According to the World Health Organisation, approximately 3.4 million adults die each year from obesity complications, and studies show that GCC countries are some of the most obese in the world. Ahead of Anti-Obesity Day (AOD) on November 26, Catering News ME investigates the scale of the epidemic and the phenomenon of “leanwashing”
Dr. Graham Simpson, MD is Chief Medical Officer and Founder of Intelligent Health, and he outlined the severity of the epidemic: “The problem of obesity in the Middle East is very severe, and according to the World Health Organisation, the Gulf countries have some of the highest rates of obesity in the world.”
Board certified in Internal Medicine and Emergency Medicine, today Dr. Graham writes extensively in his mission to educate the public about dietary requirements.
A study conducted by Forbes ranked the UAE number 18 on a list of the world’s fattest countries, estimating 68.3% of its citizens to be overweight; making this small country one of the top regions plagued with high obesity rates. Within the Middle East and North Africa (MENA) region, the obese account for: Egypt 71%, Saudi 69%, Oman 54%, Qatar 44%, Kuwait 43%, and Bahrain 31%.
Dr. Graham says: “This level of obesity is almost entirely attributable to diet. We eat a mainly Western diet out here, which is high in grains, sugars, and processed foods. But obesity is not the only concern. We are seeing a very high increase in non-communicable disease.”
However, most people do not realise that they may be at higher risk of developing health conditions due to being overweight or obese, as compared to a healthy person. Morbid obesity (when the Body Mass Index or BMI exceeds 35 kg/m(2)) often leads to a serious impairment on the quality of life, reduces life expectancy, and chronic diseases such as diabetes, cardiovascular diseases, and even cancer.
Ghida Sarieddine, quality and hygiene manager, Royal Catering, says: “Obesity is mainly caused by an excessive food energy intake, combined with a lack of adequate physical activity. In today’s world, fast food is cheaper the healthy food. Fast food is more easily available, and is also high in fat and sugar content.”
While obesity is influenced by many factors, such as poor diet, lack of exercise, genetics, and their interactions, overconsumption of food is the single most important factor. A recent editorial in the Journal of the American Medical Association concluded that, “Obesity results from overnutrition and the primary therapeutic target is preventing or reversing overeating. Exercise is associated with weight loss but its duration or intensity has minor effects on weight loss relative to diet.”
People who believe overeating causes obesity, and want to lose weight, will monitor and restrict their eating. In contrast, people who blame insufficient exercise will try to increase their physical activity. But, as mentioned, it is harder to control weight using exercise rather than diet. Moreover, people generally overestimate how many calories they burn while exercising, and underestimate how many calories they eat. What’s worse, we reward ourselves for exercise with an indulgent treat, and end up consuming more calories than we had burned. Exercise has many health benefits, of course. But when it comes to weight control, people who just eat less simply tend to put on less weight.
So to what extend is the food and beverage industry to blame and was is the level of their responsibility?
In an article written by Brent McFerran, assistant professor of marketing at the Beedie School of Business, Aneel Karnani, professor of strategy at the University of Michigan Ross School of Business, and Anirban Mukhopadhyay, associate professor of Marketing at the HKUST Business School, Hong Kong University of Science and Technology, and first published in the European Financial Review, F&B companies undermine the importance of dietary choices in the obesity debate – in a process that has become known as “leanwashing”.
The research suggests that roughly half the population is misinformed about poor diet being the primary cause of obesity, as a result of leanwashing by the food and beverage industry.
This conclusion was based on the analysis of four types of corporate messaging – public statements, lobbying, philanthropy, and sponsorships of sports teams and events – through which food companies disseminate messages non-directly advertising a specific product. In each case, the industry’s messaging is focused on either exercise or a “balanced” lifestyle, but almost never mentions poor diet as the cause of obesity. For example, most major sports competitions, including the Olympics, the NFL, or the Indian Premier League in cricket, has food companies as significant sponsors.
However, the three largest soda companies — Coca-Cola, PepsiCo and the Dr Pepper Snapple Group — recently pledged to cut the number of calories in their sugary drink by one-fifth, which is a welcome acknowledgement by the soda producers that their products contribute to the obesity crisis.
Yet, the leanwashing report suggests: “The more crucial issue is whether the companies will change their messaging to reflect the medical consensus that excessive calorie consumption, and not lack of exercise, is the primary cause of obesity. The marketing, public relations, and corporate social responsibility campaigns of food and beverage companies consistently overemphasise the role of exercise as the cause of obesity. Corporate messaging almost never mentions diet, despite scientific evidence that it plays the central role in human obesity. We call this systematic misrepresentation about the causes of weight gain “leanwashing”, and argue that it is one of the hidden factors leading to obesity.”
In discussing the role of the food and beverage industry in tackling obesity, Dr. Graham says: “Well it is big business and profit versus the right thing to do. If we look at what the food and beverage industry has introduced in the way of foods over the past decades, we have a real issue. The amount of sugar and chemicals put into our foods are done purely to make us eat more and more often. So the role of the food and beverage industry is, quite simply, to stop producing these harmful foods. But let us not expect this any time soon. This is very big business after all.”
Does this mean there should be more accountability from F&B producers? Dr. Graham says: “Absolutely. But we need changes in the law for this to ever become a reality, otherwise nothing will change because people will keep buying these foods if they are available. These foods are like a drug to us.
“We mass produce the unhealthy foods, and due to the chemicals they have a tremendous shelf life, which makes for easy and cheap transport and storage, etc, whereas healthy foods are natural and perishable.
“If the governments were to tax junk food and subsidise healthy food it would be a step in the right direction. But what we need is to start seeing many of these junk foods eliminated entirely from our store shelves.”
Ghida adds: “Eating healthy costs three times as much as consuming unhealthy food – and the price gap is widening, according to a study by Cambridge University. Researchers examined almost 100 popular items of food, which is defined under Government criteria as healthy or not.
“They found that 1,000 calories made up from healthy items, such as lean salmon, yoghurts and tomatoes, cost an average of$11.60 in 2012, while the same calorie intake from less healthy items, such as pizza, beef burgers, and doughnuts, could be purchased for an average of $3.87.”
And the gap is rising. Today the gap between the two 1,000 calorie baskets is now $7.73, the research found, when ten years ago it was $6.01.
Karen Hargreaves, founder of Beat Obesity UAE, a platform and community on the conversation of health, says: “The food and beverage industry must be committed to playing a part in helping to tackle obesity.
“Each company must have a strategy in place that supports reformulating their products, by reducing levels of sugar and calories in certain products; providing clear nutrition labelling, so that consumers can make informed food choices; encouraging better eating and offering greater choice to consumers, with lower calorie and calorie-free products and the promotion of healthy lifestyles; responsible marketing for all ages but especially towards children; and encouraging the wider food industry to establish global best practice.
“Nutrition must be a core part of the business strategy. Executing programmes that limit the use of ingredients causing public health concern – reducing levels of salt, trans and saturated fats, sugar and calories across products.”
Ghida agrees that the F&B industry must accept some responsibility, she says: “Yes there should be more accountability from F&B producers, but it should come more from the governments in the sense that restaurants should only be registered and approved by the government when they have some healthy options within their menu that incorporates nutrition facts as well.”
Dr. Graham adds: “There are certainly some initiatives being carried out at the government level, but we have a long way to go. But it is an important consideration, because I believe that it is government involvement that will lead to real change.”
One way the government could get involved is to tax junk food and subsidise healthy food but how would this affect their commercial and business relationships with vendors of such products?
According to research published in the British Medical Journal, fat taxes would have to increase the price of unhealthy food and drinks by as much as 20% in order to cut consumption by enough to reduce obesity and other diet-related diseases. Such levies should be accompanied by subsidies on healthy foods such as fruit and vegetables to help encourage a significant shift in dietary habits.
Radha K Valiathan, procurement manager at Jumeirah at Etihad Towers, comments: “Education on eating habit is something really needed in this world, but as education is not effecting the way its required, the best way to control or change the bad eating habit is by imposing taxes on the unhealthy food, which will lead to a reduction of unhealthy food purchases. And for sure HORECA will welcome this initiative. But if the guest still needs unhealthy food we will buy it on a higher price and sell it on a higher price too.”
Similarly, Kivanc Eralp, procurement manager La Serre, says: “I can say on behalf of La Serre that it is a great initiative. But the definition of unhealthy food is quite expansive; does it mean they will tax unhealthy ingredients or the product itself?
“If it’s the ingredients, which makes more sense, then it will have a positive effect on our supply chain since we are already sourcing mostly organic produce.
“With local organic produce, as the demand increases local farms will have more consistent product since they will be able to invest in land to meet the demand. Furthermore, with imported produce the increased demand will give consolidators more logistical options (currently the low demand pushes most consolidators to weekly or bi weekly shipments). Also, since the organic produce is more susceptible to weather conditions and do not store well over long periods of time, there will be less wastage.
“On another note it would be great if this initiative were extended towards product that is sourced from sustainable methods, such as sustainably farmed fish versus wild caught fish.”
Ghida says: “While it is unclear how such taxes could be brought in and enforced, they could help ensure that poor diet plays less of a role in future in a range of illnesses such as heart disease, type two diabetes and tooth decay, as well as obesity.
“Evidence suggests that bigger health gains result from increasing the price of a broad range of foods rather than a narrow one, and sugary drinks offer the best proof that such a move can be effective,” she adds.
Research in America found that a 35% tax on drinks sweetened with sugar sold in a canteen, which added about $0.43 to the price, led to a 26% drop in sales. “Studies have estimated that a 20% levy on such drinks in the US would cut obesity by 3.5% and that adding 17.5% to the cost of unhealthy food products in the UK could lead to 2,700 fewer deaths from heart disease,” says Ghida.
But the food industry attacked that research. “When the whole of the food industry is focused on continuing to give hard-pressed families great tasting food at an affordable price, discussion of adding 20% to food prices seems fanciful if not irresponsible,” said Terry Jones, director of communications for the Food and Drink Federation, which represents food producers and retailers. Firms were working with the Department of Health through its Public Health Responsibility Deal “to make meaningful improvements in public health through pledges in areas such as salt and calorie reduction.”
However, many countries have introduced health food levies, such as: Denmark has brought in a “fat tax”; Hungary has a “junk food tax”; France a tax on all sweetened drinks; Peru intends to add levies to junk food; and Ireland has suggested it may also introduce such taxes.
“Some argue that the fat tax puts an unfair burden on the low income families, this is where the money gained from the tax on junk food should be used to subsidise healthier food, making the sort of fruits, vegetables and healthy produce every child needs to grow available to the children who are currently losing out,” according to Karen.
She adds: “Governments, international partners, civil society, non-governmental organisations and the private sector all have vital roles to play in contributing to obesity prevention.”
Ghida says: “The government has taken up some initiatives, such as introducing activities at beaches and public parks, including running and biking paths, volleyball nets, and water sports, all meant to encourage everyone to get active.
“Experts from UNICEF have designed the year-long School Health Education Project, which will be implemented by the Abu Dhabi Health Services Company, Seha, and the health and education ministries. It aims to teach school nurses how to convince youngsters about the benefits of eating healthy food and leading an active lifestyle.
“And the Health Authority of Abu Dhabi has developed an intervention programme named WEQAYA, which aims to reduce chronic diseases by increasing public awareness to healthy food.”
Under the scheme food producers will have to prove the nutritional value of their produce in order to display the WEQAYA logo on their health food packaging.
Also, in May the Dubai Chamber of Commerce & Industry hosted a meeting organised by its Food & Beverages Manufacturing Group to encourage industry self-regulation in marketing and advertising food and beverages considered high in fat, sugar and salt (HFSS) to children, with a pledge from the International Food & Beverage Alliance (IFBA) in the GCC to not advertise HFSS products to children under 12.
What is clear is that a comprehensive approach to nutritional values need to be addressed at both the industrial and governmental levels, and soon, before the epidemic literally explodes.