By SOLA OGUNDIPE
Obesity is becoming an increasing health problem globally. It is rising in not just the urban but rural areas. Not just the adults are overweight or obese, these days, obesity is seen much more in children. This trend does not come as a surprise. Globally, the obesity epidemic is growing.
It is a substantial public_health crisis in the developed world, but the prevalence is increasing rapidly in numerous developing nations worldwide.
Although data from Nigeria on obesity are scant, a clear and distinct secular trend of profoundly increased weight is clearly observed, particularly within the younger generation. Just recently, a study of overweight and obesity in Nigerian preschool children showed that due to improvement in living standard and changing lifestyles, obesity appeared to be an evolving phenomenon in the country.
The study conducted at the Department of Paediatrics and Child Health, Igbinedion University Teaching Hospital, Okada, Edo State, Nigeria, revealed that a prevalence of 18 percent among school age children was recorded.
The result was evidence that moderate number of obese children would grow up to be obese adults with the risk of attending complications such as hypertension, Angina pectoris, non_insulin_dependent diabetes mellitus and hypercholesterolemia.
The conclusion from the study was a call for screening for obesity in childhood so that an early intervention and prevention of the disorder could be made. The growing rate also represents a concern that needs urgent attention if its potential morbidity, mortality, and economic tolls are to be avoided.
Generally, overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A crude population measure of obesity is the body mass index (BMI), a person’s weight (in kilograms) divided by the square of his or her height (in metres).
A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is considered overweight. Obesity represents a state of excess storage of body fat. Although similar, the term overweight is defined as an excess body weight for height. Although it is established that men have a body fat percentage of 15_20 percent, women have approximately 25_30 percent.
The body mass index (BMI) is used to define obesity. BMI is closely correlated with the degree of body fat in most settings and the good news is that even modest weight loss can improve or prevent the health problems associated with obesity. Doctors often use a formula based on height and weight called the body mass index (BMI) to determine obesity.
For instance, an adult with a BMI of 30 or higher is considered obese. Extreme obesity, also called severe obesity or morbid obesity, occurs with a BMI of 40 or more. With morbid obesity, one is especially likely to have serious health problems.
From the foregoing, conservative estimates suggest that as many 15 million Nigerians are obese while two_ to three_times more people than this are probably overweight. Although socioeconomic class and the prevalence of obesity are negatively correlated in most developed countries, this correlation is distinctly reversed in many relatively undeveloped areas, including sub_Saharan Africa.
The bottom line is that in most of the developing world, obesity is a visible concern. Estimates by the World Health Organization show that more than one_third of African women and a quarter of African men are overweight, and it is predicted to rise to 41 percent and 30 percent respectively by 2016.
Once considered a problem only in high income countries, overweight and obesity are now dramatically on the rise in low_ and middle_income countries, particularly in urban settings.
Thus experts at the 2nd Federation of African Nutrition Societies (FANUS) meeting with the theme “Accelerating Nutrition Action for Africa’s Development”, worried over the looming health crisis brought on by uncontrolled obesity within the global populace.
The meeting, held in collaboration with the Nutrition Society of Nigeria and other stakeholders, deliberated on the need to arrest the growing trend before it attained pandemic proportions.
Nutritionists at the meeting argued that the science of obesity is more complex than the simple definition of an imbalance between energy intake and energy output. “Although this concept allows easy conceptualisation of the various mechanisms involved in the development of obesity, obesity is far more than the mere result of too much eating and/or too little exercise,” the said.
Essentially, obesity is defined as having an excessive amount of body fat. Obesity is more than just a cosmetic concern, though. It increases risk of diseases and health problems such as diabetes and high blood pressure.
Key Speaker at the event, Dr Maria Pilar Riobo Servan, who led discussions with her paper, “The Obesity Epidemic and the Metabolic Syndrome”, observed that though the biology of obesity was simple, the social factors contributing to the imbalance are complex.
Pointing to factors such as changing food habits, declining physical activity in the home and in schools, increasing sedentary habits and changing physical environment are significant factors, she lamented that new factors are now being addressed, such as psychological and sleep abnormalities.”
Noting that women are at greater risk of obesity, and especially of severe obesity, than men, she said women also appear to be at disproportionate risk for some of the complications of obesity.”
Servan, Vice President of the Society of Endocrinology, Nutrition Diabetes in Madrid, Spain, Causes of obesity, according to Servan, include excessive caloric intake, psychological factors pointed to habits such as (binge eating, nocturnal eating syndrome), and social factors including excessive TV watching and video games as being contributory to the hazardous trend.
In her presentation, she described the rising rate of childhood obesity is alarming, saying the future impact of this development was grim. “The increasing rates of obesity may bring about the first generation of less healthy adults with shorter life expectancy than their parents.”
Part of the general argument is that childhood obesity is strongly correlated with obesity later in life.”We do know that at its most basic, the biological cause of obesity is simple: an imbalance between the number of calories in and the number of calories out. In other words, consistently eating more calories than you burn off could make you obese,” the nutritionist stated.
“But, of course, the reasons why this imbalance occurs are complex. Some of the social factors that contribute include changing food habits, including the trend toward bigger portion sizes and our greater reliance on convenience foods due to busy lifestyles and time pressures,” Servan pointed out.
Thanks to the declining physical activity in the home and in schools, brought on by labour_saving devices and the fact that physical education is not required in most schools. Servan didn’t overlook the aspect of increasing sedentary habits, frowing at the idea of few people getting the recommended amounts of physical activity.
“Many have become less active in their leisure pursuits_examples are expanded television options (including cable, satellite, and video/dvd), and interactive media like computer games and the Internet.” She pointed at changes in the physical environment, including urban/suburban sprawl that necessitates driving everywhere, safety issues and many communities being built without sidewalks.
“Ultimately, we learned that it is much more complex to the consumer than achieving energy balance. It’s about the hectic pace of life puts health on the back burner, especially for parents with younger children. “Consumers say they have the information they need to improve their health and manage their weight, but they just don’t act on it.
Consumers want to know how to implement changes. Even when they’re willing to change, they struggle to get and stay motivated long term. What they need are simple, easy steps to apply healthful changes to their lives.
‘Obesity is contagious’
At the gathering of health experts during the International Conference Centre in Abuja for the 2nd International Conference of the Federation of African Nutrition Societies (FANUS), the focus was on series of health concerns particularly the growing global obesity epidemic.
Guest Speaker was renowned nutritionist and endocrinologist, Dr Maria Pilar Riobo Servan, currently Associate Head of Endocrinology and Nutrition, Department at the Fundacin Jimnez Daz Hospital, Universidad Autonoma in Madrid, Spain.
Servan, a Fellow at the Jackson Memorial Hospital, University of Miami, and also Vice President of the Society of Endocrinology, Nutrition Diabetes in Madrid, as well as member of the European Enteral and Parenteral Nutrition Society (ESPEN), led the discussion with a presentation entitled:
“The Obesity Epidemic and the Metabolic Syndrome”. In this interview with Sola Ogundipe, she speaks on the salient implications of obesity on l health and proffers possible solution. Excerpts.
Obesity is key to development of non-communicable disorders. How is Nigeria responding to this threat?
I do not really know much about Nigeria’s burden or response to the obesity threat, but I know that obesity is a problem in children in Spain and most likely, elsewhere in the world. How this applies to Nigeria I cannot tell right away, but I would point out that one of the major issues about obesity in children is that it decreases their life expectancy.
Obese kids are more prone to ill health. There used to be a situation in which the family had meals together, but that is no longer available. Now the children eat alone, mainly because the mother is no longer at home. She goes to work all day long and so has no time to prepare good food for the family.
The role of social factors is very important in curtailing the threat of obesity. Habits such as going to bed on time, dieting and exercising are crucial. Obesity is a problem for society, so we have to create more recreation and relaxation for the children.
What are the common implications of childhood obesity?
The first implication is the tendency to become diabetic. Obese children aged 19 or 20 tend to develop complications of type 2 diabetes and in, say 20 years’ time, they could develop bone deformities because as children, their bones are just being formed. Then there is the psychological problems which are expanded.
An obese child is laughed at and derided by contemporaries and it is not uncommon that an obese person has lower opportunity for employment.
Is there a definite connection between soft drinks and obesity?
Certainly. But note that it is the excess of intake of nutrients and not just soft drinks that causes obesity, so there should be moderation. We know fats have more calories than sugars and excess intake of fats it is one of the causes of obesity. If you take a soft drink and you do not exercise, you could be at risk. if you do not share time with the kids at meal times, obesity is going to be increasing.
What is the role played by fast foods?
With the science that is available now, we need changes in the food industry. We can mandate a restaurant to improve their menu and move to change to offering healthier diets. Obesity is the problem of society, and requires all stakeholders to work in tandem. The entire industry should collaborate to tackle it. Concerned organisations in Nigeria can help to make changes in this direction.
How about mothers, what is their role in this regard?
The traditional role of women as mothers is being eroded by civilization. It is quite difficult for women to balance their careers with the home front especially these days when many women have to work. I think this is one important point to note. Habits of women have generally changed and it would be of benefit to society if women could work and yet be free to cater to the needs of their children.
It has to be an adaptation that women learn to cook properly for their families. It is okay to patronize the healthy fast foods but it is better to eat normal food.
Is obesity is contagious?
That could be true from the viewpoint of research. There was an epidermiological study which after 32 years of follow up, revealed that the probability of obesity was higher in an individual who has a friend that is obese. The genetic factors play a role but the environmental factors are also significant.
It is like this, if I have obese friends, then I am likely to be susceptible to eat more and exercise less and ultimately, become obese. The significance is that lifestyle plays a major role here. According to the study, your risk of becoming obese if your friends are obese is up to 171 percent.
This is much higher than if you have an obese partner when the risk is 37 percent. It is an important role for friends for children. Obesity is spreading in society like a contagious disease.
What is your recommendation for Nigeria in curtailing the obesity challenge?
My recommendation is for an obesity prevention strategy for children. They ought to feed optimally, exercise, and share feeding moments with their parents. Children should be made to learn about the benefits of food they can be given is a wonderful it is important they learn to appreciate vegetables and fruits and to imitate what the parents do.
If they see parents enjoying family meals and preparing the food, that habit would be imbibed in them and they would not be likely to develop the attitude of eating alone. Parents should be a role model and enable their children to appreciate the essence of a balanced diet and partaking in family meals.