Preventing early death from obesity
Obesity has hit almost every country worldwide. Even in Mongolia there are many morbidly obese people who will die young if the situation is not remedied.
One expects to add a bit of weight over the years, but take a look at the large number of young children whose weight is already way above normal. They will be bullied at school, left out of sporting events as too obese to compete. They will fall behind scholastically, be shunned by peers and eventually will not be capable of adhering comfortably to adult life. Do parents really want to make them misfits in society and eventually risk killing them by overfeeding them unhealthy food?
Here is a shocking example of what can occur. Two years ago I read alarming statistics showing life expectancy for Fijians is a mere 55. So I decided to work for an NGO which had set up a nutritional project on the island. A lesson should be learnt from this in Mongolia before it is too late and life expectancy is shortened here too.
It is unfortunate that the harsh climate of Mongolia differs vastly from that in Fiji, and so does the Mongolian diet. Little can be done to alter that but much can be done to avoid the “bad” food that has crept onto supermarket shelves. In particular, high sugar containing food, fizzy drinks and coke should be totally avoided.
Simply cutting these out, reducing the size of meals, eating only three regular meals a day and reducing portions of food without yielding to the temptation to eat snacks will do much to prevent overweight. However, regular exercise is vitally important too. Taking a brisk walk every day, walking instead of going by bus, walking up stairs instead of taking the lift, and if possible, taking up some sporting activity. Two decades ago, in Fiji there was little obesity, but as the country badly needed people to set up and work in sugar refineries many were recruited from India. The outcome of this was that many who came set up small supermarkets, where junk food was readily available and eagerly purchased. With an abundance of disposable income sent from the younger generation who had chosen to emigrate to Australia or New Zealand, the custom of growing their own crops ceased to be a priority. Why bother when there is an abundance of readymade food available in supermarkets? Fiji people love to celebrate, similar to Mongolians. They will celebrate everything possible and a funeral wake can last three days. Celebrations are total village events, with each household making sure there is no lack of food. No wonder there is a tendency to gain weight over the years.
Obesity starts to be a problem by the age of forty, and then gradually diseases begin to appear. The strain on the heart having to carry the excess weight can lead to heart attacks and death, or strokes, and with the increased consumption of high amounts of sugar, mainly coke and cakes, this leads to an alarming number who suffer from type two diabetes. A complication of this can be lower limb amputation as a result of poor circulation causing gangrene. The sufferer is then confined to the house, totally dependent on family for all needs. There is very little chance of obtaining a wheelchair and equally little or no availability of limb prosthesis. By the age of fifty, weight among many has increased to around a hundred kilos. Walking becomes difficult due to breathlessness and painful joints, made worse by becoming stiff due to prolonged inactivity. Sleep becomes difficult, libido is low and many suffer from depression. What then is there left to do other than eat and drink copious amounts of fizzy drinks? Small wonder there is no incentive to go on living beyond the age of fifty five! An embarrassing problem is incontinence due to the excessive pressure on the bladder. This, added to the other problems is one more reason for not wanting to venture outside the house. It is no surprise that marital harmony is more than strained. Men openly told me they no longer fancy their obese wives and as a result it is the children who become victims of sexual abuse which has become an enormous problem on the island.
The aim of this Nutrition Project is to offer a healthy eating plan to anyone willing to participate. We prepared posters showing "bad" food and "good" food, emphasizing avoiding the amount of sugar found in coke and other fizzy drinks. The next step was for a group of six volunteers to visit the villages on the island and present objectives of the program. Our aim was not to enforce a diet, but to tailor an eating plan suitable for each individual. We found all those who were obese were eager to participate. Our next stage was to bring our team of volunteers to interview each person, to take case histories and to document details of weight, blood pressure, blood sugar levels measurement of waist, and to record details of lifestyle and diet. We did not give them exact items required to eat but stressed meals should be limited to three a day, that each meal must contain protein a small amount of carbohydrate and an even smaller amount of fat, and that a portion should fit in the palm of the hand, not fill the entire plate. Little did I realize, Fijians have very large hands! Suitable meal times were suggested to each individual, with a small portion of fruit to be consumed midway between each meal, and nothing to eat after eight in the evening. We also stressed that exercise must be included and to take a walk every day. To relieve the depression, we suggested visiting neighbors. We also emphasized the need for the whole family to be involved in giving support. We then arranged for the volunteers to visit a couple of weeks later to see if they were managing to follow the plan or if there were any difficulties. Two weeks following that visit we would weigh them, check blood pressure, blood sugar levels and waist dimensions. We were delighted to find a large number had managed to reduce their weight, but sadly, many remained the same. It has also been noted that children are four centimeters shorter today than they were in the previous generation, so an effort is being made to give talks to school children, encourage regular exercise programs and to ask them to make their parents aware of the need to lead a healthy lifestyle. We gave out a hundred forms to the children to give to their parents hopefully obtaining their agreement to promoting a healthier diet for their children. As this is a long term project, it will be some years before we can see if life expectancy increases.