OBESITY= KIDNEY WOES
As more Malaysians become overweight or obese, the number of kidney patients will rise. Medical experts warn about the link between obesity and kidney disease, especially among children, writes AUDREY VIJAINDREN
TWENTY years ago, only 4.4 per cent of Malaysians were obese. A decade later, the figure rose to 14 per cent.
In 2015, the National Health and Morbidity Survey (NHMS) found that more than five million people (17.7 per cent of the country) were obese and a further 30 per cent were overweight.
In other words, nearly half the population of Malaysia were either overweight or obese.
The survey under the Health Ministry also found that 11.9 per cent of children aged 18 years and below were obese, with seven per cent of them under the age of 5.
Professor Dr Goh Bak Leong, senior consultant nephrologist and Nephrology Department head in Hospital Serdang, said obesity had independent effects on blood flow in the kidney (renal haemodynamics).
“Individuals with a low number of nephrons (the part of the kidney responsible for filtering waste from blood) are the most susceptible to these changes.
“Multiple mechanisms have been postulated, where obesity directly impacts kidney disease, including hyperfiltration (extra workload to filter blood), increased glomerular capillary wall tension, and podocyte stress (stress to the supporting cells of the kidney),” said Dr Goh, who is also president of the Malaysian Society of Nephrology.
He warned that obesity could hamper a child’s development and quality of life, leading to secondary complications, such as diabetes, cardiovascular diseases and sleeping disorders.
“It will also compromise their cognitive ability and educational attainment, increase their vulnerability to illnesses and lead to increased health costs and loss of human capital and productivity.”
Dr Arini Nuran Idris, paediatric endocrinologist at the Paediatric Institute of Hospital Kuala Lumpur (HKL), said parents could help children make healthy choices.
“Families should serve reasonably-sized portions of food, limit consumption of sugary beverages and high-calorie snacks, encourage children to eat five or more servings of fruits and vegetables a day, eat meals together as a family as often as possible, and limit eating out, especially at fastfood restaurants.
The American Academy of Paediatrics, she said, had suggested practical steps families could take to help children maintain a healthy weight.
“These include adopting healthy habits into daily life. They consist of a well-balanced diet, increased number of physical activities and reduced sedentary behaviour.
“Parents and families are strongly encouraged to be a role model for healthy behaviour in children,” she said.
The study showed that Putrajaya had the highest percentage of overweight and obese people in the country.
The administrative capital’s population had a 37 per cent chance of being overweight, while the obesity rate was at 43 per cent.
NHMS 2015 also showed that 40.3 per cent of government and semi-government employees were obese.
A change from sedentary behaviour to an active lifestyle is another important strategy in maintaining a healthy weight.
“Adequate sleep is crucial to prevent weight issues. Children who sleep less than nine hours a night are more likely to be overweight or obese,” she said, adding that parents should observe strict bedtime for their children. “Families can help kids stay active by enjoying fun, moderate intensity physical activities together to meet the recommended 60 minutes of activity most days of the week, or every day if possible.
“This can include participating in team sports, going to a park, playground or walking/bicycle trails, swimming, bowling, skipping, dancing, dog-walking, climbing stairs or walking to a destination instead of driving.
“Parents and other family members are strongly encouraged to adopt the same fitness and lifestyle changes as the child. Doctors can educate families, provide support and motivate them to make the changes.”
She also urged parents to ensure that their children got their health checkups once a year.
“During this visit, the doctor measures your child’s height and weight, and calculates his or her Body Mass Index (BMI).
“Depending on the severity and complexity of the weight problem, he or she may be referred to a family medicine specialist or a paediatrician, or a paediatric endocrinologist for further management,” she said.
Kidney diseases can be prevented by adopting healthy habits in daily life, such as eating a balanced diet, increasing physical activity and reducing sedentary behaviour.
Globally, 2.6 million patients with end-stage renal disease received dialysis in 2010 and this number will almost double to 5.4 million by 2030.
Dr Goh Bak Leong