PAkistanis love to eat a lot. We have a very food-centric society. The love of food is evident in the growing food and restaurant industry. Festive foods that we previously only ate on special occasions are now included on our daily menus, thanks in part to the availability of spice mixes and cooking shows on mainstream television.
Consumption of traditional sweets, sugary drinks, confectionery, ice cream, and fried and fatty foods is high and increasing. Most households prefer meat over other food choices. The majority prefer red meat to white meat. Hardly anyone thinks of serving only fruit or vegetables to the guests. Why then shouldn’t we gain weight?
In big cities, fitness clubs are a new trend among young adults who want to lose weight. However, many quit smoking when they don’t see the desired results, which cannot happen without significant lifestyle changes. Cost is another issue as not everyone can afford it. Access to parks, etc. is also restricted for the general public.
The rise in obesity rates among children and adults reported in Pakistan’s National Nutrition Survey released in early 2021 is alarming. The survey showed that rates of overweight and obese children nearly doubled in a decade among children under five; teenage boys and girls; and women of childbearing age.
As obesity is directly associated with the increase in chronic diseases, such as diabetes, diabesity (coexistence of diabetes and obesity) and cardiovascular diseases, it poses a huge threat to the already constrained health system in resources of Pakistan. So what is the solution and who has it?
The simplest solution is to encourage people to eat healthy and be more physically active, but obesity wouldn’t be a big problem if it were that simple. It’s much more complicated than eating healthy and increasing physical activity.
Pakistan does not have an obesity prevention policy. Health professionals are not trained to identify, counsel and treat obese people. In the absence of qualified human resources, in particular a well-organized primary care structure, the effective implementation of health initiatives remains a challenge. How many programs currently contribute to the prevention and control of non-communicable diseases (NCDs)?
National Nutrition Survey results identify urgent obesity prevention actions to avert premature deaths in children and young adults and obesity-related health problems, such as diabetes and obesity. hypertension.
Inspired by the example of countries fighting against obesity, the government needs urgent policy decisions to stop the evolution of the obesity pandemic. Here are some of our options:
The rise in obesity rates among children and adults reported in Pakistan’s recent National Nutrition Survey released in early 2021 is alarming. The survey showed that rates of overweight and obese children nearly doubled among under-fives in a decade.
1- We need a multisectoral strategy against obesity. It should involve the health, education, food and beverage industries, media, legislators and civil society organizations. The obesity strategy should aim to change people’s perception of body size and increase awareness of healthy eating, physical activity and weight. Electronic and print media should be at the forefront in educating people about healthy eating and healthy activities.
2- The government must engage in dialogue with the beverage and sugary food industries, as well as multinational fast food companies and local food chains and restaurants to reduce the sugar and fat content of their foods. Taxing industries that promote unhealthy foods and beverages can be one way to reduce the sugar and fat content of their products. The food industry should be encouraged to make a healthy change to their menus, including fewer fried food options and more vegetable and fruit choices. Calorie display should be required on food products to help individuals make informed choices.
3- The posting of warning messages on television, electronic and printed media informing people of the health risks associated with the consumption of sugary and fatty foods should be made mandatory. Other measures used to reduce smoking rates, such as banning advertisements and sponsoring popular TV shows, talk shows can also help. Cooking programs have a large audience among housewives, teenagers and children who experiment with new recipes and foods. Nutritionists and health professionals should be involved in reviewing these shows to make the recipes healthy.
4- Nutrition and lifestyle education should be part of the school curriculum, starting in primary school. Health and education departments should work closely together to build the capacity of teachers to promote healthy eating and physical activity among younger generations and identify children at risk of malnutrition. Qualified teachers can be a great resource to guide parents in healthy choices such as fresh vegetables, fruits, legumes, whole grains and high fiber diets for their children.
5- Physical activity has a crucial role in weight management and a healthy lifestyle. Appropriate physical activities keep extra calories away and help relieve stress, encourage social interaction and promote healthy sleep. Municipal and union councils should create and maintain public spaces for sports, playgrounds, cycle paths and walking paths essential to healthy living. Public places and parks should provide clean drinking water to encourage people to drink water during exercise.
Finally, it is essential to have trained personnel in primary health care to identify and counsel obese people. A large body of research recognizes that health personnel in primary care settings need the training necessary to diagnose obesity. Counseling patients about body weight is a difficult part of the consultation.
Nutrition education is a neglected subject in medical education as well as in post-graduate training. Overweight and obesity can be successfully managed in primary care settings provided they are equipped to meet this challenge.
Many patients who come to primary health care services need dietary advice specific to their condition. Integrating nutrition and lifestyle education into medical schools and continuing medical education will allow healthcare providers to educate their patients to develop healthy habits, which will ultimately help stabilize overweight/obesity rates.
Obesity prevention is a big challenge requiring urgent multisectoral efforts from the government.
Dr Tehzeeb Zulfiqar is an Associate Professor in the Department of Family Medicine, Academy of Health Services, Islamabad.
Dr Hina Jawaid is Assistant Professor in Department of Family Medicine, Lahore University of Health Sciences