Kenyan Adelheid W. Onyango, head of WHO Africa, recalls that the urban middle class is still the most affected by the increase in overweight.
While the Sahel or the Horn of Africa are fighting against food insecurity, overweight and obesity are taking hold in other regions of the continent, particularly in southern Africa. Botswana, Gabon, Eswatini, Lesotho, Mauritius, Namibia, Seychelles and South Africa eat too much and badly. To the west and north, two countries are exceptions: Mauritania and, above all, Algeria, which holds the continental record for the number of obese people.
In these ten countries, one in five adults and one in ten children and adolescents could be obese by the end of 2023 if nothing is done to reverse the dynamic, says the World Health Organization (WHO) in a analysis published at the beginning of March, on the occasion of the world day against this disease. A situation described as a “ticking time bomb” by the UN agency. Women are twice as affected as men and, new, “junk food” is also taking hold in rural areas, where industrial products are reaching family kitchens.
The Kenyan Adelheid W. Onyango, doctor who heads the group responsible for improving the health of populations at the WHO Africa office in Brazzaville, deciphers the sociological changes at the origin of this increase in obesity.
What are the causes of obesity in Africa?
Adelheid W. Onyango They are simultaneously environmental, cultural and medical. Genetics may be partly responsible for the phenomenon, but sedentarization, lack of mobility and the consumption of processed products are the main reasons. Rapid urbanization in recent years has profoundly changed lifestyles. Across the continent, the urban middle class is the most affected. The Covid crisis and its confinements have not helped matters.
That said, obesity is also starting to reach rural areas and that’s new. Some studies show an increase in the body mass index (BMI) of rural populations. This is still a very relative increase but, until now, we thought that this phenomenon only affected urban dwellers.
How do you explain it?
In rural areas, consumer habits have changed. The products sold in town have appeared in the villages and become established in the long term: sugary drinks of course, but also processed flour, white sandwich bread, pasta.
What is worrying is that the production of local fruits and cereals is decreasing and it is sometimes more expensive to buy a fruit than a fruity drink such as soda. Culturally, these drinks are taking the place of fruit.
Finally, more and more land that was used for subsistence farming is being allocated to other crops, considered more profitable, such as tobacco or sugar cane, for example, a process accelerated by a labor shortage. Climate change also aggravates the decline in agricultural production which results in the loss of healthy food.
Why are African women and their children more affected than men?
The issue of overweight is complex, it is the result of several intersecting parameters: eating and drinking is a survival activity for the body, as well as a social, psychological, economic and cultural one. On the continent, beauty, success and even a certain good health continue to be embodied by women with very generous shapes. Being plump is always an outward sign of wealth.
For children, the way of playing is also changing, with more screens and less life outside. In these adults of tomorrow, a sweet preference is established very early, as soon as they give up breast milk. The continent is working to promote breastfeeding up to 6 months and even 2 years, but the emergence of formula milk containing sugars, pushed by manufacturers, has changed the situation.
But sugar is not the only culprit. It is all the consumption from the food diversification that poses a problem: salt, flavor enhancers, consistency of food which does not allow good formation of teeth…
Mauritania, a Sahelian country, is an exception in West Africa. Why ?
Traditions die hard. Mauritanian women suffer from overweight and obesity due to the custom of force-feeding. Arrived at puberty, and sometimes even before, they are literally stuffed with a view to an upcoming marriage.
The Algerian National Institute of Public Health specified at the beginning of March that “one out of two Algerians and one out of three Algerian women suffer from overweight”. Why does Algeria stand out so much?
Traditionally, in the Maghreb countries, we eat too much fat and too much sugar. But the Algerians have more and more recourse to express catering, to the car, even for short trips. A sedentary lifestyle and lack of activity do the rest. It has become a real public health problem.
Are the health authorities of the countries concerned taking the measure of the problem?
Yes, but their action is very often limited, even hampered, by industrial lobbies and the lack of a regulatory framework. We must change the standards, develop new production standards, set up specific taxes. Several countries are working on it, such as Uganda, Kenya and Tanzania at the moment. But manufacturers are rarely inclined to comply with these changes. Furthermore, African consumers are less well informed: many products are mislabelled, if at all. The obligation to declare the composition of products, when it exists, is not necessarily respected and people are not educated enough.