Healthy diets: A critical component for improving public health in Africa

A profound shift from communicable to noncommunicable diseases (NCDs) is underway in many parts of the African region, and the World Health Organisation has predicted that by 2030, NCDs will become the leading cause of death in Africa. One of the major drivers of this surge in NCDs is the unhealthy diet consumed by a vast majority of the African population.

Globally, increased production of processed foods, rapid urbanisation and changing lifestyles have led to a shift in dietary patterns. More people now consume foods high in energy, fats, free sugars, salt/sodium, and many do not eat enough fruit, vegetables and other dietary fibre such as whole grains. For children in Africa, the consequence of this trend towards an unhealthy diet has been increased malnutrition in all its forms.

The African region faces a double burden of malnutrition. This means that despite persistent high levels of undernutrition – including micronutrient deficiencies– overweight/obesity is increasing in all age groups, and with it, the burden of diet-related noncommunicable diseases (NCDs), like diabetes, heart disease, stroke and cancer.

According to WHO Africa, malnutrition is still a major cause of death and disease, especially among vulnerable and socially disadvantaged people like women and children less than five years of age. Undernutrition contributes up to 45 percent of child mortality and, for children aged 5–19 years, obesity rates doubled between 2006 and 2016.

Given that Africa’s fragile and under-resourced health system already bears at least 25 percent of the world’s disease burden, unhealthy diets (particularly when associated with the lack of physical activity), holds devastating long-term consequences for public health in Africa.

African governments must therefore acknowledge and emphasise the critical role of food and nutrition in promoting public health and develop effective interventions to increase universal access to healthy, safe and sustainable diets across the continent.

What is a healthy diet? – components of a healthy diet

The exact composition of a diversified, balanced and healthy diet will vary depending on individual characteristics (such as age, gender, lifestyle and degree of physical activity), cultural context, locally available foods and dietary customs. However, the basic principles of what constitutes a healthy diet remain the same.

For adults, a healthy diet includes fruit, vegetables, legumes, nuts and whole grains (at least 400 g of fruit and vegetables per day, excluding potatoes, cassava and other starchy roots.) Energy intake (calories) should be in balance with energy expenditure. To avoid unhealthy weight gain, total fat should not exceed 30 percent of total energy intake, with a goal of eliminating industrially produced trans-fats.

Consuming a healthy diet throughout the life-course will effectively reduce preventable risks to health. Concerted actions that prioritize healthy foods and nutrition should therefore be taken at regional, national, and local levels to protect and improve public health in Africa

Limiting intake of free sugars to less than 10 percent of total energy intake is also part of a healthy diet. Salt intake should be less than 5g (equivalent to about one teaspoon) per day to help prevent hypertension, and reduce the risk of heart disease and stroke in the adult population.

Strategies to improve adoption of healthy dietary practices in Africa

Dietary patterns evolve over time and are shaped by many social and economic factors, including income, food prices, individual preferences, and geographical and environmental factors like climate change. Promoting a healthy food environment that improves healthy eating and nutrition therefore requires the involvement of multiple sectors and stakeholders, including government, international partners, the private sector and civil society.

However, African governments must take the lead role in creating a healthy food environment that enables people to adopt and maintain healthy dietary practices.

In view of these, Bloom Public Health proposes the following strategies to improve adoption of healthy dietary practices in Africa:

1. Creating national policies and investment plans that promote healthy diets and protect public health: These include trade, food and agricultural policies that increase incentives for producers and retailers to grow and sell fresh fruit and vegetables; reduce incentives for the food industry to continue production of processed foods; and explore regulatory measures through marketing regulations and nutrition labelling policies.

2. Promoting consumer awareness of and demand for healthy foods: This involves educating children, adolescents and adults about nutrition and healthy dietary practices; supporting point-of-sale information, including through comprehensive nutrition labelling; and providing nutrition and dietary counselling at primary health-care facilities.

3. Promoting appropriate infant and young child feeding practices by promoting, protecting and supporting breastfeeding in health services and the community, and implementing policies and practices for protecting working mothers.

Conclusion

Consuming a healthy diet throughout the life-course will effectively reduce preventable risks to health. Concerted actions that prioritize healthy foods and nutrition should therefore be taken at regional, national, and local levels to protect and improve public health in Africa.