How
have you envied your slim friends for their low weight and ability to
eat anything without worrying about excess pounds? Almost always!
Once
touted as the disease of the urban and rich, obesity is now commonly
seen among the burgeoning working class. It is a growing health concern
because obesity combined with lack of physical activity, a sedentary
life style and excessive smoking is a precursor to life threatening
diseases such as high blood pressure, diabetes, cholesterol disorders
and coronary artery disease (CAD). “In India, obesity is escalating at
an alarming pace along with diseases of the heart”, says Dr H B
Chandalia, eminent endocrinologist and diabetologist and Director of
Diabetes Endocrine Nutrition Management and Research Center (DENMARC).
In
the past five decades, the rates of coronary heart disease among rural
population in India has increased from 3 to 4 percent while in the
urban population it has steeply increased from 8 to 10 percent taking
the total toll to 29.8 million cases. This figure is expected to double
by 2010-11. WHO estimates that by 2010, Indians will account for 60
percent of the world's total cardiac patients.
WHO defines overweight and obesity as abnormal or excessive fat
accumulation that presents a risk to health. Traditionally, it’s
believed that all overweight and obese people are at risk of these
life-threatening ailments, while those who are slim or have a normal
weight are completely risk free.
But is excess weight a reliable indicator of ill health?
A nationwide study on obesity conducted in the US supplies evidence
that shatters this myth. It stated that it was possible to be fat and
healthy, while being slim or weighing normal did not necessarily mean
fit and risk-free. The study surprisingly concluded that nearly 51
percent of overweight adults and 31.7 percent of obese adults across
the nation were ‘metabolically healthy’. Despite excess kilos, the
healthy obese had normal levels of HDL (high density lipoproteins),
also known as protective and good cholesterol, triglycerides, blood
sugar and blood pressure. As opposed to this, 23 percent of slim adults
or those having a normal weight showed risky levels of two or more
parameters associated with obesity.
The study was based on analysis of lab tests, height and weight
data, physical activities and smoking habits of 5440 adults over the
age of 20 by a team of scientists from the University Of Michigan
School Of Public Health and Albert Einstein College of Medicine in New
York.
These findings only go to show that stereotypes can be misleading
while raising a moot question, “Can one be hefty and yet be healthy and
risk-free?”
“Over the past four decades I have come across data in the medical
literature which states that obesity is not necessarily a
cardiovascular risk factor”, says Dr Chandalia. “However, the genetic
makeup of Indians is different from that of other ethnic groups. Most
notably, we Indians tend to have a higher percent of fat for a given
body mass index to height ratio (BMI, which is weight (kg)/ height
(mts))”, he adds. Body Mass Index values are indicators of fatness
quotient. People with a BMI ranging from 18.5 to 25 are considered
healthy, those having a BMI above 25 are overweight and over 30 are
considered obese.
Men and women, with a waist circumference of more than 40 and 35
inches respectively, are at a higher risk for obesity-related diseases.
Shape wise, apple shaped or top-heavy people are more at risk of CAD
than pear shaped or bottom heavy people because of the excess fat
deposit is around their chest and abdomen, which is an important risk
factor, says Dr Chandalia.
The above study indicated that those having a BMI above 25 were
actually fit! Does it mean that the healthy obese are safe and should
take it easy?
“Whether this excess fat is healthy or unhealthy adipose tissue has
not been measured in the Indian subjects or for that matter any
populations in a large measure. Nonetheless, obesity has its pitfalls.
An obese person has to recognize the ill effects of excess weight gain
and make efforts to address it because healthy obesity, over a period
of time, may convert into unhealthy obesity,” Dr Chandalia emphasizes.
Common obesity-related problems:
According to Dr
Chandalia, obesity is part of a metabolic syndrome, wherein a cluster
of abnormalities including increased triglyceride and low HDL-
cholesterol levels, high blood pressure and diabetes co-exist.
Obese people are also prone to a host of vascular diseases (caused
due to hardening of the arteries) such as coronary artery disease
(CAD), brain stroke, osteoarthritis, and increased risks of cancer.
Besides these, obesity is one of the prime factors responsible for
asthma, sleep apnoea (temporary stopping of breathing during sleep)
gout, gall bladder diseases and gallstones.
One major threat, CAD, occurs when the coronary arteries that
supply blood to the heart harden and narrow due to fatty deposits or
plaque leading to atherosclerosis. In this condition, the flow of blood
to the heart gradually decreases. This severely affects the normal
functioning of the heart, leading to problems of the heart such as
angina (chest pain), coronary thrombosis (blocked arteries), and
cardiac arrest (heart attack).
Whether slim or obese, a sedentary lifestyle combined with lack of
exercise, stress and excessive smoking are among the top ten causes
responsible for cardiovascular and related diseases in young Indians.
Some obese people also suffer emotional stress thanks to social
prejudice about physical appearances. Slim is considered healthy and
attractive, while fat is seen as just the opposite. Fat people are also
seen as slothful and gluttonous. They also face ridicule as well as
discrimination socially as well as professionally. All these result in
a sense of rejection, shame, anger and low self-esteem.
Fitness counts more than fatnes
A study published in the International Journal of Obesity points
out that slim adults leading a sedentary life were equally prone to
heart problems as their heavy peers. It also suggested that instead of
considering exercise to be just a weight loss tool, slim people should
view it as a means to keep their blood pressure, blood sugar,
triglyceride, and LDL cholesterol levels in check. The study concluded
that overall fitness level is a much better indicator of health than
the body size.
Adopting a healthy lifestyle that includes a nutritious diet that
is low in saturated fats and high on fruits, vegetables and whole
grains, and plenty of exercise greatly help to avert these ailments.
“Exercise is a powerful tool in promoting cardiovascular and
overall health, even though there may be no actual weight loss. The
obese may not be able to reach their ideal weight; even if they do
succeed, it is not easy to maintain weight loss forever. Efforts,
however, should be continued to reduce the cardiovascular risk”,
emphasizes Dr Chandalia. Besides these, after the age of 40, a periodic
checking of blood sugar, cholesterol levels and blood pressure followed
by a medical consultation is advisable so that an optimum control can
be maintained.
Also read: Fast and best ways to lose weightTags: Obesity, weight,
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