LIFESTYLE NEWS - Research released in March this year has found South Africa to be the unhealthiest country on earth. The Indigo Wellness Index, one of the most comprehensive rankings to date, was based on 10 measures namely healthy life expectancy, blood pressure, blood glucose (diabetes risk), obesity, depression, happiness, alcohol use, tobacco use, inactivity (too little exercise), and government spending on healthcare1.
Dr Riekie Smit, an aesthetic medicine practitioner from Pretoria with a special interest in weight management, says that this research highlights the need to invest in health education and development2.
Although fully aware of the unhealthy lifestyles led by millions of South Africans, Dr Smit was nevertheless shocked that the results showed South Africa to be the unhealthiest country globally, out of the 191 countries included in the study1.
“People will need to start realising that your health is not only the responsibility of your doctor or the health institute you visit, but it’s your own responsibility to keep yourself healthy,” she says.
Drawing on her international experience and speaking to numerous doctors from around the globe, Dr Smit says that she is always surprised at how the attitudes of health varies from people in different cultures and countries.
“South Africans can be very lazy and expect their doctor or a tablet to fix their health problems. Changing lifestyle, diet and habits are not viewed as the first step to cure diseases by our population,” she says. Many South Africans are simply oblivious about the fact that leading healthier lives can decrease the need for medical intervention2.
Of all ten health measures included in the study, Dr Smit says that our obesity rate is alarming and needs to be addressed urgently with interventions to change the way South Africans approach this issue2.
In fact, the World Health Organisation has found that more than 28% of adults in South Africa are obese, the highest obesity rate amongst sub-Saharan African countries1.
People who are obese, compared to those with a normal or healthy weight, are at increased risk for many serious diseases and health conditions, including high blood pressure (hypertension), type 2 diabetes, sleep apnoea and breathing problems, coronary heart disease, stroke, some cancers, osteoarthritis and many others3.
“Both government and private health sectors will need to start developing systems to encourage patients to improve healthy lifestyles, diet, activity and addictions. This is vital to reduce the excess load on both public and private health care. We simply do not have enough doctors and healthcare facilities to manage our unhealthy population,” she says2.
Dr Smit says that some of the private medical insurance companies have already implemented such systems of rewarding healthy behaviour with very positive outcomes. “This type of approach should be taken by other private health institutions or insurance companies and more importantly, it should be implemented in the public health sector also,” she says2.
“This type of approach of encouraging or rewarding healthy choices should address all the points where our health showed low scores according to this research in order to get people more involved in their own health,” Dr Smit explains2.
Recent statistics from the World Health Organisation show that South Africans have a 26% probability of dying from cardiovascular disease, cancer, diabetes, or chronic respiratory disease between ages 30 and 701. Reacting to this, Dr Smit says that there is no doubt that improvement in lifestyle and weight loss will have a huge impact2.
“Numerous studies have proven this with evidence that weight loss of just 5 - 10% of body weight improves cardiovascular diseases, metabolic syndrome and risk for diabetes (22% reduction), reduction of cholesterol levels, blood pressure levels, inflammation, sleep apnoea, psyche and many more improvements,” she says2.
In fact, some studies have shown a decrease in the incidence of diabetes of as much as 40-60% with a 10% reduction in body weight4.
Dr Smit says that this evidence should really alert members of the public to the fact that their lifestyle choices have the largest impact on their health and not the quality of their healthcare2.
“This should also alert public and private healthcare how important it is to encourage healthy lifestyle amongst patients”, she says2.
In terms of doctor patient intervention, many patients might benefit more from lifestyle and health education than just receiving a quick prescription, but many doctors are too busy for this2.
Dr Smit says one solution could include pharmaceutical companies giving doctors assistance where possible in order to minimise the time spent on health consultations. “In my practice, I have found the iLiveLite program developed by iNova Pharmaceuticals very helpful. The program gives the patients access to a website and printed materials with advice and a dietician developed eating program focused on weight loss,” she says.
“Other systems that are useful are health and fitness apps with points awarded and competitive rewards systems. I often encourage my patients to start using these apps in combination with fitness trackers. These methods can take a lot of responsibility off the shoulders of health care providers,” she says2, and explains that there are numerous applications for health, diet and exercise available that give you your own personal ‘life coach’ at sometimes no cost or very low cost2.
Dr Smit doesn’t believe that our unhealthy situation is beyond repair, and hopes that these new statistics will alert the various healthcare systems in South Africa to take urgent steps2.
As individuals, we also need to start taking active steps to improve our health and the health of our families2.
“My advice for people reading this would be to start with immediate effect to actively improve your health. There is so much easily accessible information available today and therefore no excuse. The first step would be to visit your health care provider for a health screening and examination. Their advice would be of immense value,” she says2.
For many, the thought of losing even 5 to 10 percent of their weight can be very intimidating. Medical research has shown that there is strong and consistent evidence that overweight and obese patients in well-designed programmes can achieve a weight loss as much as 10 percent 5.
Dr Smit says that where necessary, pharmaceutical intervention can be helpful2.
Speak to your doctor about options for weight loss management or for more information or for dietician formulated, kilojoule specific meal plans, which are initiated and guided by your GP for individualised kilojoule intake.
Dr Smit says that there are also various professionals who can be consulted to give you the specific advice needed for your concern, who can help you to take the necessary steps to actively improve your health and ensure a better quality of life2.
Dr Smit is an aesthetic and sports practitioner and has a private practice with two clinics in Pretoria, focussing on aesthetic and skin treatments as well as individual weight loss programs. She is a global KOL for various aesthetic medical and pharmaceutical companies in the industry. Go to www.drriekie.co.za for more information.
- Business Insider South Africa. South Africa has just been ranked the unhealthiest country on earth (2019).
- Q&A with Dr Riekie Smit (unpaid) – 3 April 2019
- Centers for Disease Control and Prevention - The Health Effects of Overweight and Obesity (2015).
- Haslam, D et al. ABC of Obesity. Obesity – Time to Wake Up. BMJ VOLUME 333 23 SEPTEMBER 2006;333:640–2
- Phelan S, Wadden TA. Combining Behavioural and Pharmacological Treatments for Obesity. Obes Res 2002; 10(6):560-574
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