https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(09)61087-4.pdf

The burden of non-communicable diseases in South Africa.

Objective: This article reviews information on the rapid changes in diet, activity and body composition that lower- and middle-income countries are undergoing and then examines some of the potential health implications of this transition. Design and Setting: Data came from numerous countries and also from national food balance (FAOSTAT) and World Bank sources. Nationally representative and nationwide surveys are used. The nationally representative Russian Longitudinal Monitoring Surveys from 1992–96 and the nationwide China Health and Nutrition Survey from 1989–93 are examined in detail. Results: Rapid changes in the structure of diet, in particular associated with urbanization, are documented. In addition, large changes in occupation types are documented. These are linked with rapid increases in adult obesity in Latin America and Asia. Some of the potential implications for adult health are noted. Conclusions: The rapid changes in diet, activity and obesity that are facing billions of residents of lower- and middle-income countries are cause for great concern. Linked with these changes will be a rapid increase in chronic diseases. Little to date has been done at the national level to address these problems.

/pdf/the-nutrition-transition-and-its-health-implications-in-44tgtb0zvd.pdf

The nutrition transition and its health implications in lower-income countries.

Objectives To determine the prevalence and treatment status of hypertension in South Africa.Design National cross-sectional survey.Setting 13 802 randomly selected South Africans, 15 years and older, were visited in their homes in 1998.Methods Trained fieldworkers completed questionnaires on lifesty

Hypertension in South African adults: results from the Demographic and Health Survey, 1998.

Background— Cardiovascular disease, the major cause of mortality and morbidity in modern societies, is set to overtake infectious diseases in the developing world as the most common cause of death. The increasing prevalence of major and emerging cardiovascular risk factors accounts for the growing burden of cardiovascular disease in the world. Diabetes in all its forms is one of the main cardiovascular risk factors. Two of 3 diabetic patients will die as a result of cardiovascular complications, and approximately 30% of patients treated in cardiovascular intensive care units have diabetes. Methods and Results— This review on the cardiovascular complications of diabetes in sub-Saharan Africa is a bibliographical MEDLINE search of published data over the past 2 decades. Diabetes-related cardiovascular disease complications are considered to be rare in Africa but are on the rise and are regularly associated with classic cardiovascular risk factors. Coronary heart disease may affect 5% to 8% of type 2 diabetic patients and cardiomyopathy, up to 50% of all patients. Close to 15% of patients with stroke have diabetes, and up to 5% of diabetic patients present with cerebrovascular accidents at diagnosis. Peripheral vascular disease prevalence varies across sites from 4% to 28%. Conclusions— It is obvious that diabetes mellitus and related cardiovascular complications are gaining more importance in sub-Saharan Africa. The relative contribution of putative risk factors is not well defined, and further research is therefore needed. (Circulation. 2005;112:3592-3601.)

Cardiovascular Complications of Diabetes Mellitus in Sub-Saharan Africa

http://ipenproject-org.heracenter.org/documents/publications_docs/krugernutr2002.pdf

Physical inactivity is the major determinant of obesity in black women in the North West province, South Africa: the THUSA study

During the first quarter of 1990 Xhosa-speaking nurses interviewed mothers and took anthropometric measurements of 163 children 3-6 years old living in squatter and formal housing areas of Cape Town South Africa to determine the nutritional status of the children. 39% of the children received less than 67% of the recommended daily allowance (RDA) of calories (i.e. deficiency) and 3% received more than 120% of the RDA. Most children were deficient in calcium (80%) iron (77%) vitamin A (64%) riboflavin (52%) niacin (53%) vitamin B6 (58%) and vitamin C (76%). Most children received more than 120% of the RDA for folic acid (68%) and for vitamin B12 (63%). Milk consumption was low (median intake 0.5 portion vs. 2-3 portions as recommended by the department of national health and population development guidelines). The diet was also deficient in vegetables and fruit intake (1.32 vs. =or> 4 portions) and fat intake (2.5 vs. =or> 4 portions). Children did receive adequate portions of meat and foods from the cereal group however. Macronutrient energy distribution fell within prudent dietary guidelines: 28.1% of energy from total fat 63.7% from carbohydrates and 13.2% from protein. 44.8% of children had only 2 meals with more than 600 kJ. 15 children (9.2%) had only 1 meal. 27.6% were stunted. 7.7% were underweight. 7.9% were wasted. 20.1% were obese. The undernourished children and the obese children consumed a diet low in micronutrients. These anthropometric findings indicate a population in transition--acutely and chronically undernourished children coexisting with obesity. The overall findings suggest a need to develop a nutrition and health policy to address nutrient deficit and excess.

Nutritional status of 3-6 year-old African children in the Cape peninsula.

A cross-sectional study of risk factors for ischaemic heart disease (IHO) in a random sample of 986 black people aged 15 - 64 years living in the Cape Peninsula revealed a population at lower risk for IHO than other South Africans. Blood pressures of 140/95 mmHg or above were found in 14,4% of males and 13,7% of females. Fifty-two per cent of males and 8,4% of females smoked, while 16,5% of males and 25,8% of females had a total cholesterol (TC) level imparting risk for developing IHO. In this population the TC level is not a good surrogate measure for low-density lipoprotein cholesterol because of the high level of high-density lipoprotein cholesterol (HOLC) found in this population. A protective HOLC/TC ratio of 20% was found in 96% of males and 96,1% of females. When considering the three major reversible IHO risk factors at a high level of risk, 30,8% of males and 12,5% of females had at least one such a risk factor. The population was frequently exposed to the media, with 80% listening to the radio every day and 55% watching television at least once a week. This suggests that a healthy lifestyle could be promoted successfully by means of these media. In addition, schools should promote a healthy lifestyle and the prevention of chronic degenerative diseases should be incorporated into the evolving primary health care services in South Africa.

/pdf/risk-factors-for-coronary-heart-disease-in-the-black-5ekd8t0mw0.pdf

Risk factors for coronary heart disease in the black population of the Cape Peninsula. The BRISK study.

A cross-sectional study of risk factors for ischaemic heart disease (IHD) in a random sample of 986 black people aged 15 - 64 years living in the Cape Peninsula revealed a population at lower risk for IHD than other South Africans. Blood pressures of 140/95 mmHg or above were found in 14,4% of males and 13,7% of females. Fifty-two per cent of males and 8,4% of females smoked, while 16,5% of males and 25,8% of females had a total cholesterol (TC) level imparting risk for developing IHD

Risk factors for coronary heart disease in the black population of the cape Peninsula

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Nutritional status of 3-6 year-old African children in the Cape peninsula.

Risk factors for coronary heart disease in the black population of the Cape Peninsula. The BRISK study.

Risk factors for coronary heart disease in the black population of the cape Peninsula