Dealing with Obesity.
Obesity is a condition where the body accumulates excess fat which has a negative impact on health. Genetics, overeating and certain psychological factors are some common causes of obesity. It is no longer a concern that the west is grappling with. It has found its way onto Indian shores and it is a battle that many of us face today.
In this world replete with diabetes and heart disease; it is important to prevent obesity from childhood to stop these diseases from happening. It is important that we influence school children so as to increase their knowledge about nutrition and physical activity, in an effort to change their attitude and practices for life.
WHO global estimates state that in the year 2014 1.9 billion adults worldwide were overweight and of these 600 million were obese. Overall, about 13% of the world’s adult population (11% of men and 15% of women) were obese in 2014. The worldwide prevalence of obesity more than doubled between 1980 and 2014. Not just adults, in 2013, 42 million children under the age of 5 were overweight or obese.
How do you know that you are overweight or obese?
Overweight is defined as “a BMI greater than or equal to 25” & Obesity as “a BMI greater than and equal to 30”. BMI is body mass index, an index commonly used for classification of obesity. WHO defines it “as a person’s weight in kilograms divided by the square of his height in meters (kg/m2)”.
Urbanization, mechanization and affluence have collectively led to an increase in the consumption of unhealthy fast food. With no time on hand to prepare meals from scratch, processed and ready-to-eat foods have replaced our traditional eating habits. Physical activity has taken a backseat with every convenience available on the tap of a button. With adults leading unhealthy and inactive lives, their children aren’t exposed to or taught healthy lifestyle habits. Due to paucity of space, schools too do not focus on physical exercise and have very small or no playgrounds. Tuitions and studies have taken precedence over everything!
In India, we face the ironic double whammy of malnutrition-related public health issues and an alarming rise in Non-Communicable Diseases and overnutrition at the other end. Indian National Family Health Survey 2005-2006, NFHS-3 data showed that “12.6% of Indian women were obese (23.5% urban and 7.4% rural). Among men, the total prevalence of obesity was 9.7% (15.9% urban and 5.6% rural).
The percentage of ever-married women age 15-49 who are overweight or obese increased from 11% in NFHS-2 to 15% in NFHS-3. The percentage of women who are overweight or obese is highest in Punjab (30%), followed by Kerala (28%) and Delhi (26%). Similar variations are seen by state in the percentage of men who are overweight and obese According to NFHS-3 data 1.7% of male children and 1.4% of female children were overweight (+ 2SD), 2.5% belonged to urban and 1.2% belonged to rural areas. Most of the overweight and obese were found in well educated, urban households with a high standard of living.
If you too are faced with obesity, here’s help. Consensus Dietary Guidelines for Healthy Living and Prevention of Obesity, include a reduction in the intake of carbohydrates, preferential intake of complex carbohydrates and low glycemic index foods, higher intake of ﬁber, lower intake of saturated fats, the optimal ratio of essential fatty acids, reduction in trans fatty acids, slightly higher protein intake, lower intake of salt, and restricted intake of sugar.
What does this mean? Let’s simplify, not for being fashionably thin but for being healthy. Remember food is good, food is healthy, our choices and our selections are what decide our own health as well as that of our family. To ensure a healthy life, free of all types of malnutrition or over-nutrition, we need to eat healthy daily.
Steps you must take if you’re overweight:
A family is made up of individuals at different stages of life, of different ages but to promote health, what better way than reorganizing your kitchen. Here are some pointers:
1. Whole grain and not processed cereals provide energy to sustain and grow and are also a major source of all essential nutrients. Stock up on whole grains like Bajra, Ragi, Maize and Jowar, use them often. Try red and black and brown rice instead of white rice. Use these whole grains for breakfast porridges, they taste great.
2. Buy whole dals in addition to the staple washed dals. Fill up your shelves with Rajma, Chana, Soy, Bhatt dals. Add these as sprouts or cook them for your meal at least once every two days. When buying meat, choose the lean, low-fat cuts. Add a protein to every major meal. Proteins are essential for the body.
3. Ensure 3 servings of seasonal vegetables per head and 2 of whole fruits per day. They provide both soluble and insoluble fibre in addition to vitamins, minerals and antioxidants. We need about 25-30gms of fibre per day, one apple provides only 1gm.
15% of one’s total calories come from visible Fats. Invisible sources include fatty meat, butter, ghee, cheese, lard, cream. Limit their use, Choose low-fat milk, double toned. Polyunsaturated fats from vegetables are recommended. One oil may not provide all essential fats so use different combinations.
5. Keep the trans fats away. There is a chance that industrial trans fats would be present in fast foods, snack food, fried foods cookies, margarine and spreads). Read the labels, if there is no label, find a better substitute.
6. Keep the intake of sugar to less than 10% of your total calories, for a normal weight woman who needs 1900Kcal/day this is about 10 -11 teaspoons of sugar. Below 5% would be better. Sugar doesn’t refer to added refined sugar that you put in your tea/ coffee only. A lot of foods have natural sugar hidden in them too.
7. Do not skip meals. Eat three balanced meals. Take a standard dinner plate, fill ½ with vegetables, 1/3rd with cereal, 1/3rd with the protein, add 150 ml of milk/Dahi/dessert. You have a healthy meal.
8. Snack on seasonal fruits, keep whole fruits easily available for the family members to pick up.
9. Keep your fridge free of sugary aerated drinks and processed fruit juices. Keep fresh Aam Panna, Jal jeera, kanji, buttermilk, as per season. Involve your family in making them.
10. Nuts and Seeds make a good healthy snack to. One fistful a day is a good way to start your day.
11. Boil, Bake, Shallow fry, and roast instead of deep-frying.
12. Meals are to eat on the dining table, not in front of the TV.
13. Exercise daily. A minimum of 30-45 minutes daily @ 5-6km/hr for people below 40 years and free of any disease. Children need to be exposed to a lot of physical activity. Tuitions, studies are important but so is maintaining weight and promoting health. Also, you need to work with children and facilitate their needs.
For Infants and Children
WHO has given clear guidelines for food given to babies and children. The first two years are crucial to a child’s growth, healthy dietary habits will lay the foundation for a healthy life.
Infants should be breastfed exclusively during the first 6 months of life.
• Infants should be breastfed continuously until 2 years of age and beyond.
• From 6 months of age, breast milk should be complemented with a variety of adequate, safe and nutrient-dense foods. Salt and sugars should not be added to complementary foods.
Achieving and maintaining weight is an ongoing process for most of us, we are human, we will slip, but those that get back on the saddle faster are winners. So next time your clothes are tighter, do not buy the next size, start your health programme. As parents, all you can give your children is a good education and health. Work with them, seek professional help when confused but start today.
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