I have tried to make my own little mark in this world. My career as a Medical Educator and Clinician in Gastroenterology (see www.gastroindia.net) and my flirtations with Health Promotion, especially amongst school children (see www.hope.org.in) are shown elsewhere.This blog contains my attempts at creative writing, most being write-ups for Health Adda column of HT City of Hindustan Times (also see www.healthaddaindia.blogspot.com) as well as a few others, and some reflections and thoughts that have struck me from time to time on my life journey.Please leave your footprint on this blog with your comment.


Monday, June 27, 2011

Weight watch or Waist watch

Overweight Indians may have some cause to cheer as a recent study on one million Asians surprisingly failed to find an increased risk to life of Indians and Bangladeshis who had increased Body-mass Indiex (BMI).
Body Mass Index, a measure of whether a person’s weight is appropriate for his or her height, has become a standard measure across the world, of an individual’s health. You can calculate it by dividing your weight (in Kg) by the square of your height (in metre), or simply by feeding your height and weight and getting it from a calculator available on several websites (try www.gastroindia.net).
Despite the problems of defining what is “normal” in population studies, a BMI range of 20-25 has long been held as the one associated with the least risk of dealth, while progressively higher risk has been observed in overweight ( BMI 25-30)  and obese  (BMI more than 30) individuals, mainly due to  increased frequency of heart disease and cancer.
A recent study published in the prestigious New England Journal of Medicine has challenged this long and widely held view,  and shown that Asians may not be following the same health rules as people of European origin.
While at first sight it may appear as a welcome sanction to go back to our chips, samosas, kheers and colas, and pile up  a few kilos without the accompaniment of  guilt, a closer look at the paper tells a more intricate story.
There are several factors that contribute to our body weight, on which calculation of BMI is based, such as the density of our bones, the water content of our bodies, in addition to  the fat that we have accumulated. What we now realize is that we need not have to get too heavy to get diabetes or heart disease that we are very prone to; a moderate ponch will do.
Another interesting observation to explain the paradox,is  that smoking, still quite rampant in the indian subcontinent, helps keep the weight down, yet substantially increasing risk to life.
Our  approach therefore has to  change from weight-watch to ponch-watch. Fatty tissue, especially when it piles up in the abdominal wall and gives us that familiar ponch that we commonly associate with prosperity, is sinister. It acts as an endocrine organ, secreting cell products called cytokines that clog the arteries of the heart, make our blood pressure  togo up,and predispose us to strokes and cancers.
Weight-to-Hip ratio or even simply our waist size, seems to be the simplest risk-indiactor for Indians, and more accurate than the conventional BMI. It is time we men tried to get comfortably back into slim fit pants with waist size below 34 and ladies below 32 inches.
Good bye then to chips and samosas, and back again to an hour-a-day of aerobics to level our ponch. 
As published in HT City( Hindustan Times) dated 27 June, 2011.

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