Estimating the burden of disease attributable to excess body weight in South Africa in 2000

Burden of Disease Research Unit, South African Medical Research Council, Tygerberg, Cape Town.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde (Impact Factor: 1.63). 08/2007; 97(8 Pt 2):683-90.
Source: PubMed


To estimate the burden of disease attributable to excess body weight using the body mass index (BMI), by age and sex, in South Africa in 2000.
World Health Organization comparative risk assessment (CRA) methodology was followed. Re-analysis of the 1998 South Africa Demographic and Health Survey data provided mean BMI estimates by age and sex. Population-attributable fractions were calculated and applied to revised burden of disease estimates. Monte Carlo simulation-modeling techniques were used for the uncertainty analysis.
South Africa.
Adults >or= 30 years of age.
Deaths and disability-adjusted life years (DALYs) from ischaemic heart disease, ischaemic stroke, hypertensive disease, osteoarthritis, type 2 diabetes mellitus, and selected cancers.
Overall, 87% of type 2 diabetes, 68% of hypertensive disease, 61% of endometrial cancer, 45% of ischaemic stroke, 38% of ischaemic heart disease, 31% of kidney cancer, 24% of osteoarthritis, 17% of colon cancer, and 13% of postmenopausal breast cancer were attributable to a BMI >or= 21 kg/m2. Excess body weight is estimated to have caused 36,504 deaths (95% uncertainty interval 31,018 - 38,637) or 7% (95% uncertainty interval 6.0 - 7.4%) of all deaths in 2000, and 462,338 DALYs (95% uncertainty interval 396,512 - 478,847) or 2.9% of all DALYs (95% uncertainty interval 2.4 - 3.0%). The burden in females was approximately double that in males.
This study shows the importance of recognizing excess body weight as a major risk to health, particularly among females, highlighting the need to develop, implement and evaluate comprehensive interventions to achieve lasting change in the determinants and impact of excess body weight.

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    • "e rising prevalence of T2D is being fuelled, in part, by the high rates of obesity in these communities. For example, 87% of all T2D in South Africa is attributable to elevated body mass index (BMI) [3] and obesity rates are higher in African diaspora communities compared to residents of the respective high income countries, particularly amongst women [2]. Insulin resistance, a common accompaniment of obesity, is a signi�cant risk factor for T2D. "
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    • "21,22 Cardiac emboli in young adults due to rheumatic heart disease are more prevalent than coronary artery diseases in African patients.3 It was reported that 22% of strokes were attributed to physical inactivity.23 Forty-five percent of ischemic strokes were attributed to excess body weight.24 "
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    • "These adolescent behaviour patterns are therefore not transient in nature and are likely to have important impacts on long-term behaviour patterns and health outcomes. Overweight/obesity results in a considerable burden of death, premature death and disability in adult South African's [62], and is very much in line with the growing pandemic worldwide in developed as well as developing countries. This trend seems unlikely to be reversed as developing countries continue to struggle with the widespread availability of nutritionally poor, but cheap foods. "
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