2 January 2014

The thin fat Indian - aim to lose fat, not weight!

"Losing weight" is perhaps the most popular of New Year Resolutions. Here's a little titbit in the Indian context.

When you want to lose weight, presumably you want to lose fat? That chubby tyre that you can pick up and measure as a lump everytime you navigate towards your abdomen, or that chunk that you pinch on your thigh. Each morning or weekly you get on the machine and bemoan what number shows up? But what if knowing and measuring your weight is not good enough to indicate if you are healthy?

An oft-used parameter to assess obesity is your BMI - Body Mass Index. You measure your weight, and divide it by the square of your height. You look at the range that your BMI falls in and then categorize yourself in some flattering version of obesity. This test was devised in the west and few people realize that not all tests are applicable across races.

Dr Chittranjan Yagnik of KEM Hospital, Pune coined this term "The Thin Fat Indian" to allude to those of us whose BMI handily falls in the "Normal" category but would be considered obese based on the amount of fat we have relative to our body weight. The only way to measure adiposity (fancy science name for fat) is to do an X-ray absorptiometry scan. Basically a machine that does a full body scan, and based on density can calculate how much fat you have. The other trivial way of doing this to calculate your Body Adiposity Index which takes into account your hip circumference and height only. Yes, no weight measurements involved in this. 

Dr Yagnik has led some fascinating long term studies to show that Indians with a low birth weight, have a low BMI but high fat percentage, and tend also to develop diabetes and cardiovascular diseases more easily. This high percentage of fat in a seemingly *normal weight* individual is maybe why that Chacha died of a massive coronary despite appearing dashingly slim and walking 5 kms daily. You would never suspect that he had a high percentage of fat. One of the reasons for a low birth weight is the mothers' nutritional status during pregnancy. So, you could blame your mother for your lifestyle disease. There is also a new study [Padmanabhan et al., Cell, 2013] that shows that folate deficiency in the maternal grandparent can influence the mental and physical development of the grandchild. Yup, your grandmother is to blame too!

The bottom line is this - doing that item number and getting your body in shape might actually work out better than simply trying to reach the lowest number on that weighing scale. So ladies, do the twist!

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