Fat around the midsection is the biggest risk factor for diabetes among black South African men. We investigate why the disease is on the increase
Actor and presenter Howza Mosese has been living with diabetes for many years, and feels that while black communities know of the disease, they aren’t necessarily aware of its impact and how serious it can be.
“I think the knowledge is there just by means of the name alone,” Mosese says. “We all grew up with our elders saying they have iswekile (‘sugar’) and that’s all it would be considered to be. I think this is why the rate of people living with diabetes has gone up – it’s purely based on that ignorance about the condition and what it entails.”
Mosese is speaking from experience. His father was a diabetic, and all that meant to a young Mosese was that his dad was someone who was on medication all the time.
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“When I started noticing my symptoms – which included drastic loss of weight, dehydration and vision impairment – I started associating it with an illness I know of – HIV/Aids,” Mosese explains. “This forced me to make a decision to be tested and see what was actually wrong with me. There are people who are living with diabetes but aren’t aware, and when those symptoms kick in, they often get scared, thinking it could be HIV/Aids. As a result they never find out what is actually wrong with them.”
Gabriel Eksteen, dietician and health promotion officer at the Heart and Stroke Foundation SA, says that more than 40% of people aren’t aware that they’re diabetic and that awareness in black communities is generally poor.
“Although people are familiar with the disease and even some of the symptoms, over 40% of people with diabetes don’t know they have the disease,” Eksteen says. “Many people with diabetes, and especially with prediabetes, do not experience serious symptoms and therefore don’t seek diagnosis and treatment.
“Although symptoms such as more frequent urination, thirst, fatigue and blurred vision are signs of diabetes, they often occur only once the condition is severe, and therefore aren’t reliable methods of diagnosis,” Eksteen explains. “If you’re overweight, have a family history of diabetes or are over 45 years old, you should have a blood glucose test as a screening test.”
Big bellies equals higher risk
Eksteen points out something very interesting that speaks directly to the black community and its ideas about weight.
“In some African cultures, weight gain is seen as a sign of affluence and weight loss as a sign of poverty or sickness… the single biggest risk factor for diabetes in African males is fatness around the midsection,” he says. “Anecdotally, this is a phenomenon that we see more and more of, particularly among affluent members of society. The health effects of abdominal obesity and diabetes can take decades to present, and the short-term gratification of wealth, status and unhealthy foods outweigh the long-term risks for many.”
Weight gain around the midsection is referred to as abdominal obesity in medical terms. It’s associated with internal (visceral) fat around the organs – this increases the risk not only of diabetes but also of high blood pressure and heart disease.
“Men are more prone than women to collect this type of fat, especially before the age of 55,” he says.
Eksteen says that unless people are educated about eating healthier food, diabetes will become a bigger problem.
The “white disease”
According to Eksteen, diabetes is more prevalent in Indian and coloured communities, despite the long-held belief that conditions like heart disease, cancer and diabetes were “white diseases”.
That mentality is slowly changing. “There is a growing section of society that is taking an interest in their health and is starting to eat healthier and exercise regularly,” he says.
City life
Over the past decade, an increasing number of black people in South Africa have moved to the city. This has resulted in a drastic change in dietary patterns, with people eating foods laden with sugar, salt and extra fat; more refined and processed foods; more junk food; and fewer fruit, vegetables and beans. This has also contributed to the increase in diabetes cases in the black community.
“Moving to the city also means less activity due to commuting in vehicles. There are also fewer open spaces, and more sedentary work,” Eksteen explains.
What to do
“A diagnosis with diabetes is a big wake-up call to start making radical changes to your lifestyle,” Eksteen says. “Diabetes is a very serious disease, and unless you take it seriously, it will have a devastating impact on you and your family. If you react positively and control diabetes, you can live a long and healthy life. If you have only recently been diagnosed, you may not be able to rid yourself of the disease, but you can stop it in its tracks.”
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