Urban Indians Growing Fatter With Westernized World

Eight college students crowded around a table for lunch at the Bengali Sweet Market, its counters heaped with deep-fried pastries, cashew-paste candies and spongy dumplings swimming in syrup.

When asked if they worry about what they eat, the students burst out laughing.

"Every day, it's a McDonald's cheeseburger and chocolate ice cream with fudge and lots and lots of nuts," said Megha Kaushik, 21, before ordering platters of Chinese chow mein for the whole group of friends, who range from slender to plump.

Health experts, however, are concerned. As India struggles to eliminate malnutrition among the rural poor, wealthy urbanites are packing on extra pounds due to sedentary lifestyles and the growing abundance of sugary, high-fat foods.

While city-dwellers account for only 5 percent of India's billion-plus population, they consume 40 percent of the country's fat intake, according to The Times of India.

And in the same country where 4 million people died of famine in 1943, the Indian Medical Association reports that one in three residents of Delhi is now obese. Residents of the capital consume 20 percent more fat and 40 percent more sugar than they did 50 years ago.

Nationwide, 31 percent of urban Indians are either overweight or obese, according to professor Anoop Misra, a specialist in metabolic diseases at the All India Institute of Medical Sciences, the country's leading medical school.

Experts use a height-to-weight ratio called a body-mass index, or BMI, to define weight ranges. Overweight people have a BMI of 25 and above, while those who are obese score 30 and above.

Those levels, however, are largely based on research on Caucasians. Since Asians typically have higher percentages of body fat, Misra says, even those with lower BMI scores are likely to encounter health problems.

Although researchers are still working to collect nationwide statistics, current studies have prompted the government to take action. Officials signed on to a World Health Organization plan that promotes, among other strategies, healthier school lunches and standardized food labels.

While the government isn't bound by the plan, "it's a toolbox, really, that shows their commitment," WHO representative Cherian Varghese said.

But the country is unlikely to slim down overnight.

Indian food isn't exactly low in calories. Along with local fare — featuring saucy potatoes and flatbreads smeared with ghee, a type of clarified butter — many Indians celebrate the country's numerous festivals by gorging on sweets. Trays of candies accompany social occasions, including birthdays, funerals and all the milestones in between.

Still, Western junk food is the main factor tipping the scales of the growing trend, said preventive cardiologist K.K. Aggarwal.

"Any food item artificially prepared with carbohydrates — white rice, white bread and white sugar — causes problems," said Aggarwal, adding that many Indians do not take nutrition seriously. "Obesity is a disorder. It's as bad an addiction as smoking."

Furthermore, obesity can triple the risk of heart disease, WHO figures show. The bulging waistlines of Indian urbanites are triggering more cases of diabetes, high blood pressure and heart attacks.

"Indians are more prone to heart attacks," Aggarwal said, noting that the mean age of 45 for Indian heart attack victims is 10 years younger than for Americans. He said among Indians, heart attacks were more severe, causing more sudden deaths.

Statistics for young Indians are also alarming. One in 10 New Delhi residents ages 14-24 is obese and 5 percent have high blood pressure, according to the All India Institute of Medical Sciences, the country's leading medical school.

India isn't alone. Studies indicate heart disease, high cholesterol and diabetes are on the rise throughout Asia.

Genetic factors influencing metabolism also place Asians at higher risk for weight-triggered problems. A 5-foot-10-inch Indian man, for example, who weighs 167 pounds likely has a metabolism similar to that of a Caucasian who is just as tall, but weighs 202 pounds, according to a recent study by research groups from Asia, Australia and New Zealand.

Of course, the same economic growth that fuels India's super-sized fast-food industry — expected to top $1 billion in 2005, according to the Worldwatch Institute, an independent research group — also allows more people to live increasingly sedentary lifestyles. Most middle- and upper-class Indians hire servants to tend to household chores and chauffeurs to drive them from door to door.

"If you have money here, you're very, very comfortable," said K. Sachdeva, a doctor at Personal Point, a weight-loss clinic in the more upscale area of south New Delhi. "We're dependent on servants who will cook, servants who will clean."

Indians traditionally have regarded chubbiness as a sign of prosperity, and families admire brides with a few extra pounds. But with the popularity of svelte Western movie stars, as well as those from India's own Bollywood studios, ideas about good looks are shifting, particularly among the wealthy.

"They're very weight-conscious now," Sachdeva said, referring to her clients. "The young people, they want to dance, to wear dresses, to slim down."

Even some older people want to lose a few pounds, she said, recalling a 78-year-old client who wanted to get rid of the love-handles that peeked through the gaps in her sari.

"She wanted the pudge to be gone," Sachdeva said.

To tap into the demand for weight-loss help, fitness clubs and gyms have sprouted up in cities across the country. Body-sculpting clinics promise quick results from tummy tucks and liposuction. Even auto-rickshaws display bumper stickers advertising phone numbers for programs encouraging people to "Lose weight now! Ask me how."

Despite the growing interest in fitness, however, many children and teenagers do not exercise enough, according to dietician Rekha Sharma. One in six adolescents in urban areas is overweight, reports the weekly magazine India Today.

"They study, sit at a computer or watch television with nothing else in between," Sharma said. "The patients I used to see 10 years back were very different."

Armed with pamphlets, Sharma and her colleagues visit schools and colleges to encourage healthier living, but it is too soon to measure any progress.

So far, most state governments have yet to implement any programs to curb the growing trend toward obesity. If they don't step in, experts fear the problem — and the people — will just get heftier.

Of the eight students gathered for lunch at the Bengali Sweet Market, only three said they exercise regularly. One lifts weights, while another practices yoga a few times a week.

The third, Kaushik, admitted that she'd like to lose a few pounds. But her motivation doesn't come from any doctor or health education program. Her reason is more personal.

"I walk a few times every week." she said. "I have to think about a future marriage."