Malta has an obesity problem, but healthy eating is not that hard

Malta’s oft-recorded high-obesity rates demand that action be taken, though this is, of course, easier said than done. Shifting from an over-eating culture to one that favours a more spartan diet is already challenging enough... without having to worry about the economic impact of “eating healthy”.

However, a recently-published study has concluded that while Malta certainly seems to follow a global trend where healthier food is more expensive – and therefore simply an unattainable option for most families – it is not as badly off as other countries in this regard. This, coupled with the fact that, despite Malta’s situation as a largely import-dependent country, the island does produce a lot of its food, thus making a healthier way forward possible for the country if the necessary political and economic goodwill can be applied.

Ahead of the “over-eating season”, let’s take a look at some of the key implications of the paper, entitled ‘Food environments in Malta: Associations with store size and area-level deprivation’, penned by Daniel Cauchi, Triantafyllos Pliakas and Cecile Knai, and published in the August 2017 edition of Food Policy.

Island troubles

In what is “the first study to objectively characterise the food environment in Malta”, the paper considered the density and variety of grocery stores across the island as its main starting point, concluding that a total of 66% of food purchases in Malta were, in fact, carried out in grocery stores of various sizes. As the authors parsed through the research about local buying habits from these grocery stores – a category that encompassed everything from the smallest village groceries to supermarkets – they ran with two safe ‘assumptions’.

One of these had to do with just how Malta receives a significant bulk of its food. Indeed, “Pacific island research indicates that islands may be disproportionately influenced by the global food system due to their reliance on imported foods,” the authors state, specifying that “Malta is similarly reliant on food imports” and so would benefit from an insight into just how imports impact both the buying habits and the diet of Malta’s inhabitants.

The other key assumption – which was borne out only to a certain extent – is that a healthy dietary regime was only an option for those who can afford it. This was, however, not the only way that Malta differed somewhat from global trends.

Location, location, location

Though the authors do not delve into the factors behind this – Malta’s size may have something to do with it. For one thing their research suggests that, contrary to what is the case in other countries, the level of “social deprivation” of any given area did not make much of a difference when it came to the economic accessibility of ‘healthy’ food options.

“Findings suggest that in Malta, area-level socio-economic deprivation has minimal impact on food availability. Instead, it is the size of the grocery stores that influences the ‘healthfulness’ of the community food environment”. In other words, having access to a supermarket that stocks healthy foods is the main stumbling block of a healthier diet, rather than not being able to afford what’s available.

Breakfast of (thrifty) champions

Of course, the fact remains that, for the most part, choosing the healthier option will cost you more – even in Malta. The study, drawing on work done by the Malta Standards Authority in 2010, found that the healthier equivalent of popular foods such as pasta, bread, beef and cheese remain the more expensive option.

“Median prices of healthier versions of these products (i.e. wholegrain pasta, wholemeal bread, lean beef mince and low-fat cheddar cheese) were significantly higher than the prices of their regular counterparts (i.e. white pasta, regular beef mince, regular cheddar cheese),” the authors state, reasoning that “this represents a potential disincentive to substitute regular versions of such foods for healthier alternatives”.

In Malta, area-level socio-economic deprivation has minimal impact on food availability. Instead, it is the size of the grocery stores that influences the ‘healthfulness’ of the community food environment

However, the situation is flipped when it comes to the popular breakfast option of milk-and-cereal. According to the report, “low-sugar, high-fibre cereal and skimmed milk” turned out to be cheaper than the regular cereal and full milk option, with the authors concluding that substitution in the case of cereal-based breakfasts “could make financial sense”.

“In addition,” the authors add, “the median paired prices of plain yogurt, juice products, rice and sausages did not differ significantly, suggesting that simple substitution of regular with healthier versions of the these items would not have a disproportionate financial burden upon consumers”.

The authors also found that the price of fruit and vegetables did not vary across the fresh-frozen spectrum, and that raising more awareness of this could lead to consumers choosing to “buy fresh” more often.

Solution: keep it local

The report also finds some hope in the fact that, while Malta remains an island and is therefore reliant on food imports, this does not apply across the board.

“The breakfast cereal, pasta and cheese brands assessed in this study are imported, whereas most of the bread, yogurt, milk and beef mince brands are locally manufactured,” along with the “fruit juice and Coca-Cola brands” taken into consideration. The authors suggest that because of this, there may be some leeway when it comes to local price adjustment to “dis-incentivise” the buying of the less healthy option.

In fact, outlining a way forward, the study concludes that, “Policies designed to encourage local production and sale of healthy foods at low prices may help to counteract the disadvantage of relying on imported products whose price is difficult to control”. Such an approach, according to the authors, would likely require the “design and implementation of complementary informational policies that make it easier for people to distinguish between healthier and less healthy foods within given categories”.