CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 4, July/August 2022 200 AFRICA Review Article The Healthy Aging Adult South Africa report card: a systematic review of the evidence between 2013 and 2020 for middle-aged South African men and women Lisa K Micklesfield, Andrea Kolkenbeck-Ruh, Gudani Mukoma, Alessandra Prioreschi, Rihlat SaidMohamed, Lisa J Ware, Molebogeng Motlhatlhedi, Stephanie V Wrottesley, Shane A Norris Abstract Due to the increasing non-communicable disease burden in Africa, several strategies that target the major lifestyle and physiological risk factors have been implemented to combat such diseases. The Healthy Aging Adult South Africa report card systematically reviews national and regional prevalence data of middle-aged South African adults (45–65 years) published between 2013 and 2020 on diet, physical activity, tobacco use and alcohol consumption, obesity, hypertension, dyslipidaemia and diabetes mellitus. Each indicator was assigned two grades, (1) based on the availability of prevalence data, and (2) based on whether policies have been proposed and implemented for the respective indicators. Alcohol consumption, obesity, hypertension and diabetes received an A grade for the availability of prevalence data. Tobacco use and diet received an A grade for policy and implementation. Gaps have been identified that need to be filled by future research focusing on continued surveillance of all indicators in order to inform and implement effective policies. Keywords: diet, physical activity, tobacco, alcohol, obesity, hypertension, dyslipidaemia, diabetes Submitted 19/5/21, accepted 14/3/22 Published online 1/7/22 Cardiovasc J Afr 2022; 33: 200–219 www.cvja.co.za DOI: 10.5830/CVJA-2022-015 The burden of non-communicable diseases (NCDs) in sub-Saharan Africa is nearly equal to the total burden from communicable, maternal, neonatal and nutritional diseases combined.1 The growing NCD burden is expected to continue to increase with increasing urbanisation, life expectancy and population size, with models estimating that the sub-Saharan population will expand from 13% of the global population in 2017 to 35% in 2100.2 The Sustainable Development Goal (SDG) target of 3.4 is to reduce premature mortality from NCDs by a third by 2030 (relative to 2015), and to promote mental health and wellbeing.3 The implementation of the Strategic Plan for the Prevention and Control of NCDs 2013–2017, in order to achieve certain targets by 2020, and the adoption of the South African Declaration on the Prevention and Control of NCDs, demonstrate South Africa’s commitment to the fight against NCDs.4,5 While being in line with the World Health Organisation’s (WHO) global action plan for the prevention and control of NCDs 2013–2020, the South African strategic plan identifies various areas to be the focus of a multisectoral approach, with the ultimate aim of ensuring ‘a long and healthy life for all’. While recognising the social determinants of health, the strategic plan highlights four major lifestyle risk factors (unhealthy diets, physical inactivity, harmful use of alcohol and tobacco use), as well as four physiological risk factors (overweight and obesity, hypertension, dyslipidaemia and poor glucose control) that can be targeted through NCD prevention strategies to achieve the 10 goals and targets: • reduce relative premature mortality by 25% by 2020 • reduce tobacco use by 20% by 2020 • reduce the per capita consumption of alcohol by 20% by 2020 • reduce the mean population intake of salt by 5 g per day by 2020 • reduce the percentage of people who are obese or overweight by 10% by 2020 • reducing the prevalence of people with raised blood pressure by 20% by 2020 • increase the prevalence of people meeting physical activity recommendations by 10% • reduce the prevalence of cervical cancer • increase the percentage of people controlled for hypertension, diabetes and asthma by 30% by 2020 • increase the number of people screened and treated for mental disorders by 30% by 2030. SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Lisa K Micklesfield, PhD, Lisa.micklesfield@wits.ac.za Andrea Kolkenbeck-Ruh, PhD Gudani Mukoma, MSc Alessandra Prioreschi, PhD Rihlat Said-Mohamed, PhD Lisa J Ware, PhD Molebogeng Motlhatlhedi, BSc Stephanie V Wrottesley, PhD Shane A Norris, PhD
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