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Where does the black population of South Africa stand on the nutrition transition?

  • Lesley T Bourne (a1), Estelle V Lambert (a2) and Krisela Steyn (a3)

To review data on selected risk factors related to the emergence of non communicable diseases (NCDs) in the black population of South Africa.


Data from existing literature on South African blacks were reviewed with an emphasis placed on changes in diet and the emergence of obesity and related NCDs.


Review and analysis of secondary data over time relating to diet, physical activity and obesity and relevant to nutrition-related NCDs.


Urban, peri-urban and rural areas of South Africa. National prevalence data are also included.


Black adults over the age of 15 years were examined.


Shifts in dietary intake, to a less prudent pattern, are occurring with apparent increasing momentum, particularly among blacks, who constitute three-quarters of the population. Data have shown that among urban blacks, fat intakes have increased from 16.4% to 26.2% of total energy (a relative increase of 59.7%), while carbohydrate intakes have decreased from 69.3% to 61.7% of total energy (a relative decrease of 10.9%) in the past 50 years. Shifts towards the Western diet are apparent among rural African dwellers as well. The South African Demographic and Health Survey conducted in 1998 revealed that 31.8% of African women (over the age of 15 years) were obese (body mass index (BMI) ≥ 30 kgm−2) and that a further 26.7% were overweight (BMI ≥ 25 to <30 kgm−2). The obesity prevalence among men of the same age was 6.0%, with 19.4% being overweight. The national prevalence of hypertension in blacks was 24.4%, using the cut-off point of 140/90 mmHg. There are limited data on the population's physical activity patterns. However, the effects of the HIV/AIDS epidemic will become increasingly important.


The increasing emergence of NCDs in black South Africans, compounded by the HIV/AIDS pandemic, presents a complex picture for health workers and policy makers. Increasing emphasis needs to be placed on healthy lifestyles.

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1Statistics South Africa. Population Census, 1996: Primary Tables. Report 03-01-17 (1996). Pretoria: Statistics South Africa, 1999.
2Burkitt DP. Western diseases and their emergence related to diet. S. Afr. Med. J. 1982; 61: 1013–5.
3Segal I, Walker ARP. Low fat intake with falling fibre intake commensurate with rarity of non-infective bowel diseases in blacks in Soweto, Johnannesburg, South Africa. Nutr. Cancer 1986; 8: 185–91.
4Fox FW. Diet in the urban locations as indicated by the survey. In: Janisch M, ed. A Study of African Income and Expenditure in 987 Families in Johannesburg. City of Johannesburg: Department of Non-European and Native Affairs, 1940.
5Du Toit B. Dietary survey amongst 100 native families in the Payneville Location, Springs. S. Afr. J. Soc. Sci. 1951; 4: 6373.
6Batson E. The ethnic differentiation of fat–calorie ratios in household food purchases in Cape Town. J. Soc. Res. 1953; 4: 113–5.
7Bronte-Stewart B, Keys A, Brock JF. Serum cholesterol, diet and coronary heart disease. Lancet 1953; ii: 1103–8.
8Manning EB, Mann JI, Sophangisa E, Truswell AS. Dietary patterns in urbanised blacks. S. Afr. Med. J. 1971; 48: 488–98.
9Gericke GJ, Loock ME, Marzner L, van der Merwe CA. Die macronutrientinname en serumlipiedwaardes van swartes met en sonder IHS. J. Diet Home Econ. 1989; 17: 41–6.
10Albertse EC, Neethling A, de Villiers MA. Diet and lifestyle differences between rural and urban Zulu women. S. Afr. J. Food Sci. Nutr. 1990; 2(Suppl. 1.1): 1.
11Walker ARP, Walker BF, Walker AJ. Comparison of nutrient intakes of South African elderly black women in 1969 and 1989. J. Hum. Nutr. Diet. 1992; 5: 169–77.
12Walker ARP, Walker BF. High high-density lipoprotein cholesterol in African children and adults in a population free of coronary heart disease. BMJ 1978; 2: 1336–8.
13De Villiers MA. Diet, lifestyle and the prevalence of obesity and hypertension among Zulu women in a remote rural area. MSc thesis, University of Stellenbosch, South Africa, 1988.
14Sivis N, Mollenze WF. Nutrient intakes of black inhabitants in Qwa Qwa and Bloemfontein. Unpublished, University of Potchefstroom, 1992.
15Rossouw LJ. An interracial comparison of atherosclerosis precursors in 11-year-old South African children. MSc thesis, University of Stellenbosch, South Africa, 1990.
16Bourne LT. Dietary intake in an urban African population in South Africa – with special reference to the nutrition transition. PhD thesis, University of Cape Town, South Africa, 1996.
17Shekelle RB, Shyrock A, Mac M, Paul O. Diet and serum cholesterol and death from coronary heart disease: The Western Electric Study. N. Engl. J. Med. 1981; 304: 6570.
18Bourne LT, Langenhoven ML, Steyn K, Jooste PL, Laubscher JA, Van der Vyfer E. Nutrient intake in the urban African population of the Cape Peninsula, South Africa. The BRISK study. Cent. Afr. J. Med. 1993; 39: 238347.
19Diet Consensus Panel. Dietary recommendations for the prevention of coronary heart disease. S. Afr. Med. J. 1989; 76: 591–2.
20American Heart Association. Dietary guidelines for healthy American adults. Position Statement. Circulation 1988; 77: 721A–4A.
21Food and Nutrition Board, US National Research Council. Recommended Dietary Allowances, 10th ed. Washington, DC: National Academy Press, 1990.
22Bourne LT, Langenhoven ML, Steyn K, Jooste PL, Nesamvuni AE, Laubscher JA. The food and meal pattern in the urban African population of the Cape Peninsula. The BRISK study. Cent. Afr. J. Med. 1994; 40: 140–8.
23Department of Health Services and Welfare, Administration: House of Assembly. Guide to Healthy Eating. Pretoria: Promedia, 1990.
24Vorster HH, Jerling JC, Oosthuizen W, Becker P, Wolmarans P. Nutrient Intakes of South Africans: An Analysis of the Literature. SANSS Group Report to Roche Products, Potchefstroom, 1995; 41.
25Steyn K, Katzenellenbogen J, Lombard CJ, Bourne LT. Urbanisation and the risk for chronic diseases of lifestyle in the black population of the Cape Peninsula, South Africa. J.Cardiovasc. Risk 1997; 4: 135–42.
26Walker ARP. Urbanisation of developing populations: bearing of rise in privilege and the prevalence of diseases of nutritional deficiency and excess. In: Chaves A, Bourges H, Basta S, eds. Proceedings of the 9th International Congress on Nutrition, Mexico. Basel: Karger, 1972; 2631.
27Steyn K, Bourne LT, Jooste PL, Fourie J, Rossouw K, Lombard C. Anthropometric profile of a black population of the Cape Peninsula in South Africa. East Afr. Med. J. 1998; 75: 3540.
28Mollentze WF, Moore AJ, Steyn AF, Joubert G, Steyn K, Oosthuizen GM. Coronary heart disease risk factors in a rural and urban Orange Free State population. S. Afr. Med. J. 1995; 85: 90–6.
29Puoane T, Steyn K, Bradshaw D, Lambert EV, Fourie J, Laubscher JA. Anthropometry and obesity in South Africa – the National Demographic and Health Survey, 1998. Int. J. Obes. [in press]. Personal correspondence.
30World Health Organization (WHO). Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on Obesity, Geneva: WHO, 35 June 1997.
31Steyn K, Jooste PL, Bourne L, Fourie JM, Badenhorst CJ, Bourne DE. Risk factors for coronary heart disease in the black population of the Cape Peninsula. S. Afr. Med. J. 1991; 79: 480–5.
32Levitt NS,Katzenellenbogen JM, Bradshaw D, Hoffman MN, Bonnici F. The prevalence and risk factors for NIDDM in urban Africans in Cape Town, South Africa. Diabetes Care 1993; 16: 601–7.
33Levitt NS, Steyn K, Lambert EV, Fourie JM, Rossouw K. Modifiable risk factors for Type 1 diabetes mellitus in a periurban community in South Africa. Diabet. Med. 1999; 16: 15.
34Kruger HS, Venter CS, Vorster HH, et al. Physical inactivity is an important contributing factor to obesity in black women in the North West. S. Afr. Med. J. 1999; 89(4): 463.
35Kolbe TL, Lambert EV, Charlton K, Noakes TD. Effectiveness of a low intensity, community-based exercise program for older South Africans from previously disadvantaged communities. Med. Sci. Sports Exerc. 1999; 31(Suppl. 5): S185.
36Steyn K, Gaziano TA, Bradshaw D, Laubscher JA. Hypertension in South African adults: results from the Demographic and Health Survey. J. Hypertens. [in press].
37Guidelines Subcommittee 1999. World Health Organisation/International Society of Hypertension guidelines for management of hypertension. J. Hypertens. 1999; 17: 151–83.
38Burt VL, Whelton P, Rocella EJ, Brown C, Cutler JA, Higgins M. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988–1991. Hypertension 1995; 25: 305–13.
39Fuentes R, Illmaniemi N, Laurikainen E, Tuomilehto J, Nissinen A. Hypertension in developing economies: a review of population based studies carried out from 1980–1988. J. Hypertens. 2000; 18: 521–9.
40McLarty DG, Pollitt C, Swai ABM. Diabetes in South Africa. Diabet. Med. 1990; 7: 670–84.
41Goldberg MD, Marine N, Ribeiro F. Prevalence of glycosuria and diabetes among Indians and Bantu. S. Afr. Med. J. 1969; 43: 733–8.
42Omar MAK, Seedat MA, Motala AA, Dyer RB, Becker P. The prevalence of diabetes mellitus and impaired glucose tolerance in a group of urban South African blacks. S. Afr. Med. J. 1993; 83: 641–3.
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