Living in an era of abundant food, many people do not have the time to prepare food for themselves. Modern people often choose to dine out and even if they eat at home, their diet is full of mass-produced products.
People are putting their health in the hands of others, who control the food that they consume. In terms of “appetite” and “lust,” two fundamental human characteristics, people pay less attention to the former, as they act casually and even ignorantly. From a medical perspective, such carelessness could lead to tragedy.
Can we blame this on the public? What was once considered common sense principles for health and nutrition in the past century is now questioned or overturned by new research.
In the past, adipose, salt and cholesterol were blamed for increasing the risks of heart and cerebrovascular diseases, but recent studies have cleared their names. Some of the studies even say that an appropriate amount of such nutrients are good for cardiovascular health.
Some people avoid consuming animal fats and cholesterol, instead turning to added sugars. Today, this is considered a main cause of cardiovascular disease. This new conclusion is simple, but crucial and it is supported by the US Department of Agriculture in its latest Dietary Guidelines for Americans, the American Heart Association and the British Medical Journal.
Experts are pointing at sugar, saying that the prime suspect for causing obesity is omnipresent sugar-sweetened foods and beverages, as well as excessive food consumption. The medical costs of obesity are now higher than that of illnesses related to smoking or drinking, and sugar addiction is more widespread than cigarette or alcohol addiction. In the US, where obesity is rampant, more than 10 percent of medical expenses are obesity-related diseases.
It can therefore be said with a loud voice that “sugar is just as addictive as drugs.” Sugar addiction does not develop as fast and obvious as addiction to legally defined narcotics, such as morphine or ketamine, and withdrawal symptoms are not as strong.
With the help of advanced functional magnetic resonance imaging (fMRI), scientists found that sugar stimulates the pleasure center of the brain in the same way some drugs do. When researchers did a fMRI scan after a subject ate a piece of cake, they found that the hotspot of the brain stimulated by sugar and the hotspot stimulated by morphine were the same.
Sugar is causing an obesity epidemic among adults as well as children. It is also the prime suspect for the increase of type 2 diabetes, as the number of patients receiving dialysis is reaching a new high. Other suspects behind nutritional disorders either have been cleared of suspicion or have still not been conclusively named.
There are a lot of nutritional, medical and scientific research papers on obesity, but despite the efforts, the trend continues to spread. The population of overweight and obese people has not been reduced in most nations, and at best the sharp increase has only marginally slowed. This is more than a nutrition problem and it is closely related to various social and economic issues.
Taitung County residents are the largest in the nation and Taipei residents are the leanest. It is predicted that the overall overweight and obesity problem in Taiwan is likely to continue to increase. Obesity is more common in rural cities and counties, where residents are moving out, average household income is low and the elderly population is high. This phenomenon is not exclusive to Taiwan and nations such as the US and the UK face a similar situation.
In remote rural areas where residents are moving out, there is little variety in the food supply. Not only are there just a few items to choose from, the prices might also be higher due to low demand and transportation costs. This is a breeding ground for obesity.
In the face of worker shortages in remote areas, residents often need to spend more time on the production and management of their agricultural products. This seriously restricts both the time and the space they have available for choosing food, cooking, pursuing nutritional knowledge and improving their cooking skills. As a result, they choose ready-made processed foods and drinks, although a large amount of sugar and additives are hidden in mass-produced food in order to boost sales.
In Taitung County’s Aboriginal Hongye Village (紅葉), the hometown of the legendary Hongye Teenage Baseball Team, nurses from a public health center make weekly visits to measure the blood pressure and blood sugar levels of the members of a seniors’ club, but their high blood pressure and blood sugar levels are effects of obesity that can no longer be changed.
In Aboriginal villages, where obesity is common, scales are required to remind people of their body weight, and more importantly, they need to acquire the knowledge and methods necessary to stay away from sugary foods and drinks.
Chiang Sheng is an attending physician in the Department of Obstetrics and Gynecology at Mackay Memorial Hospital.
Translated by Eddy Chang
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