Obesity is a medical condition in which excess
body fat has accumulated to the extent that it may have a negative effect on
health.Obesity is most commonly caused by a combination of excessive food
intake, and lack of physical activity. Malaysia has been rated as the highest
among Asians countries for obesity. Science Advisor to
the Prime Minister, Tan Sri Zakri Abdul Hamid, said new findings from British
medical journal, The Lancet, showed that 49% of women and 44% of men in
this country were found to be obese.According to a new study published last
month by The Lancet, Malaysia was rated heavyweight at 45.3% of its population.
(citation: taken from https://www.thestar.com.my/news/nation/2014/06/16/obesity-malaysia-highest-in-asia-says-pm-science-advisor/)
Obesity should be prevented from affecting Malaysians because it is a
very big problem since it has implication on diabetes, heart problem and
others. As people said, prevent is better than cure. Based on the topic given, “choose one strategy from Ottawa Charter
to prevent obesity in Malaysia”, our group chooses a ‘Create Supportive
Environment’ strategy out of five strategies from Ottawa Charter (1986) The
Health Promotion. Supportive environment is in which environment that people
can live, play, work and offer people protection that can threaten good health.
The links between people and their environment
consists of the basic for a sociology approach to health. Changing patterns of
life, work and leisure have a significant impact on health. We choose create supportive environment strategy because it
is very essential for health. Even there
is healthy public policy or reorient health services, obesity cannot be
prevented without a supportive environment. Supportive environments cover the
physical, social, economic, and political environment.
Everyone has a role in creating
environment that support physical wellbeing such as families, worksites,
schools, universities, and neighbourhoods. Firstly, the role of family in
preventing obesity is very important. Parents are role model and particularly
important as encouragers and facilitators of physical activity in their children. For example, parents in Malaysia take their children for
the family outdoor activities such as cycling, and jogging every evening. They
also buy sports equipment for their children to encourage them involves in
physical activity. Secondly, worksite is an ideal place to make everyone
involved in physical activity. Some employer in Malaysia builds onsite gyms and
adopts policies to encourage exercise breaks during the workday. Some employees might not interest in doing exercise during the workday.
So what employer did to encourage their employees is by compensate them for
joining gyms or offer health insurance incentives for physical activity.
Thirdly, school and universities are particularly important to expose students
on the important of doing physical activity. Schools and universities community
in Malaysia usually hold programs that combine both nutrition and physical
activity not only focusing on the physical activity itself. Because, nutrition
and physical activity are essential parts of a person’s overall health and
wellbeing. Next, most schools and universities in Malaysia provide sports facilities such as gym, tennis court, futsal court,
and netball court. They also make the stairwells more attractive and safer to
use and put signs by elevators encouraging students to take stairs. Lastly,
some neighbourhood in Malaysia is a ‘walkable neighbourhood’ which has sidewalks, crosswalks, stores, gyms, recreational facilities, parks and safe from
‘stranger danger’ and reckless drivers. ‘Walkable neighbourhood’ allows people
that live in that area are more likely to walk rather than taking a drive
because everything is near to their home. Unlike unsafe neighbourhood, children
are less likely to play outside and adults are wary to take a walk and involve
in physical activity
influenced by food, eating patterns and physical activity vary enormously across populations. Due to this, there are differences in obesity in terms of populations and sub-populations”, (Swinburn B. A.,
2008). The socio-cultural differences such as what type of food they usually serve, what physical activity they usually do and other factors.
There are some of ways to prevent obesity in social environment. First, at the individual level, the price and product of the food can directly reached individuals and encouraged them to change their behavior towards the nutrition and physical activity. Moreover, advertising to individuals can describe socially desirable role models realizing social benefits.
Second, at family level, the parents serve as important nutrition and physical activity role models. Their behavior contribute in their child’s growth and they could serve as either a risk or protective factor for obesity. The parents should encourage their children to do community sports and recreation
programs in local neighbourhoods. Parents also could suggest small changes in food choice, for an instance when buying groceries at the market, buy one less package of processed snack foods and one more fruit or vegetable item. Parents who teach their children to eat more on healthy food rather than junk food can lay the foundation for their children to live a healthy life at home, in school and community environments.
Third, at school level, the authorities involve should investigate what kind of food that had been serve at the cafeteria and exercise pattern of the students. These strategies include a combination of place, price and product. Place is where the food is purchased in school, are they need transportation to go to the cafeteria. The price of food in cafeteria and the product indicates the food availability in school. Campaign in changing student’s nutrition and exercise pattern can be done in hope that it will increase the awareness of the community in school.
Fourth, at community level should raise awareness of the impact of obesity in one’s life. The campaign should contain important message at nutrition, physical activity, the after-effect of obesity and the strategy how to overcome it.
The effort to overcome obesity
is primarily through prevention. In order to prevent obesity, the use of
economics such as subsidies and taxes is needed to control the health problem.
Subsidy is a fund given by government to reduce the consumer pay and at the
same time increase the prices producers received. Taxes are an amount of money
paid to the government that is based on your income or the cost of goods or
services. Both subsidies and taxes involve the government. The target sectors
are including the food system such as agriculture, food processing and food
services.Food companies produced a wide range of products, some that are
healthy and some that are unhealthy. There are some ways for government
approaches to develop healthy food environment. For example, one the food
incentivesimposing taxes on food and drinks high in calories, fat, or sugar
such as junk food, fast food and sweet beverages similar to tobacco and
alcohol. It shown to be extremely cost-effective measures for government.
On the other hand,
government should improves subsidies for healthy food such as fruits and
vegetables. Department of Agriculture have taken other incentives to promote
access to health for young children especially in school by limiting junk food
at cafeterias and canteens and encouraging farm-school partnership to promote
access to fruits and vegetables. By doing this, we can control the markets and
companies that make world easily promotes unhealthy eating towards world with
healthy eating. Eating larger amount of food and vegetables also assist dietary
weight management strategies to prevent obesity.
Besides, the benefits
of economics incentives have taken careful planning of built environment that
have close access to recreational facilities and destinations may improve
physical activity such as cycling, walking and jogging and thus may reduce the
risk of obesity. The regulation of food labelling also helpful to reduce the
rate of obesity. Nutrition labelling is the provision of standardised format of
nutritional information on foods sold. For example, labelling on the food
packaging with calorie-per-serving including levels of energy, protein, total
fat, saturated fat, carbohydrate, sugars and sodium and recommended daily limit
on added sugar consumption or caffeine consumption. It can increase consumer
information and awareness to choose healthier food, thus they more health
conscious when they shop for food, convenience of packaging.
are some limitation facing by economics to prevent obesity. Even the government
have reduce the sugar intake by reducing the sugary beverages, however schools
to supply them to children. In addition, it is difficult to change people
eating habits. The high rate of obesity found in individual who have low
socioeconomic status such as low incomes, education and job status. Healthy
lifestyle is strongly influenced by the living & built environment. Nutrition
promotion & education is important but unhealthy environment will influence
people to do not support healthy eating practices. Furthermore, all ministries,
agencies & other stakeholders have a role to playmultisectoral
collaboration to prevent obesity but some of them may not give commitment to
achieve the goal.
Political environment is defined
policies, laws and regulations that are needed to drive the environmental and
social changes on preventing obesity in Malaysia.
environment plays a crucial role in preventing obesity in Malaysia. The main
government that responsible in preventing the disease is The Minister of Health
(MOH). The Malaysia government had introduced two policies in order to prevent
obesity from increasing in this country. First, is the “Soft Policies” which
the main approach of this policy is by conducting campaigns and healthy life
style programmes. Some of the examples of the soft policies are Sihat1Malaysia.
The campaign was promoting a healthy living lifestyle by having some activities
such as Balanced Meal, Blood Donation and Talk on Diabetes that also join by
the Ministry of Women, Family and Community. There is also The Malaysian
Healthy Plate that providing a visual presentation of a balance meal that
recommend by the Malaysian Dietary Guidelines. The campaign is by preparing a
five steps meal based on a model that been provided. By following the model,
the person manages to get all of the nutrients need by the body to function
properly and prevent obesity. In 2009, 10,000 Steps a Day is another campaign
that introduced by the MOH. The objective of this campaign is to reduce the
sedentary lifestyle of Malaysian which leads to obesity. Sedentary lifestyle is
meaning that a lifestyle with a lot of sitting and lying down, with very little
to no exercise. (MedlinePlus, 2017). But, the impact from ‘soft policies’ is
questionable because the number of obesity is still increasing over the last
few decades. However the Malaysia
government prefers the ‘soft policies’ to prevent obesity. This approach has
relatively weak effects, especially if they are considered as the main
interventions (Milio, 1990).
hard policies are the approach by ruling a new law or regulation to prevent
obesity in Malaysia. But in order for MOH to introduce a new law and
regulations that related to prevent obesity, the MOH will need the coorperation
from the other Ministry such as Communication and Multimedia (KKMM), Education
(MOE), Youth and Sports (KBS) and Transport (MOT). In Malaysia, there are 40
new laws and regulations that have been concern and submit to the MOH and have
been taken up in the Eleventh Malaysia Plan that is to happen from 2016-2020.
‘Hard policies’ such as regulations or fiscall diseases (Nnoaham et al 2009; Smed Jensen & Denver
2005). Gurthermore, it is shown to be a cost-saving intervention to prevent
obesity in modeling studies (Gortmaker et
al, 2011). One of the new laws is the Removal of Subsidy that include of
oil and sugar. These two ingredients is main
of obesity if taken in a large amount in their meals daily. So last year the
government has remove the subsidy of the product. Regulations Pertaining Food
and Beverages Advertising in Media is one of the government new laws that need
the collaboration of the KPKK. The law is to follow the guidelines that been
provided regarding to food and drinks advertisement and the must obtain
approval from the MOH (Food Safety and Quality Division). The other example of
‘hard policies’ is Healthy Eating in School Implementation Guidelines. This law
is to develop a healthy behavior for the children. There are two guidelines
that been develop that is Guideline in the Weight Management of Schoolchildren
and Guideline in Selling of Food and Beverages at School Canteens. This
guideline is introduced by the MOE a collaborator with MOH.
In conclusion, Create Supportive Environment from
Ottawa Charter includes the physical environment, social environment, economy
environment and political environment. These methods play a crucial role in
preventing obesity in Malaysia. But, this does not mean that the other strategy
cannot be used in preventing obesity.