| Health: BIG AIN’T BAD |
But fat not mass is bad for health: Pacific expert
Samisoni Pareti
Pacific islanders are the world’s fattest, so Forbes magazine reported last month. Nauru topped the chart with—using recent estimates by the World Health Organisation—Forbes said 94.5% of Nauruans were overweight.
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Going to church in Nauru... Nauruans are overweight according to the World Health Organisation.
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In fact, the magazine said the first five positions of the world’s fattest are all from the Pacific, namely the Federated States of Micronesia, Cook Islands, Tonga and Niue. Other islands featured quite highly on the list as well. Samoa was listed at 7th, Palau 8th, Kiribati 10th, Vanuatu 47th, Tuvalu 55th, Fiji 68th, Marshall Islands 105th, Solomon Islands 115th and Papua New Guinea 145th.
Forbes went on to quote experts as blaming the “western ways of life” as the cause of obesity.
“Due to urbanisation, more people are living in more dense environments in cities where they are removed from traditional food sources and dependent on an industrial food supply,” Neville Rigby, director of policy and public affairs for the International Association for the Study of Obesity told Forbes.
“Obesity has become a problem of poverty,” the magazine quoted Daniel Epstein of the WHO Regional Office of the Americas.
“Poor people have an easier time of eating junk food.
“People fill up on things that have a high caloric value but little nutritional value.”
Tongan medical doctor Viliami Puloka could not disagree with the statistics quoted by Forbes magazine. As the physical activity adviser of the Noumea-based Secretariat of the Pacific Community, Puloka said obesity was indeed a big problem in the islands.
“I don’t think we should complain about the article by Forbes.
“Because it is true, overweight is a big problem in the Pacific.
“It is a growing problem.
“A lot more people now are unhealthy, related to the fact that people are overweight and obsese.”
Like the experts quoted by Forbes, Puloka agreed that changing lifestyles including diet is a major cause of obesity in the Pacific.
However, in saying that, the Tongan-born medical doctor believes islanders ought not to be blamed entirely for the lifestyle change. Economic development including economic capabilities and other important factors also impinge on the lifestyle islanders choose, Puloka argued.
“In many cases, the individual person really does not have the ability to control the environment or the circumstances that he or she lives in.
“Therefore, in addition to lifestyle is the environmental factor, this could be physical, social, could be political.
“Sometimes the individual person may want to have a good lifestyle but because the only thing he can afford is fatty food, sweet food, junk food, there is not much choice.
“Before, we didn’t even have to think twice about exercise because we walk everywhere and we do a lot of manual work in our daily lives.
“Now, it’s very different. It even looks rather silly to walk along the road but not only that, you could be hit by the high number of vehicles that use the road.”
All these factors ought to be borne in mind when islands governments consider a strategy against obesity.
The matter of taxation ought to be included as well, Puloka said as healthy foods need to be made available at affordable costs.
Making a healthy choice should be an easy choice is the catchword, said the SPC expert.
Puloka said the Forbes story however excluded two critical issues. One was that being big is not necessarily bad.
Overweight and obesity are currently determined through the BM—body mass index—which is determined through a person’s weight divided by his/her height squared. An index of 25 or more is classified as overweight and 30 or more is obesity.
“There is a good reason to believe that people in the Pacific are heavier, they have a heavy body mass like all the rugby players.
“I think if you apply this criteria to them, all of them will be overweight or obese because of the muscles. Muscles are heavier than fat.
“You see being big is not the problem, being fat is the problem.
“I think a much better indicator for health is the weight circumference, the size of your trousers or your dress.
“There is a more direct correlation between the amount of internal fat because it’s internal fat that contributes to unhealthiness as far as heart diseases and other NCDs are concerned. So being big is not the problem.”
The other issue is the ‘game’ about numbers, especially in determining the percentage of obesity worldwide.
Puloka said Nauruans might be the world’s fattest, but their number of overweight people is insignificant when seen in the context of the 1.6 billion adults estimated to be overweight worldwide.
“I think in the same Forbes article, it refers to China and India as having the most diabetic patients in the world.
“But because of their high population, the number actually reflects only a very small percentage, whereas the opposite is true for us in the Pacific.
“Niue, for instance, is in the top 5. But I think there’s only 1500 people in Niue so if you have even 10 fat people, you know it really reflects in the numbers.
“For most islands in the Pacific, that really is what it’s all about."
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