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What is wellness? The role of physical health and diet

This short article is part of the What is Wellness? Expat Family Wellness Survey 2018, in which we spoke to 32 families living around the world to explore what ‘wellness’ means to expats.

Access to outside space is a prerequisite for both physical and emotional wellness. For many, this is much better than being able to visit a gym on a regular basis.

In addition to this, a large majority said that ‘physical’ health, through the medium of exercise and an absence of illnesses contributes to their overall wellness.

“It’s health: physical, emotional and spiritual” — Kirwans (Australians in Hong Kong)

“It includes mental, physical health and your finances. My whole total being” — Godwin (Americans in Nigeria)

“Physical, mental and social health” — Ali (Kenyans in Nigeria)


In general, our families said that they had relatively easy access to fitness facilities such as gyms and swimming pools. The only issue was personal motivation - whether people actually used them. The ‘expat communities’ always seem to offer these facilities but those who are living in those communities, one step removed from local life, are seen as being least likely to use them.

“We have everything available to us within our block. It’s all expats and the facilities are really excellent, but they don’t get used that much.” — Leung (Hong Kongers in Singapore)

Positive changes

There was a feeling from some that moving overseas was a catalyst for them to be healthier, that they now made more conscious effort to eat the right things and exercise more:

“It’s become a lot more important to me since we’ve been here.”

Both fitness and diet are dictated to by the availability of time. It is a part of the work/life balance and those who are working longer hours or have significant travel times are likely to find that aspect of their life compromised.

“With family and work, something has to give. There aren’t enough hours.”

We heard a few examples of couples who each had different approaches to fitness. Partly dictated by individual lifestyle and time (one working and one at home):

“There are lots of sport facilities here [in Spain]. They’ve just opened a new stadium near us and that has everything. My wife has joined but I won’t be!” — Sergei (Russian in Spain)


We heard mixed reports of how easy it was to stay fit in Nigeria. On the positive side, activity at school is a key part of the day and children were encouraged to be fit and healthy. One of our families said that they watched the weekly ‘cycle club’ in Lagos, leaving them surprised and pleased:

“It’s quite an effort because the roads really aren’t suitable for cycling!”

The less positive side of fitness in Nigeria is that it is a largely sedentary lifestyle for anyone who can afford it. Most people will take taxis and won’t consider walking. There are few public gyms but facilities for expats are usually OK.

Exercise days
Source: TomTom

1) US - 135 days*

2) Spain - 131

3) France - 116

4) Sweden - 115

5) UK - 108

6) Germany - 101

7) Italy - 96

8) Holland - 93

*Average number of days exercise/participation in sport per year (average 112 days)

Diet and fitness

Fitting the things that keep us well into our lives is always a challenge — especially when access to familiar foods and routines are restricted or need to be found.

Fitness and diet are recognised as overlapping and seen by many as being key to good health.

“We really try to eat healthily and exercise together as a family – not in a forced way but just be doing things together, outside.” — Mortleman (Australians in Spain)

Do it for the kids

Parents are often more likely to be concerned about the diet and overall fitness of their children than they are about their own.

“I don’t eat healthily, or not as well as I should, but I make sure that the children eat well and eat the right things.”Cherry (Filippina in Hong Kong)

We heard several people tell us of good intentions: “It’s one of those things where you know you should do more and eat better but it isn’t always that easy… real life cuts across.”

Food and diet

Universal city life

Whether the move to a new country has an impact on diet depends on a number of factors – but in many cases families say that they eat no worse, but no better, than they did at home.

The 21st century transport logistics and global markets mean that availability of ‘familiar’ foods is widespread:

“I feel as though things would have been different 20 years ago but big cities across the globe have the same foods and increasingly the same tastes”Anonymous in Hong Kong

Cost and availability

There are some notable exceptions to that view though — and changes to diet very much depend on the host country. For some, their diet has improved due to the variety of fresh fruit and vegetables available to buy throughout the year. Moving away can also prompt a re-evaluation of diet.

Where there are issues, these are not so much around the accessibility of fresh produce but around the cost:

“In Nigeria, you can get the same salads and vegetables as at home [in the UK], but the cost is astounding… I have paid the equivalent of £8 [GBP] for a lettuce and £6 for four mushrooms!”Witter (Brits in Nigeria)

Diet is one of the biggest issues for the Agbo family (Nigerians living in India), but have adapted their diet to blend both African and Indian influences. It’s difficult to get meat where they live in India as a lot of the diet is vegetarian. They have their friends bring African ingredients with them when they visit.

“You can eat healthy here without much effort,” say the Lagnados — Brazilians in Canada. “Just being able to buy a ready washed salad makes things easier and you’re more likely to eat healthier if it’s easy to do so.”

For some living in Singapore and Hong Kong, cost and availability of fresh produce is the biggest dietary issue. The local food is as “cheaper but very oily.”

“You have to make a conscious effort to eat healthy here.”Nizar (Sri Lankans in Singapore)

Healthy host nations

The families that live in Spain see it as having healthy foods: fresh fruit and vegetables are easy to access and very affordable.

“Food is part of the social culture which makes eating healthy more enjoyable for both adults and children.”

“We don’t have to try and eat healthily, it just happens. The availability of fresh fruit and vegetables, markets and local produce is fantastic. Nutritionally we’ve never eaten better.”Anonymous (Australian and Brazilian living in Spain)

One criticism was Spain’s lack of ‘international cuisine’ with most restaurants being limited to local food:

“Some of my British friends out here say that they miss curries… and we miss food from our (Russian) former colonies too!”Zamuruev (Russians in Spain)

Mexico was generally recognised as being a healthy place to live from a dietary perspective, if you source your own ingredients and cook at home, but not if you eat out:

“It’s so greasy and you’ve got pretty limited choice but you can get excellent vegetables and food of all kinds so you eat at home.”Astacio (Canadians in Mexico).

The 10 most obese places in the world
Source: The New England Journal Of Medicine

  1. American Samoa
  2. Nauru
  3. Cook Islands
  4. Tokelau
  5. Tonga
  6. Samoa
  7. Palau
  8. Kiribati
  9. Marshall Islands
  10. Kuwait

The 10 least obese countries in the world
Source: The New England Journal Of Medicine

  1. Ethiopia
  2. Bangladesh
  3. Nepal
  4. Eritrea
  5. Madagascar
  6. Vietnam
  7. Democratic Republic of the Congo
  8. India
  9. Cambodia
  10. Afghanistan

Click on the links below to read what our families said about various topics:

Download the 'What is Wellness?’ Expat Family Health & Wellness Survey 2018

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