As reported, some Africans have gone from under nutrition to over nutrition without ever having passed healthy nutrition. Although the figures are lower than in affluent countries, many experts fear that health systems already stretched by the AIDS virus, malaria and poverty-related diseases may snap under the additional burden of heart disease, strokes, cancer and diabetes, conditions linked to obesity.
Worldwide, an estimated 1 billion people are overweight, compared to 800 million who are undernourished.
Ironically, the poorest are often most vulnerable. Children born with low birth weights to malnourished mothers tend to be more at risk of becoming overweight as adults. They are also more prone to obesity as family members give them too much food to help them catch up.
The problem is most pronounced in Africa, where death rates from obesity and diabetes are on
the traditional diet is heavy in starch, with foods like maize meal and white bread being staples. Three spoons of sugar in coffee and tea are the norm. And, as elsewhere in the world, high-fat, high-sugar fast foods, snacks and fizzy drinks are in.
And, like elsewhere, growing urbanization has led to less walking and other exercise and the spread of television has led to a generation of couch potatoes rather than athletes. In South Africa and throughout the continent, it is considered rude to refuse food.
Let have a typical example. Someone comes from a remote rural village where walking was the main means of getting around. She or he now works in town and says she doesn’t have time to buy and cook vegetables and lentils so she often grabs convenience foods, is too tired to exercise after being on her feet all day and after the long transport to and from the here work.
South Africa is not alone. In Cameroon, where the diet is rich in palm oil, cornflower products and red meat, 35 percent of the population is overweight or obese. Similar rates are found in Gambia and Nigeria, particularly among women, according to figures presented at a recent conference organized by the Oxford Health Alliance of health professionals and academics
These numbers are still far below the industrialized world — only about 2 percent of Africans suffer from diabetes, compared with nearly 8 percent in Europe and North America. But the International Diabetes Federation says Africa’s overburdened health systems are ill-equipped to diagnose the disease, and treatment is too expensive most of its victims.
In our this week’s edition of Health Matters, Dr Hassan Azadeh, our health adviser and a senior lecturer at the University of the Gambia and a senior physician is focusing about the different ways of avoiding obesity to a better, healthy and long life.
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. People are considered obese when their body mass index (BMI), a measurement obtained by dividing a person’s weight in kilograms by the square of the person’s height in meters, exceeds 30 kg/m2.
Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, obstructive sleep apnoea, certain types of cancer, and osteoarthritis. Obesity is most commonly caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications or psychiatric illness.
Evidence to support the view that some obese people eat little yet gain weight due to a slow metabolism is limited; on average obese people have a greater energy expenditure than their thin counterparts due to the energy required to maintain an increased body mass.
Dieting and physical exercise are the mainstays of treatment for obesity. Diet quality can be improved by reducing the consumption of energy-dense foods such as those high in fat and sugars, and by increasing the intake of dietary fibber. Anti-obesity drugs may be taken to reduce appetite or inhibit fat absorption together with a suitable diet. If diet, exercise and medication are not effective, a gastric balloon may assist with weight loss, or surgery may be performed to reduce stomach volume and/or bowel length, leading to earlier satiation and reduced ability to absorb nutrients from food.
Obesity is a leading preventable cause of death worldwide, with increasing prevalence in adults and children, and authorities view it as one of the most serious public problems of the 21st century.Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was widely perceived as a symbol of wealth and fertility at other times in history, and still is in some parts of the world. In 2013, the Association classified obesity as a disease.
In children, a healthy weight varies with age and sex. Obesity in children and adolescents is defined not as an absolute number but in relation to a historical normal group, such that obesity is a BMI greater than the 95th percentile.The reference data on which these percentiles were based date from 1963 to 1994, and thus have not been affected by the recent increases in weight.
BMI is defined as the subject’s mass divided by the square of their height expressed kilograms per square meter and calculated as:
Effects on health
Excessive body weight is associated with various diseases, particularly cardiovascular diseases, diabetes mellitus type 2, obstructive sleep apnoea, certain types of cancer, osteoarthritisand asthma As a result, obesity has been found to reduce life expectancy.
Obesity increases the risk of many physical and mental conditions. These co morbidities are most commonly shown in metabolic syndrome,a combination of medical disorders which includes: diabetes mellitus type 2, high blood pressure, high blood cholesterol, and high triglyceride levels.
Complications are either directly caused by obesity or indirectly related through mechanisms sharing a common cause such as a poor diet or a sedentary lifestyle. The strength of the link between obesity and specific conditions varies. One of the strongest is the link with type 2 diabetes. Excess body fat underlies 64% of cases of diabetes in men and 77% of cases in women.
Health consequences fall into two broad categories: those attributable to the effects of increased fat mass (such as osteoarthritis, obstructive sleep apnoea, social stigmatization) and those due to the increased number of fat cells (diabetes, cancer, cardiovascular disease, non-alcoholic fatty liver disease). Increases in body fat alter the body’s response to insulin, potentially leading to insulin resistance.
Causes
At an individual level, a combination of excessive food energy intake and a lack of physical activity is thought to explain most cases of obesity.A limited number of cases are due primarily to genetics, medical reasons, or psychiatric illness.In contrast, increasing rates of obesity at a societal level are felt to be due to an easily accessible and palatable diet, increased reliance on cars, and mechanized manufacturing.
A 2006 review identified ten other possible contributors to the recent increase of obesity: (1) insufficient sleep, (2) Hormone) disruptors (environmental pollutants that interfere fat metabolism), (3) decreased variability in ambient temperature, (4) decreased rates of smoking, because smoking suppresses appetite, (5) increased use of medications that can cause weight gain (e.g., atypical antipsychotics), (6) proportional increases in ethnic and age groups that tend to be heavier, (7) pregnancy at a later age (which may cause susceptibility to obesity in children), (8) epigenetic risk factors passed on generationally, (9) natural selection for higher BMI.
Gene
Like many other medical conditions, obesity is the result of interplay between genetic and environmental factors. Polymorphisms in various genes controlling appetite and metabolism predispose to obesity when sufficient food energy present. As of 2006, more than 41 of these sites on the human genome have been linked to the development of obesity when a favourable environment is present.
Other illnesses
Certain physical and mental illnesses and the pharmaceutical substances used to treat them can increase risk of obesity. Medical illnesses that increase obesity risk include several rare genetic syndromes (listed above) as well as some congenital or acquired conditions, growth hormone deficiency,and the eating disorders: binge eating disorder.
However, obesity is not regarded as a psychiatric disorder, and therefore is not listed as a psychiatric illness, The risk of overweight and obesity is higher in patients with psychiatric disorders than in persons without psychiatric disorders.
For further information and check up, visit any Government hospital and clinics, number of NGOs and private clinics, or call on Dr Azadeh live health show on Afri-radio every Wednesday from 9-9.30 am. You can also send email to azadehhassan@yahoo.co.uk or text to002207774469/3774469.
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