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India’s Quiet Tide Of Childhood Obesity

“If your child is obese, then you can be certain that it’s not his/her fault"

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Childhood Obesity. Wikimedia

Madurai: When 12-year-old Madhu (not his real name) was diagnosed as obese—he weighed 98 kg when his ideal weight was 55 kg—there were no obvious medical issues, except a faulty diet and lack of exercise.

After counselling and improving his diet, the Madurai preteen, 160 cm or 5.2 ft tall, lost 8 kg in four months. At the age of 15, stressed from board exams, Madhu’s weight ballooned again—this time to 108 kg.

  • Overweight is defined as having excess body weight for a particular height from fat, muscle, bone, water, or a combination of these factors.
  • Obesity is defined as having excess body fat.

Definitions: Centers for Disease Control and Prevention, USA

Guided by his doctor, he exercised more, learnt how to deal with exam pressure better, got more sleep and cut out junk food. A year later, he weighs 79 kg, feels more confident and is doing better at school.

Obesity plagues India’s affluent, as IndiaSpend has reported, and it transcends socio-economic differences when it originates in childhood. Social and environmental factors are the driving forces behind childhood obesity in India, explained this 2015 study. Childhood obesity affects both developed and developing countries and there are “serious” implications for future Indian generations without corrective action, said this 2010 Indian Council of Medical Research paper.

Childhood obesity underestimated, afflicts urban, upper classes most

Stress does have an adverse influence on childhood obesity, but it can be reversed in a clinical setting with treatment. The key is to realise that children need help.

“If your child is obese, then you can be certain that it’s not his/her fault,” said V Kumaravel, Consultant Endocrinologist and director, Alpha Hospital & Research Centre, Madurai.

Some indications of childhood obesity in India come from Kumaravel’s childhood obesity prevention programme, which traces factors influencing childhood obesity in the neighbourhood around his hospital. The study, conducted in 2012 over a period of six months on 18,001 students aged five to 18 from 27 schools, found 9.5% overweight and 3% obese.

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When compared to boys, the proportion of obese girls was lower in younger age groups (below 12 years), but when they grew older (above 12 years), more girls were obese than boys their age, a global pattern.

Related: Obesity in Children – Global Public Health Problem (Challenges in India)

Another finding is childhood obesity in India is underestimated, regardless of local or global growth charts, according to this 2014 paper based on Kumaravel’s research. Childhood obesity is higher among urban, upper classes than rural or middle and lower socio-economic classes, said another 2014 paper by Kumaravel and his colleagues.

Other findings:

  • Environment, not socio-economic conditions, fuel childhood obesity.
  • Schools that served unhealthy snacks had more obese students.
  • There is a correlation between lack of playgrounds and obese students.
  • Obesity peaked in children with fewer friends, greater anxiety.
  • Teachers need to be made aware of childhood obesity.

The small, flabby Indian, and the thrifty phenotype hypothesis

You can blame the Indian predisposition to be smaller and flabbier than many other races on a history of poverty and deprivation, experiences now possibly coded into our genes, which make the body prone to horde fat.

“Indians in general are predisposed to obesity, cardiovascular disease and diabetes because of the genetically smaller builds, a condition called the thrifty phenotype,” said Sriram Mahadevan, endocrinologist and researcher, Sundaram Medical Foundation and Sri Ramachandra Medical College, Chennai.

So, it’s best to monitor diet and exercise early. Monitoring should begin in early adolescence, preferably in between 12 and 15, said Mahadevan. “Factors such as puberty should be considered,” he said. “Children have a rapid height spurt in this age. This natural growth can correct many issues related to childhood obesity without medical intervention.”

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Awareness is important because India has sparse data on the prevalence and implications of childhood obesity, save for select regional studies such as Kumaravel’s.

In Chennai, private schools tended to have more obese children than government-run schools, according to this 2014 study by the Madras Diabetes Research Foundation and Dr Mohan’s Diabetes Specialities Centre.

Yet, “there’s an increasing incidence in both rural and urban areas,” said Mahadevan.

Indeed, there is a correlation between a higher body mass index (BMI)—a marker for obesity—and hypertension in children, and this 2010 paper by the Amrita Institute of Medical Sciences, Kerala, found government schools, girls and rural areas as vulnerable.

The spread of obesity also indicates that genetics is only one determinant.

How stress from poor parenting or broken homes can affect growth

In addition to burgeoning costs of treatment for medical issues that may last a lifetime, moderately and severely obese children have a host of psychological and emotional issues to deal with.

These data were confirmed by Kumaravel’s private studies, which found a correlation not just between obesity and psychological issues but growth.

“Poor parenting, a broken home, increased stress during those critical growing years pre-puberty, all these factors affected a child’s potential to attain his/her natural height,” said Kumaravel.

While recording the height and weight of students they surveyed, Kumaravel and his colleagues noticed that stunted growth in childhood often goes unnoticed. They found children who battled anxiety at a young age didn’t always grow to their full potential. This was often overlooked because impaired growth isn’t a life-threatening issue that required immediate intervention.

In separate research—yet unpublished—Kumaravel and his colleagues measured 22,580 children from 48 schools in and around Madurai (including Dindugal and Vadamadurai) in 2015 and found that 5% (448) were stunted, short for their age.

While only 118 followed up for treatment in a clinical setting, it was found that 58 of them had family problems,” said Kumaravel. “They either hailed from broken homes or were dealing with step mothers, drunken fathers and other grievances.

Of these, eight children had growth-hormone deficiencies, a condition that could be corrected with medication, which can cost a family up to Rs 200,000 per month—87 of 118 children treated free as part of this pilot project regained some growth. India’s burden of thyroid disease is another reason for stunted growth.

India is now on the brink of a public-health crisis that involves its children, said medical professionals. Never before has screening and early intervention been such a necessity.In 2013, the government announced a nationwide health program to screen children up to 18 years of age, including for growth and obesity.

“We also need a regional reference growth chart (specific to regions),” said Mahadevan. “In addition to height and weight, waist circumference should be considered, as we are prone to abdominal obesity. This way we can prevent younger diabetics, a disturbing trend we’re beginning to see.” (IANS)

Next Story

The Rafale Deal: Corporate Rivalry Impacting National Interest

A deeper look found a correlation between the end of Shourie's dreams of being appointed Union Finance Minister and the beginning of his tirade against the Prime Minister on one issue or the other.

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Defence Minister Nirmala Sitharaman has been obtuse in accusing the Congress of becoming a pawn in corporate rivalry. She made the comments during a recent seminar on 'India's strategic interest in the context of the Rafale deal'.Pixabay

A recent European Union intelligence sharing exercise with India has revealed that Lockheed Martin, the US-headquartered company which manufactures the F-16 fighter jets, has been up to mischief mongering on the Rafale issue.

The Rafale jets, which India wants, is manufactured by the French aerospace company Dassault Aviation, a rival of Lockheed Martin.

That Lockheed Martin could be working in the shadows to sour the Rafale deal for India so that it could move in with its own deal was validated when Vivek Lall, Lockheed Martin’s high-profile head of strategy and India operations, said that the company was in the process of finalising the sale of 200 fighters to India.

During the UPA regime, the government had signed an MoU for 126 Rafale fighter jets to replenish a major shortcoming in air defence preparedness because the Indian Air Force did not have quality fighter jets. When the NDA government led by Prime Minister Narendra Modi came to power, this deal was revised and an inter-government deal was struck to receive 36 fully-loaded Rafale jets. The controversy now raging in India is related to the pricing for the fighters negotiated by the NDA.

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Defence Minister Nirmala Sitharaman has been obtuse in accusing the Congress of becoming a pawn in corporate rivalry. She made the comments during a recent seminar on ‘India’s strategic interest in the context of the Rafale deal’. Pixabay

In December when the Rafale case came before the Supreme Court, Chief Justice Ranjan Gogoi observed that processes were generally followed over the procurement. He also noted that the controversy had been triggered by comments by former French President Francois Hollande over the selection of the offset partner and that mere comments could not form the basis for a probe.

However, this has not prevented the Rafale purchase controversy from becoming a high-octane political battle between the Congress party and the Bharatiya Janata Party (BJP).

Repeatedly over the past few months and more stridently now in the lead-up to the Lok Sabha elections, Congress President Rahul Gandhi has led a no-holds barred attack on the government and the Prime Minister specifically on the issue. From the earlier public disinterest on the controversy, it is now now getting some traction — the Congress party believes this could be possible because it has relentlessly raised the matter at all public forums.

Bringing up the case of the state-owned Hindustan Aeronautics Ltd (HAL) was said to be part of the orhestrated plan to present the case of the American companies while also appearing nationalistic. In the government’s estimate, HAL’s record is abysmal and it cannot be given a big responsibility like building fighter jets — more so in the light of the safety record of MiG fighters purchased from Russia and made under licence from HAL.

The BJP-led government at the Centre believes — and it is certain it has evidence of this — that the Congress party is doing this as it has become a party to corporate rivalry between the US and French aerospace companies. For the record, Lockheed Martin is believed to have found a sympathetic ally in another US aerospace major, Boeing, which manufactures the F-18. Dassault has another rival in French manufacturer Airbus Industrie, which is associated with BAE for the manufacture of the Eurofighter. It is also angling for a fighter jet contract with India.

Rahul Gandhi’s attacks on the government over the Rafale issue started after his visit to the US in August 2017 when he met several defence lobbyists, CEOs of US defence companies and Pentagon officials.

Defence Minister Nirmala Sitharaman has been obtuse in accusing the Congress of becoming a pawn in corporate rivalry. She made the comments during a recent seminar on ‘India’s strategic interest in the context of the Rafale deal’.

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Contrary to popular perception, the Trump administration is said to be extremely unhappy with India because the NDA government under Modi has been successful in building strong relationships with Saudi Arabia, the United Arab Emirates and Qatar. Pixabay

The government’s efforts to trace the footprints of the dramatis personae at the forefront of the campaign to target the government over the Rafale deal has produced surprising results. It has found what it believes are eye-opening linkages between Prashant Bhushan, Yashwant Sinha and Arun Shourie — who filed a PIL in the Supreme Court accusing the Prime Minister of corruption in the deal — and arms dealers and defence manufacturers. At least in one case, the linkages show deep connections between members of Shourie’s family with aerospace companies, arms dealers and defence lobbies.

A deeper look found a correlation between the end of Shourie’s dreams of being appointed Union Finance Minister and the beginning of his tirade against the Prime Minister on one issue or the other.

Also Read: The Craft of Distilling Is Ancient, Different Story Behind Every Bottle

The government is also aware of the links between a top BJP leader’s son-in-law and a French manufacturer. The son-in-law is said to be advising Rahul Gandhi and is believed to be making government documents available to him for the campaign against Rafale.

Lockheed Martin’s alleged actions to work the political ecosystem to pull down the Rafale procurement deal also has a larger strategic context. Contrary to popular perception, the Trump administration is said to be extremely unhappy with India because the NDA government under Modi has been successful in building strong relationships with Saudi Arabia, the United Arab Emirates and Qatar.  (IANS)