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HEALTH |
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BODY & MIND
The new GenX epidemic: Obesity
Ravi Bhatia
With the present day lifestyle being limited to colas, burgers and computer games, the GenX of urban India is faced with the potential threat of a new epidemic-Obesity!! In a seminar to raise awareness about the adversities of obesity among urban adolescents on ‘Anti-Obesity Day’, VLCC, India’s premier chain of health and fitness, announced the startling findings of the adolescent obesity research supported by Biostatistics Department, AIIMS. The research was conducted among 450 affluent urban adolescents with the main objective to determine the level of obesity and the nutritional, lifestyle psychological and health status of these children. This study is a plea to the Directorate of Education requesting them to incorporate Health and Nutrition Education as part of the school curriculum. The findings of the research suggest that out of the 93 per cent of the young teenagers who ate breakfast in the morning, 60 per cent skip breakfast at least 2-5 times a week. Thirty-five per cent ate out more than twice a week. When asked about their preference (likes/dislikes) towards food items it was found out that 72 per cent of the adolescents ate pizzas, 49 per cent like burgers, 35 per cent noodles, 32 per cent ice creams, 12 per cent fruits, and only 8 per cent like green vegetables and salads. Elaborating on the lifestyle of adolescents, Dr Veena Aggrawal, Nutritionist, VLCC, said: “More and more kids are engaging themselves in sedentary lifestyle these days. We have found out that 48 per cent of the students spend at least 3-5 hrs in the day in sedentary activities.” She also added, “Since obesity levels are on the rise, it is expected that such research programmes will help in improving on the nutritional status of adolescents. This should help in the betterment of human resources of the country by increasing on their productivity levels and also conserving the financial resources of the country.” It has also come out more clearly that not only is adolescent obesity linked to health problems in middle age, but also that increasing number of diseases manifest themselves at a younger age. This research is a culmination of various problems connected with obesity among obese adolescents. In fact, as part research project VLCC has evolved a special “diet diary” that could serve as a friend and guide to adolescents. This diary can help them alter their dietary patterns and lead a healthy lifestyle. Obesity is a silent killer and the single largest cause of various life threatening diseases. In India, malnutrition had been associated with under nutrition and underweight. But ironically today, the terminology “malnutrition” is also associated with “overweight”. Hence, India today faces two extreme problems of both under nutrition and also over nutrition.
Adding fuelAdding fuel to the latest debate in the nutrition community, a study published in the International Journal of Obesity (USA) shows that in two groups eating two different diets containing the same number of daily calories over six months, one group lost more weight than the other. In this study, 65 overweight and obese adults - 70 per cent of whom had type 2 diabetes were put on one of two diets designed for weight loss. The first group ate a liquid formula-based low-calorie diet containing moderate fat from almonds (39 per cent total fat, 25 per cent monounsaturated fat, 35 per cent carbohydrate as per cent of energy). The second group ate a liquid formula-based, low-fat, low-calorie diet including self-selected complex carbohydrates (18 per cent total fat, 5 per cent monounsaturated fat, 53 per cent carbohydrates as per cent of energy). The two diets’ calorie count and protein levels were equivalent. After 24 weeks, patients on the moderate-fat diet containing almonds had achieved a greater reduction in weight/BMI (-18 per cent vs. -11 per cent), waist circumference (-14 per cent vs. -9 per cent), fat mass (-30 per cent vs. -20 per cent) and systolic blood pressure (-11 per cent vs. 0 per cent). Both groups experienced lower glucose and insulin levels. But medication requirements for individuals with type 2 diabetes decreased more steadily in the low-calorie almond diet than the low-calorie complex carbohydrate diet. The study comes at a time when the nutrition community is beginning to wonder, based on other recent studies, whether all calories are really created equal. One of the most hallowed nutrition beliefs has always been that losing weight hinges solely on the number of calories consumed versus the calories burned through resting energy expenditure and physical activity. Dr Shikha Sharma, Capital’s well-known nutritionist, said: “It is amazing how conscious the Indian population is about the stigma of obesity, but they do not posses the basic knowledge of a healthy balanced diet. This study reiterates the importance of natural foods in the diet, with a special emphasise on almonds. In India, adherence to these basics can begin from ones own homes, since almonds already have a rich cultural and nutritional history.”
Surgery for obesityFor the first time in India, chairman of department of minimal access surgery, Ganga Ram Hospital, Dr Pradeep Kumar Chowbey, has introduced a unique endoscopic or laproscopic surgery for the morbid obesity patients. A biocompatible, sillicon band is placed around the stomach just below the food pipe creating a 30 ml pouch (2 tablespoonful). The patient feels full after just two bites of food thus decreasing the intake and resulting in the weight loss. The procedure is safe, simple and reversible. It can be done as a short stay procedure (hospitalisation for 24 to 48 hours). It is a very patient-friendly procedure and has no cut (only few tiny puncture marks), very little pain is caused by the surgery and patient can resume his work with in few days after surgery. According to Dr Chowbey, 7-9 per cent people in India are overweight, of which 20-25 per cent are morbidly obese which amounts to a staggering 2-2.5 million people. Besides, social stigma and short life span, they are bound to face spectrum of problems. Patients with morbid obesity do not respond to medical means of health loss. Efforts to treat such patients through controlled diets, behaviour modification and exercise programmes are only temporarily successful with the patients invariably regaining even more weight than the amount lost. Obesity surgery is the only method by which long-term weight loss can be achieved in these patients. The over all cost of this surgery is around Rs.1.25 lakh.
Little known facts The Annual Conference of Rheumatology Association (IRACON-2003 at the All India Institute of Medical Sciences here has brought together more than 400 rheumatologists to exchange information on the latest treatments on arthritis, osteoporosis and other rheumatic disorders. Realising that there is minimal awareness about arthritis and other related diseases both among the community and the medical fraternity, the three-day conference started with an objective of building a team of well-informed rheumatologists not only in big cities but also in small towns. Rheumatic (musculoskeletal-bones, joints and muscles) complaints are very common in the community and constitute a large chunk of family practice. It is not appreciated that arthritis is of over 100 different types and that it is the most common cause of long-term pain and physical disability. The extent of the problem and its impact on society can be understood if one realises that joint diseases account for half of all chronic conditions in persons aged 65 and over. “People think that there is no cure for arthritis and they tend to lump all musculoskeletal disorders together. With the modern advancements, several types of arthritis are curable and many more can be controlled,” says Dr Rohini Handa, Additional Professor, Rheumatology Division, Department of Medicine, AIIMS. “By having top rheumatologist, including 50 odd overseas participants, the conference will help in educating doctors in peripheral areas to the new treatments in this area,” he adds. Contrary to the popular belief, children are prone to get arthritis too. In fact, age is no bar to arthritis and nearly one third of the patients are young. This fact is under appreciated by doctors and lay public alike. Often the diagnosis gets delayed due to lack of awareness. It is all too unfortunate to find children with crippling deformities, which could have been prevented with timely treatment. In addition, lifestyle changes in the youth and children are also likely to contribute to the burden of rheumatic diseases, notably osteoporosis, the brittle bone disease. “The urban habit of increased consumption of cola drinks, tea and coffee with reduced milk consumption predisposes the youth to osteoporosis in later life. Few people know that the seeds of osteoporosis are sown in the teens. Even fewer know anything about bone health,” adds Dr Handa. (Input by Nalini Ranjan)
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