Estimating the burden of disease attributable to excess body weight in South Africa in 2000.
OBJECTIVE
To estimate the burden of disease attributable to excess body weight using the body mass index (BMI), by age and sex, in South Africa in 2000.


METHODS
World Health Organization comparative risk assessment (CRA) methodology was followed. Re-analysis of the 1998 South Africa Demographic and Health Survey data provided mean BMI estimates by age and sex. Population-attributable fractions were calculated and applied to revised burden of disease estimates. Monte Carlo simulation-modeling techniques were used for the uncertainty analysis.


METHODS
South Africa.


METHODS
Adults >or= 30 years of age.


METHODS
Deaths and disability-adjusted life years (DALYs) from ischaemic heart disease, ischaemic stroke, hypertensive disease, osteoarthritis, type 2 diabetes mellitus, and selected cancers.


RESULTS
Overall, 87% of type 2 diabetes, 68% of hypertensive disease, 61% of endometrial cancer, 45% of ischaemic stroke, 38% of ischaemic heart disease, 31% of kidney cancer, 24% of osteoarthritis, 17% of colon cancer, and 13% of postmenopausal breast cancer were attributable to a BMI >or= 21 kg/m2. Excess body weight is estimated to have caused 36,504 deaths (95% uncertainty interval 31,018 - 38,637) or 7% (95% uncertainty interval 6.0 - 7.4%) of all deaths in 2000, and 462,338 DALYs (95% uncertainty interval 396,512 - 478,847) or 2.9% of all DALYs (95% uncertainty interval 2.4 - 3.0%). The burden in females was approximately double that in males.


CONCLUSIONS
This study shows the importance of recognizing excess body weight as a major risk to health, particularly among females, highlighting the need to develop, implement and evaluate comprehensive interventions to achieve lasting change in the determinants and impact of excess body weight.
Joubert
Jané
J
Burden of Disease Research Unit, South African Medical Research Council, Tygerberg, Cape Town. jane.joubert@mrc.ac.za
Norman
Rosana
R
Bradshaw
Debbie
D
Goedecke
Julia H
JH
Steyn
Nelia P
NP
Puoane
Thandi
T
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D017281:Cost of Illness; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D010003:Osteoarthritis / Q000453:epidemiology*; D050177:Overweight; D017678:Sex Distribution; D013019:South Africa / Q000453:epidemiology