The epidemic of obesity in South Africa: A study in a disadvantaged community

Objective: The objective of this study was: 1) to determine the anthropometric profile of adults in Mamre, a small town in South Africa, which has a population of mixed ancestry ("colored" people of Afro-Euro-Malay-Khoisan ancestry); and 2) to determine the change in this profile between 1989 and 1996. Design: Cross-sectional surveys conducted in random samples of adults in 1989 and 1996. Participants: The subjects were 684 women and 529 men in 1989, and 546 women and 430 men in 1996, aged 15 and older. Main Outcome Measures: The following measurements were recorded: height, weight, and circumference of waist, hips, and mid-upper arm. Results: Based on data from the 1996 survey, 32% of women are obese (body mass index [BMI] ≥ 30) at ages 25-44 years, rising to 49% at ages 45-64 years. A much lower prevalence of obesity is seen in men: 14% at ages 35-64 years. Obesity levels significantly increased in women between the two surveys (P=.015): up from 44% in 1989 to 49% in 1996 at ages 45-64 years. There was an increase in the prevalence of overweight (BMI 25-29.9) in men, though not in obesity. Mean BMI increased by about 3% in women and 2% in men between 1989 and 1996. Conclusions: This study conducted among people of mixed ancestry living in a disadvantaged community in South Africa shows that half of middle-aged women are obese. A rising trend in BMI was seen in adults of both sexes between 1989 and 1996. This trend may be explained by factors associated with rural-urban transition, including electrification, reduced physical activity, and increasing availability of energy-dense food.