Full Report - Food, Nutrition, and the Prevention of Cancer

to entire populations. Technology has been the main driving
force behind these systems. For instance, various food-preservation
techniques were developed as part of the industrial
revolution, and there has been further innovation since that
time. These include bottling, canning, refrigeration, and
packaging; the extensive use of sugar and salt; and technologies
that suppress, convert, or eliminate perishable qualities
in fresh foods (see chapters 4.6 and 4.9). The clearing
of land to rear cattle and sheep, and the development of railways,
refrigeration, and other technologies, have made meat,
milk, and their products cheap and plentiful all year round.
Sugar derived from cane is the most profitable edible cash
crop, and sugars and syrups made from cane, beet, and now
also corn are used to sweeten and preserve breakfast foods,
baked foods, desserts, soft drinks, and a vast array of other
manufactured products. 64 65 Steel roller mills, invented in the
1870s, separate the components of wheat and enable production
of uniform quality white bread, which has become
a staple food. 66 Hydrogenation, which converts oils to hard
fats (see chapter 4.5), has made margarine a basic item of
food, and provides ingredients used in the manufacturing of
many processed foods. 67 Perhaps the most remarkable
change following the industrialisation of food systems has
been the precipitate drop in breastfeeding. 68 At various times,
urban–industrial food systems have been adjusted in
response to the then current knowledge of nutrition and pub-
8
South Africa
In 2001 South Africa had a population of
nearly 47.5 million. 3 The country has a middle-income
economy, with a gross domestic
product of 8506 international dollars per
person (figure 1.3), which masks extreme
socioeconomic inequalities. 46 Life expectancy
at birth is 47 years for men and 49 for
Non-communicable causes of death South Africa
Per cent of deaths
10
7
20
13
51
Data from World Health Organization 46
women (figure 1.1). 46
Chronic diseases account for 53.9 per cent
of deaths, while infectious diseases, maternal,
perinatal, and nutritional conditions account
for 40.2 per cent; 5.9 per cent of deaths are
due to injuries. The figure below gives a breakdown
of deaths caused by chronic diseases. 46
Cardiovascular disease
Cancer
Respiratory disease
Diabetes
Other
P ART I • BACKGROUND
The most common cancers in men are
those of the prostate, lung, oesophagus,
colorectum, and bladder. 20 Since HIV and
AIDS became epidemic, Kaposi’s sarcoma
has become more common in both men
and women. For women, the most common
cancers are those of the cervix, breast,
Age-standardised rates of South Africa
common cancers
Age-standardised rate per 100 000
45
40
35
30
25
20
15
10
5
0
Prostate
Lung
Oesophagus
Kaposi's
sarcoma
Men Women
Colorectum
Bladder
Data from International Agency for Research on Cancer 20
lic health recommendations, notably when food security has
been threatened by wars. 69
Urban–industrial food systems generate relatively energydense
diets. These are fairly high in meat, and milk and their
products, and in total fats, hardened fats, processed starches
and sugars, salt, baked goods, soft drinks, and often also
alcoholic drinks. These diets are relatively low in both
dietary fibre and starchy staple foods, other than products
made from wheat, which has become the dominant cereal
in most countries outside Asia and Africa. Recent advances
in food technology have further altered patterns of food production
and consumption, particularly in high-income
countries. Patterns of production and consumption of
vegetables and fruits and fish vary between different
urban–industrial food systems, depending on factors such as
climate and geographical location. 70
Efficient urban–industrial food systems can ensure the
constant supply of food to all sections of the population,
even to the lowest-income and marginalised groups. In higher-income
countries and regions, this, together with basic
public health initiatives, has helped to greatly reduce rates
of nutritional deficiencies and other diseases, which people
are more vulnerable to if they have inadequate food supplies.
As a result of these food systems, people have become generally
taller and heavier.
Since the industrial revolution, as populations have moved
Cervix
Breast
Colorectum
Lung
Oesophagus