Despite what we know about the impact of food choices on our health, overweight and obesity are still on the rise in South Africa, alongside a host of preventable diseases that can be attributed to unhealthy lifestyles. Thanks to our industrialised food system, and far greater, ultra-processed and fast food choices aimed at our ‘convenience’, we’ve got further away from eating the whole foods that are really good for us. This is the message that a coalition of health professional associations, including the Department of Health, is highlighting in October across both National Nutrition Week and National Obesity Week.
The 2019 theme, ‘Make eating whole foods a way of life’ aims to focus the country’s attention on the importance of consuming a mostly plant-based diet of mainly unprocessed and minimally processed foods. Whole grains, fresh vegetables and fruits, legumes, nuts and seeds are health-promoting foods that are nutrient-dense, high in fibre, and free from food additives, added sugar, fat and salt. Whole foods offer a wide range of choice and enable a family lifestyle centred around healthy eating choices, that for children, can help cement these healthy lifestyle habits for years to come.
Carol Browne of the Nutrition Society of South Africa (NSSA) points out that the risks of unhealthy diets and lifestyles start in childhood and build up over our lives. She says, “Approximately 13.3% of South African children under 5 years of age are overweight or obese; and according to the 2012 South African Health and Nutrition Examination Survey (SANHANES), 14.2% children aged 6 to 14 years are overweight or obese. The situation amongst adults is even worse, with the 2016 South Africa Demographic and Health Survey finding that 68% of women and 31% of men in South Africa are overweight or obese. Severe obesity which is life-threatening affects around 20% of women and 3% of men. Unhealthy diets and a lack of physical activity are contributing to a considerable burden of disease in our country.”
These concerns are shared by the Heart and Stroke Foundation South Africa (HSFSA) which reports that every day 225 South Africans die of cardiovascular disease (CVD). Only a small proportion of the deaths are age-related. HSFSA’s CEO, Professor Pamela Naidoo says, “South Africa has one of the highest rates of overweight and obesity in the world, a major contributor to diabetes which in turn is a risk factor for CVD. We have to understand the link between making poor food choices on a daily basis, being at an unhealthy weight and the risks of disease and early death”. Bianca Tromp, registered dietitian at the HSFSA states: “Many South Africans don’t think twice about consuming large amounts of sugary drinks, salted snacks and ultra-processed fast food meals. This constitutes a daily diet that while overly dense in energy is actually dangerously nutrient-deficient.”
President of ADSA (Association for Dietetics in South Africa), Dr Christine Taljaard-Krugell points out that prevention of overweight and obesity in South Africa is urgent and requires multi-disciplinary collaboration. She says: “As national government departments, industries, academia, non-governmental organisations, health professionals, communities, households and individuals we have to urgently, actively and collectively turn towards the actions that are needed in order to address obesity, to ensure better health for all South Africans. Many of these actions can be linked to what we do – physical activity – and what we eat. As this week’s message focuses on the consumption of whole foods, it is important that each and every role-player, from government level to the individual level, re-think and creatively contribute to enable households to truly make eating whole foods a way of life.”
The campaign is also supported by MaTCH, the Maternal, Adolescent and Child Health Institute, an indigenous non-profit organisation providing a broad range of HIV and TB-focused assistance. Lenore Spies, the technical advisor of MaTCH says: “Limiting the intake of ultra-processed foods and rather eating mainly whole foods plays an important role in a healthy pregnancy as well as ensuring good nutrition for children, families and those whose immune functioning may be compromised. A diet based on a variety of whole foods; which are foods in, or close to, their natural state, provides us with a broad spectrum of nutrients we need to safeguard our health.”
Another important aspect of healthy eating is getting into the habit of reading the ingredient lists on the labels of the prepared food and drinks that you buy. An ultra-processed food or drink is one that usually has five or more ingredients listed on the label, and typically a number of these are not recognisable as foods you would use in home cooking. Rebone Ntsie, Director of Nutrition at the National Department of Health says, “Ultra-processed foods typically contain a wide range of food additives such as stabilisers, emulsifiers, preservatives, flavourings and colourings. These are the opposite of whole foods, which are unprocessed like fresh vegetables or minimally processed such as brown rice. We should make our drink of choice clean water instead of sugary drinks. In addition, we should plan and prepare more home cooked suppers so we have extra for our lunches and snacks the next day.”
Strategies to make eating whole foods a way of life include:
• Enjoy a variety of unprocessed and minimally processed food choices – Make sure that the vegetables, fruit, whole grains and legumes make up around 80 percent of your daily food intake. Make at least one day a week all meat-free with plant-based meals.
• Eat plenty of vegetables and fruit every day – Eating a variety of vegetables and fruit every day can help prevent chronic diseases, including heart disease, high blood pressure, strokes, some types of cancer, aging related eye diseases and type-2 diabetes. These foods also contribute to a strong immune system.
• Eat dry beans, peas, lentils and soya regularly – Naturally high in plant proteins, micronutrients and dietary fibre, soya and legumes such as beans, split peas and lentils make excellent substitutes for meat or can stretch a meat dish further. They can also be used to make soups, salads and side dishes.
• Plan and prepare healthy home meals rather than buying ready-to-eat meals and snacks or eating out frequently – Eating healthy home-cooked meals ensures that you are in control of the ingredients that go into your family’s meals. It helps save money spent on ultra-processed and fast foods.
• Always check food and beverage labels to read what is in your food and drink – Knowing how to read labels is very important in making the healthier choice when choosing foods. Product ingredients are listed by quantity, from the highest to lowest amount, so watch out for foods that have sugar, salt or fats listed in the first three ingredients.
By focusing on whole foods as a way of life, we can ensure that our families are eating the vegetables and fruits, legumes, seeds, nuts and whole grains that are essential to build and sustain healthy bodies.
National Nutrition Week and National Obesity Week Partners are:
• National and Provincial Departments of Health http://www.health.gov.za
• Department of Basic Education (DBE)www.education.gov.za
• SA Military Health Services (SAMHS)
• Maternal, Adolescent and Child Health (MaTCH) http://www.match.org.za
• The Association for Dietetics in South Africa (ADSA) http://www.adsa.org.za
• The Cancer Association of South Africa (CANSA) http://www.cansa.org.za
• The Nutrition Society of South Africa (NSSA) http://www.nutritionsociety.co.za
• The Heart and Stroke Foundation SA (HSFSA) http://www.heartfoundation.co.za
• Consumer Education Project (CEP) of Milk South Africa http://www.rediscoverdairy.co.za
• Consumer Goods Council of South Africa (CGC-SA) http://www.cgcsa.co.za
• Humane Society International (HSI) http://www.hsi.org
For additional information on how to make eating whole foods a way of life, including tips and recipes, visit http://www.nutritionweek.co.za
It is true, that for most of us, the morning is far more time-stressed in comparison to supper. However, planning, preparation and smart food choices will result in being able to either sit down and eat breakfast with your family or eat your breakfast over the two to three hours after waking. Abby advises: “From a time perspective, drinking is often quicker than sitting down to a full meal and so my suggestion is a nutritious smoothie. I encourage my patients to blend together a small banana, oats, sugar-free peanut butter and low fat milk. Baby spinach is an optional extra. Not only is this the quickest meal, but it contains balanced portions of fruit, vegetables, minimally processed grains and healthy plant fats. What a way to start your day!” With some planning, preparations for breakfast can be made the night before. Beat the clock by soaking your oats, cutting fruit and boiling eggs during your supper preparation so that it is as easy as possible to make breakfast a quick, enjoyable family meal.
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