Sunday, March 17, 2013

Thailand - Experts Discuss Rising Obesity In Asia Pacific

Experts discussed the rising epidemic of obesity at the 19th Asian Pacific Congress of Cardiology in Pattaya, Thailand.

Over eating, sedentary lifestyles, cultural attitudes, and lack of prevention programs are to blame for the rising epidemic of obesity in the Asia Pacific region, say cardiovascular experts at the 19th Asian Pacific Congress of Cardiology held from February 21-24 in Pattaya, Thailand.

Overweight and obesity has quadrupled in China and societies still label people of healthy weight as poor, they said.

“In many of the countries in Asia Pacific the malnutrition problem nowadays is not undernutrition it is overnutrition, which has resulted in overweight and obesity,” said Professor Kui-Hian Sim, President Elect of the Asian Pacific Society of Cardiology.

The Asia Pacific Cohort Studies Collaboration (APCSC) found that the prevalence of overweight and obesity among 14 countries in the Asia Pacific region varied considerably by country.

The prevalence of obesity (BMI>30) in men ranged from 0.3 percent in India and 1.3 percent in Indonesia to 13.8 percent in Mongolia and 19.3 percent in Australia. In women the lowest rates were found in India (0.6 percent), China and Japan (both 3.4 percent) and the highest rates in Australia (22.2 percent) and Mongolia (24.6 percent).

“Asia Pacific has developed rapidly and technological advances mean that children now spend too much time on the internet and mobile devices so they don’t take up much physical activity,” said Sim.

“The Asian culture revolves around food as a way of showing hospitality because in the past there was a lot of famine. As a result there is a cultural perception that if you’re not fat or obese then you are not well off,” he said.

Dr. Rachel Huxley, an APCSC co-investigator, said that although the absolute prevalence of obesity in Australia was considerably higher than that of China and Japan, the relative increases in the prevalence over the last 20 years has been much greater in these two Asian countries than in Australia.

The combined prevalence of overweight and obesity increased by 46 percent in Japan from 16.7 percent in 1976-1980 to 24 percent in 2000 and by 414 percent in China from 3.7 percent in 1982 to 19 percent in 2002.

The APCSC researchers also calculated the population attributable fraction for cardiovascular disease due to overweight and obesity in these 14 countries.

Taking China as an example, despite the relatively low prevalence of overweight and obesity, it accounted for just over 3 percent of fatal coronary heart disease and 3.5 percent fatal ischemic stroke.

At the other end of the scale, overweight and obesity accounted for nearly 8 percent of coronary heart disease in Mongolia and over 9 percent in Australia. It also accounted for nearly 9 percent of ischemic stroke in Mongolia and more than 10 percent in Australia.

“Increasing ‘westernization’ of lower- and middle-income countries in the Asia Pacific region is associated with increasing gross domestic product (GDP) and the adoption of more westernized patterns of physical inactivity and diets richer in calories and fat. The influx of fast food, confectionery and soft drink companies into the region is likely to further exacerbate the obesity problem,” said Huxley.

Huxley recommended policy changes that could influence the food environment such as mandatory use of food labeling, higher taxes on high fat/energy foods, restricted advertising on fast food (especially to children), and food subsidies for fruits and vegetables.

There also needed to be a concerted effort by medical experts in tackling the obesity epidemic, said Prof. Sim.

“Very little has been done about overweight and obesity in the Asia Pacific region because it doesn’t belong to any specialty. Cardiologists focus on smoking and risk stratification while diabetologists look at blood sugar. Cardiologists need to take up the challenge of obesity in order to curb the cardiovascular epidemic,” said Sim.

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