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IFPRI ForumHow can food policy address the "double burden" of obesity and chronic diseases in Africa?
Obesity has become a leading global public health problem. However, very little is known about its incidence, causes, and health effects in developing countries and particularly in Africa. Policymakers, donors, and researchers hesitate to draw attention to obesity in Africa, due to the huge burden of diseases associated with the high prevalence of hunger and malnutrition and acute infections in the continent. Recent studies, however, show that more and more Africans are becoming overweight or obese, and that this trend is not limited to the affluent. In Egypt, 70 percent of women and 48 percent of men are overweight or obese. In Morocco 40 percent of the population was overweight in 2004; in Kenya, 12 percent. Unless urgent measures are taken to reverse the current trend, the "double burden of disease" will hinder poverty reduction and sustainable economic development in many African countries.
Recent studies conducted by IFPRI provide insights about the root causes of obesity and its association with chronic diseases in some African countries. This understanding will help to develop wide-ranging policy measures related to food production, marketing, pricing, and nutritional education.
- Food price policies and rising obesity prevalence in Africa
Government food pricing policies can be one of the drivers of obesity. A study conducted in Egypt shows that the country's food subsidy program reduces the per-calorie costs of energy-dense foods such as bread, oil, and sugar compared to energy-dilute but nutrient-dense foods such as fruits and vegetables. The study also reveals that mothers' Body Mass Index increases as the price of energy-dense food items decreases and decreases as the price of energy-diluted food items decreases. This suggests that the food subsidy program may aggravate obesity in the country by lowering the direct costs of becoming obese. Therefore, improving the affordability of micronutrient rich foodstuffs may help to improve the diet of the population and consequently help to solve the obesity problem.
- Overweight and obesity overlap with micronutrient deficiency
Individuals who do not have access to micronutrient-rich food items are more likely to be obese. A study of Egyptian mothers shows that the odds of being overweight or obese are 80 percent higher for micronutrient-deficient mothers. This implies that the overlap between obesity and micronutrient malnutrition may be overlooked since micronutrient-deficiency is usually associated with hunger. This overlap may also create new and serious public health problems since little is known about the potential impact of the interaction between micronutrient-deficiency and diet-related chronic diseases. Thus, there is a need to focus food-related policies toward addressing all forms of malnutrition.
- Obesity is associated with chronic diseases in Africa
Little is known about the association between obesity and chronic diseases in Africa. An empirical study conducted in Senegal and South Africa examined the association between obesity and four doctor-diagnosed chronic diseases. The results reveal that obese respondents are more likely to face the risks of arthritis, diabetes, and heart diseases in South Africa and of heart disease and asthma in Senegal than their leaner counterparts. This strong association between obesity and chronic diseases has important implications for policymakers. Failure to address the problem of obesity today may impose additional burdens that the health sector and the economy of African countries may not be able to shoulder in the future. African countries must not learn about the impact of obesity the hard way, through direct experience.
Obesity is now a major health problem in Africa, along with HIV/AIDS and other communicable diseases. The problem is complicated by the coexistence of obesity and undernutrition in the same countries, households, and individuals. Under- and overnutrition are "two symptoms at either end of the same continuum." As such, a holistic approach is needed to address the two problems simultaneously. Addressing obesity demands a multifaceted approach, recognizing the roles of globalization, trade agreements, food production, marketing, pricing, education, physical activity, and other factors. In-depth research is needed in African and other developing countries to identify optimal and multidimensional policies that help to address the problems of under- and over-nutrition simultaneously and curb the current trends toward obesity and chronic diseases before the problems reach an epidemic level.
This commentary is based on the following background papers:
- Asfaw, A. 2006. The Effects of Obesity on Doctor-Diagnosed Chronic Diseases in Africa: Empirical Results from Senegal and South Africa. Journal of Public Health Policy 27 (3): 250–264.
- Asfaw, A. 2006. The Role of Food Price Policy in Determining the Incidence of Obesity: Evidence from Egypt. Review of Agricultural Economics 28 (3): 305–312.
- Asfaw, A. 2006. Do Government Food Price Policies Affect the Prevalence of Obesity? Empirical Evidence from Egypt. Forthcoming in World Development (Winter 2006).