Metabolic Diseases and Allied Specialties, Fortis-C-DOC Hospital for Diabetes, B-16, Chirag Enclave, New Delhi, India.
National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India.
Curr Obes Rep. 2019 Mar;8(1):43-52. doi: 10.1007/s13679-019-0328-0.
Obesity has increased in South Asian countries that are still grappling with undernutrition. In this review, we highlight the characteristics of obesity, its relation to morbidities, and its management in South Asians. A literature search was conducted using relevant search engines and based on key words focusing on obesity in South Asians.
The increasing trend in obesity prevalence is caused by imbalanced diets and physical inactivity. South Asians, in general, have higher body fat and lower skeletal muscle mass at the same or lower BMIs compared to white people ("high body fat-normal BMI-low muscle mass" phenotype). In addition, excess abdominal adiposity, typically seen in South Asians, and increased hepatic fat (non-alcoholic fatty liver disease) are associated with an increased risk for type 2 diabetes and cardiovascular disease. Challenges in treatment include lack of awareness regarding correct diets and non-compliance to diet and exercise regimens. Social and cultural issues limit physical activity in South Asian women. Finally, there is a lack of expert health professionals to deal with increased cases of obesity. Aggressive management of obesity is required in South Asians, with more intensive and earlier diet and exercise interventions (i.e., at lower BMI levels than internationally accepted). At a population level, there is no clear policy for tackling obesity in any South Asian country. Prevention strategies focusing on obesity in childhood and the creation of food and activity environments that encourage healthy lifestyles should be firmly applied. Obesity in South Asians should be evaluated with ethnic-specific guidelines and prevention and management strategies should be applied early and aggressively.
南亚国家在努力解决营养不良问题的同时，肥胖问题却日益严重。本综述重点阐述了南亚人群肥胖的特征、与多种疾病的关系及其管理。检索相关搜索引擎，根据关键词，对南亚人群肥胖的相关文献进行了检索。
肥胖流行趋势的增加是由饮食不均衡和缺乏运动引起的。一般来说，与白人相比，南亚人群的体脂更高，骨骼肌肉质量更低（“体脂高、BMI 正常、肌肉量低”表型）。此外，南亚人群特有的腹部肥胖和肝脂肪增加（非酒精性脂肪性肝病）与 2 型糖尿病和心血管疾病风险增加相关。治疗面临的挑战包括对正确饮食的认识不足和对饮食及运动方案的不依从。社会和文化问题限制了南亚女性的身体活动。最后，缺乏专门的卫生专业人员来应对日益增多的肥胖病例。南亚人群需要积极管理肥胖，更加强化和更早地进行饮食和运动干预（即在国际公认的更低 BMI 水平）。在南亚各国，目前没有明确的针对肥胖问题的政策。应制定以肥胖为重点的儿童预防策略，并创建鼓励健康生活方式的食物和活动环境。应根据具体的民族指南评估南亚人群的肥胖情况，并尽早积极地应用预防和管理策略。
