The Times is to be congratulated for devoting an entire pull-out section to obesity and diabetes (Two Interlinked Illnesses, April 12), topics that richly deserve more open debate in order to increase awareness of them.
Urban planners continue to create conditions that help to make us more physically inactive
A good question is whether Malta’s so-called ‘non-Mediterranean diet’ (editorial, March 19) is enough to explain the recent steep rise in obesity and maturity-onset diabetes. Common sense suggests that additional lifestyle or environmental factors must be at work because our diet has not changed appreciably during the past five or so decades and so cannot be responsible for the recent explosion of obesity and maturity-onset diabetes to epidemic proportions in western countries over the past 30 to 40 years.
The timing of this obesity epidemic strongly suggests that advances in technology, increased car dependence for mobility, prolonged ‘screen-time’ (especially television) and emergence of urban obesogenic environmental factors have resulted in lowered levels of physical activity and unhealthy lifestyles.
The term obesogenic was coined in the 1990s to describe an urban environment that does not encourage a healthy lifestyle.
There is no question that Malta’s environment is becoming increasingly obesogenic as a result of runaway property development and intense urbanisation.
This is of great public health importance because it is now accepted that unfitness arising out of physical inactivity is responsible for most of the negative health consequences previously attributed solely to obesity and overweight.
As Sandro Vella rightly points out in the feature of April 12, lifestyle factors account for 90 per cent of the problem and he singles out the obesogenic influences of our sedentary ‘urbanised and industrial society’. Unlike other countries, Malta has not taken steps to counteract this. On the contrary, our urban planners continue to create conditions that help to make us more physically inactive.
A serious consequence is that this now affects our children. As stated recently in a letter, under the apt title of Children Playing In Streets (February 26), we persist in creating unhealthy environments by giving priority to cars when designing our streets and roads, forgetting that children and pedestrians also use them.
Physical activity of Maltese children is lowest in the EU and hours spent watching television is the highest (on average nearly half of children watch television for three or more hours daily).
Street conditions are so dangerous in Malta that our children are deterred from going out, miss out on healthy walking and cycling and grow up conditioned to car dependency to move. Unlike many EU countries, it is unheard of for children to cycle to school; they are passively transported. This is a recipe for disaster.
The bottom line is that we are becoming more unfit as well as obese because we are victims of our unhealthy surroundings.
Most streets in our urbanised environments are so shabby that people prefer not to walk in them so we become ever more car dependent. This trend continues to be reinforced by our road planners’ morbid preoccupation with cars and persistent failure to recognise that roads should cater for healthy mobility options and the needs of all road users, not just motor traffic and provision of car parks.
That we have an abysmally dysfunctional public transport, served by monster buses that people have come to hate, has not helped shoehorn people out of their cars. And, let’s face it, we Maltese are a bunch of car-obsessed petrol heads.
As long as we remain in denial about Malta’s car-fixated attitudes we’ll just get fatter and more unfit from lack of exercise. The Times’ feature mentioned pious strategies as “robust food policies”, “proactive encouragement”, “championing fitness” and so on. These are mere slogans that fail to recognise the fundamental fact that no amount of slogans or well-intentioned efforts of health professionals will make an impact in persuading people to become more physically active as long as our surroundings don’t encourage a healthy lifestyle.
Gimmicks as a ‘fitness paradise’ or ‘health and fitness tools’ only benefit a few well-motivated people who are probably fit in the first place.
As long as nothing is done to provide an environment that encourages healthy lifestyle choices, our fitness will continue to deteriorate and our waistlines to grow, irrespective of diet.
Malta’s population is not only the fattest but probably also the least fit in Europe. If our town and road planners continue to omit features that encourage people to walk and use healthy mobility options, there is little hope that anything will improve.
Our children grow wrapped in bubble packing and tend to obesity and unfitness through lack of exercise. They will go on to become tomorrow’s unfit overweight adults and, later, old diabetic people. Healthy exercise has also been shown to protect against dementia in old age.
Given this time bomb, it is the duty of the Health Department to concern itself with provision of an environment that is conducive to a healthy lifestyle and fitness on a national basis to assure everybody’s future health.
George Debono is lead author of a think tank report titled Healthy Mobility In Sliema, A Case Report (www.tppi.org.mt/~user2/index.php/reports).