"The South African government should develop a plan to make healthy foods such as fruit, vegetables, and whole grain cereals more available, affordable, and acceptable, and non-essential, high-calorie, nutrient-poor products, including soft drinks and some packaged foods and snacks, less available, more costly, and less appealing to the South African population," write international health experts in this week's PLoS Medicine.

The authors, led by Ehimario Igumbor from the University of the Western Cape in Bellville argue that in South Africa, ''Big Food'' (large commercial entities that dominate the food and beverage environment) is becoming more widespread and is implicated in unhealthy eating.

They say: "Paralleling this increase in overweight/obesity, there has been a steady increase in the per capita food supply of fat, protein, and total calories in South Africa and appears to also be in excess of recommended levels. These changes of appear to be associated with changes in ."

According to the authors, Big Food in South Africa involves South African companies, some of which have invested in other (mainly African) nations, as well as companies headquartered in North America and Europe. These companies have developed strategies to increase the availability, affordability, and acceptability of its foods in South Africa but supermarkets also constitute a major sales channel for the products produced by .

The authors say: "One of the most dramatic changes in Big Food in South Africa has been the rise in supermarket retailers over past decades. Chain supermarkets now control over half of the retail share of the food market, which is dominated by four major chains… all of which are South African."

The authors argue that urgent action is required to mitigate the adverse health effects of the changing food environment in South Africa and say: "We suggest that this action should include a combination of accelerated efforts to educate the public about the adverse consequences of consuming easily available but unhealthy foods and greater regulation of Big Food and the strategies it employs to increase the availability, affordability, and acceptability of foods associated with unhealthy diets."

The authors add: "The policy response to Big Food should also recognise the role of local and possibly subcontinental governance, for example, the Southern Africa Development Community governments, in addressing the issue."

More information: Igumbor EU, Sanders D, Puoane TR, Tsolekile L, Schwarz C, et al. (2012) ''Big Food,'' the Consumer Food Environment, Health, and the Policy Response in South Africa. PLoS Med 9(7): e1001253. doi:10.1371/journal.pmed.1001253

Journal information: PLoS Medicine