Final Paper Obesity In KZ

Obesity in Kazakhstan
Darkhan Zhiyenbay
University of Southern California
IPPAM RW
Sonja Lovelace

Abstract
The Republic of Kazakhstan is one of the largest countries in Central Asia. In Kazakh culture, being overweight was considered to be normal and showed wealth. But now, Kazakhs who live in urban areas consider it as sickness. Since it gained its independence in 1991, many foreign companies invested in Kazakhstan to establish food businesses. Consequently, new fast food businesses are influencing Kazakh’s eating habits and culture.
Nowadays obesity is one of the main challenges in Kazakhstan. To prevent the obesity problem, several health improving projects and policies were launched by the government. However, the number of overweight people is still high. Many alternative solutions to the obesity problem were offered to the government; however three recommended policies were seen as more viable. The three recommended policies are the creation of uniform sustenance and physical activity measures, intensifying and coordinating obesity research, and developing physical activity programs.
Keywords: Kazakhstan, obesity, overweight, fast food, research, physical activity
Problem Section: Obesity in Kazakhstan
Obesity is a complex issue which includes an excessive measure of weight to fat ratio. Stoutness isn 't simply unappealing; it affects one’s wellbeing including, coronary illness, diabetes and hypertension. Being overweight means people are particularly susceptible to having wellbeing issues identified with weight.
Nowadays, the obesity problem is not in only in Western countries, but it is also spreading throughout Central Asia. According to the Shamil Tazhibayev, Vice President of the Kazakh Academy of Nutrition (KAN), a large portion of Kazakhstan 's population has additional body mass and one of five young people is considered fat.
The examination uncovered that 22 percent of children under the age of 14 years of age are overweight, which is nearly every fifth adolescent in Kazakhstan. More than 50 percent of Kazakhstan’s citizens are overweight with, 58 percent of females and 53 percent of males. Moreover, specialists noted that weight turns into an additionally pressing issue with age. Along these lines, 75 percent of the individuals 50 years and older are considered obese. As indicated by the review, 76 percent of respondents accept their body weight is typical; 53 percent of those, who concede that they are overweight, wish to control their body weight. However in the meantime, the Kazakh Academy of Nutrition began creating items improved with plant sterols, the most making an assurance to approaches to control obesity (Tashibaev, 2012).

Determinant Section Obesity in Kazakhstan
Obesity is a chronic disorder characterized by excessive accumulation of fat in the body. It has risen as a real health problem issue in both developed and developing nations. In the USA, American women aged 25 or older, more than 28 percent were overweight and 28 percent were obese. A study in England demonstrated that 18 percent of grown-up women were obese. The United Arab Emirates discovered that 40 percent of wedded ladies were obese (World Health Organization, 2014).
A study in Kazakhstan enlisting 25,107 subjects, spanning more than 15 years, uncovered that 23.7 percent of the participants had an extreme Body Mass Index (BMI) of 36.1 percent, or more. The obesity epidemic was increasing with age and was connected with the level of physical activity. Obesity considerably increases morbidity and disability complications and comorbidities, degrades the quality of life and overall health while reducing life expectancy. Patients with a high probability of obesity might have the following diseases: Cardiovascular disease, Cancer of the endometrium, Diabetes and insulin resistance, Osteoporosis, arthritis, chronic respiratory diseases, Deep vein thrombosis, and Urinary stones, Complications of pregnancy and childbirth, and Disorders of the reproductive function (Interfax Kazakhstan, 2012).
Nowadays, cardiovascular disease and various cancers are the leading causes of mortality in Kazakhstan. The presence of obesity in the mother before and during pregnancy significantly increases the risk of increasing body weight of the child. Childhood obesity leads to both short-and long-term adverse effects on the physical and psychosocial health which are important predictors of adult obesity and a risk factor for many diseases, including mental disorders. Obese children are most likely to get sick and to need treatment for most of their adult life. They have lower school performance and lower self-esteem, often experiencing social exclusion.
Financial misfortunes brought on by heftiness and obesity are connected with growing health insurance costs, for example, cardiovascular sickness, diabetes, disease, and different results of weight: the loss of working days because of ailment and a decreased capacity for work hits the pocketbook of workers and employers alike. Employers need to pay more for health insurance and worker 's compensation, due to the higher frequency of claims by overweight workers contrasted with those with typical weight. A few studies demonstrate that stoutness is connected with lower wages and low-salary family units. Furthermore, obese person’s medical expenses average 30% more than those with normal weight in Kazakhstan (Omarov, 2012).
The rapid growth of the epidemic of obesity is associated with an increase in food availability and reduced physical activity energy expenditure. People become obese only if the calorie consumption over time exceeds energy expenditure. The risk of excess energy consumption increases with diets high in fat and sweets, low in fiber and vitamins, and large in portion size. Foods high in fat and sweets are cheap, affordable, and high-calorie. Scientists argue that fast food is a major cause of obesity, arthritis, atherosclerosis and heart attacks. People do not want to spend time cooking a full meal, and are increasingly using ingredients rich in fats. Fascination with fast food is fraught with not only obesity and diabetes but also the risk of bowel cancer. Unfortunately, today 's youth in Kazakhstan often eat fast food. Instead of home cooking, youth prefer all kinds of sandwiches, pastries with a fairly long shelf life, and "soda." Meanwhile, 70% of all diseases are connected with eating disorders (Naquoya, 2012). The so-called fast food is fast causing serious harm to the body, because it contains all sorts of preservatives, stabilizers, leavening agents, thickeners, and flavor enhancers. Moreover, in mass food production, frying oil is used repeatedly. This concentrates carcinogens, which are one of the main causes of cancer. Long-term consumption of fast foods leads to serious disruption of the nervous system. There are various allergic reactions as well. As is known, the energy density of these products is quite high, which is achieved by the addition of excessive fat, sugar and salt which raise the risk of obesity. Kazakhstan’s researchers say that only two fast-food burgers cover the daily requirement of salt. Of course, the abuse of such food will lead to high blood pressure.
To conclude, overweightness and obesity are in fifth place among the leading causes of death in Kazakhstan. Hundreds of citizens die each year as a result of overweightness and obesity. Moreover, according to research, heaviness reduces people’s lifespan by around seven years. In addition, fatness is a consequence of social isolation. Socially vulnerable groups consume fast food most, are more obese, have less access to education, engage in less physical activity, and possess less information about healthy lifestyles.

Policy Environment of Obesity in Kazakhstan
The Republic of Kazakhstan is a sovereign “unitarian” state with a strongly presidential government. State power is derived directly from the people. Free election allows people to create state foundations (Constitution of the Republic of Kazakhstan, 1995). The President of Kazakhstan is the head of the government. His power is shaped by the legislature. Authoritative force is vested in the executive, parliament, and judicial sectors of power. The Chamber of Ministers is likewise delegated by the President. One member of the chamber is the Minister of Health and Sports Committee, who makes policy in the health field. Their job includes addressing social issues such as obesity. The accompanying sections explain the national, regional/local, and company policies related to health and obesity.
Obesity is a result of too much food consumption, which is hard to control. Kazakhstan’s national and central laws and regulations cannot directly influence peoples’ eating habits because the Constitution of the Republic of Kazakhstan reads: “The Republic of Kazakhstan proclaims itself a democratic, secular, legal and social state whose highest values are an individual, his life, rights and freedoms.” According to the Constitution, anyone has the right and the freedom for entrepreneurial activity which means citizens might (and do) produce or sell fast food which is a cause of obesity. On the other hand, the law regulates peoples’ health protection as well: “The state should set a target to secure the life and health of the individual. Authorities should be considered responsible for the disguise of truths and circumstances jeopardizing the life and health of the individuals as per law” (articles 26, 30, 31 Constitution of the Republic of Kazakhstan, 1995).
Ministry of Health and Committee of Sports of the Republic of Kazakhstan are the government offices most responsible for preventing obesity. Ministry of Health of the Republic of Kazakhstan is the central executive office in the Government of the Republic of Kazakhstan, directing inter-sectorial coordination in the field of public health and education, and regulating the safety of the food supply. In the Address of the President of the Republic of Kazakhstan "Strategy Kazakhstan-2050” and “the Strategy of the Ministry of Health: holding to a new trajectory for our people and our state” clearly states that the health of the nation is the foundation of our future success, and the Ministry of Health is instructed to study the issue to introduce new approaches to ensure the health of our citizens. Companies need to understand that disease as a result of obesity costs the people a lot, including medical insurance, treatment costs, and reduced life expectancy in general. When making such changes to the law, each person will have the option granted by the state: eat sensibly or irresponsibly to their health. The objective of every meal consists in maintaining a normal weight, a normal level of blood pressure, prevention of increase in cholesterol and blood sugar.
By policy of Kazakhstan everyone has the right and freedom to consume whatever food they want. However, good health is one of the foundations of national security. Meanwhile, a separate law "On Food Security" in Kazakhstan is not, and no head of "food security" in the Law "On national security." Kazakhstan adopted the model law "On Food Security CIS" Decree № 14-10 of October 16, 1999, which set forth the definition of: food security of the state - the state of the economy of the state, in which the food is provided by the country 's independence and guaranteed physical and economic access to food for the entire population in amount necessary for an active and healthy life. Government has no right to control citizens’ body weight or food consumption. Nevertheless, serious health is one of the threats to national security in Kazakhstan (art. 6.1. The Law "On National Security" from 06.01.2012). Resolution of the Government of the Republic of Kazakhstan dated March 3, 2014 number 172, which come into force in June (hereinafter - "Rules sourcing") The competent authorities for the control and supervision over the quality of food products to check the appropriate food technical regulations "Requirements for food safety for children and adolescents", approved by the Government of the RK from 14.09.2010, № 935.
Current condition of sports facilities insufficiently developed in Kazakhstan. Network Sports school only 7 percent of school-age children of the republic. The shortage of highly qualified coaches doesn’t match the broad needs of the population, especially children and adolescents. Modern sports facilities, equipped with quality gear and equipment, training centers and sports reserve are only in certain regions. To prevent obesity, Kazakhstan requires guarantee physical activity classes from all schools and universities. Ministry of health and Sport committee are trying communicate together to solve obesity problem in Kazakhstan.

Policy Options of Obesity in Kazakhstan
Obesity has become a very serious concern in Kazakhstan. According to Department of Statistics, percentage of population overweight is huge 24% and increasing (Statistic agency, 2013). Citizen’s health is highly valued by the Government of Kazakhstan. In last five years, Ministry of Health and Sport committee of Kazakhstan has implemented several programs to prevent and reduce the obesity rate. There were many programs offered by experts. One of them was included to the strategy of the country. "From 2015 a new program will host cross-sectorial meetings to develop a national strategy for the prevention of obesity among children in Kazakhstan. The work plan will develop of action for the prevention of childhood obesity with the definition of the relevant obligations of interested organizations and the establishment of deadlines. The organizers of the workshop are the who Collaborating Center of the National Center for Healthy lifestyle and the European Regional Office of the World Health Organization.
Director of National Academic food Kazakhstan M. Tashenov suggested to government rise the price for fast food as a policy of prevention obesity. “To stop the epidemic of obesity, it is necessary to revise the cost of food and prices in fast foods” said M. Tashenov. In his study, he learned how the change of the price of a meal is reflected in the statistics of excess weight. M.Tashenov and researchers compared data on the prices of various foods and the prevalence of obesity. Analysis showed that the price reduction in fast food restaurants 10% leads to increased rates of obesity in men and 17% and 8% women. At the same time, if the price of home prices and fatty foods at fast food restaurants grows, the rate of obesity among adolescents will slow down. In addition, the prevalence of obesity among women and adolescents depends on the prices of fruits and vegetables; they are cheaper than the less fat people in these categories.
Another policy alternative was suggested by Myrzabekov Oraz Myrzabekovich, rector on Scientific and Clinical work Kazakhstan National Medical University named after S. Asfendiyarov. The policy stressed on the importance of enhancing Physical Activity Programs in schools as kids who were physically very active are more inclined to remain physically active into pre-adulthood and adulthood thereby reducing the risk of being obese. Schools are a characteristic area for physical movement in the recent past, amid, and after school hours. Sports schools should be built in every district in Kazakhstan (Myrzabekov, 2012). Tragically, understudies today invest less time in organized physical training projects that give chances to direct to-lively physical action than in the past. This is expected to some degree to plan demands and weights to center assets on enhancing scholastic skills in whole country. An issue of organized physical instruction classes that fuse moderate-to-energetic movement for the vast majority of the class period should be practiced in Kazakhstan’s all regions.
Omarov Toktamysovich Kadir, Chairman of the Board of Directors of "National Scientific Cardiac Center" talked about a policy alternative for increasing the price of some products such as cigarettes and alcohol. Increasing costs of cigarettes and alcohol through higher duties is a proven way to reduce consumption. Taxing undesirable nourishment would be liable to have a comparative effect. Charge arrangements to abatement utilization of undesirable items, for example, vodka and tobacco in Kazakhstan are basic and are by and large preferred acknowledged over different assessments. In the event that returns from expenses were utilized to help heftiness anticipation (for instance, physical instruction in schools or ranch to-market motivators to expand leafy foods utilization), open backing for tariff would increment further. An expense of one tenge an ounce on sugar-sweetened refreshments around a 10 percent cost increment on a twelve-ounce can—would be prone to be the absolute best measure to switch the corpulence scourge (Omarov, 2011). Such an assessment would lessen normal for every capita utilization by 8,000 calories yearly, possibly counteracting around 1.3 kilograms for every year of weight gain. Similarly, sponsorships that by implication advance utilization of bad nourishment, for example, deal charge absolutions for pop and nibble sustenance basic in numerous regions in Kazakhstan ought to be dispensed with to build costs and decrease utilization.
Deputy Director "National Research Medical Center," Ph.D. Professor Tuganbekova Saltanat Kenesovna wants to change the policy of food supply. She thinks that to prevent obesity, fresh food nearby governments and market affixes can associate to grow full-benefit foodstuffs in underserved neighborhoods, as in South Kazakhstan. Stores can build produce deals with appealing, admirably kept showcases and position of produce at checkout passageways. Government can grow and finance agriculturists ' business sector that bring crisp produce into underserved neighborhoods. Expelling undesirable nourishment from all schools, kid consideration and social insurance offices and government establishments would diminish presentation and access (Omarova, 2012). More exertion is required to guarantee that all sustenance and refreshments, including those accessible outside school supper projects, meet minimum nourishment requirements.
Policy Recommendations of Obesity in Kazakhstan
The policies to prevent obesity in Kazakhstan is all combined, supplier, government, work, business, wellbeing safety net provider and nature of-consideration associations attempting to change how Kazakhstan approaches the issue of weight, overweight and weight-related dangers. The effort deliberations should concentrate on educating leaders in general society also private segments on the size of the issue, as well as conceivable pathways forward. Rolling out advancement obliges a basic improvement in the way we discuss corpulence with policymakers, experts and one another. Most people in Kazakhstan who are overweight have unlikely weight reduction objectives that are centered on nonessential changes, as opposed to long haul wellbeing. Advancing maintained wellbeing enhancements over nonessential results will help government the dialog on corpulence to sound mental and physical conclusions.
Policy Recommendation One: Create uniform sustenance and physical movement measures for Kazakhstan’s children. All childcare and preschool settings in Kazakhstan ought to give nutritious dinners and nibble alternatives comprised of however many crisp produce things as can reasonably be expected; low-fat dairy, soil-grown foods, vegetables, and whole grains. Water and low-fat milk should be the favored drinks, instead of soda. The Healthier Generation sustenance and refreshment guidelines could serve as nourishment norms for nourishments and drinks, to be adjusted for the ages of the children involved. Childcare offices are by and large directed by states, and principles change broadly, however the Ministry of Health should offer a chance to give people direction and some consistent health guidelines. The Ministry of Health should corporate with public and private organizations to implement a health strategy for child nutrition. This might give a vital chance to fortify the necessities around nourishment, sustenance instruction, and physical activity, evaluation of wellbeing strategies, powerful implementation, and enhanced clarity to families. There needs to be a viable dispersal of information to folks and parents should be incorporated in nourishment training endeavors.
Policy Recommendation Two: Intensify and coordinate the research about obesity. Empower an interdisciplinary exploration that addresses the overweight pandemic as a complex transaction of organic, hereditary, behavioral, cultural, environmental, social, arrangement and monetary elements. To prevent obesity, we suggest the development of an examination plan that incorporates all Kazakhstan’s regions for enhanced soundness of individuals who are overweight. Investigate different research approaches to the problem of obesity: re-characterizing what constitutes "overweight,” explore a mix of variables associating with one another that all contribute to overweightness and obesity. Case in point: research is required to better see how treatment for being overweight and its co-morbidities is influenced by different ways of understanding diet, exercise, overweightness, and health, whether in school, in the family setting, or in the workplace and other social contexts.
Policy Recommendation Three: Build centers for physical activity in every district and town in Kazakhstan. Physical activity should take a certain amount of people’s time. During the day, all Kazakh communities should engage in moderate-to-enthusiastic physical action. All Kazakhstan’s public/private schools and organizations should give no less than 60 minutes a day to physical movement, and ideally, organized physical activity to guarantee youngsters are getting moderate-lively physical movement. Central governments should give expense credits to partnerships or people who need help to support sports buildings or sports supplies for youngsters. Physical activity for improved health encouraging mediations and making situations that backing physical movement will enhance wellbeing and weight reduction, bringing about a healthier populace in Kazakhstan. Physical exercise has critical and boundless profits, paying little heed to one 's weight. In medical terms, cardiorespiratory wellness alludes to the wellbeing and capacity of the heart, lungs and veins, and is a target for evaluating changes in physical action. Participating in customary physical action and lessening times of idleness can build one 's wellness level and weight reduction. To prevent obesity we recommend developing recreational clubs in every district in Kazakhstan.
To conclude, we recommend to government, especially Ministry of Health and Sport committee to organize conferences, meetings and round tables to prevent obesity subjects. Using media agitating healthy life might significantly affect people’s life. Also, government of Kazakhstan might support domestic agricultural companies and encourage them to produce organic fruits and vegetables. To fulfill above mentioned policy recommendations, government officials should think about increasing Ministry of Health and Sport committee’s budget from 4 to 8 percent. Kazakhstan’s rich natural resources gives opportunities for Kazakh nation allocate sufficient amount of capital for their health, medical care and happy life.
Conclusion
Obesity-related diseases are one of the main global challenges today. There are many causes and consequences for this. Most research from developed and developing countries points to three main ways to resolve the obesity issue: reduce fast food consumption, increase physical activity, and devote more research to the complexities of obesity, its roots and its co-morbidities. Government has no power to block the supply of junk food for its citizens, because it would be restricting personal freedom. Also, government has no power to force people into physical activity because it would be restriction of their freedom of activity, as well. An essential way of preventing obesity is by increasing public awareness through research and education. The challenge is there is not enough passion and willingness from all influential organizations to end this problem. Some companies make tremendous profits from the tendency toward obesity. If government, nonprofit organizations and business corporations will come together and make an effort to solve the obesity problem, millions of people’s lives would be saved and millions of families who are suffering would be happy.

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