 Obesity is a global problem that affects everyone. Around the world approximately 800 million people are leaving with the disease while millions are at risk to get affected. Now all obesity day is observed on March 4 every year to promote practical solutions and help people achieve and maintain a healthy weight while undertaking proper treatments. Dr. Chinas Amadi is a Lifestyle Medicine Physician and the founder of Africa's Forced Digital Lifestyle Medicine Practice at Rella Health and Fitness Ltd. She joins us now to give more insight on the topic this morning. Good morning to you Dr. Chinas Amadi, thanks for joining us on the breakfast. Good morning, thank you for having me. It is our pleasure. We are seeing or hearing a very alarming statistics concerning obesity in the world and indeed Africa. Let's just bring it closer home. What are the figures? What do we have heating us here in Nigeria? According to the Global Obesity Observatory, it shows that Nigeria is at high risk actually. Nigeria obesity risk is high at 7.5 over 10. Between 2015 and 2016, there has been over 100% increased rise in prevalence of obesity in Nigeria. And what are we linking this to? We are pretty much linking it to our adoption of unhealthy habits, one sedentary lifestyle. Our love now for Westernized food, Westernized diet, and a couple of other factors. So yes, it is really close to home. It is very close to home. We are catching up with the Western world when it comes to the risk prevalent. Why do you say catching up? It is really not something good. We should catch up with the good fakes and not catching up with them. That will affect our lifestyle and indeed our health. Is it that we are not eating right or living well as a people in Nigeria? First of all, I think we are culturally conditioned to associate and increase size with affluent. So first of all, we have a lot of reconditioning to do, cultural reconditioning. So if we cannot reorient ourselves, then that is a problem. So that is the first step. We have to know that the fact that someone is losing weight does not mean the person is poor, or does not mean the person does not have food to eat. So that is the first thing first. Secondly, we are beginning to associate the fact that eating on healthy meals, or eating with the nice meals with affluent too. Somehow we like to be in that class. We like to select that too so much in this country. So you have to eat your sandwiches. I am eating my pastries, doughs, and that is like enjoyment. Yes. So that is first of all, conditioning. We need to do it as a people, as a community. It is the first step to pretty much changing this whole, declining the risk here in Nigeria. Okay, Dr. Chenes, let's also talk about the primary causes. What are the things that one should know about obesity? Is it that one is eating too much, or one is eating like you have mentioned, trying to be associated with the western culture and pattern of eating? Now, prior to this time, maybe we didn't have all of the data and information in front of us. So what were we doing differently that we are not doing now? So the thing about obesity, obesity is multifactorial. That means that different things can cause it. It can be from lifestyle, it could be from ill health, certain diseases, it could be from certain medications, it could be from certain psychological conditions. So it's important first of all, so I will just go on the aspects of lifestyle now, which is predominant. Now, what are we eating? Before we eat more wholesome foods, we are eating more, you know, I remember growing up, if my mom makes more and more obese at home with vegetables, and you're not eating it, then you're not hungry, pretty much. But now, if your child doesn't want to eat that, there is another alternative. Either a quick fast juice with a quick fast snack, you know, and those are alternatives we are giving. So we are seeing that we are creating an obese generation automatically. So by what we are eating, so we change what we learn, you know, and even our parents eat food more. I remember my grandma, they eat, they are making soups fresh. The vegetables are almost fresh. You can literally see the fish from the soup, literally. But now we're not doing that anymore. So our type of eating has changed. And of course, with life things are more stressful now, people want fast food. Now exercising before, in those days, in the past, people walk a long distance to the farm. So even though they are not intentionally exercising, they are actually getting a physical activity. But now we're sitting down behind the laptop, sitting down behind the keyboard, typing from morning, 8 o'clock till 4 p.m. Then we get up, go to the bus stop, sit in the bus, sit on traffic for 4 p.m. till 8, 30 p.m. And straight, you just eat and go lie down again. So we are literally not even moving. And even the distance we can move, there are bikes all over. You just get a bike quickly and jump over and go use the bike. So those are things that have changed from then and now. All right, Doctor, for sake of clarity, let's try and make this particular disease more understanding for Nigerians. How can you really tell if you're against them being overweight, really? Well, there is a standard, yeah, the BMI standard, which a lot of people have argued that it is not standard for black people. But the standard, which is still what we use in the books in medical school, is that a BMI of above 30 is in the obese category. Now, how do you calculate your BMI is your weight in kg all over your height in meters spread. So if, for example, you're 1.65 meters, you just square that, that is 1.65 times 1.65. Then your weight, let's say you're 100 kg. So it is 100 kg over your height in meters squared. When you get that, the value, if it's above 30, then it is considered obese. If it's between 25 and 30, then it's overweight. Now, that is one way. The other way is also the waist circumference, which is what I like. Because the waist circumference is that it tells you that women should have at least less than a 35 inch and men less than a 40 inch. Because studies have linked increased waistline with increased risk of hypertension, diabetes, hypercholesterolemia, high cholesterol and other metabolic syndrome. So it's important because of that linkage of increased waistline and that, that's the reference range that is given for women less than a 35 inch. So you just use the regular tip that the tailors use, put it around your navel and check what we are you at. Do you need to get it down or not? I think that's an easy one to do, even if you don't have a skill. Okay, so we're hoping that we can actually break this down so that the government can understand. Still sounds very medical and very technical, but I'm hoping that we can just get to that point where it's very simple to understand. You have rightly mentioned that eating differently, so I want to find out. Is it that eating too much or eating differently is what causes obesity? Now, it's not just about eating too much, but eating high, you can be eating small or eating very high calorie. For effective weight loss, it's all about a calorie deficit. So whatever you're eating, you may be eating a piece of, say for example, some random shortbread. One piece is around over 100 calorie and compared that with an apple, which is around a 50 to 70 calorie. So the apple is bigger in size, but the shortbread is smaller. So the calorie content is higher, the content of saturated fat is higher in base. So it's not just about the size of the food, it's also about the calorie content of the food one. It's also about how the food is made. We know that there are certain things that are high in calorie when it's high in saturated fat, when it's high in trans fat. So it's just about reading the label, but one thing is that it's easy. Even if you don't want to count calories, I say it's foods that are closer to the ground. So you can check the distance from your clay, from the farm to your clay. You can imagine it. If you cannot imagine it, then know that should I be eating this in a large quantity or in a smaller, very, very small quantity. So that's an easy way. Don't even bother about the calorie content. Because you can imagine vegetable noodles. You cannot imagine vegetable noodles. How does it become noodles? It's pyrao. You can imagine vegetable soup. You plot from the farm. But you will still have to use swallot to eat the soup. Swallow is not the problem. The question is when we now want to eat swallow that is like a 10-year-old baby's head. That's the problem. So that's important. I always tell people in swallow and soup, the soup is the meal. But most of the time we're using a tablespoon of bono soup with a mouthful of swallow. So we misplace it. So we need to realize that the soup is the main dish. Then swallow is the accompanying support system. But also, if you look at it, let's even talk about this practically. If you look at the soup most times. This is African. This is Nigeria. It's not every soup that has that vegetable content. For instance, you mentioned the bono soup. And you already know that there's going to be palm oil in it. And that's a lot already. Now we're not cutting food. We are cutting food that are high in calorie. All are high in calorie. All forms of all are high in calorie. So it's very important to limit it as much as possible. Is that that cultural mindset? We are culturally inclined that our soup, we keep pouring in oil until our ancestors go, my shout we can't do. Stop going away. We need to measure in this thing. We're not used to measuring. We put this salt on it. It just keeps sprinkling on it. We just keep doing these things because we feel that we are culturally conditioned to think that there has to be some, the soup has to be bright. The soup has to be red. So that's the cultural reconditioning we need to have. A bono soup doesn't have to be so oily. You can use even your tatashi bell peppers to get the redness that you need. The question is, will you, with your mind, agree that you have made a bono soup? Or tatashi? He probably might just be tatashi or bono soup. That would be, that would be. That's a light and no doubt. That would be a completely different one. But Doctor, it is a world obesity day today, but let's try and help people who are obese because oftentimes there is this concept of body shaming and people who are naturally big, often made to feel bad and small about themselves. So how do you begin to help them? Some people, they will tell you that it's not like I'm eating too much. It's not like I have a low metabolism or something. It's just that I have it in my genes that we are all very big and fat in our family. How do you help people who are obese and who want to make better decisions so that they can maybe lose weight and, of course, still feel good about themselves? I think there is, in this concept of body shaming, there is a thin line because even sometimes I have been accused of body shaming because I'm like, hey, try to lose some weight because it's affecting your health outcomes. And I'm like, you know, your body shaming, I'm like, where's the point? Can we advocate without having it being considered body shaming? But that's, by the way, now the thing is, your gene is not your destiny. Studies have shown that in part of your gene on your health status, it's not more than a 30%. So that means that you have a 70% chance of not being obese, even if everybody in your family is obese. That is the first thing. So you need to come to that point. Personally, at 16 years, I was already over 80 kg. And I grew up knowing that everyone is being in my family. See my pounds? My pounds are really being. So I always knew that. But now, at almost, you know, on my late 30s already now, I'm not even up to 75. And that is because I decided to break the jinx. But it's up to you. Are you ready to break that genetic, you know, you think that it may take, it will do extra, it will be extra work. There are some people that you feel they eat everything and they are not being. That's their lot. But that doesn't also mean they are healthy. Let's leave that for another conversation. Remember, the site doesn't determine health status, because there are some people that are very slim, they are hypertensive, diabetic, high cholesterol, which is even an independent risk factor for stroke, but will not go there yet. The issue now is, once you're obese, do you want to lose weight first? Do you think you want to lose weight? Maybe because you want to improve your health, you want to be able to walk without panting, you want to be able to run and your knees are not hurting. Find a reason, a motivation to do something. Sometimes a motivation is what we keep you going because losing weight, trying to get over the obesity status is hard. But it is possible. The question is, are you ready to do all it takes? People say they've done everything. I'm like, really? Let's also talk about what the signs and symptoms would be. Like we know with malaria, with COVID-19, and with every other disease, there probably would just be a sign and a symptom for it. So what would you say the signs and symptoms for obesity is? Like what I said earlier, first of all, just get the tail of teeth. The tail of uses for measurement. And check your waistline circumference. And see where are you at first. So do I need to start working? As a woman, is it above 35 inches? As a man, is it above 40 inches? Then that's the first step. Another thing is for some people, they start noticing that they are not sleeping now. For some people, they start noticing that either they start having breakouts because maybe acne, they start noticing that it falls on women and there is a change in their menstrual cycle. For some other people, they start getting tired easily. So they are different, like what we call non-specific symptoms. This disease has non-specific symptoms. So different people may present different with different things. Know your body. Know the point when your dress is tighter. So these dress are used to wear before. Now you're not wearing it. It's not because you're older. It's now because you have increased. Because they dress in age. So once you notice that and you start taking action at that initial time, that is the first thing. But the truth is, it starts with the mind. You have to condition your mind to do it and do it as a lifestyle. Not doing it as a diet. That's where most people tend to feel. They tend to go into whatever diet is raining and then they get tired and fall out. So imagine that I want to be healthier for my life, for the rest of my life. When healthy is the goal, weight loss pretty much is a side effect. All right, Dr. Amadi. Although some of my colleagues here are just raising their hands in the air. They're telling me that my suits don't fit anymore. But I'm just going to pass like that. But let's talk about this obesity. Do we have situations in children or adolescents? Because sometimes you see some children who are a beach chubby. Is there obesity in children? And how do we address that? Yes, there is obesity in children. And it's pretty much even glaring from their physical outcomes. Now, the studies are showing that the rate of obesity in children is 10 times more than in the past decade. Over 100% increased than the past decade. So this has also increased the risk of lifestyle diseases, diabetes, hypertension in children. So, yes. Now, so it's important for us to know that this study that was done, the Global Budget of Disease Study, and it shows that one in 10 children, one after the year 2000, will develop type 2 diabetes. And this was linked to the rising obesity rate among children. So that's the, we have a lot of work on our hands. We as parents, I say this generation of parents, we tend to gratify, we use food as a gratification. Like you do well, eat food. You cry, eat food. You don't want to speak to your neighbor, eat food. Your friend beat you, eat food. So every food is a consolation prize for everything. And that is where we need, we are getting it wrong. Unfortunately, and then the same thing, the same type of foods we're giving in their lunch packs is the same kind of foods we're giving at home. Mommy doesn't have time, daddy doesn't have time. So what is easier? Fast food. And fast food, I don't want to say what it means fast food. But the goal that we as parents, we should start thinking, am I feeding my child? I made a mother who said, at six years old, eat 10 slices of bread. If she eats five, she cries. And I'm like, does crying, crying has never been known to be a cost of death. Cry. It has never been known. However, the risk of that bread was eating all that amount of bread at a six year old has linked to death. So which one do you want? Are you speeding up your child's, are you shortening your child's lifespan by making her not to cry now? All right, doctor, you know, this month of March is actually, you know, very special for women. Let's talk about women now because of some cultural beliefs and cultural practices that sometimes they tend to be victims in all of this. You know, specifically from the southeast, from the south, south, where a woman after she gets pregnant and gives birth, she's asked to go to the fattening room. Is it something that we should be practicing really? No. Why not? Because it's just a, it's one of those cultural practices that is not important. I've still not understood the reason why the woman has to be indoors for three months. I don't understand that. There are certain things that we, you see, there are certain things that we should start breaking and we should be willing to break it. We should be, we have to make efforts to break those cultural practices that are not favoring our health. So the woman is just stitching down day in, day out, teeth like it, teeth like it, eating, eating, eating, eating. And after three months, the man is the same person who will go, wow. This was not the woman I married. I know. Okay, I just can't keep you up here. You know, we need to, you know, just, I mean, it's been very fantastic having you. But let's just move on because we probably might just spend the remaining time just laughing, laughing out. Very interesting conversation, by the way. But generally, how can this be prevented? Now, this can be prevented by first of all, we need to start eating more fruits and vegetables. That's the first thing. We don't eat enough fruits. And studies have even shown that eating up to five servings of fruits and vegetables a day reduces heart risk, heart disease risk by up to 25%. So even if not for the part of you being whether fat or thin or anything, it's about improving your heart health. So having, I tell people, just invest 200 naira every day in either a fruit or just in a fruit is easy or fruit and vegetable. Invest 200 naira. So either 200 naira, cucumbers, 200 naira, apple, apple is a thing. 200 naira, oranges, 200 naira, garden eggs, or carrots. Yes, 200 naira. Eat any fruit, any fruit in season. Go for that one. Mangoes are coming out. Wait till when they come out, so invest 200 to 300 naira every day for your health. That's the first step. Secondly, anything we're eating, we should try to be intentional with adding in some greens by the side. You have your rice, you have your beans adding greens. You can just buy 100 naira or 200 naira to add in every day. That will automatically reduce the portion of other higher calorie foods that you eat. That's moving more. So if you have a sedentary type of work, every one hour, stand up for 3 minutes. Even if it's to walk to the photocopy machine, walk and see your colleague table. Just stand up every one hour for 3 minutes. So take your time at 8.57, I'll stand up and walk. 9.57, I'll stand up and walk. You understand that? So that's an easy way, especially for busy professionals. Just be intentional about moving. We need to start moving more. Another thing which we underestimate is power and obesity is sleeping. If we're not sleeping, we are pretty much not sleeping when increasing the appetite hormone, which is growling, when increasing cortisol, stress hormone. And you just want to be... If you're not sleeping at night, you'll see that you're hungry in the night, even if you're not hungry in the daytime. So it's important to get in as much sleep as you can. Minimum is 7 to 9 hours. But usually, say, well, if you're in Lagos, you can do it 6 hours. But the goal is... When you come back from work, keep your phone away. Most of the time, we spend a lot of time on our phones. Keep the phone away and then go in and sleep. That is very important. The other thing, we're not drinking enough water. Somebody is thirsty, they grab soda. And thirsty, you're grabbing a loa, what's happening? It's important to be drinking more water. The water is so hot. We should drink... Oh, I need a cheese drink. Why do you need a cheese drink? Get chilled water if you want chilled water. So when the hot or cold water does not make one increase your waistline or anything, no, water is the only calorie-free fluid ever. So it's not going to cause weight gain. So that myth is not correct. That is another important thing. Now, as much as possible, even if you say, I cannot stop eating junk food. Tell yourself that. Okay, I will eat this. Maybe only on Saturday. Or maybe only one meal on Sunday. Or maybe just gradually until you're able to break it off totally. Or maybe when I go for that wedding tomorrow, that is when I will have this there. So not you buy that and drink whole. Buy the junk and drink whole. Drink it for those moments when you cannot control it. These are things that will really help. And of course, stress management. We need to effectively manage stress. We're living with so much stress now in our environment. Literally all Nigerians are stressed right now. But what can you do if you cannot change the situation? You can change how you react to the situation. And that is one way... That's one thing I like to engage on. If you cannot change the economy, it's not easy, but it's important for you, for your own personal health. And of course, so that it doesn't also... You don't increase the statistics. It's important to realize that your gene is not your destiny. You have the power of... Your life is in your hands. Yes, you cannot control life or death, but you can control, you know, as I'm living. Let me live healthy maximally. I can't wait for you to do this thing till I'm 75. And stop looking for big fix. Fix. If you're looking for something to drink to burn the fat. If they told you that, please dispel that. That is just a marketing gimmick. Because you didn't drink anything that made the fat to pungy inside your body. So you do not expect to drink something that will make you just melt and disappear. It's important to put in the world the goal of weight loss is not to fit into a slimmer casket. The goal is a healthier you long term. Yes. Did you get that? The goal of weight loss is not to fit into a slimmer casket. The goal is that you are healthier long term. And that is the reason why the thing of this year is everyone needs to act together. Now, we all need to do the work together. It's not a one person work. It's not only me. It's not only the whole family. It's also the whole family. And many other families. Those families, each of us. All right. Thank you so much, Dr. Chinas. Not just a harmful. That's a whole lot we have got in today. It's a collaborative effort. If you have to stand this is issue of overweight obesity and getting better life style amendments in North. We do appreciate the time. Thank you very much. Thank you. All right. If there's still the breakfast on plus TV Africa, we'll take a quick break and we'll come back and we'll be talking sports. Best time around. Stay with us.