As you leave the KLIA and take the turning into the Elite Highway towards Subang/KL, most motorists would suddenly be overcome by the pungent smell of sulphur emanating from a nearby factory. This horrendous air pollution has become such a permanent feature now that half the world pouring out of KLIA would remember this as part of their travels to Malaysia apart from, of course, the murky tap water, haze, floods, etc.
But who is to blame for this state of affairs? The finger-pointing between the Natural Resources and Environment Ministry and the Health Ministry is unending and Malaysians have become numb to their endless excuses. But there is a common end-result to all this pollution - it affects human health and therefore reduces the efficacy of the greatest resource any nation needs for its survival the human resource.
The Health Ministry (MOH), in their latest efforts to 'go after someone' have trained their guns somewhat inexplicably this time at fast food operators specifically it seems on Western fast food judging by newspaper reports. We have to assume they mean McDonalds, KFC, Burger King, Marrybrowns maybe even Burger 1901 and Dunkin Donuts.
Although this seems like an attempt to deflect recent criticism for the death of an unfortunate woman in Alor Star who appears to have consumed Kintop pills hyped up with too much sibutramine, this endeavour to pursue fast food operators perhaps must be taken in good faith.
Unless of course the MOH is under the notion that the woman would never have died if there was no fast food, in which case she would not have put on all that weight and therefore need not have resorted desperately to the banned Kintop pills. That, however, would be an elementary miscalculation on the part of the ministry.
If you have worked in cardiac surgical units in the state of Kerala in India, be they in the cities of Trivandrum, Cochin, Calicut or even in the Tamil Nadu cities of Coimbatore, Madurai, Vellore and Madras, you would frequently encounter patients in their 30s' undergoing bypass surgery. Surgeons there often remark that 'the coronary arteries and blockages of these youngish patients are equivalent to coronary artery disease of a 70-year-old American'. The arteries are often hardened and calcified.
There were no fast food chains in Cochin, Calicut and even Madras until recently and the Indian medical fraternity generally blames heart blockages there to too much coconut in their food. In scientific terms, too much Pufa (Poly Unsaturated Fatty Acids) or rather an imbalance between good and bad Pufa. Although many studies have been done on Pufa and its effects on heart disease, no Indian study has pointed the association thus far accurately.
In Kelantan, heart disease also afflicts young Malaysians especially Malays. Apart from coronary heart disease, early hypertension and diabetes mellitus are all attributed there to the Kelantanese using too much sugar in their diet. Coronary artery blockages in Kelantanese are quite similar to the patients you see in India but their arteries are not that hardened.
Another state that has young patients coming down with early heart disease, hypertension and kidney disease is Malacca. Many doctors feel it could be the high amount of 'santan' present in the 'nyonya' style cooking representative of Malacca.
But no one can really tell for sure for almost all these reports are sometimes anecdotal and not based on large prospective trials. Feedback on the statistical rise of coronary artery disease be it in Kelantan, Malacca, Penang, etc, are all based on assumptions and not based on clear evidence as medicine practiced today emphasises on.
The cause could be foods laced with too much bad oils, cheese, butter, seafood, meat perhaps containing beta agonists or nitrofurantoin, too much frying of char koay teow, mee goreng, too much condensed milk and sugar in your early morning roti canai or murtabak, perhaps even too much 'kas-kas' (poppy seeds) in curries or too much salt and sugar in any of these meals.
The variables are just too many to jump to conclusions. But what is certain though is apart from unhealthy food containing too much calories, salt and sugar, the lack of exercise plays a very telling role in the predisposition to hypertension, diabetes and heart disease in Malaysia. Malaysians have become very sedentary in their lifestyles due to not only work commitments but also due to the virtual lack of playing fields, parks or jogging paths in many of its cities.
Banning western 'fast-food' is just an emotional, un-researched knee-jerk reaction to this rise in ailments. Although heart disease has remained the major cause of mortality in the US for the last 80 years, sharp declines in mortality have been noted in the US since 1968 and in Australia since 1966.
Investigations revealed that epidemiologists and health workers in these countries identified hypertension, cigarette smoking and diet as the three major risk factors. Efforts including screening and treatment of early hypertension, intense public education in preventing smoking and switching in diet from animal fat to vegetable fat has dramatically reduced the incidence of coronary heart disease and hypertensive heart disease.
Our efforts in Malaysia indeed must be multi-factorial in approach and aggressive health education and early screening and treatment programmes must be put in place to prevent the advent of these diseases.
Little point in always jumping to punitive action as history has shown that despite everything the world tries, the Afghans and Burmese will continue growing their poppy plantations, tobacco planters in Virginia and Terengganu will still expect markets for cigarettes, the New Zealanders will still want to export their dairy products, the Chinese will continue their exponential sales of counterfeit pharmaceuticals and of course KFC and McDonalds would want to sell their fast food.
We can ban them all but as any epidemiologist or nutritionist worth his salt will tell you, the logical way to go about it in the health industry is always intense, continuous, committed public education and follow-up. And this has to start from Day One in school.
