Reflections on the Human Condition - Api-fellowships.org

CHANGING LIFESTYLES AND HEALTH
GLOBALIZATION OF FATNESS: CULTURAL, SOCIAL, AND
ECONOMIC PERCEPTION OF OBESITY IN SOUTHEAST ASIA
Wan Abdul Manan Wan Muda
“Tell me what you eat: I will tell you what you are.”
Brillat-Savarin
INTRODUCTION
The world has experienced enormous health improvement
in the last century, particularly in its later half (1950’s
to 2000). Despite the overall improvement, however,
we have to acknowledge also that developing countries
benefited unequally from the above health gains, with
many countries continue to have high mortality rate,
where in some parts of the world the burden of ill
health in the form of infectious and parasitic diseases are
still prevalent. Communicable disease is an avoidable
disease and avoidable mortality, but due to unequal
access to healthcare and preventive remedies within a
country can lead to notable number of death as a result
of lack of access to effective treatment. The leading
causes of death in children in developing countries in
2002 are shown in Table 1.
Table 1: Leading causes of death in children in
developing countries, 2002.
Rank Cause No (,000) % of all deaths
1 Perinatal conditions 2,375 23.1
2 Lower respiratory infection 1,856 18.1
3 Diarrhoeal diseases 1,566 15.2
4 Malaria 1,098 10.7
5 Measles 551 5.4
6 Congenital abnormalities 386 3.8
7 HIV/AIDS 370 3.6
8 Pertussis 301 2.9
9 Tetanus 185 1.8
10 Protein –energy malnutrition 138 1.3
Other causes 1,437 14.0
Total 10,263 100
WHO (2003), p. 182.
The challenge of communicable diseases will still be a
major reality in developing countries until effective
prevention and treatment measures are well in place.
Apart from communicable diseases, the world is also
witnessing more than 800 million people suffering from
chronic undernutrition, hunger and food insecurity.
(Behrman, 2004) Malnutrition and communicable
diseases have a synergistic relationship. This scenario has
transformed the demographic and economic balance
between the developed and less developed countries.
The changes in food supply and distribution varies from
region to region, and between and within countries.
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Developing countries particularly those in the middle
range of GNP are currently facing a double burden of
malnutrition at both extreme end of the same continuum,
undernutrition and obesity. (Doak et al., 2004) Both
undernutrition and obesity will have wide ranging
health consequences in all age groups. Figure 1 show a
few selected developing countries with the double
burden of malnutrition. As shown in Figure 1, many
countries in Central and Latin America are showing
prevalence of overweight above 30 % of their population,
particularly in Colombia, Chile, Peru, Brazil, Costa
Rica, and Cuba. The graph also depicts an increase
trend between underweight and overweight in most
countries in Latin America and Africa. This problem is
not only confining to Latin America or Africa, but is
also a common trend in Southeast Asia.
Figure 1: Underweight and overweight in selected
developing countries.
Despite gloomy conditions in terms of global health,
the world will at the same time see rapid growth of cities
and income in the near future. In 1900 only 10% of the
world’s population lived in cities, however, today the
proportion has increased to nearly 50%. (FAO, 2005)
Ref lections on the Human Condition: Change, Conflict and Modernity
The Work of the 2004/2005 API Fellows