THE anti-smoking campaign has had some qualified success. The number of new smokers has fallen among the higher socioeconomic classes. In the past few years, the incidence of lung cancer in the higher income, better educated classes (e.g. white males in the US) has decreased.
It was not long ago that heads of state confer over cigarettes and cigars. Mao Zedong and Nixon brought US-China relations to a new footing to the accompaniment of cigarettes.
Dean Martin, an entertainer, appeared on TV with a cigarette in one hand and a glass of whiskey in the other as he belted out Memories Are Made Of These. It was the height of chic.
Closer to home, the post-cabinet meeting of the Ministry of Health of two to three decades ago was conducted in a haze of cigarette smoke. The then Minister, his Secretary-General and his Director-General found that smoking calmed their nerves and helped them focus better on how to solve the health problems of the country!
Today, smoking is banned in almost all enclosed areas. Even open areas, like parks and walkways, are more and more subjected to the smoking ban. Smoking has become taboo. It is no more part of the stylish lifestyle.
Should we not discourage overeating with the same fervour with which we discourage smoking?
In the main, we became overweight and obese by overeating. Obesity is a worldwide epidemic and it is getting worse.
Malaysia is not spared. Obesity is directly linked to diabetes, heart attack, hypertension, stroke, arthritis and cancer. It is probably worse than smoking as a cause of preventable disease and premature death. And yet we are so complacent about obesity when compared to smoking.
Obesity increases the risk of cancer of the breast, endometrium (lining of the womb), colon, kidney and oesophagus. A link has also been established between obesity and cancer of the gallbladder, ovary and pancreas. Observational studies have confirmed that avoiding weight gain will decrease your chance of getting cancer.
A major review of another set of observational trials found that physical activity reduced the colon cancer risk by 50 per cent. The risk reduction occurred even with moderate levels of physical activity.
Women who survive breast cancer may also reduce their risk of recurrence by increased physical activity and keeping a normal/less than normal body weight.
More studies are required to work out the details of the link between weight, activity and cancer. However, a healthy lifestyle is a recipe that will not fail.
Apart from cancer, a healthy lifestyle - eat right, eat less, don't smoke and lots of physical activity - will lessen the chances of heart, metabolic (diabetes), vessel, brain and bone/joint disease.
Is our attitude to eating another one of our cultural hang-ups? In Eastern societies, especially among the Chinese, food in abundance is akin to prosperity. We are "gracious" when we pile our guests with food to the point of satiety (burp, burp) and beyond.
I wonder if it would help to change our mindset if I relate what was shown on BBC recently. It was a programme highlighting the serious problem of obesity in the US. The most obese are found in the poorest part of the poor state of Mississippi. We should stop associating the image of a big paunch with prosperity.
Have we failed to take into account evolutionary biology? We evolved over a span of 150,000 years as hunters and gatherers in a time of scarcity. Our bodies have been well adapted to exercise and food shortages.
Our "civilized", "cultured" existence is no more than 10,000 years. A sedentary lifestyle and plentiful food have only been in existence for the past few decades. We simply do not have the time to evolve and adapt to this detrimental modern lifestyle.
The Chinese New Year is a time when we rededicate our bodies to smoking, gambling, drinking and overeating. Let's do it differently this year. Invite your friends for a walk in the park and offer them a celery stick. Apologize for being inhospitable when you don't offer them cigarettes. And keep that alcohol down to a reasonably safe level.
I say we go on a public campaign blitz against overeating and obesity. It is probably the most important lifestyle re-engineering we can undertake apart from not smoking.
A sedentary fat person who smokes two packs a day will keep cardiologists, endocrinologists and oncologists busy and wealthy for a long time to come!
Dr Albert Lim Kok Hooi is a consultant oncologist. For further information, e-mail starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
