According to the World Health Organisation, Malta currently has the worst obesity and overweight rates in the EU and ranks third in the whole of Europe. What will tip the scales to healthier weight? asks Ronald Cassar.

Some see obesity as the direct consequence of a rich society, with an excess of food available to everyone. Others say that obesity is a result of poverty: only those who are comfortably well off can afford healthy food, while the rest have to satisfy their hunger pains with cheap, and fattening, meals.

Obesity is not caused by one single factor – rather, it is a combination of poor diets, sedentary lifestyles and a poor knowledge of what we eat.

In much the same way, there is no single solution to the obesity crisis that Malta is suffering – according to the World Health Organisation, Malta leads the EU in the highest overweight and obesity rates, and ranks third in the whole of Europe.

Moreover, according to a study conducted as part of an anti-obesity campaign called Healthy Weight for Life, 40 per cent of all boys of secondary school age are obese – while, 15 per cent of all children are overweight.

Earlier this year, a new law and the first of its kind in Europe – the Healthy Lifestyle Promotion and Care of Non-Communicable Diseases Act – was passed unanimously in Parliament.

Robert Cutajar.Robert Cutajar.

The man behind this law is Nationalist MP Robert Cutajar, who has worked tirelessly these past years to educate the Maltese public about all the dangers of obesity.

The law was endorsed by the World Health Organisation and at EU level by the European Commissioner for Health, Vytenis Andriukaitis of Lithuania, when he was recently in Malta.

The purpose of the new law is to establish and ensure a lifelong approach favouring physical education, balanced diets and a healthy lifestyle, thus reducing the level of non-communicable diseases throughout all age groups.

In May, a study carried out in local schools showed the gravity of school-age obesity, with 40 per cent of Maltese children being overweight or obese.

Children from all State, Church and independent schools had their BMI measured during PE lessons in a world-first study. The results showed that 10,850 children are obese, almost 6,000 of them in primary schools, with the rest in secondary level.

Data also showed that 15 per cent of all children are overweight though in the case of girls in secondary schools, the rate is even higher, at 17 per cent.

The study confirmed what experts have been saying for years. A WHO report issued in April ranked children in Malta as being the most obese and overweight in more than 40 countries.

Also, a recent study by researchers at the Imperial College of London found that Malta will be the second most obese country in Europe by 2025, with 34 per cent of the population overweight. Britain will top the bill with 37.7 per cent.

This research – the largest ever obese study – found that four in 10 people will be dangerously overweight within a decade in the UK.

Researchers who carried out the study revealed that the true health impact of poor lifestyles was being masked by statins and beta-blockers, which lower blood pressure and cut cholesterol. They are being taken by millions of people across Europe.

They warned that within 10 years, so many people will be severely obese, that such drugs will stop working and surgery will be the only option to prevent disease and early deaths.

Majid Ezzati, senior author of the study from the School of Public Health at Imperial said: “This epidemic of severe obesity is too extensive to be tackled with medications such as blood pressure lowering drugs or diabetes treatments alone, or with a few extra bike lanes.

“Our research has shown that over 40 years we have transitioned from a world in which underweight prevalence was more than double that of obesity, to one in which more people are obese than underweight.”

Ezzati continued: “Obesity has reached crisis point. We need coordinated global initiatives – such as looking at the price of healthy food compared to unhealthy food, or taxing high sugar content and highly processed foods – to tackle this crisis.

“Unless we make healthy food options like fresh fruits and vegetables affordable for everyone and increase the price of unhealthy processed foods, the situation is unlikely to change.”

If you do not deal with this crisis, you are committing your country to spending vast sums of your GDP on diabetes, heart disease and cancer treatment
- Clare Gerada

Clare Gerada, a London-based general practitioner and former chairwoman of the Council of the Royal College of General Practitioners – the college’s first chairwoman for 50 years – was invited to Malta to give a keynote speech at a national conference on obesity held last year.

“Though the Maltese lead the way in many areas, unfortunately, they now lead the way in childhood obesity and we all have heard the shocking statistics around the rates of obesity among children here in Malta,” Gerada said. “If you do not deal with this crisis, you are committing your country to spending vast sums of your GDP on diabetes, heart disease and cancer treatment.

“This is not about Maltese children having puppy fat,” she added. “This is about your children being exposed to the risk of early death from cancer, diabetes, infections and suffering from psychological traumas associated with being obese. This is about children having a lifelong chronic and debilitating illnesses.”

She said that, as a general practitioner in a large inner city practice in London, she spends her days trying to help patients with obesity.

“I see babies as young as 12 months who are already overweight. Children in first grade who are obese and parents who are unable or unwilling to change their behaviour and continue to believe that being fat equates to being healthy.

“I see so many young adults in their 20s, having obesity-related illnesses. I see 35-year-old men with newly-diagnosed diabetes and point out that if they adapted their diet they could reverse their high sugars,” she said.

“Non communicable diseases will soon be your biggest problem in Malta. With the new Healthy Lifestyle Promotion and Care of Non-Communicable Diseases Act, you are helping to find a way to prevent this happening and ensuring that there is a concerted effort to stem this modern tide of disease,” Gerada says.

The law explained

The main pillars of the Healthy Lifestyle Promotion and Care of Non-Communicable Diseases Act are:

• The education and promotion of healthy lifestyles and physical activity for persons of all ages, from intrauterine life to old age.

• The type of food consumption in schools and in their proximity.

• Investment and expenditure by local councils to promote healthy lifestyles.

• Nutritional qualities of food consumed in institutions licensed by public authorities including, but not limited to, old people’s homes and day centres.

• An integrated approach for the promotion of food for healthy lifestyles.

• The regulation of marketing of products which may have adverse effects on healthy lifestyles. succeed.”

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