In 2016, worldwide more than 1.9 billion people over the age of 18 were classified as being overweight or obese. Of these, over 650 million adults were obese. Here in the United Arab Emirates (UAE), the prevalence of obesity has steadily become an increasingly critical concern over the last few decades, with the country having an overall obesity rate of approximately 32% in 2016. Even more alarming is that according to the World Health Organization more than 60% of women residing in the UAE are currently classified as obese. Just as troubling is that a study reported that 25% of boys and 41% of girls (aged 6-10 years), are also overweight or obese.
Obesity is a complex health issue that leads to a reduced quality of life, poor mental health, and contributes to some of the leading causes of death associated with conditions such as diabetes, heart disease, and stroke. It also directly contributes to debilitating, if less serious, conditions such as lower back pain and osteoarthritis. Overweight and obesity rates have increased dramatically in the last few decades, which has been a result of a combination of contributing factors, such as individual level factors, e.g. a person’s dietary pattern, physical activity, and genetics, as well as other societal factors like physical environment or surroundings, as well as education level. For example, from the study discussed above, 43% of the girls and 38% of the boys were reported to have consumed more calories than their estimated energy requirement while their physical activity was low, especially among female Emiratis (of all ages) who live in urban areas. This combination leads to unhealthy weight gain and reinforces potentially lifelong negative wellness habits.
Obesity not only affects an individual’s health and increases their risk of morbidity and mortality, i.e. chronic diseases, premature death, and decreased fertility, it also has extensive impacts upon society. In terms of economic costs for individuals, communities, and countries, worldwide obesity costs around $2 trillion USD annually. This means that obesity has increased the cost of living, health care, and number of hospital stays in many developed countries.
Furthermore, several indirect losses for the economy, employers, and individuals are associated with obesity. These include decreased work productivity, low earnings, and higher worker compensation rates for workplace injuries and sick leave. For the employers, the cost of employing overweight or obese employees is increasing due to these medical claims and sick leaves. This unfortunately also impacts children, as they are often pulled out of school for family related medical emergencies or activities, or they themselves suffer from decreased productivity, increased amounts of school absences and injuries, and are less engaged with extracurricular activities, making them less competitive in their future endeavours.
To address these growing problems that are negatively impacting the Emirati community and the UAE’s residents, the UAE Government has recently launched three national initiatives; the Wellbeing Model, the implementation of the Community Wellbeing Nutrition Program, and the adoption of the Community Program for Active Lifestyle, which encourage community members to exercise and eat well. Having a healthier lifestyle, eating a healthier diet, and adopting better eating habits will help people be healthier and create an overall positive wellness climate, but looking at the problem from a narrower perspective, how will this positive climate being pushed by the government translate into healthier habits in local homes? Furthermore, what roles do families play in promoting a healthier home, culture, and society in the UAE?
To better understand the impact of having over 60% of women in the UAE being obese, as well as to try and find potential interventions for the number of overweight and obese children in the emirates, our recent research explored the eating habits of families, such as pregnant mothers and expectant fathers, to better understand the intergenerational effects of obesity. So, what do we need to know?
The impact of parent’s habits on their children
Parents are considered role models for their children, and children can be influenced by their parents' attitudes and behaviours about food. Therefore, parents need to make sure they're demonstrating a healthy attitude towards food, so their children do this, too. At the outset, it is vitally important that expectant mothers and fathers are educated to become good role models to enable them to provide healthy eating education and lifestyle habits for their families.
How can we help expectant families be healthier?
Providing education with a focus on nutrition and diet during pregnancy is a vital component for the health and wellbeing of both the mother and her developing baby. During pregnancy, women tend to be more receptive to following healthier lifestyle habits and have expressed a keen interest in nutrition education and good eating habits. Our recent study, funded by the Al Qasmi Foundation, demonstrated an improvement in healthy eating habits of expectant families after attending a healthy eating workshop. Another study reported pregnant women undertaking physical activity helped them maintain a healthy pregnancy.
Health professionals play a vital role in providing healthy eating education for expectant mothers, as this has positive outcomes for mothers’ and their baby’s health status. During pregnancy, there are opportunities to educate not only expectant mothers but also expectant fathers and families. Therefore, allocating more time at antenatal appointments to discuss and provide advice about eating healthy and adopting good eating habits is worth investing in. In addition, it is valuable for health professionals to learn about healthy eating education as they need to be up-to-date with a good level of knowledge and understanding.
Current research suggests the use of different strategies and programs for improving and maintaining nutrition and diet knowledge for health professionals and also an understanding of eating habits and behaviour lifestyle of expectant mothers and families. A program providing healthy eating education for health professionals demonstrated an improvement in their level of nutritional knowledge when providing education for expectant mothers and families.
Moreover, the three initiatives mentioned earlier that have recently been launched in the UAE are aiming to address the ever-increasing obesity and overweight problem by focussing on providing healthy eating education for parents and families. In addition, focusing on promoting healthy lifestyle and eating habits and increasing physical activity through ongoing health-awareness and prevention campaigns is a beneficial strategy.
Future research should focus on effectively raising public awareness and buy-in of healthy eating lifestyles and behaviours for individuals, and also be used to inform professional development programs for health professionals. Undertaking a larger study involving all emirates and providing education for expectant mothers, fathers, and other family members to support and normalize healthy lifestyle pathways has the potential to address the ever-increasing problem of obesity in the UAE.
For more information on the intergenerational effects of healthy eating see the English open-access publication.