Professor Suna Kassier of the Discipline of Dietetics and Human Nutrition at UKZN has offered insight into the role obesity plays in the current COVID-19 pandemic, offering advice to everyone in lockdown about how to keep spirits up and weight down.

South Africa’s National Institute of Communicable Diseases confirmed the first positive case of COVID-19 in the country on 5 March, one day after World Obesity Day. Kassier remarked that the advent of the pandemic and obesity had more in common than was generally known.

‘Both obesity and COVID-19 are classified as diseases, in addition to being declared global pandemics, and obesity is starting to emerge as a significant risk factor for contracting the virus; this is even more applicable to those younger than 60,’ she said.

Kassier explained that obesity was associated with an increased risk of developing non-communicable diseases including Type 2 diabetes, coronary heart disease, high blood pressure, a stroke and asthma. Type 2 diabetes and high blood pressure weaken the immune system, and this viral infection could send blood pressure levels soaring, making it fatal in patients with existing hypertension.

Contracting a respiratory illness such as COVID-19 would also put the respiratory systems of obese patients under significant strain. Such individuals often had a low respiratory reserve, and were already more likely to suffer obstructive sleep apnea, asthma and lung disease.

Kassier noted that, after Egypt, South Africa was ranked as the second most obese country on the continent with an obesity rate of 28.3%, making it a significant public health concern.

‘Although obesity is often associated with a privileged, affluent lifestyle, it is increasingly linked to food insecurity and a diet containing a limited variety of foods, the latter of which is the stark reality for millions of South Africans,’ she said.

‘As the country becomes increasingly urbanised and people change to consuming highly processed foods with high levels of fat, salt and sugar but low in vitamins, minerals and fibre, obesity is on the rise.’

With the national lockdown curbing the opportunity for physical activity, which is beneficial in warding off depression and high stress levels and in keeping blood pressure and weight in check, Kassier suggested several activities.

‘Dance with your children and loved ones instead of heading for the snacks, recruit an in-house exercise buddy to do sit-ups with, or follow a workout routine on an app or YouTube,’ she said.

‘If you have a garden, weed the flower beds and mow the lawn, and lift homemade weights such as milk bottles or water bottles – one litre of liquid weighs one kilogram.

‘Do push-ups, using a chair for support if you cannot do them on the floor. Bench press your children, and when out shopping park your car at the furthest end of the lot and walk briskly,’ she suggested. ‘If you use public transport, use every opportunity you get to walk briskly.’

Kassier also pointed to potentially positive developments that signal hope for South Africans, such as an indication that the Bacillus Calmette Guerin vaccination against tuberculosis, given routinely to South African children at birth, could protect the immune system against COVID-19 by reducing the severity of lung infections.

Words: Christine Cuénod

Photograph: Supplied