How Lifestyle Medicine is Reshaping South Africa’s Health

In this guide, discover how lifestyle medicine is reshaping South Africa’s health.

South Africa is rich in culture and strength, but it’s facing a hidden public health crisis.

The traditional braai is a symbol of community and national identity.

Pap, a comforting maize porridge, also enriches our culinary landscape.

More non-communicable diseases (NCDs), such as heart disease, diabetes, and cancer, are now responsible for over half of all deaths in the country. 

This isn’t a simple health problem; it’s a national challenge rooted in history.

Apartheid’s legacy has led to serious health inequities.

Access to good care and healthy food often varies by race and income.

The traditional healthcare system often manages symptoms with medication. It struggles to tackle the root causes of lifestyle-related illnesses. 

But a robust and proactive movement is gaining momentum.

Lifestyle Medicine, backed by groups like the South African Lifestyle Medicine Association (SALMA), takes a whole-person approach.

It focuses on the behaviours causing this health crisis.

A key part of this movement, and a powerful tool for coaches, is a whole food plant-based (WFPB) diet.

A Whole Food Plant-Based expert or coach must understand South Africa’s culture, society, and economy.

It’s not just a bonus; it’s crucial. 

The Looming Health Crisis: A Burden of Disease

South Africa’s health landscape is complex.

Experts describe it as facing a “quadruple burden of disease.”

This includes HIV/AIDS, infectious diseases, injuries, and a rapid rise in non-communicable diseases (NCDs).

The statistics are stark.

NCDs account for 51% of all deaths and 24% of premature deaths.

The number of deaths from major NCDs has increased by a staggering 58.7% between 1997 and 2018.

This trend is especially worrying compared to the global drop in chronic disease deaths. 

This crisis is not evenly distributed.

Health outcomes in South Africa are very unequal. This is a direct result of a deeply segregated past.

Most people depend on a strained public healthcare system. It serves nearly 85% of the population but has only about half of the country’s hospital beds.

This leaves millions without quick access to resources, preventive care, and specialised services. These are essential to improve their health. 

A study in Cape Town shows the challenges faced by resource-poor communities. It finds that money issues and high food prices make it hard for them to eat a varied and healthy diet.

Low socioeconomic status often leads to unhealthy diets. This drives the rise of NCDs. As a result, individuals struggle to work and thrive.

For health professionals, this isn’t just about individual choice. It’s a complicated mix of systemic challenges that needs a broader solution. 

Foundations of Change: The Six Pillars of Lifestyle Medicine

The South African Lifestyle Medicine Association (SALMA) is central to the solution.

SALMA is a physician-led group.

Its goal is to make Lifestyle Medicine the top choice for treating chronic diseases.

The approach focuses not on quick fixes but on empowering people. It helps them reclaim their health through a solid, evidence-based framework. This framework is built on six linked pillars:

• Nutrition: Emphasising a “whole-food, plant-predominant eating pattern” as a primary therapeutic intervention. 
• Physical Activity: Encourage regular movement. Aim for 75–300 minutes of moderate to vigorous exercise each week. This pillar is seen as a “return to our roots.” It highlights the active lifestyles of traditional African communities. 
• Restorative Sleep: Understanding that good sleep is vital for both body and mind. 
• Stress Management: Use mindfulness and meditation to boost resilience. These practices help lower the physical damage caused by chronic stress. 
• Positive Social Relationships: Embracing the African tradition of community. By building connections, we combat the harmful health effects of isolation. 
• Avoiding Risky Substances: Focus on tobacco and alcohol. People often use them to cope when other areas are unsteady. 

These pillars are not abstract concepts but a holistic and integrated system.

A WFPB expert or coach understands that a client may struggle with a new diet due to several factors. These include poor sleep, ongoing stress, or a lack of social support.

This broad view sets Lifestyle Medicine apart and makes it very effective. 

The WFPB Prescription: A Return to Roots

In this context, a whole food plant-based diet is quite important.

SALMA strongly supports the WFPB diet.

It can “treat and, when used a lot, often reverse” chronic problems like obesity, type 2 diabetes, and heart disease.

The evidence is strong: a WFPB diet is full of nutrients and antioxidants. These help combat inflammation and oxidative stress associated with many diseases. 

This approach is distinct from general veganism or a vegetarian diet.

A bag of potato chips can be labelled “vegan,” but a WFPB diet is different.

It emphasises whole foods in their natural state. This means “nothing bad added and nothing good taken away.”

Focus meals on fruits, vegetables, whole grains, beans, legumes, nuts, and seeds. Limit or avoid refined and ultra-processed foods.

A study at Rhodes University found that students are unsure how to prepare these foods. This confusion is a significant barrier to their adoption.

The WFPB coach’s expertise is invaluable. They provide practical guidance that goes beyond just the “what.” They focus on the “how” of a plant-based kitchen. 

More healthcare providers, like doctors and dietitians, are embracing WFPB diets. This trend underscores the growing importance of diet in the clinical community.

This list comes from the Physicians Association for Nutrition (PAN) South Africa.

This professional ecosystem offers vital support. It shows that this is not a fringe movement. Instead, it’s a serious, science-based approach to health. 

Navigating the Context: From History to the Dinner Table

The WFPB movement in South Africa has great potential, but it faces tough cultural and socioeconomic challenges.

For decades, the country has shifted away from its traditional, plant-based diet.

Indigenous diets were historically rich in grains like sorghum and maize. They also included wild plants and leafy greens such as morogo. Meat was a rare luxury.

Economic growth, urbanisation, and Western diets have increased our intake of processed foods and animal products.

South Africans eat twice the recommended amount of meat. They also eat three times fewer vegetables than they should. 

Meat eating, especially traditions like the braai, is now central to our national identity.

Meat is seen as a status symbol. It demonstrates economic prosperity in a society marked by profound inequality.

This creates a significant challenge for WFPB advocates.

Some view plant-based diets as a choice for “White people and wealthy people.” They see it as a trend that doesn’t fit the lives of most people. 

This is where the role of the WFPB expert becomes nuanced and sensitive.

The advice to “eat more plants” often faces pushback. This resistance comes from years of racial and socioeconomic tension.

A study in Cape Town identified three main barriers to healthy eating:

• Financial issues
• Family preferences
• Lack of knowledge

A WFPB coach’s role must therefore extend beyond simple dietary advice to include:  

Cultural Bridge-Building

We can reframe the WFPB diet. We can view it as an opportunity to reconnect with our rich, affordable, and resilient heritage, rather than something foreign. 

Offering Affordable Solutions

Focus on affordable staples like legumes, whole grains, and local, seasonal vegetables. Also, provide tips on budgeting and cooking. 

Holistic Coaching

Recognising that a healthy diet is only one piece of the puzzle. A coach needs to consider the whole person. This includes their environment, stress levels, and social support. Doing so helps create lasting change. 

The Broader Ecosystem: Policy and Practice

The grassroots movement is strong, but it exists within a larger public policy context.

The South African government has recognised the severe NCD crisis.

In its National Strategic Plan, it links this rise to poor diets and lack of exercise. They’ve even implemented a sugary drinks tax to curb sugar consumption. 

However, there remains a disconnect between policy and practical implementation.

The government’s main programs, such as the Central Chronic Medicines Dispensing and Distribution (CCMDD) program, also known as “dablapmeds,” make it easier for patients to obtain their chronic medications.

This improves access to medicine. However, it promotes a reactive approach that emphasises medication over prevention.

This shows a focus on managing NCD effects. It doesn’t prioritise helping people prevent or reverse them with lifestyle changes. 

This reality underscores the vital role of the WFPB professional.

They provide evidence-based, whole-person care. This puts them in a growing movement that bridges the gap between clinical theory and real-world use.

They’re not just treating symptoms. They’re getting to the root of the problem, one person and one community at a time.

SALMA, PAN South Africa, and other groups aim to completely reshape healthcare.

They support adding Lifestyle Medicine to medical training. They also push for broader policy changes. 

A Blueprint for a Healthier South Africa

South African Lifestyle Medicine is clearly crucial for a whole food plant-based expert.

It offers clear, evidence-based solutions to the nation’s key health issues. Also, it provides a solid framework for delivering meaningful and transformative care.

To succeed in this field, a WFPB expert needs to be more than just a practitioner. They also must act as a cultural advocate and work well with others.

Reframing a plant-based diet as an actual “return to our roots” helps people tackle cultural resistance.

It also connects to the rich heritage of African food traditions.

They can make healthy eating easy for everyone. They should focus on affordable and practical local solutions. This way, they can overcome socioeconomic barriers.

They collaborate within a diverse network to enhance South Africa’s healthcare system. This effort aims to create a healthier and fairer future for everyone. 

The journey is long and complex, but the path is clear.

South Africa can utilise lifestyle medicine and a whole-food, plant-based approach.

This can help manage disease and lead to lasting improvements in health.