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Fayth Clinic conducts workshops in Mumbai to help teens combat obesity

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Dr. Paula Goel is a practicing adolescent pediatrician with special interest in adolescent obesity and its influence on lifestyle diseases in teenagers and young Indians. She is currently the adolescent pediatrician and director of Fayth Clinic, Mumbai – the only clinic specializing in adolescent health services in Mumbai. I got the opportunity to interview Dr. Goel through email about obesity among adolescents, the effects, preventive measures, and the workshops and treatment offered by Fayth Clinic.

 

For the last 6 years, you have worked extensively in the field of adolescent medicine dealing with problems of obesity and its effects in teenagers and young Indians. How would you rate the adolescent obesity ratio in India as compared to other countries? Is it growing at an alarming rate in India?

 

The incidence of obesity in Indian adolescents is about 1/3 of the developed countries, but it is growing at an alarming rate.

 

What do you attribute as the main causes for obesity in adolescents and children in India?

 

  • Overeating
  • Lack of Exercise
  • Increased sedentary activity with lack of exercise like TV viewing for more than 20 hrs per week with decreased physical activity
  • Children exposed to food advertisements and increase in caloric intake
  • Other screen time includes video games, internet use, telephone use, home viewing of movies
  • Heredity factors which reduce basal metabolic rate
  • Socio economic status: More obese in higher socio economic status in poorer countries and more obese in lower socioeconomic status in richer countries
  • Insulin resistance leading to sugar build up causing obesity and diabetes
  • Low leptin levels – does not allow brain to get signal that food intake is enough
  • Endocrine and chromosomal abnormalities

What are the major complications that an obese adolescent can face during adolescence and as an adult

 

Following are the complications faced as young adults:

 

  • Cardiovascular system: high blood pressure, heart attack, brain stroke
  • Respiratory system: breathlessness, asthma, frequent sleep apnoea, hypoventilation. High amount of fat in chest wall / abdomen limits the respiratory excursions which lead to frequent awakening and resultant sleep deprivation leading to daytime somnolence
  • Metabolic disorders: elevated cholesterol, diabetes, insulin resistance, menstrual irregularities
  • Gastro intestinal system: fatty liver, cirrhosis, hemorrhoids, hernia, colorectal cancer , gall stones
  • Malignancy: breast cancer, endometrial cancer, prostratic cancer , cervical cancer
  • Musculoakeletal problems : back pain , joint pains, frequent strains, sprains, limp, groin pain leg bowing
  • Poly cystic ovarian syndrome in young girls : dysmenorrhea, excess body hair ( hirsutism), acne, hair loss on scalp, central obesity, insulin resistance, infertility
  • Behavioural complications: disordered eating ,depression ,negative body image, decreased school performance, social isolation ,decreased self esteem ,bullying, being bullied
  • Metabolic syndrome in young adults characterized by central obesity, hypertension, DM, premature coronary artery disease

How much is the awareness for obesity in adolescents in India? What steps are being taken by you and your clinic to spread the awareness?

Awareness of obesity in India especially in the young population is increasing. Many adolescents suffer from BODY IMAGE PROBLEM and this also results in bulimia, anorexia nervosa and eating disorders which may lead to depression. We hold regular seminars, workshops, community camps and media awareness programs.

 

You have been conducting various workshops for rehabilitating adolescents. Are these workshops conducted only in Mumbai? Are the workshops also conducted in other parts of India? How successful have these workshops been?

 

We are holding these workshops only in Mumbai at present. The results have been rewarding with positive feedbacks from the participants. The take home message has been implemented.

 

Regarding treatment, what are the various plans that you provide to the patient? Who comprise the team (doctor, dietician, counsellor, etc.)? Could you tell us in brief what are the various steps in the treatment and rehabilitation process? In terms of percentage can you tell us how much of medication and counselling is involved?

The Medical Management of Obesity consists of a detailed plan comprising of medical examination to determine the cause of obesity, diet and exercise protocol as per individual needs, detailed history will include onset, progression of obesity, growth and development, family history of obesity and complications. Exploring diet practices, family structure and habits. Over weight child with less than 50th percentile for height are screened for endocrine or genetic conditions. Screening for complications is important. certain conditions like high blood pressure, asthma and orthopaedic problems may require treatment before exercise regimen can be prescribed treatment .Laboratory screening is also required for base line investigations and associated complications .The team comprises of doctor(adolescent paediatrician),dietician and counsellor and exercise therapist. Review is done on a periodic basis .However, medications are not provided for to lose weight. Medication is required as per the medical requirement and counselling is done for all patients.

 

Talking with an adolescent is definitely different from talking to a child or an adult. So do you have to use a different approach in the treatment and rehabilitation of adolescents? (By approach I mean the method of treatment, the counselling done afterwards, even any symptoms and side effects during diagnosis).

 

Approach definitely has to be different. Understanding and gaining trust of the adolescent is very important to maintain compliance during the treatment. Vast majority suffer from problems of body image and also early depression. They are also very sceptical and have their own set of value system which is as per the peer group. So gaining the trust is most important. Once they are comfortable, they open up and counselling is then easier. Diet also has to be looked into carefully as this is a growing phase and severe restriction of diet is not possible as this will hamper growth and development. Moreover, adolescents if put on to a strict diet will always binge and will never comply with the diet plan. Certain weight training exercises are also not recommended as it damages the growth plate which is at the end of the bones and this will also affect the final height of the adolescent. Moreover, if there is any muscle injury, it is more dangerous than bone injury as bone injury is picked up by X-rays while muscle injury cannot be picked up and it takes a longer time to heal. Hence complete physical and medical examination is mandatory before starting exercise protocol.

 

Today we lead a fast pace lifestyle and stress accompanied with studies, competition among peers, peer pressure, etc. What are your suggestions to prevent adolescence obesity in India?

 

  • Lead a disciplined lifestyle
  • Breakfast provides food for the brain and should never be missed
  • A balanced diet with fruits and vegetables
  • Prevent obesity at an early stage of life
  • No child should be forced to complete the portion left behind on the plate in pre adolescent phase as it leads to obesity
  • Should not be given energy-dense foods: chocolates, ice-creams, chips, as rewards for good behavior
  • Fast foods/cold drinks be avoided
  • Life style modification -walking, cycling, playing outdoor games rather than video-games, outings- trekking/walking on the beaches instead of malls every week ends
  • Television viewing-a sedentary activity must be restricted. Snacking during TV viewing be condemned
  • May have medical reasons-evaluation required
  • Positive peer pressure through friends and peer educators may also be used to motivate to lose weight and to cope with body image problem, emotional taunts and emotional blackmail

How many workshops have you conducted on adolescence obesity? When is the next workshop scheduled to take place?

 

We have conducted about 4 to 5 workshops. The next workshop is due in January 2011.

How does one register for attending the workshop?

 

Either by phone (Mansi Kothari, Fayth Clinic admin 9869505556, tel: 02224311616/14) or by email services@faythclinic.com. For further details about Fayth Clinic visit www.faythclinic.com.

 

 

 

Cryo-Save India forays into the Western region

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Cryo-Save India, the 100% Indian subsidiary of Cryo-Save Group, announced their foray into the western region of the country by launching a full-fledged marketing set-up in Mumbai. The new office is part of their strategic plan for India and is envisioned to further strengthen the company’s position in the Indian market. To cater to parents growing need of providing bio-insurance to their offspring, Cryo-Save India has plans for a phased launch in key centres across the country. In Maharashtra, the city of Mumbai alone has 50,000 births per year and Pune has over 20,000 births every year in the Sec (Socio-Economic classification) A & A+ category. The company’s sales office is head quartered in Mumbai and their Maharashtra plans include representation in cities like Nagpur, Aurangabad, Pune, etc.

Cryo-Save India, with its corporate office in Bangalore, was recently set up with an investment of 1.8 Million Euros. Cryo-Save Group will scale up its investment to 2 million Euros within a year of its operation of the Indian subsidiary. The group company, Europe’s largest adult stem cell storage bank, has its operations in 37 countries across three continents. Cryo-Save India brings to the table a depth of expertise and experience in stem cell banking.

Cryo-Save India will be the only company in India with its unique offering of dual-storage system and this will be available for the first time in the country. They are also the only company that does automatic processing to avoid manual intervention and contamination. The company will be offering the collection and storage of ADULT stem cells derived from cord blood. The services will be available across all metros and other cities.

V.R. Chandramouli, Managing Director, Cryo-Save India, said, “We are very keen to extend our footprint to India specifically in the Western market as we see an immense market potential for adult stem cell banking or family banking in the Maharashtra region. A world-class stem cell banking service was the need of the hour for a huge market like India and Cryo-Save India will be offering this. We believe that the launch of the Indian operations has ushered in a new chapter in the quality of stem cell banking services offered.”

For more details on Cryo-Save India please visit http://www.cryo-save.com/india/index.html

Maharashtra earns an estimated 6 lakhs from fines for smoking in public places

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Less than three months of the ban on smoking in public places, the FDA claims to have already collected a whopping fine of Rs. 5, 79,925 from those found breaking the rule in Maharashtra. This collection is the amount that has been taken till November 2008 and is among the biggest collected from a state in the country.

The ban on smoking in public places was already in place since 2004. However, due to lack of awareness, required manpower and infrastructure, it did not provide the expected results. The Central government had reinforced the ban on smoking in public, which was imposed under the Prohibition of Smoking in Public Places Rules, 2008. The ban came into force from October 2, mainly to protect individuals from the hazards of second-hand smoke and to help smokers kick the habit. With the help of 250 FDA officials and support of police personnel, fines were successfully collected.

Mr. Mohan Patankar, Jt. Commissioner FDA, says, “This ban was long introduced in 2004 and we did our best to fine the offenders even then. The collections from 2004-2008 (July) amounted to Rs 2, 55,000 as against Rs. 5,79,925 in just four months (Aug- Nov 08).This was largely due to lack of infrastructure, necessary manpower, vehicles etc. Now, due to increased awareness and support from police personnel, we have noticed significant reduction in such instances. Hotels and restaurants have also strictly been following the ban. Easy availability of challans and receipts has also facilitated the process. It can be downloaded from the net for HR administrators and other competent authorities.”

The public was also more sensitized about the ban and there was a massive public support for the ban which played a significant role in the implementation of the ban.

Dr. PC Gupta, Director, Healis Sekhsaria Institute for Public Research said, “We applaud the FDA on providing us with this encouraging sign. The fines are crucial in the attitudinal transformation among general public and create a higher level of awareness. The general public already understands the significance of the ban and supports its cause. In our survey 92% respondents all over India and 96% in Mumbai strongly favoured regulations for making all workplaces and public places in India smoke-free. We are confident that effective implementation of policies such as smoke-free public places and pictorial warnings on tobacco products will play a concrete role in improving public health. Perhaps the government should take a cue from the success of this ban and implement the much awaited law on pictorial warnings; it is high time to do so in the interest of the public.”

The implementation of a smoke-free environment is the primary and most effective way to ensure that a non-smoker’s right to good health and right to breathe air devoid of smoke should be given preference over a smoker’s right to smoke and cause harm to those around him/her.

You can visit www.healis.org for more details

Written by sreelakshmi

7 January, 2009 at 10:56 pm