Recently, a lot of Maltese nationals got upset at Boris Johnson’s statement about Malta being the fattest nation in Europe. Well, whether you got upset or not, Malta is in fact the ‘fattest nation’ in Europe. Sometimes the truth hurts when someone tells it to your face. However, rather than get offended about it, we should reflect what can be done to improve this serious health situation, both on an individual as well as a nation-wide level.
Obesity is a killer
Many people still perceive being overweight or obese as a ‘cosmetic’ issue, and don’t realise the serious health implications it has. When someone is on medication for high cholesterol or high blood pressure, something is going wrong inside their body, and medication is not fixing the problem, but merely controlling it from getting worse. If you drive a car with a faulty engine and you don’t fix it, sooner or later the car will break down. High blood pressure and high cholesterol are risk factors for heart disease and stroke, and if you don’t fix them, sooner or later the body will break down.
According to the Malta Annual Mortality Report 2013, 40.1% of all deaths in Malta were due to heart disease and cerebrovascular disease, and an additional 3.2% deaths was attributable to diabetes. That’s over 1,400 fatalities every year. Malta has gone into lockdown for less than ten COVID19 related deaths, so 1,400 heart-disease and diabetes related deaths every year should definitely be a cause for concern. One must also take into consideration the many more thousands of non-fatal heart-disease patients that lead a less-than-optimal standard of living due to their health condition and substantially burden the national health care system. A report from PwC estimates the cost of obesity for the private and public sector to amount to €36.3 Million annually.
The National Anti-Obesity Strategy
The government launched an anti-obesity strategy in 2012, which includes a Healthy Lifestyle Promotion Act, enacted in 2016 with the aim of fostering an inter-ministerial lifelong approach supporting physical education and healthy eating. The causes of obesity are acknowledged to be multi-factorial, but diet and exercise still play a primary role when it comes to weight-gain or weight-loss. The energy equation still applies, and consuming more calories than the body can metabolise ultimately leads to weight-gain. Consequently, to reduce weight, more calories need to be burnt on a day to day basis than are consumed by food and drink. Therefore, the main requirements to achieve weight-loss are to eat less energy, move more or do a combination of both. Exercise, performed in a regular, long-term fashion therefore plays a key role in any anti-obesity strategy. The Malta Physical Activity Fact Sheet 2018 showed that only 36% of adults meet the minimum recommended physical activity levels. The rates for children and senior citizens are even lower (25% and 28% respectively). A 2012 analysis by the prestigious medical journal The Lancet showed that Malta was one of the most sedentary populations on earth. Clearly, in terms of exercise, there is lots of room for improvement in Malta.
This gadget really works
I recently received an Apple watch as a gift. I had been using a top-level Garmin Fenix 5 sports watch for quite a while, and so was hesitant to 
The Apple watch activity rings
Move more, stand up more, exercise more.
make the change initially. However, after making the switch to test the Apple watch I became increasingly impressed how much it motivated me to complete my daily physical activity. What sets it apart from other sports watches I know is one feature: The 3 activity rings. This app on the watch tracks the user’s movement throughout the day and encourages the user to meet his or her fitness goals. The app tracks how often you stand up, how much you move, and how many minutes of exercise you do. Three coloured rings summarize your progress. The goal is simple: Close all the 3 rings every day. This means: Do enough movement to achieve your desired active calorie burn (all movement counts), get off your butt at least once every hour for 12 hours and complete at least 30 minutes of exercise throughout the day (this includes walking around your work place, walking while shopping, walking to your car, climbing the stairs, etc).
Why the Maltese need an Apple watch
To snap us out of our inactive lifestyle and the denial of being inactive, we need a daily reality check. Technology allows us to see at a glance how much energy we have expended throughout the day, how much time we have spent sitting down and how little exercise we have done. Any smart watch can provide you with valuable information about your activity levels, but in my opinion, Apple watch does it in the best way. The benefits apply to everyone, however specifically obese and diabetic patients should be encouraged to use such technology as part of their medical treatment. Exercise is a primary treatment for obesity and diabetes, not only for controlling these conditions, but for potentially reversing them. Drugs, on the other hand can only control these conditions. They can never cure them.
We need accountability and incentives
Despite all the technology available, we still need to ‘kick our own butts’ to get our weekly exercise done. That’s the hard part. The watch can’t make us do that long-term, unless we are already motivated. Fact is, most people do not enjoy exercising regularly. Physical exertion is uncomfortable, especially for beginners, and who likes to be uncomfortable on a regular basis?
On the other hand, when we are pressured into doing something, we usually get it done. Whether it’s having to work extra hours, taking care of sick relatives, doing homework with kids or cleaning the house, when we have no choice, we usually get things done.
Can’t we apply that same mindset to exercise regularly? What if you are subjected to a serious commitment to make you exercise? What motivates you to perform? Monetary incentives? A supervisor or coach that you need to report to? Pressure from your Doctor? That is what every individual needs to figure out.
National incentives
On a national level, how can we incentivise the population to become more physically active? Can we reward their regular physical activity with tax incentives and instead increase the taxation of sugary and fattening foods and drinks to fight obesity? After all, we can track the activity levels of individuals from their wearables.
The government provides tax incentives for electric cars and solar panels to fight pollution, so why not provide tax incentives for people that exercise regularly in an effort to maintain good health and help reduce national health care costs?
It’s time for a radical, trend-setting exercise strategy and data from smart devices could help in the implementation and supervision of such a strategy. Our country is small enough to effectively launch such an experiment. Let’s become a trendsetter and role model for other nations in the fight against obesity!
Disclaimer
The author is in no way associated or affiliated with Apple watch or its distributors in any way, and the opinion is based solely on his personal experience.
