New Lancet study shows India sitting on obesity curve: What’s causing it?

Obesity, as defined by the World Health Organisation (WHO), is an abnormal or excessive accumulation of fat that poses health risks. A body mass index (BMI) over 25 is considered overweight and over 30 is obese.

WHY IS THIS STUDY RELEVANT FOR INDIA?

Obesity, as defined by the World Health Organisation (WHO), is an abnormal or excessive accumulation of fat that poses health risks. A body mass index (BMI) over 25 is considered overweight and over 30 is obese.

This finding is significant at a time when India already has a high burden of non-communicable diseases — heart disease, strokes, and diabetes topping them. Obesity is a major risk factor and a trigger for early onset of these diseases, even Type 2 diabetes among teens.

WHAT’S DRIVING OBESITY ACROSS AGE GROUPS?

Dr Guha Pradeepa, co-author of the study and Head, Department of Research Operations and Diabetes Complications at the Madras Diabetes Research Foundation, flags the primary drivers of the obesity epidemic in India — A shift in dietary choices away from traditional foods and physical inactivity. “We have moved away from whole foods such as pulses, whole grains, fruits, and vegetables. Our traditional food was low on animal products, salt, refined oils, sugars and flours but we have now moved towards a diet that is high in energy but low in nutrients – refined carbohydrates, high fat, meat products, and processed foods. In addition, a range of behavioural factors could also have a potential effect on obesity among children,” she says.

HOW SEDENTARY BEHAVIOUR HAS GONE UP IN INDIA?

Dr Avula Laxmaiah, former Director, Grade Scientist and Head of Public Health Nutrition, ICMR- National Institute of Nutrition, Hyderabad, who is also among the study authors, says sedentary lifestyles have gone up sharply over four decades. “The National Nutrition Monitoring Bureau diet and nutrition surveys in rural areas carried out in different periods (decadal surveys) have shown that the sedentary activity had significantly increased from 34 per cent in 1975-79 to 74 per cent by 2012. This could be the major contributing factor for the high prevalence of obesity in India,” he says.

SO WHY ARE OBESITY LEVELS RISING FASTER IN WOMEN THAN MEN?

Dr Pradeepa attributes it to the fact that women are in more traditional settings, are too busy to make time for physical activity, have limited access to healthy food options or may be subject to dietary practices that prioritise the nutritional needs of other family members over their own. They have limited access to healthcare and education about obesity. “In addition, biological factors, including pregnancy and menopause, uniquely affect women’s weight,” she says.

CAN WE REVERSE THESE TRENDS?

Experts say these trends can, however, be reversed with targeted interventions. Eating behaviour involves snacking, patterns of restrained eating, dieting, binge eating and dining out. “Consumption of added sugars plays a significant role in driving obesity, particularly when ingested through beverages like sodas, sweetened coffee, tea and juices,” says Dr Pradeepa.

She feels that addressing obesity in adolescents requires a multi-faceted approach by the government, community and the individual. “At least 60 minutes of physical activity per day is recommended to be fit and healthy. The sale of unhealthy foods and beverages to children, restricting junk food advertisements targeted at children, clear nutritional labelling and promoting healthier options at school cafeterias are a must. Also, increase access to affordable and healthy food options,” Dr Pradeepa adds.

Parents should also involve children in their daily household chores. “Children are spending their time sitting for long hours at school, returning by bus/car/auto/scooter/van, spending time in front of TV /and playing with gadgets at home. They need to eat healthy food and regularly go for a health screening,” says Dr Laxmaiah.