Obesity in Holland


As could be expected with such a vast physical separation and greatly differing histories, the cultures and traditions held dear by the Dutch people are strikingly different to those of the Australians. While both nations do indeed share particular traits and have numerable similarities in terms of democratic system, life expectancy, unemployment rates and population (The World Factbook, 2015), it cannot be ignored that The Netherlands and Australia are dramatically different countries geographically and — perhaps therefore — culturally. This study seeks to identify and discuss the factors that contribute to obesity in both societies, and to ultimately answer one main question that stems from the comparison of both nations’ obesity rates: What are the cultural reasons for such a high inconsistency in the obesity rate of the two MDC countries? Furthermore, why is there such a difference in the obesogenic environments that citizens from each country are exposed to?

This study examines the above questions in an objective manner, all the while supporting the hypothesis that the daily life and routine of a Dutch person is the main factor in stemming the rapid rise of obesogenic behaviour. In correlation with this, the hypothesis follows the prediction that Australians are living in an ever-increasing obesogenic atmosphere, thus contributing to the rising obesity rates that are not seen as dramatically in The Netherlands.

For the sake of both measurability and definition, this paper is researching ‘obesity’ as the state in which one registers a Body Mass Index of equal to or greater than 30.0. The Body Mass Index is measured as follows, according to the US Division of Nutrition, Physical Activity, and Obesity (May 15, 2015, para. 2):

Weight (kg)/height (m)^2 = BMI.

Additionally, another term that must be defined is the theory of a ‘cultural catalyst’. A catalyst is defined by the Oxford Learner’s Dictionary (Oxford University Press, 2015) as “a person or thing that causes a change”. Therefore, in this study, the term ‘cultural catalyst’ refers to an aspect of culture that has a changing effect on the obesity rate. In relation to this, the term ‘obesogenic environment’ simply refers to an environment that directs inhabitants towards behaviour that can contribute to obesity (Australian National Preventative Health Agency, April 2014, 18).

The hypothesis that the obesity gap between the two countries is a result of both the Dutch culture and Australia’s obesogenic environment is investigated in the following pages.


The methods undertaken to reach the conclusion of this paper are entirely qualitative. Qualitative researching methods refer to the fact that the information that is being used has come from ‘desk research’; articles and theses from other authors provide the facts to be stated in the results section, and the deductions drawn in the analysis section are then created first-hand. In order to answer the research question and identify the cultural catalysts contributing to the obesity rates of the Netherlands compared with those of Australia, a series of reliable sources that provided the relevant information have been accumulated. Firstly, the Australian National Preventative Health Agency’s 2014 Evidence Brief titled Obesity: Prevalence Trends in Australia is a key document for compiling information about the Australian state of obesity. The Dutch counterpart is titled Nutrition, Physical Activity and Obesity: Netherlands and is an informative reader released by the World Health Organization’s (WHO) European Office. It includes prevalence trends, but unfortunately does not contain the same variety of data as the Australian reader. For this reason, the WHO report was not used in comparison to the Australian National Preventative Health Agency’s brief. To accommodate this inconsistency and to provide information regarding the topics relevant in this study, further resources have been added. These resources can be seen in the annotated bibliography.

These papers can predominantly be found through the websites of the authorities or governments by whom they were published. This is a largely effective method for finding the information necessary to make comparisons between the two nations, as it is in a government’s nature to make comparisons between themselves and others in the world. All of the websites have been deemed reputable and the relevant information on how that decision was made can be found in the annotated bibliography.

Otherwise, sources can be found through the Academic Search Premier on the HHS Library’s database using a simultaneous search. For this paper, most of the results returned with a simultaneous search are from journal articles, and often this lead to the acquisition of an objective, reliable and academic source.

This process of gathering accurate, reliable and valid resources in order to generate a pool of information created by other authors, from which to draw conclusions is called secondary research. Much information on related topics has been produced by other entities, and this paper uses it to draw new conclusions threw deductive reasoning. That is, some pieces of information from other sources will be assessed and analysed, to ultimately draw a conclusion that applies to the specific situation relating to cultural catalysts of obesity in the Netherlands and Australia.

Finally, the motivation behind this study must receive due acknowledgement. It has already been mentioned that with research into the obesogenic environments of a country, the respective government could save inordinate amounts of money and budget deficits could be alleviated. This is naturally a very strong motivation to research this topic. Yet despite strong financial motivations, there is also an underlying human need to find solutions to issues that harm humanity, of which obesity is one. This paper may not provide a definitive ‘answer’ to the world’s obesity epidemic, but it is this field of research that needs to be furthered, for the collective benefit of society.


The Australian National Preventative Health Agency refers to obesity among adults as a worldwide epidemic with socio-economic implications; social implications on the quality of life and the life expectancy of citizens, and economic implications in the form of health-care spending (Australian National Preventative Health Agency, 2014, 3). According to KPMG, in Australia in the 2008-09 financial year, obesity related costs equaled 3.1% of the nation’s GDP, a total of $37.7 billion (Australian National Preventative Health Agency, 2014, 3). This is a severe economic impact, and strategies need to be utilised to reduce obesity rates, and therefore spending.

In 2015, The Netherlands registered an obesity rate of 21.9% (The World Factbook, 2015). This rate is substantially smaller than the Australian rate measured in the same year — a rate of 29.9%. Due to differences in the way that the data was collected for either country, drawing exact, accurate comparisons becomes difficult. Nevertheless, whether the data is precisely comparable or not, the difference is stark.

Weight gain is — in the simplest of terms — a result of one’s daily energy intake being larger than one’s daily energy output (Australian National Preventative Health Agency, 2014, 18). In the extreme cases, this leads to obesity. Therefore, it becomes necessary to focus on the ways that the Australians and the Dutch reach the required energy output, if at all. This study is suggesting that the Australian daily way of life amounts to a lower expenditure of energy than the Dutch, thus leading to a higher rate of obesity.

In a journal article titled “In Our Country, it’s Just Poor People Who Ride a Bike: Place, Displacement and Cycling in Australia” Siew Fang Law and Wally Karnilowicz of the Victoria University in Footscray, Australia, make the point that cycling is a marginal method of transport for countries around the world that are considered to be technologically advanced and economically developed (Law & Karnilowicz, 2014, 296). The report by Law and Karnilowicz refers specifically to the United States, the United Kingdom and Australia as examples of this. Incidentally, there are three countries that make a very obvious exception to this rule: Germany, Denmark, and The Netherlands. Law and Karnilowicz refer to a paper by John Pucher and Ralph Buehler, who wrote that in The Netherlands, the total number of single trips per person made by bicycle instead of by car is significantly higher than in Australia (Pucher & Buehler, 2008, 496). In Australia, the US, and the UK, the average per capita cycling distance per day is 0.1km, as opposed to The Netherlands where the average distance is 2.5km.

Additionally, a Western Australian research investigation into Dutch cycling habits in 2014 states that close to half the population of Dutch school students in cities surveyed arrive by bicycle (WA Department of Transport, 2014, 12).

While cycling plays a vital role in a person achieving the required daily energy output, the daily energy intake is also important. It is well documented in many reputed medical journals that the recent rise of highly processed foods (and foods containing high levels of saturated fats) correlates strongly with the growing obesity epidemic. This fact then prompts the closer examination of the eating habits of the Dutch compared to the Australians, with a focus on fast food.

According to a report prepared by Euromonitor International, “McDonald’s remained the leading brand in fast food in the Netherlands in 2014” (Euromonitor, 2015, para. 2). Incidentally, in the same Euromonitor report about Australian fast food consumption, similar results showed: McDonald’s is the highest frequented and most successful fast food restaurant in Australia (Euromonitor, 2015, para. 2). Data released through the McDonalds Virtual Press Office states that there are 292 McDonald’s outlets in The Netherlands, and 920 in Australia (McDonalds, 2013, para. 1). Comparing the population of The Netherlands with its number of McDonald’s outlets shows that there are 1.72 outlets per hundred thousand people (per capita). In Australia, on the other hand, the same calculation equates to 3.88 outlets per capita — more than double the Dutch statistic. As convenient as this finding is in supporting the hypothesis of this paper, there are other factors that must be considered. These will be discussed in the analysis.


The results that have been retrieved from the information present in current publications on this topic all largely support the hypothesis that the Australian way of life leaves citizens more susceptible to weight gain and obesity. An analysis of the data collected on two main factors — daily exercise and fast food consumption — helps verify the statement that certain aspects of Australian culture are accelerating weight gain where the Dutch culture repels it.

Firstly, the data regarding cycling, that was retrieved from the works of Law and Karnilowicz, Pucher and Buehler, and the WA Department of Transport all make the connection that The Netherlands as a nation makes exemplary use of bicycles as a transport means. Due to correct infrastructure and favourable physical geography, cycling in The Netherlands has grown since the 1970’s as a very standard mode of Transport (Pucher & Buehler, 2008, 496, and WA Department of Transport, 2014, 7). Interestingly, and in contradiction to Australia, age has very little impact on use of cycling as transport in The Netherlands, whereas in Australia, the elderly are far less represented in the already small group of cyclists (Pucher & Buehler, 2008, 496).

This data — while seemingly conclusive — fails to acknowledge the reasons for the discrepancies in the data. For example, the reasons why Australians do not cycle as much as the Dutch. There could be any number of reasons why these extreme statistical differences exist, such as lack of universal cycling infrastructure, climate, road laws, and even the public image of cycling purely as a sport and not so much as a means of transport (Pucher & Buehler, 2008, 495-497). Whatever the reasons may be, the irrefutable fact that can remain from the results section is that cycling is not as common a means of transport in Australia as in The Netherlands. People in Australia are predominantly transported by vehicles that do not require energy expenditure (cars, public transport), and thus the opportunity for the essential output of energy through this means is lost.

Turning attention now to the distribution of McDonald’s restaurants around both countries, this statistic is also subject to complex scrutiny regarding its validity. It is a fact that the per capita distribution of McDonald’s outlets is higher in Australia, but this statistic only shows one possible way that the data could be analysed. Without needing to perform calculations, a comparison of McDonald’s restaurants per square kilometre in Australia as opposed to The Netherlands would yield results that indicate that Dutch are wildly more fanatic of the fast food chain than the Australians. What can be derived from the data provided by the Euromonitor studies is that in both nations, McDonald’s was the most popular outlet of fast food in 2014. This paper then proceeds to make the new observation that in Australia, the abundance of restaurants higher than in The Netherlands, thus making this fast food substantially more readily available. However, as previously discussed, this observation is only partly relevant, as geographic and population density factors have not been taken into consideration.

One the one hand, it is obvious that the process of analysing the cultural factors of higher obesity prevalence in Australia than in The Netherlands cannot be completed after the examination of two factors. Obesity is a disease that is the constant subject of research, and a large diversity of potential factors — both cultural and purely medical — exist. These factors are genetics, diet, stress levels, sleep levels and sleep quality, working environment and working hours. Of this list of factors, sleep levels and working hours are two more inherently cultural aspects that could undergo further investigation and comparison with regard to obesity levels. For the purposes of this study, however, the two factors of exercise and fast food intake have been cross examined against the patterns that each country displays in these facets.


In answer to the original research question, this report has identified that cycling is a key factor in keeping the obesity rates of The Netherlands low, and a very noticeable lack of cycling in Australia acts as a catalyst for obesity. The fact that the Dutch people collectively cycle 25 times further than the Australians per day suggests that a much higher percentage of the Dutch population is reaching the required daily energy output, where their Australian counterparts are not. This can be concluded as a cultural factor in the differences of obesity rates.

In the case of this study, McDonald’s fast food restaurants are brought forth as the measurable element of fast food availability and consumption, and the conclusions drawn from the information presented are reflections of this. The Netherlands contains less than half as many McDonald’s restaurants per capita than Australia, supporting the statement that Australians have easier access to fast food than the Dutch. This statement is unfortunately not as irrefutable as the conclusion on cycling, but it does correlate with the trends that can be seen in the obesity rates of the countries, and in the cycling prevalence.

Even though deductive logic was the selected form of reasoning, this report has inadvertently made use of abductive logic, as the results presented only show part of a much larger picture. Obesity, its rise in Australia and its relative scarcity in The Netherlands, is a very complex issue with many influencing factors. The conclusion has been reached that prevalence of cycling and a fairly low distribution of McDonald’s outlets helps keep obesity rates low, and this conclusion can be made comfortably. However, these are not the only cultural factors effecting the obesity differences between the two countries. There are other factors that — due to lack of conclusive, reliable studies — could not be investigated in this paper. Though unlikely, these factors may tell a different story and at that point a new conclusion to this paper must be drawn.

In conclusion, the original hypothesis (that the obesity gap between Australia and The Netherlands is a result of cultural differences) cannot be considered entirely correct beyond any doubts. While this study has deemed cycling as a major contributor to achieving daily energy output, and distribution of McDonald’s restaurants as an important factor in fast food consumption, the other cultural factors are yet to be recognised. As the research question refers to all the cultural factors of obesity — not simply cycling and fast food consumption — this report is rendered somewhat inconclusive.

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