Medical Journal of Dr. D.Y. Patil Vidyapeeth

COMMENTARY
Year
: 2020  |  Volume : 13  |  Issue : 4  |  Page : 333--334

Obesity epidemic: Striking the younger age group


Sarit Sharma1, Sumita Sharma2,  
1 Department of Community Medicine, DMC and H, Ludhiana, Punjab, India
2 Department of Biochemistry, J C Juneja Hospital, Paonta Sahib, Himachal Pradesh, India

Correspondence Address:
Sarit Sharma
Department of Community Medicine, DMC and H, Ludhiana, Punjab
India




How to cite this article:
Sharma S, Sharma S. Obesity epidemic: Striking the younger age group.Med J DY Patil Vidyapeeth 2020;13:333-334


How to cite this URL:
Sharma S, Sharma S. Obesity epidemic: Striking the younger age group. Med J DY Patil Vidyapeeth [serial online] 2020 [cited 2021 Jan 27 ];13:333-334
Available from: https://www.mjdrdypv.org/text.asp?2020/13/4/333/290174


Full Text



 Problem Statement



Obesity is a chronic health problem that is now recognized as a global epidemic. It is an illness that is prevalent in all age groups. The prevalence of obesity varies with respect to age, gender, geographical environment, and socioeconomic status. Worldwide ≥1.9 billion adults are overweight, and 650 million are obese.[1] The developing countries are facing high risk of obesity and their adverse consequences due to unhealthy food habits, sedentary lifestyles, and lack of health-care services. In India, obesity is emerging as an important health problem, particularly in urban areas, paradoxically coexisting with undernutrition due to increasing trend toward eating fast food or junk food with poor nutrient content. It has been reported that almost 30%–65% of adult urban Indians are either overweight or obese or have abdominal obesity.[2] India has the second-highest number of obese children in the world (14.4 million), according to a new study published in the New England Journal of Medicine. The incidence of obesity has doubled since 1980 in over 70 countries of the world. The finding of the study is based on data collected from 68 million people in 195 countries.[3]

 Obesity and Dyslipidemia



Abdominal obesity is one of the major risk factors for cardiovascular diseases (CVDs), and the prevalence of obesity among women is reported to be significantly higher as compared to men.[1]

Obesity results in increased fasting plasma triglycerides, high low-density lipoprotein (LDL) cholesterol, low high-density lipoprotein-cholesterol (HDL-C), elevated blood glucose, and insulin levels that result in high blood pressure, increased CVDs, diabetes mellitus, and metabolic syndrome. Metabolic risk factors associated to obesity are the presence of the small, dense LDL phenotype, postprandial hyperlipidemia with accumulation of atherogenic remnants, and hepatic overproduction of apoB-containing lipoproteins. All these lipid abnormalities lead to a pro-inflammatory state in the adipose tissue itself and directly affect the endothelium.[4] Body fat distribution, especially visceral fat accumulation, has been found to correlate well with metabolic syndrome.[5]

In the article published in the current issue by Banerjee et al., titled “Bidirectional Association between Central Obesity and Serum Lipids (Triglycerides and HDL-C): A Community-Based Study on Predictors of Central Obesity,” authors reported that central obesity was present among 66% of study participants, and female gender, high per capita income, poor diet, sedentary lifestyle, decreasing HDL-C, and hypertension were found as predictors of central obesity. The authors also found a statistically significant bidirectional association between serum lipids and waist circumference (WC). Central obesity was found as an important public health problem in their study, and high WC may be considered as a surrogate indicator for dyslipidemia again, emphasizing the fact that central obesity and increased WC reflect dyslipidemia and need stringent control on lifestyle and dietary habits.

Alarming rise in obesity syndrome in children and young adults: in a study done in schools in an Northern state in India, it was observed that high prevalence of sustained hypertension, and obesity was found among urban school children and adolescents. The prevalence of sustained hypertension among rural and urban areas was 5.7% and 8.4%, respectively, and the prevalence of obesity in rural and urban school children was 2.7% and 11.0%, respectively. The adjusted multiple regression models found that urban area, hypertension and high socioeconomic status were significantly associated with an increased risk of obesity.[6]

In another study in Nepalese university students (17–24 years), the prevalence of dyslipidemia was high. Hypercholesterolemia was found in 11.1%, elevated LDL in 12.1%, low HDL in 33.9%, and hypertriglyceridemia in 13.9% of students.[7] According to a new global assessment of child malnutrition by the UNICEF, high rates of childhood obesity are a problem in a rising number of low- and middle-income countries. At least 340 million adolescents worldwide between ages 5 and 19 years, and 40 million children under age 5 years have been classified as overweight. The most profound increase has been in the 5–19 years of age group. The report also warns of so-called “hidden hunger,” in which a child may not be visibly malnourished, but is deficient in essential vitamins and other nutrients, which can lead to impaired growth and immune system function.[8]

As processed food and beverages become cheaper and more widely available, levels of childhood obesity that were once the domain of rich countries are now occurring at lower and lower household income levels. Most of those children live in high- and middle-income countries in North America, Eastern Europe, Pacific island nations, and the Middle East with the US topping the list, with a rate of adolescent overweight around 42%.[9]

From a data analysis published in Lancet, it was reported that the world's population of children and adolescents with obesity is predicted to increase by 70% by 2030, from 150 million to 254 million. World Obesity Federation's, “Atlas of Childhood Obesity,” a 212-page report also raised concern that without intervention, rates of obesity in high-income countries will stabilize at high levels, whereas low- and middle-income countries will struggle to handle a rapidly increasing public health problem of overweight and obesity.[10],[11]

 A Wake-Up Call



Rapid industrialization and urbanization in India, as well as false belief of society about eating out or eating junk food as a sign of affluence or liberalization, has deteriorated the age-old norm of home-cooked healthy food. India is a developing country, which is in a transitional state of undernutrition due to poverty and obesity. The fight against abdominal obesity will require major changes in societal norms and the involvement of dieticians, community experts, and behavior modification specialists in clinical practice to educate the general public, especially children and adolescents and reshape their physical activity levels and dietary habits. Early prevention of overweight/obesity/abdominal obesity in children involves health education at schools, colleges along with promoting sports and active lifestyle.

References

1Ahirwar R, Mondal PR. Prevalence of obesity in India: A systematic review. Diabetes Metab Syndr 2019;13:318-21.
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3GBD 2015 Obesity Collaborators, Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 2017;377:13-27.
4Klop B, Elte JW, Cabezas MC. Dyslipidemia in obesity: Mechanisms and potential targets. Nutrients 2013;5:1218-40.
5Després JP, Arsenault BJ, Côté M, Cartier A, Lemieux I. Abdominal obesity: The cholesterol of the 21st century? Can J Cardiol 2008;24 Suppl D: 7D-12D.
6Mohan B, Verma A, Singh K, Singh K, Sharma S, Bansal R, et al. Prevalence of sustained hypertension and obesity among urban and rural adolescents: A school-based, cross-sectional study in North India. BMJ Open 2019;9:e027134.
7Nepal G, Tuladhar ET, Acharya K, Bhattarai A, Sharma VK, Raut M, et al. Dyslipidemia and associated cardiovascular risk factors among young Nepalese university students. Cureus 2018;10:e2089.
8Childhood Obesity Is Rising 'Shockingly Fast' – Even In Poor Countries. Available from: https://www.npr.org/sections/goatsandsoda/2019/10/17/770905500/childhood-obesity-is-rising-shockingly-fast-even-in-poor- countries. [Last accessed on 2019 Oct 18].
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10NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet 2017;390:2627-42.
11Childhood and Adolescent Obesity Worldwide Expected to Increase 70 Percent by 2030. Available from: https://www.wsws.org/en/articles/2019/10/19/chil-o19.html. [Last accessed on 2019 Oct 18].