Former Head, Nutrition and Dietetics Unit-now Department of Nutrition
and Dietetics, Federal Polytechnic, Bauchi, and member, American
Society for Nutrition, Nutrition Society of Nigeria and reviewer for the
Nigerian Journal of Nutritional Sciences, Mrs. Mercy Sosanya, talks
about obesity and diet plans for weight loss, in this interview with MOTUNRAYO JOEL
What is obesity?
In simple terms, overweight and obesity are defined as abnormal or
excessive fat accumulation that may impair one’s health. In other words,
overweight and obesity are defined as ranges of weights that are
greater than what is generally considered healthy for a given height and
that have been shown to increase the likelihood of certain diseases and
other health problems.
Technically, overweight is defined as a body weight that exceeds the
acceptable weight for a particular person, based on the individual’s
age, height and /or frame size. Overweight translates to having a Body
Mass Index of 25-25.9Kg/m2, where BMI = Weight divided by height2 i.e.
weight (Kg)/height2 (m). Obesity is defined as a BMI = 30Kg/m2.
What are its health consequences?
Obesity is one of the risk factors for many non-communicable and chronic
diseases. However, some of the health consequences include;
hypertension (high blood pressure) due to a build-up of fat and other
lipids around the heart and within the walls of blood vessels, coronary
heart disease, type 2 diabetes, cancers of the endometrium, breast and
colon, stroke, liver and gall bladder diseases, sleep apnea and
respiratory problems, osteoarthritis, dyslipidemia, gyneacological
problems such as infertility, post-menopausal problems, economic and
psychosocial consequences and premature death.
Can one be obese and still be healthy?
There has been a strong debate in the international medical community as
to whether to classify obesity as a disease or not. In June this year,
the American Medical Association, one of the reputable authorities in
medicine, voted decisively to officially classify obesity as a disease.
Therefore it is now officially recognised as such in the US. In the
light of this, it is not possible to be obese and healthy, since obesity
is now being seen as a disease.
However, it is possible to be obese and not experience symptoms of other
associated maladies in the short term, but this absence of overt
symptoms cannot be regarded as being healthy, because ‘health’, as
defined by the World Health Organisation, is “not just the absence of
disease, but a state of complete physical, mental and social
well-being.” And, since obesity is linked to chronic non-communicable
diseases, which develop over time, decades at times, I would rather say
whatever apparent “health” an obese person is experiencing is very
likely to be short-lived.
What nutritional programme do you recommend to check obesity?
My panacea for obesity is two-fold; Healthy eating in terms of food
quality and quantity and regular exercise. Dietary counselling for
individuals and groups on how to make healthy food choices, such as,
what kind of foods to consume liberally and what kind of foods to avoid
or reduce is important. Calculating Body Mass Index, body fat
composition and to calculate the required food energy intake level that
can help reduce body weight to the desired level is also crucial. Menu
planning and simple exercise regimens that can help people lose weight
or maintain healthy weight within their normal work/daily schedules will
go a long way. People should also know facts about their diets to
prevent misinformation.
What nutritional mistake can lead to obesity?
Anything that makes people’s energy higher than their energy output is
wrong. When food energy intake (from carbohydrates, fats and proteins)
is higher than the energy being utilised for basal metabolism, thermic
effect of food and physical activity, the excess energy gets stored up
in an individual’s adipose tissues as fat. This fat, when accumulated
around the abdomen, can cause insulin resistance, leading to abnormal
glucose metabolism (diabetes). When it is accumulated around the
internal walls of blood vessels and arteries, it can lead to heart
diseases.
Excessive body fat influences the levels of a number of hormones and
growth factors such as Insulin-like growth factor, Insulin and Leptin,
which become elevated and this can promote the growth of cancer cells in
the colon, rectum, prostate, endometrium and the breast.
How can children be prevented from becoming obese?
Parents, schools and the media should encourage children to develop
healthy food habits – reduction in the intake of junk food (such as
highly processed drinks and foods, high-fat foods and fast foods),
reduction in the intake of sugar and sweetened foods and drinks,
increase in the consumption of whole fruits, vegetables and milk in
preference to refined juices, more fish in preference to more meat
(especially red meat) and ensuring that whole cereals, legumes and
grains form the bulk of their diets. Remember a colourful plate (full of
fruits and vegetables) is a nourishing/healthy plate.
Children should also be encouraged to take part in physical activities
like outdoor play/ exercise in schools and homes. Also, local, state and
the federal governments should include safe bicycle paths in their road
development plans so that more children can increase their physical
activities through cycling. Governments can also stimulate increase in
physical activities through the provision of public exercise/ sporting
facilities that are affordable and sited for easy access by many.
Television viewing time and time spent using mobile devices should be
regulated by parents to discourage completely sedentary lifestyles by
children. Parents should give their children room to breathe fresh air
and more.
Is there increasing awareness about it?
Actually, many more people are becoming aware of the health risks of
obesity, but it is alarming to note that obesity is on the increase in
Nigeria due to the changes in the diet and lifestyle of the citizenry
(as stated in the National Policy on Food and Nutrition in Nigeria).
We are actually experiencing a “Nutrition transition,” which is a shift
away from traditional diets based on whole cereals grains and
vegetables, towards refined diets high in saturated fats and sugars.
This shift is associated with changes in our lifestyles- more hours at
work, less time to cook, dependence on fast food and snack joints for
meals, western influences, etc. This nutrition transition has led to a
double burden of malnutrition- ‘under-nutrition’ (insufficient intake of
nutrients) and over-nutrition (excessive intake of energy nutrients)
co-existing side-by-side. Among the low and middle income socio-economic
classes, food quantity is valued above food quality.
The more affordable food are dense in energy and very low in other
nutrients, contributing to an upward spiral of obesity in this group.
Furthermore, the nutrient-rich foods such as whole grains, fruits and
vegetables are either highly perishable or too costly, hence they are
above the reach of many. Despite the fact that individual awareness is
increasing and that there are some spurious actions being taken in some
quarters (e.g. changing school meal plans, etc) to prevent/reduce
obesity, its prevalence is still rising steadily. More concerted efforts
need to be put in place to tackle this hydra-headed monster.
What is the greatest health risk of obesity?
Obese persons risk developing chronic, non-communicable diseases, associated morbidities and premature death.
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