Obe­sity in the Mid­dle East

Threat­en­ing fu­ture gen­er­a­tions in the Mid­dle East

Middle East Business (English) - - CONTENTS -

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

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