The Tribune

By Dr Greggory Pinto

According to the World Obesity Federation, the Bahamas had an adult obesity rate of 27.9 percent in 2021. The Bahamas was ranked the sixth most obese country in the world according to 2014 statistics by the World Health Organisation (WHO).

The Bahamas, like many nations throughout the world, has a high prevalence of obesity and obesity-related comorbidities that have reached pandemic proportions. It is a well-known fact that the Bahamas is sadly an obese nation, with an unacceptably high incidence of non-communicable diseases such as cardiovascular disease, diabetes mellitus, hypertension, obstructive sleep apnea and metabolic syndrome, which all have a strong association with obesity.

Metabolic syndrome is a medical condition characterised by high blood pressure, abnormal cholesterol levels, high glucose levels and waistline obesity. Metabolic syndrome puts affected men and women at increased risk for cardiovascular events such as strokes and heart attacks. Obesity is a direct and indirect killer in our society.

Obesity is defined as having a Body Mass Index (BMI) greater than or equal to 30. Overweight persons have a BMI greater than 25 but less than 30. The BMI is calculated by taking a person’s weight in kilograms and dividing it by their height in meters. General and abdominal obesity are associated with an increased risk of premature mortality, but studies have shown that abdominal obesity could be a stronger risk factor for premature mortality than a high BMI.

Obesity and cancer

Obesity and being overweight increases the risk for several cancers such as colon, breast, kidney, stomach, esophagus, pancreatic, endometrial, gallbladder, liver and leukaemia. Colorectal cancer is 1.3 times more likely to occur in obese versus non-obese adults as an example. Obesity is linked to a more aggressive form of prostate cancer. Weight loss particularly among postmenopausal women reduces the risk for breast cancer. Obesity also negatively impacts survival rates for those ongoing cancer treatments.

The biological mechanisms linking obesity and cancer are complex and not fully understood. Cancer cell promotion and progression are known to be related to obesity related hormones, growth factors, multiple signal pathways and inflammatory processes. Inflammation is an important factor linking obesity to cancer. Acute inflammation is a short term protective body mechanism that mobilises resources to fight infection and promote healing. Chronic inflammation in the body however can be thought of as a fire that burns, out of control. Research has shown that losing body fat can reduce chronic inflammation that can be as important in cancer prevention as healthy eating and routine exercise.

Obesity and type 2 diabetes

Obesity can lead to elevated insulin blood levels, which are contributing factors that can lead to pre-diabetes, type 2 diabetes and cancer. An estimated one third of adults have pre-diabetes. Obesity can cause cells in the body to resist insulin. When carbohydrates are consumed, they are digested to release the simple sugar glucose into the bloodstream. The response of the body to glucose in the bloodstream is the release of insulin by the pancreas gland, which leads to glucose being delivered into cells to provide energy. Insulin resistance can cause glucose to not be delivered into cells; leading to a potentially dangerous accumulation of glucose in the blood.

Obesity during the COVID-19 pandemic

Obesity is one of several comorbidities that place persons in an immunocompromised state that potentially could lead to more severe symptoms and possibly worse clinical outcomes.

Obesity levels have generally increased during the COVID-19 pandemic due to multiple causes such as:

• Decrease in exercise and physical activity

• Higher levels of stress

• Increased alcohol consumption

• Financial constraints in being able to afford healthy foods

• Delayed medical care

Childhood obesity

Obesity is a direct cause of physical and psychological poor health during childhood and adolescence. An estimated one in five children are overweight or obese. These children are more likely to develop type 2 diabetes in childhood or later in life and have a higher incidence of heart disease as adults. Overweight children are more likely to suffer from low self-esteem, anxiety and depression. Sleep disturbances related to childhood obesity can lead to poor concentration in school.

Prevention is always better than cure. As a nation, we must urgently wage a relentless war on childhood obesity as a cornerstone of the goal for a healthier nation. Healthy lifestyle changes and behavioral modifications related for example to implementing routine regular exercise and a healthy diet are of paramount importance in combating obesity. Obesity negatively impacts the quality of one’s life and shortens life span.

Preventing childhood obesity must start from the moment of conception. The first 1,000 days of life, from conception to the age of two, are a very critical period to reduce the risk of future obesity. Pregnancy risk factors for childhood obesity include maternal obesity, excessive maternal gestational weight gain, gestational diabetes, and smoking during pregnancy. Early risk factors for infants developing obesity include the too early introduction of solid foods before age four months and exclusive formula feeding without any breast feeding.

The home and school environments play important roles in combating childhood obesity. Children inherit and mimic physical activity and family eating behaviours. Healthy diet choices should be emphasized throughout childhood and regular physical activity should be actively encouraged.

The health of our nation is the wealth of the Bahamas. Obesity must be combated at all ages so that the scourge of non-communicable diseases on our country can be reversed. The epidemic of obesity has become a pandemic in the Bahamas and as a nation we must all face this reality and act as a matter of urgency.

• Dr. Greggory Pinto is a board-certified Bahamian urologist and laparoscopic surgeon. Dr Pinto can be contacted at OakTree Medical Center #2 Fifth Terrace & Mount Royal Avenue, Nassau, Bahamas; telephone (242) 322-1145-7; email welcome@urologycarebahamas.com, or visit the website:www.urologycarebahamas.com