Western life-style criticised

Press, 26 February 1983, Page 10

Western life-style criticised

Good eating

Janice Bremer DIETITIAN

The Pacific Science Association's fifteenth congress was held in Dunedin recently. Raised within a culture classified as having a “modernised" or “westernised" way of life, I sat through persistent incriminations of this life-style. Evidence was presented associating the increasing incidence of chronic diseases in different Pacific societies with "westernisation" of their life-styles. The recognition of the links between certain lifestyles and food habits, and the incidence of chronic diseases was inescapable.

That these diseases are the inevitable price of progress into the modern world is the often-held excuse for our maintenance of present habits.

We protect our individual liberty to make food choices even if it is at the eventual expense of our welfare state! So there is a reluctance in New Zealand to form preventive nutrition policies integrated with agricultural, social, and economic policies. But there are a few things we can learn from our Pacific neighbours. Within the Pacific groups, high blood pressure, diabetes (adult onset type), coronary heart disease, chronic bronchitis, and certain cancers (especially lung and bowel) and the priority diseases or chronic conditions, that primarily affect adults. These are the diseases that have prominent (But not exclusive) environmental determinants.

Obesity is also well established as a life-threatening condition. The evidence available points to an increase in the

fequency of these diseases as the result of changes in the way of life. Life-style factors At the congress. Dr Richard Taylor, of the South Pacific Commission, outlined the important environmental and behavioural factors implicated in the cause of these diseases as: • Obesity (overweight). 9 Diet' high in animal fat and cholesterol, sucrose, calories and salt; and low in complex carbohydrate and fibre. • Insufficient physical exercise. • Tobacco smoking. • Excessive alcohol consumption. • Stress. Dr lan Prior, of Wellington Hospital, opened the sessions on “Metabolic Diseases in the Pacific.” In mentioning the differing ethnic backgrounds of Polynesians. Melanesians, and Micronesians, he stressed that each group has differing risks for the chronic diseases. There are patterns which can be associated with moving to towns, migrating to another country, or changing life-styles. Studies around the Pacific during the last 20 years show an association of a low salt diet with less high blood pressure, even in old age; and low body weights appear to be protection against both high blood pressure and diabetes. Within non-European Paci-

fic communities, diabetes is almost entirely of a form that does not require injection of the hormone, insulin. The role of hereditary factors in this disorder is as yet unclear, but data from the Pacific pupulations does suggest that some ethnic groups are particularly susceptible to environmental changes. In particular, excessive food consumption leading to obesity seems to be a precipitating factor for diabetes in some groups. Physical inactivity may also partially account for rural — urban differences. But a non-traditional diet i.e. “westernisation" is constantly attacked as contributing to the rising prevalence of diabetes. These and other studies do not give all of the answers to the cause and control of these diseases. But the World Health Organisation has published technical and expert committee reports that reveal a reasonable consensus on the importance of nutritional as well as other factors as promoters of chronic conditions.

These Pacific studies have inspired serious consideration for community-wide, mass education of populations to lessen or prevent the emergence of diseases such as high blood pressure, diabetes. and heart disease. The aim of such programmes is to reduce the average levels of blood pressure, blood cholesterol, body weight, blood glucose, and smoking. The W.H.O. has supported this for the prevention

of coronary heart disease. This approach is considered logical and feasible in countries where there is insufficient medical manpower and resources to individually detect those at high risk, and then establish treatment. It was certainly questioned at the conference as to whether the approach used in New Zealand, that is: treat the symptoms or the risk factors; should have priority over much mass-education. Is New Zealand being left behind? Change can happen It was gratifying after pondering my place in a race leading by a poor life-stvle example, to hear Dr Taylor remind us that it is now accepted that the high prevalence of these diseases is not inevitable with “modernisation" and affluence. Populations of people can and do change their way of life. Some developed nations have lower death rates from

coronary heart disease than others; for example. Greece and Japan. Higher . socio-economic groups in developed countries now have a lower death rate from coronary heart disease than lower socioeconomic groups. A lower heart disease death rate has also been associated in several countries including New Zealand. Australia and United States at least in part, with behaviours and life-style changes. The most clearly established nutritional problem in New Zealand is being overweight. It is the very foods that contribute to a high calorie diet ‘ and overweight that are implicated in "western life-style." diseases. The dilemmas of hypercalorism (high calories and overweight); hyperlipidemia (high blood fats); hyperglycaemia (high blood sugars): hypertension (high blood pressure); are largely solved by the simple exclusion or reduction from our diets of;

"extracted" or "separate fats (butter. margarine, cream, fats. oils, fats on meat); refined sugars, alcohol; and salt, along with the exclusion of sloth from our life-styles. Surveys carried out in New Zealand show that already at least 40 to 50 per cent of us watch our weight. As this number comprises such a large proportion of our population then nutrition education, controls on food availability, and standards for food composition may help those who inevitably do not maintain a control on their weight. Our society provides persistent stimulation for us to eat. Our society must also provide the means for us to cope with this. As one participant at the Pacific Science Congress said. "We must ask — is it wrong not to do anything?" Intervening ■in the progress of chronic diseases means conflict with our current lifestyle. Could we face up to massmedia education of how to eat. just as some of our Pacicic neighbours almost ' certainly soon will? Or do we await the conclusive evidence and suffer the illeffects meanwhile 9