Economic growth as an underlying probable systemic driver for childhood obesity in South Africa: A Joinpoint regression and ecological analysis over 10 years

Abstract

The emergence of non-communicable diseases (NCDs), including type 2 diabetes, hypertension and obesity, in low-to middleincome countries (LMICs) has raised global concerns. [1,2] A need to reprioritise use of limited resources, capacity and infrastructure in LMICs is important. In view of limited resources to deal with emerging NCDs, prevention seems the only feasible and sustainable approach. Communicable diseases have been the priority for most LMICs, but shifts in disease burden are being observed. These shifts have shown increases in chronic diseases, warranting new and innovative health strategies in LMICs. [3-5] Obesity has become a global public health problem and is a known risk factor for type 2 diabetes, cardiovascular disease, hypertension, stroke, myocardial infarction and various cancers. [6,7] However, what is more concerning are the increasing levels of obesity among children, adolescents and young adults globally. [8,9] Recent data from a pooled analysis of 2 416 population-based studies on 128.9 million participants aged ≥5 years, including 31.5 million aged 5-19 years, indicate that the number of obese children and adolescents (aged 5-19 years) worldwide has risen 10-fold in the past 4 decades. [8,9] More children and adolescents are projected to be obese than moderately or severely underweight by 2022. [8,9] Data suggest alarming increases in obesity among children and adolescents in LMICs, particularly in sub-Saharan Africa. [8-10] LMICs, including South Africa (SA), are characterised by increased economic development. However, these gains are accompanied by negative changes and shifts in both dietary and physical activity patterns. [4,5] Increased adoption of more westernised diets and increased sedentary behaviour, due to modernisation, improved transport systems and easy accessibility to unhealthy fast foods, are some of the factors that increase obesity and its associated health problems in LMICs, including SA. [4,5] Improving economic growth has become the main agenda for LMICs, including SA. It is associated with improved access to healthcare, control of infectious communicable diseases, and improved quality of life for many. [11] However, economic growth has also accelerated other negative transitions, especially increases in and emergence of NCDs. [3] Associations between adult obesity and economic growth, technological changes, socioeconomic status (SES), and economic inequities and insecurity [12-16] have been reported, but limited data are available for children and adolescents in countries such as SA that are undergoing an epidemiological health transition exhibiting both under-and overnutrition. This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Multilevel Analysis of Urban–Rural Variations of Body Weights and Individual-Level Factors among Women of Childbearing Age in Nigeria and South Africa: A Cross-Sectional Survey

“…The likely reasons for this study finding in Nigeria and South Africa are that women with higher education are more likely to have a higher socio-economic status and material resources and have ready access to energy-dense nutrition and sugary beverages, as well as a more sedentary paying job. Women from wealthier households, having weight above average, and presently living with partner had increased odds of being overweight or obese, among women from Nigeria [ 9 , 22 ] and South Africa [ 14 , 15 ]. Moreover, as the number of children increases, the odds of being overweight or obese were decreased, and smoking of cigarettes also increased the likelihood of being underweight among South African women.…”

“…Factors such as increased adoption of more westernized diets and the rise in sedentary behavior, owing to modernization, improved transport systems, and easy convenient access to unhealthy fast foods, are associated with over-weight/obesity and its related-health problems in South Africa [ 6 , 13 ]. Studies have documented that the body mass index (BMI) cutoffs for women and men are 29.2 and 23.6 respectively, whereby 68% of women are overweight/obese while 3% are underweight, as two-thirds of women (59%) have a BMI in the standard range [ 14 ]. According to the South Africa Demographic Health Survey (SADHS), the trend analysis indicated that the mean BMI among women aged 15 and older has increased from 27.3 in 1998 to 29.2 in 2016, and the prevalence of overweight/obesity among women of childbearing age rose from 56% to 68%, with a decreased prevalence of underweight from 6% to 3% [ 12 ].…”

Country ownership and sustainable programming of the HIV response in South Africa: A scoping review

“…Signatory to international and regional declarations; explicit policies and commitments for KPs. 4 , 10 …”

“…Several mechanisms exist for overseeing programme activities, including PRC and the M&E team at SANAC, which is responsible for producing the GAM reports. 6 , 10 …”

“…SANAC, Operation Phutuma, and the Global Fund Country Coordinating Mechanism are three examples of how the SAG and stakeholders are engaged in ongoing dialogue. 4 , 10 …”