A collaborative partner of FitNet A collaborative partner of FitNet
But lo! Everybody getting down from the bus, had a big “bhunri” (Bengali of pot belly in an otherwise skinny guy) and huge central obesity with tones of belly fat. Every one of them!
I stopped for a moment and wondered why. I never saw such scene in my childhood, at least not so many of them. That moment I could realize how India was on the brink of a huge metabolic disaster. An apocalypse was just waiting to strike the nation.
DO YOU KNOW? “At present, the weight of evidence appears to link the thin-fat phenotype to an environmental and lifestyle phenomenon occurring in previously thin people. This is particularly relevant in India, given the pace of transition over the last two decades”.
Source: https://www.ncbi.nlm.nih.gov/m/pubmed/21892076/
Enough of the series of blog posts and gyans. Now let me tell an amazing story. This is the story of an Indian getting skinny fat, sick and down and then finally getting cured permanently.
This is a story of a boy who lived… No, not Harry Potter, but Raj, an Indian boy. But something which is real, the truth at this point of time. This is a story of several people around you, the problems and the solution.
Beginning of the story:
Raj was born in Kolkata, A city in eastern part of India. His parents were born and brought up in rural areas. They studied and worked hard, settled in a rented house in Kolkata in early eighties. They accumulated some money, bought a television and a refrigerator. Those were the ultimate signs of middle class luxury, back then. No one had heard of shopping malls, Android mobiles, laptops, tabs etc.
Raj’s parents were not amongst the best fed people of the world. They were hard working, lean with short height. They were brought up in the disturbed decade of the seventies. Their parents (grandparents of Raj) had several sons and daughters. They had low family income to support them.
Everybody in the family worked hard and could not get enough proteins and nutrients. But they were skinny with little fat and enough muscles to support their needs. They played a lot of outdoor games in their childhood.
Things changing in the next generation. As Raj’s mother got pregnant the family was filled with joy. Everyone in both the houses celebrated the great news. They have seen enough poverty and decided to have only a single child for proper upbringing and best of care.
Raj’s mother visited a local lady gynecologist every month. She monitored growth and health the mother and the focus. She prescribed her all she needed, from good diet (about 300 kcal with 15 gm protein extra) to iron and folic acid capsules as well as tetvac, calcium and so on. Everything was going fine and the fetus grew well as per Indian standards.
At 36 weeks, mother faced some problems and the family, with green signal from their gynecologist, decided to go for cesarean section.
A baby boy was born, he was named Raj. (parents loved the DDLJ movie and decided the name already, if the baby was a boy!) The 2 families and the relatives welcomed the baby with sweets and celebrations…
During birth the baby weighed 2.2 kg, He was below 2.5 kg, low birth weight and much lower than western standards of more than 3 kg average birth weight. Anyway the baby was okay and discharged few days later.
This brings us to the “thrifty gene hypothesis”.
“Small Indian babies have small abdominal viscera and low muscle mass, but preserve body fat during their intrauterine development. This body composition may persist postnatally and predispose to an insulin-resistant state.”
Source: https://www.ncbi.nlm.nih.gov/m/pubmed/12586996/
Also keep this in mind:
“According to the thrifty genotype hypothesis, the high prevalence of type 2 diabetes and obesity is a consequence of genetic variants that have undergone positive selection during historical periods of erratic food supply.”
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2723682/
For years the generations previous to ours have suffered from below par nutrition and South East Asia, leaded by India, is suffering from a population with lesser muscles, slower metabolism and smaller body frames. Any excess food supply is stored by the body in the central part, at the belly area. This is mostly visceral fat and is really dangerous. This leads to future insulin resistance. That, with several other factors, lead to diabetes, dyslipidemia and cardiovascular diseases. This is now extremely common in India and is increasing day by day.
Back to the story of Raj:
The baby started growing amongst the super care of the family. But mom seemed dissatisfied with the growth. She wanted the baby to grow up bigger and fast. The family pediatrician tried his best to convince that everything is going fine. She should continue breastfeeding till 6 months of age.
But Raj’s mother started lactogen 1 followed by Cereal after 5 months. She stuffed the baby as much as she could with inputs from her parents, friends, neighbors and everyone around, except her pediatrician. She hardly gave growing Raj any family food (as her pediatrician recommended as per age). But she tried all types of baby foods in the market until she succeeded! Raj finally grew up as a 2-year-old toddler with 15 kg weight.
The parents were happy to see their baby overtaking those of the neighborhood. Now came the worry about height. The TV commercials and the print media taught them a lot. All sorts of energy drinks like Complan, Horlicks, Pediasure etc. were tried. They even added sugar to these as well as local dairy milk tastier. Raj, meanwhile, grew fond of chips, kurkure and other processed snacks and started taking them too. She gave the growing Raj all sorts of vitamins to accelerate
The child was literally soaked in sugar, salt, bread (not the home-made roti) and processed food until school age. Raj reached a weight of 30 kg at an age of 5 years. The parents felt an accomplishment seeing their child grow so well. He seemed much bigger and fatter than many other children of the kindergarten. Anyway Raj’s parents felt the first battle of nutrition has been won by them.
But at the back of mind, they felt something was not okay. The family pediatrician has warned them about the excessive weight gain and its future consequences. He also prescribed diet and activities with the help of the dietitian of the clinic. But those were kept in the closet. Damn those funds, they wanted their child bigger, larger and fatter than others. They wanted Raj to be on top of others, right from the word go.
“Children with BMI and waist circumference values exceeding the established criterion values are at increased risk for the adult metabolic syndrome.”
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3988700/
BMI or body mass index takes into account Body weight and height. This, coupled with waist size by tape, can give you idea about the nutritional status of the child. The study was done with these 2 simple parameters, on children at Being.
As these get higher than the standard, the future child becomes more risky. He will have more chance of developing the features of metabolic syndrome, like high blood pressure, diabetes, insulin resistance, obesity, high cholesterol and distorted lipid profile. Premature stroke or heart attack becomes more common.
“During childhood and adolescence, adipose tissue grows mainly by an increase in adipocyte cell number (hyperplasia), especially after birth and in the prepubertal period. The proliferation rate of adipocytes decreases during adolescence and remains stable during adulthood, when adipose tissue expands initially by an increase in adipocyte size (hypertrophy)”.
Remember, Raj has got genes to store fat centrally, even at childhood. (those thrifty genes). As he is growing from a small newborn to a bigger child, his body is storing those extra calories in the newly made fat cells. These fat cells, once created in this age, will stay his body forever.
The food habit of Raj has been adding insult to injury. Those energy drinks, lots of simple carbs and sugar from the childhood foods, is making him grow. But his genes are forcing those extra calories to create fat cells and fill them up.
This could have led to more muscle in a Caucasian child but not in case of Raj. He will grow, gain some muscles, but getting more fat. At the same time, the seeds of insulin resistance is sown. No wonder, he will grow up to a obese, pre-diabetic guy in future, if this goes on.
Back to the story again :
Raj was good at studies and began performing good at school. He, being the only child, was closely monitored by parents and relatives. School also kept a keen eye on him. He studied all day and continued gaining weight. The weight of his school bag and the power of his glasses kept on increasing too.
Raj hardly played any outdoor game unlike his parents (who played and worked a lot outdoors). Besides studies, he spent time eating fast food, playing computer and video games and watching TV. He enjoyed watching runs scored by Sachin or dada rather than scoring one himself in the neighborhood field. He went to school by bus and pool cars . Raj hardly went outdoors in the sun in his whole school life.
“Vitamin D deficiency was found to be an independent predictor significantly associated with overweight and/or obesity among Ethiopian schoolchildren”.
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4848659/
(Please don’t think that Ethiopian study does not hold good here in India. There is not much climatic or basic genetic variation between these two countries.)
Raj had little exposure to sunlight. Besides he had sedentary lifestyle in his school life. These two added on to the damage of his body. Those fat cells created in childhood got filled up with fat.
Moreover, Raj and his peers avoided fresh natural diet like plague. He loved sugar and trans fat loaded high calorie indian snacks and fast food. Food was the only way out from the extreme study stress. He ate and ate to grow up fatter and fatter.
Thus, Raj had been getting more insulin resistant with every passing day of inactivity and being stressed with studies. His parents were more concerned of his career, they wanted him to be a doctor.
He was destined to be a health professional at the cost of his own health.
He knew the importance of career building and studied great and passed his school and plus 2 with amazing grades. He cleared his medical entrance exam and entered the hostel of a reputed medical college in Kolkata.
Raj had walked from frying pan to fire! The medical student days were even more demanding with lots of stress, pressure to perform.
Raj got a Simran too as life partner. All stories of Raj must have a Simran, at some point of time. They married later, but let us keep it different from DDLJ. Here we telling a different story, altogether!
Together they studied, kept awake night after night (studied, chatted or attended late night movies!). They also ate on and on. Unhealthy fast food from hostel and restaurants became the only source of nutrition.
They both grew fatter and lazier. The world seemed medical books, demo classes, wards etc. Raj was studying how to improve others health while damaging his own health in medical school. Please keep in mind, this is the story of numerous Raj-s in medical schools, all over the nation.
This was followed by extreme duty hours in his internship, house job. Finally he got into post grads. But his woes of extreme stress and mental fatigue continued for years.
Raj has develop an amazing “bhunri” or pot belly with host of other problems. Medical students, all over the nation, are stressed beyond capacity. This, along with unhealthy nutritional habits and sedentary lifestyle adds to the injury. Here is what a study from Midnapore medical college reveals:
“Of the factors contributing to obesity, stress seems to be particularly important as stressful condition leads to irregularity in diet, lack of exercise and addiction, each being considered independent factors leading to obesity. Medical education is stressful throughout the whole course of training. The amount of material to be absorbed, social isolation, pressure of examination, discrepancies between expectation and reality all can be anticipated to bring psychological stress”.
Source : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800910/
This applies to other colleges too. Education system of our country comes with all its stresses and demands. This is doing one damage for certain, the health. As people like Raj, are getting along to the middle age, his metabolism, lipid profile, hormonal state etc. are all in disarray. This has to be fixed soon to survive.
Raj, being a doctor, knew this better than everybody else. He had his back against the wall. As he got into his car for practice, his knees ached. His pot belly seemed to be getting bigger every day. He felt weak and always had less energy.
He felt stressed and irritated all the time. He also suffered from irregular episodes of diarrhea and cramping pain. He, being a medical guy, understood he had IBS (irritable bowel syndrome). His hospital duties of odd duty hours, work pressure, night shift, patient calls kept him in high cortisol and insulin resistant state. He knew this but could not get out of the cycle.
Finally, with pressure from Simran, his wife, he decide to investigate. (They had married already. I know that story is important but let us keep it for another day!)
To his dismay, he found his fasting blood sugar was raised, with higher triglyceride levels and high cholesterol and LDL. His HDL was low and HbA1c going up. His ultrasound revealed stage 1 fatty liver. His blood pressure was already high.
He was only in his early thirties! Sky seemed to crush over his head. He knew he had entered the dreaded world of prediabetes and metabolic syndrome at such a young age.
“Metabolic syndrome is a cluster of metabolic risk factors that come together in a single individual. These metabolic factors include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for blood clotting. Affected individuals are most often overweight or obese. An association between certain metabolic disorders and cardiovascular disease has been known since the 1940s.”
Source: https://www.medicinenet.com/metabolic_syndrome/article.htm#what_is_metabolic_syndrome
To know more please click the above link.
Meanwhile, let us return to the last part of Raj’s story…
Raj had no other choice but to consult with his seniors about his problem. He was given medicines like Losartan, Metformin and Atorvastatin. He started morning walk and started taking medications regularly.
But Raj was a fighter. He was not going to succumb to health issues so easily at such a young age. He knew he had to fight back before it is too late.
He searched about any support group in the internet and discussed with friend. He found many online groups for body transformation. But no one was going for the holistic approach. They only gave diet charts and asked him to exercise. But he kept on searching…
Finally he stumbled upon the new kid on the block…
Yes, you get it right, FitNet. Raj and Simran really felt relieved. They knew they were on the right track. A crazy doc, Dr. X was chosen as their fitness mentor.
Both of them started their personalised diet and exercise regimens. Raj touched barbells in a local Kolkata gym for the first time of his life and so did Simran. But they felt really good.
They also took a few days to get adapted to the low carb diet. But their crazy guide, Dr. X, insisted on perfect diet and weight training part. They weighed and cooked their food at home and counted the calories and macros. They stopped eating out, started relaxing techniques, went to gym 4 times a week together, lifted heavy and consulted with Dr. X every week.
Raj noted drop of a few kilograms of weight in a month. He felt full of energy. His pot belly has shrunk and his waist size dropped considerably. His wife also felt the same.
They went to a local shopping mall to celebrate in a weekend. Dr. X had warned them of the high carb, sugary and unhealthy foods. They decided to celebrate by buying clothes of lesser size! For the first time Raj and his wife felt all his clothes are getting looser.
Finally after a month, they tested once again. The magic has occurred. All the parameters of the lipid profile were normal or near normal. The fatty liver has vanished. Blood pressure was normal HbA1c was much lesser. Even Simran, who had been suffering from PCOS, had remarkable improvements in blood and ultrasound pictures! Let us keep her story for another day.
Raj is now great. He eats well, goes to gym thrice a week and vowed to continue this for the rest of his life. There are thousands of Raj in this country with somewhat similar story. Don’t worry, FitNet is there for everyone.
There is no real Raj or Simran as narrated in the story. But there are several stories of people like Raj in the FitNet Facebook group. The official FitNet website is on the pipeline. This blog you are reading, is the content fuel if the group. Read other posts of this blog, if you like it and be a part of the FitNet revolution.
Remember, our nation is on the brink of a metabolic disaster. India is already diabetes capital of the world. Also the country is on the way to be the homeland of highest no. of diabetes and cardiovascular patients in near future.
Together we can fight. Thousands of Raj and Simran are there in this nation. Together we can join hands and fight. Let us fulfill our dream of making India a fitter and leaner nation devoid of obesity, lifestyle diseases and metabolic syndrome.
Stay fit, stay healthy…
[…] The story of Raj and ‘Getindiafit’ […]
[…] These have been explained by thrifty gene hypothesis and in a narrative story style in my post, The story of Raj and GetIndiafit. […]
[…] ‘Thrifty genes’ – undermining our effort. […]
[…] If your answer is YES to most of the above questions, you may be having that weird Bengali genetics problem. This is all about that “thrifty gene” problem of the Bengalis. Read the details of it in a true story (don’t ask me the names!) in one of my old blog : The Story of Raj and FitNet. […]