Editorial: A burgeoning health problem

Published in The Hindu on October 14, 2005

At a time when the World Health Organisation has predicted that the diabetes burden in India is set to double and reach 70 million by 2025, it is a matter of additional concern that the number of overweight and obese children is increasing. A study done a few years ago on 4,700 adolescent school children in Chennai paints a grim picture — nearly 18 per cent of boys and 16 per cent of girls were found to be overweight, and 3.6 per cent of boys and 2.7 per cent of girls obese. Another study undertaken at a private school in Delhi had found 29 per cent of the students overweight. These findings come at a time when overweight or obesity among children is considered endemic to the developed countries. It has been well-documented that overweight and obese children have greater chances of becoming overweight and obese adults with a higher risk of developing a host of health problems. Several studies done on immigrant Indians in developed countries have clearly brought out the innate risk factors that get expressed with the intake of high-calorie food combined with a sedentary lifestyle. Compared with the Caucasians, Indians are known to have a greater genetic predisposition to becoming diabetic nearly ten years earlier and are more prone to renal and cardiovascular complications. The greater tendency of Indians to develop abdominal obesity is central to the problem even when they are not overweight or obese. This was one of the reasons why the WHO had recommended a body mass index of 23 for classifying South Asians as overweight as against 27 for Caucasian men and 25 for women.

Genetic predisposition apart, the biological clock that primes an individual’s susceptibility to diabetes starts ticking even at the foetal stage. Studies have shown that foetal under-nutrition is one of the major stress factors that make an individual develop diabetes at a later stage. In pregnant women suffering from gestational diabetes, which manifests for the first time during pregnancy, additional glucose load is supplied to the foetus forcing it to secrete more insulin. While extra insulin secreted by the foetus makes it vulnerable to developing diabetes later in life, simple measures can go a long way in preventing this chain of events. With several studies done here showing a 15-17 per cent prevalence of gestational diabetes, checking maternal glucose level during the second trimester — between 20 and 24 weeks — will prevent not only the foetus but also the mother from becoming diabetic later in life. Lifestyle changes that increase the intake of empty calories in the form of carbonated drinks and fast food with little physical activity would be a sure recipe for disaster. The motto for public health practitioners and schools should be to catch them young for preventing child obesity from becoming a major health issue. The current school education system that lays emphasis on cramming information and leaves little room for physical activity needs to be changed if the ominous trend is to be reversed.