From Fit To Fat

World Diabetes Day is on 14th November
Diabetes, one the four priority non-communicable diseases (NCDs) identified by the World Health Organization (WHO), remains a misunderstood and neglected epidemic with numbers increasing alarmingly in every region of the world. According to the International Diabetes Federation (IDF), there are over 300 million people with diabetes worldwide with low- and middle- income countries account for 4 out of 5 cases of diabetes. There are 50.8 million people with diabetes in India and 92.4 million in China. To add fuel to fire, India seems to be at a threshold of an 'outbreak' of obesity, more so in urban Indian cities. Read more

Obese children and adolescents are at an increased risk for the development of early-onset type-2 diabetes mellitus (T2DM) and coronary heart disease (CHD). This phenomenon is accelerated by nutritional westernization and sedentary lifestyle. There is a near global consensus amongst doctors and scientists that healthy dietary and lifestyle practices should be inculcated in children to prevent future development of T2DM and CHD.

Unless preventive measures are taken, obese and insulin resistant children will get affected with T2DM and CHD in young adulthood.

According to Prof (Dr) G Choudhuri, Professor and Head, Department of Gastroenterology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, "The age of onset of diabetes is decreasing, and it is occurring at a younger age these days. Diabetes has a strong genetic component but gets unmasked with disorganized lifestyle and eating habits. The 2 important lifestyle issues of concern are increased body weight and lack of exercise. Indians, especially urban ones, are particularly predisposed to exercise deficient lifestyle. These changes are being increasingly observed now in urban children, and nearly 20% or more school kids are overweight or obese, and are potentially at risk of developing diabetes."

Prof Barry M Popkin, a professor of nutrition at the University of North Carolina rues that, "some children, including very young children, snack almost throughout the day. Such findings raise concerns that more children in the world are moving toward a dysfunctional eating pattern-one that can lead to unhealthy weight gain and obesity."

According to Prof (Dr) Anoop Misra, former Professor, Department of Medicine, All India Institute of Medical Sciences (AIIMS) and Director and Head, Department of Diabetes and Metabolic Diseases, Fortis Hospitals (New Delhi and Noida), who is also the Director, Diabetes Foundation (India): "Trans fatty acids are one of the strongest poisons affecting human metabolism today." Trans Fats are found in fast food products made with hydrogenated oil in an unregulated market, a time bomb waiting to explode, even as the Indian Union Health Ministry is contemplating for processed food manufacturers to list the Trans-fat content on nutrition basis.

Diabetes Foundation (India), with help from other global agencies, is striving to create awareness about lifestyle related diseases in children and adolescents through three major community centric health initiatives involving the education of schoolchildren, teachers and parents regarding diabetes and obesity. These are:-

Project MARG (Medical education for Children / Adolescents for Realistic Prevention of Obesity and Diabetes and for a Healthy Aging), which focuses on primary prevention of not only obesity and diabetes, but also of non-communicable diseases in general, by targeting school children in several cities of India.

Project CHETNA (Children's Health Education Through Nutrition and Health Awareness), which aims at prevention of obesity, diabetes, and heart disease, in order to inculcate healthy lifestyle and nutrition habits in school children.

Project TEACHER (Trends in childhood nutrition and lifestyle factors in India) which covers 4 major cities of India to obtain in- depth understanding of nutrition and lifestyle behaviours that affect the health and well being of urban Indians , particularly children, through detailed knowledge attitude and practice survey questionnaires, group discussions and anthropometric measurements of children and their mothers.

Project HOPE (Health Oriented Programmes and Education) with Prof (Dr) G Choudhuri as its founder member - has been concentrating on lifestyle as one of its thrust areas and targeting diabetes prevention as one of its goals. Its mission is to promote health awareness in schools throughout the city of Lucknow. It recognizes that healthy children learn better and that school based programmes can help to influence the health of students.

More such initiatives are needed to encourage our children/adolescents to eat a nutritious diet and increase physical activity. Schools can be targeted to become harbingers of this change by increasing sports activities in their premises and by monitoring the food/snacks preferences of the students. Some schools have indeed changed the school canteen menu to a tasty health menu and have stopped the sale of cola drinks on the campus. It is worth mentioning here that a single serving of soda or other sweetened soft drink contains between 120 and 200 calories of sugar, equivalent to a man's recommended intake for a full day and exceeding the recommended daily intake for a woman.

According to a study conducted by researchers from the University of California, the booming popularity of sugary soft drinks has led to 6,000 more deaths, 14,000 more cases of heart disease and 130,000 new cases of diabetes in the past 10 years. "We can demonstrate an association between daily consumption of sugared beverages and diabetes risk," researcher Litsa Lambrakos said. "We can then translate this information into estimates of the current diabetes and cardiovascular disease that can be attributed to the rise in consumption of these drinks."

What better way to celebrate India's Children's Day this year on 14th November (which coincides with the World Diabetes Day, 14th November), than us parents, teachers, school authorities and youngsters to join hands in this noble endeavour of going from fat to fit, by saying no to colas/ junk food and yes to healthy snacks, and hop/skip /jump/ swim/ cycle/ dance to a diabetes free world.

Shobha Shukla - CNS
(The author is the Editor of Citizen News Service (CNS) and also serves as the Director of CNS Gender Initiative and CNS Diabetes Media Initiative (CNS-DMI). She has worked earlier with State Planning Institute, UP. Email:, website: