India has among the largest shares of underweight children and teenagers while, at the other end, it is part of a trend that has seen the number of obese under-20s worldwide rising tenfold in 10 years.
A new study in The Lancet, which looked at BMI (body mass index) trends in 200 countries from 1975-2016, found that the number of obese girls in age group 5-19 has risen from 5 million to 50 million in 40 years, and that of boys from 6 million to 74 million. In India, the prevalence of obesity is between 1-2 %.
The prevalence of mild to severe underweight under-20s in India is 22.7% among girls and 30.7% among boys. In South Asia overall, the average prevalence is 20.3% in girls and 28.6% in boys, contrasting with an average prevalence of less than 1% in other regions.
“The dual burden of overweight and obesity and underweight population in the country is massive and it is high time one looked at dealing with both. The Lancet report has taken into account a lot of government data but I must point out that for India, the data is till 2014,” Dr Tapasvi Punwar of Indian Institute of Public Health, Gandhinagar. “According to the National Family Health Survey Data, the proportion of obese men in India until 2006 was 9.3 % and by 2016 it had doubled and reached 18.6% . Among women in 2006, it was 12.6%, and by 2016, 20.7 % were overweight and obese. The Lancet study is one the biggest and points to a problem we have to address immediately.”
The study found the global average BMI of children and adolescents has increased by 1.7 for boys and 1.3 for girls over the last four decades. Released on World Obesity Day on October 11, it pooled 2,416 population-based studies with measurements of height and weight on 128.9 million participants aged 5 and older, including 31.5 million aged 5-19.
“It is time our public health systems considered both these indicators seriously… You do not see people in India taking this seriously. In many countries obesity is considered a disease. In India we have programmes that deal with diabetes or heart disease. The larger issue is not acknowledged by the public health system,” said Dr Banshi Saboo, diabetologist who has contributed to a previous Lancet study.
The largest increase in obese children and adolescents has been in East Asia. China and India have seen rates “balloon” in recent years, suggest the study. The researchers say that if current world trends continue, “obese” will soon be more common than “underweight”.
“I am not too sure if the problem of underweight will be solved in India soon. We still report an alarming number of stunted children . It is a very tricky issue. The middle class and upper middle class in India have fewer children and tend to overfeed them under the pretext of pampering. As per the Lancet study, the percentage is between 1-2 in India but these will increase as social structures are changing in India,” said Dr Leela Visaria, public health expert and former director of Gujarat Institute of Development Research. “We are trying to tackle undernourishment and malnourishment through our Integrated Child Development Services programmes by trying to make sure they get proper nutrients in their midday meals. But there has to be some sense of understanding inculcated in parents and the public health system has to take both issues seriously.