Dr Nalinikanta Mishra (PT)
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MPH (Health Management), DNGOM, BPT (Hons.)
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Food is the fuel for our life. It provides all essential nutrients to stay active, healthy and alive. These nutrients can be caloric and/or macro-nutrients such as carbohydrates, proteins and fats or micronutrients such as vitamins and minerals. Insufficient consumption of caloric nutrients lead to underweight/stunting or excessive consumption than one can burn leads to overweight/obese.
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The third type, micronutrient deficiency is not as obviously visible as the above malnutrition types, also called hidden hunger, and emphasises the importance of what we eat than how much we ate. The normal weighing people are too often victimized by this hidden form of malnutrition and make hidden hunger as the most prevalent public health issue around the world. Most of the developing and underdeveloped (economically) countries suffer from underweight/stunting issues and India with 21.92% of its citizens from below poverty line (2012, RBI annual report) is no exception. Hence, much of the government’s focus and NGOs intervention is invested in providing enough food for millions to help them sail through hunger.
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However, dietary issues in India are not limited to undernourishment. Changes in food habits, growing dispensable income, appetite for densely caloric food (fat, sugar/ carbohydrates) and sedentary lifestyle brought overweight/obesity to growing middle/upper economic strata. There is a significant rise in obesity/overweight in India over past several years and is evident through World Health Organization (2015) data. Prevalence of overweight in adults is increased to 22% (2014) from 19.7% (2010) and Obesity is increased to 4.9% (2014) from 4.0% (2010) in 4 years. 14% of women (18 to 49 age) in India were overweight or obese in 2008 (compared to 10.5% in 1998), with higher rates among urban women (25%) compared to rural women (8%). National Family Health Survey-3 (2006) also reported higher obesity/overweight rates in urban areas and higher socio-economic groups compared to the rural areas (urban men vs rural men: 15.9% vs 5.6%; urban women vs rural women: 23.5% vs 7.2%). Factors such as gender and economical status have significantly influenced the obesity epidemic throughout the world.
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Obesity and overweight are linked to several chronic diseases such as diabetes, cardiovascular diseases and cancer. This accumulation of fat in an individual impacts the country’s economy through direct costs (health costs), indirect costs (productivity losses) and burden of disease costs (financial/social costs). 600 million and 1.3 billion adults around the world suffer from obesity and overweight respectively. 78.6 million (1 in 3) adults in The United States were obese and the country spent as high as $147 billion (Rs. 9.5lakh crore) through medical costs in 2008. Developing nations are too catching up with wealth and obesity. The number of people affected from obesity is tripled in Developing countries compared to 1.7 times in high income countries. Mexico leads the world in childhood obesity and its government had to bring in new policies such as Sugar Tax to curb obesity. 4 million Australian adults were obese (25% of population) in 2007-08 and the country had to spend $37.7 billion (Rs. 1.8lakh crore) through direct, indirect and burden of disease costs. Currently, India is a home to 60 million obese individuals (which is 15 times higher than Australia) and its burden on economy will be significant and distractive.
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The risk of obesity is increasing unlike other major public health concerns such as Tobacco around the world. Middle income countries such as India are now facing double burden (underweight and obesity) of dietary issues. India and China together accounts for 15% world’s obese population and the rate of obesity are alarmingly increasing in these countries. It is widely debated whether to categorize the obesity as a personal/individual’s issue or a public health issue that warrants government intervention. Several countries such as US and Mexico have move forwarded from these discussions and started addressing this 21st century public health issue through policy changes. After US and China, India ranks 3 in number of people suffering from obesity. It is important for India to acknowledge the prevailing obesity issue and initiate efforts to curb this menace before it claims more victims. Legislatives, school health guidelines, awareness/education, community efforts, advances in nutrition labeling and better regulations on food advertising are few of several strategies that can be used to curb obesity in India. If obesity is ignored for longer in India, its impending effects on public health will take a toll on whole economy.
