Are you apple-shaped? Then it's time you cut down on those calories and did some exerciseSanjeevani has just stepped off the weighing scale. She is in a state of shock. When did those kilos pile on? Samudra had her baby two years ago. She had put on more than 12 kilos during her pregnancy. She was confident that she could lose that weight after her delivery but two years later, she is heavier than she was during her pregnancy. Samhita is 54 and has watched her weight rise insidiously. She has recently been diagnosed as having diabetes. Think India and malnutrition, food shortages, poverty and high infection rates are the first things that come to mind. The reality though is grimmer in the urban areas: more and more studies are showing the alarming fact that a significant, growing percentage of Indian women are now overweight or obese. A study conducted by the All India Institute of Medical Sciences, New Delhi, reveals that in cities, over 50 per cent of women and 40 per cent of men aged over 35 are overweight. A study conducted by investigators from the University of North Carolina at Chapel Hill's Schools of Public Health and Medicine, found 37 per cent of urban women in Andhra Pradesh overweight or obese.
Cause for concernAs obesity rises, India is beginning to feel the burden of associated chronic diseases like heart disease, hypertension and adult-onset diabetes. The World Health Organisation estimates the number of diabetics in India will triple from 19.4 million cases in 1995 to 57.2 million in 2025. The best way to find out if you are overweight is to check your body-mass index (BMI). 20-25 is considered to be normal and is associated with less health risks. Above 25 is overweight and 30 and above is defined as obesity. Health risks are much greater with a high BMI. BMI is easily calculated. Divide your weight in kilos by your height in metres squared. For example, if you weigh 70 kilos and are 1.6 metres tall, then your BMI is 70 divided by 1.6 x 1.6, i.e. 27.3. Waist circumference is determined by placing a measuring tape snugly around the waist. It is a good indicator of abdominal fat, which is another predictor of the risk for developing heart disease, hypertension and diabetes. This risk increases with a waist measurement of over 95-100 cm in men and over 80-85 cm in women (depending on the height). When the waist bulges out and is bigger than the hip, the body shape is called `apple shape' and is a health hazard.Going strictly by international standards, a study by Dr. K. Srinath Reddy and his colleagues from the All India Institute of Medical Sciences has revealed that in the 35-59 year age-group, 48.7 per cent of urban Indian women in north India are `apple shaped'.
Contributing factorsSedentary urban lifestyles, rich food, lack of exercise, and a gradual slowing down of the metabolic rate are playing havoc with the waist-to-hip ratio. Women who watch more television than others tended to weigh more. Women who have maids tend to be more overweight than those who do not. Washing machines, vacuum cleaners, food processors, mixers and grinders and microwaves are reducing the need for physical labour. An increase in consumption of sugar and saturated fat like ghee is a dangerous trend contributing to obesity.Not feeling loved? That can contribute to obesity. Many women said that they felt unwanted and uncared for. Husbands who come home late stressed out about their work and then just have dinner and go to bed, are wreaking havoc. When a woman feels that she does not have to look good anymore because her partner doesn't pay any attention to her, she takes the first step towards the slippery slope of excessive weight gain.
Fighting flabA two-pronged approach is the best way to fight flab. Decreasing calorie intake by reducing food intake and increasing calorie expenditure by exercising is the only way to lose weight and to maintain a healthy weight, consistently. The diet should be fibre-rich and low fat. Brisk walking, cycling or aerobics should be combined with a few muscle-toning exercises. Stretches are excellent for redistributing fat and help reduce the fat deposited around the waist.
(The author is a Chennai-based obstetrician and gynaecologist with a special interest in women's health issues)