05.07.2024
09.09.2024
What kind of a problem is obesity in Turkey? What is the general situation in our country?
Obesity is the most important global public health problem of the 21st century. Our country has an appearance that includes the problems of both developing and developed countries in terms of nutritional status. The nutritional status of the people in Turkey varies significantly according to regions, seasons, socioeconomic levels and urban-rural settlements. According to the 2017 data of the Turkey Nutrition and Health Survey (TBSA) conducted in our country, the overweight rate in individuals aged 15 and over was determined as 34 percent (Male; 39.9, Female; 27.6) and the obesity rate as 31.5 percent (Male; 24.6, Female; 39.1).
What are the main factors that lead to obesity?
Although the factors that cause obesity cannot be fully explained, excessive and improper nutrition and lack of physical activity are accepted as the most important causes of obesity. In addition to these factors, many genetic, environmental, neurological, physiological, biochemical, socio-cultural and psychological factors cause obesity in relation to each other. Since the increase in childhood obesity in particular is so high that it cannot be explained by changes in genetic structure alone, it is accepted that the role of environmental factors is at the forefront in the formation of obesity.
How should the diet be adjusted and regulated against obesity?
In order to regulate the diet against obesity, it is necessary to have adequate and balanced nutrition. The condition of taking in sufficient amounts of each of the energy and nutrients required for the growth, renewal and functioning of the body and using them appropriately in the body is called “adequate and balanced nutrition”. A lifestyle sustained with adequate and balanced nutrition and regular physical activity is very important for controlling body weight. For adequate and balanced nutrition, a sufficient amount of the five basic food groups on a healthy dinner plate should be consumed at each meal.
These groups are:
Milk and milk products group,
Meat, eggs, legumes and oilseeds group,
Bread and cereals,
Vegetable group,
It is a fruit group.
Providing the recommended water consumption in daily nutrition (1.5-2 liters of the 2-2.5 liter fluid requirement should come from water), including olive oil in daily nutrition, and supporting an active life are important as complements to a healthy lifestyle.
What kind of measures are being taken against obesity in Turkey and what kind of studies are being conducted? Our Ministry has been updating and implementing the Healthy Nutrition and Active Life Program Adult and Childhood Obesity Prevention and Physical Activity Action Plan (2019-2023) since 2010. In this context, awareness-education studies and legislative regulations are being carried out by using social media and official websites. In addition, clinical guidelines and national guidelines (Turkish Nutrition Guide (TUBER), Obesity, Diabetes Clinical Guide, Patient Monitoring Guide for Dietitians/Weight Management Handbook) have been developed for healthcare professionals. Within the scope of healthcare service provision, nutritional counseling and treatment are provided with a multidisciplinary approach in Healthy Life Centers in cooperation with family physicians in primary care and in obesity centers established in secondary and tertiary care hospitals.
In addition, monitoring and evaluation studies are carried out with national researches (Turkish Nutrition and Health Survey 2017, Turkish Childhood Survey (COSI-TUR) 2016).
The Nutrition-Friendly School Program continues in cooperation with the Ministry of National Education to encourage healthy nutrition in children. In accordance with the standards prepared by our Ministry, criteria for foods suitable for sale in school canteens and the School Food logo for these products have been developed. In accordance with the
RTÜK legislation and in line with the guide prepared by our Ministry, advertisements targeting children of foods and beverages with high fat, sugar and salt content have been banned in children's programs. Subtitle warnings have been made mandatory outside children's programs.
In order to reduce excessive salt and sugar consumption in places where mass nutrition is provided such as restaurants, kebab shops and patisseries, where salt and sugar consumption is important; the “Healthy Nutrition and Active Life Cooperation Platform, Protocol for Restaurateurs and Patisseries Reducing Excessive Salt and Sugar Consumption” was signed between our Ministry and the Turkish Restaurateurs and Pastry Chefs Federation (TLKPDF) and the All Chefs and Pastry Chefs Confederation (TAŞPAKON) on 28.02.2018.
What is the importance of an active life, sports and exercise on obesity? What kind of studies is the Ministry carrying out on this issue?
Increasing physical activity is not only an individual issue but also a social issue that requires a community-based, multi-sectoral, multidisciplinary and cultural approach. Therefore, in order to increase the level of knowledge of the society about combating obesity, to encourage them to acquire the habit of adequate and balanced nutrition and regular physical activity, and thus to reduce the incidence of obesity and obesity-related diseases in our country, the Turkey Healthy Nutrition and Active Life Program 2019-2023 Physical Activity Action Plan is being implemented. In addition, the “Turkey Physical Activity Guide” and the “Physical Activity Guide for Adult, Child and Adolescent Chronic Diseases” have been prepared. Within the scope of the Increasing Physical Activity Project, bicycles have been distributed to local governments, educational institutions, universities and NGOs that have established bicycle paths and sharing systems in accordance with the standards determined by the Ministry of Environment and Urbanization. A Physical Fitness Report Card has been developed for middle and high schools in cooperation with the Ministry of National Education of the Republic of Turkey. Accordingly, the height and weight of middle and high school children are measured twice a year in physical education classes, and sit-ups, push-ups and sit-and-reach tests are performed. A guide for Health-Improving Municipalities was prepared with the expert meeting attended by the Ministry of Environment and Urbanization.
What methods are used in obesity treatment?
The methods used in obesity treatment are grouped under five. These methods are;
Medical Nutrition (Diet) Therapy
Exercise Therapy
Behavior Modification Therapy
Pharmacological Treatment
Surgical Treatment
Diet therapy, increased physical activity and behavioral therapy are the three basic components of weight loss treatment. In order to obtain accurate information on nutrition-related issues and for medical nutrition treatment for overweight and obese individuals; “Nutrition / Obesity Consultancy” service can be used through family physicians, district health directorates/community health centers and healthy life centers. Medical nutrition treatment consists of the evaluation of the nutritional status of the obese individual by dietitians and the planning of a diet that will provide adequate and balanced nutrition in accordance with the individual's age, gender, physical activity level, physiological condition and nutritional habits. A multidisciplinary approach is important in order to increase the success of losing body weight in obese individuals and to avoid rapid and incorrect weight loss (because weight lost quickly is regained quickly). In order for obesity treatment to be carried out successfully, the program must be implemented by a team consisting of professional groups such as doctors, dietitians, psychologists, psychiatrists, physiotherapists and exercise specialists.
Did the inactivity brought about by the pandemic period lead to an increase in obesity in Turkey? What kind of measures are being taken and should be taken for this?
Due to the COVID-19 outbreak, our citizens who comply with the “Stay Home” calls may experience inactivity and eating high-energy foods at home with other family members during this period. As a result, obesity and obesity-related chronic diseases are likely to come to the fore. The following measures were taken during this process: The Healthy Nutrition Consultancy Line was launched. Nutrition therapy consultancy and monitoring services are provided to the entire society, especially to infants, young children, and individuals with chronic diseases (such as diabetes, hypertension). Our dietitians working in these units within the Provincial Health Directorate established consultancy lines in order to create health and nutrition awareness and awareness during this period when the majority of the society stayed at home, and provided nutrition consultancy and information services on healthy nutrition by phone. Posters and brochures on healthy nutrition and physical activity were prepared electronically in the provinces and shared with the society electronically.
During the stay-at-home period, academicians and dietitians were included in the programs on nutrition and physical activity on TRT-1 channel in cooperation with TRT, and public information activities were carried out. During Eid al-Fitr and Eid al-Adha, social media shootings and interviews were conducted under the title of healthy nutrition recommendations during the holiday.
Within the scope of the Fight Against COVID with Women Leaders Project carried out by Bilkent University and KEDV, a webinar was held for Syrian and Turkish neighborhood leader women on healthy nutrition during the COVID-19 period and training materials were prepared.
Trainings were provided for General Directorate and Ministry center employees. Online teacher trainings on healthy nutrition are being carried out in some provinces via the zoom application.
Insulin resistance
Hyperinsulinemia
Type 2 Diabetes Mellitus (Sugar disease)
Hypertension (High blood pressure)
Coronary artery disease
Hyperlipidemia-Hypertriglyceridemia (Increase in blood fats)
Metabolic syndrome
Gallbladder diseases
Some types of cancer (gallbladder, endometrium, ovarian and breast cancers in women; colon and prostate cancers in men)
Osteoarthritis
Paralysis
Sleep apnea
Fatty liver
Asthma
Difficulty breathing
Pregnancy complications
Menstrual irregularities
Excessive hair growth
Increased risks of surgery
Psychological problems (Anorexia nervosa, bulimia nervosa, binge eating, night eating syndrome and trying to achieve psychological satisfaction by eating more of something)
Social disharmony
Skin infections, fungal infections in the groin and feet, especially due to excess subcutaneous fat tissue as a result of frequent weight loss and gain
Musculoskeletal problems
Consume a variety of foods.
Consume according to the recommendations from each food group.
Do not skip meals.
Do not start the day without having breakfast.
Reduce the size of the dinner plates you use at the table.
Avoid fast food and snacks.
Eat your meals in small bites and chew them for a long time.
For a healthy diet, choose natural and fresh foods that are in season.
Reduce your sugar consumption.
Reduce your salt consumption.
Remove salt shakers from your table. Consume less but iodized salt.
Prefer whole grain products.
If you are going to consume breakfast cereals, choose those without added sugar.
Choose vegetable oils instead of animal fats. Avoid trans fats.
Avoid consuming carbonated and sugary drinks.
Prefer drinks such as semi-skimmed milk, ayran, and small amounts of freshly squeezed fruit juices rich in vitamins and minerals.
Excessive and wrong eating habits
Insufficient physical activity
Age
Gender
Level of education
Sociocultural factors
Income Status
Hormonal and metabolic factors
Genetic factors
Psychological problems
Frequent very low-energy diets
Smoking and alcohol use
Some medications used (antidepressants, etc.)
Number of births and interval between births
