Join us as we delve into Ultra-Processed Food consumption and its health implications, particularly in low and middle-income countries. Our panel of experts shared insights on the alarming association between UPP consumption and increased risks of obesity, overweight, and stunting.
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How taxation and subsidies can work together to ensure that South Africans have healthier diets
The theme for this year is My Health, My Right. The theme according to the World Health Organisation (WHO) “was chosen to champion the right of everyone, everywhere to have access to quality health services, education, and information, as well as safe drinking water, clean air, [and] good nutrition”.
South Africa is facing an alarming scourge of under-and over nutrition. Over 1 in 4 children in the country are stunted, while 1 in 8 children under the age of 5 are obese and overweight. On the other hand, almost 70 percent of adult women in the country have overweight and obesity.
“While eight million children go hungry every day and a quarter of all children are stunted, we also see that one in eight children is overweight. According to statistics, these children will grow into a cohort of adults where every second person is obese,” explains Petronell Kruger, Programmes Manager at the Healthy Living Alliance (HEALA)
Being overweight or obese is a well-known driver of diseases like cancer, heart disease, diabetes, and high blood pressure.
What can be done?
Nutrition is one of the most important contributors to good health, HEALA believes that urgent interventions by government need to be put in place to urgently address these issues. Research shows that subsidising healthy food, which can be more expensive than unhealthy, energy dense alternatives, has been shown to decrease the consumption of unhealthy food and lead to healthier life outcomes for all.
Where will the money come from?
Experts suggest that taxes from SSB such as South Africa’s Health Promotion Levy (HPL) can be used to fund various health promotion intervention such as children’s diet and nutrition programmes and subsidising of healthy food.
From its inception on 1 April 2018 to 31 March 2021, the HPL has generated R7.9 billion in cumulative revenue from domestically produced and imported products. Specifically, collections in 2018/19, 2019/20 and 2020/21 were R3.2 billion, R2.5 billion and R2.1 billion respectively. An increase in the HPL to the recommended 20% could almost double the revenue collected by Treasury.
Why do we need to do this?
We need to end food poverty and we need policies to help South Africans eat less unhealthy food. Government must take steps to end hunger and poor nutrition.
SONA: Government should prioritise the health and wellbeing of all South Africans
Civil society groups demand what they call decisive leadership from President Ramaphosa. Nzama Mbalati is the Interim CEO of lobby group HEALA, a coalition of civil society organisations that advocate for equitable access to affordable and nutritious food for all in South Africa.
#NotTodayNestlé: Food giant Nestlé flouts SA law. Again.
12 August 2021
Food giant Nestlé flouts SA law. Again.
Food and beverage company Nestlé’s latest marketing campaign violates long-standing national health department regulations meant to safeguard the nutrition and health of South African children. It’s not the first time the company has done this but it should be the last.
On 14 August, Nestlé will host an online event with Media24 outlets You, Drum and TrueLove magazine. The webinar, “Free Stokvel Mom and Child Forum”, promises to tell “all moms, grandmas, aunties and guardians of little ones” everything they need to know about infant and child nutrition. Attendees also stand a chance at winning R500 in vouchers for use at a major grocery store.
Nutrition experts agree: Nestlé’s event and its marketing clearly violate 2012 national regulations aimed at protecting South Africa’s children from aggressively promoting consumption of ultra-processed food, including products with high sugar content.
Civil society coalition the Healthy Living Alliance (HEALA) strongly supports calls by nutrition leaders for Nestlé and Media24 to cancel this event and remove all related advertising from their online platforms, including social media.
“Nestlé’s decision to ignore regulations meant to protect children’s health at a time when three-million children in South Africa have been affected by hunger in recent months is unconscionable,” says Tamryn Frank, a researcher at the University of the Western Cape’s School of Public Health.
“We know COVID-19 has left many families hungry, yet this isn’t the first time during the epidemic that Nestlé has flouted regulations — similar webinars took place in April and May,” she says. “We urge Nestlé and Media24 to do the responsible thing and cancel this and future events.”
South Africa continues to grapple not only with childhood hunger but also with increasing obesity rates driven in part by ultra-processed foods. More than one in 10 children under the age of five are overweight, according to South Africa’s latest 2016 Demographic Health Survey.
How Nestlé’s webinar violates health department regulations
Advertising for the webinar prominently features three Nestlé products: Cerelac and Nestum cereals for babies six months of age and older as well as the Nido3+ milk beverage for toddlers who are three years or older.
All three products — Cerelac, Nestum and Nido3+ — are ultra-processed products that contain added sugars. Nestlé marketing of the event and products contravenes 2012 national regulations aimed at protecting infants and children from these types of food.
South Africa’s Regulations Relating to Foodstuffs for Infants and Young Children prohibit manufacturers or distributors of foods like these from providing incentives, enticements or invitations of any kind that might encourage the sale or promotion of products such as formula, powdered milks or complimentary foods aimed at infants or young children.
Nestlé’s webinar offers consumers the chance to win R500 — a clear incentive for attending an event featuring brand ambassadors for Cerelac, Nestum and Nido3+products.
Additionally, regulations prohibit companies such as Nestlé from producing, distributing or presenting educational information relating to infant and young children nutrition. Nestlé’s promise to parents that they will “learn everything [they] need to know about feeding [their] little one” again clearly flouts regulations despite the inclusion of a professional nurse on the webinar panel. Even Nestlé’s attempts to account for regulations in the fine print of its advertising falls foul of this segment of the law.
Regulations were meant to break a cycle with lasting effects
The World Health Organization (WHO), UNICEF and the South African National Health Department all agree: Whenever possible, all babies should be exclusively breast-fed for the first six months of life. If possible, children can continue breastfeeding up until two years and beyond together with the addition of safe, affordable and nutritious complementary foods from six months.
Still, for decades, infant formula makers — including Nestlé — used aggressive advertising and donation tactics to convince many people, especially in resource-poor countries like South Africa, to needlessly feed their infants formula.
Companies profited from these ploys but formula-fed infants paid a high price, missing out on crucial nutrients and antibodies from their mothers’ milk. Outrage over Nestlé’s tactics eventually led to global boycotts of the company’s products before the WHO, the South African Health Department and others developed regulations to counteract aggressive marketing.
Today, only about one in three babies are exclusively breastfed until the age of six months, shows the 2016 Demographic Survey, in part because many families continue to introduce complimentary foods like formula early.
And companies like Nestlé are still breaking the rules. A 2020 study published in the British Medical Journal found numerous instances in which Nestlé or other similar companies used social media, including WhatsApp to flout South African and international regulations.
“Companies are finding new ways to reach people and sidestep regulations,” says researcher Catherine Pereira-Kotze, who led the study. “We need to ensure that they are held accountable.”
The Healthy Living Alliance is a civil society coalition working to advance food justice in South Africa to ensure that communities are able to exercise their right to affordable, nutritious food.
For interviews:
Chantell Witten
Nutrition Lead for SACSoWACH
0714855893
Lisanne Du Plessis
Associate Professor, Division of Human Nutrition, Department of Global Health,
Lori Lake
Communication and Education Specialist, Children’s Institute, University of Cape Town
Katie Pereira-Kotze
PhD Candidate, School of Public Health, University of the Western Cape
+44 7389 778222
Tamryn Frank
Researcher and PhD Candidate, School of Public Health, University of the Western Cape
084 782 9035
Safura Abdool Karim, researcher at Priceless, SA MRC/ Wits Centre for Health Economics and Decision Science
Cell: 072 6137254
The evolution to healthy eating
Food is fuel, but this concept is relatively new to me. I wasn’t always conscious of what I ate and I would often wolf down food because I was either hungry, bored, or emotional. That was me in 2017, writes Reesha Chibba.
My life changed in December 2017 when I decided to investigate my tiredness and inability to lose weight. I didn’t have any of the usual signs of pre-diabetes like thirstiness, excessive urination in the middle of the night, weight gain, or lethargy. I was just tired and I unknowingly blamed it on my early morning shifts at work which I have been working on and off for more than a decade at that time.
A rude awakening
My alarm would scream every week-day at 2:45am, violently interrupting my body’s cortisol function, and killing any chance it ever had of recovering and operating normally throughout the day. I would get dressed and collapse into the routine of my duties and execute them to the best of my ability until my shift was over. Then I would get into the car and drive home with a lump in my throat, analysing and re-analysing everything I did and said, and beat myself for anything I failed at. I was exhausted, every day,
I would go to the gym run for as long as I could and switch off mentally on the treadmill. That was my routine. My life played out like a CD on repeat, from Monday to Friday. Occasionally I would enter the odd endurance event and train for it like an athlete in an effort to excite and re-invigorate myself. But my body was crumbling, much like a Tennis biscuit dipped in tea. My pancreas was malfunctioning and producing insulin three times more than the average human, my hair was falling by the handful, and my mental health was deteriorating. On the outside I looked and acted fine, but on the inside, I was gasping for air.
Time of reckoning
In March 2018 after numerous visits to my GP I sat across from a specialist who told me I needed to change my lifestyle, or else live with diabetes for the rest of my life. And he wasn’t whimsical about his recommendations, he was firm. He gave me a choice and the thought of popping tablets for the rest of my life with shocked me. I had to change, and I knew it.
I started taking Metformin to help regulate and control my body’s insulin production, vitamin D to kickstart my sleep hormone, cortisol, and Burnout by Solal because well, I was pretty burnt out. He also recommended I see a dietician and his exact words were, “She’ll guide you on what you to eat.“ I wasn’t disheartened, but I was scared, and instantly I knew that my sweet tooth and raging love affair with carbs was going to have to come to an end.
My dietician didn’t give me an eating plan or strip me of junk food like most diets out there. For a year, she coaxed me into gentle eating patterns by reducing my intake of carbs and increasing the amount of vegetables in my diet. She educated me about various food groups, the properties, nutritional content and its functions. She entertained emails from me requesting more snacks and peanuts because I initially starved and felt hungry all the time, but I actually wasn’t. This happened during winter when the dip in temperatures make you want to nibble everything in the house, including the cat.
She nudged me to make better choices by eating timeously and not binge eat and starve my body of carbs early in the day. She also provided me with skills to indulge in a donut, practically, without shocking my body. So instead of treating myself willy-nilly to junk food, I’ve gradually learnt how to manipulate myself mentally and give it treats twice a week without hurting myself. And I eat everything, donuts, chocolate, bread (Rye), biscuits, chips, popcorn … the list is epic. But like everything in life, moderation is key. And if mistakes happen and I accidentally decide to eat a slab of chocolate because I’m having a bad day, I rectify the situation by trying again and being kind to myself. No one is perfect. Food is not a reward and restricting yourself shouldn’t ever be a punishment. Food is my only fuel and I’ve learnt what makes me function and function well.
Learning what my body needs has been a game-changer these past two years. I scrutinise everything in stores and think twice about condiments and sauces. I try to steer clear of using stock cubes and instead of using store-bought dressing and mayo, I make my own because I know what’s in it.
Every little change
I’m also not the best person to shop with because I’m a linger-longer – every time I come across new products I tend to linger in the aisles, for longer. My eyes dart straight to the back of the packet to check the sodium, sugar, fat and carb content. And you’ll often see me doing the math or talking to myself about whether or not to buy what I’m holding. I’ve become that girl.
I’ve learnt now that without being cognisant of what is in different products, you will never truly be able to gain control of your diet. Because there is so much variety on the shelves and most of them these days are touted as healthy – and they probably are healthier than other products – but they are actually full of carbs, sodium or fat. Being skilled, finally, on how to identify and interpret the nutritional values has opened my eyes to a new world of possibilities.
Fulfillment and knowledge
My weight gradually peeled away over the months I was with my dietician and I started getting very creative in the kitchen. I was encouraged by the results and my smaller pants to be honest and would tweak all my favourite foods to make it less carb-rich or fatty. Instead of buying coconut milk, I started making my own and adding it to Thai-infused dishes because real coconut milk is very high in fat. I also started making quinoa roti instead of using refined flours and I gradually started ghosting foods that made me feel tired or heavy. My sweet tooth has never relaxed so I’ve learnt to bake with dark chocolate and Xylitol instead.
And as the time progressed my energy levels started to increase as well. I’ve always been a runner, and an avid swimmer, but last year I challenged myself to taking part in the 94.7 Cycle Challenge and doing a triathlon. I did my first Ironman sprint towards the end of the year, just weeks after my first cycle race. And I felt awesome. This year I cycled the Cape Cycle Challenge, previously known as the Argus with water as a supplement and my very own date, coconut, and peanut butter concoction.
I have trained myself to run a 10km with only having had water, honey, and coffee and I because I feel so in tune with my body, I push it to see how far I can go with various homemade power treats. My point is; over time I’ve rediscovered my body and discovered all its kinks, loves and hates. My palette loves chocolate but my body doesn’t. When I eat chocolate, I feel tired almost immediately. But when it is that time of the month, chocolate makes me feel euphoric. My endorphins kick in and my body collapses into its happy self. I’ve also noticed that my body metabolises caffeine differently on days when I sleep well and am rested and on days when I don’t.
I’m learning every day, about myself and my body. I noticed the subtle changes and I am loving my food evolution.
I’ve also started a blog to share some of my recipes and experiences with people. I don’t think I am different or better than anybody, but I do think it’s important to share knowledge and tales of fascination and flops from the warmth of one’s kitchen. My website, On the Board, features only what I eat and what I like to eat. When I tried to lose weight before, I would motivate myself by reading stories of people who dropped excessive amounts of weight by exercising and dieting along with supplements. I tried everything but nothing really worked for me until I started understanding what I was feeding myself.
I have stopped seeing my dietician for over a year and my weight has never returned. I am not razor thin, nor toned to perfection; but I am happier and healthier than I’ve ever been in my life. I no longer take Metformin, and all my levels are the lowest it’s ever been. My story is not extraordinary, but it’s one of balance. I balance protein, carbohydrates, fats and treats, daily. – Health-e News
Reesha Chibba is an output editor at eNCA and an online food blogger. Visit her blog at www.ontheboard.co.za
Sparking a fresh fruit revival in the heart of Venda
Tshakhuma Fruit Market attracts tourists from all over South Africa, but locals consumption of the market’s offering of fresh fruits, vegetables and nuts is dwindling, according to fruit vendors.
“We are fortunate as people of Venda [Vhembe] to have so many fruits at our disposal, but I don’t think we value all these fruits enough. Some even go a week without eating any fruit, despite having all these quality fruits around us,” said Vhulahani Masia, a fruit vendor at Tshakhuma Fruit Market.
Tshakhuma Fruit Market, situated just outside Thohoyandou in the Vhembe District, is the only 24-hour fresh produce market in Vhembe, and sells bananas, mangoes, litchis, tree nuts, pecan nuts, nectarines, avocados and more. The market was established over two decades ago, and to this day, the majority of produce is locally grown.
Masia, who has sold bananas, avocados, paw-paws and litchis at the market since 1996, believes there is general decline in sales at the fruit market. According to her, decrease in interest and consumption of fruit is pronounced in the younger generation.
“I have been selling fruits at this market since 1996 and I can say that over the years there has been a decline in the number of local people who purchase fruits here. It’s something we should worry about, as it might mean that people no longer see the importance of fruits,” she says.
She added: “Something should be done urgently to educate local people about the importance of eating fruit before it’s too late. People who usually come here for fruits are mainly tourists from far away, and they often say that they wished they stayed this side [Venda], so they can have these fruits daily.”
Fresh fruit and vegetable reduce NCD risk
Eating fruits on a regular basis has various health benefits, as people who eat more fruits and vegetables are at a reduced risk of developing some chronic diseases. Per World Health Organisation (WHO) guidelines, fruits and vegetables are important components of a healthy diet, while reduced fruit and vegetable consumption is linked to poor health and increased risk of contracting noncommunicable diseases (NCDs) such as diabetes, high blood pressure and more.
“Including fruits and vegetables as part of the daily diet may reduce the risk of some NCDs, including cardiovascular diseases and certain types of cancer,” says WHO.
According to a 2019 study published in Nature, into body mass indexes (BMI) across the world, obesity rates in rural populations are on the rise. The dietary shift from traditional food that includes natural fruits and vegetables, to highly processed food, is one of the risk factors mentioned in the study.
Last year, Limpopo Department of Health introduced a new standardised eight-day cycle menu which includes fruits and vegetables at all its hospitals to promote healthy lifestyle and to fight obesity.
‘Our children don’t like eating fruits’
Although the region has easily available fresh produce, as the market is a testament to, fruit vendors feel that education around healthy diet is lacking.
“I think we still need more education on the importance of eating healthy meals, which includes a lot of vegetables, and a fruit on the side at all times. Our children don’t like eating fruits, but I think we’re to blame as parents because we don’t instill the importance of eating fruits and vegetables when they are still toddlers,” says Mavis Mudzanani, another vendor at the Tshakhuma Fruit Market.
“The worst part is that we only start valuing the importance of eating healthy when we are sick and by that time, the damage has already been done. We should start utilising the fruits and vegetables at our disposal to promote healthy eating habits, especially among our children,” she adds.
Nurse Phumudzo Themeli says that a child’s lunchbox is the perfect place to start with healthy eating practices.
“Children should be taught the importance of eating fruits and vegetables, and it should start with their lunchbox. Eating fruits and vegetables has a lot of health benefits such as strengthening the immune system which in turn helps the body fight off various diseases such as most NCDs such as heart diseases, strokes, diabetes, and high blood pressure.” – Health-e News.
