With growing economic wealth and development come dietary change. We eat more, move less, grow fat and suffer lifestyle diseases, writes Kasmiah Mustapha
IN the last 50 years, we have gone through tremendous changes, from an economy dependent on agriculture and primary commodities to one spurred by technology, knowledge and capital-intensive industries.
Our per capita income has increased significantly to more than RM28,000 annually at the end of 2011 compared to RM1,159 in 1970. It is expected to reach RM45,000 by 2020.
With economic growth, come wealth for the people and changes in lifestyles. As we become more affluent, our needs too change and these are not limited to only material things.
Development and wealth have also affected patterns of food consumption — another common effect of globalisation. Studies show that what determines changes in food demands are income growth which leads to major shifts in demand across different types of food, the process of urbanisation which brings about new dietary needs and more generally, lifestyle changes.
According to Harvard School Of Public Health, modernisation, urbanisation, economic development and increased wealth lead to predictable shifts in diet, referred to as nutrition transitions.
The Food & Agriculture Organisation of the United Nations says another factor is the increase in the amount of food imported from the industrialised world. As a result, traditional diets featuring grains and vegetables give way to meals high in fat and sugar.
Nutrition Society of Malaysia (nutriweb.org.my) president Dr Tee E Siong says that in the 1970s, issues of dietary habits in the country were mainly about malnutrition as people did not eat enough vitamins and minerals. Now the problem is over-eating, compounded with lack of physical activity.
Our food consumption pattern has changed to more meat, fish and egg as well as foods high in oils, fats and sweeteners. We eat less complex carbohydrates which include fibre, as well as fruit and vegetables. Another factor is advertising and marketing, especially from the West, which lead to the change in dietary habits from plant-based to animal-based food.
“In the old days, eating meat or chicken was a status symbol as not many people could afford it. Now everyone can eat it. Back then people ate complex carbohydrates such as tapioca, yam and sweet potato. But now we think such foods are not tasty.”
NATION OF FOOD
“Malaysians overeat. At the buffet table, you will see people piling their plates with food. They return again and again as there is so much food to choose from. Unfortunately, most of the food contains a lot of oil and fat. Even local dishes have a lot of oil, salt and sugar,” says Tee.
While we grow more knowledgeable about nutrition over the years, many of us don’t practise healthy habits. With more choices and growing affluence, the number of fast food restaurants, food and mamak stalls has also increased.
Tee says: “There are so many choices now due to consumer demand. We can eat at any time of the day. This is not healthy. It’s not just what we eat but also when and how often we eat that lead to a host of health issues.
“I’m not saying we should avoid these foods. But the problem is, we eat what we like, excessively.
“Another contributing factor is serving size. We consume huge portions at one go. We do not understand portion control.”
Such high-risk eating habits lead to a high prevalence of diet-related chronic diseases such as hypertension, diabetes, heart disease and cancer in the country. Obesity is a major problem and is the main cause of other non-communicable diseases.
In 1980, a study placed the overweight rate in Malaysians at five per cent. Ten years later, this had increased to 15 per cent.
Tee says: “In addition to the change in food consumption pattern, more Malaysians are not involved in physical activities. Obesity and diabetes in rural areas have been increasing over the years. Now, 50 per cent of adults are overweight and obese. In the United States, it is 75 per cent.
“Younger people are suffering heart attacks. Childhood obesity is increasing with 16 per cent preschoolers being overweight while 30 per cent of primary schoolchildren are overweight and obese. These children are more likely to become obese adolescents and adults.”
IMPORTANCE OF EDUCATION
Tee says one of the steps to change dietary pattern is nutritional education in schools, starting with preschool children. Teaching the young about healthy eating habits will prevent them from getting heart attacks, diabetes or high cholesterol when they are older. (Evidence shows that overweight and obese children also suffer from high cholesterol and diabetes).
There should be concerted efforts involving the Health Ministry, Education Ministry, nutritional organisations and other associations to ensure children learn about and practice healthy eating habits.
“We have not spent enough effort and energy on nutrition education for children. We launch healthy lifestyle campaigns for adults but usually, these don’t work. Adult behaviour is more difficult to change. We are not going to prevent chronic diseases if we don’t start with behavioural changes in children,” he says.
“Parents should also play a role. Most parents don’t pay enough attention to their children’s health and nutrition. They worry about what the children eat in school but they are not bothered with what they eat at home or outside. Parents need to stress the importance of balanced meals and nutritious food.”
Read about portion control in next Tuesday’s Life&Times to better regulate food intake.
WHAT’S ON OUR PLATES
KHADIJAH SHAARI, 65, retiree
Growing up in a village near Kuala Kangsar, Khadijah says her food sources were all fresh. The family grew vegetables and reared chickens. As their house was near the river, her father would catch fish every day.
“He went to the river to fish. At that time, the river was not polluted and he usually managed to catch quite a few. We had a small orchard with banana, tapioca and durian trees, among others. We also planted beans, brinjal, cabbage and other vegetables. Meals were home-cooked. My mother loved to cook and sometimes she even made roti canai or tosai.
She made fried bihun (rice vermicelli) or nasi lemak and forced us to drink milk before we went to school. Lunch was rice and dishes that she and my grandmother prepared with ingredients from the garden,” Khadijah says since the family had their own supply of food sources, they didn’t eat out. There were also few places to eat at then.
“Besides, we couldn’t afford it. I had seven siblings and we lived with my grandmother. Even when we moved to Ipoh, we didn’t eat out since we were so used to home-cooked meals.”
When Khadijah moved to Kuala Lumpur to further her studies, her eating habits changed. As she was busy and did not have time to cook, she usually ate instant noodles.
“It was the easiest food that I could find. Then my mother told me to stop eating it. At that time my youngest sister was diagnosed with leukaemia,” says Khadijah.
In 1990, her mother died from lymphoma and another sister from breast cancer. Their deaths changed Khadijah’s view on food.
“I am aware that food plays a big role in health. Since then, I have stopped eating fast food. I tell my nieces and nephews to do the same. I send them articles on how fast food affects health, lead to obesity and other issues. Now I am trying to be more organic. I am also practising portion control and I do gardening to keep myself fit.”
JOHAN YEONG, 66, retiree
Just like other children in the 1960s and 1970s, Johan’s diet then comprised mainly of home-cooked meals. Living in a village near Ipoh, his family grew vegetables and reared chickens. However, chicken was reserved for special occasions such as festivals.
When Johan went to work in Kuala Lumpur, he had a colleague who was a vegetarian. They often patronised vegetarian restaurants at lunch. Since he did not develop a taste for meat, Johan did not mind eating vegetarian food every day.
“I am not a vegetarian but I like the food. Back then, I was not aware of how food affects health but now that I am, I’m glad that I ate healthy food when I was young.
“I don’t claim to be eating super healthy food and I do indulge once in a while. I like curry or fried food too but most of the time, I try to eat organic food. There are many organic shop near my house and can just eat simple and healthy food there.”
Johan and his wife, Khadijah, run a support centre for cancer patients. He says when they trace the history of the patients, they realise that unhealthy diet is a common link. For example, he says, a 38-year-old man diagnosed with liver cancer used to eat bak kut teh every day.
“When I was a child, char kway teow and soft drinks were a luxury so we hardly ate them. But now, people eat such foods daily. As the quality of food drops, people eat more.”
IZZUL IQRAM RAHIM, 21, student
Breakfast is a rare meal for Izzul, a communications and media student at Universiti Teknolgi Mara Melaka. For lunch, he eats rice with chicken or fish but avoids vegetables as he doesn’t like the taste.
“For dinner, I eat either nasi goreng ayam or daging merah. For supper, I will also have fast food such as burger, fries or fried chicken. In between, I eat roti canai and drink teh tarik. I love fast food, which I eat five or six times a week.”
When studying or doing his assignments, Izzul snacks on chocolates and chips. As he stays up late often, he hangs out at mamak stalls or fast food restaurants.
Izzul is aware that unhealthy eating habits can cause health problems but for him, eating is an enjoyable experience.
“I plan to start eating healthy when I reach 30. I know that the younger generation don’t pay attention to what they eat. Most of us eat anything and are not bothered whether the food is healthy or not.”
JKAVETHA MURUGAYA, 25, intellectual property lawyer
Kavetha eats in moderation with lots of greens and fruit. She also makes an effort to avoid overcooked and fried food.
“I love food, so I never skip meals. For breakfast, I will eat something light such as oats or cereal with banana, strawberry or prune. Lunch is the heaviest meal of the day for me. Carbohydrates are a must so there will be rice, bread, noodles or pasta. Dinner is lighter. I have chapati, soup or oats and I eat my meal before 9pm.
“I occasionally indulge in snacking. I have a sweet tooth so I love cookies, chocolates, nuts and yoghurt. I do eat fast food but I like other food more so I can do without it.
“I am aware that an unhealthy diet can be detrimental to health. This is why I have everything in moderation except for fatty and oily food which I try to avoid. People are getting to be more health conscious. I know my friends practise healthy eating. We normally share ideas on dietary intakes.”
http://www.nst.com.my/life-times/health/weighing-in-on-our-health-1.292936
