South Africa is facing a dual challenge: food poverty and diet-related diseases. Households struggle with limited access to diverse and nutritious food, while diabetes and other non-communicable diseases continue to rise.
As part of National Nutrition Week, running from October 9th to 15th, statistics reveal a serious public health issue, indicating that people may consume enough food to feel full, yet lack vital nutrients for healthy development and long-term well-being.
According to the latest mortality data from Statistics South Africa (Stats SA), diabetes mellitus accounted for 6.1% of registered deaths in 2024, an increase from 5.8% in 2023. It became the leading cause of death among individuals aged 45 to 64, comprising 7.9% of deaths in this age group.
The International Diabetes Federation estimates that 2.32 million South African adults aged 20 to 79 suffered from diabetes in 2024, corresponding to a prevalence of 7.2%. Meanwhile, UNICEF reports that 23% of children under five in South Africa suffer from severe child food poverty. The organization's latest data also shows that in 2022, 21% of children and adolescents aged five to 19 were overweight.
Dietitian Zeenat Simjee notes that financial and practical pressures often dictate family diets, with the priority being ensuring sufficient food for all meals rather than achieving nutritional diversity. She explains: 'When household budgets are under pressure, the first reaction is not always the healthiest diet, but rather the choice of products that guarantees enough food to sustain the household, stretch across several meals, and is easier to prepare.'
Simjee emphasizes that meals built predominantly on staple foods can provide necessary energy but may lack sufficient protein, fiber, and essential micronutrients, including iron, zinc, calcium, vitamin A, and folate. She concludes: 'Thus, a meal can provide satiety but be nutritionally inadequate.'
The expert warns that the consequences can be particularly severe for children, as their bodies and brains require adequate nutrients for healthy development. The first 1000 days, from pregnancy to the child's second birthday, are especially critical, as nutrient deficiencies during this period can have long-term effects.
In Simjee's view, South Africa is grappling with a triple burden of malnutrition, where undernutrition and micronutrient deficiencies coexist with overweight, obesity, and diet-related diseases. However, she clarifies that the link between diet and chronic diseases is not about blaming individual foods; the concern lies with the overall dietary pattern, where energy-dense foods rich in refined carbohydrates, added sugars, saturated fats, or sodium constantly displace more nutrient-rich options.
The Ministry of Health has acknowledged that access to affordable, nutritious, and diverse food is a crucial health factor closely linked to preventing non-communicable diseases. A representative from the Department, Foster Mohale, stated that the National Strategic Plan for the Prevention and Control of Non-Communicable Diseases for 2022–2027 identified unhealthy diets as one of the five main modifiable risk factors.
Mohale added that the department views food accessibility and the availability of healthier options as issues beyond individual choice. Measures taken by the department include regulating sodium reduction, controlling industrially produced trans fats, food fortification, nutrition education, and steps to improve the food environment. It was noted, however, that education alone is insufficient to overcome structural barriers affecting what people eat. Foster also announced the upcoming 2022 National Dietary Intake Survey, which is expected to provide updated data on dietary patterns, nutrient intake, and nutritional status across different socioeconomic groups.
Dr. Karen Heath, a senior researcher at The Noakes Foundation, believes that National Nutrition Week should not turn into a list of instructions addressed to individuals. She argues: 'National Nutrition Week cannot be reduced to a list of rules for individuals. The data points to a much more complex challenge: making nutritious choices more accessible and affordable, helping people interpret reliable information, and taking chronic disease prevention seriously.'
The Foundation will host a World Nutrition Summit in Cape Town from October 14th to 16th, gathering South African and international participants to discuss nutrition research, clinical practice, prevention, and nutrition environments. Professor Tim Noakes stated that scientific debate is necessary to improve health outcomes, emphasizing that 'Scientific progress depends on asking difficult questions and being willing to change one's mind.'