Obesity is a growing epidemic in India due to the increasingly sedentary lifestyle of the average citizen. But while dieting plans promise the moon, they often do more harm than good. From tapeworms to cotton balls, people have tried the most ridiculous of fads over the past century. Anorexia and Bulimia are entering the daily lexicon. The current measures to judge fitness, like the BMI, are not really trustworthy. A fulling life needs a wholesome diet.
What is making India fat?
Obesity has in recent years emerged as a risk factor for a number of diseases ranging from stroke to cancer, driving health experts to caution against its increasing incidence.
The National Family Health Survey (NFHS-4) in 2016 found that the percentage of women and men across India who are overweight or obese almost doubled in a decade: while 12.6% women and 9.3% men were obese as per NFHS 3 in 2006, the numbers increased to 20.6% and 18.9% in NFHS-4.
An inactive lifestyle and unhealthy diet are the main culprits. “White bread, white rice, phulkas…the overall intake of simple carbohydrates is huge. The widespread availability of fast food is also a problem,” says Ambrish Mithal, chairman and head, department of endocrinology and diabetes, at Medanta, the Medicity, Gurugram.
The higher people rise in the social order, the less they work by hand. “Whatever little movement we do is paid activity, like going to the gym or yoga,” says Sapra. Taking a 1-hour exercise class lulls us into thinking we’ve done enough when we actually should be turning our entire day into a mini-workout if we want to maintain a healthy weight.
With childhood obesity on the rise — India has the second highest number of obese children in the world after China, according to a study published in The New England Journal Of Medicine — it has become imperative for people to find a way to control their weight before they hit age 30.
Dr Mithal explains: “As the years pass, a person’s metabolism (the process by which the body converts food into energy) slows down and the body collects more fat. For the same level of diet and activity, we tend to put on more weight. This happens everywhere, but Indians experience it more acutely because we don’t maintain a level of physical activity as we get older.”
It’s much easier to tackle a weight problem in the early stages, but people are largely indifferent when they put on an extra kilo. Experts say minor gains are a crucial turning point. “**The idea is to take quick measures to stop the weight gain in its tracks and not wait to cross a limit to take action**,” advises Dr Mithal.
Why dieting doesn’t really work?
Think back to the last time that you went on a diet. Maybe it was several years ago. Maybe it was right before the summer. Maybe you’re thinking of starting a new one on Monday! But whenever the last time was that you tried to lose weight permanently through restricting your calories and upping your fitness routine, ask yourself: Did it work?
Did you lose weight initially, and then fall off the bandwagon and gain it all back again? Did it actually work? Or did it kind of work? Did you lose weight permanently? Was the practice sustainable? Did you feel satisfied and fulfilled? The answers are probably not to your liking.
The fact is, our bodies simply aren’t made to sustain long-term significant weight loss because, more often than not, it’s not in our best interests. Dieting goes against the tendencies and needs that our bodies have developed over centuries of evolution.
Weight loss through dieting is temporary: The vast majority of people who lose weight through dieting end up regaining all the weight — it’s not just you. As many as 60% of those gain back more weight than they lost.
Dieting trains your brain to make food harder to resist: It’s a survival mechanism. We need to eat to live — calories are converted into energy, and we exist off that energy. Without it, our bodies start to shut down. So when food is in short supply, hormones kick in that are designed to make sure you eat. Those hormones also make food taste better. The end result is a double whammy that makes food much harder to ignore. Remember thinking, rather philosophically, during your dieting plan that the most important need in life is to be happy (therefore eat what you want)? Now you know why that thought came.
Dieting causes emotional overeating, leading to dependence on food to manage stress: Because our bodies are complex, delicate miniature ecosystems, disruptions in some hormone create disruptions in others. Eating a low-calorie diet can actually increase the levels of cortisol in our bodies — and that’s the hormone related to stress. This might actually lead us to eat more by setting up a reward system in our brain. This can also lead to eating disorders such as binge eating disorder.
Dieting causes your metabolism to slow down: That means that any calories you do consume are used more efficiently. This makes it not only harder to lose weight, but much easier to gain it back. And it’s gained back primarily as fat — which simply isn’t most folks’ goal with a diet in the first place.
Diets are often missing important nutrients that are essential to health: Miss out on these nutrients too long — including on many popular diet programs that you may think are safe — and you’ll likely find yourself less than healthy. This can also cause weight gain — it may have nothing to do with calories, but everything to do with the body’s attempt to take care of itself by getting the vitamins and minerals that it needs. Sometimes the body controls you, not the other way round.
Instead, we should remember that there’s no simple secret to losing weight. Achieving sustained weight loss and maintenance requires reducing your calorie intake and increasing your activity level – in a sustainable way. Being healthy is a lifestyle, not a goal to be achieved by punishing yourself for a few months.
Here’s a story
Akshita Singal was 18 and weighed just 35 kg when she was brought in for a medical checkup. A team of doctors – a psychiatrist, a gastroenterologist, a nutritionist and her family physician – implored her to bite into a bar of chocolate, a treat she loved as a child. She refused to ingest even a tiny bit of it. Singal was diagnosed with anorexia, coupled with osteoporosis and a severe infection of the oesophagus. It took weeks of psychiatric sessions before she would accept the course of treatment.
Singal is one of the many Indian teenagers who are today pushing themselves to the brink – even risking death – in their obsession for perfectly sculpted bodies. With the concept that “thin is beautiful” being hammered into young minds, eating disorders such as anorexia nervosa and bulimia nervosa – virtually unheard of only a decade or so ago in India – are becoming serious issues of concern.
Anorexia is an aversion to food due to an extreme fear of gaining weight. Bulimia is a food disorder characterized by a cycle of binge-eating in a short duration followed by purging or self-induced vomiting due to guilt.
What’s worrisome is that both these disorders often go unrecognized and, therefore, undiagnosed.
According to the US-based National Eating Disorders Association, anorexia and bulimia, among the worst of mental disorders characterised by an extreme fear of gaining weight, take more lives than any other psychological ailment.
Anorexia affects men, too, though it’s 10 to 15 times more prevalent in young women, says Samir Parikh, director of the department of mental health and behavioural sciences at Fortis Healthcare, Delhi.
While a person might be genetically predisposed to anorexia or bulimia, Parikh says the increasing number of cases speaks of the burden that societal pressures and Western constructs of beauty are putting on youngsters.
Is BMI always correct?
BMI(Body mass index) is supposed to estimate the amount of body fat a person carries based on height and weight, and categorizes people based on what is appropriate for their size. BMI readings under 18.5 mean you are underweight, and could put on a few pounds. If you fall between 18.5 and 24.9, you’re considered normal, while a BMI of 30 or higher qualifies as overweight.
But in recent years, more researchers argue that it’s not the most accurate way to measure body weight. For years, scientists have said that BMI can’t distinguish between fat and muscle, which tends to be heavier and can tip more toned individuals into overweight status, even if their fat levels are low.
BMI cannot take into consideration, for example, where the body holds fat. Belly fat, which is known as visceral fat, is more harmful than fat that simply sitting under the skin. Visceral fat develops deep among muscles and around organs like the liver and by releasing certain hormones and other agents, it disrupts the body’s ability to balance its energy needs. Even relatively thin people can have high levels of visceral fat, which means they might be considered healthy by BMI standards, but internally they may actually be at higher risk of developing health problems related to weigh gain.
So why is BMI still the preferred way to measure weight and evaluate obesity? For one, it’s a relatively easy measurement for doctors to take during an office visit. Taking a person’s height and weight and plugging it into an equation produces a number that informs doctors about whether their patients are at high, low or no risk when it comes to weight-related health problems.
But there may be better ways to measure body fat that provide more useful readings on how likely a person’s weight will contribute to chronic health problems. CT scans and MRIs can provide a clearer glimpse at the body’s make-up by separating out fat from muscle, for example. But these are expensive and involved compared to stepping on a scale.
On a more practical level, some researchers have been pushing for using waist circumference or even wrist circumference to gauge potentially harmful weight gain and fat depots, but the evidence supporting this measurement and its ability to predict future health problems isn’t definitive enough yet.
So without a viable way to change how we measure body fat, for now, BMI is the best option. Perhaps doctors should rely on not just assessing body composition but measuring hormones and bio-markers in the blood or urine, for example, to get a better handle on abnormal processes that may contribute to obesity and chronic disease. And until such tests become available, BMI may still prove useful yet — if doctors combine BMI with a comprehensive evaluation of their patients’ medical history and lifestyle habits to get a meaningful, if not yet perfectly precise picture of their weight-related health.
How can one achieve optimum nutrition?
Eat a variety of foods
Eat a combination of different foods, including staple foods (e.g. cereals such as wheat, barley, rye, maize or rice, or starchy tubers or roots such as potato, yam, taro or cassava), legumes (e.g. lentils, beans), vegetables, fruit and foods from animals sources (e.g. meat, fish, eggs and milk)
Why?
Eating a variety of whole (i.e. unprocessed) and fresh foods every day helps children and adults to obtain the right amounts of essential nutrients. It also helps them to avoid a diet that is high in sugars, fats and salt, which can lead to unhealthy weight gain (i.e. overweight and obesity) and noncommunicable diseases.
Eating a healthy, balanced diet is especially important for young children’s development; it also helps older people to have healthier and more active lives.
Eat plenty of vegetables and fruit
For snacks, choose raw vegetables and fresh fruit, rather than foods that are high in sugars, fats or salt. Avoid overcooking vegetables and fruit as this can lead to loss of important vitamins. When using canned or dried vegetables and fruit, choose varieties without added salt and sugars
Why?
Vegetables and fruit are important sources of vitamins, minerals, dietary fibre, plant protein and antioxidants. People whose diets are rich in vegetables and fruit have a significantly lower risk of obesity, heart disease, stroke, diabetes and certain types of cancer.
Eat moderate amounts of fats and oils
Use unsaturated vegetable oils (e.g. olive, soy, sunflower or corn oil) rather than animals fats or oils high in saturated fats (e.g. butter, ghee, lard, coconut and palm oil). If you eat non-veg, choose white meat (e.g. poultry) and fish, which are generally low in fats, as compared to red meat. Eat only limited amounts of processed meats because these are high in fat and salt.
Where possible, opt for low-fat or reduced-fat versions of milk and dairy products. Avoid processed, baked and fried foods that contain industrially produced trans-fat
Why?
Fats and oils are concentrated sources of energy, and eating too much fat, particularly the wrong kinds of fat, can be harmful to health. For example, people who eat too much saturated fat and trans-fat are at higher risk of heart disease and stroke.
Trans-fat may occur naturally in certain meat and milk products, but the industrially produced trans-fat (e.g. partially hydrogenated oils) present in various processed foods is the main source.
Eat less salt and sugars
When cooking and preparing foods, limit the amount of salt and high-sodium condiments (e.g. soy sauce and fish sauce). Avoid foods (e.g. snacks), that are high in salt and sugars. Limit intake of soft drinks or soda and other drinks that are high in sugars (e.g. fruit juices, cordials and syrups, flavored milks and yogurt drinks). Choose fresh fruits instead of sweet snacks such as cookies, cakes and chocolate
Why?
People whose diets are high in sodium (including salt) have a greater risk of high blood pressure, which can increase their risk of heart disease and stroke.
Similarly, those whose diets are high in sugars have a greater risk of becoming overweight or obese, and an increased risk of tooth decay. People who reduce the amount of sugars in their diet may also reduce their risk of noncommunicable diseases such as heart disease and stroke.
Breastfeed babies and young children
From birth to 6 months of age, feed babies exclusively with breast milk (i.e. give them no other food or drink), and feed them “on demand” (i.e. as often as they want, day and night)
At 6 months of age, introduce a variety of safe and nutritious foods to complement breastfeeding, and continue to breastfeed until babies are 2 years of age or beyond. Do not add salt or sugars to foods for babies and young children.
Why?
On its own, breast milk provides all the nutrients and fluids that babies need for their first 6 months of healthy growth and development. Exclusively breastfed babies have better resistance against common childhood illnesses such as diarrhea, respiratory infections and ear infections.
In later life, those who were breastfed as infants are less likely to become overweight or obese, or to suffer from noncommunicable diseases, such as diabetes, heart diseases and stroke.
Alternate philosophy: Just eat what you like, be happy and live. There is no why.
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LINKS AND SOURCES
https://knappily.com/lifestyle/dieting-fad-612
http://vikaspedia.in/health/nutrition/dietary-guidelines-1/dietary-guideline-1#section-1
