http://in.lifestyle.yahoo.com/wellness/whats-wrong-pot-belly-article-ilpv.html
Wellness
What's wrong with his pot belly?
Bellies are a touchy topic: we know plenty of men consumed by erratic schedules, following unhealthy lifestyles who are expanding their middles, don't we? But their large tummies aren't just an appearance-related issue. What's worrying is that this puts them at risk of the metabolic syndrome.
Bellies are a touchy topic: we know plenty of men consumed by erratic schedules, following unhealthy lifestyles who are expanding their middles, don't we? But their large tummies aren't just an appearance-related issue. What's worrying is that this puts them at risk of the metabolic syndrome.
What is the metabolic syndrome?
MS is a combination of health markers that include high blood pressure, LDL (bad cholesterol) and triglyceride levels, blood sugar and abdominal obesity that increase the risk of diabetes and heart disease. It is also called Syndrome X and Insulin Resistance Syndrome. According to Dr Anoop Misra, Prevention advisor and chirman, Fortis CDOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Fortis Hospital, New Delhi, the metabolic syndrome is on the rise in urban India. His research shows that more than one-third of New healthDelhi's adult population suffers from it. An article published in the Journal of Association of Physicians of India quotes a Chennai study that found the prevalence of the metabolic syndrome in men to be 40%. According to another report published in Diabetes Research and Clinical Practice, a larger study in Chandigarh that examined the prevalence of MS in both men and women found the rate to be 35%. All published studies on MS seem to point at a prevalence of about 1 in 3 adults, which is incredibly high!What makes us so susceptible?
A large body of medical evidence points to central obesity as being a major risk factor for developing the syndrome. Unfortunately Indians are genetically prone to accumulating weight around the midriff. We also tend to turn energy-giving foods (carbs) into fat more easily. Actually, the percentage of fat in our bodies at a particular weight is much higher compared to Caucasian people of the same weight.Known as 'the thrifty gene' response, it was an evolutionary blessing secured to survive droughts (by storing energy as fat that could be utilised when food was scarce). But this now puts us at risk of developing both heart disease and diabetes. "Although food is now plentiful, these genes continue to store energy in the form of central fat," explains Dr Sujoy Majumdar, consultant endocrinologist, Ruby General Hospital, Kolkata.What are the signs?
You are unlikely to 'feel' this condition coming on. According to a study by the British Medical Journal, there is a link between chronic job stress and MS: the higher the stress level, the greater the chance of developing the metabolic syndrome. So if you have been feeling under a lot of pressure lately, it's time to lighten up.
Interestingly, a study (published in the Journal of Diabetes Science and Techno-logy) done in Chennai, found a correlation between snoring and the metabolic syndrome even after the results were adjusted for factors like age, sex, level of physical activity, smoking and drinking. But then that can hardly be a diagnostic criterion. "The best thing to do is to see if your waistline is increasing-if you need a larger size of trousers, watch out. Also, get your blood sugar levels checked and then take it from there," advises Misra. If you have a family history of diabetes, heart disease and/or obesity, you should get your blood sugar levels checked every year. If they are high then the doctor will recommend other tests (see box on previous page).
What can this lead to?
A person suffering from the syndrome may not feel its outcome immediately, but it puts that person at grave risk of developing both type 2 diabetes and cardiovascular disease (CVD), as well as other diseases related to plaque build-ups in the artery walls, like strokes, and even cancer, later in life. According to several studies, MS increases the risk of developing diabetes anywhere between 9 to 30 times and cardiovascular disease two to four times. The results are evident. We are the diabetes capital of the world and soon to be the CVD leaders too. "Worse, the age for CVD-related cardiac arrests resulting in death has come down to 35 years!" says Dr Suman Bhandari, Director of Cardio-logy and Cath lab, Fortis Escorts Heart Institute and Research Centre, New Delhi. Such deaths could be prevented if the person had been screened for MS and made the necessary lifestyle changes with or without medication, Bhandari adds.
Prevention at every age
KIDSStart healthy habits early on in life and be a role model. Serve healthy, nutritious food: fibre-rich fruits and veggies, healthy fats, lean meats, etc. Cut out the junk: sugary, starchy, fatty foods and soft drinks that carry empty calories, advises Dr K Srinath Reddy, Prevention advisor and president, Public Health Foundation of India. Also, get them moving. (They need at least 60 minutes of outdoor activities daily.) "Let them go out and play in the park, let them take up a sport and encourage them to move around the house, lifting, carrying objects, etc.," Reddy adds.
THE 20S AND 30S
If you haven't been bothered about health in your teens, time to smarten up now. "Start off with at least 30 minutes of daily exercise and take it up to an hour including cardio, weight training and flexibility workouts," advises Vesna Jacob, Pilates expert from New Delhi. "Make sure to be active through the day-whether it's climbing stairs, get ting your own coffee, cooking or cleaning-every step helps." Make healthy food choices. Quit smoking and reduce drinking. Get enough sleep and do what you can to cut stress (do deep breathing, meditate, relax, slow down). "Observe changes in your body-it tells you a lot-and take immediate action if you need to," adds Jacob.
AFTER AGE 35
Your metabolism is slowing down, so you'll find yourself putting on kilos even with the same diet and exercise. "So watch your diet, don't skip exercise and go for annual medical check-ups to make sure that all the health parameters are within limits," advises Bhandari. Also, learn to make yourself and your health a priority, don't neglect it to fulfill other responsibilities, adds Jacob.How is the metabolic syndrome treated?
The idea that so many factors need to be tackled and brought under control may be daunting. But an aggressive effort in changing lifestyles can help tackle the symptoms and even cure the metabolic syndrome, according to Misra. Here's what you should aim for:
Do moderate intensity exercise for at least 30 to 60 minutes daily.Lose weight to achieve a BMI (ratio of weight in kg to height in metre squared) between 18.5 to 23 kg/m2.Adopt healthy eating habits that include reduced intake of saturated fat, trans fat, cholesterol and refined carbs.Attempt to use only half litre of oil per family member per month.Increase intake of green leafy vegetables and fruits.Stop smoking, drink moderately.Manage stress.
If your symptoms don't go away with lifestyle modifications, you may need medication. According to Misra, if your blood sugar levels are high then you may be prescribed metformin. Metformin has dual benefits: it decreases insulin resistance and helps with weight loss. If your triglyceride levels are high then fenofibrates are Misra's first choice as they help bring triglyceride levels down and lower insulin resistance simultaneously. If blood pressure is the primary concern, then ace inhibitors or angiotensin II receptor blockers (like lisinopril, telmesartan, olmysartan, etc.) are prescribed.
Dr Sujata Kelkar Shetty writes regularly on public health issues and is an NIH-trained research scientist.
