Good evening, ladies and gentlemen. I am here to talk today under the title “The obesity pandemic.” Can we still consume this solution? I will come back to this later.
What is the current position? And what is the issue? The world is experiencing a global epidemic or pandemic of obesity, or overweight individuals. The World Health Organization currently estimates that 40% of the adult population of the world are overweight, and of this figure, 13% are obese. This figure has doubled in the last 30 years alone. And it’s not just a cause for concern for developed nations like our own; it’s also one that will exhibit itself in developing nations around the world: a truly global issue.
No man is an island, and the Isle of Man does not escape this issue. In 2009, the Isle of Man health and lifestyle study showed that 50% of the adult population in the Isle of Man were either overweight or obese. These figures resemble strongly those of the UK. And recent statistics in the UK suggest this figure is now over 60% overweight or obese, obviously a great concern.
In 2013, figures for reception-age school children in the Isle of Man: at the first year primary school children suggested 20% were overweight or obese, so something that is manifesting itself in our younger generation as well. This drew, Allan Bell, Chief Minister, to identify in 2013 that parents should take responsibility for their children and their diets, and for their own diets, in pursuit of righting this issue. And why is it bad? Why can’t we be fat or obese, if we choose?
I’ll be honest, that the issue is not about obesity, or overweight. In fact, that is just a manifestation, a visual manifestation of a greater issue. This is illustrated well by statistics from the United States, which showed that 40% of normal weight adults, like myself, and like many of you in the audience today are actually exhibiting obesity internally, the fat deposits around our organs: organ fats.
And this is the great concern, because the overriding concern is chronic diseases, not obesity, which is a visual manifestation of it.
What is chronic disease? Well, in 2011, to start with, the United Nations identified that for the first time ever, chronic diseases had accounted for more deaths in the world population than communicable diseases, such as HIV and AIDS and malaria. These diseases are encapsulated by the term chronic diseases. Often things like heart diseases, which account for one in five deaths in the UK population currently. Type-II diabetes, which account for nearly 10% in the population of the adults. And things like liver disease, atherosclerosis, hypertension, gout, strokes, certain forms of cancer, and strepto-hepatitis.
What is the cost to the society because of this? Well, current estimates for the UK suggest that there’s a 14 billion pounds direct cost to the NHS for treating these conditions, these chronic diseases, and an estimation of a 27 billion pounds cost to the wider society, through lost economy, sick days taken, and lost utility, lost capacity to the economy. If we make a crude estimate from these figures to extrapolate to the Isle of Man situation – that would suggest a figure of around 80 million pounds per annum to address the direct cost to NHS for redressing these conditions. And also a 35 million cost to the wider society in the Isle of Man, through the lost economy and sick days taken. This is obviously a great concern.
We have identified the problem: the chronic disease, the obesity. And we have identified the issue to society: the massive cost exhibited and the massive burden it is placing on top. And not only us the developed nations, but also the developing nations which burden their infrastructures or the health services, to cope with this issue. This was taken in Man in 2008, and represents the idea that it’s the individuals’ responsibility. Individuals are choosing what they consume and it’s therefore that they should take the burden for it and change their habits. But I think that’s looking for the lens the wrong way. What we should be looking at is the environment, and specifically the last 40 years.
Looking back at the individual who is going to be subjected to this environment. And what is it in our environment that is causing this problem? This graph illustrates the increased consumption of sugar in our environment over the last 300 years, but notably in the last 40 years. And against the increase in obesity. What is it about sugar that is causing the problem? Sugar is made of glucose and fructose. And I had a list of products with sugar in our diet that is causing this problem. Fructose is implicated in all these chronic diseases. When you consume a can of soda, what you are actually consuming is fat because glucose is metabolized in the liver as fat. Then, it has an issue with liver disease, atherosclerosis, inflammation in the liver when the glucose is metabolized.
Next, the issue of insulin resistance creating insulin-resistance around the liver which causes the pancreas to boost up insulin in all of the body, creating an insulin mistake, which has been an implication in type-II diabetes. Then, you have atherosclerosis, built-up fat deposits around the interior wall of arteries, so heart disease.
Then, you have uric acid, which is released when metabolized, and that is implicated for hypertension, again. All these chronic diseases: hearts disease, strokes, atherosclerosis, liver disease, type-II diabetes, gout and hypertension. We have identified the problem. We have identified the issues to society. And sugar and fructose are specifically implicated in this. Should our government do something to address it? Should governments around the world do something? I would assert that it’s a public health epidemic. It’s not an individual’s responsibility to change this, when it is a public health issue.
Why? Well, fructose is a poison when we can’t consume it and it pervades our diet. It’s ubiquitous, it’s all over the place, we can’t escape it. Poison, ubiquitous. Number three, we abuse it, we can’t stop consuming it. There is an indication that when fructose is chronically consumed and there are insulin issues, then the signal hormone leptin, which sends our brain to tell us we are full, is switched off. So we have an abuse issue. And then lastly we have identified the net effects on our society, a huge financial burden on our communities and global communities.
How can the Isle of Man government be addressing this? This is what companies choose to sell us, but we can reverse that. Product placement: should we sell these products in our schools? And in our hospitals? Would we sell beer in schools? Well, beer has an acute effect on the brain when it’s metabolized, but fructose does not exhibit that. However, look at beer: liver disease, insulin resistance, type-II diabetes, heart issues, atherosclerosis. All these chronic conditions that are also exhibited by fructose. Would we sell beer to our children? This is where our argument can step in.
Products: this is the area where we will have less influence, because they are shipped to the Isle of Man. We don’t have the remit to regulate them in their production. However, in information, we may have an impact. We couldn’t address things like marketing on the internet or on TV. However, we could look at promo-issue: buy one, get one free. Free-strategies that companies use to sell their products and increase our consumption of these products, causing medical issues. This is something that can be addressed.
And lastly, price. Identifying: is it something that Isle of Man can do? Should they do? And will it solve the problem? Or will the system educate it? This is a great issue. So, number one: watch these three beverages. Sugary beverages are implicated as one of the greatest concerns. Why? Firstly, you consume the product without fibre, so it hits the liver straight away, and that’s when the problems arise: the insulin resistance, the fat making, and gluconeogenesis.
Secondly, you wouldn’t go to a shop to buy five oranges, sit down and then eat through them. You’ll probably get through three oranges. You sit and say, “I am full. I don’t want to eat anymore.” But then you go and squeeze five oranges into a concern-orange juice, it may be 50 ml, you knock it back in two seconds. That is when the issue arises, when the fructose hits the liver really quickly. That’s when these chronic conditions develop. It’s not just about soda. It’s all about all these sugary beverages. They are the medium where we all feed in our diseases. We are sick people.
Lastly, these products are very cheap, but they have a huge social implication and massive cost to our society. A tax, introduced to right this, where it sits. To close, I think it’s imperative that we act now. And this can be the greater good for our society. And we can hold up the mantle to the rest of the world, who is also suffering these conditions. And I appeal to the audience today, If you can assist me in this drive, please come to me, talk to me afterwards. Thank you.