iconimg Wednesday, September 02, 2015

Dr KK Aggarwal, PTI
New Delhi, June 09, 2004
Obesity all over the world has been declared as a silent epidemic. The year 2003 ended with a special concern for obesity. This is now classified as a disease and should be treated only by specialist and not by just any doctor. Obesity has been considered a serious health hazard with West, especially in the US, but is now as much a concern in Asians settled abroad and in Indians especially in the affluent class. Awareness about obesity reminds us about a famous joke in India: Seeing an obese person riding an elephant a child started laughing. When the obese person asked the child, “have you never seen an elephant?” The child replied: “Yes. I have, but I have never seen an elephant riding an elephant”.

Obesity is often linked to an elephant. Truly speaking, an elephant is not obese. It only has a huge body with increased lean body mass, but a normal proportion of fat. Therefore, elephant is a normal non-obese animal.

According to Ayurveda, a thin built individual with low lean body mass is called ‘vata’ personality. The heavy built with increased lean body mass but normal proportion of fat is called ‘kapha’ personality.  The rest in between are called ‘pitta’ personality people.  The ‘kapha’ personality people are also known as elephant personality people.  These people are not at an increased risk of developing obesity related illnesses. 

Obesity in Indians is different.  Even people with normal body weight can be significantly obese and at a high risk of developing life style illnesses like high blood pressure, diabetes and heart attack.

Conceptually, assessment of obesity is to know the body weight at the age of 18 in women and 20 in men. That is the age when most people are also most fit after which the bones, organs, muscles etc cannot gain weight. One can do conditioning exercises and increase muscle weight by 5-10 per cent.  The weight of various organs, muscles and bones cannot increase.  Any weight gain after this age has to be on account of fat deposition and that is obesity.

For example, a 18-year-old girl weighing 40 kg with normal fat deposition gets married. In the new atmosphere she is made to eat more as everybody feels she is not healthy.  After the first pregnancy her weight becomes 60 kg and she maintains this weight.  She might look healthy, but from the medical point of view she has gained 15-17 kg fat which means obesity.

Indian or life style obesity basically involves preferential fat deposition in the abdomen. The so-called couch potato or pot belly obesity can easily be diagnosed by measuring the maximum abdominal circumference. If the same is more than 36 inches in men and 34 inches in women, it puts the individual at a high risk for future heart disease. A catchy slogan has been “Longer the waist line, shorter the life line.”

Indians are more prone to get pot belly obesity because of genetic pre-disposition. Our traditional Ayurveda based Indian diet is said to prevent this.

The traditional Indian life style prescribes a lot of exercise, outdoor games, walking and prefers high fibre natural foods.  It was a common tradition to eat ‘gur’ and not white sugar, eat unpolished rice and not polished basmati rice, put a lot of fibre in diet, have fruits and dry fruits and eat refined carbohydrate based samosa, kachori and puri only on holidays and that too at lunch time. Defying the laws of nature once or twice is alright but if you break the laws everyday and especially at night, one will be prone to develop pot belly obesity.

Whether living in India or abroad one should not forget the above diet code. Our Dadi Maa used to say: “If you want to eat rookhi-sookhi come and have dinner with me any day of the week but if you want to have a diet with 56 different foods come to me on Sunday afternoon."  There is a clear health message in this 'Dadi Ma Ka Nuskha'. The food, therefore, should be more simple and natural at dinner time and one can have a non-natural food only in the day time and that too once or twice in a week. The digestive power is stronger during the day.

The bottom line is to learn about Ayurvedic principles of diet and try to practice them. Have your children, especially the women folk, get sensitised and read little bit about traditional Indian cooking storage and eating.

(Dr. Aggarwal is Sr. Consultant, Mool Chand Hospital, Executive Vice Chairman, Heart Care Foundation of India & President, IMA New Delhi Branch.)