Sunday, May 9, 2004

Pacific islanders top
the world’s scales

KOSRAE, Micronesia >> Tadao Wakuk, traditionalist, looked forward to a down-home dinner this tropical evening. "We're going to eat taro, with Kosraean soup -- you know, fish, banana, coconut."

As for his neighbors, the rest of Kosrae's wide-bodied population, "this has become an island of turkey tail, corned beef, Spam," the 60-year-old nature guide lamented. "They're eating this imported stuff. They like fast food, and it's making them sick."

And, most of all, making them fat.

Mountainous and reef-ringed, Kosrae is a green dot in the blue mid-Pacific, a place where slender peaks reach to 2,000 feet, where skinny palms bend to the breeze, where sleek fish dart through the lagoons -- and where the people have ballooned to a size that has won them headlines in international medical journals.

The World Health Organization warns of an "emerging epidemic" of diabetes, hypertension and other conditions associated with obesity in Kosrae and the rest of the Federated States of Micronesia. Meanwhile, villagers from this ramshackle, sleepy but beautiful island -- it's pronounced KOSH-rye -- are flocking to the United States to find medical treatment on welfare.

A former U.S. territory 2,900 miles southwest of Hawaii, Kosrae is hardly unique.

From Tuvalu to Tahiti, Pacific islanders have been putting on weight for decades as lifestyles and diets changed, and are generally recognized as the world's fattest people. Almost two-thirds of adults on some islands are obese, by international standards, compared with one in three in the United States.

Studies by New York's Rockefeller University have detailed the heavyweight status of adults among Kosrae's 8,000 residents, finding more than half to be obese. A total of 82 percent are overweight. One in eight adults has diabetes.

The Rockefeller scientists are still studying causes, particularly genetic underpinnings of overeating, overweight and diabetes.


An overweight man drives a little motorcycle in Athens.

Obesity growing into
worldwide epidemic

Processed foods are partly to
blame for expanding waistlines,
even in poor nations

It's a bitter truth to swallow: about every fourth person on Earth is too fat. Obesity is fast becoming one of the world's leading reasons why people die.

In an astonishing testament to globalization, this outbreak of girth is occurring just as doctors everywhere but sub-Saharan Africa are winning the fight against infectious diseases from smallpox to malaria.

Now a new enemy is emerging in the 21st century -- our appetite. Around the globe, about 1.7 billion people should lose weight, according to the International Obesity Task Force. Of those who are overweight, about 312 million are obese -- at least 30 pounds over their top recommended weight.

Already, a third of all deaths globally are from ailments linked to weight, lack of exercise and smoking. And perhaps most worrisome is obesity's spread beyond wealthy Western nations.

From the glaciers of Iceland to the palm-fringed beaches of the Philippines, there are now more fat people in the world than hungry people. And in extreme cases, people who are heavy since childhood could die as much as five to 10 years early.

"The developing world in particular is going to bear the enormous brunt of this weight gain," said Neville Rigby, policy director of the IOTF.

"We're even seeing obesity in adolescents in India now. It's universal. It has become a fully global epidemic -- indeed, a pandemic."

Type 2 Diabetes is the illness most directly linked to obesity. A condition that often leads to heart disease and kidney failure, it is blamed for more than 3 million deaths a year. It afflicts 154 million people -- nearly four times the number who have HIV or AIDS -- and the World Health Organization forecasts more than twice as many people will develop diabetes in the next 25 years.

Obesity can triple the risk of heart disease. One-third of all deaths globally -- about 17 million -- are blamed on heart disease, stroke and related cardiovascular problems, WHO figures show.

Countries with extensive health care have stalled the onset of heart disease into old age. But in much of the world, fatal heart attacks and strokes are much more common among working-age adults. Over the next 30 years, the trend is projected to worsen.

Many factors contribute to the widening of the world's waistline.

For starters, there is cheap, plentiful food. Even in poor nations, the relative cost of eating is declining.

And the consumption of oils and fats used in processed foods has doubled over the last 30 years.

"One year they had very expensive butter and the next year edible oil came on the scene," said Barry Popkin, who heads nutrition epidemiology at the University of North Carolina and serves as a WHO adviser. "All of a sudden for very little money you could make your food taste better."

Nutritionists say cheaper sugar is another factor, despite the industry's strenuous denials.

Another factor is how food is promoted and distributed.

In 1990, no more than 15 percent of food bought in Latin America came from supermarkets. Now, 60 percent is from six supermarket chains.

There are demographic changes, too. In many nations, women in the work force created a demand for convenience foods.

And then there is technology. People spend more time sitting in the car, at the computer and especially in front of the television -- an average of 1,669 hours a year in the United States, a habit that is extending internationally.


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