The SANHANES-1: Non-communicable diseases in South Africa
Suggested citation: Shisana O, Labadarios D, Rehle T, Simbayi L, Zuma K, Dhansay A, Reddy P, Parker W, Hoosain E, Naidoo P, Hongoro C, Mchiza Z, Steyn NP, Dwane N, Makoae M, Maluleke T, Ramlagan S, Zungu N, Evans MG, Jacobs L, Faber M, & the SANHANES-1 Team (2014) South African National Health and Nutrition Examination Survey (SANHANES-1): 2014 Edition. Cape Town: HSRC Press.
Prevalence of risk markers for non-communicable diseases
In the SANHANES-1 of 2012 25 532 individuals of all ages were interviewed, 12 025 had a physical examination by a medical doctor and 8078 provided a blood sample for laboratory analysis. High blood pressure was found among an important proportion of the study participants, with 30.9% reporting a family history of hypertension and 16.5% reported that they had high blood pressure. The physical examination revealed that 10.4% of the participants aged 15 years and older had a blood pressure in the range between 120-139/80-89 mmHg and a further 10.2% were hypertensive. Almost one-quarter of persons aged 15 years and older had high serum total and LDL-cholesterol, while almost half had an abnormally low HDL-cholesterol. Almost 20% had impaired fasting glucose and 9.5% were diabetic.
Lifestyle related risk factors
The prevalence of general obesity, based on body mass index was significantly higher in women than in men, with 24.8% of women being overweight and 39.2% obese. In line with these results, 68.2% of the women had a waist circumference that placed them at risk for metabolic disorders, such as hypertension and type 2 diabetes. If the results are compared with the 2003 SA Demographic and Health Survey, obesity among women increased from 27% to 39.2% over 9 years. About two-thirds of women were satisfied with their current weight, although 76.4% of South Africans perceived that they had a ‘fat’ body image. Furthermore 88% indicated that their ideal body image was ‘fat’ and only 14.6% of women reported that they attempted to lose weight.
A step-fitness test revealed that more than one-quarter of men and almost half of all women were physically unfit. Almost 20% of the study participants consumed a diet with a high fat score or a high sugar score, whereas more than a quarter had low fruit and vegetable intakes.
The SANHANES-1 team encouraged the Department of Health to address risk factors for non-communicable diseases at the home, workplace and community level. The Food Based Dietary Guidelines and guidelines relating to physical activity should be used in an educational campaign. Health care facilities and community health workers should be enabled to offer services to prevent and control non-communicable diseases. They recommended that a task force should be formed to address the clinical management of hypertension, hyperlipidaemia and glucose homeostasis.