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Updated: January 23, 2011 01:44 IST

‘Calories in' is easy, ‘calories out' is arduous

Dr. V. Gurumoorthy
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BIG ISSUE: Obesity is a universal problem. In the U.S. obesity costs the economy at least $ 215 billion a year in direct and indirect impacts, according to a study released on September 14, 2010.
AFP
BIG ISSUE: Obesity is a universal problem. In the U.S. obesity costs the economy at least $ 215 billion a year in direct and indirect impacts, according to a study released on September 14, 2010.

Let us walk. Walking is simple, safe, highly effective and most purposeful. Let us aim for at least 60 minutes of walking a day, either all at once or in smaller chunks, as the benefits are cumulative.

The rapid rise in the number of obese subjects globally is staggering and alarming. ‘Globesity' sounds a pandemic alert. Excess body weight presents us with an unflattering figure. When the scale points to 30 kg excess weight, it denotes that more than 2,00,000 calories are already deposited in fat stores. ‘Calories in' is easy, ‘calories out' is arduous. To burn just 100 calories, one has to brisk walk for a mile.

No more graceful

Many adults, even adolescents, become pregnant with fat, losing their graceful human form. Our physique is beautifully poised for constant movement and mobility and not just meant to be confined as ‘classic couch potatoes.'

Body mass index (BMI) — body weight adjusted for height — is a popular method of defining a healthy weight. BMI, along with waist size, helps to estimate the amount of body fat.

Of course, it is important to know how much one should weigh; a much more important issue is to know how much abdominal fat one has. Excess fat seated anywhere is bad. But excess abdominal fat is the worst offender and true villain. It takes a big toll on health.

Abdominal obesity is a better indicator of health than BMI. Large waist circumference is firmly linked to increased death rate. A bulging midsection, the apple shape, is truly the shape of risk. It forms a spacious secluded sanctuary for many of the serious lifestyle diseases. It is increasing even faster than the BMI in our ‘affluent' society. It is a matter of grave concern, as it forms a major health hazard.

The fat that collects around the waist poses a greater health problem than the fat around hip and thighs. Abdominal fat exists in two different forms. The first one is subcutaneous fat, located just beneath the skin. The second is visceral fat — the most dangerous and hazardous stuff — packed around the internal organs.

Stress response

Visceral obesity leads to over-activity of the body's stress response, pumping stress hormones. Triglyceride-filled visceral fat cells pour free fatty acids into circulation, affecting liver, pancreas, heart, blood vessels and other vital organs, proving toxic to them. Fat cells, in addition to hoarding excess calories, produce a large number of proteins, many of them harmful.

Our parents have gifted us with about 25,000 functional genes. Some increase or decrease the risk of disease. Our genes alone do not determine our health. Healthy lifestyle choices, though difficult to initiate and maintain, can actually make good things happen to genes and to improve them.

Genes are not just static. Many genetic errors occur spontaneously. Others are triggered by environment, causing bad things to happen to good genes (smoking, ionizing radiation, etc). The genetic material of the most active subjects scores favourably — about 10 years younger — than those of the least active subjects.

Heredity extends to us a hand of cards, but our lifestyle decides how we play those cards, for better or for worse. Genetic factors do play a role in obesity. But personal behaviour and dietary habits are the most important factors.

Specific moves meant for abdominal muscle strengthening, gadgets that promise spot fat reduction, liposuction, apronectomy and cosmetic surgeries do not improve health but only marginally modify the external profile. The only way to reduce visceral fat is to lose weight by consistently burning more calories than we consume, with structured and leisure-time physical activities.

Surgery is a pretty serious option, given its risks. Bariatric surgery, weight reduction-oriented surgical intervention, should be reserved only for select cases where life is threatened by morbid obesity and related co-morbidities. In such instances, it can be life saving.

Our lifestyle habits — the way we eat, exercise, sleep, smoke, drink, drug — reflect the harsh truth, we simply do not take care of our health.

Let us build a lot of physical activity into our daily routine. Let us walk. Walking is simple, safe, highly effective and most purposeful. Let us aim for at least 60 minutes of walking a day, either all at once or in smaller chunks, as the benefits are cumulative.

Let us pile up deeply coloured garden-fresh fruits and vegetables and be relatively liberal with whole grains, complex carbohydrates, fat-free dairy products and other calorie-sparse nutrition-rich sources.

Water is an essential nutrient, totally devoid of calories. Let us have it freely. Let us avoid trans fats and heavily cut down on saturated fats, cholesterol, simple sugars, refined carbohydrates, calorie-dense foods/drinks and salt.

Let us try to be within the ideal BMI figures, not above 25 and not below 19. Even within this bracket, it is preferable to remain in the lower range.

Periodic fasting

Let us remain, not fit and fat, but lean and fit, to survive for long. In physically fit people, calorie restriction and periodic fasting slow down the ageing process. Regular physical activity helps the body and mind achieve peak performance and prolongs healthy longevity.

(The writer is a former Professor of Medicine, Sri Ramachandra University, Chennai. email: drvguru@yahoo.com)

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