Vector Issue 10 - 2009

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tipping the scales the ‘expansion’ of the global community Words Rhea Pserickis, Medical student, University of Tasmania www.ghn.amsa.org.au I looked up from the desk and watched as my next patient walked in through the door. She was a middle-aged obese woman and beads of sweat had formed along her forehead in spite of the cooler weather. It took her a while to shuffle in, navigate the chair and find a comfortable sitting position. I noticed her heavy breathing. This patient was presenting with back and knee pain and had come in hoping for some analgesia. As I continued the consult, I pondered how to broach the fact that her weight was probably contributing to, if not directly causing, her pain. Just another obese patient with more chronic disease. Right? Well, not quite. The disparity is that this patient wasn’t in Australia nor was she a white Caucasian. I had in fact been working at a mobile clinic in remote Western Kenya, and this was a native Kenyan; more alarming, she was not the first or last obese Kenyan I came across during my time in Africa. Once considered a problem only in wealthy countries, the number of overweight and obese individuals has escalated in low and middle income countries. As risk factors for cardiovascular disease, type 2 diabetes, stroke and other chronic diseases, the rising prevalence of overweight and obesity in less developed countries is a hallmark of the now increasingly recognised ‘global society’ (1). Furthermore, the morbidity and mortality associated with these chronic diseases are significantly higher 6 vector november 2009
Right: Influences on the energy equation in developing countries (3). Below and facing page: One can appreciate the irony in all this when you see both the malnourished and obese side by side in a Gambian hospital (2). in less developed countries due to lack of education and understanding, as well as the age-old problem of resource insufficiency. In sub-Saharan Africa case-specific mortality rates for diabetes are more than 10 times higher than in the UK (2). The WHO indicates that globally, greater than 75 percent of women over the age of 30 are now overweight (1). Estimates are similar for men. In the Pacific islands of Nauru and Tonga nine out of every 10 adults are overweight (1). Obesity is even spreading rapidly through many an African countryside, along with its bevy of chronic disease burden which is both devastating and costly (2). Indeed, the existence of obesity and malnourishment within the one community presents an unintelligible paradox (see figure 1) (3). The increase in obesity in developing nations is due to ‘a global shift in diet towards increased energy, fat, salt and sugar intake, and a trend towards decreased physical activity due to the sedentary nature of modern work and transportation, and increasing urbanisation.’ (1) The developing world is now more than ever a target of many food companies and less developed countries present the largest growth markets for soft drink producers (4). Even where the Global Financial Crisis has tainted the US and European markets, consumption of soft drinks has increased in countries as diverse as Mexico, Egypt and China, encouraged by aggressive marketing campaigns, often aimed at children and youth (4). It is estimated that by 2015, 1.5 billion individuals globally will be overweight (1). At this point, non-communicable diseases associated with the overweight and obese will surpass malnutrition as the leading cause of death in low-income communities (5). The contribution of chronic disease on the health status of the global community may paint a bleak picture, but it is our responsibility to take action to combat it. And where obesity is such a paradox to concurrent poverty, malnutrition, environmental instability and development, this responsibility becomes even more urgent. 1.Anon. The World Health Organization warns of the rising threat of heart disease and stroke as overweight and obesity rapidly increase. (Media release). Geneva: September 22 2005. Article retrieved online on September 17 2009 from, http://www.who.int/ mediacentre/news/releases/2005/pr44/en/ 2.Prentice A and Webb F. Obesity admist poverty. Int J Epidemiology. 2006; 35:24-30 3.Witkowski TH. Food Marketing and obesity in developing countries: analysis, ethics and public policy. J Macromarketing. 2007; 27(2):126-137 4.Anon. Soft drinks and obesity: global threats to diet and health. (online article). Retrieved online on September 17 2009 from, http://www.dumpsoda. org/health.pdf 5.Tanumihardjo SA, Anderson C, Kaufer-Horwitz M, Bode L, Emenaker NJ, Haqq AM, Satia JA, Silver HJ and Stadler DD. Poverty, obesity and malnutrition: an international perspective recognising the paradox. J Amer Dietetic Assoc. 2007; 107(11):1966-1972 november 2009 vector7 www.ghn.amsa.org.au
Page 1 and 2: vector The Official Student Publica
Page 3 and 4: editor’s note “ Kruthika Naraya
Page 5: Heart disease and stroke threaten d
Page 9 and 10: Many of you may recognise the paint
Page 11 and 12: Mental Health Crisis in China Words
Page 13 and 14: Stories from Cambodia Behind these
Page 15 and 16: global health network update Welcom
Page 17 and 18: Student Involvement Helping VSAP to
Page 19 and 20: This morning, with thanks to the Au

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