Obesity in times of hunger

Despite chronic food shortages afflicting all parts of Swaziland, a national survey has discovered that 55 percent of Swazi women are overweight or obese.

"The likelihood of a woman being overweight (pre-obese) or obese increased with age: 70 percent of women 40 to 49 years of age were overweight or obese," said the recently published survey by the health ministry's Vulnerability Assessment Committee (VAC), while about one-third of women aged 30 to 39 years were classified as overweight or obese.

The survey of about 1,000 households focused on Swazi women and children, including 700 women who were not pregnant, and classified women who were pre-obese as those having a body mass index (BMI) above 25, or obese if their BMI was above 30.

BMI is a measurement of the relative percentages of fat and muscle mass in the body, in which the person's weight in kilograms is divided by their height in meters and the result used as an index of obesity. A BMI between 18.5 and 24.9 is considered healthy.

In the eastern Lubombo region, hard hit by drought since 2001, and the underdeveloped Shiselweni region in the south of the country, which is also drought prone, two percent of women were undernourished.

About a quarter of Swaziland's roughly one million people rely on some form of emergency food relief as a result of prolonged drought and the impact of HIV/AIDS on the agricultural workforce: the prevalence rate is 34.2 percent among people aged 15 to 49, the highest in the world.

The apparent contradiction between poor food security and obesity rates can, in part, be attributed to local custom, according to Samuel Ndwandwe, a physical therapist in Manzini, the country's commercial hub 35km east of the capital, Mbabane.

"Swazi women and middle-aged men grow fat. It's in our genes, put there as a way to survive the next famine, and then made into a fashion by the attitude that people who are fat are healthy," Ndwandwe told IRIN.

Anthropologist Hilda Kuper said for centuries, fat was seen as insurance against periods of food shortages, which were a way of life for Swazis until recent times, with the early summer months known as the times of hunger, when the crop surplus from the previous year had been finished and the next harvest had not yet been gathered.

By tradition, men and women in their 40s became elders and the VAC survey found this was also the time when obesity in women increased, but life expectancy in Swaziland currently stands at 33 years because of the impact of the HIV/AIDS pandemic.

Obesity among the three-quarters of the population unaffected by food scarcity has led to an increase in "ailments of affluence", such as diabetes and heart disease.

Although many adults seem to have more than enough to eat, the survey found that throughout Swaziland, children were malnourished.

During the VAC survey, 1,200 selected children aged between 0 and 59 months were weighed and the figures compared to those considered normal for children's ages and heights. The results indicated that 29 percent of children suffered medium malnutrition, 39 percent were seriously malnourished, and boys were more likely to be underweight than girls.