The fat is in the fire

2013-02-10 10:01

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Study shows one in three black women are obese. Really, asks Zinhle Mapumulo.

South Africa has a big fat problem and it is not going down well with black women.

Reports this week on a study that found – a decade ago – that a third of black women were obese were met with scepticism and criticism from dieticians and the full-figured ladies themselves.

Nutritionists argued that the SA Institute of Race Relations findings – based on research conducted in 2003 by the Medical Research Council of SA – were too old to be a true reflection of what black women looked like 10 years on.

They also questioned whether the body mass index (BMI) tool was the right instrument to determine whether black women were fatter than their white, coloured or Indian counterparts, saying it didn’t take into account varying body shapes.

The BMI is a calculation that uses the height and weight of a person to determine how much body fat they have and whether or not they are healthy, underweight or overweight.

Comedian Tumi Morake (pictured) said as a full-figured woman, she didn’t see the relevance of rehashing such findings as she was not “in some fat race with white women”.

“I don’t want to pretend to be a spokesperson for fat black women everywhere. But some of us, like Saartjie (Baartman), are naturally born with big hips, big bums and big hearts. Maybe we are fat because life is good and culturally a big woman is a well-fed, rich woman,” she added.

Nomadlozi Ntshingila, a Pretoria-based dietician, said while the findings might have been true 10 years ago, they might not represent what was happening now.

“Middle class black women have become conscious about how they look. They now watch what they eat and spend most of their time working out at the gym,” said Ntshingila.

Another dietician, Phumzile Ndewu, agreed, saying: “Young black women, especially those living in affluent areas, are conscious about how they look.

“Gyms are always packed and, as dieticians, we are seeing more black women who want to be helped to lose weight or maintain it. I think a new survey will give us a different picture.”

But Dr Julia Goedecke, the scientist studying ethnic differences in obesity and diabetes risk at the Medical Research Council, was not convinced.

She said although the study findings might be old, they still applied to South Africans and should be taken seriously.

“The values still apply, as the prevalence of overweight and obesity has not changed substantially from the original survey undertaken in 1998 to 2003, when the last survey was undertaken,” Goedecke said, adding that while there was no new data on obesity, it had been a growing problem among black women.

“The increase is associated with urbanisation and the nutrition transition – increased intake of processed high-energy-dense foods, in combination with reduced levels of physical activity and increased levels of inactivity or sedentary behaviours like watching TV and sitting in front of a computer,” she said.

But Ndewu and Ntshingila also questioned the use of BMI measurements for patients of different race groups, saying many factors like age, gender and body shape should be taken into account.

Goedecke did agree with that.

“Black women are generally shorter than their white counterparts,” she said.

“This could be related to the impact of socioeconomic status. The prevalence of stunting in childhood is much greater in the black than white populations and as BMI is based on height, this would impact their BMI.”

Obesity has been linked to lifestyle diseases such as diabetes, hypertension and heart disease.

Morake, however, said she was not worried about the health risks associated with her weight.

“I worry about not being able to run around with my kids and so I have made a lifestyle choice to get healthier.

“I’ve never been thin, so that’s not even on my to-do list.”

She also lamented the criticism women faced about their weight.

“Thin chicks get chided for malnutrition, fat chicks for overindulging. It just doesn’t end. People suffer from underactive thyroids, some are emotional eaters. Either way, they end up fat.

“I’ve heard of people being called morbidly obese. I guess any woman who is bigger than they would like to be is morbid because they think they are obese.”

The BMI debate

Dieticians use a measurement tool known as the body mass index (BMI) to indicate whether you are overweight, underweight or at a healthy weight for your height.

According to the World Health Organisation, those with BMIs of 18.5 or less are considered underweight, and those of healthy weight have BMI scores of between 18.5 and 24.9.

Overweight people have BMIs of between 25 and 29.9, and those with scores of 30 and above are considered obese.

The BMI is calculated by dividing your weight (in kilograms) over your height squared (in centimetres).

Although the BMI continues to be used to determine a person’s health status and their risk of contracting certain lifestyle diseases, its relevance remains hotly debated.

Local dieticians argue that different races have different body shapes and, as a result, fat is distributed differently.

White women have more fat surrounding the organs in the abdomen and black women have more fat under the skin, especially in the peripheral areas such as the buttocks and legs.

Dr Julia Goedecke says the differences in body fat distribution may impact on disease risk and may explain why black women have a more favourable lipid profile (lower cholesterol and triglyceride level) than white women.

“Paradoxically, black women are more insulin resistant and therefore at increased risk for type 2 diabetes than white women,” Goedecke said.

Fat of the land

These are the demographic health findings by the SA Institute of Race Relations.

They were released this week:

»?A third of all black women are obese;

»?Overall, almost one-third of South African women are obese;

»?South African men were less likely to be obese than women, fewer than one-tenth being obese;

»?At least 18% of all white men were obese, followed by 9% of Indian, 8% of coloured and 6% of black men;

»?The highest level of obesity was seen in white men aged 65 years and older in the Western Cape;

»?In women, obesity was most prevalent in the 45-54 age group, in the Eastern Cape, in those with low education and in black urban women;

»?About 39% of urban black women had a waist circumference of greater than 88cm and Indian women had the lowest rate at about 25%; and

»?The largest prevalence of women with a waist circumference of greater than 88cm was observed among those who were older, lived in Gauteng and in Western Cape, and had low levels of education.

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