Obesity and the nutrition transition in Sub‐Saharan Africa

Abstract

This review illustrates the outcomes of the nutrition transition in Sub-Saharan Africa (SSA) and its association with overweight and obesity; the relationship with the double burden of malnutrition is also explored. We describe the increase in overweight in nearly all Sub-Saharan African countries and present data on associated increased gross domestic product, and availability of energy, protein, fat, and sugar at country national levels. Predictors of overweight are described by means of various studies undertaken in SSA, and dietary intakes of numerous countries are presented. Overall, we show that socioeconomic status, gender, age, parity, physical inactivity, and increased energy, fat, and sugar intake are powerful predictors of overweight and/or obesity. The urgency for health interventions in countries in the early stages of the nutrition transition is emphasized, particularly in view of the fact that fat intake is still less than 30% of energy intake in nearly all Sub-Saharan African countries.

The Local Food Environment and Body Mass Index among the Urban Poor in Accra, Ghana

“…The nutrition transition first described by Popkin (1994) 10 illustrates shifts in dietary patterns from periods of famine to periods of nutrition-related chronic diseases of lifestyle associated with the adoption of modern lifestyles that accompany socio-economic development, urbanization, and acculturation. 2,11,12 Urbanization in sub-Saharan Africa has been accompanied by the availability of modern food items including sweetened carbonated soft drinks and fast foods, particularly in urban areas. 2 Nutrition transition in Africa has been observed in countries such as South Africa in the Transition and Health during Urbanization of South Africans (THUSA) study.…”

“…2,11,12 Urbanization in sub-Saharan Africa has been accompanied by the availability of modern food items including sweetened carbonated soft drinks and fast foods, particularly in urban areas. 2 Nutrition transition in Africa has been observed in countries such as South Africa in the Transition and Health during Urbanization of South Africans (THUSA) study. The THUSA study revealed decreased consumption of staple foods and plant-based proteins and increased consumption of energy dense snack-based foods, sweetened carbonated beverages, red meat, fast foods, and convenience foods.…”

“…14 The simultaneous occurrence of the demographic and epidemiologic transitions together with the nutrition transition contributes to the increasing shift towards obesity and diet-related noncommunicable diseases. 2 The increasing availability of energy dense foods has resulted in a Bbuilt environment^which has implications for obesity, physical activity, and dietary choices especially in poor areas. 15,16 Research in developed countries including the USA, UK, and Canada has shown that conditions in the built environment are often associated with obesity especially in deprived and socio-economically disadvantaged areas.…”

“…1 Even in regions such as sub-Saharan Africa (SSA) where the prevalence is relatively low, there has been an increase in prevalence over the last three decades. [2][3][4] While individual characteristics and behaviors such as genetic makeup, excess calorie consumption, and physical inactivity are among the factors that have been attributed to the rising prevalence of obesity, these proximal individual factors alone do not explain the rapid global increase in the prevalence of obesity over the last three decades. [5][6][7] It is argued that the rapid increase in the prevalence of obesity is as a result of people responding normally to changes in the environment (distal factors) that encourages excess calorie consumption and sedentary lifestyles.…”

Validity of an FFQ to measure nutrient and food intakes in Tanzania

“…In SSA, although data remain sparse, it is clear that access to food is increasing but diet quality is worsening. Data from the FAO show that per capita energy intake has increased over the past 30 years (11) , snack food and soft drink importation to the fifteen countries that make up the Southern African Development Community has quadrupled over the past two decades (12) , and overall dietary quality has worsened (13) . Reflecting the consequences of the worsening dietary situation in SSA, the Global Burden of Disease study estimates that the proportion of deaths attributable to unhealthy diet in Tanzania has increased from 5·8 % in 1990 to 9·3 % in 2015 (14,15) .…”