Fat is not fit

Why Sri Lankans are getting increasingly rounder:

by Carol Aloysius

In this day and age when our fast paced society forces us to lead hectic lives, people of all ranks of society are turning to junk food, fast food, instant food, picked up at cafes, restaurants, and wayside eateries on their way to school or office.

The outcome of so much food high in calories, starch, sugar, salt, and oil has had a horrendous impact on our collective digestive systems resulting in a host of preventable diseases such as diabetes, hypertension and cardiac problems that are both long lasting and life threatening.

Commonly known as chronic or lifestyle related diseases and also known as Non Communicable Diseases ( NCDs), they continue to invade our bodies, sometimes starting from the time of conception.

Obesity is the starting point. But to reach that point it takes years of over eating, especially at a young age.

Underscoring this point, the World Health Organisation (WHO) says there is now a global obesity epidemic with some 70% of persons ( men, women and children) getting rounder at the waist every day, every year and ending up with various NCDs. Sri Lanka's Health Ministry, endorses this when it says NCDs are the leading cause of death, which is why it has launched a ' Healthy Lifestyle & Nutrition' programme islandwide, targeting people of all ages - from the very young to the very old..

"Unless we act now our future generations will be exposed to such diseases", says Renuka Peiris, Director, Health & Nutrition in charge of the programme.

While she insists the level of obesity among school kids in Sri Lanka is low ( 1.6%) according to data obtained from school medical records based on the yearly inspections and screening of children in Grades 1,4,7 and 10, she also admits it is a growing trend among adolescents mostly those in town and city schools.

The media is largely to blame, she believes.

"Teenagers like following latest trends whether in fashion, music or eating. Attractive advertisements of popular film stars or popular singers munching on a packet of potato crisps or a hamburger with a bottle of fizzy drinks in one hand is a fashionable ' now' statement. It appeals to their senses and feelings and they imitate them”.

So has the Health Ministry done anything to stop this trend from progressing to its disastrous end?

"Our school programme is geared towards the healthy food concept. Only healthy food is served in school canteens, which are regularly inspected by the teachers,” she says. " This message is also passed on to parents at our Parents Teachers Meetings," says Dr Shanthi Gunewardene, Director, Nutrition Co-ordinator and Consultant, Community Physician.

“We have also introduced Health & Nutrition in the Environmental studies at Grades 1-5. From grades 6-9 Health and Physical Education is part of the curriculum. Children in these grades now learn how to measure Body Mass Index ( BMI), check on their nutrition status, differentiate between healthy and unhealthy foods and the risks to their health by consuming unhealthy diets.

Our Schools Canteen Policy is now followed in most schools. So students no longer eat oily, starchy and sugar high meals and carbonated drinks, while in school. But we can only discipline their eating habits during the six hours they spend at school. Parents need to take on that responsibility as well”.

Developing pattern

“If you look at our children today, you will see that many are overweight. Obesity is a developing pattern now in Lankan children, she says. Why? “Look at their life style and eating habits. The moment they begin their formal education , starting from Grade 1 onwards, children have no time to play. Instead they are busy attending tuition classes after school hours and when they come home they have to do their homework. That means they are seated most of the time. So they are not spending energy : only taking in energy. So their bodies gain weight. If you increase your weight more than your height you will be obese.

Obesity can a result in metabolic changes in the body that affect the body system . It means the body will be under stress. Oily food can result in cholesterol problems., which in turn can lead to cardiac failure, stroke," she warns.

Deputy Director NCD Unit, Health Ministry, Dr Parameswaran Anandan agrees.

“Life styles and food habits must change. Avoid starchy, oily foods, Take more exercise, so that you burn more energy than putting in more energy to your body,” he says, adding that whenever there is a festive season people tend to eat more foods than they normally do which are also high in fat and sugar. “So they put on more weight and add to their risk of developing NCDs. Our Unit's aim is to prevent these health risks."

To achieve that goal, he says, the Health Ministry now has over 630 Healthy Lifestyle Clinics islandwide affiliated to State hospitals and MOH clinics, where health education and guidance on avoiding obesity and NCD's are given in all three languages. We invite all those over 40 years to attend these clinics. They will be screened, given a blood test to measure their sugar level and cholesterol level, their weight and height measured using the WHO recommended BMI method, and advised on the kind of food, exercise and risk factors they should avoid such as cigarette smoking and alcohol. If they are already afflicted with an NCD , they will be referred to a specialist and treated free.”

Health education and guidance are the main activity in these Healthy Life Style Clinics.

Lankan diet

The daily diet of Lankans must change to prevent obesity, Health officials insist.

Quoting a study by the NCD Unit, Dr Anandan says, that while Sri Lankans consume less fat (between 15% -18%.) they are consuming a higher percentage of saturated transfats in their diet.

“Unsaturated fat ratio is an important risk factor for developing cardiovascular diseases,” he warns. Lankans also ingest much more salt and sugar in their diet than what the WHO recommends, adds Dr Gunewardene. Whereas a person should take only one teaspoon of salt, and the maximum of 6 teaspoons of sugar for the whole day, the average Lankan consumer ingests 10-12 grams of salt and around 12 or more teaspoons of sugar per day!." These two ingredients can not only lead to hypertension and diabetes, but breast, colon and bowel cancer as well,.”she warns.

Speaking on grounds of anonymity, a nutritionist notes the low intake of vegetables and fruits in a country where both abound. “ Our studies have shown 82% of adults don't consume adequate amounts of fruits and vegetables.

Fruit and vegetables with high fibre, low fat and rich in iron, eaten raw or steamed is the best for one's health and preventing a person from getting fat”, she observes, She further laments that although living in a hot tropical climate such as ours, Lankans don't drink enough water.

“They must drink between 6-8 classes i.e. 1 ½ litres or more a day depending on the kind of activity they do. On hot days when they tend to sweat excessively, more water should be drunk. Avoid carbonated and fizzy drinks at all costs. They are definite weight promoters!. Fizzy drinks contain more than 9 teaspoons of sugar.”

A Physical trainer also notes that while most Lankans (78%) are engaged in moderate or high level physical activities today, only a small proportion is engaged regularly in recreational activities." Studies have shown that 30 % of females lead sedentary lives compared to 18% males. To be fit everyone whether old or young needs to be active – not just getting onto an exercise bike or walking on a treadmill machine. But walking, jogging and cycling,” he says..

A top Health official agrees.

“Personally, I find a daily walk for one hour or more every day has helped me to get rid of excess fat and kept me fit these days,” says Director General Health Services, Dr . G Maheepala, who if you walk past his Ministry these days, can be seen walking or jogging to his officials tasks, which probably explains the trim look he has recently acquired.