiovascular diseases (heart disease and cerebrovascular accidents, stroke), diabetes, musculoskeletal disorders (osteoarthritis) and certain types of cancer (endometrium, breast, ovary, prostate, liver, gallbladder, kidney and colon).

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