South African Society for the Study
of
Chair - PROF. M-T VAN DER MERWE
Senior Consultant Physician
Endocrinologist
Honorary Secretary, International
Association for the Study of
Tel +27 11 484 1323
South
African Society for the Study of
IASO launches new congress in
The first ever IASO
obesity conference for
The 1st IASO Regional
Congress on
The South African
Demographic and Health Survey, undertaken in 1998, found high rates of
overweight and obesity, twenty-nine percent of men and 56 percent of women were
overweight or obese. In
Even more recent data
published in the South African Youth Risk Assessment Survey 2002 by the South
African Medical Research Council show the prevalence of overweight (including
obesity) among young people aged 13-19 years to be 17% overall affecting more
girls (25%) than boys (7%). Prevalence was highest (over 20% for boys and girls
combined) in white and Indian population groups.
The congress programme
covers a wide range of topics with a clinical and management orientated theme,
addressing the challenge to link advanced scientific approaches to basic and
practical metabolic and obesity issues. Delegates from diverse areas of
specialization, including nutrition and dietetics, endocrinology, cardiology,
gynaecology, sports physiology, psychology, as well as general practitioners,
nurses and social workers are expected to attend.
Abstracts are being invited for
poster presentations only, and the posters will be displayed in the trade
exhibition area alongside the lecture rooms. The deadline for abstracts and
early registration is June 30th. The Scientific Committee will review abstracts
and authors will be notified by
Early registration fee before
Delegates attending the Congress
have an opportunity to expand their professional education and study the latest
advances in obesity research in a luxurious setting in the heart of the African
bushveld.
Nowhere in the world is
obesity more prevalent than in the USA and a particularly worrying aspect is
that obesity is now the most common medical condition in childhood in that
country, the prevalence having doubled over the past 20 years to the current
one in every six children, and the rest of the world is not too far behind. Not
coincidentally, many of these children are the targets of saturated marketing
by the junk food industry which aims to displace healthy local eating habits
with its own high calorie, high added fat and high added sugar junk food
containing little vitamins, minerals, protein or fibre. Sweetened drinks
constitute the primary source of added sugar in the daily diet of children, one
330ml can containing the equivalent of 10 teaspoons of sugar. These contribute
not only to overweight or obesity but also displace milk consumption, resulting
in calcium deficiency with associated long-term risk of osteoporosis and
fractures. Dental cavities and enamel erosion are further consequences. Figures
from the USA (I do not think ours can be much different) show that up to 85% of
school children drink at least one soft drink per day and among male teenagers,
20% consume four or more servings per day.
In January 2001 the
United States Dept. of Agriculture tabled a report to congress entitled ‘Foods
Sold in Competition with the USDA School Meal Programs’1 pointing out
that while the school meals programme’s lunches exceeded the RDAs for
standard key nutrients, in most schools participation in this programme was
voluntary, and most schools supplied vending machines for snacks and soft
drinks. These competitive foods not only have a much lower nutritional value
but also tended to stigmatize participation in the school meals programme, and conveyed
a mixed message when it came to teaching about good nutrition and the value of
healthy food choices.
School meal programme
managers face overwhelming competition from foods marketed to children through
multi-million dollar, glitzy marketing campaigns. Today’s children come
to school with established preferences for fast foods, sweetened beverages and
salty snacks and, inevitably, they prefer to meet their friends around vending
machines than in line in the school cafeteria. In the
In early 2004 the
American Academy of Pediatrics published a Policy Statement2 on the sale of
soft drinks in schools which called for the restriction of sales and
recommended that all paediatricians work to eliminate their sale altogether.
This would entail educating school authorities, students, parents and patients
about the health ramifications of soft drink consumption. The statement
recommended that:- each school should have a nutrition advisory council as a
means of ensuring that the health and nutritional interests of students form
the foundation of nutritional policies in schools and not financial
considerations school districts should invite public discussion before making
any decision to sign a vended food or drink contract advertising and
consumption of soft drinks within the classroom should be eliminated.
We have very similar
problems to these in many of our schools in
Dr Ray Moore
References :
1 The USDA report to Congress on
Foods sold in competition with the USDA School Meals Program.
Available at: http://www.fns.usda.gov/cnd/Lunch/CompetitiveFoods/report_congress.htm
2 Soft Drinks in Schools. AAP
Policy Statement. Paediatrics. 2004; 113 : 152-154.
Available at:
http://aappolicy.aappublications.org/cgi/reprint/pediatrics;113/1/152.pdf
A question often asked by others,
as well as asking it myself, is ‘What is wrong with moderation?’
Moderation in weight
loss. How are people actually achieving, or trying to achieve, this goal of
losing weight? A colleague pointed out to me that dietitians have been preaching
moderation in weight loss for all these years and yet the success rate is so
poor. I agreed with him, but I still believe that the way to stop the obesity
epidemic is to teach people how to positively change their lifestyle, how to
eat properly and how to introduce appropriate exercise into their lives. In
order to do this it has to be done slowly, moderately with the individual in
mind.
Instant gratification
The present culture of
instant gratification does not help. You want something hot, microwave will do
it in seconds; you want to send a letter, e-mailing will get it there in
immediately; you want to change a TV program, remote will do it instantly.
Therefore people who need to lose weight expect to, and want to, do it now,
straight away, perhaps in a week. We have to educate them of the benefits of a
moderate weight loss over a longer period of time. They start following the
moderate way and then, the latest best-seller hits the bookstores, promising
exactly what the instant gratification generation wants to hear: lose weight
now and this is how. How can even those who were diligently following the
moderate way resist. Of course they buy and follow the plan – millions
can’t be wrong. They follow the quick-fix, lose weight quickly, and find
out again that this is not the long term solution.
Easy way out
Many people also seek
the “easy way out” solutions. You want something, if you can afford
it, surely you can have it. Unfortunately there are a lot of
“helpers” out there promising that weight loss is easy. If they are
paid money they will tell people how, and even assure some that they can do it
for them. Here again, most people will be tempted to buy.
Looking for something out of the
ordinary
The recently published SASSO
Guidelines for the Prevention and Management of Overweight and
for weight loss:
Reduction in fat intake.
Reduction in food quantity.
Limiting alcohol consumption.
Balanced and moderate food intake.
Increase in physical activity.
As dietitians we plan a
reduced and balanced eating plan based on the individual’s needs, likes,
and dislikes. We recommend a moderate weight loss of approximately 0,5 kg per
week. Studies have shown that this can be achieved and maintained with
continuous contact and adherence. Somehow, this is not what the people want to
hear. They want something out of the ordinary. Only if they suffer do they
think they will lose weight, they need to be punished for putting on this
weight. They have to eat differently to shed the kilograms.
The high protein diet is
fashionable at the moment. Not much research has been done in this field, but
the public out there do not need, or want, figures and statistics about the
good or the bad of something. The New England Journal of Medicine has
published an article ‘A Randomised Trial of a Low-Carbohydrate Diet for
Renata Wilson
TTERS TO THE EDITOR
We would love to hear from you!
Please fax all comments, suggestions, criticism etc.
to the SASSO Secretary, Sarah
Hallas on (011) 803 4997 email:
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