Stress and lifestyle diseases are killing South African women

South African women are killing themselves with their pace of life.

Obesity and chronic illness rates are at their highest ever, so this year Diabetes Awareness Week in South Africa is focused on women.

Doctors say it is the result of a lifestyle crisis that is costing women their health, and their lives.

Right now, in South Africa:

• More women (41%) are obese than men (15%). Obesity and lifestyle and weight-linked diseases are affecting more women, and at a younger age;

• Women work the most hours in the world (up to nine hours a day), for less money and still do most of the unpaid work in the home; and

• Women exercise less and allocate less time for recreation. One out of four males (27.9%) and one out of two females (45.2%) are unfit.

Johannesburg endocrinologist Dr Sundeep Ruder said his patient profile had changed - from older women to younger, particularly black, women.

"The complaint is the same - tired, stressed and putting on weight. People who are working without the equivalent reward feel stress. The stressed behaviour then makes them indulge in behaviours that create pleasure: cigarettes, fast food, alcohol, to satisfy the joy quantum," he said.

All of these worsen the diabetic outcomes, said Ruder. "When you are obese and overweight, the bad fat releases chemicals which increase inflammation. We know that affects cholesterol, blood pressure and normal body functioning."

Dr Hema Kalan, a specialist in the treatment of lifestyle diseases such as diabetes and high blood pressure, said these were linked to women's adrenal stress.

"What it means is that when women are stressed out it affects the insulin levels. Combined with a poor diet and exercise regime, [that] is a recipe for illness. You only have to speak to a woman to understand.Whether or not they work, [there is] automatically homework with children, taking care of the home, logistics - most of the responsibility goes to women. Chronic stress and eating badly expose a person to many combinations of illness."

Kalan said nutrition was neglected in South Africa. "It does start with cutting out the bad stuff, refined sugar, too much animal protein etc. But the first step for women is to stop putting yourself last on the list."

The recent Discovery Health ObeCity Index found that 45% of women are obese, and linked this to poor shopping and eating habits. It quotes a study that found:

• Women who were nutritionally deprived as children are significantly more likely to be obese as adults, whereas men who were deprived as children face no greater risk;

• Women of higher adult socioeconomic status are significantly more likely to be obese, which is not true for men; and

• These two factors can potentially explain the difference in obesity rates between men and women.

Ruder said South Africans should not discount environmental stress as a trigger.

"Doctors can suggest early screening, prevention and treatment. But the bigger structural issue is a clue as to why we are stressed. Patients...are stressed about the political situation, the parks are not safe to run in, and they cannot afford healthy food. We have to go back to the structure of our society."