Monday, June 06, 2005

Choose to Be Healthy for Life

AS LONG as the food tastes good, Malaysians will eat it, declared Health Minister Datuk Dr Chua Soi Lek.
“They are not concerned about a balanced diet. Most times, the food is too salty, sweet or contains too much fat. They do not bother to divide their protein, carbohydrates or fat. Or eat more vegetables and fruits.
“The gravy for nasi beriani has too much salt and nasi lemak, which appeals to all Malaysians, is too oily and spicy. And you top it off by having sweet teh tarik.
“The Chinese have their dim sum, which is also oily, salty and fatty. People are not eating the correct amount of food. They are eating excessively,” a flustered Dr Chua said.
He has warned time and again of the negative effects to health if Malaysians continued with their downward spiral to the world of detrimental living.
“If you do not exercise and eat a lot, you are going to have problems and suffer from lifestyle diseases such as diabetes, hypertension, cancer, cardiovascular diseases, stroke and osteoathritis.
“And if you are diabetic with high cholesterol, it is like being passed a death sentence because of the risk factors – these contribute to heart disease, stroke and cancer,” he added.
After 11 years of trying to get Malaysians to adopt a healthy lifestyle, the ministry seems to be at its wits' end in achieving this. Its healthy lifestyle campaign, which is divided into three phases, seems to have not had any positive effect in creating healthy Malaysians.
Into its third phase, the focus of the campaign now is on promoting behavioural changes so Malaysians can achieve and maintain better health.
Dr Chua said the slogan chosen –“Be Healthy for Life” – reflected the campaign's emphasis and focus to get people at all stages of life to promote their own good health.
It focuses on four basic elements of a healthy lifestyle: healthy eating, exercise and physical activity, no smoking and coping with stress. The latest to be added to the list is getting Malaysians to give up alcohol.
The first and second phase concentrated on diseases, and health behaviour and lifestyle respectively.
The future of the health of Malaysians looks bleak, judging by statistics. Among them is that the total calorie intake of Malaysians has increased from 2,400 to 2,900 in 10 years. The average intake should be 2,200.
The National Health and Morbidity Survey 1996 revealed that only 30.9% of the population exercised, and only 11.6% exercised adequately. It also revealed that 70% of Malaysian women had never exercised.
Estimates indicate that there will be 4.4 million obese or overweight Malaysians by 2020. There are now about 900,000 adult diabetics and it is estimated that 15% of the population would have diabetes by 2020 and 30% of adults hypertension.
More than half of adult Malaysian men smoked. This is higher than the figures for developed countries like Britain (38%), the United States (35%) and Sweden (30%).
A study by the ministry's Public Health Institute in 2003 revealed that mental disorders contributed 8.6% of the burden of disease in the country while unipolar depression stood at 3.6%.
Dr Chua predicted that mental illness would be the second most major disease in five to 10 years' time.
“From my first day in the ministry and when we started talking about this campaign, I had a strong feeling that it would not be effective,” he said.
He went on to list some of the reasons that had contributed to the campaign's ineffectiveness. This includes lack of funding for the campaigns, lack of involvement at state and district levels and not fully utilising media like the television.
“We also feel that there is very little follow-up to the programme launch. There is a big 'hoo-ha' and a lot of money is spent for the launches but there is no follow-up action.
“I recently had to present the Cabinet with a paper for a special budget for HIV and healthy lifestyle. There was no budget. It was just talk,” he added.
The getting of states, districts and grassroots to be involved in the campaign can be seen in the ministry's Jom Kayuh (Let's Cycle) campaign, which was launched on May 14.
Jom Kayuh involves a tour to different states by cyclists, who are members of the community, and state or district ministry staff.
Each stop would see the launching of the state-level healthy lifestyle campaign, where free pap smears and health checks on glucose level, body mass index and blood pressure are conducted. Pamphlets would also be handed out.
The participating cyclists will be welcomed at the last pit stop in Port Dickson, Negri Sembilan, by Prime Minister Datuk Seri Abdullah Ahmad Badawi on Saturday.
Because of the ineffectiveness of previous programmes, Dr Chua said the ministry had decided to change its direction in the running of the campaign. Under the Ninth Malaysia Plan, the major thrust would be health promotion. This would include using the media, NGOs and Hospital Visitors Board.
“It is the cardinal principle for medicine anywhere in the world that prevention is better than cure,” said Dr Chua.
Despite the challenge, he said getting Malaysians to change their behaviour was exciting.
“It has been grossly neglected. I was quite surprised to look at the budget under the Eighth Malaysia Plan and saw that the figure allocated for prevention was not significant.
“There was a fixation on curative rather than preventive medicine,” he said.

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