PART 8 of the series in
"The weight of our nation:
REDUCTION IN ENERGY EXPENDITURE
Urbanization has taken its toll on children in the cities where they are dropped to school by car or the school bus and brought back home the same way. Also there is not much of physical activity in the schools due to the load of subjects and a physical education class is only a once or twice in a week kind of activity which also gets restrained due to several factors like the teacher being absent or a rainy day. At home too, the story remains the same as the children are burdened with a lot of assignments or home-work which hardly leaves them any time for fun and games outdoor. The electronic media has captured the kids quite charmingly where even if and when they do get free time they prefer to play computer games or watch their favourite programmes on the television. All this directly affects the child’s BMI and BMR and gradually such a sedentary life style will eventually lead to obesity.
INCREASE IN CONSUMPTION OF ENERGY DENSE FOODS, LIFESTYLE AND DIETARY PATTERNS
With a lot of processed foods available in the market today and their seductive advertisements the children have been targeted to consume energy dense, packaged, unbalanced and processed foods. Such highly unbalanced diets will not only affect the child’s weight but will also affect his/her growth, and lay the foundation for a future filled with diseases. The wholesome meal has been replaced by endorsed foods which are high in carbohydrates and fats containing less amount of protein with many additives and preservatives. Also if vegetables have been involved, they are usually dehydrated and processed losing their essence. The excessively high sugar intake leads to tooth decay and also to being over- weight and obesity, which in the future will lead to diseases and disorders as such an unhealthy life- style, has been rooted in children at such a young age. And the horror of horrors is that their life expectancy can be reduced to be even shorter than their
SOCIO ECONOMIC STATUS
The economic status of the people has a great hold on their dietary habits. Those who can afford tend to be lured towards the pull of highly advertised foods. Unfortunately these foods are processed and package. However, the excess consumption of such foods leads to a dietary imbalance which leads to overweight.
The class of the society which is unable to afford a balanced meal tends to consume empty calories like they make a meal out of a vada-pav. Although the food is energy dense it is not a balanced meal and hence they suffer from many deficiencies and a regular consumption of foods that are only rich in energy and fat and lack protein, antioxidants, vitamins and minerals take a toll on their metabolism and this again eventually leads to being overweight.
So both the extremes of eating to live and living to eat will never lead to a healthy lifestyle; and that is why good health depends on balance, variety and moderation.
SOCIO CULTURAL STATUS
In a culture that glorifies being underweight it may come as a surprise to you that there are cultures which glorify obesity and consider it a sign of good health.
It has been found that there are certain cultures which find obesity appealing. One such example is Kuwait where 52% of women over the age of 15 are dying of cardio-vascular diseases. As Kuwait is a nomadic desert and in the past has faced scarcity of food, the people there have come to believe that over weight is a sign of health and wealth. This is a completely wrong approach as over weight is in no way a sign of good health but a sign of deterioration of health. Another example is Jamaica where 65% of women are obese. The emphasis on a curvy body has been taken to extremes. Beauty is reflected in generous hips. And this leads to the desire of women to not only voluptuous but also over weight. In Samoa in South Pacific, food shortages have in the past the people since the good old days have genetically evolved in a way where their bodies store excess fat. So once again heavy women are to be found commonly and considered to be beautiful. Few other developing countries where obesity is prevalent are Afghanistan, South Africa, Mauritania and Tahiti. In Tahiti, a windward island obesity is celebrated and it is considered as a sign of beauty and fertility. (16)
Now that we know that the women are encouraged to be obese, they tend to continue with similar feeding practices for their children too; the result being that the children in such an environment develop high blood pressure, high cholesterol, diabetes and a number of disorders related to obesity. Such cultures must therefore understand and be educated about the health hazards of being overweight.
“It is a known fact that about 40 per cent of the infertility in women is contributed by polycystic ovarian syndrome or PCOS and the problem is rampant in Kerala. Several preliminary studies done in adolescent girls and young women show that over 10 per cent of the general population in Kerala have PCOS, which also explains the increasing spectrum of infertility issues here,” says Sheila Balakrishnan, Associate Professor of Obstetrics and Gynaecology, who also heads the fertility clinic at SAT Hospital.
There is a direct association between stress and obesity. It has been generally observed that people who are stressed tend to over eat. This is because of the hormones, Serotonin which is a feel good hormone and excess of carbohydrates and sugars raise this Serotonin level. Also Cortisol which is released by the body under extreme stress and excess Cortisol increases appetite. Due to such increase in appetite there is obviously a tendency to eat more which leads to an increase in weight. This tendency of stress leading to over eating and over eating once again leading to psychological stress tends to become a vicious cycle. One must therefore learn to break this cycle by trying to relieve stress by exercising and in case of children involving oneself in activities which one likes such as drawing, swimming, playing and so on.
EATING TIME AND SPEED
The Journal of American Dietetic Association published a study called ‘Fast Eaters Eat More’ in 2008. According to the paper, the rate at which a person eats affects how many calories he ingests. There is a play of hormones in our bodies which lead us to a feeling of hunger or satiety. The hormones are PYY, GLP-1 and Ghrelin. The journal of clinical endocrinology and metabolism by Kokkinos et al has found that levels PYY and GLP-1 increase when a person is eating slowly. This causes a person to feel full. The research also states that Ghrelin levels were higher after 2 hours of eating for those people who ate too quickly as Ghrelin causes a feeling of hunger.
The time at which a person eats also plays an important role in digestion of food. A study done by Georgios Paschos PhD who was involved in the research at the university of Pennsylvania, analysed the link between eating late at night and obesity. The study was done on mice and the observation was that when there is consumption of food in a period which is generally used for resting, the body favours energy storage which leads to obesity. The eating clock therefore matters and can disrupt metabolism and cause weight gain.
From the above observations we can come to the conclusion that care must be taken regarding what the children eat, when they eat and how they eat. The initiative that the Education Minister has taken is praise worthy as he has incorporated Nutritional Education in School Syllabuses. Our children must know that obesity does not only result in being cute and cuddly but also in many unwanted problems and health risks