-
Obesity
From flab to fab!
With VAZER Lipo, the new and fast procedure using ultrasound that’s safer that traditional liposuction
Want to be a few Kilos lighter, a few inches lesser, but diets and exercise aren’t getting you the shape and physique you desire? Despair not, cosmetic surgery in the form of Liposuction is helping millions around the world to lose inches that prove to be stubborn.
Dr. Rustom F. Ginwalla, plastic and aesthetic surgeon, offers hope. “Liposuction,” he says, “is a most commonly performed cosmetic surgery done to flatten any areas of the body that have excess fat. It is ideal for people who control their diet, exercise moderately, but have reached a plateau and cannot get rid of those last few trouble-some areas.”
Liposuction removes fat from deposits beneath the skin using a hollow stainless steel tube with the assistance of a powerful vacuum. There are many Liposuction techniques available, but the latest, high-technology VASER ultrasound liposlection gives best results. It is a minimally invasive procedure, and an alternative to the harsh traditional liposuction, using ultrasound technology designed to gently reshape the body.
The VASER Lipo procedure differentiates targeted fat from important tissues such as nerves, blood vessels and connective tissues. It breaks up fat while conserving these tissues to promote smooth results to promote smooth results and rapid healing with only low to minimal pain. Traditional liposuction, on the other hand, uses high-pressure liposuction, which tears out all tissues from the targeted areas, including blood vessels and nerves, leading to bleeding bruising and pain, almost any area can be treated by VASER Lipo, the most common ones being the tummy, love handles, waist, arms, back, hips, buttocks and thighs. It can even be safely used on the face and neck to reduce a double chin and gives excellent results for male breast reductions. Total body contouring can also be done with excellent results.
VASER Lipo has been exclusively available with Dr. Ginwalla at the D.R.S. Medical Centre since early last year. He has performed over 50 surgeries over different areas of the body.” It is a wonderful technology, and I have entirely stopped doing traditional.
Liposuction, since the results with VASER are superior and the patients are more comfortable and recovers in only a few days,” says Dr. Ginwalla. “The procedure can take from one to five hours and be done under local or general anaesthesia, depending on the areas to be treated and the amount of fat o be removed.”
The recovery period is also determined by this and varies from a week to a fortnight. But the fat loss is permanent as it is physically removed from the body. Diet control and exercise is recommended after the procedure. Rare complications do arise occasionally but are usually not life-threatening and resolve in a few weeks.
Zap or chill? Targeting fat without surgery
REDUCING fat around one’s midriff and thighs has become a defining quest of the modern age. It has brought us Zone Diet delivery, the ThighMaster and liposuction, which involves surgically vacuuming fat out of your body.
Now a pair of machines that promises to tackle love handle without surgery can be added to this parade of wonders. The Zeltiq device is affixed to the offending jiggle and then cools a patch of midsection during an hour-long session at the doctor’s office. Zerona—a four-armed laser-Zaps your belly, flanks and hips with red beams during six 40-minute treatments.
Doctors and patients alike are excited by the prospect of having new technologies that can attack fat without surgery. It is too early, however, for consumers to know how effectively wither device works. That hasn’t stopped men and women unhappy with back fat and muffin tops from paying thousands for treatment in recent months.
“It’s so freaky, this can’t work,” kate Killgore, 37 of Los Angeles, recalled thinking about the Zerona laser. But after 12 treatments in a month last summer, costing $3,40o, she lost 11 inches from her waist, things and hips. She has maintained her new figure since then, she said. Another Zerona patient, Annie Bonvouloir, 53, of Nederland, Colo; who heard about the procedure on the daytime television talk show “The Doctors”, was less successful.
Hoping to reduce her things and midsection without the risks and inconvenience of liposuction, she paid $2,300 for six treatments from a chiropractor in the Denver area. Even though she continued to diet and work out, she had no change in her things, belly and hips. Her doctor offered her three more sessions at no cost. Still, no change. Since most aesthetic medicine is elective, and not covered by insurance, marketing plays a major role in capturing the minds and wallets of consumers. The concern is that promoting innovations that the Food and Drug Administration hasn’t approved will fuel patient expectations that clinical data may not substantiate.
Zeltiq Aesthetics, based in Pleasanton, Calif, is a cautious wallflower that aims to get the data behind its device approved by the FDA before it makes too rowdy an entrance to the party. Its slogan is “More Science. Less Fat.”
Meanwhile, Erchonia Medical, based in McKinney, Texas, has aggressively marketed its Zerona laser as” the first non-invasive body contouring procedure to effectively remove excess fat” even though it has yet to receive FDA clearance to promote this use. (In general, the FDA must sanction a medical device for a specific use before a company can marker that use. But doctors are free of use device off label.)
Nonetheless, a brochure for Zerona states patients can collectively” lose up to 9 inches without the pain or down time of surgery.”Nationwide, medical spas, chiropractors, cosmetic surgeons, plastic surgeons and dermatologists now offer Zerona for $1,700 to $3,800 for six sessions. Part of the reason the device has made inroad during these strapped times is that doctors don’t buy it outright, but pay per use.
So how is Zerona supposed to work? The low-level laser causes “fat to seep out of a cell, almost like a balloon being struck by a needle,” said Ryan Maloney medical director for Erchonia Medical. The fat enters the lymphatic system and is eventually used as energy, maloney said. Zeltiq uses controlled cooling to target and eliminate fat cells, a process called selective cryolipolysis. Skin isn’t damaged, but subcutaneous fat, which is more sensitive to targeted cold begins a two-month death march soon after exposure to Zeltiq.
Doctors on the advisory board for Zeltiq Aesthetics have put the word out about it on television news segments. But at this stage, the company itself has been careful not to promote its device directly to consumers since its FDA clearances or, say, pain reduction during dermatologic treatments don’t encompass fat reduction. Gordie Nye, the chief executive, sent an e–mail message declining to be interviewed for this article. The company has clinical data that has been submitted to the FDA for approval, according to a few doctors who were principal investigators. Data relayed at a meeting of the American Society of Dermatologic Surgery showed a 22% reduction of the fat layer as measured by ultrasound. Erchonia Medical has published the results of its clinical trial in lasers in Surgery and Medicine. Thirty-five-patients in the treatment group lost an average of 3.5 inches total in hips, things and their midsection according to the company’s clinical trial. The company has promoted Zerona as” a new body-sculpting procedure designed to remove fat and contour he body without invasive surgery.” But the FDA has not sanctioned marketing this use, it his cleared the Zerona laser for pain reduction 24 hours after breast augmentation or as a way to decrease the pain associated with recovering from liposuction. In general, Karen Riley, a spokeswomen for the FDA, said “It is considered off-label promotion if you are marketing to the public a use that has not been cleared,” StevenShanks, the president of Eruchonia Medical, said, “Since we use the exact same power for liposuction and breast augmentation, we self-certified the device.” He said that in January 2009, the company had applied for a 510 K clearance-which is based clearance-which is based on the notion that an older device is substantially equivalent to a new one-and had year to receive it.(such a delay is atypical, Riley said, adding. “Most 51oKs are cleared within six months.”)
Last month, Dr. Robert B, Seltzer, a dermatologist in Pasadena. Calif, ran an advertisement in The Los Angeles Times for an informational seminar that called Zerona” the holy grail. “In a phone interview, however, he said, “I’m not 100 percent convinced. “ He said he planned to return his Zerona if he didn’t continue seeing results in his patients. (So far 5 out of 6 have been pleased.)
After reviewing Erchonia Medicals’s clinical study, Dr. Brian M. Kinney, plastic surgeons in Los Angeles, said, “I can’t prove that it works.” His concerns are that the tape measure method of gauging circumferential changes” isn’t consistently reliable.” What’s more, study participants and the placebo group were assessed only two weeks after their last treatment, not long enough to measure adequately whether results last.
Kinney doesn’t have a Zerona or a Zeltiq cooling device, though in the case of the latter, he said, ”it is well documented that freezing fat tissue aggressively enough can lead to fat necrosis,” or, fat dying, over a few months.
Patient selection for anybody contouring procedure is crucial, said Dr.Jeffrey M. Kenkel, vice chairman of plastic surgery at the University of Texas Southwestern Medical Center in Dallas.
LOSS WEIGHT FAST!
BT presents six detox tips to speed metabolism and few tips to lose weight rapido...
Six detox tips:
The body needs to be working as efficiently as possible to los weight fast; as if your body organs are working at maximum efficiency you will shed weight quicker. Logical but not many people think about this when dieting.
*Eat Grapes- These are rich in flavionls, which help your arteries work to their maximum and make blood run smoothly and quickly around the body.
*Eat citrus fruits such as berries- These foods are rich in Vitamins C and E, which will help cleanse and detoxify the liver making it work more efficiently.
*Prunes and Fibre-Eat prunes as they will naturally cleanse the colon stimulating the gut and help expel waste quicker, you should also up your intake of fibre as well to cleanse the colon further:
*Apricots-If you are smoker this food is particularly useful, apricots are rich in betacarotene and Vitamin C which helps repair smoke damage to the lungs.
*Cranberries or juice-Contains.Proanthocyanidin which are antitoxants that will help cleanse and flush out the kidneys. You can also add a couple of supplements if you wish top the abovge list to help detoxify further. Alfalfa and milk thistle are good choices. The first acts as a general cleanser and the second as a cleanser for the liver.
Now here are a few tips to lose weight fast:
*Drink iced Water- Two litres a day minimum. Water has to be iced as the body will burn 100 calories just heating the water to normal body temperature. Also hunger pangs are very often thirst pangs, so this will help you stop over eating. Add lemon to flavour if you wish and gain the added benefit of cleansing your liver at the same time. Water also helps your body metabolise stored fat by helping the kidneys flush waste quicker. When you don't drink enough water the liver needs to help the kidneys perform this function. When the liver has to help the kidneys its normal function of providing stored fat for energy is slowed down.
*Green tea- Drink five cups a day. Research shows this can burn a massive 80 calories a day! It is belived the antioxidant catechins in green tea boost the metabolism and help burn fat.
*Chilli sauce and mustard-These foods increase your calorie burning capacity by between five to ten percent for up to two hours after eating. This is because they contain capsaicin which speeds the metabolism, so if you enjoy hot food your in luck!
*Low fat diary foods-Can increase fat burning in the abdominal area. Why? Because these foods are rich in calcium which encourages the release fo fat from fat cells and also reduces the amount of fat absorbed.
Eat Fibre- Eating fibre foods to help keep things moving through your bowel as stated above and makes you feel full . The average person can lose 9-10 pounds in one year just from doubling their fibre intake aim for 25grams per day(the average for most adults is just eight grams) fibre rich foods include strawberries, apples, brown rice, chick peas, potatoes(with skins) and brown rice.
*Gorge on salads-eating cooling salads in the summer months not only helps you stay fresh, but also helps knock off those additional inches!
The above tips should be incorporated into a sensible diet and they will enhance it and help you lose weight fast.
Why eating soup could help you lose weight!
Abowl of soup a day could keep the pounds at bay. Health experts have discouvered that adding low-calorie vegetable broth to the start of a meal can actually help to lose weight. Because you tend to feel full sooner, you eat less of your main course.
The soup regime was tested by researchers at Pennsylvania State University, led by Dr Barbara Rolls. They found that when particulpants in the study ate a first course of soup before lunch they reduced their total calorie intake by 20 percent, compared with those who did not begin the meal with soup. But those who favour creamy soups should beware. Researchers stressed the soup must be low-calorie and based on stock, not cream.
All of the soups tested in the study were made from identical ingredients-schicken stock, broccoli, potato, califlower and carrots. They were blended to create four different textures and thickness from separate stock and vegetables through to pureed soup.
Scientists thougt that thick soups with chunks of vegetables which required chewing might be more filling, but to their surprise they found all forms had the same effect. The findings were presented to the Experimental Biology conference in Washington, DC, this week and the research was partfunded by the National Institutes of Health.
Women burn more calories playing football than at the gym
Women burn more calories playing football than doing an intensive workout at the gym, a surprising new study has found. Leading sports scientist Professor Don Maclaren investigated how much energy was used in the beautiful game.
He found while rowing and cycling burns 543 calories an hour, football uses up a whopping 683 caloriescalories over the same period. This is even 40 calories more than a cross-trainer: This means women could lose at least a stone if they played a 90 minute football game a week for a year, and this is before taking training sessions into account.
Professor MacLaren, who is currently sports nutritionist to football clubs including Liverpool FC and Everton FC men's teams and the England women's team, said:"More and more women are waking upto the fact that they're not going to shed pounds with yoga once a week-they need the all over body workout that football can give you. All the running around has a cadivascular benefit. It improves both heart and lung capacity. This applies to anyone playing outfield. Football also tones the muscles. Not just the legs but the stomach muscles as well due to the breathing involved."
Professor Maclaren added: "In any contact sport there are risks of injury. The most common are the knee and ankle joints with the twisting and takling involved in the game. But a reasonable warm up would help with this. You should n't rely solely on football to get fit. You should stretch and strengthen the knee and ankle joints and do core stability exercises to improve your lower back and stomach muscles."
How does one benefit from drinking warm lemon water
*Lemon is a Vitamin C rich citrus fruit that enhances your beauty, by rejuvenating skin from within and thus bringing a glow on your face. One of the major health benefits of drinking lemon water is that it paves way for losing wieght faster, thus acting as a great weight loss remedy. Lemon water flushes out body toxins and thus is extremely beneficial for the body.
*Warm lemon water serves as the perfect morning drink, as it aids the digestive system and makes the process of eliminating the waste products from the body easier. It prevents the problem of constipation and diarrhoea from taking place, by ensuring smooth bowel functions.
*Lemon, a fruit popular for its therapeutic properties, helps promote your immune system and thus, protects you from the clutches of most types of infections. It also plays the role of blood purifier.
Experts warn of a steep rise in cases of morbid obesity in the years to come. Thankfully though, awareness of corrective procedures is on the rise, even as doctors make newer breakthroughs in the fight against fat it's an all-out battle against the bulge fighting fat has become easier on the wallet.
There was a time, about tow years ago, when Kavita Singh found it difficult to stand up or sit confortably. Running or climbing a flight of stairs was out of the question for the 35 years old homemaker. Singh had other problems too-pain in the joints, particularly in the knees, chest pain, diabetes that refused to be controlled , and hypertension were just a few of them."Mere breathing put a strain on my lungs," recalls Singh.
All of Signh's problems were attributable to here wight- a whopping 140 kg with a body mass index (BMI) of 39. But that was before she underwent gastric bypass surgery.
"My stomach is now just on-third of its original size. I cannot overeat even if Iwant to,"she says, claiming to have lost 15 kg in the first three months after surgery.
"I started gaining weight in my twenties," says the mother of two."Each delivery just made it worse." She tried several other weightloss techniques but without success.
Coaxed by her family physician and after speaking to another morbidly obese patient who had benefited from bariatric surgery, Singh finally took the decision as "I didn't want to embarrass my family anymore."
The decision may just have saved her life, the surgeon who operated on Singh later told her. At last count, Singh has lost 58.5 kg. "I weigh myself every day. It motivates me," she says, waiting for her weight to fall to 60 kg.
Like Singh, several morbidly obese patients have not only escaped death, but have also improved their lives through bariatric surgery. Any adult with a BMI of over 35 is 'morbidly obese'. The condition brings with it a host of other health problems."For such people, surgery is a life-saving procedure, not just a cosmetic enhancement," says Dr. Muffazal Lakdawala, consultant laparoscopic surgeon, Hiranandani Hospital.Nevertheless, it should be the last resort, he warns.
While a number of weight-conscious patients approach surgeons, not all undergo surgery."Before surgery, a number of tests are prescribed. This includes a hormonal test and psychiatric analysis apart from counselling says Dr Shrikant Bapat, another surgeon.
6% of Mumbai's population is morbidly obese
6mn Indians are extremely obese
370mm Indians will suffer from Type 2 diabetes due to obesity by 2025
Fat count: Body Mass Index(BMI) is a measure used to define obesity. It's a figure obtained by dividing the body weight by the square of the height in metres. If, for instance, your weight is 80 kg and height is 5 foot 7 (1.70m), your BMI would be 80/2,89=27.68
The higher your BMI, the higher the percentage of fat in your body.
Normal: BMI between 18.5 and 24.9
Overweight:BMI between 25and 29.9
Obese: BMI equal to or greater than 30
New health hazard for Indians
What do we mean by Diaobesity?
Excess body fat or obesity can lead to diabetes and a term coined to diabetes and a term coined to state it is diaobesity. The extra fat in the cells often causes resistance to the action of insulin ( which takes blood sugar into cells), a hormone made in the pancreas. Due to this blood sugar rises, turn stimulates more insulin secretion, which makes one feel more hungry and thus results in more fat deposition. If sugar levels are not controlled properly, then over a period of time the extra glucose molecules stick onto hemoglobin molecules which can damage the smallest blood vessels in the eyes, kidney and peripheral blood vessels in the legs. This may lead to heart problems, vision problems and blindness, kidney damages that necessitates dialysis, and nerve damage that may cause infection and possibility lead to amputation.
Reasons for the growing trend
Why are these numbers growing so dramatically?
Researchers point to a complex set of physiological, sociological and behavioral factors. In our country, many changes have taken place over the past 10-15 years that have affected people’s eating and exercise habits.
Snaking and that too snacking on juck foods(chips, biscuits chocolates, vada, samosa, sandwiches, burgers etc). has become a way of life for both adults and children. Though such practices once in a way not inherently bad, repetitively they promote health, the food people chose is often high in calories.
Restaurant eating and socializing has increased like never before. This food may be food to taste but your health suffers. Along --- a growing tendency to consume more --, we have tended to become far less active than we were 20 years 20 years ago. Our lives are full of conveniences and gadgets that discourage physical exertion, including cars, servants, washing machines, vacuum cleaners, food processors, computers, play stations and many more. Even those who pride themselves on not surfing much TV may spend hours surfing the internet in a sedentary position. The result of the imbalance in energy is an epidemic of excess body fat.
Diaobesity in India
Indians are more at risk because of a sudden dramatic change in our living conditions. Most of our grandparents and great grandparents were farmers, physically active, with limited income and limited food resources. Our culture and eating followed a definite pattern.. Our habits have changed at a faster pace. We like a continental breakfast, Gujarati thali for lunch and Chinese for dinner. We have confused our genes thoroughly leaving no time for into adapt to new change. Physiologically too. We are at risk. Body composition of we Indians show that we have more fat than muscle. The projection is that there will be 75 million diabetic patients in India in the next 25 years. There are 25 percent over weight women in India at present and it is going to be 50 per cent in another 10 years. The situation looks grim and no Karela and Methi seeds will do miracles to shun away diabetes, unless you get aware and improve your health quotient from today. Also, Indians have a genetic vulnerability that of contracting the disease 10 years earlier.
To Avoid diaobesity what should you check?
BMI(Body mass Index) should be ideally as low as 24 (females) and 25(males).
Check your waist circumference: Waist circumference greater than 40 inches in males and 35 inches in females indicates increased fat deposition in the abdomen. In fact, a simple measurement is, “ the pinch should not be more than an inch“ on your waist. This by no way means that fat around other areas is okey. You need to maintain the weight of overall body.
What can you do to improve your health quotient?
Let your health regime be simple, realistic and individualized if it has to work, for example, if your weight is 80 or 90 kgs and your ideal weight is 50 kgs don’t try to play havoc with your body by going on a crash diet and a drastic exercise plan to reach an unrealistic goal, you will do more harm than good. Secondly, this plan will not sustain long and also remember there are many things in life that are equally or more important than losing weight. Take professional help from a person who is qualified and experienced to understand your lifestyle and will inculcate a health plan to fit your lifestyle.
Make a small change, but follow it regularly. Discipline is the need of your health. For example dedicate at least 40 minutes daily for some physical activity like brisk walking for some physical activity like brisk walking, swimming, badminton, tennis etc.
Don’t turn into a couch potato or sit glued to your computers. However exciting the serial or news or matches may be, remember the air in the open is more refreshing and your lungs just want to replace that stale oxygen with the fresh one. You will have to get physically active to get your supply.
To see the progress compare your present parameters from where you have started and not with any height weight charts.
Eat wisely. Increase your back balance, not your fat balance. Eat a balanced diet with variety. When you are eating junk, remember the food stays for a moment on the tongue but stay long as unwanted fat in your cells.
Make a smart choice. Most patients who suffer from obesity, diabetes and alike also have long-term nutritional deficiency like anemia, calcium or other mineral or B complex deficiencies which can add to fatigue, depression which can add to fatigue, depression, weak bones and muscles. This in turn may make you less active and crave you for certain unhealthy foods. Hence, the recommendation is to improve your total health.
A cocktail for weight loss?
CELEBRITIES are following a new fitness mantra that kills workout boredom and melts the fat away.
Going to the gym everyday and looking at those heavy, bulky machines can be really boring. There might be days when you would want to bunk your workout sessions because the monotony of your exercise regime would be killing you. Fitness experts across the work, and also a few in Mumbai, have worked out a perfect solution to make your workout sessions fun.
The concept of ‘cocktail workout’ has become increasingly popular in the city. Celebrities like Preity Zinta, Bipasha Basu, Sandip Soparrkar and Neetu Chandra also follow this technique.
So, what is this ‘miracle’ regime all about? As the name suggests, a cocktail workout is one that has a little bit of everything right from yoga to Pilates to aerobics and also swimming and cycling.
Fitness expert Deanne Pandey says” Cocktail workout can be lots of fun, but the only challenge is that your weekly program has to be carefully designed by your trainer keeping in mind your body type,” informing that she’s building a new studio, which will have provisions for lots of a activities and even a spa. “Variety always interests people and the same rule works while achieving new fitness levels,” she adds.
Another fitness instructor Shaini Bhargava claims that doing something different everyday is very good for the muscles. She explains, “Your muscles don’t get habituated to a specific kind of workout and that is very challenging. This helps one burn calories faster.”
Dance expert and instructor to Bollywood stars Sandeep Soparkar obviously dances regularly. He has enrolled himself in a boot camp and also does aerobics, yoga and swimming on different days of the week. He says, “I believe that after doing the same kind of workout for a long time your muscles get immune to it. They stagnate and hence you need to add some variety.”
Actor Neetu Chandra practices this too and is extremely happy with the results. “I like to do something different every day. One day I just go for a jog, the next day I swim and probably dance the other day. I get to learn lots of things and simultaneously keep fit”.
Cocktails workout includes
• Pilates
• Swimming
• Aerobics
• Martial arts
• Boot camp
• Any form of dance
Newer Obesity Guidelines
India reworks its obesity guidelines.
“Every 10 second, a new diabetic patient is diagnosed in the world.”
“Nearly 19,ooo every day die to diabetes and its complications.”
“A diabetes related amputation takes place every 30 seconds.”
Alarmed by reports that India will become the global diabetic capital by 2050, the health ministry has for the first time revised the standard consensus for the prevention and management of obesity and metabolic syndrome in the country.
The guidelines were released jointly by the health ministry, the diabetic foundation of India, All India institute of Medical Sciences (AIIMS), Indian Council of Medical Research (ICMR), National Institute of Nutrition(NIN) and 20 other health organizations
This is the first time India has officially complied its weight and flab statistics to step up the fight against obesity and its direct fall out-Diabetes.
Why we need a new consensus?
Several studies have procrastinated that India will become the global diabetic capital by 2050 if abdominal and lower limb obesity and metabolic syndrome are not arrested.
The current load of diabetes in the country is 41 million. which is still expected to rise by 170A% in the next 20 years. Even today, India has the largest population of diabetes in the world(excerpts taken from www.doctorbruno.com).
Researches over the last several years have shown that, Indian bodies and their genetics are quite different from the western counterparts. Indians normally suffer from abdominal obesity compared to the westerners whose bodies uniformly obese.
According to the new analysis of the National Health and Nutritional Examination survey (NHANS III) as body mass index increases, the average blood pressure, total cholesterol levels rise and average HDL-cholesterol decline. Men in the highest obesity category have more than twice the risk of hypertension, high blood cholesterol or both, as compared to men with normal weight. Women on the other hand in the highest obesity category have four times the risk of either or both of these risk factors.
The absolute mortality due to chronic heart disease is estimated to increase to 20.3 million and by 2020, it is forecasted to touch 2.58 millions. In 2000, the mortality rate was 1.59 million.
Present statistics show that one in every 3 Indians has high blood pressure, which is expected to shoot by 60A% in next 20 years.
The Indian body composition puts them in high risk for diabetes and hypertension. For every 10 extra kilos above the stipulated body weight (measured according to the height), life expected of a person reduces by three years.
In view of all these the need for weight and fitness guidelines specified to Asian countries was first stressed in a study by the World Health Organization’s subcommittee set up to look into obesity and metabolic syndromes in the Asia pacific region in 2000. And one step towards the prevention of this deadly lifestyle related disease was taken up by the Health Ministry by making country’s fitness measurements leaner on eve of India’s eighth AntiObesity Day observed on Nov.26, 2008.
Revised Guidelines for Obesity:
The Body mass index (BMI) considered as the individual’s fitness and obesity indicator is the ratio of the body weight in kilograms versus height in m2. The country’s new diagnostic cut off for the body mass index is 23 kg/m2 as opposed to 25kg/m2 used globally. Thus, now according to the newer stricter norms a person with a BMI of 23 Kg/m2 will now be considered overweight and below that as normal; those with BMI of 25kg/m2 will be clinically obese (as opposed to 30kg/m2 as at international level) and those with 32.5 kg/m2 will require bariatric surgery to eliminate the excess flab.
According to the guidelines, Cut offs for waist circumferences will be 90 cms for Indian men ( as opposed to 102 cms globally) and 80 cms for women (as opposed to 88cms at the international level).
Thus according to the report every second person in metros like Delhi or Mumbai fulfils the criteria of obesity or has excess abdominal fat and one fourth of the adolescent population in these cities has Syndrome X metabolic syndrome that heralds the onset of heart disease and diabetes.
Why is abdominal fat dangerous?
Abdominal or visceral or belly fat which is located around the internal organs is being linked to elevated stress hormones which in turn rise the blood pressure, blood sugar levels and cardiac risk, unlike subcutaneous fat, at the visceral fat cells release metabolic products directly into the blood; free fatty acids from visceral fat thus accumulate in the liver and other organs. This impairs the body’s regulation of insulin, blood sugar and cholesterol. In addition to this, the fat cells produce a large number of proteins that contribute to the metabolic abnormalities, inflammation and heart disease.
Obesity in children –growing concern:
Childhood obesity is a fast emerging global dilemma not only in the developed western counties, but also in many developing Asian counties including, but also in many developing asian counties including India. In the U.S. a dismaying 32 percent of young people aged 2 through 19 were judged overweight or obese as measured by body mass index, with roughly half falling into each of those categories. In New Delhi alone, nearly one in five school children ages 10 to 16 are found to be either overweight or clinically obese.
‘The figures for India indicate that the rapid progress of urbanization and demographic trends are associated with unhealthy lifestyles and related non-communicable disease with obesity leading the way!!(Vedavathi S. Jayashree R. Rafi M: Prevalence of overweight & obesity in Affluent adolescent school girls in Chennai in 1981 & 1998 Indian pediatrics, 2003;40;775-779 and kapil U et al: Prevalence of obesity among Affluent adolescent school children in Delhi. Indian Pediatrics: 2002;Vol39:449-452.)
Experts estimate 16% of kids as overweight and another 24% are at risk of becoming overweight. Among these, two thirds of overweight kids will become overweight adults.
Problems associated with childhood obesity.
50-80% of obese children will continue on into adulthood as obese adults and fall into the high risk group of Diabetes, Hypertension and coronary Heart disease. Complications of adult obesity are made worse if the obesity begins in childhood, as it is harder to treat in adults than in children. (Style D.M: Childhood obesity and adolescent obesity: PCNA 2001;48: 823-847 and Park k: Par’s textbook of Preventive and Social Medicine: Banarsidas Bhanot Publishers, 18th Edition, 2005; 316-319)
In addition to these disease, the extra fat tissue causes hormonal imbalances leading to an early onset of menstrual cycles in overweight girls; this in turn may stop them from achieving their full growth potential.
These children undergo social stigmatization by other children and parents who think that obese youth are lazy, unclean, and of lower intelligence
Young adolescents with eating disorders often start developing their restrictive eating patterns in order to avoid these strong negative images associated with being overweight and go through swings in excessive weight gain and loss.
Who is to blame for this rise of obesity in children? A recent survey of parents done in US reported that a majority of parents blamed manufacturers to advertisements on TV, some blamed it onto the child itself while some said it was due to the unstipulated growth of fast food industry. Only a very few admitted that parents can easily control their eating fast food, limit watching TV and encourage outdoor activities. To combat with this several European countries have considered practical measures in town planning and some like France have even implemented these. These include:
• Regular weight-ins for children as they leave primary school, including the recording of BMI
• Increasing the number of cycle lanes.
• Designing safe walking routes to schools and from suburbs to the center.
• Programs in schools to inspire children to eat healthy avoid fast food outsets, learn to cook and play sport at a young age.
• Larger parks, modern playgrounds and improved leisure activities.
• Studies have confirmed that by implementing this concept in 10 eco towns in France, the proportion of overweight boys aged 7-12 years fell from 19% to 10% and in girls from 10% to 7%.
Revision of obesity guidelines would help to change the attitude of parents of such obese children who themselves may also be obese or overweight and adopt a healthy lifestyle.
Diabetes and Obesity-the link:
The fact that both obesity and diabetes are interlinked is the recent observation by US study that Obesity surgery reversed the diabetes in patients who were on insulin. Similar observations are also found in Indian population, where gastric bypass surgery done to combat obesity is found to reverse the type 2 diabetes. But the question is, is this the solution?
The second national health and Nutrition Examination Survey in the US study that observed that the relative risk of diabetes for overweight adults was nearly 2.9 times that for the non-overweight adults. The relative risk imposed obesity in young adults (30-45 years) was 3.8 times that of the non-overweight match control. Another survey in USA showed men in BMI range of 25-26.9 had 2.2 times higher risk for type 2 diabetes than those with BMI with 23. The risk increased with increasing BMI with men in BMI group > 35 having a relative risk of 42.1 times greater than men with BMI<23.
A British study showed that men in the upper fifth of BMR range (> 27.9) had a risk factor 7 times more than those in the lowest.
The findings for women are quite similar, not only the age adjusted relative risk increase with increased BMI value, excess risk was seen in women in the upper end of normal risk was seen in women in the upper end of normal BMI (<22.9) range, From a risk of 1.0 at BMI of <22 the risk rose to 2.9 at BMI of 22-22.9 and a whopping 93.2 at BMI of > 35.
BMI along with weight gain is an important risk factor for diabetes. A Health Professionals follow up study which considered varying parameters including BMI showed that, men who gained weight> 13.6 kg over a 5 year term had 4.5 times higher risk than men whose weight remained within 4.5 Kg of their weight at entry. Across the range of BMI , weight gain was positively correlated with risk for diabetes. Among women, those whose weight increased from 5 to 7.9 Kg during the 14 year period of study had a risk of 1.9 times that of men who did not gain weight. The risk was conversably reduced when they lost weight.
The longer one stays obese greater is their risk for developing type 2 diabetes. In a study those who were at a BMI 30 for.> 10 years had a risk twice that of those who had been obese for less than 5 years.
According to figures, for every diabetic patient in India, these are two who have the disease but are undiagnosed and four who have abnormalities that could lead to their becoming diabetic in future. Diabetes has its own complications, retinopathy and nephropathy both linked with diabetes. It’s well established that it is one of the major risk factor for heart disease. Visceral or Central distribution of fat is responsible for the breakdown of normal glucose homeostasis. This causes increased availability of free fatty acids (FFA) and increased oxidation of FFAs, increased hepatic resistance. Hyperinsulinaemia and insulin resistance are positively correlated not only to increasing BMI but also to the amount of visceral fat.
Glucose fatty acid cycle: A factor of significance in initiating and maintaining the evolution of obesity to diabetes, as
mentioned earlier. Is increased availability of FFA and its oxidation which block the peripheral action of insulin as well as affects the oxidative and anaerobic pathway of glucose metabolism. It also brings about impairment of glucose utilisation. Increased plasma FFA levels increases the liver glucose release and adversely affect glucose uptake by peripheral tissue and causes insulin resistance.
Among women, those whose weight increased from 5 to 7.9 Kg during the 14 year period of study had a risk of 1.9 times that of men who did not gain weight. The risk was considerably reduced when they lost weight.
Summary
Hence there is a need for early detection of diabetes with a regular screening of the population at high risk. People at high risk of developing diabetes (Age > 40, obesity, abnormal lipids and strong family history) need special attention and should undergo regular screening for diabetes.
Though India has not worked on the strategies that help in bringing down obesity at the moment, with obesity norms becoming more stricter we can always follow the NIH strategies for weight loss which stresses on calorie reduction, increased physical activity, and behavior therapy designed to improve eating and exercise all combined to achieve the target BMI.
Key to obesity: We have a taste for fat
Discovery of 6th Taste Explains Why Some Can't Resist Fatty Foods; Those Sensitive To Fat Should Consume Less
Sydney: It's a theory set to confirm why humans are so fond of fatty foods such as chips and chocolate cake: in addition to the five tastes already identified lurks another detectable by the palate - fat.
"we know that the human tongue can detect five tastes - sweet, salty, sour, bitter and umami(a savoury, protein - rich taste contained in foods such as soy sauce and chicken stock)," Russell Keast, from Deakin University, said on Monday."Through our study we can conclude that humans have a sixth taste - fat"
Researchers tested the ability of 30 people to taste a range of fatty acids in otherwise plain solutions and found that all were able to determine the taste - though some required higher concentrations than others.
They then developed a screening test to see ho w sensitive people were to the taste and found that, of the 50 people tested, their ability to detect fat was linked to their weight - a finding which could help counter obesity.
"We found that the people who were sensitive to fat, who could taste very low concentrations, actually consumed less fat than the peoplewho were insensitive," keast said, "We also found that they had lower BMIs (Body Mass Indexes)."
The reverse was happening in people who were not sensitive to the taste. "They are over-consuming and this is creating an energy imbalance, which is leading to higher BMI or development of overweight or obesity", he added. Keast said the research, conducted in collaboration with the University of Adelaide, New Zealand's Massey University and Australian Science body CSIRO, suggested that the taste of fat could trigger a mechanism in the body.
"We all like eating fatty foods. What we speculate is (that) the mechanism is to do with stopping eating. Your body is able to tell you you've had enough and stop," he explained. "And if you are insensitive to it, you're not getting that feedback"
with fats easilyaccessible and commonly consumed, it was poaaible that people may become desensitised to the taste of fat, leaving some more prone to overindulging in calorie-rich foods, he added.
The results,published in the British Journal of Nutrition, have not definitively classified fat as a taste but Keast says the evidence is strong and mounting.
For something to be classified as a taste there needed to be proven receptor mechanisms on taste cells in the mouth, he said.
"We have what.... e will call posible candidate receptor cells," he said.
He says low-fat foods can be ineffictive because the body becomes convinced it is not getting what it needs and then people revert to hte full-fat version.
He says the research may lead to the development of better low-fat foods people will be less likely to abandon. "Celery will always taste like celery. Brie will always taste like bire. this is not perceivable," he said.
"(But) what this (research) would do in theory is ensure that the body.... actually would recognise there was fat without there being those excessive levels of fat in the food. You can't replace fat entirely and it would be wrong to think so. Fat is good. It is just that we eat too much of it."
