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French fries and fat kids - Asia’s next epidemic

Asia has a new epidemic on its hands – obesity – and the food industry should accept some of the blame. Now, governments need to respond to protect their citizens, says Roger Tatoud, but questions whether they have the courage to challenge big business.
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Popular belief has it that obesity only affects wealthier societies where food is plentiful: the curse of the developed world epitomized by hulking Americans that struggle to order their king-size Big Mac, French Fries and Coke without breaking sweat.

Obesity is no longer exclusive to the developed world

The reality is a very different. Obesity and its associated diseases - diabetes, hypertension and kidney diseases – respect neither wealth nor class and strike instead into the heart of every society where there is easy access to convenience food, low physical activity and ubiquitous advertisements for sugar-fat-salt-rich food.

Heart disease, stroke, cancer and other chronic diseases associated with poor diet and low exercise have now made serious inroads into the lives of people in poor and middle-income nations. In total, these accounted for 80% (28 million) of the cases of chronic illness in 2005, according to the World Health Organisation (WHO), which fears that a further 388 million people will die from such illnesses over the next ten years.

Photo by Malias

Across South East Asia, cases of chronic disease are also high, accounting for 54% of all deaths during 2005. The situation in Thailand is particularly serious, says the WHO, which estimates that the number of obese 5-to-12 year olds increased from 12.2% to 15.6% in just two years. Obesity is generally associated with older age groups, but has yet to permeate into poorer areas where the price of convenience food associated with the epidemic is prohibitive.

China, too, has an emerging epidemic with one or two pockets of high incidence. Overall, obesity levels range from under 5% to almost 20% in some areas, according to regional surveys conducted during 2003. Most concerning, however, is high prevalence among the young. In Wuhan Province 8.9% of 10-12 year-olds were classified as obese by the study. Some areas, such as Beijing, also suggest that there is a gender perspective to the epidemic. In the capital more than 10% of 10-12 year old boys were obese – more than three times the rate for girls in the same study.

Responsibilities are divided

The existence of a genetic predisposition to obesity would provide a straight-forward explanation for the world’s growing stock of rotund individuals, but the precise causes of obesity are multiple.

Changing diets have clearly contributed to the development of the pandemic, driven by the move towards food processing that relies heavily on high injections of sugar and salt. Recent research by The Thai Health Promotion Foundation, for example, found that more than 90% of its sample of 700 pre-packed foods to contain excessive levels of sugar, fat and salt – a cocktail that can lead to diabetes and hypertension as well as obesity.

Choice, of course, enables informed individuals to avoid (or moderate their consumption of) foods that are known to have damaging health effects, but bad labeling, the study suggests, does not help in the decision-making process. Just one third of the sample in Thailand, for example, managed to provide adequate nutritional information on their packaging or list ingredients. Where available, say researchers, labels also tended to use small fonts and present information in a way that is difficult to understand. At least part of the blame, therefore, lies with the food industry itself.

Photo by Malingering


Children are most at risk

For now, young Thais have refrained from overindulgence in burgers and chips on account of taste. But tastes are changing and so is the food industry. Pizza Hut (aka Pizza Company in Thailand) has already rewritten its menu to include a Tum Yum Kung (spicy prawn soup) variety. Western convenience food, which contains 3 or 4 times more fat, sugar and salt than healthier local Thai snacks, is now thought to pose one of the greatest dangers to a country of “snackers.”

Catering to oriental taste in order to boost market share is only one dimension of the corporate weaponry. Intensive marketing activity now mostly targets children and changing cultural values now mean that a visit to see Ronald McDonald has become a symbol of growing affluence and status. The price of a Big Mac in Bangkok (the equivalent of USD 1.5 or Baht 60) may cover the food costs of one meal for a family of four, but younger Thais are prepared to splash out on junk-food if it means impressing friends – especially girlfriends. Similar trends are noted throughout many of China’s larger central and eastern metropolises. Shopping malls in Cambodia also house fashionable western eateries that only the privileged can afford.

Obesity ought not to be a problem affecting children, but cases as young as 3 are not exceptional. And for those that then become obese adults the risks (particularly in developing countries) have alarming potential – an increasing susceptibility to illness coupled with reliance on fragile health care systems that may not be able to offer or afford treatment. In China, there is only a very basic social safety net and hospitals are run like profit-making concerns: Only those that can afford treatment receive treatment

Child obesity is expected to soar worldwide according to the International journal of Pediatric obesity, and could start to erode health gains in many countries. Both morbidity and cases of premature death are expected to rise over the next decade costing the economies of China, India and Russian billion of dollars according to the WHO. China alone will lose $558 billion over the next 10 years of its national income due to heart disease, stroke and diabetes. And other important Asian economies - Thailand, Malaysia, Indonesia and others – are fast reaching western levels of development and consumption.

Photo by Robad0b

An incomplete response

Political will and increased public awareness will decide whether obesity is here to stay or go, according to Prof. Philip James, the chair of the London-based International Obesity Task Force (IOTF).

“It is noticeable,” he says, “that the public and Ministers readily accept the problem of obesity in adults…..then often and very conveniently blame the individual for their predicament rather than questioning whether their obesity reflects the impact of deliberate policy and industrial developments over the last few decades.”

While the political elite ponder their next move a coalition of five international non-governmental organisations (NGOs) – known as the Global Prevention Alliance – has already pledged new action worldwide to combat obesity-driven chronic diseases. Obesity, the alliance says, ranks alongside HIV/AIDS in terms of importance and impact.

“Cutting death rates alone will not be enough,” according to Prof. James, adding that “No health system or economy can afford the cost of spiraling cases of chronic disease. The only way to address this is to recognize the need to revolutionise our approach to delivering healthier diets and reducing consumption of the foods high in fats, sugar and salt.”

Obesity is a new challenge for countries like China, which suffered a major famine in 1961, suffered routine food shortages until the mid-70s and received food aid from the World Food Programme until 2005. But a solution is not out of reach. As many as 80% of the cases of premature heart disease, stroke and type-2 diabetes could be prevented by a healthy diet according to the WHO. Missing only is the political will to legislate, educate and take on the powerful Food Industry.

Homepage photo by Afdn

The Author: Roger Tatoud holds a Ph.D. in Cell and Molecular Biology. He has worked in North Africa as a teacher and Europe as a scientist, volunteer fundraiser for an HIV/AIDS organisation and, most recently, as programme coordinator for a project that tackles insulin resistance and obesity.

Related articles:

1. Health effects of obesity

2. Children becoming too big for car seats

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Default avatar
匿名 | Anonymous

亚洲肥胖儿童问题

感谢Roger Tatoud博士对亚洲肥胖儿童问题的关注,希望肥胖症这一肆意发达国家的疾病不要在亚洲年轻一代横行。
正如Dr.Roger 指出的那样,不良的饮食习惯, 西方的洋垃圾快餐食品是诱发儿童肥胖症的元凶。
在中国,一方面虽然许多地区仍存在儿童营养不足的问题,一方面儿童肥胖问题又日益严重。儿童是我们的未来,中央政府在这个问题上应当引起足够的重视,及早采取措施。

李新忠

Asia's childhood obesity problem

I thank Dr. Roger Tatoud for bringing attention to childhood obesity in Asia. I hope that Asia's younger generation are not caught up in the obesity epidemic that has swept through the developed world.
As Dr. Tatoud points out, bad eating habits and Western-style junk food are prime culprits in causing childhood obesity. In China, whilst childhood malnutrition is still a problem in many areas, childhood obesity is also an increasingly severe problem. Children are the future; the government should give this issue due emphasis and take action as soon as possible.
-Li Xinzhong

Default avatar
匿名 | Anonymous

该现状确实让人担忧

目前该情形确实有越演越烈的趋势,着实令人担忧,相关主管部门应采取相应措施,不要在仅仅停留在所谓的政绩上

A worrying situation

At present,this situation truly is worsening,making people feel really worried.
Responsible departments should take appropriate action, not rest on their laurels.

Default avatar
匿名 | Anonymous

除非政府废除晨练,否则过度肥胖不会是真正的问题

这个现象是存在的,但是这大部分出现在中国东部的一些富裕城市里。就是说,甚至在上海和北京挨着那些参加规律运动的居民的一些西部的人会感觉不舒服。走访中国任意一所学校,操场上都是打篮球、踢足球等的男生女生们--很可能就是晨练的产物。在中国一些学生不喜欢强制的晨练。事实上,一些学校/大学地区可能只是松散地坚持运动。但是这种专制的/遗传的主动性是自小开始就鼓励运动时的中国学生应该发扬的东西,而不是骑着自行车闲逛、抽烟。好的和坏的习惯都是在小时后形成的。

Obesity won't be a real problem unless the party abolishes morning exercises

This phenomenon is real, but largely restricted to China's eastern Provinces where the wealthy live. That said, even in Shanghai and Beijing westerners feel uncomfortable next to the locals who mostly engage in regular exercise. Pay a visit to any school in China and the playgrounds will be packed with girls and boys playing basketball, football etc - the product, most likely, of morning exercises. Some students in China dislike mandatory morning exercises. Indeed, some schools/universities areas may only adhere loosely to their practice. But this authoritarian/paternal initiative is something which students in China (and the West) ought to salute since it actually encourages exercise from an early age, rather than hanging around bike-shed smoking cigarettes. Both bad and good habits form early in life.

Default avatar
匿名 | Anonymous

希望政府及早控制

其实我觉得中国的传统食物并没有太大的问题。而一定要注意的,是美国的快餐垃圾食物进驻中国的情况。如上面评论指出的,中国东部沿海地区比较发达的城市有肥胖症的增加。而就是因为发达地区,麦当劳和KFC就特别多。所以我觉得政府应该控制麦当劳和KFC的数量。并且要求食品产业在食品包装上著名食物的营养成分。让年轻一代开始注意事物的热量和脂肪含量。否则以后肥胖会成为中国又一基本国情。

Expecting timely control from the government

As a matter of fact, I don't think traditional Chinese foods should account for this. We must pay attention to the expension of American fastfood, or junk food, in China. As mentioned in the above comment, obesity is on the rise in Eastern China, the relatively developed cities by the sea. And they have lots of McDonald's and KFC. Therefore, I think that government should control the number of McDonald's and KFC in China. And they should require the food industry to include nutritional components of their products on the package. By doing so, our younger generation will start to pay attention to calorie and fat content of their food. Otherwise, obesity will become the next fundamental national condition of China.

Default avatar
匿名 | Anonymous

不应允许

我总是不明白为什么有些大的企业总是能不用顾及环境的影响,就通过生产不健康的产品而获得巨大利益,对他们应该才采取一些法律措施才行。比如说征税,就像对待烟草产品一样,况且食物味道和其质量并不互相冲突。美国善待动物组织(PETA)最近就在对Burger King的声讨中取得了些许进展。

http://www.goveg.com/murderk_release.asp

Shouldn't be allowed

I've often wondered how these big companies get away with making so much money on such unhealthy products - in any part of the world. Not to mention the environmental impacts of their packaging and farming. There's got to be a way to legislate against it. Or to tax it, like cigarettes. Surely, it couldn't taste worse, by being of better quality? The PETA in the US has recently won some victories against/with Burger King after their "Murder King" campaign.

http://www.goveg.com/murderk_release.asp

Default avatar
匿名 | Anonymous

是个大问题

肥胖是个大问题。个人认为,政府还是不惜要制定法律来制止饮食行业。政府能做的是,让过多食用快餐食品会造成的坏影响公之于众,加以宣传。最重要的是,父母应该意识到快餐食品对健康,尤其是对儿童健康潜在的危协。 Jane

the problem is big

Obesity is a problem. Personally, i think there is no need for government to enact law to curb the food industry, what the official should do is to publicize the bad effects of eating too much fast food for its citizens.The most important is the parents should know the latent danger of having dinner in fast food restaurant,especially for the children.
Jane

Default avatar
匿名 | Anonymous

自约、生活方式和责任

1.中餐比西餐和快餐来得健康。任何一项都比快餐健康,那还有谁选择食用快餐呢?消费者。没有任何一家快餐公司试图隐藏他们所生产的食品。你可以看见油炸的薯条和汉宝被置在烧烤架上所发出的声音。走入或离开快餐店是你自己的选择。中餐并不比西餐来得健康,并且在某一方面当你附加沙拉、烤肉和清蒸项目时比较没那么的健康。许多中菜式是属于油炸的。因此,尽管你吃了些什么,若是生活在缺乏活动性质的生活方式中,这么一来你并没有消耗所食用的能量。许多华裔都习惯以骑脚踏车为运动的方式,然而目前大部分的人都没有这么做(至少50岁以下的一群)。当学生们成为上班一族的时候,这种趋向将更是日益减少,因为他们每天有10-12小时的时间是座在办公室的位置,下班后则回家观赏DVD或者出外购物。2.“然而,中国学生必须敬佩的是这种独裁主义/家长自发性的方式,实际上是始于年少时期。”那种“自发性 ”的方式只是占据中国的一小部分,更属于支配性的问题。专制主义不是解决问题的方法。假设如此,中国的环境将比美国或者欧洲来得洁净。nanheyangrouchuan

self control, lifestyle and responsibility

1. Chinese food is healthier than Western food and fast food.

Anything is healthier than fast food and who chooses to eat fast food? The consumer. No fast food company attempts to hide what it produces. You can see the french fries sitting in oil and hear the burgers on the grill. It is your choice to walk into or out of the fast food restaurant.
Chinese food is no healthier than western food and in some ways less healthy when you included salads, baked meats and steamed items. Many chinese dishes are fried in oil.

And no matter what you eat, living a sedentary lifestyle means you are not using the energy you consume. While many chinese used to ride bikes and do exercises, many now do not (at least those under 50). This tendency increases as students become office workers and sit around in a cubicle for 10-12 hours per day then go home to watch DVDs or go shopping.

2. "But this authoritarian/paternal initiative is something which students in China (and the West) ought to salute since it actually encourages exercise from an early age,"

That "initiative" is a small part of China's much bigger governance problems.
Authoritarianism is not the answer to anything. If it was, China's environment would be cleaner than the US's or Europe's.

nanheyangrouchuan

Default avatar
匿名 | Anonymous

肥胖和转基因食品

我觉得中国的传统食物并没有太大的问题。而一定要注意的,是美国的快餐垃圾食物进驻中国的情况,
在中国大城市里,KFC最多,儿童最喜欢去吃肯德鸡,很多热恋中的 男女也喜欢,但是大家都知道里面最多的是鸡腿,鸡翅,薯条,一只鸡只有两条腿和两个翅膀,世界上这么多KFC,哪里来这么多鸡腿和鸡翅,有的报道说一只鸡能长四条腿和六枝翅膀,鸡毛还没长出来,就进了KFC了,是什么让鸡长了特异功能,在药力还没被鸡吸收完时就成了人们的食品,人吃了能不发生变化吗?试问,过渡肥胖的儿童是不是喜欢吃肯德鸡? Jackson

Obesity and GM food

I think chinese traditional food is not a big problem. However, it is must be aware of the situation of American junk food comes into China. There are highest number of KFC in big cities in China. Children like KFC. Lots of people, who are in love, like it as well. People know that most of the food are chicken legs, wings and chips. There are so many KFC, but one chicken has only two legs and two wings, where are these chicken legs and wings from. According to some report, one chicken can have four legs and six wings. These chicken have already in KFC even before they have feather. What make chicken have this kind of ability? They become food before the medicine fully affected. Changes must happen to those who eat them. Do children have obesity like KFC?

Default avatar
匿名 | Anonymous

不只是快餐

在生活方式改变的今天,青少年肥胖确实会是一个严重问题。不只是快餐,还有家庭膳食结构改变,以及活动减少。单纯地说中餐是否比西餐健康是不合适的,也得分类。对这个问题进行干预需要多方面的努力,从政府角度来说,强制性标准是很难的,可以对食品加工产业进行引导,同时投入资源加强健康教育和全民体育运动。

Fast food isn’t the only factor

With an unhealthy lifestyle today, obesity among youngsters is set to be a serious problem. Apart from fast food, changed household diets and lack of exercise is also to blame for the phenomenon. It is inappropriate to claim that Chinese food is healthier than western food. Instead the two categories should be compared case by case. We should take a multi-thronged approach to this problem. On the part of government, it can issue guidelines for food processing industry since it is hard to introduce mandatory standards. The government can also invest in health education and promote popular participation in sports and exercise.

Default avatar
匿名 | Anonymous

自我控制

无论如何,不管政府和社会对此有多大责任,我都认为一个人应该为自己负责,为自己的健康负责。人不是一天变胖的,一个人应该懂得控制自己的饮食结构,也应该懂得保护自己孩子的健康。控制自己不要长胖,我认为这很简单。
yansy

Self-control

Anyway, whatever responsibilities the government and society hold for this, I think one should be responsible for his/her own health. One does not get fat in one day, and one should know how to control his/her own diet, as well as their children's. I think it's rather easy to prevent oneself from putting on weight.
yansy