13 April 2014

Rwanda: Paradox Shift Sees More Obese Poor Than the Rich

He sways his body mass into Planet Club at Kigali Business Centre. He sways because he cannot in the true sense of the word just walk, but drags his feet around and sways his body in a movement posture.

The doors in the club are understandably expansive but he fills it all, turning sideways to let himself in. His trouser alone could make a sizable tent if the material were turned to such a use. But Mr X is jovial. He is a regular patron and goes around bumping fists in greeting gesture with other patrons.

He is obese.

There was a time obesity was considered for the rich. It was mainly in the developed countries. Then, nearly 80 per cent of obese people were in the Western world. Not anymore. Today, the shift has been so paradoxical that developing countries have the biggest percentage of obesity estimates in the world, new studies show.

A report from the Overseas Development Institute says the number of overweight and obese adults in developing countries increased from 250 million to 904 million between 1980 and 2008.

Future Diets, an analysis of public data about what the world eats, says there are almost twice as many obese people in poor countries as in rich ones.

In 2008, the figures were 904 million in developing countries, where most of the world's people live, compared with 557 million in industrialised nations.

Dr Rachna Pande, a specialist in internal medicine at Ruhengeri Hospital, says the shift in state of affairs is attributed to change in lifestyle among people in developing countries, with increasing affluence such as taking foods with more sugar and fats, lack of exercise or even walking, and sedentary lifestyles like sitting for long.

Other factors behind the increase in obesity include rising incomes and urbanisation, which tend to lead to diets rich in animal produce, fat, salt and sugar; and the various influences of globalisation, including advertising.

"Whereas in developed countries people are aware of risks of obesity, hence try to avoid it by proper diets and regular physical exercises, people in developing countries are still at large ignorant about it," Dr Pande says.

Tackling the nightmare:

Also considered a lifestyle disease, obesity disease increases risk of atherosclerosis, that is, increase in fat deposited in inner layers of blood vessels thus reducing blood supply to heart and vital organs, which increases risk of high blood pressure and heart problems.

Dr Pande says one can be considered obese when their body mass index (BMI) is more than 25 or waist hip ratio more than 0.85 in women and more than 0.90 in men.

"Central obesity leads to increase in resistance to insulin produced in body, which increases risk of diabetes, high blood pressure, high lipid levels and heart problems (metabolic syndrome)," she adds.

Rwanda Biomedical Centre (RBC) is sensitising people to do physical exercises, as well as to value to essence of a healthy diet.

"We don't have statistics of the number of obese people in the country, but we know that we have such kind of people. We are trying to avoid obesity in our country," says Dr Marie Aime Muhimpundu, the director of Outbreak Response and Preparedness Unit in RBC.

"To fight obesity, government has put time of sport for every Friday, there is also a campaign against malnutrition. Other efforts to scale up nutrition include One-Cow-Per-Family initiative, the construction of vegetables gardens (Akarima k'igikoni), One-Cup-of-Milk-Per-Child, and terracing to improve agricultural production."

Christian Mazimpaka, a student of University of Rwanda who has published a research on obesity in the country, says the disease is caused by increase of beverages and food from industries in public service venue, fear of losing weight, insufficient physical education in school and lack of education.

Francois Ngamije, the director of SOS Obesity, an association of obese people in Kigali, says it will require concerted efforts from all stakeholders to ensure that families understand the importance of having healthy diet aas well as good lifestyle.

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