Minimize the intake of white bread; as it is high in calories and carbs, but low in fiber, protein and nutrients. The simple starches in bread are digested so quickly that they spike your glucose levels just like sugar — and leave you hungry soon afterward. So these foods should be avoided to prevent weight gain and other health concerns like diabetes.
Limit white rice as they are less in fiber and protein but simply are loaded with empty calories. White rice is quickly digested and absorbed, making your blood sugar rise faster. White rice should be avoided if you are diagnosed with prediabetes or if your family has a history of diabetes. If rice is your staple diet try replacing it with brown rice as they are healthier and has more nutrition benefits.
Skinless white potatoes have a very high glycemic index — meaning they raise your blood sugar quickly. So, however you like your potatoes, try to incorporate their skin. The skin’s fiber will slow your digestion and keep you full longer. (You’ll benefit from potatoes’ potassium, phosphorus, and vitamins B and C, too). Try making mashed potatoes with the skin on.
Avoid processed cereals like maida as they are starchier. The more processed a grain is the more unhealthy and calorie leaden it is. Try to consume cereals which have a bigger grain size. Just for an instance atta is more nutritious and healthier than maida. Gram flour is healthier than besan.
Pasta and chips are high in starch which is digested quickly and are low in essential nutrients. You can try for a whole wheat pasta or bean pastas. Their fiber will leave you feeling full for longer. If you want to enjoy crackers, choose whole-grain varieties. Look for brands with minimal added sugar and ingredients.
It’s Reasons and Prevention
Obesity is a disorder which results in an excessive accumulation of the body fat. To keep a check on obesity is not only important for cosmetic reasons, but it causes serious health issues like heart diseases and high blood pressure. If you are obese it is most likely that you may encounter various health problems.
Obesity is a multifaceted health disorder that affects both adults and children. Being obese not only affects the overall persona of an individual but also increases the risk for many health concerns. An obese person is at a higher risk of developing health conditions like diabetes, heart disease, stroke, arthritis, breathing problems, and some cancers.
Statistics have revealed that obesity is a major factor contributing factor for metabolic syndrome and type 2 diabetes mellitus (T2DM) among Asian Indians. Various factors contribute towards making an individual obese. Some major factors which contribute towards obesity are environment, family history and genetics, metabolism or the way your body converts food and oxygen into energy, and individual’s lifestyle. Besides these factors certain medical conditions also leads to obesity. Scientists are also trying to understand that some chemicals in the environment may be playing in the growing obesity problem.
Recent guidelines have revealed that 10-15% of Indian population would fall under the obese category and would need appropriate management. Purpose of these guidelines on countrywide basis projects an alarming situation of T2DM and cardiovascular disease.
Some startling facts about obesity:
According to a recent survey conducted worldwide: India has second highest obese children in world.
Followed by China India ranks second in childhood obesity with the incidence of China with 15.3 million and India with 14.4 million.
According to National Family Health Survey in 2018 –In past one decade the number of obese people has doubled.
According to a latest publication in a medical journal-“The Lancet” –Currently there are 30 million obese Indians and by 2025, this number is expected to pass 70 million.
Did you know lack of sleep increases the chances of obesity- If you do not sleep enough you produce Ghrelin, a hormone that increases your appetite and hence adds extra pounds to your body.
India the third most obese country in the world – According to a study published in a medical Journal Lancet- India is just behind US and China in this global hazard list of top 10 countries with highest number of obese people.
Latest Survey reveals that technology addiction too is adding to obesity amongst young adults and children in India. Television, computers and video games at the cost of sports and physical activity, causing sedentary life style are prime causes of obesity among young ones.
Surprisingly but true-Globally, Obesity causes more deaths than malnutrition -Worldwide, obesity is one of the top five leading causes of death. It results in greater than 2.8 million deaths every year.
What is the need for new guidelines for obesity among Asian Indians?
New guidelines have been proposed in view of alarming situation of obesity among Indians. These guidelines have been prepared by 100 medical experts all across the country hailing from the backgrounds of internal medicine, diabetes, metabolism, endocrinology, nutrition, cardiology, exercise physiology, sports medicine, bariatric surgery and representing reputed medical institutions, hospitals, government funded research institutions. The very need for these guidelines has been enumerated below:
In view of increasing trend in frequency of obesity and related metabolic diseases, there is dire need of effective interventions in obesity
As Asian Indians manifest a higher risk of cardiovascular risk factors and T2DM at lower levels of obesity, the appropriate obesity diagnosis should be based on lower level of weight for height than in non-Asian Indian populations.
Current obesity international guidelines are not appropriate for Asian Indians. Moreover, WHO has authorized local governments and scientists to decide on the localized guidelines for the Asian Indians.
If appropriate diet, exercise, drug and surgery are employed at lower levels of obesity, nearly 15% of the adult population of India (nearly 5-7 crore people) will show improvement in obesity coupled with reduced risk of diabetes and cardiovascular disease.
How obesity is diagnosed among Indians?
Three parameters which are used to measure obesity are body mass index BMI, waist circumference WC and waist-to-hip circumference ratio (WHR). The most accepted method to define thinness and fatness is BMI, a ratio of weight in kilograms divided by height in meters squared (kg/m2).
What are the cut offs for BMI and WC in defining obesity among Asian Indians?
After a major consensus among scientists below table has been prepared to depict the obesity among Asian Indians:
Principal cut-off points
Cut-off pointsfor Asians
18.5 – 24.9
18.5 – 22.9
23.0 – 24.9
25.0 – 29.9
25.0 – 27.4
27.5 – 29.9
Obese (Class I)
30.0 – 34.9
30.0 – 32.4
32.5 – 34.9
Obese (Class II)
35.0 – 39.9
35.0 – 37.4
37.5 – 39.9
Obese (class III)
Source: Adapted from WHO 2004 and recent guidlines
What does recent guidelines say about WC and WHR cut offs in defining obesity?
Research has revealed that abdominal obesity is associated with higher risk of diabetes and cardiovascular disease when compared with generalized obesity. Cardiovascular disease is associated with increased amounts of excess abdominal adipose tissue, both intra-abdominal adipose tissue (IAT) and subcutaneous adipose tissue (SCAT). In view of this a joint discussion and consensus among scientists concluded the WC cut off among Asian Indians as defined below:
Action level 1: Men: 78 cm, women: 72 cm. Any person with WC more than these levels should refrain from gaining weight and adopt healthy lifestyle to prevent the risk of any of the cardiovascular risk factor.
Action level 2: Men: 90 cm, women: 80 cm. Individuals with WC above this should seek medical help so that obesity-related risk factors could be diagnosed and handled.
What are the causes of obesity?
Obesity could be genetic, behavioral and can also result due to the hormonal changes in the body. Obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat. Some medical conditions also result in obesity such as Prader-Willi syndrome, Cushing’s syndrome, and other diseases and conditions. The main reasons for obesity are either sedentary lifestyle or eating unhealthy such as junk foods at wrong intervals.
What are the risk factors that can contribute to obesity?
Obesity usually results from a combination factors, including:
Genetics. Genetics may also play a role in how efficiently your body converts food into energy and how your body burns calories during exercises.
Family lifestyle. Family members share common eating habits. Obesity runs mostly in families as common eating habits of eating fatty foods contribute to obesity.
Inactivity. If you are inactive throughout the day, you are more prone towards obesity. Certain diseases like arthritis also result in decreased mobility and hence inactivity
Diet. A diet rich in fats and less minerals and vitamins can result in obesity
Medical problems. In some people, obesity can be traced to a medical conditions like Prader-Willi syndrome, Cushing’s syndrome and other conditions. Medical problems, such as arthritis, also can lead to decreased activity, which may result in weight gain.
Medications. Some medicines such as antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers also make the person obese
Social and economic issues. Research has shown that weight gain can be linked to social and economic factors.
Age. As we grow in age a decreased physical activity and lower metabolic rate can result in obesity.
Sleep deprivation. Not getting enough sleep or getting too much sleep can cause changes in hormones which may lead to an increase in appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.
What are the complications associated with obesity?
A number of health problems arise if you are obese. Some of the diseases which you may encounter include:
High triglycerides and low high-density lipoprotein (HDL) cholesterol
Type 2 diabetes
High blood pressure
Breathing disorders, including sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts
Gynecological issues such as infertility and irregular periods
Erectile dysfunction and sexual health issues
Quality of life-If you are obese you are most likely to suffer from other issues, which can severely affect the quality of life. Some common problems which arise due to obesity include depression, disability, sexual problems, shame and guilt, social isolation, and poor performance at workplace
How can you prevent obesity?
You can take some below-mentioned steps to prevent obesity:
Exercise regularly. Exercises such a fast walking and swimming for 150 to 300 minutes in a week can prevent obesity
Eat healthily. Eat low-calorie, nutrient-dense foods, such as fruits, vegetables, and whole grains. Refrain from foods which are high in fat content.
Monitor your weight regularly. Keep an eye on your weight at regular intervals as it can help you to assess your weight regularly
What are the recent guidelines on physical activity?
According to joint decision among scientist below is the list of guidelines about physical activity in combating obesity and associated health concerns:
Physical inactivity should be refrained as much as possible
Pro active medical consultation is recommended for those with chronic conditions or those who are symptomatic
Inactive people must switch on to physical activity
Brisk walking (walking at an intensity wherein an individual finds speaking difficult but not impossible) should be encouraged
On an average a total of 60 minutes of physical activity like aerobic activity, work-related activity and muscle strengthening activity should be included daily
For additional and greater health benefits, adults can increase their aerobic physical activity to 300 minutes (5 hours) a week of moderate-intensity, or 150 minutes a week of vigorous-intensity aerobic physical activity
Yoga should be included; however, more research is needed to fully explore its benefits
Children should undertake at least 60 min of outdoor physical activity. Screen time (television/computers) should be less than 2 hrs a day.
What is the treatment of obesity?
The treatment of obesity includes a combination treatment from a dietitian, behavior counselor or an obesity specialist. Recent guidelines suggest identifying and treating the underlying cause of obesity, lifestyle modification, pharmacological treatment like ant-obesity drugs along with lifestyle modification, and if needed surgical treatment is advisable in treating obesity.
Scientists have concluded that anti-obesity drugs should be prescribed in combination with dietary and lifestyle changes as a part of comprehensive weight loss program. Also, drug treatment should be monitored on an ongoing basis for efficacy as well as safety. In general, anti-obesity drugs should be administered for BMI above 27 kg/m2 or a BMI above 25 kg/m2
Anti-obesity drugs which are recommended to treat obesity are sibutramine, orlistat should be used as a second line therapy. At times metformin and exenatide can be used under special clinical conditions.
What is the surgical treatment for obesity?
Over the past few years bariatric surgery has come out as an option for obesity reduction. Bariatric surgery involves an alteration in the digestive system by reducing the gastric volume or by changing the path of food bolus which can lead to malabsorption. According to current international guidelines below are the guidelines for bariatric surgery:
Current International Guidelines: BMI above 35 kg/m2, or BMI above 40 kg/m2.
For Asian Indians: BMI above 32.5 kg/m2
Various surgical options are available under the umbrella of surgery which includes:
Restrictive Procedures like Adjustable gastric banding (LAGB) & sleeve gastrectomy
Combined Procedures like Roux-en-Y Gastric or Bypass (RYGBP)
Malabsorptive Procedures like Bilio-pancreatic diversions (BPD)
Experimental Procedures like ileal interposition
Duodeno-jejunal bypass and other implantable pulse generators.
Pros and Cons are associated with above mentioned procedures; however, it is upon the physician to decide that which surgical treatment is best suited for the particular patient.
Having a positive attitude towards weight loss and employing various changes in lifestyle such as exercising and eating a well-balanced diet can help you to lose weight. Nevertheless, obesity remains a rampant problem even in developing nation like India. Appropriate interventions are required in a timely manner to combat this problem to prevent other major health concerns.
Obesity Support Groups
These inspiring stories of those who have overcome Diabetes will keep you motivated
Put the papaya, orange juice, banana, tofu, coconut milk and root ginger into the blender.
Blend until smooth and serve immediately. (This is also very refreshing on a hot day if you freeze the papaya chunks and banana first)
Note: Papayas are particularly rich in vitamins C and are also a useful source of antioxidants and fibre. They also contain an enzyme called papain which breaks down protein. In Chinese medicine, papayas have traditionally been given to those who find it difficult to digest protein-rich foods.
The combination of papaya, orange juice and banana delivers quite a high glycemic load, which is why we have added some tofu. It would be wise to eat a protein food alongside this too, such as poached and scrambled eggs without the toast, or a piece of fish.
Diabetes is a chronic medical condition, which can severely affect the physical and emotional condition of a patient. Family/partners of people living with diabetes may sometimes find caregiving an overwhelming experience, because of the exhaustive demands in diabetes management. They often undergo emotional, mental and physical stress.
Read on to find out what you can do & how you can cope.
According to ADA, partners/caregivers who do their own little research in diabetes are more equipped and apt in managing diabetes well. Knowing a various aspects of diabetes like what food can be consumed and what self measures one can take to prevent diabetes. Studies reveal books, medical online sites, diabetes communities can be of great help in enlightening about diabetes. Caregivers may also consult a certified diabetes educator to educate themselves about the Do, s and Don’ts of caregiving for people with diabetes.
Avoid “miscarried helping”:
Research suggests, too much nagging can back fire in diabetes management. Psychologist Gerald Straus, calls too much nagging “miscarried helping”.You may be having every intention to help your partner/ patient but studies reveal, miscarried helping may lead your loved ones runningin just the opposite direction”, leading to very poor diabetes management.
Research suggests imposing rules and executing doctor’s instructions in the wrong tone or dialect may rub the patient/partner in all the wrong ways. Studies reveal explaining things compassionately, like what you would appreciate your partner/patient to do, and what may disappoint you, can get you better results in treatment compliance. Dr Strauss, ADA suggests, you can take additional help from expert diabetes educators to ensure your approach is well received and followed.
On the other hand, with children, and adolescents one has to supervise, and sometimes might have to be a little strict to ensure treatment compliance..
Bring in changes together:
Research suggests bringing in necessary lifestyle changes in your life too can help enormously to motivate your partner/patient living with diabetes. By adopting healthy changes together, like eating the same diet, one can manage the conditions better, because people living with diabetes will have company, in making efforts to lead a healthy lifestyle. You may choose to make a few sacrifices to let the patient/spouse you are caring for, know that you are fully committed to the diabetes management programme. A caregiver’s role is one of the most important aspects in diabetes management. A compassionate and well understanding partner can help in addressing the diabetes issues more effectively.
Share your feelings:
We understand that caregiving can be stressful at times. Research suggests, caregivers may often suffer from compassion fatigue and burnout. Compassion fatigue is a common condition observed in medical professionals, nurses, and caregivers.
Dr Charles Figley Professor from New Orleans LA defines, compassion fatigue as a state experienced by caregivers, who are preoccupied in constantly caring for patients, which leads to a degree of self-distress, creating a secondary traumatic condition in the caregiver/helper. Hence, it is most important for a caregiver to stay calm, stress free during the diabetes care for the partner.
Feel free to share your feelings with your spouse/patients/doctors whenever you feel absolutely exhausted. Speaking your heart out can be a very good way to lighten up yourself. There are several ways of coping up with compassion fatigue such as taking up recreational activities, outings with the patient/family, yoga & meditation. You may also choose to seek medical advice if you are completely undergoing burn out.
Make feasible plans
According to the American diabetes association-Setting up realistic goals and taking a step-by-step approach is the easiest and the best way to incorporate lifestyle changes. For example, doing small things at first, like including a 45 minute walking regime daily, may lower your partner/patient blood sugar levels, which can motivate your partner/patient to embrace further inclusions of the diabetes programme. A daily regular regimen followed can help in alleviating the much caused anxiety and helps in keeping a check on the spiked glucose levels.
Make meals interesting:
Studies reveal that meals have been always an area of interest for people with diabetes. Nothing should come your way in serving tasty food, keeping diabetes in mind. Stock your kitchen with healthy fruits and vegetables, so that you can always quickly prepare an interesting snack or meal for frequent munching.
You may want to check out our diabetes friendly recipes, before you step out to shop for grocery for yourself and your partner. We recommend you to have a look at the section-Food as Medicine where our expert Dr. Mona Johar speaks about the right food that can be to prevent and control diabetes.
Have fun while caregiving:
Did you know that you can have fun while caregiving too? Experts say, freestyle singing or off key singing such as singing a parody or making up your own lyrics can be great fun for both the patient & the caregiver. This simple activity can minimize stress. Stress plays a vital role in getting diabetic and controlling when the levels are raised.
Taking a break? You may choose to silly dance and request your partner/patient to join you. This is a great stress buster and can bring smiles to the both of you.
Most Important- Take care of yourself:
Studies reveal caregivers often put themselves at last, in terms of caring for themselves. This can really take a toll on both their physical and mental health. Joan Lunden’s “Camp Reveille” exclusively for caregivers suggests that, caregivers must take out time to nourish their soul, mind and body.
The following are the few activities for thecaregiver’s, listed as the caregivers“favourites” that can easily be done in the comfort of their homes.
Meditation – meditation can be done, anywhere, anytime. It delivers a sense of calm and peace, making it an excellent stress and tension reliever. If one can spare 10 minutes or 20 at the beginning or end of your day, it can help ease tension and allow you to gain a new perspective on a stressful situation. There are many forms of meditation, so try a few to find the one that works best for you.
Morning and Evening Stretches – Beginning and ending your day with some gentle stretching can relax and release tired muscles, improving circulation and range of motion. Just a few minutes each morning and evening can make an impact on your day.
Tai Chi – Tai Chi is a Chinese form of workout, which involves a series of slow, graceful movements accompanied by gentle deep breathing. Some describe Tai Chi as “meditation in motion.” It’s an excellent, low-impact exercise that reduces stress and anxiety while getting your energy flowing.
Yoga – Yoga basicallyfocuses on the synchronization of movement and breathing, yoga builds strength, stamina, balance and flexibility. It can help reduce stress and lower blood pressure, while improving your overall fitness. Along with meditation, there are a variety of yoga forms. You may also choose to enrol in a yoga centre.
Pilates – This popular form which focuses on building core strength and torso stability, which improves levels of strength, balance, flexibility, muscle tone, stamina, and general well-being. Pilates is an excellent option for any age or fitness level as the exercises can be done on a floor mat or Pilates equipment at home.
Conclusion- Though diabetes is a chronic disease but managing diabetes can be achieved with the help of lifestyle changes. It is vital for the caregiver and patient to stay happy and cheerful during the journey of diabetes management. Right modalities opted can help manage diabetes and can make the journey comfortable both for the patient and caregiver.
Famhealth, derived from the term family health is a platform,
that strives to help the patient and the ‘family health guardian’
navigate through various issues related to the health of her family.
Famhealth derived from the term Family Health is a healthcare venture in bringing people with common health conditions and concerns together.
Patients and their caregivers have questions that remain unanswered. We plug this information gap by aggregating; curating and disseminating evidence-based information through various media platforms.
We strive to help the patient and ‘family health guardians’ navigate through various issues related to their health by Informing, Inspiring and Empowering them. In short, equipping families to take informed, thought-through decisions.
We have a wide network of experienced super-specialists who advise us and our medical content is created by an unbiased team of professionals with a cumulative experience of more than 100 years and who come from various backgrounds – medical, media, advertising, digital, and academics… mostly humanitarian. We are proud to offer India a platform dedicated to healthcare people can trust.
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our core team
asha kapoor, MD
Close to 30 years work ex in advertising and marketing. Began her career in account management at Lintas (Delhi and Mumbai) and McCann Erickson (Delhi and Mumbai) as also by working on iconic brands like Dettol; Disprin, Stayfree; J&J Baby products. L’Oreal etc.
A stint at McCann Erickson New York (Consumer Health) followed by setting up new ventures:
McCann Healthcare India, one of the first specialist agencies in this domain.
As an Executive Director & President a Sudler & Hennessey India & Singapore, a high-end specialist niche communications company (a WPP/ Rediffusion Y&R company. This encompassed setting up a series of disciplines ranging from consumer advertising (OTC businesses), direct marketing, BTB marketing, loyalty programs, a medical knowledge bank and PR not just for India, but Singapore too.
Worked as Director Marketing at Ozone Ayurvedics, and as Director, Business with Tag Worldwide.
vibha paul rishi, investor, chief whip & advisor
Vibha holds a BA (hon) degree in economics from Delhi University and a Master of Business Administration degree from the Faculty of Management Studies, New Delhi. Vibha Paul Rishi is an experienced marketing professional with stints in Indian and international markets, coupled with an abiding passion for people.
Her last role was as the executive director, brand and human capital of Max India Limited. Prior to this, she was the director, marketing and customer strategy at the Future Group. She served PepsiCo for 17 years in leadership roles in marketing and innovation in India, US and UK. She was one of the founding team of PepsiCo and Titan watches when they started up in India.
She serves on the boards of several reputed companies such as Asian Paints, Indian Hotels, Tata Chemicals etc. She is also on the board of Pratham, an NGO that works to provide education to underprivileged children in India . Recently she was appointed to the Faculty Board of her alma mater FMS , Delhi University.
maulshree joshi, content & strategy director
Ex National Director Group M’s Motivator, Maulshree Is a seasoned advertising and content professional with over 15 years of cross functional experience in the Industry.
She was with GroupM for about 10 years, where she had stints at various GroupM agencies including ESP, Mindshare and Motivator. She worked extensively on creating branded content across brands at GroupM and created India’s first Cookery based reality which ran for multiple seasons on Colors. She also conceptualized the first ever Virtual Reality show on Doordarshan for Perfetti besides many other award winning content projects.
In addition, she launched RadioM, India’s first ‘only Radio content’ agency to harness the power of radio for brands working with Pepsico, Hero Moto Corp, Tata Tea, GSK and many others. Earlier in her career she worked with agencies like Mudra, Lowe and RKSwamy BBDO.
nitin kapoor, founder director and head operations
Over 35 years of diverse experience across industries from the Merchant Navy, Software & Solutions Sales, International trading, Project Management and as an Entrepreneur. Served as an integral member of the NIIT software team in its formative years.
His experience ranges from spearheading and management of operations, key client relationship building, business development (domestic and global), managing liaisons and all that needs in running your own business.
our social responsibility
The large part of health conditions in India today are lifestyle led and are chronic or ‘lifelong’. While our medical fraternity does an outstanding job in treating our diseases and conditions, there is an enormous stress on our healthcare infrastructure.
Efficacy of treatments is very heavily dependent on how well we have modified our lifestyle. We are here to help our country and our doctors by understanding effective patient self-management techniques and consistently complying with these.
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Each one of us is different and react to things differently. Please remember that while many ideas will be shared and discussed on this platform, some of these may not be applicable/suitable for some of us. Hence we urge you to check with your doctor if they are appropriate for you. Also, we neither encourage nor subscribe to any discussions on a specific doctor, hospital or treatments on this platform.
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