Miércoles 1 de Octubre de 2008, Ip nº 249

Flood of junk food puts Greeks at risk
Por Elisabeth Rosenthal

Kasteli, Greece: Dr. Michalis Stagourakis has seen a transformation of his pediatric practice here over the past three years. The usual sniffles and stomachaches of childhood are now suddenly interspersed with far more serious conditions: diabetes, high blood pressure, high cholesterol. A changing diet, he says, has produced an epidemic of obesity and related maladies.

Small towns like this one in western Crete, considered the birthplace of the famously healthful Mediterranean diet - emphasizing olive oil, fresh produce and fish - are now overflowing with chocolate shops, pizza places, ice cream parlors, soda machines and fast-food joints.

The fact is that the Mediterranean diet, which has been associated with longer life spans and lower rates of heart disease and cancer, is in retreat in its home region. Today it is more likely to be found in the upscale restaurants of London and New York than among the young generation in places like Greece, where two-thirds of children are now overweight and the health effects are mounting, health officials say.

"This is a place where you'd see people who lived to 100, where people were all fit and trim," Stagourakis said. "Now you see kids whose longevity is less than their parents.' That's really scaring people."

That concern has been echoed by the Food and Agriculture Organization of the United Nations, which said in a report this summer that the region's diet had "decayed into a moribund state."

"It is almost a perfect diet, but when we looked at what people were eating we noticed that much of the highly praised diet didn't exist any more," said the report's author, Josef Schmidhuber, a senior economist at the food organization. "It has become just a notion."

Greece, Italy, Spain and Morocco have even asked Unesco to designate the diet as an "intangible piece of cultural heritage," a testament to its essential value as well as its potential extinction.

The most serious effects of its steady disappearance are on people's health and waistlines. Alarmed by the trends, the Greek government has been swooping into schools in villages like this one annually for the past few years to weigh children and lecture them on nutrition. The lessons include a food pyramid focused on the Mediterranean diet.

It is an uphill battle, though. This spring, a majority of children who were tested in their classes at the elementary school of this sleepy port town of 3,000, also known as Kissamos, were found to have high cholesterol. "It was the talk of the school," said Stella Kazazakou, 44, whose son Theodore is 9. "Instead of grades, the moms were comparing cholesterol levels."

In Greece, three-quarters of the adult population is overweight or obese, the worst rate in Europe "by far," according to the United Nations. The rates of overweight 12-year-old boys rose more than 200 percent from 1982 to 2002 and have been rising even faster since.

Italy and Spain are now also European front-runners in obesity, with adult rates over 50 percent. That compares with about 45 percent in France and the Netherlands, for example.

In the United States, 66 percent of adults older than 20 were overweight in 2004, and 31.9 percent of children 2 through 19 were overweight in 2006, although childhood statistics are compiled somewhat differently in different countries.

In Greece, the increase in the number of fat children has been particularly striking, parents and doctors say.

"Their diet is totally different than ours was," said Soula Sfakianakis, 40, recalling breakfasts of goat milk, bread and honey.

Her son, Vassilis, a husky 9-year-old with a chocolate mustache from a recently conquered ice cream cone, said he preferred cornflakes in the morning and steak or macaroni and cheese for dinner.

Dr. Antonia Trichopoulou, a professor of epidemiology at the University of Athens Medical School, said the problem had grown acute with the spread of supermarkets and, especially, convenience foods.

"In the last five years it's become really bad," she said. "The children are all quite heavy. The market is pushing a lot, and parents and schools seem unable to resist."

Advertising geared toward children has invaded Greece full force, stretching into the countryside. On television there are commercials for chips; at supermarkets there are stands of candy. Last year, Coca-Cola sponsored a play about healthful eating.

But facing both aggressive convenience food marketing and obesity for the first time, many rural residents here have little resistance to or knowledge of the dangers.

Trichopoulou said that some older people might have even been tolerant of childhood chubbiness because Greece had for so long been a poor nation where hunger was a recurrent problem.

The traditional diet, low in saturated fats and high in nutrients like flavonoids, was based on vegetables, fruit, unrefined grains, olive oil for cooking and for flavoring, and a bit of wine - all consumed on a daily basis.

Fish, nuts, poultry, eggs, cheese and sweets were weekly additions.

Red meat, refined sugar or flour, butter and other oils or fats were consumed rarely, if at all.

Research on the diet took off in the 1990s, as scientists noted that people in Mediterranean countries lived longer and had low rates of serious disease despite a penchant for patently unhealthy habits like smoking and drinking. But that protection is now seen as rapidly eroding.

A generation ago, the typical diet in all Mediterranean countries complied with nutritional recommendations by the World Health Organization that less than 10 percent of calories should come from saturated fats and that less than 300 milligrams of cholesterol should be consumed per day.

Today, the typical diet in all of the countries exceeds those limits significantly, Schmidhuber said. In Greece, average daily cholesterol consumption has risen to 400 milligrams from 190 in 1963.

Germany's is similar. In Portugal, where the jump was highest, consumption went to 460 milligrams from 155.

In 2002, a British study found that 31 percent to 34 percent of 12-year-olds in Greece were overweight - a 212 percent increase since 1982 - and "it has gotten worse, much worse, since then," Stagourakis said. One-quarter of all children on Crete have cholesterol problems, he said, noting that seeing children with diabetes and high blood pressure was no longer uncommon for him.

Being overweight, particularly being obese, is associated with a wide variety of medical problems, like diabetes and liver disease.

While heavy children may not suffer immediate health effects, they are statistically far more likely to grow into obese adults than their trimmer classmates. And in adulthood the conditions can be lethal.


  24/09/2008. International Herald Tribune.