Advice Column, Health, Recently

Advocates call for policy changes to prevent SA childhood obesity

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Approximately 13% of South Africa’s children under five years are overweight – more than double the global average.1 Being overweight and developing obesity in early childhood increases the risk for adult obesity, as well as associated conditions like high cholesterol, diabetes and high blood pressure. All of these conditions are increasingly prevalent in South Africa.1

Childhood obesity is a serious medical condition that affects children and teens.2 It’s particularly troubling because the extra kilos often start children on the path to lifelong health problems.2 Childhood obesity can also lead to poor self-esteem and depression.2
The main cause of overweight and obesity among children is the consumption of high-calorie diets — those that are rich in salt, sugar and fats.1 This is also influenced by other factors such as household poverty coupled with the high cost of healthy foods.1
South African children’s fast-food consumption rates are high.3 In a 17-country study completed in 2014, researchers found that fast-food consumption among South African children and adolescents was more frequent than in high-income countries such as Japan and Belgium.3

“Highly processed and unhealthy foods have become increasingly accessible and affordable over the last three decades, leading to a global increase in weight issues and obesity, especially in the poorest and most vulnerable communities and households,” says Nzama Mbalati, Programmes Manager at the Healthy Living Alliance (HEALA).

One of the major factors associated with obesity is sugar consumption. South Africans are estimated to consume up to 24 teaspoons of sugar per day – double the daily WHO recommendation.4

South Africa passed a Health Promotion Levy (HPL) on sugary beverages in 2018.5 Commonly known as “the sugar tax”, it has led to considerable reductions in the purchase and consumption of taxable drinks, proving that legislation can support consumers to reduce intake of unhealthy foods and beverages.5

“Currently, at least 85 countries have sugar-sweetened beverages (SSB) taxation,” says Mbalati. “Data from countries like the UK and Mexico indicates that SSB taxes successfully reduce sugar consumption. In South Africa, people are buying 28% fewer sugary drinks since the government implemented the HPL in 2018. In addition, the levy has slashed the South African beverage sector’s use of sugar by a third. The combination of the two has cut sugar intake in the country by nearly a third. It is now time for the sugar tax on drinks – currently at 10% of the cost per litre – to be doubled and this needs to happen soon.”

Mbalati stresses that this is critical to address the country’s raging diabetes epidemic and the high rates of obesity that fuel it. “South Africans are addicted to sugar. With more than a quarter of the population living with obesity, we are among the top 20% of the most obese nations in the world. More than 4,5 million people are diabetic, with diabetes being the second-largest cause of death after tuberculosis,” says Mbalati.

Mbalati adds that sugary drinks should be drastically reduced in children’s diets. “Even 100% fruit juice with no added sugar contains a lot of sugar with none of the fibre you would find in a piece of fruit to help fill you up. Encourage kids to drink mostly water and plain milk. Get them to eat whole fruit, like an apple, instead of drinking apple juice,” says Mbalati.

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  1. Statistics on children in South Africa: Overnutrition in children, Sambu, W. Children’s Institute. University of Cape Town. [Nov 2019]. Available from:
  2. Childhood obesity. Mayo Foundation for Medical Education and Research (MFMER). [Dec 2022]. Available from:
  3. South African Child Gauge 2020: Food and nutrition security. May, J.; Witten, C.; Lake L. Children’s Institute. University of Cape Town. [2020]. Available from:
  4. McCreedy, N.; Shung-King, M.; Weimann, A.; Tatah, L.; Mapa-Tassou, C.; Muzenda, T.; Govia, I.; Were, V.; Oni, T. Reducing Sugar Intake in South Africa: Learnings from A Multilevel Policy Analysis on Diet and Noncommunicable Disease Prevention. Int. J. Environ. Res. Public Health 2022, 19, 11828. Available from:
  5. Stacey, N; Edoka, I; Hofman, K; Swart, EC; Popkin, B; Shu Wen, N. Changes in beverage purchases following the announcement and implementation of South Africa’s Health Promotion Levy: an observational study. The Lancet. 5, 4, E200-E208. [Apr 2021]. Available from:

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