The Sunday News
Dr Cherifa Sururu
“The issue of diet is a volatile one. An individual’s eating habits are integral to that person’s way of being, and as such are often difficult to change, even if one desire to do so.”
THE ‘‘obesity epidemic’’ deserves much more serious attention than it is getting. More so, because it is associated with a wide array of diseases that are rapidly overtaking HIV and Aids as the main killers in Zimbabwe. We can also not ignore the immense pressure it is exerting on our health services.
With so much morbidity and mortality, one would want to stimulate interest in the public policy response to such a rampant problem.
In 2014 more than 1,9 billion adults (39 percent) of adults of 18 years and older were overweight globally. Of these, over 600 million were obese (13 percent). Most of the world’s population live in countries where overweight and obesity kills more people than being underweight. In 2014, 41 million children under the age of five were overweight or obese. Comparatively 36,7 million people were living with HIV (including 1,8 million children) in 2014.
While we do not have statistics on the prevalence of obesity in Zimbabwe, 2014 statistics from other African countries are as follows: South Africa 26 percent, Seychelles 26,3 percent, Botswana 22,4 percent, Namibia 18,9 percent and Mauritius 17,9 percent.
Should we worry about childhood and adolescent obesity? The answer is a big yes! There is scientific evidence that supports that once obesity is established, it is difficult to reverse through interventions and is likely to persist in adulthood.
Scientific evidence concludes that children’s exposure to television advertising for non-nutritious food products is a significant risk factor for contributing to childhood obesity.
Important definitions
Malnutrition: Undesirable changes in nutritional status
Under-nutrition: Process of insufficient nutrient intake and/or nutrient absorption
Over-nutrition: Process of excessive nutrient intake and/or nutrient absorption
Obesity in adults is associated with increased risk of type 2 diabetes mellitus, cardiovascular diseases and various types of cancers for example breast, prostate and colon. Other diseases related to obesity are gallbladder diseases, non-alcoholic fatty liver disease, dyslipidemia, glucose intolerance and insulin resistance, hypertension, gout, menstrual abnormalities, orthopeadic problems, reduction of cerebral blood flow and sleep apnea.
It is thought that obesity maybe associated with psychosocial problems which range from depression, discrimination, low self-esteem, negative body image, negative stereotyping, social marginalisation, stigma and teasing and bullying.
Functionally, obesity is associated with absenteeism from school or work, disability, early retirement on medical grounds, low physical fitness, mobility limitations, reduced academic performance, reduced productivity and unemployment.
Obesity is also associated with increased risk of premature deaths in adults younger than 65 years and increased health care costs due to obesity related illnesses. Obesity however, is preventable. Prevention is always better than cure.
Obesity has been on the rise due to a number of factors. Improvements in technology has made life easier simultaneously making us lazier. There has been a rise in high carbohydrate and fatty diets. Most people lack appropriate physical exercise. We have also witnessed an increasing number of fast food chains and proliferation of ‘‘comfort eating’’. The majority of our people lack basic understanding of good nutrition. On the other hand there are medical and genetic factors as well as rise in high sugar diets.
Definition of obesity adults
-Being overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health
-Body Mass Index (BMI) is the simple weight-for- height tool commonly used to classify patients (kg/m2)
-WHO definition is: BMI, 25 is overweight (range 25-29,9kg/m2), BMI, 30 is obesity; Class 1 — 30-34,9; Class 2 — 35- 39,9; Class 3 — 40
While the Body Mass Index (BMI) correlates with amount of body fat, it does not directly measure body fat or differentiate fat from muscle.
Health care providers should look for waist circumference as a measure of abdominal obesity as well as assess for risk factors such as high blood pressure, physical inactivity, smoking and dyslipidemia.
Normal waist circumference in women should be less than 88 centimetres and in men less than 100 centimetres.
It is not always easy to lose weight to the ideal weight. Modest reduction in weight (5-10 percent) of total body weight can have significant health benefits.
In conclusion, to win the obesity struggle, the health care providers and the patient must be able to manage the various interventions: diet, physical activity, psychological measurers.
To be continued . . .
Until we meet again may God bless you all.
