Introduction

The 2019 theme, ‘Make eating whole foods a way of life’ aims to focus the country’s attention on the importance of consuming a mostly plant-based diet of mainly unprocessed and minimally processed foods. Whole grains, fresh vegetables and fruits, legumes, nuts and seeds are health-promoting foods that are nutrient-dense, high in fibre, and free from food additives, added sugar, fat and salt. Whole foods offer a wide range of choice and enable a family lifestyle centred around healthy eating choices, that for children, can help cement these healthy lifestyle habits for years to come.

Carol Browne of the Nutrition Society of South Africa (NSSA) points out that the risks of unhealthy diets and lifestyles start in childhood and build up over our lives. She says, “Approximately 13.3% of South African children under 5 years of age are overweight or obese; and according to the 2012 South African Health and Nutrition Examination Survey (SANHANES), 14.2% children aged 6 to 14 years are overweight or obese. The situation amongst adults is even worse, with the 2016 South Africa Demographic and Health Survey finding that 68% of women and 31% of men in South Africa are overweight or obese. Severe obesity which is life-threatening affects around 20% of women and 3% of men. Unhealthy diets and a lack of physical activity are contributing to a considerable burden of disease in our country.”

These concerns are shared by the Heart and Stroke Foundation South Africa (HSFSA) which reports that every day 225 South Africans die of cardiovascular disease (CVD). Only a small proportion of the deaths are age-related. HSFSA’s CEO, Professor Pamela Naidoo says, “South Africa has one of the highest rates of overweight and obesity in the world, a major contributor to diabetes which in turn is a risk factor for CVD. We have to understand the link between making poor food choices on a daily basis, being at an unhealthy weight and the risks of disease and early death”. Bianca Tromp, registered dietitian at the HSFSA states: “Many South Africans don’t think twice about consuming large amounts of sugary drinks, salted snacks and ultra-processed fast food meals. This constitutes a daily diet that while overly dense in energy is actually dangerously nutrient-deficient.”

President of ADSA (Association for Dietetics in South Africa), Dr Christine Taljaard-Krugell points out that prevention of overweight and obesity in South Africa is urgent and requires multi-disciplinary collaboration. She says: “As national government departments, industries, academia, non-governmental organisations, health professionals, communities, households and individuals we have to urgently, actively and collectively turn towards the actions that are needed in order to address obesity, to ensure better health for all South Africans. Many of these actions can be linked to what we do - physical activity - and what we eat. As this week’s message focuses on the consumption of whole foods, it is important that each and every role-player, from government level to the individual level, re-think and creatively contribute to enable households to truly make eating whole foods a way of life.”

The campaign is also supported by MaTCH, the Maternal, Adolescent and Child Health Institute, an indigenous non-profit organisation providing a broad range of HIV and TB-focused assistance. Lenore Spies, the technical advisor of MaTCH says: “Limiting the intake of ultra-processed foods and rather eating mainly whole foods plays an important role in a healthy pregnancy as well as ensuring good nutrition for children, families and those whose immune functioning may be compromised. A diet based on a variety of whole foods; which are foods in, or close to, their natural state, provides us with a broad spectrum of nutrients we need to safeguard our health including dietary fibre.”

Another important aspect of healthy eating is getting into the habit of reading the ingredient lists on the labels of the prepared food and drinks that you buy. An ultra-processed food or drink is one that usually has five or more ingredients listed on the label, and typically a number of these are not recognisable as foods you would use in home cooking. Rebone Ntsie, Director of Nutrition at the National Department of Health says, “Ultra-processed foods typically contain a wide range of food additives such as stabilisers, emulsifiers, preservatives, flavourings and colourings. These are the opposite of whole foods, which are unprocessed like fresh vegetables or minimally processed such as brown rice. We should make our drink of choice clean water instead of sugary drinks. In addition, we should plan and prepare more home cooked suppers so we have extra for our lunches and snacks the next day.”