Island Nutrition dietitians Sarah Mattinson, Rosanna Strickland, Keelin Hankin and Hannah Jones discuss the dangers of obesity.
Q: What qualifies someone as obese?
A: Overweight and obesity are conditions where a person carries excess body weight in the form of body fat deposits. Obesity can be detected by making a simple calculation with your weight and height, this is known as your body mass index or BMI. A BMI greater than 25kg/m2 would indicate that you are overweight and a BMI higher than 30kg/m2 is classed as obesity.
Many of us are aware that the BMI calculation has its flaws, as the measure does not take body composition into account.
However, carrying excess body fat, particularly around our middle, is associated with an increased risk of type 2 diabetes, cardiovascular disease, stroke and certain cancers.
At Island Nutrition we utilise medical body composition scales, when appropriate, which calculate an individual’s muscle, bone, water and fat mass, along with visceral fat and a unique metabolic age assessment.
Q: How does Bermuda’s population look?
A: In 2023, over 70 per cent of the population was reported to be overweight or obese, with similar levels seen in both the male and female population. Nearly 34 per cent of males and 36 per cent of females fall into the obese category. The Chief Medical Officer’s report gives further insight into those adults who are more at risk of obesity, highlighting people from a Black, mixed or other ethnic background and those whose income is between $75,000 and $150,000, although those with an income of over $150,000 are the most likely to be overweight.
Bermuda has the third highest rate of diabetes in the OECD. Over 50 per cent of the population are living with diabetes, heart or kidney disease, and one in three people have high blood pressure or high cholesterol, both of which can exacerbate the risk of heart disease, stroke and kidney disease. These conditions can be linked to things we cannot change, such as our age, ethnicity or genetics, but they are also associated with poor diet, low activity levels and excess body fat (which we can change).
There may be many reasons for seeing statistics like this in Bermuda. As the cost of living rises, those with lower incomes may need to work multiple jobs, which means less time to focus on exercise and home cooked meals. Likewise, the cost of fresh fruits and vegetables is significantly higher than most heavily processed convenience foods. Shipping considerations can influence the foods that are imported; for example processed, sugary and salty foods may have a longer shelf life than healthier alternatives.
Generally, physical activity in Bermuda can also be quite low. On a small island like this it isn’t required for us to commute very far at all on foot, and most people will park their vehicles very close to where they need to be. This means to meet the minimum activity recommendations (150 minutes of moderate intensity a week), we need to find time outside of our daily routines. The expense of a gym membership is unaffordable for many, and a lack of sidewalks on residential streets may also impact a person’s willingness to exercise.
There is a large role that could be played by implementing sufficient education around the impact that our lifestyles have on our health. But even with education programmes in place and with sufficient knowledge, the above can remain as huge barriers to making changes to our diet and lifestyle.
A lack of focus on physical activity, good nutrition and cooking skills in many schools, means many children are not learning how to incorporate these things into their lifestyles. But the community as a whole must bear the responsibility. Adults and community leaders need to set a good example and make sure health is prioritised in all that we do. Organisers and suppliers of community events and fundraisers should consider the health impact of the event, and encourage physical activity and healthy food choices.
Q: At what point do medical professionals get concerned?
Medical professionals need to be vigilant across the life span when it comes to weight.
A third of children screened in Bermuda’s schools had a BMI indicating they were overweight in 2022. Children that are overweight are more likely to track into adult overweight or obesity, so it is important to try to improve general health habits from a young age. Educating our children on the importance of a healthy lifestyle may help to establish these habits through to later life.
Another key time for medical professionals to encourage weight management is during pregnancy; extra weight gain is likely to lead to weight retention after giving birth. Increased body weight is also a risk factor for developing gestational diabetes. Although this usually resolves after childbirth, poor blood sugar control can lead to complications during labour, abnormally high birth weight, and the birthing-parent being at a higher risk of developing type 2 diabetes in later life.
Early referral to a registered dietitian to help people understand how food impacts on our health and our bodies is also beneficial, especially for those with modifiable health conditions.
Q: With adults, is a lifestyle change sustainable?
With access to the internet and a wealth of conflicting fad diets promising to help “lose weight quick”, it can be challenging for individuals to tell facts from fiction.
The dietitians at Island Nutrition are experienced, qualified healthcare professionals whose medical nutrition services are covered by all local health insurance. We can:
- Help you know if dietary information is safe and based on evidence.
- Consider any medical conditions, medications and social circumstances.
- Discuss the best way to maintain a healthy weight by considering your diet and lifestyle as a whole.
- Support you to make healthier choices where possible and include variety and balance.
- Educate on helping people listen to their body’s hunger and fullness cues.
- Optimise your awareness of portion sizes and consider activity levels.
- Work with individuals, families and groups.
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