Killer disease

The world is getting fatter, sicker

Published: Saturday 15 May 2004

Killer disease

-- Obesity has become a worldwide concern because people in each and every nation are falling prey to it. WHO defines obesity as a body mass index (BMI) of at least 30 kg/m2 and overweight as a BMI of at least 25 kg/m2 (BMI is calculated by weight in kg divided by the square of a person's height in metre). Around one billion adults in the world are overweight and around 300 million of them are obese.

Diabetes, hypertension, cardiovascular diseases, gallbladder ailments, cancer, psycho-social problems, breathlessness, sleep disorders, asthma, arthritis, weak bones and reproductive hormone abnormalities are just some of the NCDs which are more likely to affect obese and overweight people. WHO's surveillance of risk factors (SuRF) report, which came out in 2003, says diet, lack of physical activity and obesity are common risk factors for NCDs. The World Health Report 2003 says that in all continents except Africa more people die of NCDs than communicable diseases. WHO estimates that by 2020, 73 per cent of all deaths will be caused by NCDs.

The governments of several developing countries like India claim that obesity and NCDs aren't their problems. But the fact is NCDs are increasing even in developing countries (see table: No place safe). Of the 16.6 million people who died of cardiovascular diseases (CVDs) all around the world in 2001, around 80 per cent were from low- and middle-income countries. It's feared that by 2010, CVDs would be the leading cause of death in developing counties. India, China, Indonesia, Pakistan and Brazil are among the top 10 countries affected by diabetes. At least 19.4 million Indians had diabetes in 1995 and the number rose to 31.5 million in 2000.

No place safe
Death caused by communicable and non-communicable diseases (Figures multiplied by 1,000)
Country Communicable
Non communicable
Africa 7,779 2,252
The Americas 875 4,543
Eastern Mediterranean 1,746 2,030
Europe 567 8,112
South East Asia 5,730 7,423
West Pacific 1,701 9,000
Source: Presentation by Robert Beaglehole, director, health promotion, surveillance, prevention and management of ncds, who. Presentation based on World Health Report 2003
The situation is no better in rich nations. The number of people who die because of reasons linked to obesity has doubled in Canada in 15 years. Approximately 2,79 000 people died in the European Union (EU) in 1997 due to problems caused by excess weight and obesity, says a study done by the department of preventive medicine and public health, School of Medicine, Universidad Autnoma de Madrid, Madrid.

In the US obesity has doubled in the last 20 years and now affects one in three adults (see box: Catching them young). Obesity and inactivity could soon overtake tobacco as the leading cause of preventable deaths in the US, says a study, which came out in March 2004 and was done by the country's Centers for Disease Control and Prevention. A 20-year-old obese man's life expectancy in the US is reduced by 13 years, says a study, which used data collected over three decades. A 20-year-old obese woman's life expectancy is reduced by eight years, says the same study.

Obesity is one of the key causes for a 50-per cent increase in disability rates in the US in the last two decades, says the RAND Corporation, a think tank and research group. A study by the group says obesity rates and disability cases in the US increased during this period. The number of disability cases attributed to musculoskeletal problems like chronic backache, which is linked to obesity, also grew rapidly during the period.

Paying for the fat
This massive obesity epidemic is eating up the money countries spend on healthcare, and it's also wasting their human resources. Industrialised countries could be spending 2-7 per cent of their healthcare on obesity. United Kingdom in 1998 spent 9.5 million (US $17 million) on obesity treatment and 470 million (US $ 840 million) on treating diseases caused by it, says a study done by Stephen Morris, a researcher at the economics department of London's City University. Lost earnings due to deaths attributed to obesity amounted to 830 million (US $ 1.5 billion) and lost earnings due to sickness were 1.3 billion (US $ 2.3 billion).

As many as 40,000 years of working life were lost due to the 31,000 deaths attributed in 1998 to obesity, which also cost the nation 18 million days of sickness. UK's health service directly lost half-a-billion pounds (US $ 894 million) due to the disease and 2.5 billion (US $ 4.5 billion) indirectly. If the trend persists, obesity could cost the UK 3.5 billion (US $ 6.2 billion) by 2010.

The US spends an average 6.8 per cent (US $70 billion) of its total health expenditure on obesity. USW businesses spend US $12.7 billion on expenditure attributed to obesity which includes insurance and paid sick leave.

Blame it on bad food
For all these diseases and the money spent on treating them, researches conducted all over the world blame sugar- and fat-rich food. Jim Mann, professor of human nutrition and medicine at University of Otago in New Zealand, has reviewed several studies which found that:

When people were asked to cut down intake of sugars and replace it with starchy foods such as potatoes for five months, they lost weight

When overweight people were asked to reduce fat consumption, they lost weight

People eating high-fat or high-sugar diets gained weight. The weight gain in people having high sucrose diet was double that gained by people on high fat diet

Children drinking soft drinks rich in sugars gained weight with each serving of a drink

Food and drinks rich in sugar have higher energy and lead to weight gain as compared to low energy, artificially sweetened food

Fixing sweetness
Guidelines for calories from sugar in daily diet

Limit in per cent



Netherlands 10 Health ministry 1986
Australia 12 Health department 1987
Finland 10 or less Nutrition board 1987
Poland Less than 10 National institute 1989
United Kingdom 10 Health department 1991
Sweden 10   1997
Note: TRS916 says calories from sugar should be less than 10 per cent of daily diet.
Source: Background paper prepared by WHO, February 2004.

Researchers in UK have found that children who regularly consume carbonated drinks are more likely to gain weight over a year compared with other children who drink water or fruit juice. The Bournemouth Diabetes and Endocrine Centre used 650 children aged 7-11 for the study. Half of them had their carbonated drink consumption cut by 50 per cent, which meant they could only drink about 250 millilitres per day. The rest of the children drank 0.2 glasses more per day plus about two glasses every three days. A year later the researchers weighed the children. The group that had cut their carbonated drinks down had lost weight; the percentage of overweight or obese kids in that group fell by 0.2 per cent. In the other group, however, obesity and overweight rates went up by 7.6 per cent.

There is a link between food and obesity -- research has proved. The trouble is the food industry does not accept that their products are causing harm.

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