Fighting the flab

More than half the population of the Middle East is now obese and the number is rising sharply. Unless drastic action is taken, experts fear that the region is on the cusp of an unprecedented health crisis. David Robinson reports.

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By  David Robinson Published  April 3, 2005

Fighting the flab|~|BLAMED-200.jpg|~|BLAMED: Calorific foods are being blamed for the region’s obesity problems.|~|FOR THE first time in human history, feasting threatens to overtake famine as a global killer. More than half the population of the Middle East is now obese, according the World Health Authority, and the number of people affected by the condition is rising at an alarming rate. A large swath of society eats badly and exercises infrequently and the implications could be catastrophic. In the past, obesity was viewed as an indication of success and prosperity. Being fat gave the appearance of living and eating well. If only it were that simple. The truth is that piling on extra pounds can take a terrible toll on health, significantly increasing the risk of heart disease, high blood pressure, strokes, diabetes, infertility, gall-bladder disease, arthritis and many forms of cancer. And treating obesity’s ills costs the region’s governments billions every year. Experts fear the number of obese adults could double in the next 20 years unless far-reaching action is taken. The crisis is so prescient, that today’s children may be the first generation in history whose life expectancy is projected to be less than that of their parents. “The severity of the situation makes it quite comparable with the Aids epidemic,” says Professor Philip James, chairman of the International Obesity Task Force, a global body that aims to alert the world about the growing threat posed by the situation. James, a world expert on the subject, was in the region last week to meet with doctors from Kuwait, Qatar, Saudi Arabia, and the United Arab Emirates to discuss new ways to tackle the crisis. “The Middle East has one of the highest rates of overweight and obese people in the world,” James says. “We have to do something because the situation is totally out of control and people have not got a grip on it.” Accompanying him on the trip was Professor Mike Lean, chairman of the human nutrition department at the University of Glasgow, who is also involved in global anti-obesity campaigns. They hope to begin changing opinion on the severity of the problem by having obesity reclassified as a disease. “Ten years ago doctors didn’t recognise obesity as a disease, it was more seen as indicative of a successful economy and a successful lifestyle. Now there is recognition that obesity is a disease that is partly genetic, mainly environmental and causes immense disability,” James says. “Children who are overweight often develop low self-esteem, which can lead to depression in later life.” He says these symptoms are then compounded by metabolic complications and physical disabilities such as arthritis. Campaigns against smoking and drink-driving have raised popular consciousness about public-health issues dramatically. So there’s no reason to think an anti-obesity campaign can’t work as well. But changing people’s habits may take a long time. They have, after all, been eons in the making. Guided by the inexorable laws of evolution, the human race has adapted over millions of years to living in a world of scarcity, where it paid to eat every good-tasting thing in sight when it could find it. Although human physiology has stayed pretty much the same for millennia, the environment we live in has been utterly transformed. Over the past century in particular, technology has almost completely removed physical exercise from the day-to-day lives of huge swaths of the world. The problem is particularly acute in the developed parts of the Middle East where its sizzling summer temperature lead people to spend more time indoors and exercise less. At the same time, supermarket shelves are filled with cheap, mass-produced, tasty foods packed with calories. Furthermore, technology has allowed advertisers to deliver constant, alluring messages to consumers every hour of the day. The roots of the modern obesity epidemic began a few decades ago, James says. After the Second World War, governments in the West encouraged the development of a low-cost food economy in an effort to make a wide range of products available to all. The result has been an explosion in the availability of high fat, salty and sugary products. Big US firms in particular realised that if they produced certain foods — for example French fries — in a certain way, they could cheapen the whole production process. “The food companies made a riot of money, but then discovered they’d penetrated the market so it became a question of whether different firms’ products could compete with each other,” James says. “So by the late 1960s firms started pushing brands.” The big food corporations soon worked out the best way to persuade people to buy their brands was to target consumers early, he continues. “There is incontrovertible evidence the European and American food companies went systematically for younger and younger age groups,” James says. “They employed child psychologists to work out how to lure children with a whole variety of marketing devices.” As a result, many restaurant-chains now have sophisticated child entertainment areas, and many food products directly target children. “Marketing is a multi-billion dollar business that been proven to be very effective in manipulating children from the age of one to selectively identify with a particular product. This often leads to confusion about nutrition, and inappropriate choices, which often continue into later life,” James adds. The finger of blame is pointed at the ubiquitous Western foodstuffs — such as hamburgers, hotdogs, pizzas, fries, crisps, chocolate, candies and ice cream, all washed down with sugary soft drinks — that make up the bulk of many people’s diets. The big Western food corporations have now turned to targeting the developing World in an effort to boost their bottom line, says James. “You’ve got all these people who are being constantly manipulated to see the West is a wonderful life and are being bombarded by marketing to buy Western foods, instead of traditional foods. It’s a deliberate strategy,” he exclaims. Overall life expectancy in many parts of the world is being slashed because of the crisis, Lean says. “Life expectancy may be increasing because of declining rates of smoking and improved living standards but the life expectancy of some children who get fat early is going to be less than their parents,” he says. “The world is producing too much saturated fat,” James adds. “We don’t need it.” Lean and James’ hope to have obesity considered a food safety issue, and therefore taken into account where global trade is concerned. It’s a message they are taking to government figures around the world, including in the Middle East. Under World Trade Organisation rules, American and European food corporations can sell their products all over the world. However, the WTO rules have one phytosanitary sub-clause. The importation of food perceived to be damaging to health — for example beef stocks at risk of carrying BSE — is banned. “Yet the importation of fatty, sugary, salty foods that contribute to far, far higher rates of death and disability than BSE is allowed,” James exclaims. He, with Lean, hope to encourage governments to take action and invoke the sub-clause thereby banning certain high-fat food products from ending up on shop shelves. “The only justification for government intervention is if there is a market failure,” Lean continues. “In the question of obesity, there is patently a market failure. Customers are being misled and misunderstand the basis on which foods are sold — they have not been told by the food companies which ones are high fat.” Lean says the court cases in the United States in the last few years where consumers have taken fast food chains to court claming they were not given clear information on the fat content of certain products may be the tip of the iceberg. “Companies are selling foods that are very high in fat and they have not allowed customers to understand that,” he says. “If you buy things off the shelf, you have very little idea how much fat there is there, even if it tells you, you don’t know how high or low the fat content is. If you see something that is labelled low fat then it’s maybe lower than something else but who says so, who’s evaluating — it’s the company. There is no independent way of evaluating. “Low fat often means half what the product was before. However, if the product was 60% fat, halving it will still make it 30% fat, which is still high,” he says. A traditional Middle Eastern meal contains 15-20% fat, he estimates. But human instincts run deep. During times of scarcity, humans developed instincts for basic tastes — sweet, salt, fat — that they could never fully satisfy. Millennia may have passed, but these cravings remain. Studies have consistently shown that people associate foods that are desirable with foods that have a higher fat content. “Fatty foods carry flavours there’s no doubt about that.” Lean concedes, adding that the food companies can accommodate this in two ways. “One way is to produce food that’s very high in fat. The other way — and food companies know this — is to produce the fat in a very fine film on the surface which carries the flavour. You can adapt the flavour of a food with a very small amount of fat using modern technology.” Lean adds that people’s tastes can change quite quickly under various circumstances. “People tend to like whatever foods they are exposed to,” he says. “If you change the way you eat your palate adapts very quickly.” The food companies use food panels to defend their high fat products saying that they are what people like, but if a subtle process of change is introduced over a period of time then people’s palates will change. “For example, in Europe about 20 years ago, everybody drank high fat milk, then the milk industry began to develop half fat and skimmed milk. Initially people didn’t accept it, but now everybody drinks low fat milk and will complain if they’re given high fat milk,” says Lean. The same process, he says, can be applied to products across the dietary spectrum. Lean says a number of leading food and soft drink firms are already anticipating a market where consumers will want less fat and will be more discriminating in their choices. One of the world’s two big manufacturers of cola is already preparing for the time when it will no longer sell the carbonated sugary beverage, he says. The stirrings of change may be in the air, Lean stresses, but unless sweeping action is taken on a governmental level to limit the amount of cheap, fatty, sugary food that the average person consumes, there'll be hell to pay further down the line. ||**||

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