Malta’s rates of obesity may be the result of an environment that promotes it, including an “energy-dense” food supply and lack of physical activity, according to research published recently in an international scientific journal.
The study calls for more research to be done in order to take measures to counteract the country’s high obesity rates.
The paper, called ‘An Obesogenic Island in the Mediterranean: Mapping Potential Drivers of Obesity in Malta’, is by researchers Daniel Cauchi, Harry Rutter and Cecile Knai. It was funded through the Malta Government Scholarship Scheme and appeared in Public Health Nutrition, an online Cambridge journal.
Previous studies have shown that at least 22 per cent of Maltese people aged 15 and older are obese, while 36 per cent are overweight.
Based on an analysis of previous research published between 2000 and 2013, the study argued that the diet prevalent in Malta “cannot be said to be truly Mediterranean”. Instead, it is more typical of that found in northern Europe.
Vegetable and fruit intake is low, while that of pasta, bread and meat is substantial.
Maltese children have a high intake of carbohydrate-based foods such as pasta, pizza and fast food style meals together with breakfast cereals and soft drinks while very few Maltese consume sufficient fruit and vegetables.
It is not unusual for children to be taken to [fast food] outlets as a treat for good behaviour
The Maltese consume large amounts of cheddar cheese, sugar, corned beef and condensed milk, which is “unusual” in the Mediterranean. Malta’s per capita supply of sugar is the highest in the EU and among the highest in the world, indicating that sugar could be a major source of energy in the Maltese diet, the study says.
Even though there is an increasing awareness about a healthy diet, a “socially learned attitude” towards food may be passed on from one generation to another.
The Maltese show a marked preference for “large portion sizes, a tendency to eat out with family and frequent engagement in religious, public or family oriented feasts and celebrations that are traditionally characterised by an abundance of food”.
Even the traditional village or festa have been commercialised with fast foods such as hot dogs, burgers, ice cream, kebabs, chips, nougat, fried pastry and other foods rich in saturated fats and sugars.
There are more mobile vendors selling doughnuts, ice cream and sweets and often directly targeting children by parking next to schools. Major fast food chain outlets in Malta also market very heavily in the media and it “is not unusual for children to be taken to such outlets as a treat for good behaviour”.
Lack of exercise is also a problem – children are becoming more sedentary and watch more television, which leads to more snacking while exposing them to aggressive food advertising, which might be a major factor in the high consumption of sugary drinks by Maltese children.
Another factor is that a relatively-high proportion of Maltese have part- and full-time jobs, which may leave less time for parents to cook healthy food or take children outdoors, potentially leading to unhealthy food choices and lack of exercise.
The paper also questioned whether the recent proliferation of pastizzeriji and confectionary stores could be a result of an increase in demand where, for example, working mothers were likely to eat prepared food and watch television or buy on their way to private lessons.
However, the study admitted it was difficult to clarify the links between the evolving food environment, nutritional and physical activity habits and their impact on obesity rates when data was lacking.
There is little data about food consumption at home and little information about policies or interventions that might influence the physical activity levels of Maltese children.
The study called for a national survey to collect data on food consumption and food pricing in order to have a nutrition policy based on evidence which targets specific sections of the population.
It should also take into consideration the family’s economic status and expenditure together with the amount of physical activity done in schools.