Lifestyles carry health consequences in Gulf region
London - Levels of obesity and corresponding diseases in the Middle East and North Africa (MENA) region are staggering, a report by medical journal the Lancet showed, particularly in Gulf countries.
The problem is particularly bad for women. The rate of obesity in women exceeds 50% in Kuwait, Qatar and Libya, while 58.5% of men in MENA countries are considered overweight or obese.
Obesity has been on the rise internationally, with 2.1 billion people now considered obese or overweight, double the number in 1980. Non-communicable diseases related to weight levels include cancer, diabetes and heart disease.
An annual Global Food Security Index, published by the Economist, showed that Gulf countries have seen the most dramatic change in diets in recent decades, with 36.7% of those populations considered obese.
Dr Ayoub al-Jawaldeh, regional adviser for the World Health Organisation, Eastern Mediterranean, said: “Food consumption here [MENA] is high-calorie, exceeding in six countries, especially in the (Gulf Cooperation Council) GCC, 3,200 calories a day. The average requirement is 2,200.”
Qatar and Kuwait are perfect breeding grounds for over-consumption: Incomes are high, populations are small and public sectors well-funded.
They ranked highly in the report’s “Affordability” of food, one of three criteria — “Availability and “Quality and Safety” are the others — used to rank countries but rated poorly in both other measures.
In addition, there is a noticeable absence of national dietary guidelines in these areas: 36 countries of the 188 countries studied lacked such guides completely, many of which were MENA countries.
“The culture is also a problem. There is no awareness about healthy food. We have very low consumption of fruit and vegetables as a result.” Jawaldeh said.
Shahzad Agmeh said he had experienced this first-hand.
“After six or seven years living in Abu Dhabi, I gained a lot of weight. I was taking pills for high blood pressure, high cholesterol, asthma and diabetes. You are always inside under the air condition. You get so lazy ordering fast food over the internet all the time, you barely have to move,” he said.
Agmeh has since recovered and acts as a source of inspiration via his blog. “They think they are active,” he said. My first advice is to get a step-counter. They would see that they don’t clock more than 2,000 to 3,000 steps a day on average.”
Obesity is calculated using the body mass index (BMI), which is derived by dividing a person’s weight with the square of their height. “‘Overweight” is a BMI of 25 or greater; “obese” is 30 or greater.
Type 2 diabetes is shockingly prevalent in MENA countries.
The International Diabetes Foundation (IDF) said 37 million people — nearly 10% of the overall population — in MENA have diabetes. This figure is predicted to double by 2035. An obese individual is seven times more likely than a person of healthy weight to develop type 2 diabetes; an overweight person trebles those chances.
Non-communicable diseases, such as heart disease, diabetes and cancer, are so widespread that the World Bank estimates that by 2030 it is expected those diseases will be the cause of 81% of deaths in MENA and almost 87% in the GCC.
Jawaldeh pointed to the type of food people in the region consume: “Most of it is high in fat, trans fat and total saturated fat. American fast food… is the worst. What they produce in Europe or America is different than what they produce in our region. It has higher trans fat and they use palm oil, which is banned in Europe. So there is no quality control here. Even in soft drinks, the level of sugar in America or Europe is around 10%, while here it’s 13%.”
Those statistics have led states and private initiatives to ramp up efforts to move health standards to the forefront of long-term government planning.
The UAE’s Vision 2021 programme highlights healthcare as a key area of focus for the government.
In Qatar, Minister of Health Abdullah bin Khalid al-Qahtani launched Sahtak Awalan (Your Health First), an initiative to encourage people to make correct lifestyle choices.
Action is not limited to governments: Landmark Group’s Beat Diabetes initiative, launched in the UAE to promote healthy living, has reached an audience of 6 million people across Oman, Bahrain, Qatar, Kuwait and India.
Agmeh said: “The [UAE] government has provided free facilities to do cycling… to jog, etc. They’ve opened parks and beautiful beaches but unfortunately the trend is changing very slowly. A lot of education is required to inspire the general public to change.”
Obesity is one of the largest drivers of health care costs in the developed world. A tax on sugar is being debated in Britain and Thailand and could be one way of tackling the epidemic.
Jawaldeh said the World Health Organisation had proposed policies on salt reduction, sugar reduction and fat reduction.
Cost-effective interventions would be to promote healthy diets and oppose marketing for unhealthy food, he said. “This includes adding taxes to sugary beverages. Most countries in this region are subsidising sugar and oil. This is wrong. We should encourage them to subsidise fruit and vegetables, while promoting physical activity.”