A Time-Device Called X
What is Syndrome X
It is a combination of medical disorders that increase the risk of developing cardiovascular disease and diabetes. Also know as insulin resistance syndrome.
Risks
Syndrome X can lead to hypertension, heart disease, infertility, diabetes and other metabolic-related diseases.
Causes and signs
- Biggest causes are sedentary lifestyle and an increase in processed foods consumption.
- Excessive abdominal weight is the first visible sign and parents must have their children checked for syndrome X.
What the government is doing
- For the first time the government has officially reduced the Body Mass Index (BMI) for Indians from the global norm of 25 kg/m2 to 23 kg/m2.
- The ministry of health made this the official cutoff after fears of India becom-ing the global diabetes capital by 2050.
- The government’s note on obesity also recognises that for every 10 kilograms above the normal body weight, life expectancy of a person reduces by 3 years.
Syndrome X in India
Results of a study conducted by the Fortis Hospital on abdominal obesity in Delhi, Agra, Jaipur, Pune and Allahabad.
1/4 children between 14-18 years are likely to have syndrome X
It is more common in girls as they are more sedentary. 36% of the girls and 24% of the boys have insulin resistance. These children are at the risk of developing serious health conditions in early 20s and 30s.
Another study by AIIMS showed govt school children at lesser risk, linking socio-economic factors to the diseases. Asian kids are more prone to it in early childhood. In the West, it’s seen more in adults.
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Doctors’ Recommendations
At home parents must
- Track weight/height and BMI of children
- Restrict TV/Computer time
- Encourage physical activity daily
- Restrict eating out, eating junk food
- Annual physical examination of children
What schools must do
- Give importance to physical activity
- Provide healthy food in cafeteria
- Incorporate more knowledge about nutrition in curriculum
What authorities must ensure
- More playgrounds, parks, walking/bicycle tracks
- Ban on oils and commercial food items containing high amount of trans-fatty acids
- Restriction of advertisement for commercial food on prime time TV and children’s programmes
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That obesity among today’s teenagers is a growing problem is well-known. However, news that syndrome X or metabolic dysfunction among school children is on the increase is a matter of concern since it means the early onset of conditions like diabetes, hypertension, coronary heart disease, polycystic ovarian syndrome and other metabolic derangements. A recent study in five cities (Delhi, Agra, Jaipur, Allahabad and Pune) by Fortis Hospital, Delhi, in the age group 14-18 reveals that one in four Indian children are overweight and likely to have syndrome X. The study concludes that factors such as increase in abdominal fat, insulin resistance, hypertension and obesity are all on the upswing and this will result in an explosion of diseases like diabetes, infertility and heart disease in people even when they are in their 20s.
Syndrome X is defined as a combination of medical disorders that increase the risk of developing cardiovascular diseases and diabetes leading to premature death. The risk factors that develop because of syndrome X include: insulin resistance, obesity (especially abdominal obesity), high blood pressure and abnormalities in lipid levels and blood-clotting. Says Anoop Misra, director and head, department of diabetes and metabolic diseases, Fortis Hospitals: “In children it is very difficult to identify bio-medical features of these diseases. However, abdominal obesity is a good way of assessing the risk for up to 80 per cent of the children. We found that this was more common in girls as they are more sedentary. Insulin resistance was found in 36 per cent of the girls and 24 per cent of the boys. These children are at the risk of developing serious health conditions in their early 20s and 30s.” The Fortis study was carried out this year and included children from government and private schools.
Research in Delhi’s schools by the All India Institute of Medical Sciences shows that in the past 17-20 years, the average weight of a teenager has increased by 5-15 kg. Explains Nikhil Tandon, professor, department of endocrinology and metabolism, AIIMS: “This is a huge jump and the percentage of children who are overweight or obese and the number of them registering symptoms of metabolic dysfunction is very high.” The AIIMS study also measured the skin folds around the stomach and revealed that excess abdominal fat was a common occurrence.
The AIIMS study also revealed that private schools had a higher percentage of students who were overweight, obese or had high abdominal fat when compared to their peers in government institutions. This clearly pointed to a direct link between socio-economic factors and syndrome X and that it had a lot to do with lifestyle and eating habits.
Also a member of the WHO expert group on childhood obesity, Misra identifies the rise of syndrome X in Asian children. In a paper on metabolic syndrome in children in India, Misra notes, “Metabolic syndrome in children assumes significant importance in view of the current epidemic of childhood obesity. South Asian children are highly predisposed to develop insulin resistance, metabolic syndrome and its components when compared with Caucasian children and need more aggressive prevention and management. The emphasis should be on therapeutic lifestyle changes incorporating moderate physical activity and dietary modifications.”
He adds, “There is a substantial link between being overweight and obese in childhood and body weight in later life: 70 per cent of overweight adolescents go on to become overweight adults. It is the responsibility of parents to ensure healthy meals at home, encourage an active lifestyle and become good role models for their kids through their own actions.”
Expressing concern over obesity, the government for the first time has officially reduced the ideal Body Mass Index (BMI) for Indians from 25 kg/m2— the global standard—to 23 kg/m2. The ministry of health made this the official cutoff after fears of India becoming the global diabetes capital by 2050. Those with a BMI of 25 kg/m2 will be clinically termed obese as opposed to 30 kg/m2 at the international level. The government’s note on obesity also recognises that for every 10 kilogram above the normal body weight, life expectancy of a person reduces by three years.
Increase in smoking among the same 14-18 age group is also another area of concern, as smoking is directly related to heart disease. Says Monika Arora, director of Hriday, an NGO that has done extensive study on teenagers, “For the first time in the world, we have found a much higher number of youngsters starting to use tobacco as early as 11 years of age. There is intervention needed here.” The study conducted in Delhi and Chennai covered students from both government and public schools.
Nearly 22 million children under the age of five are estimated to be overweight across the world. And in India we need to urgently address the burgeoning syndrome X problem. If not, younger generations will run the risk of leading lives crippled by various medical complications and their equally malignant socio-economic repercussions.
