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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
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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)

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All You Need To Know About India’s Strategic Chabahar Port

The Chabahar Port is a seaport in Chabahar, which is on the Gulf of Oman, near Iran-Pakistan border.

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Chabahar Port is of great international significance in terms of trade, especially for India. Wikimedia Commons
Chabahar Port is of great international significance in terms of trade, especially for India. Wikimedia Commons

By Ruchika Verma

  • The Chabahar Port is of great strategic importance for India
  • It is in Iran and is being built and operated by India
  • This port will increase India’s trade with Central Asia and Europe

The Chabahar Port is a seaport in Chabahar, which is on the Gulf of Oman, near Iran-Pakistan border. Chabahar is the trans-shipment and logistics hub for the Makran Coast and Baluchistan province of Iran.

Chabahar Port is built and operated by India. Wikimedia Commons
Chabahar Port is built and operated by India. Wikimedia Commons

The tension between India and Pakistan is nothing new. There are several instances where both the countries have tried to obstruct each other’s political or economic agendas. This obstruction, along with other strategic reasons, resulted in the India and Iran’s deal on the Chabahar Port, which is crucial because of several reasons.

Here are few things about it you may not have known before :

  • Under the Trilateral Transit and Transport Agreement of 2016, the Chabahar port is the gateway to the Transport Corridor between India, Iran and Afghanistan, which allows multi-modal goods’ and passengers’ transport.

Also Read: India and Iran sign agreement to develop Chabahar Port

  • The agreement also states that India will develop and operate two berths in the first phase of the port. The contract is for 10 years and extendable. This time period excludes the first two years as they will be used for construction.
Chabahar Port will make India's trade with Afghanistan easier. Wikimedia Commons
Chabahar Port will make India’s trade with Afghanistan easier. Wikimedia Commons
  • The Chabahar Port’s first phase, which was developed by India, and inaugurated by Iran on 4th December 2017, is of great strategic importance as it makes it easier for India to conduct trade with Central Asia and Europe.
  • Iran’s Chabahar port is also important for India’s trade because of Pakistan’s reluctance in allowing India to send goods to Iran and Afghanistan through its land territory.

Also Read: Gwadar Port: China Turning Pakistan Port Into Regional Giant 

  • The development of Chabahar Port will increase the momentum of the International North-South Transport Corridor whose signatories include India, Afghanistan and Russia. Iran is the key gateway in this project. It will improve India’s trade with Central Asia as well as Europe.
    The Chabahar Port has also reduced Afghanistan’s dependence on the transit road, which went through Karachi. Now, trade can be conducted via Chabahar Port too. Islamabad has accused India of trying to use this development as a means to destabilise Pakistan.

    The Chabar Port is the said to be the counter to the Gwadar Port. Wikimedia Commons
    The Chabar Port is the said to be the counter to the Gwadar Port. Wikimedia Commons
  • The Chabahar Port also acts as a counter to the barely 100 km away, Gwadar port in Pakistan, which is developed by China. However, Iran has defended that Chabahar is not a rival to Gwadar and Pakistan is invited to join in its development.
  • In October 2017, India sent its first shipment of wheat to through Chabahar to Afghanistan, in order to test the viability of the route.
  • India will also construct a 900-km Chabahar-Zahedan-hajigak railway line that will connect Port of Chabahar to Hajigak in Afghanistan. It will also connect Mashad in the north, providing access to Turkmenistan as well as northern Afghanistan.This project is worth $1.6 billion.

    India will supply $400 million worth of steel rails to Tehrain. Wikimedia Commons
    India will supply $400 million worth of steel rails to Tehran. Wikimedia Commons
  • It is being said that India will supply $400 million of steel rails to Tehran. There are also possibilities of setting up a fertilizer plant through a joint venture with the Iranian government.