Fat Of The Land: In India, Obesity Affects The Affluent, Not The Poor

Obesity, long a scourge in the advanced nations of the West, has now spread to India -- and some are blaming overweight mothers and their dietary habits for the increased preponderance of too-chubby babies.

According to a study conducted by doctors from India's National Diabetes, Obesity and Cholesterol Foundation and published in Annals of Nutrition & Metabolism, a medical journal, if an Indian mother is even slightly overweight, the odds favor that her infants will also be heavy.

The study covered the cities of Delhi, Agra, Pune and Bangalore. (Another study by the SNDT University in Juhu, Mumbai, found similar results in Mumbai.)

The likelihood of obesity is particularly prevalent in families with monthly incomes in excess of 50,000 rupees (U.S. $900), suggesting that the middle classes and affluent are more susceptible to becoming overweight than the poor. (The average monthly income in India is about 5,100 rupees, according to the Financial Express).

In contrast, in the United States, obesity disproportionately strikes the poor and working classes, whereas it appears to be more commonplace among India’s higher earners.

"In the U.S., wealthier families are more knowledgeable about nutrition and hence have lower levels of obesity," said Seema Gulati, an official at the foundation, the principal author of the study. "[But in India] children from well-to-do families were overweight or obese and so were their mothers,” suggesting poor nutritional knowledge among even well-educated, upper-income young mothers.

The foundation’s report noted that in some Indian cities almost two-thirds of new mothers are now either obese or overweight by global standards.

Part of the problem is that busy working Indian mothers are now feeding their babies and children commercial pre-packaged, ready-to-eat meals, rather than taking the time to prepare food from scratch as previous generations had.

"It is important to realize that mothers are the center point for promotion of health for the family,” said endocrinologist Dr. Anoop Misra, one of the report’s authors. “For prevention of obesity, diabetes and metabolic disorders in the family, [the Indian mother] needs to be trained well in principles of healthy lifestyle."

But Dr. Shashank Joshi, an endocrinologist who consults at the Lilavati Hospital in Bandra, Mumbai, counters that excessive eating is not the only cause of fatter mothers and babies in India.

“While there is no denying that we need nutritional education, the real challenge isn't food or income,” he told the Times of India.

“It is physical activity... Our children go to classrooms that have gadgets and spend more time in front of computer screens. They are bound to be sedentary and are therefore overweight.”

The Daily Telegraph reported that, perhaps as a cultural bias, too many Indian mothers regard an overweight baby as a sign of good health.

"If the child is overweight [the mothers] consider them healthy rather than fat," Misra said.

Indeed, in a country that is all too familiar with starvation, hunger and periodic famines, a heavy baby is not something to be alarmed by at all.

"It has been handed down by grandmothers over the centuries… Once [their infants and children] became fat they were considered healthy," Misra added.

Overall, rates of obesity in India have been increasing in tandem with rising prosperity, though levels remain substantially lower than in the U.S.

Nonetheless, given India's vast population, any increase in obesity will lead to grave consequences for the nation's health, and for the government’s expenditures on health care.

A report in the Atlantic magazine noted that cases of diabetes, a direct result of obesity, are spiraling in India – from 37.6 million cases in 2004, to 41 million in 2007, and projected to jump to 80.9 million by 2030.

Paradoxically, while India suffers from high rates of malnutrition, affluence in urban areas is pushing up obesity rates in the larger cities.

India Today reported, for example, that more than three-quarters (76 percent) of residents in Delhi are either overweight or obese.

Bangalore, Hyderabad, Chennai and Kochi are closely behind, with 75 percent of their people overweight or obese.

Such high rates of excess weight raise the risk of contracting not only diabetes, but also cardiovascular diseases.

"High dependence on processed and fried foods and a menu lacking [in] vegetables, fruits and whole grains would make people vulnerable to heart diseases," said Dr. Ritika Samaddar of Max Healthcare, an Indian hospital complex, which conducted another study last year.

Dr. Amar Singhal, head of cardiology at Sri Balaji Action Medical Institute in Delhi, warned that India's urban young are vulnerable to serious health risks due to their poor diets and inactive lifestyles.

"Most urban youngsters consume too much fatty, oily food, and this is coupled with a fast-paced sedentary lifestyle. Social networking has taken precedence over outdoor activities. This has led to many of them developing heart diseases in their 20s," he said.