The Spread of Obesity in Developing Countries
BY LISA PAWLOSKI
Obesity is increasingly becoming an epidemic in industrialized nations, particularly in the United States, where one out of every three adults is obese. We are not alone in this emerging public health crisis. In Europe, rates of obesity among adults are as high as 25 percent in the United Kingdom and Germany, and 10 percent in Italy and France. Much of the blame in the developed world is laid on more time watching television, increased portion sizes, and the proliferation of cheap fast food restaurants, all of which contribute to a toxic food environment.
Ironically, while many underdeveloped regions of the world are focused on issues related to poor nutrient intake, many poor countries are also facing an emergence in overnutrition.1 One region of the world that is now seeing an emergence in obesity is Southeast Asia, particularly Thailand, due to dramatically improved social and economic transitions.2 Kosulwat has reported many improved demographic trends over the last three decades in Thailand, including increases in life expectancy and decreases in infant mortality.3 Further, Harnroongroj et al. have reported that obese Thais are at risk for some micronutrient deficiencies, including riboflavin and Vitamin C.4
Last summer, I examined the issue of obesity among adolescent girls in a periurban community approximately 25 miles north of Bangkok. This area is surrounded by large rice fields and dilapidated shacks. However, in the past five years, huge modern superstores, such as Carrefour, have also sprouted up among these poor rural farms. Data from 300 girls attending primary and middle schools revealed that 16 percent were overweight. The prevalence of overweight was higher among primary school girls compared to middle school girls.
In this community, parents reported that fewer children are walking to school because the roads are unsafe and there are no sidewalks. Parents are making more money, and therefore, they can afford to drive their children to school. Children also have an endless supply of availability to food. Food venders set up shop across the street from the school and sell high-calorie fried and sweet snacks. And with a 7-Eleven on every corner selling cheap, low nutrient-dense snacks, students have a hard time avoiding these delicious temptations. Further, most families have an air conditioner in their home, discouraging children from playing outside in the hot and humid climate.
The Thai government has recently developed initiatives to prevent chronic illnesses in that country. Such initiatives include the development of health promotion centers where local communities can benefit from gym rooms. However, these initiatives are lacking efforts focused on children and adolescents, much like in the United States. Prevention of obesity during childhood is critical, because these early eating habits set the stage for future eating behaviors.
Lessons can also be learned from policies developed from the government of Singapore and within the European Union, which have established policies to encourage children to maintain a healthy weight and reduce unhealthy snacking during school.
Overnutrition continues to grow throughout the world. As humans, we have adapted to efficiently store fat to survive through severe famines. However, as improved economic transitions occur, food becomes more readily available and more cheaply processed. Globalization has been defined as “the process whereby increasing economic, political, and social interdependence and global integration take place in terms of capital, traded goods, persons, concepts, images and ideas.”5 Some have suggested that globalization may lead to the homogenization of diets that include more animal fats. These changes have significant impacts on health, including reducing micronutrient and phytonutrient intakes found to be important in reducing risk for chronic illnesses. Thus, we, as an international community, must examine the issues related to obesity as a global concern. Further, emphasis needs to be placed on the impact of obesity among children so that chronic illnesses such as diabetes and heart disease do not become global juvenile epidemics.
Lisa Pawloski (lpawlosk@gmu.edu) is assistant professor of nursing at George Mason University (cnhs.gmu.edu/).
- Patricia Aguirre, “Socioanthropological Aspects of Obesity in Poverty,”Obesity and Poverty: A New Public Health Challenge. Pan American Health Organization, WHO. 2000. [↩]
- V. Kosulwat, “The Nutrition and Health Transition in Thailand,” Public Health Nutrition. 5(1A):183-189, 2002. [↩]
- Ibid, supra note 2). However, these transitions have also brought increases in obesity that are believed to be due to higher intakes of meat and processed foods. Sakamoto et al. reported that the prevalence of obesity among preschoolers living in the Saraburi Province to be 22.7 percent among the urban sample and 7.4 percent among the rural sample. ((N. Sakamoto, S. Wansorn, K. Tontisirin, E. Marui, “A Social Epidemiologic Study of Obesity among Preschool Children in Thailand,” International Journal of Obesity and Related Metabolic Disorders: Journal of the International Association for the Study of Obesity. 25(3):389-394, 2001. [↩]
- T. Harnroongroj, P. Jintaridhi, N. Vudhivai, P. Pongpaew, R. Tungtrongchitr, B. Phonrat, S. Changbumrung, F.P. Schelp, “B Vitamins, Vitamin C and Hematological Measurements in Overweight and Obese Thais in Bangkok,” Journal of the Medical Association of Thailand. 85(1):17-25, 2002. [↩]
- Globalization, Diets, and Noncommunicable Diseases. WHO, Geneva Switzerland, 2002. [↩]
