Think you are slim? New norms may make you obese

Health experts lower BMI and waist size cut-offs for Indians

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Lose some extra kilos and a few more centimetres from the waist to be healthy now. Because experts have just lowered the benchmark to measure obesity as Indians are more prone to lifestyle diseases like diabetes.

So, Indian men should keep their waist size below 90cm (35 inches) and women below 80cm (31.5 inches). Anything more will mean they are obese, according to the new norms endorsed by the Union health ministry.

The World Health Organisation (WHO) waist size cut-off for abdominal obesity is 102cm (40.2 inches) for men and 88cm (34.6 inches) for women.

Breaking away from the WHO standards, experts have also lowered the body-mass index (BMI) cut-off for Indians. BMI is the ratio of weight in kilograms to height in metres squared. The new norms say a person with a BMI of 23 will be considered overweight while one with a BMI of 25 will be obese. The WHO standards call a person with a BMI of more than 25 overweight and anyone with a BMI above 30 obese.

Also, according to the new norms, an Indian with a BMI of more than 25 is a fit case for drug therapy to control obesity while those with a BMI of 32.5 or more can go in for bariatric (stomach-stapling) surgery.

The WHO had recently asked all countries to formulate their own standards based on their genetic, social, and economic requirements.

The Indian standards were prepared with the help of more than 200 experts from the Indian Council of Medical Research, National Institute of Nutrition, AIIMS, Sir Ganga Ram Hospital, Indian Association of Advancement of Research on Obesity, Association of Physicians of India, Fortis Hospital, Diabetes India, Diabetes Foundation, Nutrition Foundation of India, and Research Society for the Study of Diabetes.

Endorsing the revised BMI and waist circumference limits, Dr PK Chowbey, senior surgeon at Delhi’s Sir Gangaram Hospital, said: “The clinical presentation of obesity, its associated metabolic dysfunctions, and their problems in Indians is different from the Western population. There was an urgent need to have guidelines for the Indian population. Indians have to be treated as Indians, not as Americans or Europeans.”

Dr Anoop Mishra, head of diabetes and metabolic diseases at Fortis Hospitals, New Delhi and Noida, said: “Indians have a different composition of the body, and that puts them at high risk for diabetes and hypertension. We need to intervene early with diet, exercise, and drug therapy. For this, the need to lower international guidelines for obesity and abdominal obesity was almost urgent.”

The revised guidelines are expected to benefit 15-20% (6-8 crore) of Indians.

Obesity in India
* Obesity has reached an alarming stage. Current figures in New Delhi indicate that every second person fulfils the criteria of obesity or has excess abdominal fat.
* Nearly 1/4th of the adolescents have syndrome X, which predates diabetes and heart disease.
* The current load of diabetes in India is expected to increase by 170% in the next 20 years. An India-US collaborative study indicates that 1 in every 10 person in Delhi is a diabetic and 1 in every 5 Indian in US is a diabetic.
* The absolute mortality due to CHD shall increase in India from 1.59 million/year in the year 2000 to 2.03 million in 2010 and 2.58 million by the year 2020, an increase by 61%.
* One in every three Indians has high levels of triglycerides (a form of bad cholesterol) and 30-70% has low levels of HDL (good cholesterol).
* One in three urban Indians have high blood pressure. It is predicted to increase by 60% in next 20 years.

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