Poor nutrition and obesity are the leading causes of heart disease, diabetes and some cancers. Similar to the United States, 70% of the South African adult population is overweight or obese according to the Centre for Disease Control and Prevention.  Furthermore, an increasing amount of children are falling into this bracket.

With 35.1% of adults being classified as obese in the United States, obesity has reached epidemic proportions. The World Health Organization (WHO) labels the increase in obesity and related syndromes as an epidemic in both first and third world countries. What is worrying is that the current generation in the United States may have a shorter life expectancy than that of their parents if the obesity epidemic is not controlled.

Consequences of Obesity. Adapted from: Raphael Rubin, David S. Strayer, Rubin’s Pathology: Clinicopathologic Foundations of Medicine, 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2008.

The obesity epidemic is also responsible for:

  • Almost 25% of the heart disease epidemic;
  • Over 40% of the diabetes burden; and
  • Over 40% of the cancer burden.

Poor food choices are the main culprits / causes for the formation of obesity and other related diseases.

These poor food choices include:

  • Increased intake of:
    • Calorie-dense foods
    • Foods high in fat, particularly saturated fat and trans fats
    • Foods high in sugar
    • Foods high in refined starch;
    • Excessive intake of salt; and
  • Not enough fruits and vegetables, which are rich in antioxidants.

What can I do to counteract obesity and other related diseases?

  • A lower glycaemic load is helpful for some people. Foods that have a low glycaemic index include salads with an oil and vinegar dressing, high-fat granola cereal, and most fresh fruits and vegetables.
  • Schedule 6–8 small meals at frequent intervals to prevent cheating and overeating.
  • Breakfast should be emphasized. High-fibre cereal consumption may play a role in curbing appetite at lunch.
    • Fibre-rich foods take longer to chew, are low in calories, and increase satiety. Encourage the consumption of high fibre foods such as oats, barley, nuts, fruits and vegetables.
  • The American Dietetic Association supports a “total diet approach,” where the overall food pattern is more important than one type of food or meal. If food is consumed in moderation with appropriate portion size and regular activity, a positive approach to food makes the client feel less anxious and guilty.
  • Decrease the overall salt intake if fluid retention or hypertension is a concern. Use other spices and herbs.
  • Practice portion control.
    • Measuring and weighing foods can be useful.
    • Food diaries may improve mindfulness.
    • Eat slowly; chew well.
    • Use smaller plates.
  • To delay automatic eating, drink a glass of water and wait 20 minutes. If the sensation persists, it is probably hunger. Make meals last 20 minutes or longer.
  • The best diet is “don’t buy it” to reduce temptations later.
  • Avoid diets with energy levels that are too low, as there are numerous risks associated (skeletal muscle breakdown, nutritional deficiencies, fat retention, etc) with these restrictive diets. Consult your dietician if you are uncertain.
  • Because diets lower energy intake, the use of a multivitamin supplement is required to prevent deficiencies.
  • Physical activity is integral to weight loss maintenance; aim for moderate levels of physical activity for 30–60 minutes daily whenever possible.

The real challenge in obesity and weight loss involves keeping weight off after it has been lost. Permanent lifestyle changes are better than popular diets or trends. Avoid bizarre fad dieting, skipping meals, or emphasis on any one nutrient. A “no fad diet” approach encourages healthy eating patterns.

Retha Booyens (RD) SA

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