Fight obesity the Japanese way

Malaysia must be prepared to make a big shift in lifestyle and policies in order to reduce obesity, writes Dr Norsham Juliana Nordin

THE burden of obesity in Malaysia has tremendously increased, hence significantly promoting the rise of non-communicable diseases (NCD). The National Health and Morbidity Survey 2015 reported that 51.8 per cent of Malaysians were either overweight or obese.

The prevalence of obesity-related diseases is also worrying with 1.9 million Malaysians diagnosed with diabetes and 73 per cent of total deaths due to NCD.

The trend does not show any sign of regression as Malaysian children have the tendency of being at extreme ends of the scale, either being obese (30 per cent) or undernourished (based on the United Nations Children’s Fund 2017 report).

Theoretically, these conditions lead to an increased risk of obesity and NCD later in life. So we already have a high-risk next generation on our hands to deal with.

In order to win the battle against obesity and NCD, let us look at available policies designed to empower people to make healthier choices.

The most relevant country that we should look up to is Japan as it manages to keep its obesity rate at 3.7 per cent.

A working paper produced by professors from the University of Minnesota, USA and Waseda University, Japan, described that economic factors have indirectly resulted in a healthy lifestyle among the Japanese.

Those who have visited Japan can see that food prices there are considerably more expensive than other countries due to strict food policies.

Availability of caloric dense food at retail level in Japan is also very limited and costly.

On the contrary, in Malaysia, there is an abundance of caloric dense food readily available in almost all retail stores at cheap prices.

Besides that, the Japanese traditional diet emphasises rice, vegetables and fish with very little fat. In fact, its food pyramid has much in common with the Mediterranean diet.

Both diets promote a high intake of vegetables, fruits and grains. Perfection has always been the trademark of the Japanese and the same applies to their food. There is an old Japanese saying that means “they eat with their eyes”.

Therefore, their food must be presentable with particular attention to colour, texture, portion and variety.

Despite being urbanised for decades, the Japanese still have a higher preference for eating at home.

All these circumstances are conducive to maintaining restricted calories in their diet without even bothering to count them.

Another explanation for the low obesity rate in Japan may be its level of physical activity.

However, this does not mean that the Japanese spend more time at the gym or plan their physical activity more than Malaysians. Data from the Japan Ministry of Health, Labour and Welfare shows that the average Japanese person aged 15 years and above walks more than 7,000 steps per day.

A study done in urban areas in Malaysia, on the other hand, found that 65.1 per cent of Malaysian did not achieve the recommended standard for walking to gain health benefits.

The sedentary person in Malaysia may walk only 1,000 to 2,500 steps per day. The disparity in walking between both countries may be explained by the difference in utilisation of public transportation.

In Japan, it is common and more cost effective to use public transportation. Hence, it usually entails walking to the destination.

Above all, under Japanese national law, companies and local governments must measure the waistlines of Japanese people between the ages of 40 and 74 years old as part of their annual check-up.

The state-prescribed limit for men is a strict 33.5 inches and for women, it’s 35.4 inches.

Those who exceed the limit will be given dieting guidance to lose weight within three months. The law went into effect for all companies and industries. Companies that fail to meet this target will incur high penalties.

In conclusion, the prevalence of obesity is much lower in Japan partly because they walk more as part of their daily life. It’s also because of their strict government policies and cultural integrity.

Malaysia must be prepared to make a major paradigm shift in lifestyle and policies in order to reduce obesity rates in the country.