Obesity in Malta

Last updated

Obesity in Malta is a contemporary health issue. This problem is connected to several other illnesses and economic costs for the government. The causes for Malta's obesity are various and one of the leading aspects is physical inactivity.

Contents

Malta's authorities declare that obesity is one of the major preventable causes of other illnesses and finally, leading to an earlier death. In 2014, with the publication of the Eurostat statistics, Malta's obesity problem caught the national, as well as international attention intensively. In the same year, Malta's Parliamentary Secretary for Health, Chris Fearne, announced that the government is committed to tackle the prevailing obesity problem in Malta. [1]

Malta appears to be the most obese country within the European Union - according to Eurostat and the World Health Organization. [2] [3]

With 26% - meaning one out of four adults - being obese, Malta is far ahead on the obesity scale, comparable to other EU countries. [3] For children, the situation is worse in Malta, as 40% of all children are obese there. The prevalence of obesity has increased from 23% in 2002 to 25% in 2015. [4]

In general, Eurostat bases its obesity observation on a BMI calculation. In regard to this method, the definition of obesity is that a person needs to have a higher BMI of 30 in order to be categorized as obese. [5]

Important findings of the Eurostat statistics included the systematic difference between men and women concerning the obesity level. The proportion of men being obese, with 28.1%, was much higher than that of women in Malta, with 23.9%. [3] The age also plays an important role in Malta's obesity problem. Whereas only one young adult person out of 10 is considered to be obese in Malta (12%), one out of three older persons in Malta (33.6%) is categorized as obese. [3]

Education plays a certain role in Malta's obesity problem. In almost every EU member state, the share of obesity decreases with education level. 30.3% of Malta's obese population come from a low education level, and only 15.8% of people with a high education level were being classified as obese. [3]

Effects

Obesity tends to lead to a number of non-communicable diseases and impacts individuals through a lower quality and length of life. The mental effects of obesity should not be ignored either: depression, discrimination and lower educational attainment are psychological aspects related to the physical negative consequences. [4] Regarding the subsequent illnesses of obesity, the chances of being affected by diabetes type two, high blood pressure, heart diseases, a stroke, as well as some forms of cancer are way higher. [6] Furthermore, there exists evidence that obesity and mortality risks are positively related. [7] Malta, contradictory to this statement, has one of the highest life expectancies within Europe. [8] Its life expectancy at birth was 81.9 years in 2015 and therefore above the EU average of 80.6 years. [9] Nevertheless, cardiovascular diseases remain the leading cause in Malta for men and women. Additionally, death rates from ischaemic heart disease in Malta remain above the EU average, but have shown a relatively consistent downward trend. More than a quarter of all deaths from ischaemic heart disease were premature, occurring in people aged under 75. [9]

Costs for the Government

But not only the health and quality of life of individuals is negatively influenced by obesity, but the costs associated with obesity are also weighing on the shoulders of several stakeholders, inter alia the government and the society at large. Based on the 2015 EHIS results, the cost of obesity in Malta has been estimated at 36.3 million euro. 23.8 million euros are thereby direct costs, divided into primary care, specialist care, hospital care, cost of allied healthcare professionals, pharmaceutical care, weight loss interventions and public interventions. The indirect costs, amounted to 12.5 million euro, consist of absenteeism, presenteeism, government subsidies, forgone earnings and forgone taxes. [4] Different scholars point out a figure of 23.7 million euro for overweight and obesity in Malta, including herewith hospital costs and the cost of visits to general practitioners and specialists. [10] Furthermore, the inability to stop the growing levels of obesity will probably result in a loss up to 90,000 hours of work for Malta due to the connected health complications. Besides, it is also estimated that, if the rising percentages of obesity will not be stopped, the costs of obesity will rise to 41.4 million euro which is equal to 110 euro per capita. In the long term, the figure could even rise to 46.5 million euros by 2050. [11]

Physical Inactivity

For decades, Malta has been sheltered from the influence of other cultures, but with its entry into the European Union and the growing globalization, Malta became easier to access. This aspect, in turn, led to more trade relations, enhancing its tourism and economic opportunities. Moreover, its culture and lifestyle were equally influenced. It is argued that it is exactly this change of Malta's traditional Mediterranean diet to a high-fat and high-sugar fast food nutrition which is favored by many Western European countries and the United States. [12] When regarding the causes of obesity in general, the major reasons for weight gains include diminished physical activity, high-fat diets and inadequate adjustments of energy intakes. [13] [14] On the one hand, it is Malta's extremely westernized diet - which the Mediterranean genes cannot adopt to quickly. [15] On the other hand, it is Malta's lack of physical activity, affecting its obesity rate.

Taking the aspect of physical activity more detailed into account, there can be different layers identified for impacting the physical activity of a country. There exist natural,- built,- and social environment factors, as well as individual determinants. [16]

One factor influencing Malta's physical inactivity plays its built environment, meaning its urban design and its infrastructure. Infrastructure which is designed to encourage physical activity, such as the construction of bike lanes, diminishes obesity. [17] Malta has the highest motorisation rate among any region from one of the Member States that joined the EU in 2004 or more recently. Following this argument, its motorisation rate consisted of 592 passenger cars per thousand inhabitants in 2012. [18] There are usual smaller EU countries which are having the highest motorisation rates: Luxembourg makes the first place with 661 passenger cars per 1000 inhabitants, whereas Malta follows directly with 634 cars per 1000 inhabitants. [18]

Next to the built environment, it is the social environment which influences the physical activity of a country. In this respect, the income factor is decisive. There exist a definite correlation between physical inactivity and a low level of income. [19] With 11 billion euro, Malta has the lowest GDP ration as country in 2017, compared to the other EU countries. When looking at the GDP per inhabitant (in accordance with the Purchasing Power Standards), Malta belongs with 27,500 euro to the lowest quarter of the EU countries. Luxembourg, with 75,000, is the country with the highest GDP per inhabitant. [20] Malta's comparably low income level explains partly its physical inactivity and its high obesity rate.

The individual determinant includes the education factor. It is a concern that people with a lower education status are more prone to be less physically active, since these groups have less leisure time or poorer access to recreation and sport facilities. [21] With 18.6%, Malta has the highest percentage of all EU countries regarding early leavers from education (aged 18–24). [22] Malta's low commitment to exercise is also based on its general low education level.

Remedies

Especially since 2014, when the statistics about Malta being the most obese country, got published, Malta's government tries actively to tackle to obesity issue. Childhood obesity, in particular, is one of its major concerns: Kindergarten children learn how to prepare healthy foods and shops in schools are allowed to sell only products the Maltese authorities consider as healthy. [23] In general, Malta's government launched several initiatives in order to reduce obesity. One of them is the 'Healthy Weight for Life strategy for 2012–2020, which aims to establish a society in which healthy lifestyles related to diet and physical activity become the norm and healthy choices are easy and accessible to all. [24] Furthermore, Malta published the "Food and Nutrition Policy and Action Plan for Malta 2015-2020". [25]

Related Research Articles

<span class="mw-page-title-main">Obesity</span> Medical condition in which excess body fat harms health

Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it can potentially have negative effects on health. People are classified as obese when their body mass index (BMI)—a person's weight divided by the square of the person's height—is over 30 kg/m2; the range 25–30 kg/m2 is defined as overweight. Some East Asian countries use lower values to calculate obesity. Obesity is a major cause of disability and is correlated with various diseases and conditions, particularly cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis.

Health has a variety of definitions, which have been used for different purposes over time. Health can be promoted by encouraging healthful activities, such as regular physical exercise and adequate sleep, and by reducing or avoiding unhealthful activities or situations, such as smoking or excessive stress. Some factors affecting health are due to individual choices, such as whether to engage in a high-risk behavior, while others are due to structural causes, such as whether the society is arranged in a way that makes it easier or harder for people to get necessary healthcare services. Still, other factors are beyond both individual and group choices, such as genetic disorders.

<span class="mw-page-title-main">Preventive healthcare</span> Prevention of the occurrence of diseases

Preventive healthcare, or prophylaxis, is the application of healthcare measures to prevent diseases. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices, and are dynamic processes that begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention.

<span class="mw-page-title-main">Diseases of affluence</span> Health conditions thought to be a result of increasing wealth in society

Diseases of affluence, previously called diseases of rich people, is a term sometimes given to selected diseases and other health conditions which are commonly thought to be a result of increasing wealth in a society. Also referred to as the "Western disease" paradigm, these diseases are in contrast to so-called "diseases of poverty", which largely result from and contribute to human impoverishment. These diseases of affluence have vastly increased in prevalence since the end of World War II.

<span class="mw-page-title-main">Healthy diet</span> Type of diet

A healthy diet is a diet that maintains or improves overall health. A healthy diet provides the body with essential nutrition: fluid, macronutrients such as protein, micronutrients such as vitamins, and adequate fibre and food energy.

<span class="mw-page-title-main">Sedentary lifestyle</span> Type of lifestyle involving little or no physical activity

Sedentary lifestyle is a lifestyle type, in which one is physically inactive and does little or no physical movement and or exercise. A person living a sedentary lifestyle is often sitting or lying down while engaged in an activity like socializing, watching TV, playing video games, reading or using a mobile phone or computer for much of the day. A sedentary lifestyle contributes to poor health quality, diseases as well as many preventable causes of death.

Health promotion is, as stated in the 1986 World Health Organization (WHO) Ottawa Charter for Health Promotion, the "process of enabling people to increase control over, and to improve their health."

Physical fitness is maintained by a range of physical activities. Physical activity is defined by the World Health Organization as "any bodily movement produced by skeletal muscles that requires energy expenditure." Human factors and social influences are important in starting and maintaining such activities. Social environments can influence motivation and persistence, through pressures towards social conformity.

The social determinants of health are the economic and social conditions that influence individual and group differences in health status. They are the health promoting factors found in one's living and working conditions, rather than individual risk factors that influence the risk or vulnerability for a disease or injury. The distribution of social determinants is often shaped by public policies that reflect prevailing political ideologies of the area.

Diseases of poverty are diseases that are more prevalent in low-income populations. They include infectious diseases, as well as diseases related to malnutrition and poor health behaviour. Poverty is one of the major social determinants of health. The World Health Report (2002) states that diseases of poverty account for 45% of the disease burden in the countries with high poverty rate which are preventable or treatable with existing interventions. Diseases of poverty are often co-morbid and ubiquitous with malnutrition. Poverty increases the chances of having these diseases as the deprivation of shelter, safe drinking water, nutritious food, sanitation, and access to health services contributes towards poor health behaviour. At the same time, these diseases act as a barrier for economic growth to affected people and families caring for them which in turn results into increased poverty in the community. These diseases produced in part by poverty are in contrast to diseases of affluence, which are diseases thought to be a result of increasing wealth in a society.

Workplace wellness, also known as corporate wellbeing outside the United States, is a broad term used to describe activities, programs, and/or organizational policies designed to support healthy behavior in the workplace. This often involves health education, medical screenings, weight management programs, and onsite fitness programs or facilities. It can also include flex-time for exercise, providing onsite kitchen and eating areas, offering healthy food options in vending machines, holding "walk and talk" meetings, and offering financial and other incentives for participation.

Nutrition transition is the shift in dietary consumption and energy expenditure that coincides with economic, demographic, and epidemiological changes. Specifically the term is used for the transition of developing countries from traditional diets high in cereal and fiber to more Western-pattern diets high in sugars, fat, and animal-source food.

<span class="mw-page-title-main">Epidemiology of obesity</span> Recognition of obesity as an epidemic

Obesity has been observed throughout human history. Many early depictions of the human form in art and sculpture appear obese. However, it was not until the 20th century that obesity became common — so much so that, in 1997, the World Health Organization (WHO) formally recognized obesity as a global epidemic and estimated that the worldwide prevalence of obesity has nearly tripled since 1975. Obesity is defined as having a body mass index (BMI) greater than or equal to 30 kg/m2, and in June 2013 the American Medical Association classified it as a disease.

<span class="mw-page-title-main">Social determinants of obesity</span> Overview of the social determinants of obesity

While genetic influences are important to understanding obesity, they cannot explain the current dramatic increase seen within specific countries or globally. It is accepted that calorie consumption in excess of calorie expenditure leads to obesity; however, what has caused shifts in these two factors on a global scale is much debated.

<span class="mw-page-title-main">Lack of physical education</span> Inadequate provision and effectiveness of physical education in schools

Lack of physical education is the inadequacy of the provision and effectiveness of exercise and physical activity within modern education.

Nutrition education is a set of learning experiences designed to assist in healthy eating choices and other nutrition-related behavior. It includes any combination of educational strategies, accompanied by environmental supports, designed to facilitate voluntary adoption of food choices and other food and nutrition-related behaviors conducive to health and well-being. Nutrition education is delivered through multiple venues and involves activities at the individual, community, and policy levels. Nutrition Education also critically looks at issues such as food security, food literacy, and food sustainability.

Health in Malta has seen improvements in recent years, with one of the highest life expectancies in Europe. Malta has a good overall quality of health and has seen rapid growth and improvement in key health indicators. Malta has seen significant development in the practice of mental health which has been supported by new infrastructure and increased government health spending. The introduction of health-focused government initiatives, particularly around nutrition, alcohol, smoking, and health will likely contribute to the further improvement of overall health nationwide.

<span class="mw-page-title-main">Obesity and the environment</span> Overview of environmental factors affecting the incidence of obesity

Obesity and the environment aims to look at the different environmental factors that researchers worldwide have determined cause and perpetuate obesity. Obesity is a condition in which a person's weight is higher than what is considered healthy for their height, and is the leading cause of preventable death worldwide. Obesity can result from several factors such as poor nutritional choices, overeating, genetics, culture, and metabolism. Many diseases and health complications are associated with obesity. Worldwide, the rates of obesity have nearly tripled since 1975, leading health professionals to label the condition as a modern epidemic in most parts of the world. Current worldwide population estimates of obese adults are near 13%; overweight adults total approximately 39%.

Montenegro is a country with an area of 13,812 square kilometres and a population of 620,029, according to the 2011 census. The country is bordered by Croatia, the Adriatic Sea, Bosnia, Herzegovina, Serbia, Kosovo and Albania. The most common health issues faced are non-communicable diseases accounting for 95% of all deaths. This is followed by 4% of mortality due to injury, and 1% due to communicable, maternal, perinatal and nutritional conditions. Other health areas of interest are alcohol consumption, which is the most prevalent disease of addiction within Montenegro and smoking. Montenegro has one of the highest tobacco usage rates across Europe. Life expectancy for men is 74 years, and life expectancy for women is 79.

<span class="mw-page-title-main">Obesity in Thailand</span> Overview of the causes for and prevalence of obesity in Thailand

Obesity in Thailand has been flagged as a major source of health concern, with 32% of the population identifying as overweight and 9% obese. With reference to 2016 data from the World Health Organization (WHO), Thailand has one of the highest incidence of overweight citizens in the South East Asian region, second to only Malaysia. The Thai National Health Examination Surveys (NHES) found that obesity in Thailand more than doubled during the period 1991-2014. This spike in obesity levels has been largely attributed to increased access to junk food, and unhealthy switches from active to sedentary lifestyles. These factors are closely linked to economic growth in the country.

References

  1. ↑ "Government committed to tackle obesity with solid measures - The Malta Independent". www.independent.com.mt. Retrieved 2018-05-18.
  2. ↑ "Nutrition, Physical Activity and Obesity - Malta" (PDF). World Health Organization. 2013. Retrieved 18 May 2018.
  3. 1 2 3 4 5 "Overweight and obesity - BMI statistics - Statistics Explained". ec.europa.eu. Retrieved 2018-05-18.
  4. 1 2 3 PricewaterhouseCoopers. "Weighing the costs of obesity". PwC. Retrieved 2018-05-18.
  5. ↑ Ltd, Allied Newspapers. "40% of Maltese children overweight or obese". Times of Malta. Retrieved 2018-05-18.
  6. ↑ Javier), Varo, J.J. (José; Ángel), Martinez-Gonzalez, M.A. (Miguel; de, Irala, J. (Jokin); (J.), Kearney, J.; (M.J.), Gibney, M.J.; Alfredo), Martinez, J.A. (José (2003). "Distribution and determinants of sedentary lifestyles in the European Union". International Journal of Epidemiology. ISSN   0300-5771.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  7. ↑ Abdullah, Asnawi; Wolfe, Rory; Stoelwinder, Johannes U.; de Courten, Maximilian; Stevenson, Christopher; Walls, Helen L.; Peeters, Anna (August 2011). "The number of years lived with obesity and the risk of all-cause and cause-specific mortality". International Journal of Epidemiology. 40 (4): 985–996. doi: 10.1093/ije/dyr018 . ISSN   1464-3685. PMID   21357186.
  8. ↑ "Life expectancy in Malta is higher than European average - TVM News". TVM English. Retrieved 2018-05-18.
  9. 1 2 "Malta: Country Health Profile 2017 - en - OECD". www.oecd.org. Retrieved 2018-05-18.
  10. ↑ Cuschieri, Sarah; Vassallo, Josanne; Calleja, Neville; Camilleri, Ryan; Borg Axisa, Ayrton; Bonnici, Gary; Zhang, Yimeng; Pace, Nikolai; Mamo, Julian (2016-10-09). "Cuschieri et al-2016-Obesity Science & Practice".{{cite journal}}: Cite journal requires |journal= (help)
  11. ↑ Ltd, Allied Newspapers. "Rising levels of obesity may soon hit the economy". Times of Malta. Retrieved 2018-05-19.
  12. ↑ "Why Are The Maltese So Fat?". International Business Times. 2011-11-26. Retrieved 2018-05-19.
  13. ↑ Whitaker, Robert C.; Wright, Jeffrey A.; Pepe, Margaret S.; Seidel, Kristy D.; Dietz, William H. (1997-09-25). "Predicting Obesity in Young Adulthood from Childhood and Parental Obesity". New England Journal of Medicine. 337 (13): 869–873. doi: 10.1056/nejm199709253371301 . ISSN   0028-4793. PMID   9302300.
  14. ↑ Attard, Manuel (2010). "Assessment of the Nutritional Knowledge of Maltese Adults" (PDF). Masters Thesis: 1–2.
  15. ↑ Wells, Jonathan C.K. (2012-03-02). "Obesity as malnutrition: The role of capitalism in the obesity global epidemic". American Journal of Human Biology. 24 (3): 261–276. doi:10.1002/ajhb.22253. ISSN   1042-0533. PMID   22383142. S2CID   21400866.
  16. ↑ Graham, H.; White, P.C.L. (2016-12-01). "Social determinants and lifestyles: integrating environmental and public health perspectives". Public Health. 141: 270–278. doi: 10.1016/j.puhe.2016.09.019 . ISSN   0033-3506. PMID   27814893.
  17. ↑ Tucker, Patricia; Irwin, Jennifer D.; Gilliland, Jason; He, Meizi; Larsen, Kristian; Hess, Paul (March 2009). "Environmental influences on physical activity levels in youth". Health & Place. 15 (1): 357–363. doi:10.1016/j.healthplace.2008.07.001. ISSN   1353-8292. PMID   18706850.
  18. 1 2 "Transport - Statistics Explained". ec.europa.eu. Retrieved 2018-05-20.
  19. ↑ Jin, Yichen; Jones-Smith, Jessica C. (2015-02-12). "Associations Between Family Income and Children's Physical Fitness and Obesity in California, 2010–2012". Preventing Chronic Disease. 12: E17. doi:10.5888/pcd12.140392. ISSN   1545-1151. PMC   4329950 . PMID   25674676.
  20. ↑ publisher. "Data by country - EU comparison 2018: Germany and the other Member States - Federal Statistical Office (Destatis)". www.destatis.de. Retrieved 2018-05-20.
  21. ↑ Ford, E. S.; Merritt, R. K.; Heath, G. W.; Powell, K. E.; Washburn, R. A.; Kriska, A.; Haile, G. (1991-06-15). "Physical activity behaviors in lower and higher socioeconomic status populations". American Journal of Epidemiology. 133 (12): 1246–1256. doi:10.1093/oxfordjournals.aje.a115836. ISSN   0002-9262. PMID   2063832.
  22. ↑ publisher. "Data by country - EU comparison 2018: Germany and the other Member States - Federal Statistical Office (Destatis)". www.destatis.de. Retrieved 2018-05-20.
  23. ↑ "Malta's battle of the bulge". POLITICO. 2017-04-10. Retrieved 2018-05-20.
  24. ↑ "Malta launches obesity strategy". www.euro.who.int. 2012-05-01. Retrieved 2018-05-20.
  25. ↑ "Policy - Food and Nutrition Policy and Action Plan for Malta 2015-2020 | Global database on the Implementation of Nutrition Action (GINA)". extranet.who.int. Retrieved 2018-05-20.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.