Friday, May 30, 2014

GLOBAL BURDEN OF DISEASE STUDY ON OBESITY




In the 28th May online issue of Lancet,  Dr Marie Ng and colleagues from the Institute of Health Metrics and Evaluation, University of Washington, published their research on the Global Burden of Disease. This was a Global survey carried out to estimate the scale of chronic lifestyle disease across the globe, including 188 countries across 21 regions. The survey included data from 1980 - 2013.
They found that from 1980 - 2013, there was a 27.5% increase in obesity amongst adults and 47.1% increase incidence amongst children. Over these 30 + yrs, no country has registered any drop in incidence of obesity. Every conry, developed and developing and undeveloped, have seen the incidence of obesity rise. There seem to be slome slowing down in the rise of obesity amongst developed country. While developed country have seen a higher incidence of obesity amongst males, in developing countries, females had a higher incidence of obesity.

Global Burden of Disease Study

       1980
2013
Overall
  857 Million
2.1 Billion
      Males
   28.8%
  36.9%
     Females
   29.8%
  38.0%
     Boys
   16.9%
  23.8%
     Girls
   16.2%
  22.6%


The fact that on obesity in on the rise is not in doubt. What is more challenging is, what can we do about it? Obesity will give rise to higher incidence of hypertension and diabetes and these 3 sisters will increase cardiovascular morbidity and mortality. This will obviously impact on a country's healthcare budget, which in many developed countries have become a serious issue, causing severe budget deficits.
 What then shall we do?.

Of course, the data and research on preventing obesity is well established. Obviously controlling the advertisement and sales of fast food and carbonated drinks to kids, is one of the main causes of obesity amongst children.


Nowadays, ads are directed at children, so that mum and dad is put under tremendous pressure to control.
Which country will take the first step to control the ads and also the sale of fast food and carbonated soft drinks, because these are the killers.

Of course, drinks go with food and fast food is a favourate in our fast track society of the 21st century. We are in the "instant" age. Remote control for instant gratification, is a must and looks like life cannot do without. Fast food is one manifestation, and of course the instant culture promotes a sedentary lifestyle.
The McDonald culture must in some measure be to blame for the epidermic of obesity that we see around us. As McDonald's influence spread across the globe, so also obesity. It looks like they are both in tandem.
In Malaysia, besides battling the McDs, parents also have to battle the mamak stalls with their kurang manis ( even that it is still sweet++) teh tariks. and the so unhealthy roti canais. Nasi lemak, which our government advertises as popular Malaysian food also contributes to obesity and dyslipidemia. Controlling these food, may prove politically unacceptable.
To be fair, there is also a proliferation of gyms and exercise joint for you to jog, do yoga, do line dancing etc etc, this are all good and helpful. But unfortunately, the number of McD joints far outweigh the number of gyms and exercise joints.


If only we can convince some governments that it pays to close down  fast food joints and control adverts of these fast food joints to children. Maybe it is time to label carbonated drinks as "sin beverages" and raise taxes on them. Calorie labelling has started but has had limited effectiveness.
Another worth while measure that was raised before was to reward people who lose weight, either in terms of reduction in health insurance premium ( almost like a lose weight claims ). Rewarding success maybe a better way, than punishing people who sell offending foods.
Basically we know what needs to be done. Food ( calorie ) control, more exercises for individuals, less sedentary lifestyle. These measures will be a good start. But it is easier said than done as some of these measures may be politically unacceptable. Politicians would rather hold a highly publicised "we exercise together" campaign once in awhile,  paying lip service to the importance of lifestyle modification in the fight against chronic non-communicable diseases control.

1 comment:

Winston Yap said...

Doc, since fast foods and fizzy drinks, which are so popular, are the main causes of so much problems, shouldn't a way be found to make these food and drinks healthier?
Like using good oil for frying fast foods or even change the way they are prepared so that they become healthy food?
As for drinks, it seems that the main culprit is the high sugar content.
So, in the same vein, cut down the sugar but do it quite gradually.
Meanwhile, the government can educate the public to reduce or even refrain from frequenting such establishments so often.