25/03/2025

TUESDAY | MAR 25, 2025

HEALTH 12

Being overweight damages kidneys

F OOD is central to life in Malaysia, from nasi lemak to late-night teh tarik . However, a health crisis looms over this vibrant culinary culture. The National Health and Morbidity Survey (NHMS) 2023 reported 54.4% of Malaysians are overweight or obese, with over two million affected by noncommunicable diseases (NCDs) such as diabetes and hypertension. Studies have showed obesity increases the risk of developing low eGFR and albuminuria, which are features of chronic kidney disease. In Malaysia, 56% of new dialysis cases arise from diabetes, followed by hypertension at 30%, according to the Malaysian Dialysis and Transplant Registry 2023, highlighting a concerning health concern of kidney disease. Obesity does not just lead to diabetes or high blood pressure — it independently damages the kidneys, even in people without those conditions. The kidneys are the body’s natural filters, removing waste and excess fluids, regulating blood pressure and balancing electrolytes to keep everything running smoothly. However, these finely tuned organs can be overwhelmed by excess weight. Damage may be permanent Obesity poses risks beyond diabetes and hypertension — it silently damages kidneys, often with devastating consequences. Obesity can strain the kidneys through o Younger Malaysians at risk of disease due to lifestyle choices

chronic inflammation, oxidative stress, increased blood pressure and insulin resistance. These effects can lead to protein leakage in the urine, an early sign of kidney damage. Obesity can increase the risk of chronic kidney disease (CKD) and accelerate its progression. When the kidneys are under constant stress, they fail faster. For those already struggling with obesity, kidney disease can remain undetected for years. By the time symptoms appear, such as swelling or fatigue, it is usually too late to reverse the damage. Young Malaysians at risk of early kidney damage Younger Malaysians are increasingly affected by obesity-related kidney damage. The NHMS 2023 study also showed 84% of adults aged 18–24 do not know that they have diabetes. If you are obese since childhood or in your teens, the negative impact of obesity to your kidneys can start from then and may already be facing with CKD when you are in your 30s-40s. This early onset of kidney disease disrupts the most productive years of life and places significant strain on the families, the healthcare system and the nation. However, two in five adults aged 18–24 have not undergone health screening in the past 12 months. Advanced CKD (stages four and five) often leads to complications such as limited physical activities, affecting one’s mental health and reduced quality of life. Living with damaged kidneys is a daily challenge. It is not just about surviving — it is about losing the ability to enjoy life fully. Unhealthy habits fuelling obesity The concerning rise in obesity rates in Malaysia can be traced back to major

As more young Malaysians face obesity-related kidney disease, early prevention through lifestyle changes and regular screenings is crucial.

Fighting obesity and kidney damage Early action against obesity can help prevent kidney disease — the earlier, the better. Healthy eating habits and lifestyle must start early. Families must focus on balanced diets and encouraging kids to stay active from a young age. For those already dealing with obesity, small, consistent changes can protect kidney health. Swapping processed foods for fibre-rich options, reducing sugar and staying active are essential. Cutting back on sugar is not an overnight fix. Your taste buds need time to adjust, but you will crave less sweetness over time. While obesity’s link to diabetes and hypertension is well-known, its impact on other aspects of kidney health is not. Obesity has been associated with increased risk of

changes in dietary habits and lifestyle choices. Once rich in fibre and wholesome ingredients, traditional diets have increasingly been replaced by a greater dependence on processed foods and sugary drinks. This change also coincides with a decline in physical activity, as many children and adults have adopted more sedentary lifestyles. Kids used to play outside — football, cycling, running around. Now, screens dominate their lives and adults are less active, spending hours in front of computer or TV. Malaysia’s round-the-clock food culture is also a contributing factor to the issue. Food is available 24/7. If you are tempted to eat at midnight, you can find a meal and young adults are working long hours where convenience trumps nutrition when it comes to food.

kidney stones and increased risk of developing various types of cancer including kidney cancer. Regular health screenings are important, as kidney function and urine protein tests can detect problems early, especially for those who are overweight or diabetic. By addressing obesity and prioritising kidney health, Malaysians can build stronger, healthier futures. Obesity is not just about weight — it is about what it does to your organs, especially your kidneys. Your kidneys work 24/7, and it is time we gave them the care and attention they deserve. This article is contributed by Sunway Medical Centre, Sunway City

consultant nephrologist and kidney transplant physician Prof Dr Wong Hin Seng.

BMI misleading tool for measuring obesity? BODY mass index (BMI) is commonly used to evaluate a person’s weight status and determine whether they are of normal weight, overweight or obese. However, a new study to be presented at the European Congress on Obesity in Malaga calls the relevance of this tool into question. The results revealed, over the years, fat mass increases while muscle mass decreases, particularly in men. In women, these variations are more subtle, but a trend emerges: with age, abdominal fat increases (from +1.23% to +4.21%), while muscle mass in the limbs decreases (from -0.81kg to -2.63kg). However, the BMI hardly changes at all. This paradox revealed a major flaw, which is BMI does not measure the true evolution of the body nor identifies the associated risks.

PIONEERING FUTURE OF HEALTHCARE

The inaugural SEA Healthcare and Pharma Conference 2025 will take place concurrently with the SEACare 2025 exhibition from April 23–25 at the Malaysia International Trade and Exhibition Centre. As Malaysia advances its healthcare agenda with a focus on digital integration, sustainable funding and policy reforms, the conference will spotlight the intersection of technology, policy and investment in building a future-ready healthcare system. It will cover healthcare transformation, healthcare financing and policy, digital health and artificial intelligence integration. SAUDI HEALTH MINISTRY UPDATES HAJ REQUIREMENTS Saudi Health Ministry has updated the health requirements for the 1446 AH (2025) haj to ensure the health and safety of pilgrims, while enriching their experience in the holy sites with ease and safety, Saudi Press Agency reported. The updated requirements cover health fitness, vaccinations, preventive measures and general health guidelines for those coming to Saudi Arabia for haj or seasonal work in haj areas, ensuring a safe and healthy environment for pilgrims and workers. The ministry urged those intending to perform haj to review the health requirements documents. – Bernama-SPA

“The use of BMI becomes useless and misleading, and future research is needed to identify new tools that are able to detect these changes in fat and muscle mass in (middle aged and older people),” the researcher explained. However, longitudinal studies will be necessary to confirm these observations and refine the tools for measuring obesity across the ages. These issues are becoming increasingly important with the emergence of a new class of drugs, “GLP-1 agoists”, which include semaglutide (Ozempic, Wegovy) and liraglutide (Saxenda). Composed of compounds that mimic digestive hormones, these treatments act on satiety and are revolutionising the treatment of obesity. But their real effectiveness could be better evaluated with more reliable indicators than BMI. The stakes are high — without significant political intervention, nearly 60% of adults and one-third of children and adolescents worldwide could be overweight or obese by 2050, according to projections published in March in the British medical journal The Lancet . There is, therefore, an urgent need to use more precise tools that are capable of reflecting the biological reality of the human body. The future of public health may depend on it. – ETX Studio

BR I E F S

Conducted by researchers from the University of Rome Tor Vergata, the University of Modena and Reggio Emilia in Italy and the Beirut University in Lebanon, under the direction of Professor Marwan El Ghoch, this study shed new light on the evolution of obesity with age. The main takeaway is that it is not so much BMI that changes over the years, but rather the distribution of fat and muscle tissue. To reach these conclusions, the researchers studied the body composition of 2,844 adults with a BMI of at least 25. BMI is calculated by dividing a person’s weight (in kg) by their height squared (in m). Currently, a person is considered obese with a BMI equal to or greater than 30. In order to analyse the evolution of the distribution of fat and muscle mass, the participants were classified into three age groups: Young adults (20–39 years old), middle-aged adults (40–59 years old) and seniors (60–79 years old). They were compared with each other after being matched by body weight and BMI.

“These results clearly indicate we cannot rely only on BMI without considering the content and distribution of body composition in people with obesity across the different age groups,” El Ghoch explained in a statement. The specialist emphasised the importance of analysing the distribution of body mass, as an excessive accumulation of abdominal fat combined with muscle wasting can have serious health consequences. This tissue transformation promotes chronic low-grade inflammation, increases insulin resistance and increases the risk of cardiometabolic diseases, regardless of BMI. This study reopened the debate on the reliability of BMI. Its authors called for a paradigm shift in the assessment of obesity and suggested the use of more accurate indicators, such as waist-to-height ratio or muscle strength tests.

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