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Thursday, October 6, 2022


Fight the Flab


In India, 55 percent of deaths are caused due to obesity and unhealthy food habits
DR. SUSHIL SHARMA | Issue Dated: March 2, 2014, New Delhi
Tags : Bizarre | National Family Health Survey | US FDA | ObamaCare |

Bizarre reactions are pouring in with respect to obese people. The New Zealand government asks an African national weighing 130 kgs to leave the country because they can’t afford him. Airline companies are planning to charge additional money from travellers weighing more than 95 kgs. On the face of it, such statements have a common denominator called commercial anxiety, but who knows, all this become a reality some day. However strange it may sound but reports from Oxfam and other researchers now have  established beyond doubt that developing countries have more obese population than developed. And India, a developing country - mostly considered malnourished - now has a 15 percent overweight population. Figures show that Indians are adding flab pretty fast. As per the National Family Health Survey -2 (NFHS), 11 percent Indians were obese but NFHS-3 shows a 4 percent rise. Many may question this over-emphasis on obesity when bigger diseases confront the nation. WHO has recognized obesity as ‘the New World syndrome’ and mother of all non-communicable diseases. About 1.7 billion global citizens are obese. The Vienna convention has called upon EU members to fight obesity very seriously as 50 percent of citizens are obese and 77 percent of deaths in EU are attributed to non-communicable diseases (NCD).  In India, chronic NCD is responsible for about 55 percent deaths in India - more than 30 million each year.

How does it happen? Body mass index above 25 is obesity and below 18.5 is underweight. Multiple morbidities are indirect product of obesity. In young girls it leads to early puberty, heart disease, diabetes and a good percentage of arthritis, osteoporosis, sleepapnea and hypertension. Obesity is not all about self controlled eating - it is much more. Issues like genes, slow metabolism, psychological status, dietary profile and food availability are of extreme importance.

What should be the counter strategy? Benjamin Franklin said “an ounce of prevention is better than pound of cure”. The US FDA eliminated transfats from food and this is expected to prevent 20,000 heart attacks every year because transfats increase LDL (bad) cholesterol in system. Prevention of obesity is very important aspect of US health policy popularly called ‘ObamaCare’. US policy makers are convinced that despite spending 16 percent of GDP on health, prevention of major diseases alone can save them and cure remains largely unaffordable. A NGO, Partnership for Healthier America, headed by first lady Michelle Obama works with the private sector on health strategies to reduce obesity and its ill effects. Indeed the results are showing- Coca Cola and Kraft Foods group pledged to cut one trillion calories from marketplace by 2012 and 1.5 trillion calories by 2015. Coke and Pepsi have shifted to low-cal products and small packs advertising. In India the present per capita consumption of carbonated drinks is about 4 litres and may reach eight litres in next five years but can never reach US levels of 165 liters. So, the task is easier.

We must sanitize school canteens from high cal junk food.  Courts have intervened to restrict junk food sale in schools, but the implementation is partial and slow. In case of adults the cause and effect mechanism needs to be understood. Obesity is more in urban India due to sedentary lifestyle and faulty eating habits. The poor are obese because of cheap oily food consumption, fruits and vegetables are anyway expensive. The rich are obese because of excessive intake and sugar-based diet. In one respect obesity is directly proportional to wealth- citizens of rich states like Punjab (30 percent ), Kerala (28 percent), and Delhi (26 percent) are bulkier than their poorer counterparts in Jharkhand, Orissa and Chhattisgarh. Interestingly the issue is also linked to races: a study by the Anthropology department of Delhi University’s Sardar Patel Institute proves that obesity is highest in Punjabis (Aryans), less in Keralites (Dravidians) and the least in Manipuris (Mongloid)

Taking into account all these factors needs no great imagination; what is needed are corrective steps for changing the scenario. A few steps that are driven with passion and sincerity  are required. For instance, more health programmes on visual media to increase health awareness, sports and yoga needs to be encouraged at all levels, Nutritional advice in schools, food information and health education in general is a vital component of this drive.
Remember, reducing obesity is not only an art but also the science of controlling chronic non-communicable diseases. The Indian government does mention it as one out of 26 interventions in the national NCD programme but on the ground level, there is hardly anything that is visible.

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Issue Dated: Feb 5, 2017