Reducing obesity, COVID-19 deaths

*90% of global COVID-19 deaths occurred in countries with a 50% obese population, says WHO
*NHF advocates taxing of sugary drinks, strengthening nutrition labelling regulations

Experts have charged government, non-governmental organisations (NGOs), sports organisations, health and education authorities to develop policies of building environments supportive of healthy and active living towards the reduction of obesity and avoidable COVID-19 deaths.

They gave the charge while raising the alarm of the deadly health risks posed by the rise in obesity at the maiden edition of World Obesity Day commemorated in Nigeria on March 4, 2021, with the theme: “Everybody needs everybody.”

Speaking at a media conference, the Chairman, Nigerian Heart Foundation (NHF), Nutrition Committee, Prof. Tola Atinmo, pointed that doctors, policymakers and others do not fully understand the causes of obesity, which are often a complex mixture of lifestyle, genetic, psychological, socio-cultural, economic and environmental factors, as those with the disease are regularly stigmatised.

Obesity linked with higher risk for COVID-19 complications CREDIT: https://thewell.unc.edu<br />

“The nutritional transition developing countries are experiencing a shift from traditional types of diet to Western diets, such as high fat, sugar and low fibre, as well as less involvement in active transportation, physical and sedentary activity,” he said.

Atinmo said the outbreak of COVID-19 is a testimony that many aspects of people’s health are determined by the socio-economic environment, adding that the pandemic has highlighted the elevated risks with no barrier globally, hence the need to advocate and promote a healthy lifestyle from an early age to help prevent obesity and overweight in children.

He added that the policy of inculcating physical activities in every school curriculum is a good way of teaching healthy living habits that would be carried to adulthood, thereby preventing obesity and its consequences.

“There is a lot we can do to make a difference and this includes: restricting the marketing to children of food and drinks high in fat, sugar and salt; taxing sugary drinks and providing better access to affordable, healthy foods in our cities and towns.

“We need to make space for safe walking, cycling and recreation. We must teach our children healthy habits from an early age,” Atinmo said.

On her part, the Coordinator of Passion for Healthy Kids Initiative (PHKI), Mrs. Edirin Metseagharun, said this year’s World Obesity Day is a great opportunity to focus on the challenges of obesity, as there is a rise in the percentage of obese children, particularly amongst children of the affluent.

She observed that one major factor contributing to the increase in obesity among children is the gradual reduction in the time allocated for physical activities in schools, as many schools now use their recess times for extra studies.

Metseagharun also lamented the lack of sports facilities as another challenge, adding that the inactivity of children was made worse with the COVID-19 pandemic that necessitated a lockdown that made everyone stayed indoors for months.

She suggested that the only way to beat this disease and save the future generation is to encourage the children to eat healthily and be active.

She further called for an increase in advocacy to get the government and well-meaning Nigerians to invest more in facilities for physical activities in schools, while not losing sight of the importance of good nutrition.

The Director, Scientific Affairs, Nigerian Heart Foundation, Prof. Adebayo Adeyemi, in his address titled: “Obesity: Fighting a Global Pandemic through a Multidimensional Approach,” said the complications of the global increase in the incidence of obesity among adults and children are immense, as it includes heart disease and strokes, types 2 diabetes, certain cancers, digestive problems and severe COVID-19 symptoms.

This, he said, should call for concern on means of reducing this trend, bearing in mind the health implications in a country with increasing population growth and urbanisation, without corresponding improvements in the health care delivery system as witnessed with the current COVID-19 pandemic.

Adeyemi said it is therefore imperative to put in place, a roadmap at addressing the pandemic, noting that failing to do so will put our health care systems and the lives of Nigerians in jeopardy.

The Director lamented that Nigeria is blessed with many varieties of fruits and vegetables, but unfortunately, production, consumption, processing and utilisation of these highly economical crops have been on the low level, more especially fruits.

He said fruits have not been accorded the importance they deserve in Nigerian diets, but they are sources of highly cherished nutrients like minerals, vitamins, energy, due to sugars and some proportions of carbohydrates and fibre.

Adeyemi said in addressing the global obesity pandemic, there is a need for a change in dietary pattern and habits that encourage increased consumption of fruits, vegetables with less starchy, high sugar, unhealthy fats, and highly processed foods.

He said it is only then that any other therapeutic approach in preventing obesity would be effective.

Also speaking, the Director, Exercise is Medicine, Nigeria National Centre, Prof. Fatal Adeniyi, noted that physical activity and exercise play key roles in the prevention and control of overweight and obesity, adding that deliberate efforts should be made by individuals, government and other agencies to curtail the disease.

Adeniyi who is also the Director of Physical Activity, Nigerian Heart Foundation, stated that a robust collaboration among primary care physicians, physiotherapists and other exercise professionals on care of people with obesity is a panacea to controlling the disorder.

Adeniyi, who is also the Deputy Provost, College of Medicine, University of Ibadan, further called for strict implementation of existing policies and enactment of others that are related to the prevention and control of overweight and obesity.

He, however, added that in the forefront would be policies to enhance active commuting, built environment and active workplace.

The Chief Executive officer, Consumer Advocacy for Food Safety and Nutrition Initiative (CAFSANI), Prof. Olugbenga Ogunmoyela, said while Nigeria faces a significant nutrition challenge, which poses a potential danger to the population, with growing incidences of communicable and non-communicable diseases, there is, therefore, need for increased awareness on improved diet patterns/habits and the risks associated with obesity.

He said preventive programmes should be targeted more at children, particularly those from urban affluent families, as well as increased nutrition education, awareness and public enlightenment activities.

Ogunmoyela also advocated increased knowledge about nutrition labelling facts and adoption of Front-of-Pack labelling by industries, as software for producing nutrition labels is available now.

He added that industries must be sincere and truthful about nutrition claims; hence nutrition-labelling regulations need to be strengthened.

He further called for promoting and encouraging home gardens for the planting of fruits and vegetables to increase access for the poor.

Ogunmoyela, however, stressed the need for the implementation of public health and workplace policies that promote active living and a healthy lifestyle.

Also, a new United States (U.S.) Centres for Disease Control and Prevention (CDC) data revealed Americans who are overweight or obese makeup more than 73 percent of those who die of the virus.

People who were obese made up nearly half of all fatalities among hospitalized coronavirus patients logged in the new report.

Those figures align with the overall rates of unhealthy weights in the US. About 74 percent of Americans are overweight, including nearly 43 percent who are obese.

It comes after a World Health Organization (WHO) report revealed that 90 percent of global COVID-19 deaths have occurred in countries where half the population is obese, and yet another study showed that two-thirds of hospitalizations for coronavirus were attributable to one of four conditions, including obesity.

As found by the WHO report last week, obesity was the second most significant predictor of who would be hospitalised or die of coronavirus, behind only old age.

Being overweight or obese means existing at a higher baseline level of inflammation, so the effects of the virus are compounded.

Research by the World Obesity Federation found COVID-19 deaths have been 10 times higher in countries where over half of adults are overweight, and they have accounted for a staggering 90 per cent of global deaths.

The WHO warned the finding was a ‘wake-up call’ for the West, where sedentary jobs and processed foods mean being overweight has become the norm for the majority of adults.

The report, which compared countries’ obesity rates and COVID-19 death tolls, found that the COVID-19 death rate was 10 times higher in countries where 50 per cent or more of the population is overweight.

It saw that 2.2million of the world’s 2.5million deaths so far had happened in countries with these high obesity rates.

“Increased body weight is the second greatest predictor of hospitalization and a high risk of death for people suffering from COVID-19,” the report said.

A recent Tufts University study estimated that about two-thirds of US COVID-19 hospitalisations were attributable to four chronic conditions: obesity, diabetes, heart disease and high blood pressure.

Obesity raises risks of the other three conditions as well, and complications from all three can be lessened with healthy diets and exercise.

And countries where healthy lifestyles are more common – and where governments have prioritized initiatives to encourage them – have fared better against COVID-19.

Meanwhile, a recent review finds that self-monitoring of diet, exercise levels, and weight using digital health tools could be helpful, in the short term, for people with obesity who are trying to lose weight.

The participants most commonly used websites used to track weight-loss interventions. However, there was higher engagement among people using passive technology, such as wearable devices and e-scales.

Tracking weight loss interventions over short periods of time seems to be more effective than tracking them long term. This is due to reductions in engagement with recording over time.

While the world grapples with the COVID-19 pandemic, the ongoing obesity epidemic takes at least 2.8 million lives each year. The Centers for Disease Control and Prevention (CDC) report that the prevalence of obesity increased from 30.5 per cent in 1999–2000 to 42.4 per cent in 2017–2018.

People who have overweight or obesity can reduce their overall mortality risk by losing weight. Weight loss also lowers the risk of cancer, metabolic syndrome, and other conditions. A 2018 CDC report found that in 2013–2016, 66.7 per cent of adults with obesity attempted to lose weight.

Various psychological and biological factors influence weight loss.

A 2019 study in the journal BMC Public Health suggests that people with obesity were more successful in losing weight when they reported being personally motivated to lose weight after receiving a diagnosis of obesity and when their doctors acknowledged their past efforts to lose weight.

Managing realistic expectations is also necessary for losing weight. According to one 2018 study, realistic goals of five–10 per cent weight loss differed from a person’s ideal weight. The authors suggest that people with severe and morbid obesity were at higher risk of creating these unrealistic goals of over 10 per cent weight loss.

There are also biological reasons behind not losing weight. A study covered by Medical News Today in 2017 suggests that faulty signals in the brain could promote obesity by reducing the amount of fat burned after eating.

Mental health concerns may also worsen attempts at losing weight. A 2018 study suggests that stress decreased motivation to exercise and increased cravings and overall weight gain. A small study, also from 2018, suggests that managing stress levels helped with weight loss and decreased the participants’ body mass index (BMI).

Although losing weight can be difficult, it is not impossible. In a recent paper, researchers showcase evidence suggesting that digital technologies are effective in managing weight loss.

The review appeared in the journal Obesity, which is the Obesity Society’s flagship journal. Michele L. Patel, Ph.D. — from the Stanford Prevention Research Center at the Stanford University School of Medicine in California — is the first and corresponding author of the review.