OBESITY: A GROWING PUBLIC HEALTH PROBLEM IN DEVELOPING COUNTRIES
The August Edition of the Institute of Child Health, University of Benin Monthly Seminar was delivered by Dr Andrew Ifeanyichukwu OBI; a Lecturer and Epidemiologist/ Public Health Consultant, Department of Community Health, University of Benin and University of Benin Teaching Hospital, Benin City, Nigeria. On Thursday the 27th August, 2015. The synopsis of the lecture is presented below:
There have been tremendous increases in global obesity rates over the past three decades, with global prevalence in obesity seen to have more than doubled between 1980 and 2014. Recent global estimates reports as at 2014, put obesity at over 600 million among adults (i.e 13% of the world’s adult population; 11% of men and 15% of women respectively) with overweight estimated at 1.9 billion adults (i.e. 39% of adults aged 18 years and over; 38% of men and 40% of women respectively). Based on current trend global estimate for overweight is projected to increase to 3 billion adults by 2030 while that for obesity to more than 1 billion adults by 2030 if appropriate multifaceted control measures are not put in place.. Data are scarcer on obesity in children, but global estimate as at 2010, put it at 43 million pre-school children, based on the latest international benchmarks set for children, and obesity rates have been steadily rising in pre-schoolers since the 1990s. Although, in 2013, the WHO estimated 42 million children under the age of 5 to be obese.
Obesity was once considered a high-income country problem; but is now on the rise in low and middle-income countries including Nigeria, particularly in urban settings (i.e developing countries) described as emerging economies; with the rate of increase in childhood obesity estimated at more than 30% higher than that from developed countries. Obesity is now considered as a global health problem affecting both rich and poor nations of the world, be they developed, developing and under developed. Obesity has been linked to more deaths worldwide than underweight, as most of the world’s population live in countries where obesity kill more people than underweight (this includes all high-income and most middle-income countries).
GLOBAL REALITY ON OBESITY “GLOBESITY”
There have been worldwide increases in obesity over the past three decades resulting to increases in obesity-related chronic diseases, a trend that threatens healthcare systems, economies, and individual lives. Given the huge financial burden (both public and personal) of obesity and how hugely difficult it is to lose weight once someone becomes obese, prevention is key,.
FACING A DOUBLE BURDEN OF DISEASE
Many low- and middle-income countries are now facing a “double burden” of disease.
While they continue to deal with the problems of infectious disease and under-nutrition, they are experiencing a rapid upsurge in non-communicable disease risk factors such as obesity and overweight, particularly in urban settings.
It is not uncommon to find under-nutrition and obesity existing side-by-side within the same country, the same community and the same household.
Children in low- and middle-income countries are more vulnerable to inadequate pre-natal, infant and young child nutrition. At the same time, they are exposed to high-fat, high-sugar, high-salt, energy-dense, micronutrient-poor foods, which tend to be lower in cost but also lower in nutrient quality. These dietary patterns in conjunction with lower levels of physical activity result in sharp increases in childhood obesity while under-nutrition issues remain unsolved.
A recent 12 years systematic review on obesity showed that the prevalence of overweight and obesity in Nigeria ranged from 20.3%–35.1%, and 8.1%–22.2%, respectively. This review indicated that the prevalence of overweight and obesity in Nigeria is on the rise. Childhood obesity is also on the increase in Nigeria with prevalence among adolescents ranging between 0.9-4.2percent.
RISK FACTORS “CAUSE(S)” OF OBESITY
The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. That is more calories taken than is needed. Globally, there has been:
An increased intake of energy-dense foods that are high in fat and calories; and
An increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization.
Changes in dietary and physical activity patterns are often the result of environmental and societal changes associated with development and lack of supportive policies in sectors such as health, agriculture, transport, urban planning, environment, food processing, distribution, marketing and education.
WHAT ARE THE COMMON HEALTH CONSEQUENCES OF OBESITY FOR ADULTS?
The risk for these non-communicable diseases increases, with an increase in BMI. People who are obese are at increased risk for cardiovascular diseases (Stroke, atherosclerosis, Hyperlipidaemia etc), metabolic diseases (Diabete Mellitus etc,) cancers (Colon cancers etc) and other health conditions to mention a few.
WHAT ARE THE COMMON HEALTH CONSEQUENCES OF CHILDHOOD OBESITY?
Childhood obesity is associated with a higher chance of obesity, premature death and disability in adulthood. In addition to increased future risks, Obese children experience breathing difficulties, Increased risk of fractures, Hypertension, Early markers of cardiovascular disease, Insulin resistance and psychological effects etc.
Prevention is key to tackling obesity. Obesity has become inter-woven into the fabric of our society. To successfully disentangle it will require a multifaceted approach which not only gives individuals the skills to make healthier choices but also sets in place policy and institutional infrastructure that support those choices.
The reality is that obesity exists in increasing magnitude in developing countries including Nigeria plagued by the double burden of Communicable and Non-Communicable Diseases. Sadly, to note is the poor implementation of institutional frameworks existing in the country, if available at all. A Nation further bedevilled by a weak health system entangled with corruption and misplaced priorities enshrined in her numerous vertical programmes.
Dr A Obi delivering the lecture
Written by DR ANDREW IFEANYICHUKWU OBI
MB,BS (Benin); MWACP (West Africa); MPH(Benin); FMCPH(Nig.); Cert. Epid. (North Carolina)
LECTURER/ EPIDEMIOLOGIST AND CONSULTANT PUBLIC HEALTH PHYSICIAN
DRPARTMENT OF COMMUNITY HEALTH
UNIVERSITY OF BENIN, BENIN CITY, EDO STATE
CONTACT: E-mail:[email protected]; Tel. +2348023447122