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Diabesity: A Deadly New Cocktail of Sugar and Fat
Dr Praful Pawar
It is yet another American and western export. It is emerging as a deadly cocktail of sugar and fat. It is called diabesity – signifying a strong association between an age old disease called diabetes and an emerging lifestyle curse called obesity.

Diabesity is the new world disorder. Ancient Indians used to test for diabetes by observing whether ants were attracted to a person’s urine.
The physician Sushruta (6th century BC) identified diabetes and classified it as Madhumeha. He identified diabetes with obesity and sedentary lifestyle and advised exercise to help cure it.

A syndrome of disordered metabolism
Since long, diabetes is known as a syndrome of disordered metabolism, usually due to the combination of hereditary and environmental causes. These result in abnormally high blood sugar levels. Obesity is a preventable lifestyle disease characterized by excessive body fat.

There are various stages of overweightness which are medically defined by Body Mass Index (BMI). BMI is calculated by dividing a person’s weight in kilograms by his or her height in meters squared. BMI is used in determining the extent of obesity. According to official reports every second person in India’s capital Delhi is either obese or has excess abdominal fat!
Genetic predisposition
To fight abdominal flab, India has reduced the diagnostics cutoffs for BMI from international standards of 25 Kg/ m2 to 23 Kg/m2. Indians are genetically more prone to abdominal obesity than any other global population. The cutoff for waist circumference for Indian males is now 90 cm (as opposed to 102 cm globally) and 80 cm for Indian women (as opposed to 88 cm globally). More medical conditions are linked to diabesity than any other disease.

The most prevalent diabesity related diseases include high blood pressure, high cholesterol, heart disease, stroke, gallbladder disease, gastro-esophageal reflux disease, osteoarthritis and sleep apnoea. Genetic susceptibility, environmental and behavior factors contribute to diabesity. As globalization becomes more and more significant, Indians, especially young Indians, find themselves at the crossroads of environmental and behavioral changes. These lead to a new and deranged lifestyle of cola culture, junk food and physical inactivity.

Sugary drinks and a couch potato lifestyle are the two main villains of the obesity crisis. Obesity is no longer an American privilege! As the number of obese Indian grow, so also does the number of slimming centers. Today’s obese child is soon going to be a diabetic. A worrying trend that is emerging is that diabetes, linked with obesity, is being diagnosed in an increasing number of young Indians.
The future need not be fat

Social awareness leading to behavior modification, physical activity and non-clinical weight management programs can compensate for our bad genes and prevent diabesity. Promoting weight loss and physical exercise is the way out.
International studies have shown that a weight loss of seven percent and exercise for 30 minutes daily lower the rate of diabesity by about 60 percent.

 The World Is Flat is a book written by Thomas Friedman in response to globalization of the industries and economics. The ‘World Is Fat’ is an observation by Bary Popkin on how the whole world is becoming obese. For us Indians, it is time to seriously ponder about our lifestyle before our flat and fat world becomes fatal.
Dr Praful Pawar is CEO of Apollo Hospitals, Ahmedabad.