The 2016 South African Demographic and Health Survey (SADHS) indicated that 68% of women and 31% of men in the country are classified as overweight or obese, while 20% of women and 3% of men are considered as severely obese. The results also indicated that 67% of the women have a greater waist-to-hip ratio than recommended, which indicated an increased risk for heart disease and type-2 diabetes.

On the other hand, 13.3% of South Africa’s children, younger than five years tend to be overweight or obese which exceeds the global average of 6.1%.

Four main factors are identified that may result in overweight and obesity. This includes a lack of knowledge, poor diet, physical inactivity and inappropriate early childhood feeding practises.

Unhealthy diets and lifestyles are mainly responsible for the development of chronic non-communicable diseases (NCD’s). These diets are characteristically low in grains, fruits, nuts and seeds or vegetables and high in sodium.

Another factor that also contributes to obesity and NCD’s is regular consumption of ultra-processed food. These foods are having a high fat, sugar and/or salt content. It is also palatable, has an extended shelf life and is convenient to use, because no cooking is required.

Leading international experts and health organizations recommended a whole food diet approach. This includes plant based food e.g. vegetables and fruit, legumes, nuts, seeds, whole grains and locally produced home-prepared meals. Consumption of meat, processed meat, and ultra-processed food must also be limited, while sugary drinks should be avoided.

Nowadays, consumption of processed food is on the increase. Unfortunately the type, intensity and food processing may have an impact on health. Food is classified in different categories which include Ultra-processed foods (UPF’s) that will be discussed below:

Ultra-processed foods (UPF’s) are not only used by the higher income countries. Even the lower income countries start to replace fresh food with UPF’s due to increasing incomes and urbanization.

UPF’s are defined as industrial formulations consisting of five and more ingredients. This include substances extracted from food; e.g. casein, lactose, whey as well as gluten. While other ingredients are derived from further processing of food constituents namely hydrogenated or inter-esterified oils, hydrolysed proteins, soy protein isolate, maltodextrin, invert sugar and high fructose corn syrup.

UPF’s are convenient, because it is ready to eat, to drink or to heat and very palatable. The following are examples thereof; energy bars and energy drinks, milk drinks, fruit yoghurts, instant sauces, health and slimming products, pies, and pasta and pizza dishes, meat and chicken extracts, nuggets, sausages, burgers, hot dogs instant soups, noodles and desserts.

Regular consumption of UPF’s and drinks are associated with an increased risk of obesity as well as diabetes. Diabetes is considered as the second leading cause of death among adults, while it is the leading cause of death among women in the country. If more than four servings of UPF’s are consumed daily one’s risk for all-cause mortality increase with 62%.

To optimize general health, consumption of whole food and minimal processed food are recommended, because the risk of being overweight and obese decreases dramatically.