• 
• 
• 

Obesity, inactivity: WHO declares war

The global epidemic of diabetes, cardiovascular diseases, excess weight and obesity is responsible for 47% of the world's deaths. Deaths which quite often could be avoided. But each year, tens of millions of lives are lost, especially because of an unbalanced diet and growing inactivity. Confronted with a massacre which is projected to increase, WHO has decided to act. During its Executive Board, held last January, it proposed a draft for a Global Strategy on diet, physical activity and health to each of its Member States. A document that has now been finalised and should be endorsed by the 57th World Health Assembly, just opening now in Geneva. Catherine Le Galès-Camus is WHO's Assistant Director General. She is in charge of the Non-communicable Diseases and Mental Health Division. Thus, she works at the forefront to elaborate this project. "Our objective is to fight against the effects of unbalanced diet and inactive lifestyle, because these are risk factors for all cardiovascular diseases, cancers and diabetes." Today in the world, there are almost as many overweight people as there are underweight. And sadly, the developing nations have joined the ranks of the rich countries, overwhelmed by obesity. In urban areas, women are the most affected, Catherine Le Galès-Camus explains. "Today in India, 26% of all women between 20 and 49 years of age are overweight; in China it?s 20% and in Zimbabwe, 36%." Therefore, obesity is no longer a burden only in rich countries! Even if these have the highest concentrations of people who are overweight. France alone, for example, counts 5.3 million obese inhabitants and 14.4 million who are overweight. Impressive figures for a country with 60 million inhabitants. But the absolute record is held by the United States. Nearly 130 million Americans, or 60% of the population, are concerned by the problem. How did this happen? Everything began with a food consumption that is greater than energy consumption. French fry servings three times larger than in 1955 And the servings offered in restaurants, and especially fast-foods, have increased beyond measure. For example, in the United States, hamburger volumes have quadrupled between 1955 and 2002. Today, the French fry portions offered in fast foods are three times larger than in 1955! The same goes for candy bars, whose volume has increased 10 times in 100 years. The result is that today they are 13 times bigger than in 1908. This style of eating has spread throughout almost the entire world. So much so that all countries are affected by the inflation of servings. But this phenomenon alone cannot explain everything. As Catherine Le Galès-Camus indicates, it is the spread of the Western lifestyle which has caused the greatest damage. "This epidemic of obesity can be explained by a change in the job types, in the means of transport and also in the available food products." According to a former nutritional advisor to the American government, "the food industry uses extremely sophisticated marketing methods to incite consumers to eat more. It has thus become socially acceptable" he states "to eat anything, all day long and in larger quantities". In France, the National Association of the Food Industry (Association Nationale de l?Industrie Agro-alimentaire, ANIA) has opposed the establishment of a system that separates foods according to their nutritional qualities. According to its executives, indeed "each food, regardless of its composition, has its place in a balanced diet." In fact, the national government wished to establish maximum limits for lipid, salt and high glycemic index sugar contents in prepared foods. The glycemic index? To sum it up simply, let's say that it is a food's capacity to increase the sugar content in the blood, or the glycaemia. Therefore, this is its true influence on the biology of our body. In any event, this initiative was little liked in the food industry. Even in France, a country which as we will see, stands out because of its industries relative moderation in the current debate. Whereas, for Catherine Le Galès-Camus, "WHO's project will succeed only if all actors are moving in the same direction."So during the latest WHO Executive Board, last January, the world's food industry used all of its weight to prevent the WHO project from being presented to the World Health Assembly. Heading the lobby, the American Sugar industry. As our colleague from The Observer stated it in January, "the American Sugar Barons are barring the global fight against obesity." Of course, this position is not representative on a world-wide scale. If the American sugar industry has a certain brand of tenacity, their European counterparts are more open to negotiate. Thus, the very powerful European Confederation of the Food Industries, which represents a turnover of 600 million euros with 3 million employees. It plainly states that it is favourable to WHO's strategy. And in January, it clearly stated its determination to collaborate. Nevertheless, certain hard-liners remain. Even in France and certain ANIA companies, it is felt that it would simply not be politically correct to collaborate with the WHO. For its part, the European Union, during its Irish presidency, has expressed its desire to see the case move forward. And it is advancing? As of Monday in Geneva?s Palais des Nations, the 57th World Health Assembly will open. WHO's goal is to get its global strategy for diet, physical exercise and health adopted by its 192 Member States. On the particularly battered ground of diet, is added the problem of inactivity. In most countries, the amount of time spent in front of the television or the computer exactly parallels the progression of the number of overweight and obese persons! Americans have even invented a word to describe the victims of this phenomenon, lazing about all day in front of their television with their bag of pop-corn. Over there, they're known as Couch potatoes? Inactivity causes two million deaths each year! According to WHO, each year in the world, inactivity causes two million victims! Two million deaths due to cardiovascular diseases, diabetes and obesity. In fact, simply for lack of physical activity? Inactivity has truly become an epidemic of the modern era. Our lifestyles have changed. Television, video games, desk jobs, automobiles... All these contribute to physical passiveness. On the global scale, between 60% and 85% of all adults are not sufficiently active to maintain their health! And the industrial countries are far from being the only ones affected? Whereas, the association of a highly rich diet and a quasi-universal inactivity, cause the heads of WHO to fear for a significant increase in the number of cases of type II diabetes. But that isn't all! Because obesity during adolescence increases the risk of cancer. According to a Scottish study, an increase by 5 points of the body mass is translated by an increase in the risk of cancer mortality in adult life; 20% in men and 30% in women. Nevertheless, solutions exist. For example, according to the WHO, we should reserve at least thirty minutes per day to working out to preserve our health. Thirty minutes, there's something everyone can do? Including those who aren't sports "addicts". No need for major revolutions and draconian diets, nor for medications to avoid the problem which is posed today. Just a bit of lifestyle hygiene is sufficient and a little bit of attention to our diet, because it is perfectly feasible to eat healthy and well at the same time.