Will The Food Industry Sacrifice Its Fat Profits For Health?

• South Africas growing obesity epidemic wont be reversed by preaching healthier eating habits and exercise alone; theres a growing realisation that the food industry needs to change.

• Studies from Guatemala , Kenya and Zambia have found that big supermarkets can worsen obesity rates through the types of foods they stock typically highly processed, calorie-rich foods.

• In South Africa people who live closer to big grocery stores and fast-food restaurants tend to weigh more than those living further away .

• Medical doctor, David Harrison and dietician Liezel Engelbrecht explain why asking supermarkets to lower the prices of 10 good foods isnt anti-business, but pro-health .

In todays newsletter, Mia Malan outlines why the food industry needs to change . Sign up .

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Driving through Mpumalanga recently, it was inspiring to see how South Africas largest food seller, Shoprite, helps locals to sell fruit and vegetables grown in community gardens in some of the retailers outlets.

Making it easier for South Africans to buy fresh produce at affordable prices and to support them to make a living from growing it is valuable in getting the country to eat healthier and improve local food security.

But to turn around South Africas growing obesity and stunting rates, and overweight peoples consequent higher chance of developing type 2 diabetes, stroke, cancer and heart disease, we need to do considerably more than this.

Almost half of adult South Africans are overweight or obese, the countrys 2023 National Food and Nutrition Survey shows, and 69% of obese adults live in households without enough food. If people dont have enough types of food to choose from, they end up eating nutritionally poor food.

The World Health Organisation says an adult is obese when their weight-to-height ratio is 30 or more. This ratio, called the body mass index (BMI), is worked out by dividing someones weight (in kilograms) by the square of their height (in metres). Although scientists say BMI is not the perfect way to tell if someone has a healthy weight, its practical, cheap and widely understood, which researchers say makes it a fairly accurate check on a population level.

But most people dont just become obese because they overeat in general they often eat too much of the wrong food , such as cheap, highly processed starches ( like salty snacks and instant noodles ) and sugary drinks. Thats why an obese person who ate too much of the wrong food as a child can be both overweight and short eating too many processed starches made them put on carbs, but didnt contain the protein and vitamins they needed to grow tall enough. This height retardation from poor nutrition is called stunting.

Good data on the concurrence of stunting and obesity is hard to come by, but a recent study from Mbombela in Mpumalanga found that 41% of obese children under the age of two were also stunted. And in rural KwaZulu-Natal and the Eastern Cape, 2010 research showed that one in six children younger than five years were both short-for-age and overweight. Among adults, two thirds of women and one third of men have a waist-to-height ratio higher than 0.5 , which is regarded as the cut-off above which the risk for conditions such as type 2 diabetes (called a metabolic disease) increases. (A waist-to-height ratio is different from a weight-to-height ratio, or BMI, and another way to calculate someones chances of developing metabolic disease).

The National Food and Nutrition Survey findings reveal that people eating the wrong foods is a massive problem in South Africa.

The study found only 58.1% of South African households consume acceptable diets and that most people survive on nutrient-poor foods such as processed cereals, condiments, sugars, oils and fats. Consumption of nutrient-rich foods such as fruits, pulses, nuts, eggs, fish and seafood was far and few between.

Foods are nutrient rich when they contain a high proportion of nutrients good for your health (such as protein, vitamins, minerals and fibre) compared with the calories they provide, while nutrient-poor foods have more calories but fewer of the vitamins, protein and minerals you need to stay healthy. ( Calories measure how much energy there is in the food you eat ; to stay at around the same weight, the calories your body uses should be the same as the amount of calories you eat and drink.)

Carbohydrates are an important source of energy but these should be in the form of minimally processed whole-grain cereals, legumes like beans, and root vegetables like sweet potatoes. Eating minimally processed food preserves their vitamins, minerals