On occasion of WORLD KIDNEY DAY

Shed weight, be slim and enjoy life !!

Obesity is not a disease. It is a lifestyle affliction. It is a symptom. It is a side-effect of poor habits and it can be reversed.

Risks associated with Obesity

Obesity is an excess of body fat resulting in a significant impairment of health and longevity . Obesity is dangerous .  Diabetes , hypertension , heart disease , arthritis , liver disease , cancers , psychological and sleep disorders  are associated with obesity . Chronic kidney disease is three times more common in obese individual. Obesity is also associated with kidney stone and cancer of kidneys . Mortality is higher among obese people .

What cause Obesity

In a study conducted covering  many schools in Delhi,  children of different socio economic groups , 24.4 % children were found to be  obese in private schools while only 1.5% of children in government schools were obese . This indicates that children of affluent society are prone for obesity . Why is it so ? Childhood obesity is best tackled at home through improved parental involvement, increased physical exercise, better diet and restraint from eating. 

Whatever we eat gives us energy  or calories. Different foodstuff has different energy value , for example 100 grams of cucumber has 15  calories but 100 gms of jalebi has 300  Calories.  Also once ingested , Jalebi gives instant energy while cucumber  takes more time to get assimilated .

We spend this energy in  two ways – one , to maintain  our basic metabolic processes like respiration , heart beat etc  and secondly for activities like walking , running , weight lifting etc . We spend 100 calories for moderate pace walking for an hour .So eating 100 gms  jalebi is equivalent to walking for three hours ! So think of calories before we eat or drink . 

All junk foods like burger , noodles , ready to eat fast foods , samosa are rich in calories .  Alcoholic beverages are also rich in calories , 30 ml of whiskey contain 75 calories.

If we ingest more calories than what we spend , we accumulate that energy in the form of fat.

Body mass index ( BMI )

Body mass index ( BMI ) tells us about our nutritional status ,whether  malnourished or obese . BMI is calculated as weight in kilogram  divided by square of height in meters ( weight / height ² ).  As per WHO , BMI below 18.5 is underweight , 18.5 to 25 normal , 25-30 overweight and more than 30 is obesity . For Asians , more than 25 is considered as obesity .  

Ministry of Health & Family Welfare along with the Indian Council of Medical Research released updated guidelines (in 2012) that a BMI over 23 kg/m2 is considered overweight. Further definitions: Normal BMI: 18.0-22.9 kg/m2, Overweight: 23.0-24.9 kg/m2, Obesity: >25 kg/m2.

Earlier , Obesity used to be a sign of prosperity and limited to affluent class but now we consider it as a sign of  physical inactivity , because obesity is seen even in poor and middle class people.

Excessive food intake and inactivity is main reason for developing obesity. We hardly spend energy if we just relax and watch television. Eating junk food while watching television or playing mobile  games is easiest way in gaining calories i.e. energy.

Obesity leads to diabetes

Obesity is believed to account for 80-85% of the risk of developing type 2 diabetes. Obese people are up to 80 times more likely to develop type 2 diabetes than those with a BMI of less than 22 . 

Adipose cells release ‘pro-inflammatory’ chemicals, which make the body less sensitive to insulin by disrupting the function of insulin responsive cells and their ability to respond to insulin.

This is known as Insulin resistance - the hallmark of type 2 diabetes. 

Obesity leads to Hypertension

Obese persons have enhanced sympathetic tone,  activation of the renin-angiotensin system (RAS), hyperinsulinemia, structural changes in the kidney, and elaboration of adipokines (hormones produced in fat itself) such as leptin. Renal sodium retention also increases. There is activation of the RAS in hypertension with elevations of circulating renin, angiotensinogen, and angiotensin II.

The pressure of fat deposits around the kidneys, coupled with increased abdominal pressure secondary to central obesity, has been suggested as an additional cause of disordered renal sodium reabsorption.

Glomerular  hyperfiltration observed in obesity sets the stage for progressive glomerular loss and loss of renal function and associated increases in arterial pressure.

Hypertension is associated with well-known sequelae, including coronary artery disease, cerebrovascular disease, renal insufficiency, atherosclerosis, left ventricular hypertrophy, atrial fibrillation, and congestive heart failure.

Obesity damages kidneys

Multiple mechanisms have been postulated whereby obesity directly impacts kidney disease including hyperfiltration, increased glomerular capillary wall tension, and podocyte stress .

Kidneys are also damaged due to hypertension and diabetes due to obesity , increased abdominal pressure on kidneys . Atherosclerotic renal artery stenosis is also a potential mechanism.

How to prevent  or control obesity

To reduce obesity , one must control eating food stuffs rich in calories , eat more of fibers , take fiber rich foods more frequently  to keep hunger at bay and also exercise .Walking or cycling for 40 minutes daily for most of the days of a week  is a good habit. This habit should start right from childhood.

The ancient proverb , ‘ breakfast like a king , lunch like a prince and dine like a pauper ’ holds true for all. You can avoid obesity by following this simple rule. But this simple rule is most difficult to follow . Group therapy is the best way to treat obesity. A group of motivated obese people walking together , exercising together and sharing each others food is a nice way to shed weight. This keeps them motivated to loose weight without going into depression .

Once a person starts shedding weight , diabetes and blood pressure get easily controlled , kidney disease comes under control and arthritis can be avoided.

If you wish to enjoy life , just shed few pounds !