The situation is different for overweight and obesity among men. The 2016 SADHS reported that 31% of men aged 15 and older were classified as overweight or obese, with 11% identified as obese. However, the 2023 NFNSS shows a significant increase, with 38.2% of men now classified as overweight or obese. This noticeable rise suggests a growing concern regarding overweight and obesity among men in South Africa.

The 2023 NFNSS data shows that 57.4% of adults are classified as either overweight (25.3%) or obese (32.1%), highlighting the persistence of these conditions across the adult population.

Among children under 5, the 2016 SADHS reported a prevalence of overweight at 13%, with obesity at approximately 2.9%. The 2023 NFNSS reveals a troubling increase in overweight prevalence, now at 22.6%. This rise highlights a growing concern in early childhood nutrition and feeding practices that needs urgent attention.

The prevalence of stunting among children under 5 has also seen a slight increase. The 2016 SADHS reported a stunting rate of 27%, a sign of chronic undernutrition. The 2023 NFNSS indicates that stunting now affects 28.8% of children under 5, suggesting that despite various interventions, stunting remains a persistent and unresolved issue in South Africa. Similarly, the prevalence of underweight among children under 5 has increased. The 2016 SADHS reported a prevalence of 6%, but the 2023 NFNSS shows this figure has risen to 7.7%, pointing to a worsening situation in child undernutrition.

Food insecurity is still a major concern in South Africa. The NFNSS found that 63.5% of households in South Africa experienced food insecurity, while 36.5% were food secure. The findings differ slightly from Statistics SA’s 2021 findings, which found more food secure households. NFNSS highlighted that the majority of the ‘very poor’ (90%) and ‘poor’ (87%)  households have been severely affected by Covid-19 restrictions, leaving them vulnerable to food insecurity. They rely on food aid from both State and non-State actors, but struggle to cover their basic food and livelihood needs, leaving little financial ability for their children’s needs. In 2021, 80% of South Africa’s households had adequate access to food, while 15% and 6% had inadequate and severe inadequate access. Rural areas face challenges like limited resources and infrastructure, leading to higher food insecurity. Unemployment, poverty, and climate change effects also exacerbate these disparities. The Covid-19 pandemic has exacerbated the issue, with lockdowns and economic crises resulting in job losses and higher food prices. Food insecurity in adults can lead to low nutrient intake, diabetes, cardiovascular disease, obesity, and mental health issues because they rely on low-cost, high-energy foods that are high in added sugar and fat, and they worry about where their next meal will come from. Energy-dense foods, often low-cost, are associated with low food expenditure, low fruit and vegetable consumption, and a less-healthy diet.

NFNSS found that food prices increased significantly across all provinces due to global food production limitations and disruptions in supply chains, with the highest shocks in KZN being 81%. This was attributed to socio-economic factors such as Covid-19 restrictions, unrest in July 2021, and floods, which disrupted supply chains and triggered price increases. During the Covid-19 period, most households were unable to eat healthy and nutritious foods due to lockdown restrictions and loss of income and jobs.

Poor diet, as defined by a cluster of dietary risks, is the leading cause of death and is the first or second biggest contributor to non-communicable (NCD) disease burden in all six World Health Organization (WHO) regions. Of these dietary risks, the biggest contributors to the global burden of disease in 2017 were diets that are low in whole grains, high in sodium, or low in fruits, nuts and seeds, or vegetables. Additionally, there is an effect of higher body mass index (BMI) on disease outcomes.

Emerging evidence suggests that diet may influence the onset of mood disorders and specifically, depression. For instance, many studies described in recent systematic reviews have demonstrated associations between measures of diet quality and the probability of and risk for depression. A systematic review of 61 studies by Glabska et al. (2020) found that the consumption of fruit and vegetables seems to have a positive influence on mental health. Therefore, the general recommendation to consume at least 5 portions of fruit and vegetable a day may also be beneficial for mental health.

The 2016 SADHS found that among respondents 15 years and older, the consumption of sugary drinks (including fruit juice) the day or night before the survey was 35.7%. The average volume consumption was 607.2 ml. 36.5% of respondents consume fried foods at least once per week. Vegetable and fruit consumption the previous day or night was only 48.8 and 59.9 percent respectively. The consumption of poor food and drink choices starts at an early age, with 18% of children aged six to eight months consuming salty snacks and 4% consuming sugary drinks the day or night before the survey. This increased quickly to 64% and 33%, respectively, of children aged 18 to 23 months. Children of this age (six to 24 months) should not be having any foods that do not contribute to their high nutrient needs.

The concept of optimising nutrition in the first 1 000 days (the period from conception through to the first two years of life) is important for the prevention of over- and under-nutrition. The WHO member states (which includes South Africa) agreed on the goal to reduce the global population’s intake of salt by 30% and halt the rise in diabetes and obesity in adults and adolescents as well as in childhood overweight by the year 2025.

Leading international experts and professional health organisations recommend increased consumption of plant-based food, such as vegetables and fruit, legumes, nuts, seeds and whole grains and locally-produced, home-prepared foods.

One of the goals of the National Strategy for the Prevention and Control of Non-Communicable Diseases in South Africa 2022 – 2027 is to promote and enable health and wellness across the life course. This goal aims to address unhealthy diet which is one of the five major shared and modifiable risk factors. Strategic objective 2.1 is to promote healthy nutrition in prioritized settings.

The deliverables include to:

• Implement healthy nutrition policies in workplaces, schools and early childhood development cenctres.
• Support the provision of healthy food options in public and private institutions.
• Undertake regular screening and awareness campaigns on obesity among children and adults.

In line with increasing evidence emphasising the importance of nutrition in preventing and managing disease, and to support the implementation of the National Strategic plan, the theme for the National Nutrition Week 2024 is: “Eat right for a better life!”