Changes in dietary patterns
Changes in dietary patterns

Bloemfontein is the city where you’re likely to find the fattest middle-class people with the “least healthy weight status”. Here, middle-class citizens eat the least amount of fruit and vegetables, but consume the most sugary drinks and salty foods. 

In Pretoria, people add more fat to their food after cooking than in any other South African city surveyed by the medical scheme Discovery’s Vitality programme, and its inhabitants sleep worse than anywhere else. 

But in Cape Town, there’s good news: Capetonians eat healthily, exercise regularly and are psychologically content.

These are some of the findings of the 2014 Vitality ObeCity Index that was released on Tuesday. The index uses information about health habits collected from Vitality members in the cities of Johannesburg, Cape Town, Durban, Port Elizabeth, Bloemfontein and Pretoria to determine which cities have the healthiest members with respect to “weight status” and associated factors.  

Vitality is a wellness programme that Discovery medical scheme members can join for a monthly fee. It rewards people when they make healthy choices – members can, for instance, join gyms at lower fees and get cash rewards when they buy fruit and vegetables at selected stores.

Average age at 32
According to Discovery, the average age of a Vitality member is 32 and members are mostly middle class. For the study, the information of a sample of just under 170 000 of a total of 1 672 062 Vitality members was used. All of them completed a Vitality Age Assessment in 2013. 

Johannesburg was the city with the second best “weight status” after Cape Town, with Durban and Pretoria in the third and fourth places. Bloemfontein had the worst status. 

South Africa currently has among the highest number of overweight people per capita in the world. Sixty-four percent of South African women and 30.7% of men are overweight or obese, according to a 2012 Human Sciences Research Council survey, SANHANES-1.  

The World Health Organisation considers someone with a body mass index (BMI) – a measure that relates weight to height – greater than or equal to 30 as obese. An adult is overweight if their BMI is between 25 and 29.9. 

The Vitality index highlights obesity as the number one risk factor for non-communicable diseases: obese individuals are at a higher risk for chronic diseases and premature death, and the higher the body mass index, the higher the risk. 

According to the index, the probability of a South African between the ages of 30 and 70 dying from one of the major non-communicable diseases such as diabetes, heart disease or cancer, is 27%.  

Discovery says obese individuals spend on average 30% more on medical costs compared to their normal weight counterparts. 

Processed food, increased consumption
The index authors point to one of the most important factors contributing to the “obesity epidemic” as global changes in dietary patterns, characterised by the increased consumption of sugar, salt, fat and animal products. 

Processed food contains high percentages of most of these products.  

In South Africa, there has been a 40% increase in sales of ready-made meals, snack bars and instant noodles between 2005 and 2010. “The majority of supermarket floor space is dedicated to processed food,” the index notes. 

Increased fast food consumption, according to the index, has played a huge part in increases in weight in the country. “South Africa is one of McDonald’s expansion stories, breaking records by opening 30 outlets in 23 months,” the index report points out. “Today the company operates more than 200 restaurants across the country.”

According to the index, “one in two South African adults visit a Kentucky Fried Chicken [KFC] at least once per month” – this is about 12-million people over the age of 15. KFC plans on having 850 stories in the country by 2015.  

Too little exercise also impacts on obesity. The index found that people who live in Pretoria did the least amount of exercise, with Johannesburg short on its heels. Cape Town was the most active city.


Fast food consumption in South Africa

  • 72.3% of people surveyed in SANHANES-1 ate street and fast food at least one or more times per week. Amongst adolescents, more than 60% ate fast foods at least three times a week on average;
  • One study found urban black adolescents eat fast food seven to eight times per week; and
  • The most popular choice of street food for young people is the kota: a quarter loaf of white bread, with a fried egg, processed cheese, sausage or polony, sauce, and fries. Almost 6 000 kilojoules, this meal contains around half of the daily energy requirements of the average 17-year old.