Chronic diseases linked to obesity could put the brakes on economic progress in many developing countries

Chronic diseases linked to obesity could put the brakes on economic progress in many developing countries unless urgent action is taken, experts warned at the opening of the first major international conference on obesity in Africa yesterday (Oct 28).

Finance and trade ministers need to lend their support to health ministers for strategic actions to improve the nutritional welfare of their populations or face huge costs already in the pipeline from an epidemic of obesity, type 2 diabetes, heart disease and other obesity-related health concerns.

Obesity has already created a “double burden” of disease in many parts of the developing world still struggling to overcome a legacy of undernutrition and its metabolic consequences for the generations that follow. Many people were now highly susceptible to the adverse health impact of “western” diets, high in fats, sugars and salt, leading WHO to revise its recommendations on “action points” for overweight populations across the whole of Asia.

Professor Philip James, chair of IASO’s International Obesity TaskForce, who is delivering the keynote address on “The global epidemic of obesity: a challenge for developing countries” to the IASO First Regional Congress held in Sun City, South Africa, from October 28-31, said that countries must embrace the advantages of economic development, but take care to protect the nutritional health of their people, particularly the younger generation.

“Childhood and adolescent overweight and obesity already present massive problems in this country and in many other parts of the developing world, which are already on the fast track to a massive explosion in type 2 diabetes. The economic burden from this will act as a brake on development, which depends on having a healthy and productive population,” he added.

About 60% of all deaths across the world and 47% of the burden of disease can be attributed to non-communicable diseases such as diabetes, cardiovascular diseases, osteoporosis and cancers. About two-thirds of deaths linked to these diseases occur in the developing world. The major risk factors are poor diet and physical inactivity, and associated obesity.

Professor James said that 191 ministers had agreed at the World Health Assembly in Geneva in May to a WHO global strategy on diet, physical activity and health and he praised the stand taken by South Africa’s health minister to support the strategy. It was important now for governments at regional and national level to take determined action to implement the strategy, improve nutritional health and help to prevent the chronic diseases that could pose a major economic threat to development.

On South Africa, Professor James, senior vice president of IASO, said it was enormously significant that the country and region was hosting the IASO conference when the world is acknowledging that obesity knows no borders, and is having a seriously detrimental impact.

“The obesity crisis - particularly among women - has been overlooked for too long. The peak levels of obesity in the Cape Province were highlighted in the first IOTF report on the issue of global obesity in 1997,” he added. This led to the World Health Organization’s groundbreaking expert report Obesity: Preventing and Managing the Obesity Epidemic (WHO TRS894). Since then the South African government has recognised the important impact obesity and related non-communicable diseases is having, and has been extremely concerned to establish the extent of the problem in the young as well as in adults.

The South Africa Demographic and Health Survey undertaken in 1998, undergoing revision and due to be published next year, found high rates of overweight and obesity with 29% of men and 56% of women overweight, including 9% of men and 29% of women obese. The percentage with a BMI>30 reaches 46% in women between the age of 45-64.

The survey concluded: "Overall, these data suggest that the predominant pattern of malnutrition in adult South Africans, particularly in African and coloured women, is one of over nutrition, with remarkably high rates of obesity."

More recent data published in the South African Youth Risk Assessment Survey 2002 by the South African Medical Research Council show the prevalence of overweight (including obesity) among young people aged 13-19 years to be 17% overall affecting more girls (25%) than boys (7%). Prevalence was highest (over 20% for boys and girls combined) in white and Indian population groups. Another key factor revealed in the 1999 National Food Consumption Survey was that one in five children under the age of 9 had suffered from stunting, related to chronic undernutrition early in life, and ironically, the problem was worst among small children raised on commercial farms. These children may be particularly vulnerable to developing abdominal obesity with energy-dense western diets.