India’s new disease of plenty

For centuries Indians have had to live with the fear of famine and malnutrition. A poor monsoon season and crop failures brought economic dislocation, social upheaval, starvation, disease and death.

In the 21^st century that danger, while not eliminated, is receding, just as another is taking hold — an epidemic of diabetes, cardiovascular disease and related health issues linked with overweight and obesity.

India is one of the few countries in the world that must simultaneously grapple with the problems brought on by poverty and over-consumption. The latter came to the attention of the media recently when Air India decided to test more than 3000 of its employees and found around 20 per cent of them were overweight. The airline promptly ordered a strict regimen of diet and exercise on pain of dismissal.

Many Indians find it difficult to get their minds round the fact they should be addressing overweight and obesity when for centuries there have been millions who did not have enough to eat.

When I made my first visit here almost four decades ago, it was a rarity to see anyone in the street carrying excess kilos. Today those same street scenes are very different. The Minister of Finance, Arun Jaitley has had treatment for diabetes. Bariatric surgery, where the size of the stomach is reduced in order to physically limit the amount of food it can contain, is on the rise.

In April the World Health Organisation reported that more Indian men die from diabetes than in any other country, the condition accounting for two per cent of all deaths across age groups.

Inevitably, the rise in western-style junk food outlets, persuasive advertising, and the increasingly sedentary lifestyle of many middle-class Indians have been blamed for this new epidemic and undoubtedly these have had their influence; but there may be a more deep-rooted reason, buried in the country’s psyche.

When for centuries people have lived one bad harvest away from starvation, the tendency has been to tuck into the food in the good years in readiness for the bad times — as in the Biblical seven fat years and seven lean years — now for many the lean years never appear and the fat keeps building.  

A recent European Union-funded study into weight loss and diabetes has revealed that a significant loss of weight in overweight and obese people (around 10 per cent of total on average) is by the far the best way of reducing the likelihood of type 2 diabetes.

While the study concentrated on the soaring rates in fully developed countries, the same has to apply in India and China, which between them now account for 19 per cent of the world’s overweight and obese people.  

Air India’s ultimatum to its over-indulging employees is probably not the best way of addressing the issue on a national level, but it should be a wake-up call to the country’s health authorities that more needs to be done before this already weighty problem overwhelms them.