Weight Management of Urban Educated Elderly for Healthy Ageing

Introduction

Weight that is higher than what is considered as a healthy weight for a given height is described as overweight or obese. Body Mass Index (BMI), is used as a screening tool for overweight or obesity. Body Mass Index (BMI) is a person’s weight in kilograms divided by the square of height in meters. A high BMI can be an indicator of high body fatness. BMI does not measure body fat directly, but research has shown that BMI is moderately correlated with more direct measures of body fat. Overweight/obesity is defined by body mass index of more than 24.99kg/m2. Obesity results from the accumulation of excess fat on the body1. Obesity is considered a chronic (long-term) disease, like high blood pressure or diabetes. Obesity has many causes. Our age, gender, genes, psychological makeup, socioeconomic, and environmental factors all may contribute [1].

The distinctive features of obesity in Asian Indians include greater total, truncal, intra-abdominal and subcutaneous adipose tissue compared to white Caucasians. Fat deposition is seen in ectopic tissues like liver, pancreas, dorso-cervical region (‘buffalo hump’) and under the chin (‘double chin’) and this is closely associated with the metabolic syndrome [2]. The prevalence of obesity in India is increasing and ranges from 8% to 38% in rural and 13% to 50% in urban areas. Obesity is a risk factor for development of type 2 diabetes mellitus (T2DM), hypertension, dyslipidaemia, coronary heart disease and many cancers [3].

Between 1998 and 2016, overweight/obesity prevalence increased among men and women in both urban and rural areas [4]. In all periods, overweight/obesity prevalence was consistently highest among higher SEP individuals. In urban areas, overweight/obesity prevalence increased considerably over the study period among lower SEP adults. For instance, between 1998 and 2016, overweight/obesity prevalence increased from approximately 15%-32% among urban women with no education. Whereas the prevalence among urban men with higher education increased from 26% to 34% between 2005 and 2016, No notable changes were observed among high SEP urban women between 1998 and 2016. In rural areas, more similar increases in overweight/obesity prevalence were found among all individuals across the study period, irrespective of SEP. Among rural women with higher education, overweight/ obesity increased from 16% to 25% between 1998 and 2016, while the prevalence among rural women with no education increased from 4% to 14% [5].

Methods

A cross sectional study was done among 106 retired UN organization’s India office. The author had started a series of awareness creation efforts called “Awareness of Health of Ageing Senior Citizens AND Self-Empowerment (AHASAS) “by sharing knowledge to all 106 staff and providing personal advice on diet, exercises and sleep. In early 2018 a total of 23 candidates were identified as obese based on BMI in and were counselled online/over phone to moderate their diet, exercise and sleep practices and setting a target of reducing a weight of 30-50 G per day (10-15 Kg over a year). A follow up study of the BMI was done by this author in June 2019 (12-15 months of practicing the advises) to understand the impact of practices followed by the effected people. Baseline and recent measurements were taken by the staff themselves or their primary health care providers [6, 7, 8, 9, 10, 11, 12].

Results

There were 23 cases of obesity {6–male (26.1%) 17- female (73.9%)}. Out of them 8 cases were with diabetes (34.7%) and 16 cases were with Hypertension (69.1) in 2018. Among them 20 were able to reduce their weight from 3-10 Kg in a span of 12-15 months of following dietary and exercise advises [13]. Two of the three did not continue in the study and one case did not achieve the weight reduction goals despite efforts, though she was able to reduce about 3Kg over a year. Five out of 8 diabetes cases reported a better Blood sugar maintenance and 12 of the Hypertensives reported better control of their hypertension.

Conclusion

General guidelines help obese persons to be aware and take steps to eat sensibly and maintain their normal weight and individual counselling empowers obese people to finetune their diet, exercise regimen and sleep practices to reduce the desired weight and manage their Diabetes and hypertension better.