1 00:00:00,040 --> 00:00:03,240 Speaker 1: We're actually one day premature with our first interview today 2 00:00:03,279 --> 00:00:06,680 Speaker 1: because tomorrow is actually World Obesity Day, but. 3 00:00:06,760 --> 00:00:07,840 Speaker 2: I'm taking the gap. 4 00:00:07,880 --> 00:00:10,399 Speaker 1: We have to reflect on what is being hailed as 5 00:00:10,440 --> 00:00:13,480 Speaker 1: a very positive step forward in managing one of this 6 00:00:13,560 --> 00:00:17,680 Speaker 1: country's biggest healthcare challenges. The ESSA Medical Journal has recently 7 00:00:17,720 --> 00:00:22,040 Speaker 1: published our first ever national clinical practice guidelines for the 8 00:00:22,079 --> 00:00:25,400 Speaker 1: management of obesity and adults and this move has been 9 00:00:25,480 --> 00:00:28,600 Speaker 1: welcomed by a number of medical professionals, including those working 10 00:00:28,680 --> 00:00:31,639 Speaker 1: in the diabetes space. And my guest today who is 11 00:00:31,640 --> 00:00:35,840 Speaker 1: a representative of the Physicians Association for Nutritions South Africa 12 00:00:36,000 --> 00:00:38,720 Speaker 1: otherwise known as PAN and this for those who don't 13 00:00:38,760 --> 00:00:41,280 Speaker 1: know the organization. They're a local branch of a global 14 00:00:41,320 --> 00:00:45,720 Speaker 1: nonprofit organization which aims to promote evidence based best practice 15 00:00:45,760 --> 00:00:49,400 Speaker 1: around diet and nutrition as part of an overall health 16 00:00:49,440 --> 00:00:51,760 Speaker 1: management strategy. And with me on the line, it's a 17 00:00:51,760 --> 00:00:54,360 Speaker 1: great pleasure to welcome their medical director for the South 18 00:00:54,360 --> 00:00:57,760 Speaker 1: African chapter, Professor Andrew Robinson, who is a seasoned public 19 00:00:57,760 --> 00:01:01,200 Speaker 1: health specialist professor at Northwestern Diversity. Andrew, thank you so 20 00:01:01,280 --> 00:01:03,120 Speaker 1: much for your time this afternoon, and welcome to the. 21 00:01:03,120 --> 00:01:08,600 Speaker 3: Showffen and Papa and grotling to your listeners. Thank you 22 00:01:08,640 --> 00:01:09,280 Speaker 3: for inviting me. 23 00:01:09,360 --> 00:01:10,759 Speaker 2: It's a huge pleasure to have you with us. 24 00:01:10,840 --> 00:01:13,880 Speaker 3: It's also good to be a day ahead of the fact. 25 00:01:14,240 --> 00:01:16,280 Speaker 1: I suppose we can look at it that way. Yeah, well, 26 00:01:16,319 --> 00:01:18,680 Speaker 1: thank you. I'm so glad we could squeeze you in today. Look, 27 00:01:18,720 --> 00:01:21,639 Speaker 1: we I think everybody knows that obesity is a major 28 00:01:21,680 --> 00:01:24,319 Speaker 1: problem in South Africa, that we have large numbers and 29 00:01:24,360 --> 00:01:27,600 Speaker 1: percentages of the population who would fall into a clinical 30 00:01:27,600 --> 00:01:29,920 Speaker 1: definition of obesity, and that that has a lot of 31 00:01:30,080 --> 00:01:33,520 Speaker 1: knock on impact in terms of the healthcare burden that 32 00:01:33,600 --> 00:01:36,880 Speaker 1: the public system in particular has to shoulder. In fact, 33 00:01:36,959 --> 00:01:39,200 Speaker 1: I was quite surprised that we're only seeing this kind 34 00:01:39,200 --> 00:01:42,280 Speaker 1: of guideline published now in twenty twenty six, because it 35 00:01:42,319 --> 00:01:46,160 Speaker 1: really is a significant contributing burden to our healthcare system, 36 00:01:46,200 --> 00:01:46,959 Speaker 1: isn't it. 37 00:01:47,840 --> 00:01:53,360 Speaker 3: Yes, definitely, And that's a really important watershed I think 38 00:01:53,720 --> 00:01:59,000 Speaker 3: for two reasons. The one that it wasn't stated clearly 39 00:01:59,040 --> 00:02:03,600 Speaker 3: in the guidelines. In my opinion, people soft talk and 40 00:02:03,680 --> 00:02:07,560 Speaker 3: talk around it in many ways. If you look at 41 00:02:07,560 --> 00:02:13,679 Speaker 3: the clinical evidence, we have a global obesity pandemic that 42 00:02:14,600 --> 00:02:22,480 Speaker 3: needs to be taken into account. Usually with diseases that 43 00:02:22,639 --> 00:02:27,919 Speaker 3: have high prevalence, and we know in South Africa we 44 00:02:28,040 --> 00:02:32,200 Speaker 3: have a really high prevalence of obesity and there's a 45 00:02:32,240 --> 00:02:37,200 Speaker 3: lot of evidence for that. But more importantly, these guidelines 46 00:02:37,440 --> 00:02:42,720 Speaker 3: recognize obesity as a chronic disease and that changes the 47 00:02:43,080 --> 00:02:48,920 Speaker 3: ball game in how it is managed, because if it 48 00:02:49,040 --> 00:02:52,919 Speaker 3: is defined as a disease, then in my statement, being 49 00:02:52,919 --> 00:02:55,480 Speaker 3: a pandemic is relevant. Because what. 50 00:02:58,160 --> 00:03:01,280 Speaker 2: Hello, professor, we seem to just lost the line there. Apologies. 51 00:03:01,320 --> 00:03:02,840 Speaker 1: I'm going to ask my producer to just try and 52 00:03:02,840 --> 00:03:06,600 Speaker 1: get him back dialing back and so we can restart 53 00:03:06,639 --> 00:03:10,400 Speaker 1: that conversation, hoping we can reconnect with Professor Andrew Robinson 54 00:03:10,919 --> 00:03:14,880 Speaker 1: speaking on behalf of Physicians Association for Nutritions South Africa. 55 00:03:15,000 --> 00:03:16,200 Speaker 2: While we re establish that. 56 00:03:16,200 --> 00:03:18,200 Speaker 1: Line, let me just fill in a couple of the 57 00:03:18,240 --> 00:03:21,079 Speaker 1: gaps here in terms of what the National New Clinical 58 00:03:21,120 --> 00:03:24,959 Speaker 1: Practice Guidelines actually refer to. The key thing, as you've 59 00:03:25,040 --> 00:03:27,960 Speaker 1: just heard the PROFT mentioning is the recognition of obesity 60 00:03:28,440 --> 00:03:32,240 Speaker 1: as a chronic disease, not just an issue of people 61 00:03:32,600 --> 00:03:35,800 Speaker 1: eating too much or being too lazy to exercise, or 62 00:03:37,120 --> 00:03:41,200 Speaker 1: that it recognizes it as a multifaceted condition requiring multi 63 00:03:41,320 --> 00:03:43,880 Speaker 1: level engagement to deal with it and to deal with 64 00:03:43,920 --> 00:03:47,240 Speaker 1: the subsequent knock on impact on people's health. So that 65 00:03:47,360 --> 00:03:49,560 Speaker 1: is a big step forward. We've got Professor Robinson back, 66 00:03:49,600 --> 00:03:51,680 Speaker 1: Sorry about that. Hopefully the phone line holds up for 67 00:03:51,760 --> 00:03:54,560 Speaker 1: us better. You were just saying that the recognition of 68 00:03:54,720 --> 00:03:58,760 Speaker 1: this of obesity as a chronic disease is so significant, 69 00:03:58,760 --> 00:03:59,840 Speaker 1: won't you just start there? 70 00:04:00,040 --> 00:04:06,440 Speaker 3: It definitely because if one has a health condition and 71 00:04:06,480 --> 00:04:09,200 Speaker 3: before it is obesity and it's a sort of all 72 00:04:09,240 --> 00:04:15,560 Speaker 3: these terms of poor self control, etcetera, all those slurs 73 00:04:15,600 --> 00:04:22,120 Speaker 3: and stigmas. Now it's recognized as an illness, and you 74 00:04:22,160 --> 00:04:27,480 Speaker 3: can't treat conditions effectively until the vague issues of it 75 00:04:27,560 --> 00:04:30,680 Speaker 3: are crystallized to a diagnosis. Once you know, okay, I've 76 00:04:30,720 --> 00:04:35,760 Speaker 3: got this, this is the management for it. And this 77 00:04:35,920 --> 00:04:40,760 Speaker 3: clarity is important and it always is whichever disease you've got, 78 00:04:40,800 --> 00:04:43,839 Speaker 3: whatever condition you've got, you're feeling unwell, you've got a 79 00:04:43,880 --> 00:04:46,240 Speaker 3: timmy ache, and you go in and you find either 80 00:04:46,279 --> 00:04:49,839 Speaker 3: got an house or if you've got an attum or whatever. 81 00:04:50,520 --> 00:04:53,120 Speaker 3: Once you have the diagnosis, then you can focus on 82 00:04:54,200 --> 00:04:58,200 Speaker 3: managing it far more effectively. And if we recognize such 83 00:04:58,200 --> 00:05:05,400 Speaker 3: a huge amount of peace or suffering from a causative 84 00:05:05,640 --> 00:05:11,800 Speaker 3: factor nutrition, And obviously, as you said, it is multi factorial, 85 00:05:13,520 --> 00:05:19,760 Speaker 3: then it should be acted upon because obesity is an 86 00:05:19,839 --> 00:05:28,400 Speaker 3: indication of inflammation. It's your body reacting to the obesogenic 87 00:05:28,560 --> 00:05:37,480 Speaker 3: food environment that causes obesity to occur. And it is 88 00:05:37,520 --> 00:05:42,680 Speaker 3: often the sort of first signal of other noncommunicable chronic 89 00:05:42,720 --> 00:05:48,120 Speaker 3: diseases such as diabeta, hypertension, cancers, autoimmune conditions, etc. And 90 00:05:48,560 --> 00:05:51,040 Speaker 3: the reason I sid fifty percent because people trying and 91 00:05:51,080 --> 00:05:58,200 Speaker 3: differentiate obesity and overweight obesity and all those categories. But 92 00:05:58,440 --> 00:06:02,359 Speaker 3: if one is of a weight, then that is for 93 00:06:02,480 --> 00:06:05,640 Speaker 3: me the first sign that you help. Your body is 94 00:06:05,680 --> 00:06:09,240 Speaker 3: inflamed for whatever reason, and you need to pay attention 95 00:06:09,760 --> 00:06:16,320 Speaker 3: and you need to prevent that inflammation. Because obesity is 96 00:06:16,320 --> 00:06:21,600 Speaker 3: associated with an increased or cause mortality. You don't see 97 00:06:22,000 --> 00:06:25,640 Speaker 3: aged obese people. All old people as giving the little 98 00:06:25,680 --> 00:06:29,720 Speaker 3: things that live till one hundred, you won't see an 99 00:06:29,760 --> 00:06:32,520 Speaker 3: obese person living that age. And that's a fairly crude 100 00:06:32,920 --> 00:06:38,320 Speaker 3: visual kind of picture of obesity is shortens one's life 101 00:06:38,480 --> 00:06:43,200 Speaker 3: and it increases the mobility tremendously with all the accumulated 102 00:06:44,200 --> 00:06:47,480 Speaker 3: or associated diseases. 103 00:06:47,880 --> 00:06:51,760 Speaker 1: Now, as you've said several times, now, these guidelines take 104 00:06:52,000 --> 00:06:54,440 Speaker 1: a multi factoral approach that they do speak to the 105 00:06:54,520 --> 00:06:58,320 Speaker 1: role of exercise, They speak to the role of pharmacological 106 00:06:58,400 --> 00:07:03,120 Speaker 1: intervention to several different aspects. But obviously you're looking at 107 00:07:03,120 --> 00:07:06,919 Speaker 1: it specifically with an interest on the nutritional content. The 108 00:07:06,960 --> 00:07:10,320 Speaker 1: other thing to say that these guidelines recognize that there's 109 00:07:10,320 --> 00:07:13,320 Speaker 1: not a one size fits all solution here, and that 110 00:07:14,520 --> 00:07:18,000 Speaker 1: even an approach that is coming primarily from a nutrition perspective, 111 00:07:18,040 --> 00:07:20,800 Speaker 1: even that has to be more nuanced and saying here 112 00:07:20,880 --> 00:07:22,720 Speaker 1: is the diet pyramid you need to work for and 113 00:07:22,840 --> 00:07:25,200 Speaker 1: work from and just go and use that. Do you 114 00:07:25,240 --> 00:07:26,840 Speaker 1: want to talk to us a little bit more about 115 00:07:27,480 --> 00:07:30,120 Speaker 1: the nutritional aspect of what these guidelines say about how 116 00:07:30,160 --> 00:07:32,400 Speaker 1: we use nutrition as a tool in the arsenal to 117 00:07:32,440 --> 00:07:33,720 Speaker 1: help treat obesity. 118 00:07:35,560 --> 00:07:39,560 Speaker 3: Yes, based on this there food based dietary guidelines that 119 00:07:39,720 --> 00:07:44,080 Speaker 3: we've got in our country, across the world, and these 120 00:07:45,080 --> 00:07:50,240 Speaker 3: guidelines important components of it, and I'm speaking to is 121 00:07:50,880 --> 00:07:58,520 Speaker 3: the nutrition, the medical nutrition therapy. And as you said, 122 00:07:58,840 --> 00:08:02,040 Speaker 3: everyone's got a owned particular diet and a three hundred 123 00:08:02,040 --> 00:08:07,040 Speaker 3: percent no two people will enjoy the same flatter foods 124 00:08:07,280 --> 00:08:10,280 Speaker 3: day and day out. There's always a variation. Someone more 125 00:08:10,280 --> 00:08:16,840 Speaker 3: of this, less of that, and talenty. Medicine is the 126 00:08:16,880 --> 00:08:22,680 Speaker 3: medical term used to enable people through the medical nutrition 127 00:08:22,840 --> 00:08:27,480 Speaker 3: therapy to personalized So you come in obese, this is 128 00:08:27,480 --> 00:08:29,880 Speaker 3: how you eat, this is where you live, and they 129 00:08:29,920 --> 00:08:33,719 Speaker 3: locate it. And trouble is our medical profession haven't been 130 00:08:33,760 --> 00:08:38,960 Speaker 3: trained in nutrition as sufficiently to enable people to do it. 131 00:08:39,000 --> 00:08:42,400 Speaker 3: And that is the thread through the clinical guidelines. I 132 00:08:42,400 --> 00:08:45,200 Speaker 3: can see there are a lot of words spoken, but 133 00:08:45,280 --> 00:08:49,920 Speaker 3: I didn't see any examples of this is what we 134 00:08:50,600 --> 00:08:53,600 Speaker 3: do and these are ours. These are our type two 135 00:08:53,600 --> 00:08:57,840 Speaker 3: diabetics that have reversed their disease. These are people in 136 00:08:57,880 --> 00:09:01,240 Speaker 3: our normal weight. And there are many examples of such 137 00:09:01,520 --> 00:09:06,560 Speaker 3: clinical practice where it reminds me a bit of the 138 00:09:06,559 --> 00:09:11,800 Speaker 3: old days of smoking, because people were so confused as 139 00:09:11,840 --> 00:09:15,520 Speaker 3: to which diet is a diet. Everyone's got their own 140 00:09:15,520 --> 00:09:20,520 Speaker 3: specific thing, and the confusion kind of feeds the continuity 141 00:09:20,640 --> 00:09:25,360 Speaker 3: of the obysogenic environment, for example, highly processed foods, the 142 00:09:25,440 --> 00:09:29,640 Speaker 3: advertising to choln that are keeping the market going. So 143 00:09:32,240 --> 00:09:36,160 Speaker 3: two know what the person in front of you's environment 144 00:09:36,320 --> 00:09:40,160 Speaker 3: is and show them how to cook a low fat 145 00:09:40,400 --> 00:09:43,959 Speaker 3: meal that is tasty because people always make drugs about 146 00:09:43,960 --> 00:09:48,599 Speaker 3: the plant's predominant diet, which the Planetary Health Diet of 147 00:09:48,679 --> 00:10:00,480 Speaker 3: the Lindset Commission emphasizes whole food as opposed to with 148 00:10:00,520 --> 00:10:03,679 Speaker 3: a moderate dairy intake and limited to neat. So it's 149 00:10:03,960 --> 00:10:07,360 Speaker 3: a big emphasis on whole plant foods that must be 150 00:10:07,520 --> 00:10:12,120 Speaker 3: the centerpiece of one's diets, and not only because of 151 00:10:13,040 --> 00:10:16,120 Speaker 3: to enable an individual to know where if you're in 152 00:10:16,120 --> 00:10:19,200 Speaker 3: an informal settlement, where do you find your food that 153 00:10:19,320 --> 00:10:23,400 Speaker 3: is healthy, if you are in a santon, what you've 154 00:10:23,400 --> 00:10:27,520 Speaker 3: looked out for and what you avoid. Because people always 155 00:10:27,559 --> 00:10:33,000 Speaker 3: talk about the cost of plant based or plant forwards diets, 156 00:10:33,200 --> 00:10:39,439 Speaker 3: but studies across the world are shown they are usually expensive. 157 00:10:40,480 --> 00:10:44,800 Speaker 3: Maids when in dairy, are soppt for fruit and vegetables, 158 00:10:45,280 --> 00:10:52,640 Speaker 3: and except in higher socioeconomic groups where chasing fancy non 159 00:10:52,840 --> 00:10:58,720 Speaker 3: animal products which must be more expensive. But for basic 160 00:10:59,720 --> 00:11:02,280 Speaker 3: to dotional African diet which has been on the continent 161 00:11:02,360 --> 00:11:09,119 Speaker 3: forever and has been kind of sidelined, it as an inferior, 162 00:11:10,720 --> 00:11:13,800 Speaker 3: inferior table. If you're eating this, if you haven't made it, 163 00:11:14,320 --> 00:11:19,920 Speaker 3: and that's often what drives the the food industry providing 164 00:11:19,960 --> 00:11:22,120 Speaker 3: all the high sugar effect. 165 00:11:22,880 --> 00:11:25,240 Speaker 1: So actually moving us away from what was good for 166 00:11:25,360 --> 00:11:28,760 Speaker 1: us originally and was always the way we ate into 167 00:11:28,880 --> 00:11:32,800 Speaker 1: unhealthier patterns which then result in all the health complications. So, 168 00:11:32,880 --> 00:11:36,360 Speaker 1: just to emphasize again what you've said, the guidelines are 169 00:11:36,360 --> 00:11:40,720 Speaker 1: not suggesting everybody has to go vegetarian andrew, but plant dominant. 170 00:11:40,800 --> 00:11:44,839 Speaker 1: Increase the amount of vegetables and the like on the plate. 171 00:11:45,280 --> 00:11:48,800 Speaker 1: Moderate intake of dairy, limited consumption of meat. Again, it's 172 00:11:48,840 --> 00:11:51,400 Speaker 1: not saying none at all, but it's saying be mindl 173 00:11:51,440 --> 00:11:52,199 Speaker 1: of the portion. 174 00:11:52,120 --> 00:11:54,120 Speaker 2: Sizes, the quantities, et cetera. In balance. 175 00:11:54,880 --> 00:11:56,960 Speaker 1: That's a big ask though in a country which loves 176 00:11:57,000 --> 00:12:00,480 Speaker 1: its meat potatoes as much as South Africa does, I mean, 177 00:12:00,520 --> 00:12:03,319 Speaker 1: do you believe it is practical to implement those guidelines 178 00:12:03,360 --> 00:12:06,120 Speaker 1: within our context when. 179 00:12:05,679 --> 00:12:10,480 Speaker 3: People understand and value their health. It's now normalized to 180 00:12:10,600 --> 00:12:15,160 Speaker 3: die young suddenly with the heart attack, to die young 181 00:12:15,240 --> 00:12:21,480 Speaker 3: with cancers, to die or complications that are beat A three, 182 00:12:21,800 --> 00:12:27,720 Speaker 3: all those things. It's normalized. One doesn't die healthy and 183 00:12:27,760 --> 00:12:30,760 Speaker 3: that used to be the case when died of old age, 184 00:12:30,760 --> 00:12:37,040 Speaker 3: and that in South Africa, for example, there's huge marketing 185 00:12:37,080 --> 00:12:41,480 Speaker 3: of meat and dairy our meat consumption per capita has 186 00:12:41,480 --> 00:12:44,040 Speaker 3: gone up four or five times per person in the 187 00:12:44,120 --> 00:12:48,640 Speaker 3: last twenty or thirty years. And now we sit with 188 00:12:49,120 --> 00:12:53,319 Speaker 3: a foot and mass outbreak and we'rezed because we've got 189 00:12:53,320 --> 00:13:00,360 Speaker 3: such a stressed beef industry with these feed lots that 190 00:13:00,600 --> 00:13:03,600 Speaker 3: have and these dairies, I mean these dairy cars, their 191 00:13:03,600 --> 00:13:08,760 Speaker 3: eyes are bulging out. Was the huge odders dragging them 192 00:13:08,760 --> 00:13:11,680 Speaker 3: for milking three times a day on all sorts of 193 00:13:11,679 --> 00:13:16,200 Speaker 3: hormones and stuff. And it's marketed. A lot of money 194 00:13:16,200 --> 00:13:22,760 Speaker 3: are spent on it. And I come from a dairy farm. 195 00:13:23,160 --> 00:13:28,600 Speaker 3: I know exactly what the dairy industry entails. And as 196 00:13:28,600 --> 00:13:33,640 Speaker 3: we say, moderate milk intake, but not in the old 197 00:13:33,760 --> 00:13:36,560 Speaker 3: days you'd have adverts of people drinking milk and have 198 00:13:36,640 --> 00:13:40,640 Speaker 3: the milky mustache. No, you don't see much of that. 199 00:13:40,960 --> 00:13:43,800 Speaker 3: But milk is put into all sorts of other avenues, 200 00:13:44,760 --> 00:13:47,920 Speaker 3: into the fat food fast food industry. You don't get 201 00:13:47,920 --> 00:13:50,640 Speaker 3: a burger without a cheese, or a steak and cheese, 202 00:13:50,679 --> 00:13:56,560 Speaker 3: and you know there's because they shifted their marketing towards 203 00:13:56,600 --> 00:14:01,120 Speaker 3: the cheese industry, which in its off isn't bad except 204 00:14:01,800 --> 00:14:06,079 Speaker 3: it's saturated fat and salt. If you analyze it and 205 00:14:07,800 --> 00:14:13,560 Speaker 3: what the Way industry is another industry interesting thought because 206 00:14:13,800 --> 00:14:18,040 Speaker 3: it used to be discarded when we're making cheese. Now 207 00:14:18,480 --> 00:14:20,800 Speaker 3: it's been put in part of form and put in 208 00:14:21,000 --> 00:14:25,520 Speaker 3: massive tubs for bodybuilders too. You couldn't have a bodybuilder 209 00:14:25,560 --> 00:14:27,040 Speaker 3: having way in a little bottle has got to be 210 00:14:27,040 --> 00:14:31,560 Speaker 3: a mega bottle for emphasis. And it's a billion dollar 211 00:14:31,600 --> 00:14:36,800 Speaker 3: industry marketed heavily marketed as the dairy industry. I think 212 00:14:36,840 --> 00:14:40,320 Speaker 3: in twenty eighteen spent nearly seventeen million just in South 213 00:14:40,320 --> 00:14:46,960 Speaker 3: Africa marketing dairy goods and making sure dairy products come 214 00:14:47,000 --> 00:14:50,200 Speaker 3: into I mean there's dairy and orange juice, all sorts of. 215 00:14:52,640 --> 00:14:54,920 Speaker 2: Okay, Andrew, thank you very much. 216 00:14:55,080 --> 00:14:57,000 Speaker 1: I mean you you've raised some really important points here 217 00:14:57,080 --> 00:15:03,400 Speaker 1: around our mindfulness of what we are eating in what proportions, 218 00:15:03,440 --> 00:15:04,760 Speaker 1: in to what degree. 219 00:15:04,440 --> 00:15:06,920 Speaker 2: Of processed food versus food. 220 00:15:06,680 --> 00:15:09,080 Speaker 1: That looks the way it did when it was picked 221 00:15:09,080 --> 00:15:11,720 Speaker 1: off the plant originally, et cetera, before we run out 222 00:15:11,720 --> 00:15:13,960 Speaker 1: of time. So these guidelines, and by the way, if 223 00:15:14,000 --> 00:15:16,040 Speaker 1: anybody wants to read them, they are readily available to 224 00:15:16,080 --> 00:15:20,320 Speaker 1: read if you google for the Clinical Guidelines for Management 225 00:15:20,360 --> 00:15:23,320 Speaker 1: of Obesity or go to diabetes essays website which has 226 00:15:23,360 --> 00:15:26,440 Speaker 1: got a very good summary of what they contain. Just 227 00:15:26,480 --> 00:15:29,160 Speaker 1: want to quickly put a question to you from our listener, Terry. 228 00:15:29,200 --> 00:15:32,400 Speaker 1: And I know you're speaking with the nutrition hat as 229 00:15:32,440 --> 00:15:35,960 Speaker 1: your primary concern here, but Terry asking whether the guidelines 230 00:15:36,000 --> 00:15:39,480 Speaker 1: support the use of drugs like ozembic and Manjaro, et cetera. 231 00:15:40,040 --> 00:15:42,520 Speaker 1: The short answer, Terry is yes, it speaks to their 232 00:15:42,560 --> 00:15:46,280 Speaker 1: potential effectiveness. But Andrew to emphasize again, it speaks to 233 00:15:46,320 --> 00:15:51,480 Speaker 1: their potential effectiveness combined with the dietary change, the lifestyle change, 234 00:15:51,560 --> 00:15:53,680 Speaker 1: the other interventions that also have to happen. 235 00:15:54,880 --> 00:15:58,720 Speaker 3: Sure, Oh sorry, it's a ready whole thing. Is a 236 00:15:58,720 --> 00:16:02,320 Speaker 3: really complex subject, downloaded quite a bit in the short 237 00:16:02,400 --> 00:16:09,280 Speaker 3: space of time. But unfortunately these pharmaceutical products are not 238 00:16:09,400 --> 00:16:15,000 Speaker 3: being used like that. Then they've got into the informal market. 239 00:16:15,720 --> 00:16:23,240 Speaker 3: They've been used without any lifestyle modification, and it's because 240 00:16:23,920 --> 00:16:30,560 Speaker 3: doctors aren't skilled enough to give that culinary medical intervention. 241 00:16:31,160 --> 00:16:35,040 Speaker 3: And the guidelines say throughout you know, it's not We're 242 00:16:35,040 --> 00:16:37,800 Speaker 3: still got to find out what those effective ones are. 243 00:16:37,920 --> 00:16:40,880 Speaker 3: But there are many such and they tend to be 244 00:16:41,280 --> 00:16:49,720 Speaker 3: long lasting because patients feel better, they experience the what 245 00:16:49,800 --> 00:16:53,280 Speaker 3: wellness is and you know, people as soon as you 246 00:16:53,560 --> 00:16:55,280 Speaker 3: pull on a pair of genes and suddenly you feel 247 00:16:55,480 --> 00:16:59,560 Speaker 3: or these are tight, you should think, hang on, what's 248 00:16:59,600 --> 00:17:03,040 Speaker 3: going on here? How can I become healthy and normal 249 00:17:03,080 --> 00:17:08,960 Speaker 3: weight again? And just in doing that is or impacts 250 00:17:08,960 --> 00:17:12,080 Speaker 3: her positively on so many diseases. And you can see 251 00:17:12,080 --> 00:17:14,440 Speaker 3: what a problem it is if you go through the malls, 252 00:17:14,480 --> 00:17:20,000 Speaker 3: if you go to our sports events, even our sporting 253 00:17:20,040 --> 00:17:26,919 Speaker 3: events are sponsored by sugar sweet and beverages. You know, 254 00:17:27,119 --> 00:17:31,480 Speaker 3: is that? Is that all right? It also sponsored by alcohol? 255 00:17:32,160 --> 00:17:37,800 Speaker 3: Is that all right? And that's our national teams? Yea? 256 00:17:37,920 --> 00:17:39,960 Speaker 2: If a lot of food for thought. 257 00:17:40,359 --> 00:17:45,000 Speaker 3: Environment, it's a very contested environment. But I think it 258 00:17:45,200 --> 00:17:49,280 Speaker 3: was people recognizing obesity as a disease treated with kindness 259 00:17:49,280 --> 00:17:53,280 Speaker 3: and compassion. But because you are obese, or because you're 260 00:17:53,320 --> 00:17:56,400 Speaker 3: not obese, doesn't you say you are well? You need 261 00:17:56,640 --> 00:17:59,120 Speaker 3: There is a significant proportion of people who are thin 262 00:17:59,800 --> 00:18:03,400 Speaker 3: but do have noncommunical chronic diseases. So I also need 263 00:18:03,480 --> 00:18:08,760 Speaker 3: to push a healthy lifestyle because their genes treat them 264 00:18:08,840 --> 00:18:12,480 Speaker 3: kindly and keep them thinner although they're eat of junk food. 265 00:18:12,840 --> 00:18:13,800 Speaker 3: Some people are like that. 266 00:18:15,160 --> 00:18:16,639 Speaker 1: A lot for us to think about Thank you so 267 00:18:16,720 --> 00:18:19,639 Speaker 1: much for joining us this afternoon. Professor Andrew Robinson speaking 268 00:18:19,640 --> 00:18:22,920 Speaker 1: there on behalf of the Physicians Association for Nutrition's South 269 00:18:22,960 --> 00:18:26,520 Speaker 1: Africa with a big call there not just for greater 270 00:18:26,560 --> 00:18:30,160 Speaker 1: awareness among the population around what we are eating and 271 00:18:30,280 --> 00:18:32,600 Speaker 1: the kinds of foods we are eating in what proportions, 272 00:18:32,600 --> 00:18:34,200 Speaker 1: but also there I think a very strong call for 273 00:18:34,240 --> 00:18:37,120 Speaker 1: the medical profession itself to keep track with the kind 274 00:18:37,119 --> 00:18:39,640 Speaker 1: of advice that can be shared with patients and encouraging 275 00:18:39,680 --> 00:18:43,480 Speaker 1: them to adopt the healthier lifestyle approach that in combination 276 00:18:43,640 --> 00:18:45,720 Speaker 1: with so many other factors can play a role here. 277 00:18:46,280 --> 00:18:48,680 Speaker 1: So for those who are asking where they can see 278 00:18:48,720 --> 00:18:51,560 Speaker 1: these guidelines, look, the full guidelines have been recently published 279 00:18:51,600 --> 00:18:55,080 Speaker 1: in the South African journal of let Me get it Right, 280 00:18:55,200 --> 00:18:58,960 Speaker 1: the South African Medical Journal. Apologies for those asking about 281 00:18:58,960 --> 00:19:00,720 Speaker 1: the summary I mentioned you want to be on the 282 00:19:00,760 --> 00:19:04,280 Speaker 1: Diabetes SA website which is Diabetes. 283 00:19:03,880 --> 00:19:05,679 Speaker 2: SA dot org dot za. 284 00:19:05,920 --> 00:19:08,800 Speaker 1: It's got a very helpful summary blow by blow around 285 00:19:09,640 --> 00:19:14,520 Speaker 1: what the guidelines say around food, around exercise, around mental 286 00:19:14,560 --> 00:19:19,480 Speaker 1: health management, around stigma, around the use of weight loss drugs, 287 00:19:19,520 --> 00:19:22,000 Speaker 1: et cetera. And it's quite a detailed summary that is 288 00:19:22,040 --> 00:19:24,640 Speaker 1: worth reading. If You are interested, and we should all 289 00:19:24,640 --> 00:19:25,800 Speaker 1: be interested in this topic.