A man with a height of 5 feet 9 inches,who weighs 75 kg,is considered normal weight as internationally. But according to Indian standards he is overweight. When it comes to weight,till a few months ago,Indian doctors accepted International standards. But recently,as a group of doctors met to mull obesity in Indian population,this,and many other norms were changed painting a far grimmer picture.
Already,almost 65 per cent of adult urban Indians are either overweight or obese or have abdominal obesity. But now,it is expected that an additional 10 to 15 per cent people will be labelled overweight or obese a further risk in a country where people are genetically far more vulnerable to heart attacks and Type 2 diabetes than Europeans and Americans.
The consensus for diagnosis of obesity,abdominal obesity,metabolic syndrome,physical activity,drug therapy and bariatric surgery in Indians was prepared after due consultation with experts from various fields: internal medicine,metabolic diseases,endocrinology,nutrition,cardiology,exercise physiology,sports medicine and bariatric surgery. There were also experts from government-funded research institutions and policy making bodies.
The revised standards have been published in the February issue of Journal of the Association of Physicians of India.
A person weighing 75 kg who is 59 height is considered overweight as his Body Mass Index (BMI) is 24.5. So by Indian standards,he is overweight, says Dr Anoop Misra,one of the key investigators and Director and Head,Department of Diabetes and Metabolic Diseases,Fortis Hospital.
WHO IS OVERWEIGHT
According to the new standards,anybody with a BMI of over 23 (weight 68 kg and height of 58) is overweight.
As per Indian standards,normal BMI is 18 to 22.9 kg/m2. From 23 to 24.9 kg/m2 is considered overweight and 25 kg/m2 is obese.
On the other hand,the cut-offs of BMI recommended by World Health Organisation is 18.5 to 24.9 kg/m2 for normal,25 to 29.9 for overweight and above 30 kg/m2 for obese.
Likewise,earlier,Indian woman with the waist circumference of 85 cm was considered normal as the international cut-off was 88 cm. But now,according to Indian guidelines,a waist circumference of 85 cm is abdominal overweight. The cut-off stands at 80 cm.
As for Type 2 diabetes patients,the BMI cut-offs is 22 kg/m2 in men and 23 kg/m2 in women.
WHY GUIDELINES FOR INDIA
Says Dr Misra: Indians exhibit unique features of obesity excess body fat,abdominal adiposity,increased subcutaneous and intra-abdominal fat,and deposition of fat in ectopic sites (liver,muscle,etc.). This is why we felt the need to have our own standards. This has helped define obesity as per the Indian BMI.
We have more visceral fat. Studies show if a person of same BMI of Indian origin and British origin are compared,the fat content is much higher in Indians, said Dr AK Jhingan,chairman,Delhi Diabetes Research Centre. Based on percentage of body fat and morbidity data,limits of normal BMI are narrower and lower in Indians than in Caucasians.
WHAT WILL THIS ACHIEVE
Experts hope that the application of these guidelines countrywide will also help curb the galloping Type 2 diabetes,and cardiovascular disease.
Naturally,they have stretched the time span for physical activity required every day.
Earlier,exercising for 30 minutes three to five days a week was considered fine. But the new guidelines advises at least 60 minutes of physical activity every day for adults, adds Dr Misra,who will be presenting these guidelines at the International Obesity Conference starting in Mumbai on Saturday.