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Abstract
There has been a significant increase in the near global populations daily per capita supply of food is the result of globalisation and industrialisation. While the cause of obesity at the individuals level is based on the amount of energy consumption that is exceeding the impact of energy expenditure by habitual behaviour towards and energy-dense food choice, it is essential to recognise that external factors can determine the susceptibility of obesity to an individual or nation. (Crammond B. et. Al., 2013)
Introduction
Obesity is considered to be a non-communicable disease which is linked to an excessive amount of body fat and is generally assessed as a Body Mass Index (BMI) over 30 (B.M Popkin, 2006). The ever increasing prevalence of obesity rises and poses fatal health issues which include type 2 diabetes, stroke, heat disease and musculoskeletal disorders. When taking into consideration the broader view of the cause, the prevalence of obesity has many different aspects including environmental factors influencing it. Some environmental factors include the change in marketing and pricing of food products, the increasing number of fast food restaurants around a nation and the industrialisation of agricultural production. (Johar. M, 2016)
Size, Nature and Distribution
In order to determine the presence of global obesity between men and women, data must be collected using the National Health and Nutrition Examination Survey. This survey was used in the United States between 1971 and 1973 providing data showing that the prevalence of obesity was 12.1% in men and 16.6% in women. This is significantly lower when compared to the data collected between 2009 and 2010 showing the prevalence to be 35.9% for men and 36.1% in women. (Nguyen, D. M, 2010). The trend is similar when conducted in various other countries. In 2004, the prevalence of obesity in Canada was 22.9% in men and 23.2% in women while in 2006 in Mexico, it was 24,2% in men and 34.5% in women. In the United States, there was a 15.2% increase of the daily per capita supply of food energy during the 1980s-1990s. As a result, meal potion sizes for different social environments increase (Harnack, et al,. 2002; Nestle, 2003; Nielsen and Popkin, 2003). There is evidence that the ever-increasing popularity and accomplishment of the food industry has influenced weight gain by promoting caloric sweeteners, fats and oils and carbonated soft drinks in meals and ultimately increasing the prevalence of obesity (Wright, et al, 2004; Diliberti et al. 2004).
The attitudes and behaviours of society has dramatically affected the way an individual interacts with their diet and the prevalence of obesity. This is a result from trade, services, goods and more freedom in capital resulting from globalisation. As a result of globalisation, there has been a nutritional shift in developing countries where an individuals diet would usually consume starchy staples consisting of coarse grains, fruits, vegetables and legumes but have altered their diet to consume edible vegetable oils, processed food, animal sources and caloric sweeteners which poses a long-term influence on weight gain and obesity (Popkin and Nielsen, 2003). Following World War II, one of the biggest modifications in the food system was the introduction of oilseed-based fats. New technology allowed for a development of high yield of oilseed and the refining of production ultimately lowering the price of frying fats and baking, cooking oils and margarine (Williams, 1984). To satisfy the increasing global demands for low-cost vegetable fats, oil crops began emerging across the United States, Europe, Argentina, Brazil and South East Asia creating an increase of vegetable oil production. This resulted in additional goods and services to be imported into developing countries from high income nations. It is evident that production of inexpensive fats being accessible for developing countries compared to established countries causes long-term implication towards the prevalence of global obesity (Drewnowski and Popkin, 1997). In addition to the attitude and behaviour of society affecting the prevalence of obesity, it is evident that the distribution of food and its food system play a role in the increase of global obesity. It is evident that the increasing prevalence of global obesity is due to the drastic changes in the distribution of food and its food system. An example of this is supermarkets overtaking fresh markets in popularity with consumers. It has been reported that supermarkets provide consumers with products containing processed higher fat, added sugar and salt laden foods. Supermarkets in the United States account for more than 80% of retail food sales. There has been a 45% increase in supermarket food sales in Latin America. Similar to the United States, supermarket food sale promotions are increasing and quickly spreading across to other countries such as Africa and Eastern Europe (Popkin, B. M., & Reardon, T. 2018)
The Leading Determinant of Obesity
When an individuals living and working condition influences the pathological issue of weight gain, it can be simply referred to as an obesogenic environment. A significant determinant of weight gain can be called automation or mechanisation. In 2003, a study was conducted focusing on examining the influences domestic automation has on energy expenditure. It was found that when subjects hand washed clothes, they used 2.07kcal/minute compared to 1.32kcal/minute when using a washing machine and 1.83kcal/minute washing dishes by hand compared to 1.31kcal/minute using a dishwasher. These results provided data, that was correctly predicted, that participants energy expenditure was increased by non-merchandized activities. When taking floor transitions into consideration, the results showed that 4.2kal/minute is used climbing stairs opposed to 1.3kcal/minute when taking an elevator, demonstrating that there is a substantial increase in energy expenditure. Results also showed that if mechanised household activities were decreased, there would be a 111 kcal/day increase of energy expenditure achieved. However, when combined with an increased intake of food, the annual weight gain of an individual would be an estimated 4kg per year (Lanningham-Foster, Nysse & Levine, 2003). This phenomenon can apply to most countries, especially high-income countries where households habitually use machines to simplify their lifestyles but consequently contributing to an obesogenic environment.
The social gradient is one of the most significant determinants of health and is a concept which identifies the discrepancies in living conditions across the different socio-economic statuses. It is evident in two separate studies conducted by Sobal & Stunkard(1989), and McLaren (2007) that individuals with different socio-economic statuses have similarly had different behaviour towards food availability. It was found that individuals who live in a developing country who hold a higher grade status usually weight more but when compared to someone with the same status in a high-income country, they weigh less. In comparison to individuals with a low grade status, the trend is reversed and is demonstrated in the reliability for food access for both low grade and high grade statuses. There is a lack of food security of the low SES population. This means that in a well off country, there is a lack of access to nutritious foods whereas, in a developing country, it means theres a lack of any food. The leading problem of socioeconomic obesity is highlighted by the reversed relationship of obesity. As an example, the growth of fast foods, the reliance on readily prepared foods and the changing production and pricing of foods that are high in calories compared to home-cooked meals is accountable for the presence of obesity. (Bleich, Cutler, Murray, & Adam, 2008; Kumanyika, 2008; Chou, Grossman, & Saffer, 2004; Cutler, Glaeser, & Shapiro, 2003).
In comparison, a population with a high SES have the advantages of education and income. When faced with the same exposure they have a tendency to be much more responsible with their diet as they understand the value of exercise and a controlled food intake. This ultimately motivates them to actively target for an ideal health goal and body weight. Individuals with low SES in developing countries are unfortunate and lack the access to food supplies which in extreme circumstances can lead to fatality due to malnutrition. Individuals in the same country with a higher SES on the other hand, come affordable and redily availbale foods to ensure survival. However, these readily available foods lack good nutritional value and as a consequence can cause morbidity through a number of non-communicable diseases.(Dinsa, G. D, et al. 2012).
Barriers and opportunities for Prevention
Obesity has been an increasing problem worldwide that was undetected until recent decades (Cabellero, 2007). Since 2004, an approach called Ensemble Prévenons lObésité Des Enfants (EPODE) which translates from French to together lets prevent childhood obesity has established over 500 communities within 6 different countries. EPODEs goal is to combine community-lead activities with corporate and government intervention methods as a move to prevent obesity in children worldwide. There are 4 key elements to their approach: 1. Gain political commitment. 2. Securing resources for the funding of support services, 3. Delivering support services and 4. Evidence to inform the public of the progress and outcome of the program (Borys J.M., 2011). Another example of opportunities for the prevention of obesity is seen at an international union called The World Health Organisation conference at the Ottawa Charter for Health Promotion. At this global union advocated a worldwide mission designed to address serious health concerns such as obesity and encouraging healthier alternatives among all nations (Kruk, 2012). The aim is to prevent an increase in obesity by creating supportive environments, strengthen community actions, develop public health policies and change the direction of health services. (Ng et. al 2014).
The executive arm of the Australian Commonwealth Government has, thus far, rejected requests to establish a legislation in order to regulate interventions to prevent obesity across the nation. In a study carried out by B. Crammond et al 2013, 13 members of the Australian Government were surveyed to find out the reasons for the rejection of the requests. They responded by addressing two key barriers: the role of the office of best practice regulation (OBPR), and the lack of evidence to supporting the effectiveness. The OBPR guarantees that interventions does not place any problem upon business. For any attempt in regulation, the department in charge is required to submit a Regulation Impact Statement (RIS) to the OBPR and to show the advantages of intervention that exceed business costs. Nevertheless, the requirement to demonstrate the efficacy of any regulation in combating obesity and satisfying the OBPR process is difficult given the multifaceted nature behind the health issue (B. Crammond et al 2013).
Another setback for interventions targeting the prevention of obesity is the lack of supporting evidence. According to the 13 members of the Australian Government who were surveyed in B. Crammond et al, 2013s study, the research was not sufficient to satisfy regulatory reviews despite demonstrating the increasing prevalence and existence of obesity at an epidemic level. Many of the members from the Australian Government voiced the opinion that they believed a more worthwhile research study would include proof based on quantifiable impacts of individuals regulatory measures on weight loss.
Conclusion
In this report, it is discussed that obesity is not only caused by an undetected influence on an individual. It is also stemmed from politics, the environment and lifestyle an individual lives in and the marketing and promotion of inexpensive food items that are energy-dense. Another cause for the rise of obesity is the worldwide increase of exposure to unhealthy eating habits is the result of globalisation impacting the food industry and its popularity. The Social Gradient is able to display the causes of obesity by displaying the relationship between the quality of an individuals living conditions and behaviours associated with their food. Despite many tactics have risen to counteract the increase of worldwide obesity, not a single country has provided comprehensive strategies and interventions to significant decrease obesity. In order to battle the prevalence of obesity in the future, it is essential for various fields of science such as health agencies, engineering and biomedicine to conduct studies and be able to collect quantitative and qualitative data on the effect an individuals lifestyle can have on pathological weight gain.
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