Letter to the Editor [Volume 14 No. 4 (2014)]

LETTER TO THE EDITOR – Hon Prof Ruth Oniang’o,
African Journal of Food, Agriculture, Nutrition and Development
- 9 June 2014

Dear Ruth / Dear Editor,

Phoebe Barnard

Thank you for the wide-ranging material you publish in the African Journal of Food, Agriculture, Nutrition and Development. I think it cuts to the source of much of Africa’s strengths and weaknesses in economic development, health and wellbeing, and food security, and points to important directions for us in the future.

In particular, many thanks for focusing on gluten, and how widespread the intolerance of gluten is becoming in many societies.

In my adopted countries of Namibia and South Africa, the adoption of increasingly westernized diets and fast foods, and the government subsidies of cheap carbohydrates have led to near-epidemics of obesity, hypertension and other ‘western diseases’ (see Ng et al. 2014).  This is no longer a new observation in Africa. Yet for many cultural, historical and political reasons we continue to associate being fat with being healthy and wealthy, and being thin with hunger or HIV/AIDS.   The recent publication in The Lancet (Ng et al., 2014) of the Global Burden of Disease study highlighted how South African women had sub-Saharan Africa’s highest rate of obesity at 42%.   South Africa’s health minister Dr Aaron Motsoaledi has made it a policy priority to reduce this situation urgently through nutrition and exercise.

Much obesity in southern Africa, at least, may be directly linked to the juxtaposition of political, social and economic factors.  In South Africa and Namibia, wheat-flour bread and maizemeal have been subsidized since the days of apartheid.  Nearly 20% of children under the age of 9 in South Africa are stunted by malnutrition (Joubert &Miller, 2012).  Countries can lose 2-3% of their GDP due to malnutrition through the burden of health care and loss of productivity, even though malnourished people can be overweight and obese.  This is the tragedy of cheap, subsidized carbohydrates that fill people up but do not nourish them to be good parents, good workers, or contribute to national development (Joubert & Miller, 2012).

I have always had a pretty healthy diet, and have been mostly vegetarian for most of my adult life. But I only really started to become aware of the excessive use of carbohydrates in society, and how widespread gluten-intolerance and allergies are when my own daughter, 25, developed an autoimmune illness, M.E. (myalgic encephalomyelitis) and leaky gut syndrome.  She became very intolerant of gluten, maize, soya, dairy, eggs and a number of nuts and vegetables in the Solanaceae, the tomato family.   As a result of her experimentation with food, the rest of us realized that we had developed mild intolerances of dairy, gluten and maize.  In South Africa, there are widespread and usually non-disclosed “flour improvers” added to government-subsidized wheat breads. Many people including myself have suspected these, and/or toxins derived from wheat rusts, as being the inflammatory agent.  Gluten intolerance has become so prevalent in southern Africa that most city pizzerias and restaurants now offer some gluten-free options.

Gluten intolerance is getting very visibly widespread in middle and upper income families in southern Africa, like much of the rest of the world.  But it is not yet widely understood in rural and urban poor communities.  I think that’s only because we’re not yet looking.

I appreciated your editorial which advises people to reconnect with vegetables and to sorghum, millet and teff, which we still eat in our family. If only we could grow quinoa or amaranth, the Bolivian and Peruvian grains which are complete proteins, rich in nutrients and trace minerals and very delicious, similar to pearl millet in Africa.  I was pleased to see the paper by Tibagonzeka et al (2014) in AJFAND, for example on the use of amaranth in Uganda.  

Ultimately, we humans have lived for many tens of thousands of years as hunter-gatherers on a non-grain-based diet of wild-foraged vegetables, fruits, insects and occasional meats, and some of us have more recently adopted pastoralist diets of meat and blood, or settled diets of farmed tubers, fruits and smallstock eggs, dairy and meat.  Only very recently have we started to consume imported cheap grains such as maize and wheat.   It is important for us to take stock of impacts of these foods on our health and our development in Africa.   The lively controversy started by Professor Tim Noakes at the University of Cape Town, for example, on high-fat, low-carbohydrate diets rich in vegetables, is sure to contribute to this discussion.

1. Ng M, Fleming T, Robinson M et al. (2014).  Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.  The Lancet, 29 May 2014, http://dx.doi.org/10.1016/S0140-6736(14)60460-8.
2. Joubert L & Miller E (2012). The hungry season: feeding southern Africa’s cities. Pan McMillan, Johannesburg, 224 pp.   EAN 9781770102293.
3. Tibagonzeka J, Wambete J, Muyinda AM, Nakimbugwe D & Muyonga JH (2014). Acceptability and nutritional contribution of grain amaranth recipes in Uganda.  AJFAND 14(3):8979-8997.

Dr. Phoebe Barnard
Climate Change Adaptation Division * South African National Biodiversity Institute *
Kirstenbosch Research Centre * P/Bag X7, Claremont 7735, South Africa
and
DST/NRF Centre of Excellence at the Fitzpatrick Institute * University of Cape Town * Rhodes Gift 7701, South Africa
Email: P.Barnard@sanbi.org.za
www.sanbi.org.za *
www.fitzpatrick.uct.ac.za/docs/climate.html *
www.fitzpatrick.uct.ac.za/docs/phoebe.html *
http://acdi.uct.ac.za/research-projects