Obesity in the Middle East

Threatening future generations in the Middle East

Childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and is steadily affecting many low- and middle-income countries, particularly in urban settings. The prevalence has increased at an alarming rate. Globally, in 2015 the number of overweight children under the age of five was estimated to be over 42 million. Almost half of all overweight children under 5 lived in Asia and one quarter lived in Africa.

Overweight and obese children are likely to stay obese into adulthood and more likely to develop noncommunicable diseases like diabetes and cardiovascular diseases at a younger age. Prevention of childhood obesity1 therefore needs high priority, and is the region’s greatest health challenges.

What can be done to fight the childhood obesity epidemic?

Obesity, as well as related noncommunicable diseases, is largely preventable. It is recognised that prevention is the most feasible option for curbing the childhood obesity epidemic since current treatment practices are largely aimed at bringing the problem under control rather than finding a cure. The goal in fighting the childhood obesity epidemic is to achieve an energy balance that can be maintained throughout the individual’s lifetime.

Societal recommendations

Curbing the childhood obesity epidemic requires sustained political commitment and the collaboration of many public and private stakeholders. Governments, international partners, civil society, NGOs and the private sector have vital roles to play in shaping healthy environments and making healthier diet options for children and adolescents affordable, and easily accessible. It is therefore WHO’s objective to mobilise these partners and engage them in implementing the Global Strategy on Diet, Physical Activity and Health (DPAS). WHO supports the design, implementation, monitoring and leadership of an anti childhood obesity plan. A multi- sectoral approach is essential for sustained progress: it mobilises the combined energy, resources and expertise of all global stakeholders involved.

The Role of Member States

The WHO’s Global Strategy on DPAS fosters the formulation and promotion of national policies, strategies and action plans to improve diet and encourage physical activity. The role of government is crucial in achieving sustainable changes in public health. Governments have a primary steering and stewardship role in initiating and developing DPAS, ensuring that it is implemented and monitoring its impact in the long run. National institutions for public health, nutrition and physical activity can provide the necessary expertise, monitor developments, help to coordinate activities, participate in collaboration at international level, and provide advice to decision-makers.

A step- wise approach for local countries

Possible intervention strategies or examples of areas for action local countries can take in order to fight the childhood obesity epidemic include:

At the core level

Promoting breast feeding for six months or more in newborns; Promoting a healthy school environment, involving parents, where activity is increased, healthy food options offered by the cafeteria, and decrease ‘ screen time’ - TV, tablets, phones etc. Mass media campaign targeting parents and children encouraging activity and healthy eating. This will be supported with special programmes targetting new or young parents.

Desirable

Legislation to support healthier composition of foods (editor’s note: sometimes known as sugar/fat tax). Eliminate trans fatty acids and decrease saturated fats. Fiscal policies to encourage healthier food choices - including providing prompts at point of sale. ( Examples: reductions in vending machines offering solely high fat, high sugar foods, especially in the school environment). Reduce food and soft drink marketing to children. (Example: ban adverts on TV promoting high fat food and drink before a certain time of night). For more info : www.who.int

Globesity - how obesity and diabetes are becoming the norm

Aetna International, a health insurance firm, combined data from the World Health Organisation ( WHO), the United Nations, governments and the global food industry to form a comprehensive analysis6 of the true picture of global obesity. Their report, ‘ Globesity: Tackling the world’s obesity pandemic’, calls upon governments, food producers, retailers, employers and insurance companies to combine their efforts to tackle the obesity crisis. Richard di Benedetto, President of Aetna International, said: “The rise in obesity rates make it clear; there needs to be a shift in the narrative around diet and healthy living. We must work together to combine our knowledge and expertise in order to curb the rise of globesity.” The WHO statistics show that obesity rates have more than doubled since 1980, with 13% of adults worldwide classified as obese and nearly 40% as overweight. The report findings show that these numbers will rise further if urgent, collaborative and targeted action is not taken.

The report concludes that the only way to tackle globesity is through a newly formed holistic approach combining health incentives, taxes and education programs. It has been proven that one of the most effective means of reducing obesity is providing clear information about the direct correlation between nutrition, weight gain and non-communicable diseases, such as diabetes. The International Diabetes Federation ( IDF) says that, the

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number of diabetes cases in the Middle East will nearly double in the next 20 years while almost half of cases in the region remain undiagnosed. (2015: 35.4 million 2040: 72.1million). A very sobering thought. 1 The prevalence of overweight and obesity in adolescents is defined according to the WHO growth reference for school-aged children and adolescents (overweight = one standard deviation body mass index for age and sex, and obese = two standard deviations body mass index for age and sex). 2 World Health Organisation. ' Obesity: preventing and managing the global epidemic'. WHO obesity technical series 894. 2000. 3 World development indicator database, World Bank, (2008) 4 P. Mirmiran, R. Sherafat-Kazemzadeh,S. Jalali-Farahani,F. Azizi Childhood obesity in the Middle East: a review Eastern Mediterranean Health Journal, 16 (2010), pp. 1009 - 1017 5 A. Kamal,A. Bener,A. Al-Mulla Growth pattern of Qatari preschool children Croatian Medical Journal, 45 (2004), pp. 461- 465 6 https://www.aetnainternational.com/en/ about-us/explore/future-health/globesitytackling-world-obesity-pandemic.html