2017 was one of the worst years on record for world hunger. Africa was – and remains – at the heart of famine crises and widespread malnutrition. In March 2017, the UN had predicted not only one famine but four simultaneously in Somalia, South Sudan, Nigeria and Yemen. But growing economies, urbanization, globalization and changing lifestyles have skyrocketed obesity rates among African populations. Sub-Saharan Africa witnesses the fastest rates of growth for obesity prevalence. According to the New York Times, adult obesity in Ghana, Togo, Ethiopia and Benin has increased by 500 percent since 1982. In Burkina Faso, the rate reaches a whopping 1,400 percent. However, obesity does not signal the end of malnutrition. Many African countries are now facing the “double burden of malnutrition” characterized by the co-existence of widespread and increasing obesity rates with undernutrition.
Many African countries are entering a nutrition transition which accompanies changing lifestyles as their GDPs grow. Studies from the World Bank and WHO reveal a correlation between GDP increase and overweight rates. The increasing availability of industrialized jobs in urban areas in conjunction with rapid demographic growth and the scarcity of rural land, pushes millions of Africans to a rural exodus. By 2030, more than 50 percent of Africans will live in cities. As a consequence, many people are adopting a more sedentary ways of life with less physical exercise. Their nutritional habits are heavily affected by this economic shift. Traditional fresh -food diets, mainly plant-based and high in fiber, are replaced by the consumption of processed foods rich in saturated fats, sugars and sodium. In urban areas, processed food from multinational companies has becomes more and more accessible. Fast-food franchises from Subway, Dominos, and Burger King to McDonalds and Krispy Kreme open stores in cities like Johannesburg and Nairobi to tap into the African market. Big food conglomerates, such as Nestle and General Mills are following a similar policy and expanding in African supermarkets. As sales of processed foods in the wealthiest nations slow down, these companies turn to the urbanized lower economic classes in Africa. Not only is “Big food”, which refers to multinational food companies with high market power, physically accessible in low-income areas, it is also cheaper. ForAs an example, The New York Times delveds into Coca Cola’s implementation in Kenya and found that,. tTo reach the working classes, the company produces smaller 200 milliliter bottles, which cost 15 cents as opposed to the standard 300 milliliter bottles costing 25 cents. Processed foods like chips and sodas fit in their budgets while vegetables, fruit and fish do not. Changes in traditional food habits also entail changes to socio-cultural practices, as Western modes of consumption such as eating alone and snacking slowly begin to prevail. While not discusseddeveloped in this e present article, it is also worthwe should also keeping in mind the issues of ecological destruction and the loss of indigenous markets associated with this nutritional transition.
The development of the global food system in urbanized Africa is directly responsible for the obesity epidemic and the proliferation of nutrition related non-communicable diseases (NCDs). An epidemiological shift, with cases of diabetes, osteoporosis and cardiovascular diseases, is taking place. A 2017 report published by the Lanes Diabetes and Endocrinology Commission found that the prevalence of type II diabetes among adults has reached almost 22 percent in some African countries but that overall only 1 out of 10 received treatment. In 2008, NCD mortality rates in Africa were the highest in the world (742 per 100,000 for women and 844 per 100,000 for men) with poor diet, physical inactivity and tobacco use increasing the chance of mortality.
Fighting this epidemic has proved to be complicated. Across Africa, health systems have been heavily focused on combating the traditional mortal diseases of AIDS, malaria, tuberculosis and tropical fever. Few doctors are specialized in obesity-related NCDs. For instance, Kenya suffers from a cardiologist shortage with only 40 specialized doctors for 48 million people. Similarly, education and healthcare communication emphasize the importance of safe sex without treating the issue of food overconsumption. The longstanding impact of child malnutrition is an additional difficulty. People who doid not get enough nutrients as children are more likely to become obese as low nutrient intakes can chronically slow down the metabolism. Finally, mentalities are also sustaining the obesity epidemic. With the stigma of HIV and AIDS, as well as that of a low social status, being overweight can be perceived as a positive thing and play out as a marker of socio-economic prestige. Structural changes in health care and educational policies are urgent to combat the noxious effects of transitional nutrition. Most governmental responses rely on campaigns promoting physical activity and a healthy diet. Nutrition labeling and restrictions on marketing unhealthy foods for children are also increasingly becoming part of the agenda. South Africa has gone even further by introducing a sugar tax in April 2017. The obesity epidemic is a multilayered problem which can only be tackled effectively through solutions targeting its multiple levels, from its cultural to its economic roots.
Article written by Vasiliki Malouchou
GETTLEMAN, Jeffrey. “In Kenya, and Across Africa, an Unexpected Epidemic: Obesity”. The New York Times. Jan. 27 2018. Web. Accessed Feb. 8 2018. https://www.nytimes.com/2018/01/27/world/africa/kenya-obesity-diabetes.html
GETTLEMAN, Jeffrey. “Drought and War Heighten Threat of Not Just 1 Famine, but 4”. The New York Times. Mar. 27 2017. Web. Accessed Fed. 8 2018. https://www.nytimes.com/2017/03/27/world/africa/famine-somalia-nigeria-south-sudan-yemen-water.html
GARFIELD, Leanna. “There’s a ‘war between two food systems’- and the big food conglomerates are winning.” Business Insider. Sept. 19 2017. Accessed Feb 8. 2018. http://www.businessinsider.fr/us/big-food-companies-obesity-epidemic-world-2017-9
HARVARD SCHOOL OF PUBLIC HEALTH. Diabetes increasing at alarming rates in sub-Saharan Africa. July 5 2017. https://www.hsph.harvard.edu/news/press-releases/diabetes-in-africa/
RASCHKE, Verena and Bobby Cheema. Colonisation, the New World Order, and the eradication of traditional food habits in East Africa: historical perspective on the nutrition transition. Public Health Nutrition 11(7), 662-674. 2007. DOI:10.1017/81368980007001140.
STEYN, Neila and Zandile J, Mchiza. Obesity and the nutrition transition in Sub-Saharan Africa. Ann. N.Y. Acad. Sci., 1311:88-101. 2014. DOI:10.1111/nyas.12433.
WORLD HEALTH ORGANIZATION. “Double Burden of Malnutrition”. WHO. Web. Accessed Feb. 10 2018. http://www.who.int/nutrition/double-burden-malnutrition/en/