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Showing posts with label Obesity. Show all posts
Showing posts with label Obesity. Show all posts
Tuesday, 6 May 2025
Sunday, 13 April 2025
Indian pot belly: From status symbol to silent killer
Soutik Biswas
India correspondent•@soutikBBC 9 hours ago
The Indian pot belly - once a badge of prosperity, indulgence and aging respectability - has long been a target of satire and social commentary.
In literature, it quietly signalled comfort or complacency; in films, it became a shorthand for the lazy official, gluttonous uncle, or a corrupt policeman. Cartoons exaggerated it to mock politicians. In rural settings, it was once considered a status symbol - a sign that "this man eats well".
But what was once dismissed or even celebrated is now raising alarm bells. The obesity crisis in India is ballooning - and the seemingly harmless pot belly may be a far bigger villain than we think.
India had the second-highest number of overweight or obese adults in 2021, with 180 million affected - behind only China. A new Lancet study warns this number could soar to 450 million by 2050, nearly a third of the country's projected population.
Globally, more than half of all adults and a third of children and adolescents are expected to face the same fate.
At the heart of this issue in India lies the pot belly, or in medical terms, abdominal obesity.
This form of obesity refers to the accumulation of excess fat around the belly and doctors say it's more than a cosmetic concern. As far back as the 1990s, studies showed a clear link between belly fat and chronic conditions like Type 2 diabetes and heart disease.
Obesity isn't just abdominal. It appears in different patterns, depending on fat distribution: peripheral obesity affects the hips, thighs, and buttocks, while generalised obesity involves fat spread more evenly across the body.
The numbers on abdominal obesity in India are already troubling. According to the latest National Family Health Survey (NFHS-5) - which, for the first time, measured waist and hip sizes - about 40% of women and 12% of men in India have abdominal obesity.
Abdominal obesity, based on Indian guidelines, means a waist over 90cm (35 inches) for men and 80cm (31 inches) for women. Among women aged 30 to 49, nearly one in two already show signs of it. Urban populations were found to be more affected than rural ones, with high waist circumference or waist-to-hip ratios emerging as a key red flag.
So why is belly fat such a big deal?
One reason is insulin resistance - a condition where the body stops responding properly to insulin, the hormone that helps regulate blood sugar. Abdominal fat disrupts how the body uses insulin, making it harder to control blood sugar.
Studies have found South Asians, including Indians, tend to have more body fat than white Caucasians at the same Body Mass Index. (BMI is a simple measure of body fat based on a person's weight in relation to their height.)
It's not just how much fat you have - it's where it goes. In South Asians, fat tends to collect around the trunk and under the skin, but not always deep in the abdomen as visceral fat.
Though South Asians may have less of the more harmful deep abdominal fat around organs like the liver and pancreas, studies show their larger, less efficient fat cells struggle to store fat under the skin. As a result, excess fat spills into vital organs that regulate metabolism - like the liver and pancreas - raising the risk of diabetes and heart disease.
India, China, and the USA lead eight nations housing over half the world's overweight and obese population
Scientists still don't fully understand the biological reasons behind the fat distribution patterns. Though numerous genetic studies have been conducted, no single gene has consistently explained this tendency.
One theory offers an evolutionary root. India, for centuries, was wracked by famines and chronic food shortages, leaving generations to survive on meagre nutrition.
In such conditions, the human body adapted for survival in extreme scarcity.
The body needed a depot for this energy and the abdomen, being the most expandable area, became the prime storage site. Over time, as food became more plentiful, this fat store continued to grow - eventually to harmful levels.
"It's a conjectural but plausible evolutionary theory - one that can't be proven, but makes sense," says Anoop Misra, who heads Delhi's Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology.
Last year, in a paper doctors belonging to the Indian Obesity Commission redefined obesity guidelines for Asian Indians, moving beyond BMI to better reflect how body fat relates to early health risks.
They created a two-stage clinical system that considers fat distribution, related diseases and physical function.
Stage one involves a high BMI, but without abdominal obesity, metabolic disease, or physical dysfunction. In such cases, lifestyle changes like diet, exercise and sometimes medication are usually enough.
Stage two includes abdominal obesity - the harmful visceral fat - and is often accompanied by health issues like diabetes, knee pain or palpitations. This stage signals higher risk and calls for more intensive management.
This classification guides treatment intensity. Once belly fat appears, early action is key - new weight loss drugs like semaglutide and tirzepatide are proving effective at targeting it, doctors say.
"As shocking as it may sound, even people with a normal weight can have dangerous levels of belly fat," says Dr Misra.
Indian physicians say abdominal obesity is rising due to lifestyle changes - more junk food, takeaways, instant meals and greasy home cooking. Between 2009 and 2019, Cameroon, India and Vietnam saw the fastest growth in per capita sales of ultra-processed foods and beverages, studies found.
So, what needs to be done?
Experts say Indians need tougher lifestyle changes than Western norms recommend. While 150 minutes of weekly exercise may suffice for their European men, their South Asians counterparts need around 250–300 minutes to offset slower metabolism and less efficient fat storage, studies show.
"Our bodies simply aren't as good at handling excess fat," says Dr Misra.
In short, the pot belly isn't just a punchline - it's a warning sign. And India is sitting on a ticking health time bomb.
Monday, 27 May 2024
In the News: CoQ10 Linked to Better Liver Enzyme Levels
Ultraprocessed foods boost cancer risk; CoQ10 improves liver enzyme levels; glucosamine reduces risk of vascular dementia; higher B12 levels linked to lower inflammation.
Scientifically reviewed by Amanda Martin, DC, in March 2024.
Eating Ultraprocessed Foods Increases Risk of Cancer and Other Diseases
A review and meta-analysis of randomized clinical trials concluded that coenzyme Q10 (CoQ10) was significantly associated with better, reduced levels of the liver enzymes: alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT).* These enzymes are often elevated in people with liver disorders.
The researchers analyzed the find- ings of 15 randomized, controlled trials that administered CoQ10 and reported changes in liver enzymes.
Participants included a total of 712 men and women with conditions such as coronary heart disease, type I or type II diabetes, nonalcoholic fatty liver disease or elevated lipids.
CoQ10 supplemented participants had beneficial reductions in elevated liver enzymes.
Editor’s Note: Coenzyme Q10 doses ranged from 100 to 400 mg per day consumed for two to 24 weeks.
* Food Sci Nutr. 2023 Jun 7;11(9):4912-4925.
Higher B12 Levels Associated with Less Inflammation
Researchers uncovered a link between higher serum vitamin B12 levels and lower levels of C-reactive protein (CRP) and interleukin-6 (IL-6), which increase during inflammation.*
The study utilized data from a sub- group of 136 participants in the PREDIMED trial who had available data concerning their serum con- centrations of vitamin B12 and CRP, and plasma IL-6. The PREDIMED trial was designed to evaluate the relationship between consuming a Mediterranean diet and cardiovas- cular disease prevention.
Men and women who had higher vitamin B12 levels had lower con- centrations of CRP and IL-6. Similar findings were obtained when the researchers measured these factors in aged mice.
Editor's Note: "Since chronic inflammation is associated with a wide range of diseases, understanding how vitamin B12 status influ- ences inflammation could have significant implications for disease prevention and management," the authors noted.
* J Sci Food Agric. 2024 Jan 30;104(2): 875-882.
Glucosamine May Also be Beneficial Against Vascular Dementia
People with osteoarthritis who used glucosamine, a compound that supports joint health, were also at reduced risk of developing vascu- lar dementia, according to a study published in Alzheimer’s Research and Therapy.*
Participants included 214,945 men and women in the UK Biobank, over the age of 60, who did not have dementia at baseline. Their question- naire responses provided informa- tion concerning regularly consumed nutrients. During a median 12-year follow-up, 1,039 individuals developed vascular dementia, 1,774 developed Alzheimer’s disease and 122 developed frontotemporal dementia.
Habitual use of glucosamine was associated with an 18% lower risk of vascular dementia compared with non-use. People who additionally consumed calcium had a 54% lower risk of vascular dementia than those who did not use glucosamine. No association was observed between glucosamine and the development of Alzheimer’s disease or frontotemporal dementia.
Editor’s Note: “If further confirmed, habitual glucosamine use may act as a dietary supplement for primary prevention of vascular dementia in the elderly,” the authors stated.
* Alzheimers Res Ther. 2023 Sep 9;15(1):152.
Eating Ultraprocessed Foods Increases Risk of Cancer and Other Diseases
Consuming ultraprocessed food increases the risk of cancers of the upper digestive tract, which includes mouth, throat, and esophageal cancers, according to a study published recently in the European Journal of Nutrition1 and reported on by CNN and other news media.
Ultraprocessed foods include soda, chips, instant soups, cookies, ice cream, cereal bars, and many others that include ingredients you wouldn’t use in a regular kitchen.
These additives are designed to resist mold and bacteria and to keep ingredients from separating. They also include bulking and bleaching agents, artificial dyes, or added salt and sugar to make the product more appealing.
Participants included 450,111 adults in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. They were recruited from 1992 to 1999 from 10 different European countries and the United Kingdom.
Results showed that people who consumed just 10% more ultra- processed foods than others in the study had a:
- 23% higher risk of head and neck cancers, and a
- 24% increased risk of esopha- geal cancer.
These data were collected in the 1990s, when consumption of ultra-processed food was much lower than it is now, and so the link to health risks is even higher today.
Indeed, as of 2019, ultraprocessed food made up approximately 71% of the food supply in the United States.2
Many studies over the past two years have demonstrated the alarm- ing link between ultraprocessed foods and cancer and other serious health problems. Here are a few examples of the findings:
- Men who consume ultraprocessed food have a higher risk of colorectal cancer, heart disease, and early death.3
- For every 10% increase in ultraprocessed food, there is a 2% increase in developing any kind of cancer, and a 19% increased risk of ovarian cancer.4
- Eating higher amounts of ultra- processed animal foods and sweetened beverages increases the risk of having multiple chronic conditions like cancer, diabetes, and heart disease.5
- Consuming more ultraprocessed foods is connected to depression in women.6
- Consuming about 20% of daily calories in ultraprocessed foods is linked to 28% increased risk of dementia.7
In the most recent study, researchers dug deeper to determine if excess weight accounted for the increased cancer risk.
Ultraprocessed foods are calorie dense and can contribute to obesity, and being obese or overweight is connected to an increased risk of 13 different types of cancer.
However, results showed that weight alone did not account for the increased cancer risk. Increased hip-to-weight ratio accounted for 5% of the 23% increased risk of head and neck cancer.
And increased body mass index (BMI) accounted for 13% of the 24% increased risk of esophageal cancer.
This indicates that factors other than obesity contribute to the increased cancer risk.
Editor’s Note: According to a large number of recent studies, ultraprocessed foods are associated with an increased risk of cancer, heart disease, dementia, and more.
References
- Eur J Nutr. 2023 Nov 22.
- Nutrients. 2019 Jul 24;11(8).
- BMJ. 2022;378:e068921.
- EClinicalMedicine. 2023 Feb;56:101840.
- The Lancet Regional Health.2023;0(0):100771.
- JAMA Netw Open. 2023 Sep 5;6(9):e2334770.
- JAMA Neurol. 2023 Feb 1;80(2):142-50.
https://www.lifeextension.com/magazine/2024/3/coq10-linked-to-better-liver-enzyme-levels-in-the-news
Friday, 9 June 2023
How obesity evolved from a lack of willpower into a disease
Walk into your local convenience store and take a good look at the shelves. Are you looking at food?
Walk into your local convenience store and take a good look at the shelves. Are you looking at food? Or does the brightly coloured packaging largely contain something engineered to resemble food, but with a list of unrecognisable ingredients as long as your arm? The chances are you are mainly looking at what is termed ultra processed food (UPF), and which experts believe is responsible for a grave public health crisis on a par with smoking.
Welcome to the obesogenic environment in which we all now live. Just as parking an ice cream van outside a school every day will lead inexorably to more children eating more ice cream on school days, filling our shops and food outlets with the kinds of products that make it easy to make bad choices and hard to make the right ones leads to more obesity.
At least, that is one explanation for why, as a society, we have become so overweight. In the UK, an estimated 25 per cent of adults are living with obesity, according to the NHS. By 2030, this figure is expected to rise to 35 per cent in England. As the health service points out, it is “a complex health issue with many causes.”
The NHS is yet to categorise obesity as a disease. But a growing number of health experts and organisations believe it should be viewed as such.
The World Health Organisation, European Parliament and American Medical Association (AMA) already use the term “disease” to describe what used to be regarded as the failure of individual willpower.
Time and again we were told that if only we ate a healthy, balanced diet and took regular exercise, we could more or less avoid becoming fat, or lose any excess weight we had gained. This remains the official advice in the UK. And of course, for many people, it remains true – to some extent. But as the NHS acknowledges, the obesity problem has grown because “the environment we live in makes it difficult for many people to eat healthily and do enough physical activity.”
It is here – and also in our increased understanding of the part genetics plays – that the line between personal responsibility and an affliction beyond our control becomes blurred.
It has been a decade since the AMA voted to recognise obesity as a disease, with a number of other medical societies supporting this position. We have been slower in the UK to reach this conclusion; but in 2019, the Royal College of Physicians adopted the same stance. Their reasoning? That this was the only way to ensure funding for effective treatment options that could halt the spread of obesity across society and control its health and socioeconomic costs.
“I think the scientific community is well aligned with the view [that obesity is a disease],” says Dr Simon Cork, senior lecturer in physiology at Anglia Ruskin University. “We’ve known…for a long time that body weight isn’t due to personal choice but a combination of genetics, physiology and the environment.
“I often think of body weight as like blood pressure. If your blood pressure goes too high, we use medication to artificially bring it down. Body weight is regulated in very much the same way. It’s programmed around what we call a set point. So for the vast majority of people, whether they are underweight, overweight or obese, their body weight is stable…Your body tries to protect what it thinks is your normal body weight.”
You may succeed in shedding the pounds temporarily. Keeping them off is far harder. The reasons for this, as Dr Cork explains, lie in the interplay between genetics and the environment.
There are hundreds of gene variants associated in some way with body weight so many people have a genetic vulnerability to weight gain.
In a world where energy-dense foods that are rich in refined carbohydrates, saturated fats and salt, and low in dietary fibre are widely available to the point of being impossible to avoid, the environment makes it impossible for many of these people to live at a so-called ‘healthy weight’.
“I like to count the number of opportunities to buy a can of Coke from when I arrive at an airport to when I board a plane,” says Dr Chris van Tulleken, author of Ultra-Processed People, an investigation into the science and economics of ultra-processed foods. “There are typically dozens of opportunities. These foods are everywhere in the way cigarettes were in the 1970s. And the evidence that for some people they’re addictive is very strong.”
Most of us already know that cola does not form part of a healthy diet. Fewer people may be aware how many of our daily comestibles fall into the category of UPF: from supermarket sliced bread, breakfast cereals and frozen pizzas, to fruit-flavoured yoghurts, ham, sausages and some alcoholic drinks.
These foods and beverages are everywhere – more than half our diet is now composed of UPFs – and research in recent years has linked high consumption of them with being overweight and obesity. Because these (often highly flavoured) energy-dense foods are designed to be so moreish, it is hard to regulate our intake of them.
The solution, then, is evidently nowhere near as simple as telling people to cut them out and switch to a diet of whole foods and meals cooked from scratch. (Although, ideally, this is exactly what we should do.) Not only are UPFs ubiquitous and addictive, but as Henry Dimbleby, Leon co-founder and former Government food tsar, writes in his recent book Ravenous: “The plain fact is that unhealthy processed food is cheaper per calorie than fresh food.” In other words, not everyone can afford to avoid it.
Van Tulleken, like Dimbleby and others in the public health and scientific arenas, believes it makes no more sense to blame obesity on the individual than we would cancer or any other condition.
“As a doctor, I see [people living with obesity] as having a disease caused by living in an environment that’s deeply harmful to their body,” he says. “The idea that willpower or personal responsibility has anything to do with any of this is entirely debunked.”
He cites the weight gain that was seen across all ethnic and income groups in the US from the Seventies onwards. “You can’t think of anything that suddenly created a failure of individual willpower or personal responsibility that would explain all those groups being affected together, especially when we have a robust explanation: the rise in food engineered to be eaten to excess.”
So what do we do about it? Dimbleby and van Tulleken are among those who believe far more robust regulation of the food industry is needed. Frustrated at the Government’s failure to take the required action, Dimbleby quit his role in March, blaming ministers’ obsession with “ultra-free-market ideology”. They were too worried about being seen as a “nanny state” to act, he suggested.
But van Tulleken argues we are already living in a “nanny state”, only one in which the nannying is done by the food corporations. “I’d like our elected officials to enable us to have access to good information and to make real food available,” he says. “I’d like more choice and freedom. It’s a libertarian argument.”
In the meantime, we now have effective drugs to treat the symptom of the problem – obesity – just as the lung cancer caused by cigarettes has long been treated in hospitals. At a time when the NHS is under inordinate pressure, we can hardly afford not to treat obesity before it triggers the illnesses associated with it (including cancer and cardiovascular disease). The illnesses that also cause economic inactivity.
Data shows that in 2021, the NHS spent £166 billion on the treatment of obesity and overweight across the UK. It seems clear that advising people to get off the sofa more often just isn’t working.
It is against this backdrop that a new generation of weight loss drugs has arrived. You’ve probably heard of Ozempic. Wegovy is another. Such medications are now seen as crucial weapons in our multi-pronged battle against the bulge.
“Obesity leads to disease states so we should treat it as a disease and treat it with effective, safe drugs,” says Dr Cork.
Are we satisfied they are effective and safe?
“I think we are,” he says. “As long as they are prescribed and monitored appropriately.” Although all drugs carry the risk of potential side effects, Dr Cork believes the weight loss drugs we have now are the best yet.
“It’s not a question of ‘is [the solution] drugs or is it changes to the environment?’” says van Tulleken. “People living with obesity today need treatment now. The drugs aren’t as good as the companies say they are, but they’re among the best treatments we have, they’re good and they should be freely available and accessible to everyone.”
Failing to take action, both in treating the disease of obesity and treating its causes, is a false economy, he argues. “I want people to have real choice,” he says. “We can’t afford not to do this.”
https://uk.news.yahoo.com/obesity-evolved-lack-willpower-disease-171158210.html
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