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January 29, 2014

Two white killers on the loose

Dr. Mohamed Elmasry

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Out of some fifty countries I visited and five where I worked as a professor; the US, Canada, Switzerland, Kuwait, and my birth country Egypt, observing local diet especially among young university students, I found Egyptians consume sugar and salt the most.

All Egyptians feasts are associated with consuming sweets. The Arabic word Halwa - sweet found its way to other languages for example in Iran, Turkey, India and Malaysia. Egyptians praise their ancestors by saying they all were “Halwani” – sweet makers. Getting ready to mark the Prophet’s Birthday, Egyptians crowd especial and makeshift shops to buy varieties of sweets for the whole family.

Watch how Egyptians today use table sugar and salt-shakers even before they taste their food or drinks. The fast and processed food and soft drink industries spend the most on TV commercials.

During the fasting month of Ramadan, their average consumption of sugar increases, not decreases.  Worse still, at open buffets for breaking their fast they pile their plates as high as possible and inverting the salt dispensers over their food and genoursly add sugar to their tea or coffee.

Egyptians also, since ancient times, crave for salted, rather than dried food as method for preservation.

Sugar and salt are killing Egyptians, slowly but surly. The only group of people who are immune from these two killers are the very poor who will die from malnutrition early in their lives, before these two killers can catch up with them.

Sugar and salt are also killing the people of oil-rich Arab countries but at a faster rate than that of the Egyptians because of the rapid switch to ‘enjoy’ Western life style. American fast food outlets are everywhere including in the holy city of Mecca.

Not long ago a family outing in these countries used to be a picnic at seashore or in the desert, or at a local kebab restaurant. But now a family treat is having lunch or dinner at an American fast food outlet. Only two generations ago these same families were consuming a low-salt low-sugar diet.

Today among the top ten countries with the highest national diabetes prevalences, eight are Arab oil producers.

The adoption of a Western lifestyle by people previously having a traditional lifestyle results in NCD (non-communicable diseases) epidemics. That lifestyle include: high salt and sugar consumption, low physical activity, high calorie intake, weight gain or obesity, smoking, and high alcohol consumption.

NCD include various cardiovascular diseases (heart attacks, strokes, and peripheral vascular diseases), the common form of diabetes, some forms of kidney diseases and some cancers such as stomach, breast, and lung cancers.

“The vast majority of you readers of this book – e.g. almost 90% of all Europeans and American and Japanese – will die of one of these NCD, while the majority of people in low-income countries die of communicable diseases,” said Dr. Jared Diamond in his best selling book The World Until Yesterday.

NCD differ from infectious (communicable) and parasitic diseases which are caused by an infectious agent.

For some NCD the evidence is clear: smoking is a cause of lung cancer, high salt intake is a cause of hypertension and stroke. 

Worldwide, average daily food supply per person has steadily increased from 2,200 to 2,800 calories over the past 50 years, due primarily to advances in agriculture. This trend has had a dual effect, decreasing undernourishment rates in many developing countries while becoming a health risk issue in all other.

According to the UN Food and Agriculture Organization (FAO), global consumption of sugar, salt and saturated fats is expected to grow.

Today, the highest daily calorie consumed per person is in the US at 3,688, while Egypt is not far behind at 3,349, while in Sub-Sahara Africa state of Burundi it is only 1,604, below the needed amount to sustain life at 2,200.

The percentage of overweight and obese people in 2010 in the US is 85 and in Egypt it is again not far behind at 70.

What the world needs now is a change of lifestyle. This includes not smoking, exercising regularly, limiting our intake of total calories, alcohol, salt and salty foods, sugar and sugared soft drinks and food, saturated and trans fats, fast and processed foods, butter, cream, and red meat and increasing our intake of fiber, fruits and vegetables, calcium, and complex carbohydrates.

“Another simple change is to eat more slowly,” said Dr. Diamond, “Paradoxically, the faster you wolf down your food, the more you end up eating and hence gaining weight, because eating rapidly doesn’t allow enough time for release of hormones that inhibit appetite.”

The alarm and the advice in this article are both so familiar that it is embarrassing to repeat them. But it is worth repeating the truth.

“We already know enough to warrant our being hopeful, not depressed: NCD are killing us only with our own permission, “ added Dr. Diamond.

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