Al Nasr is an area that occupies less than a square kilometre, roughly seven kilometres from the centre of Doha, and where ubiquitous flashing neon lights have earned it the pejorative epithet cholesterol corner. The prominent signage here includes some of the main favourites, such as Burger King, Chili’s and Applebee’s, while a nearby Korean restaurant, founded at a time when South Koreans flocked to work in Qatar’s oil and gas fields, has become famous for affordable kimchi and sushi.
Even Yee Hwa, the mom-and-pop operation which became a gentrified hit for health-conscious professionals, however, illustrates a point about eating in the GCC, and particularly about Qatar. The dining choices available to you, and the prices you pay for them, often bear little or no relation to the surrounding human and physical geography.
Indeed, arguably in the GCC, globalised food brands such as TGI Friday’s and Applebee’s, with the more pedestrian options – KFC, Pizza Hut, McDonald’s and Burger King – following behind, have now established themselves firmly as local eateries. Taken together, the high-volume throughout fast food restaurants (or ‘quick-service restaurants’ as they like to be called) accounted for nearly 58 percent of the USD16.5 billion (QAR60 billion) restaurant sector in the GCC, according to 2012 figures. The clout of the slightly more sophisticated ‘casual dining’ establishments – such as Chili’s and TGI Friday’s – is more difficult to estimate, but likely accounts for a further USD1.5 billion (QAR5.5 billion) to USD3 billion (QAR11 billion).
Combatting diet- and lifestyle- related illness is an express strategy of the Qatari authorities, who along with the private sector have increased awareness through various programmes.
With an estimated population of 51 million, this would mean that per capita annual spending at restaurants in the GCC is estimated at USD300 (QAR1100, or about QAR90 per person a month), a figure that is a quarter of, say, the United Kingdom, where the comparable figure is about USD1400 (QAR5000 or QAR425 per person per month). But this hides an important point: most of the population of the Gulf countries is made up of migrant workers from South Asia with little or no disposable income, whereas the spending figures reported above ostensibly come from a small clientele of well-heeled, and very well-fed, restaurant patrons.
Corn addicts
Notwithstanding the huge variety of food on offer, the market is clearly dominated by globalised food chains that have a reliance on one ingredient in particular: high-fructose corn syrup, lovingly known as HFCS. Thanks to the trailblazing work and advocacy of people such as Dr. Robert Lustig, we know that HFCS – a sweetener that is based on a novel isomer, combining both fructose (fruit sugar) and glucose and developed in the late 1950s – is arguably a toxin, and might be one of the ingredients responsible for the epidemic of obesity and diabetes in the United States (US).
A number of facts about HFCS stand out for particular concern. Firstly, the fact that its production has been effectively subsidised by the US government means that food distributors can use it as a cheap additive. This has allowed for it to be rolled out in almost every food item imaginable, sometimes turning up in very non-intuitive items such as the bread in hamburger buns and even in beef patties.
Native American reservations are the focal points of obesity-related diseases, and prevalence of overweight and obesity among Native American children is similar to that among Qatari children.
This combination has helped to ensure that some of the pockets with the least amounts of disposable income, such as Native American reservations, are also focal points of an epidemic of obesity-related diseases. In fact, the prevalence of overweight and obesity among Native American and Alaskan Inuit children is similar to that among Qatari children.
By 2006, fully nine years since the World Health Organization (WHO) designated obesity as an epidemic, data published by Professor Abdulbari Bener, formerly head statistician at Qatar’s Hamad Medical Corporation, indicated that more than 30 percent of Qatari school age boys were reported as either overweight or obese, closely mirroring the statistics for Native American populations. What is striking here is that these numbers might be counterintuitive when compared to another set of data, on the GDP per capita of the Gulf states.
At the complete opposite end of the wealth spectrum, Qatar’s GDP estimates, at around USD94,000 (QAR324,000) per capita annually, make it the wealthiest country in the world (when median income is taken into account, the picture becomes more complicated, but it remains true that Qatar is home to some very rich people).
It is far removed from the pockets in post-industrial countries such as the US in which obesity is rife. In fact, although obesity had previously been thought to be a First World problem, trends over the past 30 years have shown that it affects the poor more than the wealthy, at least in the industrialised world. Ironically, in the GCC states, by contrast, particular fast food chains, which are generally associated with the underclass in North America, have arguably become fashionable among many moneyed citizens of the Gulf.
According to Zahra Babar, a Doha-based academic and one of the editors of Food Security in the Middle East (Oxford University Press, 2014), this can often create a problem for public health experts, who are used to Western societies, trying to solve problems in Qatar and the Gulf. The difficulty, as Babar points out, is that it was not that long ago when eating at Western chain restaurants, and being seen to eat there, was the height of class. Enjoying Pizza Hut or a KFC held out the cache of eating “like they do in London”, a perception which stuck even as the West became health conscious and trend-setters jettisoned their fast food addiction.
If people want to eat more calories than they expend in physical activity, then the obvious conclusion is that they will become overweight.
Further occluding the view, says Babar, is that the data available, when it is there, is often unreliable. She cites the work of Salman Rawaf, a public health expert at Imperial College London, who has repeatedly cast doubt on the veracity of data in Qatar and other Gulf states, largely because of the lack of a fully-fledged infrastructure to record the relevant metrics across all sections of the population.
A colourful idea that Babar uses to illustrate this point is that, in reality, the “typical Qatari”, if measured properly, would be a malnourished South Asian labourer working on a construction site and not a well-fed citizen in an air-conditioned car. Indeed, even today, cereals comprise more than 44 percent of the food consumed in the GCC, compared to seven percent for meats – a characteristic more typical of poorer communities.
Big problem, big business
Yet, like anybody who lives in Qatar knows, the country is meticulously measured, with much fanfare made out of the publication of data relating to the size, shape and well-being of the population. More to the point, and as Babar herself points out, the problem is clear for all to see: stand in a food court in one of Qatar’s shopping malls, and the girth of a typical waistline will leave an impression on you.
The anecdotal evidence goes further still: Qataris often speak of friends, relatives and colleagues who have had gastric bypass surgery, who suffer from hypertension and diabetes at an early age, or who have had to undergo some major medical intervention or the other to be able to function as adults. So if we can all agree that there is a crisis, even if the scale of it remains unclear, then who is to blame?
Without a doubt, the public’s consumption habits play a big role here: if people want to eat more calories than they expend in physical activity, then the obvious conclusion is that they will become overweight. An interesting idiosyncrasy in the Middle East is the way in which Western diets have supplanted – but not entirely replaced – the dining habits which are grounded in generations of tradition: one striking observation about the consumption of fast food in the Gulf is the way in which people partake in it communally, in kinship groups and shared out as equals.
Unlike the way that the import of coffee chains completely altered the consumption patterns of coffee, turning it from a ritualised, slow affair into a morning rush-hour pick-me-up, hamburgers and pizzas did not change the rituals around food consumption – people make a show of being generous with their food, insisting that others sit down and share their meals. Clearly, consumers are not doing enough by way of exercising their judgement and free will.
Yet, as the work by Lustig shows, such a simplistic reading of the situation is unfair in the way it assumes so much responsibility is even possible on the part of the individual: especially in countries such as Qatar, where the variety of food is limited, the ability of consumers to make a choice seems like a sleight of hand. Indeed, as several of the gleeful and optimistic reports on the food industry and catering sectors in the Gulf make clear, the GCC food market is dominated by a small group of corporate players with incredible clout.
Some regional giants that represent this fact are some of the oldest in the region, and are dominated by well-established patrician merchant families. They benefit from a local regulation system that makes their participation in the business chain a necessity, but they also have mutated in size as business concerns, turning the fast food franchise business into a behemoth in the process.
Business regulations in the Gulf allow for largely unhindered trading of Gulf-owned business across the borders between the countries, as well as ensuring that all local branches of a global chain need to be controlled by a single franchisee. Plain and simple economies of scale do the rest of the work to make sure that a small group of family-controlled conglomerates, which are the local partners of international fast food restaurants, have economic clout.
Subsidised starch
Another feature of the food market in the Gulf is the effective, blanket subsidies on food items. This is a hangover from an earlier time, when the populations in the Gulf had to contend with the very real spectre of famine, a periodic visitation before the large incomes now bestowed by hydrocarbon wealth.
One consequence of this is that the price of a hamburger you buy at Johnny Rocket’s – a mid-level, casual dining experience with an American 1950s theme – is impacted by government subsidies on bread, cooking oil and meats. It might also provide another clue for the link between specific food items and the rapid increase in obesity rates across the broader Middle East.
While it has an income profile completely different from the Gulf states, Egypt has also suffered from rapidly accelerating levels of obesity over the past three decades. That is also the same time frame that corresponds with the arrival of food subsidies that were rolled out to cushion the blow of Anwar Sadat’s massive economic liberalisation programme in Egypt.
Here again, the imperative was to put calories into people’s plates, and not worry about the health benefits of the ingredients used. In the end, the Egyptian public, just as those in the Gulf, display high levels of both obesity and micronutrient deficiencies, the same problems which one finds in American inner cities and on Native American reservations, amongst groups reliant on foodstuffs distributed by the US government, and highly reliant on HFCS.
So welcome to the Gulf, where the wealthiest people on the planet suffer the same health epidemics as found among some of the world’s most downtrodden. While the dominance of a small group of family conglomerates over the food sector continues for the moment, it does seem that the empire is striking back.
Qatar is in a particularly difficult place if it ever aims to become food independent. Besides the heat and extremely limited fresh water reserves – domestic water consumption is met entirely by desalination – the lack of top soil makes the idea of large-scale agriculture difficult. This has not stopped brave individuals from trying to turn the tide.
For example, one such intrepid soul is Qatari Mohammed Khamis Al Sulaiti, an electrical engineer who left a government position to attempt a world first – the farming of local truffles. If Sulaiti’s plan works out, he will have introduced a new source of fresh non-animal protein to the food market, possibly at a reduced price. Another effort involves government-subsidised greenhouses, which provide consumer cooperatives, dotted across Qatar’s residential districts with fresh, organic produce.
Indeed, combatting diet- and lifestyle- related illness is an express strategy of the Qatari authorities, who along with the private sector have increased awareness through various programmes. But there is clearly a long way to go. With time, one can be optimistic and hope that the people of Qatar will ditch fast foods dripping with HFCS that are poisoning its people and shake off the stranglehold of the fast food chains in favour of healthier choices.
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