Development & Aid, Headlines, Health, Latin America & the Caribbean

HEALTH-CHILE: Obesity, the Heavy Price of Economic Development

María Cecilia Espinosa

SANTIAGO, Jun 21 2005 (IPS) - Chile has the highest incidence of obesity among schoolchildren in Latin America, and if current trends continue, six out of every ten Chileans will be either overweight or obese in five years.

Government agencies, doctors and others working to promote healthy lifestyles have become increasingly concerned about what the National Institute of Food Technology (INTA) has dubbed “the epidemic of the bicentennial”, in reference to the fact that Chile will be celebrating 200 years of independence five years from now.

In 2010, there will be an estimated nine million overweight or obese people in Chile. (The total population currently stands just under 16 million).

In the 1960s, Chile had high infant and maternal mortality rates and a significant incidence of infectious diseases and malnutrition. But beginning in the 1990s, chronic and non-transmissible illnesses and accidents took over as the leading causes of death, and heart disease is now the number-one killer.

Chilean Health Ministry statistics indicate that 7.5 percent of children under six and 14 percent of teenagers are obese. Among adults, between 50 and 60 percent are above their recommended weight, and one out of three is clinically obese.

In an interview with IPS, Dr. Tito Pizarro, the head of the Health Ministry’s Department of Nutrition, noted that these rates are lower than those found in the United States, where between 10 and 12 percent of children under the age of six are obese. But when it comes to Latin America, Chile has the highest rates in the whole region.

Figures from the United Nations Food and Agriculture Organisation (FAO) reveal that in Brazil, the proportion of overweight and obese children decreased from eight to five percent between 1975 and 1996, although the proportion of overweight and obese adults rose.

In Argentina, the proportion of children under six who were over the recommended weight for their age was 5.4 percent in rural areas and 16.3 percent in urban areas, according to a 1995 study.

Also in 1995, 31 percent of Colombian women between the ages of 15 and 49 were classified as overweight, and nine percent as obese. By 2000, a full 41 percent of the country’s female population was overweight.

A study carried out in 1994 among adolescents in Ecuador indicated that 10 percent were overweight or obese, with higher rates for both found in girls and in the country’s Pacific coast region.

In Mexico, a 1999 study showed high rates of excess weight and obesity among schoolchildren between five and 11 years of age. The same study revealed that the proportion of overweight and obese women of childbearing age had increased since the last time statistics were gathered, in 1988.

And in Peru, 35 percent of women aged 15 to 49 and nine percent of children under five were classified as overweight or obese in 1996.

“Women face a greater risk of obesity than men, in almost every age group. And there is a greater tendency towards obesity, especially morbid obesity, among the poor,” noted Pizarro.

He believes that one of the main reasons for the rise in obesity in Chile is the largely sedentary lifestyle. “Over 90 percent of Chileans engage in very little physical activity. They go straight from their homes to work and from work to their homes, they travel by public transportation or in cars, they spend most of their time at work sitting down, and a lot of time at home watching television.”

Pizarro described obesity as “a silent epidemic that is affecting the entire world, where dietary factors are resulting in a lower quality of life and higher mortality. Average life expectancy has stopped growing in the most developed countries because of obesity,” he said.

The Chilean Health Ministry carefully monitors the country’s child population through all public and private medical facilities, and has been able to implement programmes that have succeeded in stabilising the advance of obesity for the past three years, he noted.

In terms of the medical treatment of obesity, Pizarro stressed that no genuinely effective methods have been found anywhere in the world, adding that most treatments fail because it is difficult to get people to change their habits and adopt healthy lifestyles.

What is the cost of obesity in Chile? “It can’t really be measured, because there are so many variables involved, in terms of treatment, decreased quality of life, diseases like diabetes, high blood pressure and osteomuscular problems, and higher work absenteeism because of sick leave,” said the Health Ministry official.

But although an exact cost cannot be determined, “I can definitely say that in terms of public health, it is the factor that accounts for the greatest expenditures after smoking,” he stated.

“Obesity is not only a health problem, it is also a cultural problem related to the ways we should organise ourselves as a society, as a country, in our cities and in the workplace to promote development in combination with healthy attitudes,” he stressed.

For her part, Raquel Barros, an endocrinologist and child obesity specialist at INTA, told IPS that the dramatic increase in obesity in Chile between 1985 and 2000 “is very closely linked to our model of economic development, which brought about tremendous technological development, meaning that children are now brought to and from school in motor vehicles, and there is far more access to television and computers.”

The growth of the food industry has led to an abundance of pre-packaged ready-to-eat or easily prepared food products that are especially convenient for working women but tend to be high in calories, Barros noted.

As for children, they now spend longer hours in school, but with no increase in the time devoted to physical education or other exercise, and also consume large amounts of “junk food”, loaded with saturated fats, sugar and calories, she added.

According to Barros, the difference between Chile and other South American nations like Peru and Bolivia is the fact that “in those countries, obesity exists side by side with malnutrition. We share more similarities with Uruguay and Argentina, although the crisis they experienced (between 1998 and 2002) led to a certain nutritional deficit.”

Marcela Taibo, the nutritional director of the National School Assistance and Scholarship Board, commented to IPS that in Chile today, “adults are dying from diseases linked to nutrition, and this is a problem that starts right from the moment when children are weaned from breast milk and begin to eat regular food.”

“Obesity cuts across all sectors of the population. It isn’t limited to schoolchildren, but is also seen in children under six, pregnant women, adults and the elderly,” she emphasised.

A healthy eating programme was implemented in conjunction with FAO for a two-month period in a number of public schools. The results indicated that in comparison with the schools that did not participate, the institutions that took part in the programme achieved a decrease in the incidence of obesity from 15 to 13 percent and an increase in the consumption of dairy products, Taibo reported.

Ester Maldonado, a 51-year-old public sector administrative employee who weighs 96 kilos, recognises her physical limitations. “I get tired really easily, my back hurts and my feet are swollen at the end of the day,” she commented to IPS.

Her son Patricio, 16, already weighs 83 kilos. “I can barely keep up in phys ed class at school, and the other kids are mean to me and make fun of the way I look. That makes me mad, so I eat even more,” he said.

Alex Escalona, a surgeon at the Catholic University Clinical Hospital, noted that five percent of Chileans suffering from obesity are classified as morbidly obese – in other words, 50-100 percent or 100 pounds above their ideal body weight.

“These are figures very much comparable with those of the industrialised world. Chile is one of the countries where obesity in children and adolescents has grown at an especially high rate, and that is an extremely serious problem,” he told IPS.

“Five, 10 or 20 years from now, these obese children will be obese adolescents and adults. This is a time bomb, and in a few more years, it will become a problem increasingly difficult to treat,” he predicted.

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