Tuesday, January 30, 2018

Public health alarm on habitual late diners

(Note: The original article title is installed back in this post... Editor's version is 'Late Night Supper? Think again')
AT the end of 2017, the government announced that it was considering banning eateries operating after midnight, as one of the 13 measures to promote healthier living among Malaysians as well as fight the growing threat of non-communicable diseases (NCDs).
Following this, many groups, especially those that habitually practiced night-eating, expressed disapproval over the government’s proposal. Some called it a ‘big brother’ move by the state, and felt it infringed their rights and freedoms.
Others argued that it would cramp the Malaysian lifestyle of meeting up at such eateries to ‘hang out’ all night long. Interestingly, the Malaysian Indian Muslim Congress (Kimma) president Syed Ibrahim Kader reportedly said that mamak eateries and 24-hour restaurants can prevent acts of khalwat. Yet others voiced concern that the proposal would deny the convenience of affordable and accessible food to late night shift workers.
I might be sympathetic with the late night workers, but there are still ways to go around the issue. For example, exceptions could be made for eateries operating at highway rest stops exception (though there might not be many food operators here that are willing to open 24 hours) to cater for long distance drivers.
These are diners who seek food, not for socialising, but to fulfill their basic sustenance needs. In that way, rest stop’ restaurants are markedly different from eateries located in the communities that cater more for habitual late diners. Eventually, these late night workers might even get into the habit of preparing or packing the food for themselves.
However, none of these disgruntled parties would deny that overeating and consumption of excessive calories and carbs late in the evening or at night has negative health consequences. Night eating syndrome (NES) is a recognised eating disorder, characterised by the consumption of at least 25% of food intake after dinner or the incidence of at least has two episodes of nocturnal eating per week. Studies from Europe and the United States found strong associations between severe obesity and NES.
Another 2016 study performed on a sample of 1,738 Korean adolescents revealed that 21% were night eaters who had greater tendencies to skip breakfast, and derived a higher energy intake from snacks, with a greater proportion of energy from fat. Night eaters also had lower Dietary Diversity Scores than non-night eaters. Alarmingly, adolescents were 4.4 times more likely to be night eaters when both parents were night eaters.
I am less confident that Malaysian situation would be any better, especially when the current proportion of obese Malaysians (17.7%) is 3 times higher than South Korea’s (5.3%). Malaysians are generally spoilt for choice when it comes to after midnight eateries, whereas this is far less common in South Korea and many other countries.
Furthermore, most eateries that operate after midnight tend to serve food that is laden with high calories and fat, with limited healthy options. Eating such food at late night would certainly cause health issues in the long run.
In 2015, NCDs were responsible for 1.2 million admissions to hospitals and 38,500 deaths nationwide. In the last two decades, the prevalence of diabetes, as well as hypertension and hypercholesterolemia, has increased among the Malaysian population. On that point, I agree with Dr Marimuthu Nadason, President of Federation of Malaysian Consumer Associations (Fomca), who stated that “If the government do(es) not take action now, it will be a burden in the future as the younger generation will keep falling sick and this could affect the country’s productivity.”
As part of the strategy to tackle NCDs, it is right that the government should curb ‘after-midnight’ operating hours of eateries. Doing so may help discourage the culture of late night dining and reduce the risk to public health caused by such habits.
It is true that, such a ban does not completely prevent night-eating behaviour, as one could still stock and feast on unhealthy snacks at home, or visit convenience stores, food trucks or even “Ramly Burger” food stalls to purchase food in the dead of night. Unless the government imposes similar restrictions on the operating hours of food stalls and food trucks, rooting out midnight snacking habits effectively would require further efforts to educate and inform Malaysians about healthy eating habits. Official policies can only do so much in this regard. Concerted effort and cooperation are needed from local communities and within the home.  
SM Mohamed Idris, President of Consumer Association of Penang (CAP), put it rightly that many people “do not know the right time to eat”. More often than not, people who gather in the mamak restaurants past midnight are not really hungry for food. They come in groups and tend to stay for long hours chit-chatting and ordering round after round of food. The government’s proposal is thus meant to be a nudge towards reducing this culture, rather than a blanket prohibition on the individual act of night eating.
One policy alone would not solve the entire obesity and NCDs problem. Nevertheless, limiting the operating hours of eateries would send out the right message that such late night dietary habits should not be condoned.
For example, the government does not ban smoking entirely, but the policy of placing anti-smoking restrictions in more public areas would alert smokers to the fact that they should consider the harmful effects of smoking imposed not only to themselves but also to others. If we just leave it to the market to solve public health issues, interest-bound parties and lobbyists would certainly favour the status-quo (in this case, more food sales), and leave more individuals vulnerable to harm.
The purpose of public policy is to shape desirable collective social outcomes. There are times when a government sees fit and reasonable to intervene. This is the time.
I believe that the government is acting with the best health knowledge, and the right public intentions to safeguard public interest, in proposing regulations aimed at reducing harm caused to the society.

No comments: