India is a country plagued by paradoxes. While there is a booming IT and technology sector there is still a 30% illiteracy rate. Women have had positions of power throughout history including the seat of Prime Minister and yet women are still discriminated against and have little power over their own lives. The country is plagued with malnutrition and yet there is a rising obesity rate. It is difficult for a government to care for the problems of over 1 billion people when there are such contrasting issues. Yet obesity rates are in issue that should not be ignored considering the rapid rise and various health affects that obesity causes.
Malnutrition is often the leading issue when it comes to discussions of health and nutrition. However, India is now seeing a rise in the prevalence of obesity, especially in Indian women. According to the 2005-2006 National Family Health Survey 14.8% of ever married women between the ages of 15-49 are obese compared to 12.1% of males. Interestingly, women suffer a double burden from also having a higher rate of malnutrition. The National Family Health Survey reported that 33% of women were below normal on the Body Mass Index compared to only 28.1% of males. This is a fascinating phenomenon because it would seem that obesity rates would be more prevalent among men because they are often the ones that eat first and receive the best foods due to various cultural habits. However, there have been many studies on this issue that have uncovered various reasons as to why obesity is more prevalent among women and the effects that it has on their health.
Overall obesity rates seem to have risen due changes in the nature of work and transportation and the increased consumption of energy dense processed foods (Subramanian, Kowachi, Smith, 2007). Urbanization of India has also led to increase levels of sedentary lifestyle because the activity of choice is often watching television (Shetty, 2002). India seems to be following the pattern of other developed nations where the majority of the working population does not walk to school, commercials are encouraging diets filled with processed foods, and thus diets have become richer in fats. However, the class of people that consume a diet of higher fat content is not the lower classes but rather the higher income class. It has been shown that higher income groups consume a diet with 32% energy from fat while lower income groups consume only 17% energy from fat (Subramania, Perkins, and Khan, 2009, 373). This is most likely due to the fact that those of higher incomes have enough resources to more than meet their caloric requirements of the day while lower incomes barely have enough resources to meet their daily needs. This maldistribution of resources and food reveals problems within the country indicating inefficient public distribution and extreme income inequality.
While the prevalence of obesity has risen for both men and women, women have been the most affected. There is a 2% bigger rate among women than men and the rate has continuously been growing. Obesity is most prevalent among women ages 40-49, living in urban areas, with high education, belonging to the Sikh community, and having a higher income (Garg, Shan, Ansari, and Garg, 2009). The reason for higher obesity rates among older women may be due to the fact that older women have less energy expenditure and altered metabolic rates. Obesity within Sikh communities may be a factor of the culture because women have less freedom to travel.
There are higher health risks associated with obesity in men than women which makes the prevalence extremely troubling. Studies done in Bombay show that obesity is associated with hypercholesterolemia, hyperlipidaemia, diabetes, and cardiovascular disease. There are also higher abortion rates among obese women due to medical and surgical complications of pregnancy (Garg, Shan, Ansari, and Garg, 2009). Not only does obesity affect the birth of infants but it affects their health following birth. Childhood obesity risks are somewhat tied to parental obesity which then affects the child’s adulthood obesity rates. Currently about 1% of preschool aged children are obese (Shetty, 2002). The high prevalence of obesity among children coupled with higher birth weight also puts children more at risk for diabetes.
With a country that is plagued by poverty it is interesting to see the rise of obesity rates coupling the high amounts of malnutrition. Not only is the fact that obesity rates are rising fascinating but women are the ones who are being affected by both malnutrition and obesity. This trend speaks largely to the problems existing in India, mainly the problem of misdistribution of food and extreme income inequality. It is difficult for any nation to formulate a nutrition plan that addresses both problems and to have the resources to deal with both issues. India has largely focuses on malnutrition but it is equally as important to deal with obesity rates due to the various health issues it creates and the issues it creates for offspring of obese parents. The mass media and the governments have to start educating the public about healthy diets so that as more people rise out of poverty the obesity rates do not increase even more, thereby placing further pressure on the health system in India.
References:
Garg, D., Khan, S.A., Ansari, S.H., and Garg, M. (2009). Prevalence of obesity in indian women.
Obesity Reviews, 11: 105-108. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19793374
Shetty, P. S. (2002). Nutrition transition in india. Public Health Nutrition, 5(1A): 175-182.
Subramanian, S.V., Perkins, J.M., and Kahn, K.T. (2009). Do burdens of underweight and
overweight coexist among lower socioeconomic groups in india. American Journal of Clinical Nutrition, 90: 369-376. Retrieved from http://www.ajcn.org/content/90/2/369.full.pdf
Subramanian, S.V., Kawachi, I., and Smith, G.D. (2007). Income inequality and the double
burden of under- and overnutrition in india. Journal of Epidemial Commmunity Health, 61: 802-809. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660005/
National Family Health Survey. (2009) Key indicators for india from NFHS-3. Retrieved from
http://www.nfhsindia.org/pdf/India.pdf
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