Overweight Middle East struggles with heart disease and diabetes

According to report, ischemic heart disease is now the leading cause of death in middle and high-income Arab nations – and it comes in at number 4 even in the lowest-income countries in the region.

Stroke is also a leading cause of death, and Kuwait, Lebanon, Qatar, Saudi Arabia, Bahrain and the UAE are now among the 10 nations with the highest global prevalence of type 2 diabetes, it said.

The study’s authors put most of the blame for this on the change in dietary habits among the region’s population.

Fat of the land​

The report added that the prevalence of overweight and obesity has increased in both young and adult populations of GCC countries, including Kuwait, Qatar, Saudi Arabia, and Bahrain.

According to the report, 66-75% of the adult population (over 18) and 25-40% of children and adolescents (under 18) in the Middle East are estimated to be overweight or obese.

“The traditional Arab diet has changed from high-fibre and low-fat food with increased integration of the Arab world into the global market over the past four decades,”​ the study’s authors said.

“Unhealthy dietary habits are prevalent in children, adolescents, and adults, especially in the wealthy GCC countries where a wide variety of global fast-food chains are near ubiquitous,”​ they added.

According to the report, people in the Arab countries have a high intake of fast food and carbonated beverages and a low intake of milk, fruits, and vegetables, and frequently consume snacks rich in calories, salt, and fat between meals.

Pricing policies?​

According to the report, national policies, programmes, and action plans to improve diet and increase physical activity are undeniably important for non-communicable disease prevention.

“But the realities of implementation are likely to be very different from the written policies,”​ the authors said.

According to the results of a review of diet and physical activity policies in low-income and middle-income countries, only Jordan had a policy that addressed all four risk factors: salt, fat, fruits and vegetables, and physical activity.

“In particular, the review reported that diet and physical activity policies tended not to be associated with specific action plans, timelines, and budgets, and they were also mostly focused on individual behavioural changes,”​ they said.

“Policies that link to specific budgets and priority actions, and involve a broader range of stakeholders, are needed. Importantly, pricing regulations are needed to ensure that fruits and vegetables are more affordable than processed foods, thus targeting both obesity and micronutrient deficiencies.”​

Salt and trans fats need attention​

According to the authors, even slight reductions in salt intake will result in substantial reductions in medical costs and cardiovascular events.

“Reduction in salt intake can be achieved with behaviour modification efforts (through advertising and health education campaigns) and reformulation of food products by industry. In the Arab world, bread is a big source of salt in the diet, and should be the first target for reformulation by gradual reduction,” ​they said.

The authors pointed out that in high-income and middle-income countries, reduction of trans-fat consumption has been addressed through mandatory labelling of the trans-fat content in foods and voluntary agreements.

“But little information about trans-fat intake in the Arab world is available. A recent study in Jordan showed a high and variable content of trans fat in both locally produced and imported foods,”​ they said.

“The WHO has proposed various policies to reduce trans-fat intake, including further studies on trans fat with respect to labelling, pricing regulations, and import restrictions. Health education campaigns are needed to educate consumers about trans fats,”​ they recommended.

Source:​ The Lancet​

Non-communicable diseases in the Arab world​

doi:10.1016/S0140-6736(13)62383-1

Authors: Dr. Hanan F Abdul Rahim. Prof Abla Sibai, Yoused Khader, Prof Nahla Hwalla, Ibtihal Fadhil, Huda Alsiyabi, Awad Mataria, Shanthi mendis, Prof Ali H Mokdad, Abdullatid Husseini