Monday, March 30, 2009

Why are we in Dubai so fat?

It is one of the most enduring of UAE myths: the ‘Dubai stone’, where those who move to Dubai pile on the pounds due to an unhealthy diet, lack of exercise and an immersion into the service culture so beloved in the region.

While there are no statistics to back up these claims, the transitory nature of expatriates here making such assertions unreliable, there is concrete data about the poor health of UAE nationals.

In the most recent World Health Organisation (WHO) study, the UAE was ranked as the eighteenth most overweight nation in the world. If you take the South Pacific island nations off the list, the UAE comes in at number ten.

The statistics are startling: 68 percent of those 15 years and above being overweight or obese. In the same study it was calculated that 70.8 percent of UAE men over 30 years and 77.8 percent of UAE women over 30 years were at an unhealthy weight. In the Middle East, only Kuwait ranks higher in the global obesity rates. So just why are we so fat?

Moderation is clearly not a Dubai trait. This is a city where it takes 20 minutes to get through to a bank, but less than a minute to call, and order, a fast food delivery. In a city of haves and have-nots, bad dietary choices are the one common denominator: from the calorie-laden brunches that take place every Friday to the street-side stalls selling fatty, buttery food, Dubai is a city that loves to eat, and eat a lot.

And it seems a city whose rapid growth has been as pronounced on the city’s waistlines as it has on its skyline. According to Peta Picton, a nutrionist at the Dubai Physiotherapy Clinic, this growth is part of the problem. “Locals have gone from a healthy traditional diet to a western diet with more fats and sugar intake.” As the city has gotten bigger, so the option of walking has shrunk. “Unlike the west, where you can do things like walk your kids to school or to the corner store, it’s not possible with the heat and distances in Dubai.”

The WHO backs up Picton’s view, citing a shift in dietary trends and a decrease in physical activity as the main reasons for the UAE’s growing obesity problem. This is an issue that affects everyone — a 2005 study from the Ministry of Health revealing that 20 percent of children in the UAE are at risk of being overweight.

This is a real issue — and ads targeting children are commonplace in the UAE market. Ugar Sugar Works (USW), an Indian-based sugar manufacturer, has recently launched a boat-shaped sugar product — Filmu Shakkar — that the company claims can be used as “energising candies for children”. “It’s sugar in a different shape,” says Picton. She felt it was a major concern that it was being marketed at children. “As a mother myself, obviously, I wouldn’t encourage my kids to eat sugar as a snack.” Niraj Shirgaokar, USW’s vice-president justifies marketing it as candy. “It’s not only sugar, it’s got a good amount of glucose which is used for having [sic] energy.” Glucose is a form of monosaccharide (or simple sugar) and is used it as a source of energy but it is however, still sugar. “The parents have to decide how much of it to give, too much will be obviously bad because it’s sugar but it’s just like any chocolate or candy, it’s for the parents to decide the amounts” says Shirgaokar.

The role of parents is crucial, and not just in terms of filtering out questionable marketing campaigns. Dr Rajendra Joshi, a pediatrician with the Prime Healthcare Group says 20 percent of UAE children are obese and another 30 percent are at risk. He believes parents have a defining role to play in whether their children are obese or not. “The risks of obesity start during pregnancy and expectant mothers should not gain excessive weight. After delivery, children who are on a scheduled feeding of every two to three hours develop higher fat cells and tend to be overweight later in life.”

He attributes obesity to genetics, poor diet and lack of exercise. “Children born to obese parents are at double the risk of being obese. I’ve been in Dubai for more than ten years. Babies who were brought to me at that ten years ago because they weren’t gaining weight are now very overweight children,” he says.

A lack of awareness campaigns for healthy eating in the UAE the world is another contributing factor according to Picton, however the country is slowly beginning to create such initiatives. Dr Joshi feels most school cafeterias sell too much junk food to students.

A study will be carried out this spring in collaboration with the Ministry of Education and will be extended across the emirate and then nationwide in the autumn. A sample of 320 students — half male and half female — will keep food diaries recording everything they consume. The results will be utilised when forming the foundation of a national anti-obesity strategy. This is a hopeful beginning to curb obesity here.

For now, Dubai is still ignoring the health risks involved with weightgain and obesity. USW has already made deals in the UAE with Spinneys, Geant Hypermarket, United Hypermarket, Ansar Mall, Union Co-operative Society and Hyper Panda. By 2010-2011, the company expects their sugar production to exceed 20,000 tons per day. It’s a case of supply and demand — if the company can profit from such high production numbers, people are well on their way to eating themselves into a sugary grave.

Fittingly, for a city that lives the fast food life, the measures taken to offset weight gain are often equally quick. Dr Faruq Badiuddin, a consultant surgeon at Dubai’s Wellness Medical Centre performs weight loss surgeries. “Obesity is global now. The Middle East has taken over the west in terms of incidences of obesity,” he says. Out of the four surgeries offered, the most popular is laparoscopic gastric banding. A band is placed around the top portion of the stomach using laparoscopy to make the patient feel full after a small amount of food. The surgery is one and a half to two hours long. After a day in the hospital, “patients are usually up and about after about a week, doing whatever they normally do,” says Dr Faruq.

After surgery, patients are on a liquid diet for two weeks, slowly re-introducing solids. It takes about a month before they are back on regular food. An emerging favourite surgery is the Laparoscopic Sleeve Gastrectomy, otherwise known as Gastric Stapling.

Dr Faruq sees all types of people. The most common reasons patients seek his help are risk of diabetes, cardiovascular disease, hypertension, arthritis, sleep apnea, psychological problems, the socio-cultural impact of being obese and discrimination in employment opportunities. Being overweight is not just a superficial issue. In 2002, 66 percent of deaths in the UAE were related to chronic diseases. Of these, 38 percent were from cardiovascular disease and three percent from diabetes. Both of these chronic ailments are linked with overweight and obesity. A study by the American Heart Association shows that 75 percent of hypertension is directly attributed to obesity. Being on the plump side can also lead to cancers such as endometrial, breast and colon. Patients “must meet the criteria for surgery [if risk of being overweight outweigh the risks of surgery] and then they must deserve the surgery,” comments Faruq.

Services such as Dr Faruq’s look set to gain popularity in the coming years if the WHO statistics turn out to be accurate. It predicts that by 2015, 78 percent of UAE men and 81 percent of women will be overweight. It’s a bleak prediction and one that is set to become reality unless the UAE takes as much interest in its waistline as it does in its skyline.