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“Why are Fiji women obese?” (FT 18/1/2020)

19/01/2020

Why are Fiji women obese?

Not too long ago, I was surprised when a visiting friend who had been peering over my shoulder, exclaimed “Wow. Fiji has a lot of fat women”.

I had been engaged in my morning ritual of flipping through the pages of the online Fiji Times, at that moment the social pages with their many photos of groups of women.

I admonished her “Come on “fat” is not an appropriate term to use to describe anyone, even if they are a bit plump.”

While I informed her that many Pacific communities think plump women are attractive, one of my sons chipped in that Body Mass Indexes are western constructs and not suitable for some Pacific communities like Tongans and Samoans who are “big” by nature.

“Yeah, yeah” said our nutritionist friend “I know it is not politically correct to use the term “fat”.
But 90% of the women in these pictures, even the young ones, are really overweight and they are heading for massive health problems down the line, if they do not already have them.”

I had to reluctantly admit that this friend had a point as she was a nutritionist who knew about the impact of obesity on Non Communicable Diseases like diabetes and the associated high rates of mortality.

She also happened to be an ethnic mix of two large nations in the South Pacific (Australia and NZ) whose women are renowned sportswomen, playing all kinds of sports and extremely fit even into their middle ages.

The nutritionist asked me: “Anyway. Why are Fijian women so obese when Fijian men are such super stars in rugby and other sports”.

She did not wait for my reply but went clicking away on her IPad.  “Hey, look at this photo of Fijian women seventy years ago. They are so slim and statuesque. What has changed this last century?” she asked.

You had to admit Fijian women in the olden days were indeed slimmer and more athletic looking a hundred years ago.

Even Fiji’s Minister of Health (Dr. Ifereimi Waqainabete recently reported at a regional meeting that childhood obesity was a “slow motion disaster” in Fiji and the Pacific.

But a Research paper but a BioMed Research International paper by Hendircks, Delai and Jansen (“Perspectives of Fijian Policymakers on the Obesity Prevention Policy Landscape” noted that  while 15% of children are overweight, a massive 56% of adults were overweight,  women are more overweight than men, and indigenous Fijian women are more overweight than Indo-Fijian women.

These researchers also found that obesity policy developments in Fiji were hampered by “A poor economic situation, low food self-sufficiency, power inequalities, inappropriate framing of obesity, limited policy evidence, and limited resource sharing”.

I guess “inappropriate framing of obesity” means that “fatness” it is not being recognized?

But “limited policy evidence” was a bit of a puzzle as I am aware that there are many household surveys run professionally by the Fiji Bureau of Statistics which give lots of data on possible causes of Fiji’s obesity problems.

For instance, there are Employment and Unemployment Surveys which give data on how Fiji people spend their time on leisure activities, including sports and watching television, clear factors in obesity; and there are also Household Income and Expenditure Surveys (HIES) which also give data on what Fiji people eat and drink in their diets, including fatty foods and sugars (next article).

Women and sports

FBS data from the 2010-11 EUS, clearly shows that females are simply not playing enough sports and the gender gap begins right at primary school and widens at secondary schools and continues into adulthood.

Graph 1 shows that at primary school ages, only 61% of females are engaging in any sports compared to 70% of boys.

Then at secondary school ages (14 to 18), girls playing any sports drops further to 55%, while that for boys rises to 78%.

The gap widens further at tertiary ages (19-12) with only 31% of females playing sports, contrasted with 78% of males.

Then there is a disastrous decline for females to 13% at the ages of 22 to 34, of course when most of them are likely to be having children.

The gap continues into old age.

But health experts know that it is important to spend enough time on physical activity if there is to be any significant impact on health.

Actual time spent on sports

Unfortunately, Graph 2 shows very similar patterns of amount of time females and makes devote per week to sports.

At primary age, females spend only 2.7 hours per week, compared to 3.6 hours for males.

At secondary ages (14 to 18), females spend a lower 2.3 hours per week while males spend a higher 4.6 huors.

Again at tertiary ages, females spend an even lower 1.3 hours per week compared to 5.1 hours for males.

There are no clear reasons why females up to the age of 21 should be spending so little time on sports.

One might understand that at the ages of 22 to 34, with the demands of motherhood, females can be expected to spend less time than males, but not as low as 0.6 hours per week.

All health experts will tell you that these numbers of hours, especially for females are simply not enough to have any significant impact on health.

Keep in mind that these are averages only and large proportions of all these age groups play no sports at all.

I present the data at these age groups because for the first three education age groups (primary, secondary and tertiary) the authorities do have some means at their disposal to encourage females to be more engaged in sports.

The authorities and those framing National Plans of Action can ask the following:

* Do primary and secondary schools (and government budgets) provide

  • the facilities such as grounds and equipment to encourage girls in sports
  • the coaches
  • the compulsory sports periods in the daily curriculum

* Do tertiary institutions and their budgets ensure that they provide the facilities, the grounds and equipment to encourage girls?

* Do all City Councils and their budgets provide the facilities for children, adults AND the elderly to engage in suitable sports.

* Do parents encourage their daughters to engage in sports or do they want them to go home to do household work AND/OR do they fear that playing sports will make them promiscuous and vulnerable to negative social pressures.

* Do men encourage their wives to engage in sports and other physical activities other than those inside the home?

But ultimately, we must ask:

* Do the girls and women have the interest and the will to engage in sports?

Those who have relatives living in developed countries like Australia, NZ, Canada and NZ will know how well the Fiji girls abroad are doing in sports, compared to their relatives staying in Fiji.

Other reasons for physical inactivity?

There are many other reasons why females (and males) do not engage in more sports in Fiji.

The first is that the 2010-11 EUS data indicates clearly that on average, both females and males devote more than 8 hours per week in watching television and videos, pretty much at virtually all age groups.

Secondly, both females and males devote around 6 hours per week on average in attending religious gatherings- far more than they devote to sports.

Third, and I hope that the 2015-16 EUS obtained solid data on this, children today are engaging far more in computer games than is healthy for them, to the level of addiction.

Fourth is that females at all age levels do far more unpaid household work than males (the subject of my last week’s FT article).

I would argue that especially at the age groups of 22 and above, males in households need to do more unpaid household work so as encourage females to have more time for sports.

A remaining puzzle

The 2010-11 EUS data on time spent on sports and health researchers’ observations also throws up a puzzle.

While the EUS has clear evidence that indigenous Fijian girls and women play far more sports than Indo-Fijian girls and women, why are the health researchers finding that indigenous Fijian women are more overweight than Indo-Fijian women?

I suggest that here again, there may be an answer in the data collected by the Fiji Bureau of Statistics through its comprehensive Household Income and Expenditure Surveys, which has comprehensive information on out people’s diets and the likely impact on Fiji’s obesity problem (my next article).

I will also address the perverse current reluctance of the FBS to publish data disaggregated by ethnic categories, even though such dis-aggregation is absolutely essential for policy makers.

Post-scrip

To my great dismay, I recently found out an even more disturbing change in FBS EUS design that women’s organizations in Fiji should be really concerned about PLUS a statistical gem waiting to be discovered on the computers of the FBS- if anyone cared.

 

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