Context: The rise of certain Non-Communicable Diseases like diabetes, obesity and cardiovascular diseases in India, particularly puts women at a higher risk than men.
Non-Communicable Diseases
- Non-Communicable Diseases (NCDs) are a group of chronic diseases that are not caused by infectious agents and typically have a long development period.
- They include a range of conditions such as cardiovascular diseases (e.g., heart disease and stroke), cancer, diabetes, chronic respiratory diseases (e.g., chronic obstructive pulmonary disease), and mental health disorders.
- Risk factors for NCDs include unhealthy diets, physical inactivity, tobacco use, harmful use of alcohol, pollution and environmental factors.
- According to the World Health Organisation, NCDs account for 71% of all deaths globally, with cardiovascular diseases being the leading cause. As per the latest report (2022), 66% of total deaths in India in 2019 were due to NCDs.
About Diabetes
- Diabetes is a lifelong condition that causes a person's blood glucose (sugar) level to become too high. The hormone insulin – produced by the pancreas – is responsible for controlling the amount of glucose in the blood.
- There are two main types of diabetes:
- Type 1 – where the pancreas does not produce any insulin.
- Type 2 – where the pancreas does not produce enough insulin or the body’s cells do not react to insulin.
- Type-1 diabetes:
- Type 1 diabetes (insulin-dependent) is a condition/autoimmune disease in which the body’s immune system mistakenly destroys insulin-making cells (beta cells) in the pancreas.
- The exact cause of this autoimmune response is not fully understood, but it is thought to involve a combination of genetic and environmental factors.
- The condition is usually diagnosed in children and young people, also called juvenile diabetes. Characterised by deficient insulin production, it requires daily administration of insulin.
- Symptoms: Excessive excretion of urine, thirst, constant hunger, weight loss, vision changes, and fatigue.
- Type 2 diabetes:
- Type 2 diabetes (non-insulin-dependent) results from the body’s ineffective use of insulin. It occurs when the body does not produce enough insulin to function properly, or the body's cells become less responsive to the effects of insulin (insulin resistance). This means glucose stays in the blood and is not used as fuel for energy.
- This type is often linked to lifestyle factors like overweight/obesity, physical inactivity, and unhealthy diet and tends to be diagnosed in older people. However, it is now frequent in the population with any age group.
About Obesity
- Obesity is a medical condition characterised by excessive accumulation of body fat, to the extent that it may have a negative impact on health. It is typically defined by body mass index (BMI), which is a measure of weight in relation to height. A BMI of 30 or higher is generally considered indicative of obesity.
- Among women, obesity is typically defined as having a waist circumference greater than 80 cm and a Body Mass Index (BMI) over 30. NFHS-5 data (2019- 2021) indicates that nearly 2 out of every 5 women suffer from abdominal obesity, putting them at serious risk of cardiovascular ailments.
- Several factors that contribute to the development of obesity include:
- Imbalance between the number of calories consumed and the number of calories expended through physical activity and metabolism.
- Diets high in calories, unhealthy fats, sugars, and processed foods
- Lack of physical activity and environmental factors.
- Genetic Factors: Certain genes can influence appetite, metabolism, and fat storage, making some people more prone to weight gain and obesity than others.
Cardiovascular diseases:
- Global Burden of Disease Study estimates heart disease to be the leading cause of death amongst women in India, higher than all cancers combined.
- The strong link between obesity and heart disease has long been common knowledge. Obesity elevates cholesterol levels, increases blood pressure, and causes diabetes — all conditions that lead to heart disease.
Unique observations in India (Thin-fat Indian):
- Indian data provides a unique insight into the evolution of diabetes and obesity in individuals born small and undernourished.
- Indians deposit most fat in and around the abdomen (central obesity, simply measured as waist size). The highest glucose levels were in those who had the lowest BMI but the highest waist measurement.
- An Indian pancreas secretes less insulin, and the secreted insulin cannot act efficiently because of fat deposition in and around different organs.
- The reasons include: Epigenetic.
- Exposure to a challenging environment in the womb (undernutrition, maternal diabetes, infections, stress and others) increases the risk of future diabetes, obesity, and heart disease.
- Malnutrition of babies while still in the womb alters the structure and function of the developing organs, reducing their capacity to cope with stress (overnutrition, inactivity, psycho-social stress, migration, etc).
Govt. Efforts:
- India is the first country to adopt the National Action Plan with specific national targets and indicators aimed at reducing the number of global premature deaths from NCDs by 25% by 2025.
- India has been implementing the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) since 2010 up to District level under the National Health Mission.
Way Forward
- Improving the nutrition and health of young women and their babies when they are in the womb can curtail these epidemics.
- Strengthening access to nutritious food, creating safe and supportive environments for physical activity, and ensuring responsible use of medications.