IN our study of the geographical clustering of body mass index (BMI) among adults in Malaysia, clusters of high BMI among men were found in suburban areas with moderate and high access to fast-food restaurants.
Because most men are employed, they spent more time outside with long working hours, where eating out and increased processed food consumption is unavoidable.
This, coupled with greater access to restaurants, lowers the frequency of home cooking.
When eating away from home, eating decisions tend to be spontaneous and quick, influenced by appetite, financial constraints and whether the environment facilitates spending toward healthy or unhealthy diets.
The availability, accessibility and affordability of unhealthy foods make eating unhealthily easier and reinforce its preferences and demands, thus creating a vicious cycle of an unhealthy environment where the appetite control system is desensitised.
Therefore, weight management can be challenging in an environment that belittles the willpower to eat healthily.
In Malaysia, fast-food consumption is prevalent among rural (32.7% once a month), suburban (17.4% at least once a week) and urban (25% more than four times per month) communities, especially among university students.
At the same time, only 5% of our population eat five servings of fruits and vegetables daily as recommended.
Habitual fast-food consumption is associated with a taste preference for fried and sweet foods, higher calorie intake, higher intake of sugary beverages and a lower intake of wholegrain, fruits and vegetables throughout the remainder of the day and even on a non-fast-food day.
Meals from fast-food restaurants are mostly high in calories and fats, including trans-fatty acids and salt whereas beverages are the largest driver of differences in calories.
Frequent and long-term consumption of these foods strengthened the expression of obesity-related genetic variants and increases the risk of diabetes, metabolic syndrome and cardiovascular disease. Besides chronic inflammation, fast food consumption also impairs the host’s defence against viruses, increasing the risk for severe Covid-19 morbidity and mortality.
Therefore, in conjunction with World Obesity Day, let us all focus on creating a healthier food environment.
Besides fast-food franchises, all restaurants are also responsible. Here are some recommendations:
Fast-food industries should make healthier options available at all times e.g corn, fruit and vegetable salad, low-fat milk, wholemeal bun, granola, plain water, non-caloric beverages, etc;
Restaurants must reduce the amount of sugar and salt used in their cooking and food preparation, besides offering fruits, vegetables and whole grains on the menu; and
Customers must make their demand for healthier food choices known to the industry.
Obesity is a public health war which we cannot afford to lose. It takes a collaborative effort to fight a challenge so great.
Kimberly Wong Yuin Y’ng (PhD candidate) and Prof Dr Moy Foong Ming are from the Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya. Comments: letters@thesundaily.com
