A burgeoning burden
Obesity refers to abnormal or excessive fat accumulation in the body that impairs health It is fundamentally caused by the imbalance between the consumption and expenditure of calories. (WHO). Several factors can be attributed to rising obesity levels in India, including abundance of food resulting from societal affluence, limited physical activities or sedentary lifestyles, cultural fixation with sweets, excessive use of fats in cooking or carbohydrates-rich diets and genetic factors.
The World Obesity Federation has warned that obesity-related lifestyle diseases like cancer, diabetes and heart conditions will cost India a whopping $13 billion annually by 2025, in the wake of continued increase in childhood obesity. The WHO has revealed that 8.7% of the Indian population (70 million) suffers from diabetes, even if they are not overweight. The percentage of Indians living with obesity is set to jump from 3.7% in 2014 to 5% in 2025. The rate of increase in obesity has far outstripped the decline in levels of under-nutrition.
According to the National Family Health Survey-4 (NFHS-2015-16), the number of obese people in the country have doubled in the last decade. In 2017, a WHO study showed that one in every 50 children in India is obese. The changes in physical activity and dietary patterns are a product of societal and environmental changes, related to the lack of policies to support the development of health, agriculture, urban planning, transport, environment as well as food processing, marketing, education and distribution.
Misconceptions
Sometimes, the twin paradoxical challenges of malnourishment and obesity exist within the same families. Malnourished women give birth to under-weight babies who are then overfed in childhood, leading to early onset of hypertension and diabetes. This is the Barker hypothesis, wherein individuals not receiving adequate nutrition in-utero, but have access to excess or even regular calorie intake later, are more likely to become overweight adults and are hence, susceptible to obesity-linked disorders/life-style and chronic diseases. The individual’s vital organs are unable to utilize the calories that leads to fat deposits (excess energy) in the body.
The Body Mass Index (BMI) is an internationally accepted clinical measure of obesity, originally designed to determine broader health trends among large groups of people. However, it is not meant for assessing the “healthy weight” of an individual, even though it is widely used for that purpose, as a means of enforcing a particular body type as “normal.” While there is not enough research done on the scientific validity of BMI, some scholars have questioned the underlying mathematical logic.
The BMI formula requires dividing the individual’s weight by the square of the height to determine the categories of “underweight, normal, overweight or obese.” Thus, it assumes a two-dimensional perspective while ignoring crucial factors like the body frame, tissue composition, bone density etc. Forget variance across regions and countries, two people with identical heights cannot possibly weigh the same in all instances.
Role of diets
The quick transition from being underweight to over-weight, caused by the consumption of energy-dense but nutrient-poor foodsis unhealthy. The unaffordability of healthy food options like whole grains, fresh fruits and vegetables can lead to social inequalities and impose limits upon efforts to reduce the burden of obesity. On the other hand, the trend of low-calorie fad diets (Paleo diet, Ketogenic diet, Intermittent fasting etc.) to counter obesity and weight issues, often endorsed by popular figures, is especially harmful for people in the long-run, unless adopted under medical advice, due to deprivation of essential nutrients. Such diets are not tailor-made for specific nutrient needs of individual body types.
The WHO’s report titled Assessing and Managing Children at Primary Healthcare Facilities to Prevent Overweight and Obesity in the Context of the Double Burden of Malnutrition regarding assessments of eating habits and counselling, highlight some simple dietary changes to help prevent obesity. It endorses whole grains over processed cereals as a major source of energy and all essential nutrients, dal for protein, avoidance of binge eating, sugar intake less than 10% of total calorie consumption to maintain normal weight, limited consumption of visible fats that comprise 15% of total calories consumed and use of a combination of cooking oils.
Collective action
According to Regional Director WHO South East Asia, Poonam Khetrapal Singh, governments must tax sugary drinks, re-invest revenues in health-related activities and insist on accurate food labeling to enable consumers to make informed choices. The Indian government and FSSAI are likely to implement packaging and advertising norms for packaged junk food and beverages (soft drinks, energy drinks and other sugar sweetened beverages). Such investments can help achieve the WHO’s 2025 targets to halt rising obesity and achieve 25% reduction in mortality caused by NCDs.
India boasts of being one of the world’s largest consumer markets and producers of fruits, vegetables, milk and seafood. However, it historically lacks the infrastructure to process raw materials into high-value food products for domestic and international sale. The consumption of fats, sugars, oils, animal products and packaged/processed foods have surged since 2011, according to India’s National Council of Applied Economic Research, and the U.S. Department of Agriculture. Such soaring rates raise major questions about India’s flourishing unorganized food sector and the government’s billion-dollar campaign favoring foreign processed foods in the Indian market.
The key to countering obesity risks through regulation of dietary habits and lifestyle choices of people is spreading awareness and education. In addition, the regulatory frameworks around food advertising and labelling must be strengthened, especially in case of products that are targeted towards children. Moreover, transformation of food systems at the national and global level can help alleviate the economic, health and environmental impacts of unsustainable food production and consumption practices.
Aditi Rukhaiyar
February 1, 2019
source https://indiaoutbound.org/specificities-of-tackling-the-obesity-menace-in-india/
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