Health Parliamentary Secretary and paediatric surgeon Chris Fearne plans to target the obesity problem in Malta. Photo: Jason BorgHealth Parliamentary Secretary and paediatric surgeon Chris Fearne plans to target the obesity problem in Malta. Photo: Jason Borg

If the government succeeded in reducing just one per cent of the population’s obesity it would save €1 million in healthcare costs, according to the Health Parliamentary Secretary.

Recognising the gargantuan impact obesity has on the island’s coffers – €35m by 2020 – Chris Fearne is planning on targeting the problem equipped with the exact knowledge of what is responsible for the nation’s obesity.

“At the moment we’re guessing what’s making people fat, an educated guess, but a deduction nonetheless,” the paediatric surgeon told The Sunday Times of Malta.

The National Food Consumption Survey is projected to give the island a blueprint of the islanders’ eating habits complete with the exact consumption of salt, sugar, fat and protein, among others.

Having first announced the survey on Times of Malta’s TV programme Times Talk, Mr Fearne gave more details about this food ‘census’ that will cost €150,000; a small amount compared with the projected savings.

The news comes as Opposition leader Simon Busuttil announced that his party will table a Private Member’s Bill in Parliament tomorrow to address obesity and promote a healthy lifestyle.

This step was welcomed by Mr Fearne who was pleased that all stakeholders, now including the Opposition, were understanding this public health challenge and showing a willingness to work with the government in tackling it.

Both sides are united in slimming down the problem after a study in the medical journal The Lancet listed Maltese as the sixth most obese or overweight in the world.

“The steady increase in obesity over these last 30 years... is worrying. Obesity is primarily a personal condition but is now becoming a national concern.

“The burden obesity is having, and will continue to have, on the nation’s economy is only less frightening than the burden obesity is having on the nation’s health,” Mr Fearne added.

If I was going to list the foods anyone would want to cut out to lose weight easily then I would limit a lot of traditional Maltese foods

The national survey will be carried out in conjunction with the World Health Organisation and the International Agency for Cancer Research, with specific software bought from the Netherlands’ health promotion unit.

At the moment, Malta’s health promotion director Charmaine Gauci is going through the laborious process of inputting the nutritional information of every product available on supermarket shelves and food outlets.

Once this is done, a pilot sample of 100 individuals will be scientifically chosen to determine everything they eat over 24 hours. The body mass index (BMI) will be calculated and urine samples will be taken to verify the levels of salt, among others.

The actual survey will then target 2,000 individuals and start in 2015 and results should be in hand by the beginning of 2016.

“The results will empower us to specifically target the problem at its core. So if, for example, the figures show huge consumption of soft drinks, then we’ll embark on talks with the industry to bring about say, better labelling,” he said.

The high consumption of soft drinks among children has already been flagged as an issue in previous studies, and Mr Fearne believes the island’s obesity could also be down to a low breastfeeding rate and the large quantities of fast foods consumed.

High starchy foods such as timpana, pastizzi and bread are also targeted by John Briffa, a leading UK doctor and nutritionist.

“If I was going to list the foods anyone would want to cut out to lose weight easily, then I would limit a lot of traditional Maltese foods.

“I’m not saying never eat them. But if these foods are staple, and for many Maltese they are, that’s where the fundamental problem lies,” he said, when contacted at his home in the UK.

Dr Briffa, whose parents are Maltese and is the author of the bestselling book Escape the Diet Trap, believes the standard approach of eating less and exercising more will not lead to sustained weight loss.

Science and his clinical experience have shown him that if people were serious about shifting the kilos, then they had to focus on hormones, biochemistry and physiology.

While this may sound complicated it is really simple – move away from calorie counting and embrace the science.

He explains that insulin facilitates the uptake of fat into the body’s cells and impairs its ability to release the fat, so in effect insulin is the “chief fattening hormone”.

“What causes the most insulin secretion is carbs. It is secreted primarily in response to rises in blood sugar, which comes from sugar in the diet. So if you have a soft drink you’ll get a spike.

“Starch is also sugar so when we eat relatively starch-rich carbs – and there’s plenty of those in the Maltese diet such as ross il-forn or timpana – a lot of these foods release sugar to an extent very similar to eating sugar, which is very disruptive.

“So after eating them you get a big surge of sugar in the system, which is insulin and fat-forming.”

This is half the problem, Dr Briffa said, because such foods were also disease-inducing – the more insulin you secrete, the more likely you are to become unresponsive to insulin in time and risk developing type 2 diabetes.

In the short term, there is another problem because after secreting a lot of insulin, you will then experience low levels of sugar leading to listlessness, inability to concentrate and cravings for sweet and starchy foods two hours later.

So what is the solution?

“Move away from a diet based on starch and carbs and focus on eating more meat, fish eggs, vegetables and a bit of fruit,” he advises.

“These should be the core foods in a diet, not breakfast cereals and bread. Science shows this and my clinical experience bears this out. When people adopt this sort of diet, they experience a significant and sustained weight loss, without hunger.”

Eating according to John Briffa

Dos

• Ensure 80 per cent or more of your diet comes from ‘primal’, natural, unprocessed foods, such as fresh meat, fish, eggs, nuts, seeds, non-starchy vegetables and some fruit.

• Eat mindfully, chew thoroughly and savour your food.

• Balance alcoholic drinks with water – the ‘benefits’ of alcohol have been overstated.

• Walk regularly and supplement this with brief resistance exercise sessions.

• Ensure your appetite is well under control.

Don’ts

• Don’t consciously restrict calories or go hungry.

• Don’t judge your weight according to the body mass index.

• Don’t buy into erroneous and misleading marketing messages.

• Don’t see the changes you make as a ‘diet’.

• Don’t consume aspartame, which is used as a sweetener and found in diet soft drinks, among others. Aspartame contains molecules that are converted into formaldehyde – used to preserve the dead – in the body.

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