From Indias largest newsroom, I'm Arun George and this is the
Times of India podcast. A new Lancet report says that
roughly 80 million Indians, including one million in the 5
to 19 age group, may be obese. The report had some good news
for India, though, showing that while obesity may have risen
between 1990 and 2022, there has also been a reduction in
malnutrition in India. The report says that while India
is among the leading countries as far as malnutrition,
characterized by thinness and undernutrition is concerned,
now, the rate of obesity has grown at an alarming rate
between 1990 and 2022. In today's episode, my colleague
Alka Dukar and I are in conversation with.
Doctor Guha Pradeepa. From the Madras Diabetes
Research Foundation in Chennai, Doctor Guha is one of the
co-authors of The Lancet report. She talks about what the report
reveals and what Indians need to do given the number of people
with obesity is still far less than other developed economies.
Alka started. By asking her why, the report
presents an alarming trend for India.
Let's start with understanding the latest Lancet report from
the Indian perspective. Why do you think it reveals an
alarming trend? Yes, this study is very, very
important for the nation currently because you can see
the dual burden of obesity as well as under nutrition among
children and adults. Doctor.
Guha says it's. Important for us to know obesity
estimates because it's a factor behind things like heart disease
and diabetes which are called NCDS or non communicable
diseases. It's a common risk factor for
the other NCDS like cardiovascular disease and
diabetes. So it is very important that we
know the burden of obesity so that we can plan how this can be
curbed so that we can reduce the risk of developing NCDS among
children as well as adults. So as per this study, the
obesity rate has increased from OH point 1% in 1990 to 3.1% in
2022 for girls and from OH point 2% to 3.9 for boys.
This is really alarming. And also you can see that
obesity among women has increased from 1.2% in 1990 to
9.8% in 2022 and from OH point 5 to 5.4 among men.
But while there has been a rise in the number of people who can
be classified as obese, the study also shows that the number
of people classified as underweight has dramatically
reduced in 30 years. At the same time, the study also
found that those who are classified as underweight
declined from four 1.7% in 1990 to one 3.7 in 2022, and from
three 9.8 to 12.5% for men. And among children, there was a
7% decline among girls and two 3.5 among boys.
What, for you, is the most worrying aspect of the findings
from this study? One is children are becoming
more obese at a younger age and this goes through their life
course. And if you consider girls and
women since they have many like puberty, pregnancy then going to
menopause so many stages, there is a reason for them to the
obesity increases gradually from childhood.
So that is alarming where you can see that women, the
percentage, the millions are more among women compared to
men. So all these biological changes
influence women and the obesity rates are high among them.
They have to take care of women, particularly because they they
don't think it is important to look at, take care of their
health, whereas they only want to take care of their family's
health. They are not taking care of
themselves. That's very, very important.
Also, could you talk about the non communicable diseases, the
burden that India has and the findings of the study?
What does it reveal about how vulnerable we are to these non
communicable diseases? Non communicable disease include
cardiovascular disease, cancers, respiratory disorders, diabetes.
So what happens is this increase is seen due to various causes
including lifestyle changes, urbanization.
Earlier it was very less. Now it is really a huge burden
in India and you can see that the common risk factors are
there like hypertension, obesity, all these are common
risk factors in cities and you can see that due to the stress
which people are undergoing now work stress, the at home
children have stress at school studying.
So earlier it was all mostly playful and the children used to
play but now schools mostly they do not have place like for doing
their physical activity. When you go to a workplace
mostly they are sitting. So the cerentialism has
increased and the screen time, mobile time that has all
increased which is one of the Causeway as well as the diet
part. When you look at diet pattern,
the traditional diets including whole grains, pulses, fruits and
vegetables, green leafy vegetables, all this has
disappeared and now all refined foods, sugary items like drinks
and everything has come up and also junk foods.
So the intake of fruits and vegetables which WHO recommends
is at least five servings per day of fruits and vegetables.
But in our ICMR India have said the national study which we are
the National Coordinating Centre, Metas Diabetes Research
Foundation, we found that only 2.5 is the servings.
They take maximum 2 to 2.5 S where how will they get that
recommendation? So now even who has increased
the physical activity recommendation to 150 minutes
per week to 300, we are not getting that 150 itself.
How will people manage to get the three 300 per week?
But if they do have an idea and think about how they have to
keep themselves fit, then all these have to be followed.
One of the headlines that I mean a lot of the media organizations
focused on was the fact that 1.25 crore Indian children are
now overweight. How much of A concern is that at
this point given it's still currently restricted to maybe
the richest portion of India in a sense and there is a large
segment that isn't in that category just yet?
Schools have to promote good eating habits and increase
physical activity. Apart from the regular classes,
that is very, very important. That is mainly in the middle and
upper social economic classes where I'm talking about they
This has to be taken up by the schools to promote healthy
living among children. And what happens to those who
are not in that category just yet?
What, for you is the action to be taken in that case, where you
have a lot of children who are perhaps not getting adequate
nutrition? Yes, that also we have to take
care and government has to look into this because this is mostly
the low socio economic group going into this category and in
schools like noon meal that is good.
So maybe they can also give breakfast to them.
What we can say is even awareness to the people in lower
socio economic parents, we have to target parents there.
So we need to see that parents give healthier foods.
They have to increase their proper balanced diet as well as
healthy diet. But wouldn't that be a problem,
especially for somebody who is poorer?
Because like, it's something that even the study notes that
for a poorer person, a healthier meal is costlier and is actually
may be out of reach. As you say even vegetables,
fruits all have become costly. So we cannot ask them to take 5
servings at least one to two servings as whatever they are
taking because they have all forgotten about vegetables and
fruits. One is cost then also like the
unhealthy fat, saturated fat which they are taking fried
items. So we can at least tell them
that these foods are unhealthy. These foods are healthy, give
them the healthy choice and see millets and all are not that
costly. So they have to move to
traditional foods which are low cost.
So we need to give them ideas like which is healthy, which is
non healthy. Those we need to tell them and
educate the parents at least the women who are looking for the
children. That's very, very important.
There are also questions over the body mass Index measure
itself about whether it is the best measure for obesity.
So could you explain why BMI data was then used for this
study? And are there any better metrics
that you'd like to see for measurement of obesity, at least
going ahead? See, obesity can be measured in
two ways. One is BMI which regularly that
is just we need a height and weight.
The other one is waist circumference.
Abdominal obesity is measured by using waist circumference.
Many studies have shown that waist circumference that is
abdominal obesity is more risk than the generalized obesity
which we use BMR. So therefore even just a waist
measurement is just enough. So we do have diabetes risk O
with us where we have just four simple questions which is
developed by MDRF. You need age, you need a waist
circumference, even a pant size or whichever you may not have
measured your waist there. You have a pant size then family
history and how active are you. Just post all questions and we
have diabetes IDRS risk. So this can be used to just
screen whether they are at risk for diabetes.
Even even many studies have validated for other disorders.
Also whether this is useful even for identifying diabetes
complications we can use this. So simple risk tools are very
important. And are these trends, especially
for the obesity numbers that are there, are they reversible in
any way? And how would one even go about
doing that? Yes, now we are also showing
that diabetes is reversible if you have lifestyle changes, just
physical activity and dietary pattern changes and reducing
stress. But what you can do is try to
reduce the burden. So this needs effort from the
government side, NGOs, schools, organisations, family itself,
all of them need to take a few steps towards this.
Then only the whole the burden can be reduced.
Basically, something that you'll point out in the paper also is
that a lot of efforts are pointed at individuals and you
know, individuals are told you need to do something about it,
but there is a larger systemic change also that's needed,
right? And how do we go about changing
that? We need government policies,
community initiators apart from individual actions.
So children's parents as well as educators should be educated
about the importance of balanced diet, regular physical activity
and the risks associated with obesity.
Schools can incorporate a nutrition and physical education
into the curriculum to promote healthy habits right from the
younger age. And also they need to know that
at least for children, at least 60 minutes of physical activity
per day is recommended so that they stay fit and healthy.
And at the government level, policies that regulate the
marketing and sale of unhealthy foods, that's very, very
important, and beverages to children, such as restricting
junk food, advertisements targeted at children, clear
nutritional labeling is needed and promoting healthier options
in school canteens. All these can be implemented at
the school level. Also, there should be increased
accessibility and to affordable and healthy food choices, which
is lacking now. And by bringing up these
changes, it will be possible to reverse the trend of rising
obesity rates among boys and girls as well as adults.
We need a multifaceted approach to this.
So there is a push to label foods better here to improve
nutritional information, particularly on processed foods.
What does India need to do in this regard, given its
consumption is still far lower than many advanced economies?
The. Consumption of processed food is
lesser compared to Western countries, but it is of great
concern here because that is also one problem caused which is
leading to obesity and other health conditions.
Now there are some laws coming up saying that all processed
foods should have labelling so that people are aware of what it
contains and this is coming up and many of them are aware of
that. Now this is very useful because
the labelling is very, very important and also like even
what even other processed foods like even in canned drinks and
everything, how many calories it has, what artificial flavours
have been added, everything. The government is working on it
and it is very actually it is a good move to reduce this intake
of processed foods so once they are aware of what the contents
are then they will restrain from taking those items.
Today's episode was produced by Jayaraj Singh and Sahil Gupta.
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