Hong Kong health care and hospitals

Are Hongkongers really getting fatter? The recent obesity alarm explained

Recent government figures said half of the population is overweight, because of a bad diet and infrequent exercise. We take a closer look at the numbers

PUBLISHED : Thursday, 30 November, 2017, 8:31am
UPDATED : Thursday, 30 November, 2017, 11:19am

Monday’s revelation that half of Hong Kong’s population is overweight has prompted calls for people to rethink their unhealthy lifestyle, improve their diet and get more exercise.

The findings were from a government survey of more than 12,000 people aged 15 to 84 between December 2014 and August last year. Apart from finding an increase in the number of people suffering from various chronic diseases, it also exposed the fact that Hongkongers in general are not eating enough fruit and vegetables, while eating too much salt.

Are Hongkongers getting less healthy?

It depends on which figures you look at. They are, according to the findings released by the Department of Health on Monday.

The number of overweight or obese people increased from 38.8 per cent from the last survey, carried out in 2003 and 2004, to 50 per cent in the latest survey, done between 2014 and 2016. More people also had high cholesterol, with the number jumping from 1.8 million to 2.9 million over the same period.

But if you look at the yearly data released by the department, which only interviews those aged between 18 and 64, the increase is hardly noticeable. The number of people defined as overweight and obese remained between 36 per cent and 41 per cent of the city’s population from 2004 to 2016.

Why do the different studies give different results?

There are at least two relevant differences between how the studies were carried out. The large-scale report was based on measurements done by interviewers who met the people they were studying, while the yearly data is based on measurements and information voluntarily reported by individuals. And the yearly reports exclude people aged over 65, so changes in the health – or just the number of – elderly people would not be picked up.

Why could things be getting worse?

Dr Chow Wing-sun, a specialist in endocrinology, diabetes and metabolism, said an uncontrolled diet and lack of exercise could be some of the reasons for a less healthy population.

For example, with buffets being popular in the city, people might easily overeat.

Further, only 5.6 per cent of respondents in the latest survey, down from 16.3 per cent in the previous one, managed to have at least five servings, or 400g, of fruit and vegetables daily – the amount recommended by the World Health Organisation (WHO).

“The younger generation are less likely to play football. Instead, more of them prefer playing football games on their phones,” Chow said. The prevalence of long working hours in the city also means Hongkongers have less time to exercise, he added.

With the city’s ageing population – the number of those aged 65 and above is projected to more than double to 2.3 million in 2034, making up a third of the population then – Chow warned that the obesity rate could further increase as the elderly tend to do less physical activity and have slower metabolism.

The latest survey showed obesity was also common among women aged 65 to 84 and men aged 45 to 54.

How does Hong Kong compare with other countries in Asia?

Just looking at figures on body mass index (BMI) – an indicator of health and fitness – Hong Kong is not the worst when compared to its neighbours in the region.

Using the WHO’s definition, 29.9 per cent of Hongkongers are overweight and obese, with a BMI of 25 or above.

According to WHO statistics from 2016, which covered the population aged 18 or above, the city’s share of people with a BMI of 25 or above was lower than Singapore’s, at 31.8 per cent, and 30.3 per cent in South Korea. But it was higher than Japan’s figure of 27.2 per cent.

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Is it true that poor people are more likely to be obese than others?

The latest large-scale survey found people from poorer families were less likely to have a family doctor. And the likelihood of people being overweight or obese drops as household income increases.

Roger Chung Yat-nork, assistant professor of public health and primary care at Chinese University, described this as the global phenomenon of “health inequality”.

“Poor families are less aware of health because they might have less education or less information on what constitutes a healthy lifestyle,” Chung said.

“Those who are working long hours might have less flexibility in executing their health plans, like exercising and resting enough.”

He pointed to research by the WHO, which stated that in general, temporary workers “have less freedom to choose when to take personal leave and are far less likely to be represented on health and safety committees,” hence poorer health.

Chung added: “Poor families will also tend to eat cheaper food like fast food which has low nutritional value but very high calories.”

What could the implications be for our health care system?

The WHO calls obesity “a major risk for serious diet-related chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension and stroke, and certain forms of cancer”.

Chung said such chronic conditions would pose a heavy burden on the city’s health care system.

“These chronic conditions are recurrent so patients have to keep going back to public health care [services],” Chung said. “For example, if an obese person has had a stroke, after the initial episode is cured, he might still need lifelong medical attention.”

A report by a global consulting firm, McKinsey and Company, stated that obesity is one of the top three global social burdens generated by human beings, costing the world US$2 trillion in 2012. In the United States, for example, obesity was the second largest drag on GDP, after armed conflict. It caused an economic and social loss of US$663 billion, or 4.1 per cent of GDP in 2012.

How can people achieve a healthier lifestyle?

Having a balanced diet and doing regular physical exercise are some of the golden rules to maintain good health. Apart from eating at least five servings of fruit and vegetables a day, choosing dishes with no sauce or requesting sauces be served separately when dining out can also help reduce sodium intake. Spending at least 30 minutes a day on physical activity of moderate intensity, such as brisk walking or going up stairs, would also help. To achieve health benefits, people should exercise five times a week. Director of Health Dr Constance Chan Hon-yee also said the department would step up monitoring and conduct major health surveys more frequently.