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18 June 2020 | Story Dr Chantell Witten | Photo Supplied
Dr Chantell Witten.

On 26 March 2020, the President declared a national lockdown in response to the COVID-19 pandemic as it started to emerge in South Africa. Since then and several weeks into the lockdown, Statistics South Africa (2020) has provided evidence which many intuitively knew would be more devastating to households than the coronavirus itself – loss of income and the negative effects that follow hunger. Stats SA reported that the percentage of respondents receiving no income increased from 5,2% before the lockdown to 15,4% by the sixth week of the national lockdown. Given that the majority of South Africans depend on the informal labour market, such as informal traders and casual workers, this lack of income would hit millions of households. Furthermore, Stats SA also reported a decrease in formal wage/salary earners for the same period, from 76,6% before the national lockdown to 66,7% by the sixth week of national lockdown.

While South Africa is food secure at national level, millions of households are food insecure. According to the United Nations Food and Agriculture Organization’s (FAO) 1996 definition of food security, this simply means that there is not enough food at all times for all the people in a household to have physical and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life.  In short, people are hungry and at greater risk for ill health – physically, emotionally, and spiritually.  A hungry man is an angry man. Likewise, a hungry nation is an angry nation.

In July 2019, the measurement of extreme poverty – the food poverty line (FPL) – was raised to R561 (using April 2019 prices) per person per month, which was up from R547 last year. This is the amount of money that Stats SA calculates an individual requires “to afford the minimum required daily energy intake” of 2 100 calories per day. Before the onset of the COVID-19 pandemic, South Africa already had a precarious food and nutrition situation, especially for young children. South Africa’s child stunting levels – an indication of chronic and long-term food insecurity – increased from 21% in 2008 to 27% in 2016.  With COVID-19 and the subsequent lockdown, child malnutrition rates are expected to increase. Stunting not only affects a child’s health, making them more susceptible to disease and infection, but also impairs their mental and physical development – meaning that children who suffer from stunting are less likely to achieve their full height and cognitive potentials as adults.  

What can we do to address this food situation or prevent it from worsening?
The 2020 Global Nutrition Report recognises and asserts that inequality and globalisation are major drivers of food insecurity. As individuals and as collectives, we need to continue to advocate for and support calls to continue raising the child support grant to help households stay above the poverty line.  Millions of households in South Africa are supported by social grants; in solidarity, we need to appreciate the safety net that these social grants provide to vulnerable households. Advocate for and support initiatives to safeguard child health and nutrition, including efforts to promote, protect, and support breastfeeding in neonatal care, postnatal care, and ongoing support to breastfeeding mothers.  Breastfeeding remains the most cost-effective health intervention for infants and young children, supporting optimal growth and development and providing long-term health benefits into adulthood. Advocate for and support initiatives to coordinate sustainable food support to vulnerable households, including, among others, food distribution, food vouchers, onsite feeding, home gardening, and tax-free food baskets.  These efforts would be our collective solidarity to support and protect vulnerable households as we enter the global economic recession as a result of COVID-19.

How can we protect our households’ food and nutrition security? 
COVID-19 brings with it much uncertainty and many unintended negative effects.  While we seek out strategies to support mental well-being and emotional resilience, we also need to remain physically healthy.  Good nutrition is fundamental to good health and well-being. South Africa has a set of ten healthy eating guidelines that promote the principles of eating more unprocessed foods, eating more vegetables and fruit, reducing the use of fats and oils and reducing the intake of sugar and salt.  Good nutrition starts with good food and sometimes good food can cost more, so it is important to use your food budget wisely.  The food budget includes food eaten at home, as well as funds spent on food eaten outside of the home, eating take-outs, foods bought online, and food eaten away from home.  Planning your meals in advance and sticking to a food plan will limit opportunities to spend money on items that are not on the plan; planning ahead also means you can take advantage of good prices, especially as food prices are on the increase and will continue to increase. Bulking up when prices are low and on special, making use of combo buying, e.g. buy three and pay for two, and buying directly from food producers such as co-ops, all help to save money in the long run.  Meat, fish, and especially seafood are the most expensive food items; rather use eggs, chicken, and less expense meat cuts for your meals.  Legumes such as dried beans, peas, and soya are less expensive with great nutritional value.  Explore these less-known group of foods with many great health benefits, such as no fat, more fibre, and lots of vitamins and minerals.

In an effort to eat more fresh vegetables and fruit, starting a home garden is a great family challenge and a definite way of keeping food costs low. And as we navigate the new normal post-COVID times ahead, let us keep mealtimes and meal preparation a fun family activity. Discovering new foods and new tastes can be as exciting as travelling to a new place.  Stay safe, stay healthy! 

Opinion article by Dr Chantell Witten, Division of Health Professions Education, University of the Free State.


News Archive

Childhood obesity should be curbed early
2017-03-15

Description: Child obesity Tags: Child obesity

Serious intervention by parents is required to deal
with childhood obesity. Prof Louise van den Berg and
a group of final-year PhD students worked on a study
about the prevalence of obesity in six-year-olds in
South Africa.
Photo: Supplied

If your child is overweight when they start school at the age of six, unless you do something about it at that point, the indications are they are going to be overweight teenagers and obese adults. This is according to University of the Free State’s Prof Louise van den Berg.

Evidence has shown that overweight children and teenagers have a greater risk of developing lifestyle diseases such as type 2 diabetes, hypertension and cardiovascular disease later in life, and dying prematurely.

Obesity is a global pandemic rapidly spreading among adults and children, in developed and developing countries alike.

Dr Van den Berg worked with Keagan Di Ascenzo, Maryke Ferreira, Monja-Marie Kok, Anneke Lauwrens, all PhD students with the Department of Nutrition and Dietetics, to conduct the study. Their research found that children who are overweight by the time they turn six should be screened for weight problems.

Why six-year-olds?
Children who are overweight between the ages of two and five are five times more likely to be overweight when they are 12. There are two periods in a normal life cycle when the body makes new fat cells. The first is in the uterus and the second is around the age of six. The second phase lasts from the age of six to puberty.

The study assessed the prevalence of obesity in six-year-olds as part of a campaign in South Africa to raise awareness of the problem among parents and educators.

A total of 99 children were chosen from seven schools in Mangaung, the capital city of Free State. The schools were chosen from quintile four and five schools, which when measured by their own resources and economic circumstances, are well resourced and serve largely middle-class and wealthy communities.

The children’s weight, height and waist circumference were measured and used to calculate a body mass index score and waist-to-height ratio. Both these figures are good predictors for future lifestyle disease risks such as type 2 diabetes, hypertension and cardiovascular disease. A person with a good waist-to-height ratio can wrap a piece of string equal to their height around their waist at least twice.

When the children had a higher body mass index, they also had an increased waist to height ratio. The study found one in four children from the schools surveyed were overweight when they started primary school.

Nipping the fat in the bud
Although there are many factors that play a role in preventing childhood obesity, parents’ perceptions of their children’s weight play an important role. A recent study found that more than 50% of parents underestimate the weight of their obese children. These parents remain unaware of the risks their children face and are not motivated to take any action.

At least half of the parents whose children are overweight struggle to recognise their children’s weight problems fearing that they will be labelled or stigmatised. By the time they turn six overweight children should be referred to dieticians and nutritionists who are qualified to guide their parents in getting them to eat well and be more physically active at pre-primary and primary school.

The high prevalence of weight problems among six-year-olds found in this study is an urgent call to healthcare professionals to step up and empower parents, educators and children with the necessary skills for healthy dietary practices and adequate physical activity.

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