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Paradox in India as mass obesity joins malnutrition as a killer
Sydney Morning Herald - April 15, 2010
Matt Wade, New Delhi – India's economic boom is changing the way its people die. Diseases linked to affluence, especially heart problems, are overtaking poverty-related illnesses such as tuberculosis and diarrhoea as the biggest killers.
As these middle-class "lifestyle" diseases grab public attention, aid workers and child health advocates fear they could distract from efforts to eradicate easily preventable diseases that mostly affect the poor.
A new government study shows heart disease accounted for about a quarter of all deaths of those aged between 25 and 69 between 2001 and 2003. This compares with one in 10 for tuberculosis and about one in 20 for diarrhoea.
In urban areas a third of deaths resulted from heart disease. The figures, from the Registrar General of India and the Indian Council of Medical Research, showed malaria, once one of the worst killers, now accounts for only 2.8 per cent of deaths.
Dr P. C. Bhatnagar, of the Voluntary Health Association of India, said the country was in an "epidemiological transition" that will lead to non-communicable diseases such as heart problems accounting for a growing proportion of deaths.
This shift coincides with rapid economic growth and the huge expansion of cities over the past two decades.
Health experts attribute the increased prevalence of deadly lifestyle diseases to sedentary urban lifestyles among the booming middle class, the rise of vehicle ownership and a higher intake of fatty foods.
Dr Bhatnagar said there was also concern that Indians may have a genetic predisposition to heart disease.
Potentially deadly conditions such as diabetes and obesity have also risen alarmingly.
A recent study by the University of Maryland and the National Council of Applied Economic Research found 22 per cent of Indians living in cities were overweight and 7 per cent were obese.
Overweight and obesity were not confined to relatively affluent households. The survey found the proportion of overweight and obese people living in urban slums was lower but not markedly so.
The Indian Council for Research on International Economic Relations has estimated that "modern life" diseases such as heart diseases, strokes and diabetes could cut national income by $US200 billion ($214 billion) in the period 2005-2015.
At the same time, India has the largest number of malnourished and stunted children in the world. About 48 per cent of children are underweight and almost 2 million under the age of five die each year from preventable disease.
These trends mean India faces a paradoxical burden of fighting the problems of mass obesity and malnutrition.
Santosh Mathew, of Emmanuel Hospital Association, a medical non-government organisation, said the health system had to prevent a disproportionate amount of resources flowing to costly, high-tech treatments for lifestyle diseases at the expense of primary health care in the poorest regions.
"It's a real challenge for resource allocation," he said.
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