The Conflict Between Health and Culture

Kuwait is a nation in the Gulf Arabian region of the Arabian Peninsula. It has a plentiful food supply and a high per capita income in comparison to other developed countries. The discovery of oil resulted in increased economic status, which resulted in modernism and cultural reform (Al-Kandari 147; Amine and Al-Awadi 387). Obesity has been linked to all age classes in this country since modernization (Al-Kandari 147). While illiteracy is decreasing and healthcare is free, there is still a lack of nutritional knowledge. It contributes to obesity and other noncommunicable diseases not only in Kuwait, but throughout the Gulf Arabian Region (Kilpi et al. 1,6). Studies presented here all tackled the impacts of culture on obesity in Kuwait. Researchers obtained their data from the measurement of anthropometric indices, answered questionnaires and through interviews where relevant questions to the studies were asked (Al-Kandari 148). For data analysis, the SPSS software was used for most studies with a variation in the version. Chi-square test was used to check for the significance of variation between groups (Zaghloul et al. 598). T test was used for differences between males and females while ANOVA was employed for the variation in multiple groups. Regression models were used to describe the trends of data collected (Kilpi et al. 2) while correlation tests identified and described associations (Al-Kandari 149).

All the studies found obesity to be oddly high in Kuwait, both in children and in adults. The disease is influenced by genetic and sometimes environmental factors resulting in psychological distress. This condition predisposes one to chronic and morbid conditions with severity in those who acquire it at tender ages (AN Al-Isa 1273; Kilpi et al 1,6.; Al-Kandari 147; Abdulwahab Naser Al-Isa 369,373). Kilpi’s et al.’s study found obesity rates to be highest in children with an overall range between 20-49% (6). AN Al-Isa ( 1275-1276) found obesity rates to be at 14.9% for girls and 14.2% for boys for the ages between 10-14 years, with an overall obesity at 30.7%. Also, it was lowest in 11 years and highest at 14 al. A similar study indicated the highest levels were at 11years while lowest at 10 years of age.Also, females had higher BMI than males (El-Bayoumy, Shady, and Lotfy 155). This coincides with other studies confirming the higher weight gain among adolescent girls than boys (AN Al-Isa 1275; El-Bayoumy, Shady, and Lotfy 157).Obesity was found to be lower in men than in women (Abdulwahab Naser Al-Isa 369; Kilpi et al. 1; Al-Kandari 150; El-Bayoumy, Shady, and Lotfy 148)369,1, 601,148,150el and the risk increases as women age beyond 2o years. Also since young women are more concerned with how they look than men, they tend to lose weight to look good (Abdulwahab Naser Al-Isa 369; Kilpi et al. 7). Another study reported that among men of the 18-29 bracket, 44,3% are overweight and obesity among them stands at 17.1%.The bracket of 20-29 showed an overweight prevalence of 67.7% while obesity was at 32%. This study checked for diabetes among college men. It also reported that older, married men, and fathers were more likely to developing obesity as compared to single, younger men, and nonparents (Abdulwahab Naser Al-Isa 370). Among the college men, a family history of obesity, physical inactivity, dieting and being at the first year of study, was associated with obesity (Kilpi et al. 7). Abdulwahab Naser Al-Isa (369) also recorded that 38.5% of college men were overweight and 11% were obese. He continues to state that obesity was higher in males below 18 years as compared to females of 9-13 years and those chances of being obese increases with age. All the obesity and overweight percentage levels presented in most of these studies were are higher than in those of the West particularly European countries (Abdulwahab Naser Al-Isa 373).

Most of the studies seem to agree that modernization has affected Kuwait’s food patterns and physical activity1276, 2,387. Rich families are more affected by obesity. The use of cars, energy saving devices, television, the internet, playing gadgets and transition from manual to office work have encouraged sedentarity and physical inactivity justifying the high levels of obesity observed (Kilpi et al. 2-7 El-Bayoumy Shady and Lotfy 157). Longer sleep time and among rich kids also contributes to this condition as compared to the lesser periods for other children. The shift from the uptake of traditional food to eating out is also blamed for high obesity prevalence. Consumption of fast foods and soft drinks served in restaurants has led to high-calorie intake and consequently weight gain and obesity(Al-Kandari 152; Abdulwahab Naser Al-Isa 369; Kilpi et al. 1,7; Zaghloul et al. 597; El-Bayoumy, Shady, and Lotfy 148; AN Al-Isa 1276).This shift has also affected college students. Those students who feel that they have added weight attempt dieting to lose it. However, warns that dieting increases the chances of developing diabetes fivefold (Abdulwahab Naser Al-Isa 369, 373).

Sociocultural variables such as literacy levels and size of households influence the occurrence of obesity. Large families tend to sit together for long hours resulting in the consumption of higher amounts of food and frequent snacking (Al-Kandari 152; Abdulwahab Naser Al-Isa 373). This pattern is reflected even in social gatherings, common among Arabs, where men even compete about food intake. Women are culturally restricted to engage in physical activities such as sports and thus lead largely sedentary lives increasing the likelihood of acquiring diabetes (Al-Kandari 152 Kilpi et al. 7)

Two studies deviated from the rest and covered nutrition and obesity. Zaghloul et al. attempted to find a correlation between the excessive consumption of macronutrients and occurrence of obesity. Their results showed males had higher energy intake compared to females. Carbohydrate intake among female as was at an average of 184–264 g, proteins 48–71 g and fat 44–75g. For males, carbohydrates were at 175–355 g, proteins at 48–110 g and fats between 45–96 g. Fiber and cholesterol intake was found to be lower except in males between 19 and 50 years for the latter. Vitamins appeared to be well consumed unlike minerals such as Calcium and foliate that was quite low in the blood. Levels of sodium were above recommended (Zaghloul et al. 600).

Amine and Alwadi researched on nutrition among preschool kids. Their findings show that the dietary change increased anemia in preschool children (387). The availability and higher frequency of sweets cakes sodas chocolates and fast foods increased obesity and poor nutrition among children.Nutritionally, 11.9%of male children exhibited stunted growth, 10.8% were wasted, where wasting was defined as the occurrence of a lower weight for a given height. Obesity rates were at 16.1%.Among females, 9.9% were stunted,9.6 % wasted, obesity was at 18.4%, higher than males (Amine and Al-Awadi 389-392). Anemia was at 29.3% with male children being the most affected. Anemia was found to be inversely related to the mothers’ literacy levels and highly prevalent in low-income families (Amine and Al-Awadi 391). This study also showed the prevalence of malnutrition, obesity, and anemia among the firstborns. This is attributed to the inexperience of first-time mothers.Amine and Al-Awadi (394) recommended a reduction of nutritional disorder prevalence levels.

These studies reported their limitations as the absence of reference/standards for BMI levels and prohibition of relevant laboratory tests (Al-Kandari 158), lack of data for some Middle East countries (Kilpi et al. 7). Their recommendations included health education, surveillance of anthropometric indices among adolescents (AN Al-Isa 1277) awareness creation (Al-Kandari 152). Subsidizing healthy foods (Zaghloul et al. 600), implementing interventions to reduce obesity and evaluating the outcome of every intervention on the BMI (Kilpi et al. 7).

Works Cited

Al-Isa, Abdulwahab Naser. “Dietary and Socio-Economic Factors Associated with Obesity among Kuwaiti College Men.” British Journal of Nutrition 82.5 (1999): 369–374. Web.

Al-Isa, AN. “Body Mass Index, Overweight and Obesity among Kuwaiti Intermediate School Adolescents Aged 10–14 Years.” European Journal of Clinical Nutrition 58.9 (2004): 1273–1277. Web.

Al-Kandari, Y. Y. “Prevalence of Obesity in Kuwait and Its Relation to Sociocultural Variables.” Obesity Reviews 7.2 (2006): 147–154. Web.

Amine, E K, and F A Al-Awadi. “Nutritional Status Survey of Preschool Children in Kuwait.” Eastern Mediterranean Health Journal 1996: 386–395. Print.

El-Bayoumy, I., I. Shady, and H. Lotfy. “Prevalence of Obesity Among Adolescents (10 to 14 Years) in Kuwait.” Asia-Pacific Journal of Public Health 21.2 (2009): 153–159. Web.

Kilpi, Fanny et al. “Alarming Predictions for Obesity and Non-Communicable Diseases in the Middle East.” Public Health Nutrition 17.5 (2013): 1078–1086. Web.

Zaghloul, Sahar et al. “Evidence for Nutrition Transition in Kuwait: Over-Consumption of Macronutrients and Obesity.” Public Health Nutrition 16.4 (2011): 596–607. Web.