Watching television and shopping are among the things I don’t do much of, so I was rather taken aback when, to fill time, I wandered into Best Denki, an electronics and appliances store. More than half the floor space was devoted to television sets, some of humongous size. It wasn’t so TV-heavy the last time I was here. Wow, TV-watching must be a really big thing in Singapore, I muttered to myself.
Does this explain the rapidly expanding girth of people here?
A meta-study recently published in the Journal of the American Medical Association reported that the more time spent watching television, the greater the incidence of heart disease and Type 2 diabetes. (Television Viewing and Risk of Type 2 Diabetes, Cardiovascular Disease, and All-Cause Mortality, by Anders Grontved and Frank Hu. Link to abstract).
No, it isn’t the result of radiation from the TV screen, nor is the relationship a directly causative one. Nonetheless, it almost surely stems from the sedentary habits associated with television-watching. There is also likely to be an association with consumption of snacks and sugary drinks, a common accompaniment to such entertainment.
The researchers reviewed eight previous studies that covered over 210,000 people with 6,428 cases of diabetes and 1,052 cases of cardiovascular disease among them and found that for every two hours of TV-watching per day, there was a 20 percent increase in diabetes over 8.5 years of follow-up and a 15 percent increase in cardiovascular disease over a decade of follow-up.
Three of the eight studies reviewed had also collected data on television-watching and mortality from any cause. Grontved and Hu found that for every two hours daily of TV-watching, the chance of dying from any cause increased 13 percent, as observed over a 7-year follow-up.
Interestingly, exercise doesn’t necessarily make up for long sessions in front of the tube. When adults who exercised the same amount but watched varying amounts of TV were compared against each other, those who watched more TV were still at a higher risk of dying during the study. Why that is so remains unknown.
See also the story in the Los Angeles Times.
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That obesity is on the increase in Singapore is all too obvious. Here is a chart I found from the Health Promotion Board’s site:
Although the chart does not say so, I believe it uses the international definition of obesity (BMI 30 or more).
You can calculate your own Body Mass Index (BMI) by dividing your weight (in kilograms) by the square of your height (in metres). If it exceeds 25, you’re considered overweight, if 30 or more, you’re obese.
Actually, I believe the Ministry of Health has more data than the graph shows. In 2010, the ministry conducted a National Health Survey with a section on weight, but I can’t find the results anywhere on the web. If anyone can point me to a table or two, I’d be grateful.
Over the weekend, I found myself sharing a lift with a plus-sized young man. It was just him and me, but I felt rather crowded inside the lift with him, though part of the reason had to do with the smallness of the lifts in our public housing. The absurd thing was that he waited patiently for the lift with me on the ground floor, just to take it up to the second level. There was a flight of stairs right beside the lift and he could have gotten up to the second level in a tenth of the time it took us to wait for the lift to arrive, but I guess it was too much exertion to walk up the steps.
Town Councils have been spending loads of money retrofitting our housing blocks to get lifts to stop at every floor. The need comes from our aging population, but a side effect would be to help the obese stay obese — one more example of how the universe is full of unintended side effects.
Besides the cost to one’s personal health, obesity has social and environmental consequences. The carbon footprint is multiplied each time a lift is operated. Seats on buses and trains hold half a large person instead of an average one. Demands on the healthcare system increase.
Obesity represents one of best test cases for how we balance personal liberty and social costs, the control of which necessitates some form of social control. Why should others bear the costs of those who lead unhealthy lifestyles? On the other hand, surely people have the right to lead the life they want, including watching as much television as they wish, complete with fatty snackfoods and sugary soda.
With tobacco habits, we lean more and more on control, but with obesity, we generally respect individual autonomy. Why that is so might be a good question to ask.
That said, I am also aware of an increasing number of scientific studies that show a link between antibodies to human adenovirus-36 and obesity. There are indications that infection with this virus, usually associated with the common cold, may lead to a tendency to gain weight. In light of this, it would be simplistic to merely say that overweight people are entirely responsible for their status, though I would hasten to add that the relationship between antibody detection and weight is not straightforward. Some overweight people do not have antibodies to the virus, while others who have normal weight also demonstrate antibodies in their bloodstream.
Nonetheless, if weight gain is not entirely within one’s control, can social control be justified? Would doing so not amount to an unreasonable circumscription of liberty?
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At long last, McDonald’s in Singapore is offering a grilled chicken salad among its menu choices. I gave it a try the other day and have to say it’s not bad. . . . but could be better. They could make it still healthier by having more vegetables in it and less chicken. The skin should also be removed. The salt content can also be reduced.
However, a funny thing happened along the way. As I was about to tuck into it, a ‘McDonald’s uncle’ (one of the restaurant’s elderly employees) who was tasked with clearing tables, walked past and looked quizzically at my order. He then quietly said to me that I should not bring outside food into a McDonald’s restaurant.
“But I bought this here,” I protested. “Haven’t you seen this item before?”
Apparently not. Apparently no one else has yet ordered it.
Doesn’t this incident illustrate the problem? We can go on about corporate social responsibility, and here at last, McDonald’s offers a healthier choice, but few among its customers seem to be interested in it. Looking around the restaurant, everybody else was stuffing their mouths with burgers and french fries. (It also made me wonder how long that salad in front of me had been sitting in the fridge before I ordered it.)
Then again, I won’t be so quick to praise McDonald’s. If they’re really serious about social responsibility, they would cut out fries and soda from all meal options. A burger meal should consist of burger + side salad + sparkling water.
And purveyors of television sets should sell them attached to exercise bikes. You sit on the bike in front of the screen and pedal like mad to generate the power needed to run the TV. How’s that for healthy entertainment?