Multinational food corporations are focusing on Africa, Asia, and Latin America as new markets for packaged foods as a result of dwindling markets in Western nations. This strategy could exacerbate the global epidemic of chronic diseases linked to diabetes.
Governments are taking action against the causes of obesity, such as bad foods. Singapore, where up to one million citizens may have diabetes by 2050, already compels soda manufacturers to lower sugar content. The long-term "silent" problem of obesity and other lifestyle-related disorders will cost governments in healthcare costs and lost productivity.
However, promoting lifestyle changes through education and expanding access to nutritious foods are more important than passing legislation piecemeal in order to enhance public health.
NOT A DISEASE FOR THE RICH ONLY
Rural communities in Asia who are used to working in active farming are relocating in greater numbers to urban regions where they work in sedentary manufacturing or service industries. These migrating communities are also altering their eating patterns as a result of time restrictions and the accessibility of cheap foods with lots of calories.
According to a recently released research of 98,000 adults in China, it is oversimplified to equate obesity to merely affluence, and regional variances in China's "nutritional transition" account for variations in public health.
As the West's soda market struggles, a booming Asian market for sugary beverages has developed, raising the health risks of diabetes and obesity among Asians and forcing governments to retaliate with sugar tariffs.
Alarmingly, in the Asia-Pacific region, two out of every five persons are either overweight or obese. According to estimates from the World Health Organization (WHO), Asia is home to about half of all persons with diabetes worldwide.
The cost of obesity in the Asia-Pacific area is projected to be around US $166 billion yearly. Among Southeast Asian countries, healthcare and productivity losses from obesity are highest in Indonesia ($2 to 4 billion), Malaysia ($1 to 2 billion), and Singapore ($400 million).
Malnutrition has long been a problem in China and India, the two nations with the largest populations, but obesity rates are rising.
A 2015 New England Journal of Medicine study found that between 1980 and 2015, the prevalence of obesity among males in India approximately doubled. Obesity prevalence surged 15 times in China between 1980 and 2015, where 110 million adults already live with the condition and that number could reach 150 million by 2040.
Heart, stroke, and diabetes-related annual national income losses grew more than sixfold in India and sevenfold in China between 2005 and 2015. Health statistics for children indicate a bleak future. While China has the biggest proportion of obese children in the world, one-quarter of urban teenagers entering middle school there are obese, and 66 percent of children there have a high risk of developing diabetes.
Numerous elements, such as a shortage of open space for physical activity, young people's predilection for sedentary diversions like computer gaming, and an increasing emphasis on time spent preparing for university admission tests, could be behind this trend.
TAXING OVERWEIGHT
There are numerous strategies that Asia's governments can use to combat obesity. Soft drinks and other sugary drinks are being taxed by governments in the United States and Europe because of the argument that they cause obesity by supplying too many calories without any nutritional value. Philadelphia and Cook County, Illinois (Chicago), two significant local governments, have already enacted sugar taxes; in 2018, San Francisco and Seattle both intend to do the same.
In November 2014, Berkeley, California, which has a large population of highly educated and high-earning people, became the first city in America to impose a tax on sugary drinks. A research published in the journal PLOS Medicine found that Berkeley's sugary beverage sales dropped by 10% in the first year after the levy was implemented, bringing in almost $1.4 million.
The city uses the money in part for community health and child nutrition initiatives. Berkeley is a unique instance, but the spirit of the city's strategy, particularly the wise use of revenue, can serve as a model for Asian cities.
While soda consumption has fallen off in the developed West, Asia's markets are expanding quickly.
THE SUGAR BATTLE
Malaysia, which has a serious problem with obesity, is looking at Mexico's tax on sugary drinks as a possible model for its own. In April 2017, Brunei enacted a tax on sugar-sweetened beverages, and the Philippines' senate is currently discussing a similar tax. A tax levy on sugary beverages was implemented in Thailand in September 2017 and will increase gradually over the following six years.
Asian governments have also demonstrated a readiness to combat obesity in other ways. Following surveys that shown one third of the army to be overweight and China's army publicly expressing concerns over recruit sugar consumption, India recently implemented an annual obesity evaluation for all army personnel.
Due to worries about childhood obesity, the western Indian state of Maharashtra banned so-called "junk food" from being served in school cafeterias. In addition, Hong Kong will soon implement a labelling system for pre-packaged foods served in classrooms.
IMPLICATIONS OF POLICY
Although many cities throughout the world have implemented or are considering implementing taxes on sugary drinks, it is unclear if these levies have a positive impact on health outcomes. There is reason for some optimism, such as the result in a research by the Asian Development Bank that a 20% tax on sugar-sweetened beverages was linked to a 3% decline in the prevalence of overweight and obesity, with the biggest impact on young men in rural regions.
From the standpoint of policy research, long-term studies are required to identify the effects on long-term health, and research spanning cases is required to identify the sensitivity of consumption to small increases in tax rates. Information gathering is a crucial first step. India's nutrition atlas, which provides a state-by-state comparison on a variety of public health indicators, including obesity, is one such example.
Socioeconomic justice is an issue with sugar taxes, as levies on inexpensive, unhealthy items may have an impact on low-income populations. For instance, Denmark implemented a comprehensive "fat tax" that applied to all items with saturated fats in 2011. Due to worries about price burdens on consumers, the tax and plans for a sugar tax were abandoned after just one year.
Limited policy control presents another difficulty; as a result, consumers may simply switch to sugar-rich, non-taxed goods or find other ways to avoid paying taxes. Notably, many Danes just crossed the border into Germany to get cheaper goods.
A restricted focus on simple tax reform may win quick political points, but it runs the danger of delaying important public health and development objectives. For instance, due to the poor quality of the tap water in many Asian cities, alternatives to sugary drinks may not be readily available.
Sugary beverage taxes must work in tandem with larger programmes that provide incentives for leading healthier lifestyles. A 2016 study on obesity in India makes the case that rather than taking a "one-size-fits-all" approach, relevant policy should take into account complex socio-cultural issues.
Governments should follow Berkeley's lead and use the proceeds from the soda tax to fund nutrition and physical education initiatives as well as incorporate lessons on sugar in school curricula. The strategy should take into account regional circumstances, improve education, and give people access to healthier substitutes. That is the cornerstone of a lasting remedy for Asia's obesity pandemic.
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