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Obesity epidemic in India: intrauterine origins?

  • C. S. Yajnik (a1)
  • DOI:
  • Published online: 01 March 2007

The epidemic of ‘obesity’ in India is not appreciated because BMI underestimates the adiposity of Indians. Specific adiposity measurements are necessary for recognition of the adiposity of ‘thin’ Indians. The origin of this adiposity is only beginning to be understood. In addition to a possible genetic predisposition, intrauterine ‘programming’ might be responsible, although in the ‘thrifty phenotype’ hypothesis the adiposity of the ‘thin’ fetus has not been appreciated. Dutch men who faced ‘winter hunger’ during the first trimester of their in utero life have become more obese as adults. Low birth weight predicts central obesity in some studies, including studies in urban children. It has also been shown that small and thin Indian newborns (weight 2·7?kg and ponderal index 2·4?kg\m3) have poor muscle and visceral mass but higher adiposity for a given weight compared with white Caucasian babies. This body composition is influenced by maternal adiposity before pregnancy and by aspects of maternal nutritional intake and circulating nutrient concentrations during pregnancy. There are no strong paternal determinants of adiposity at birth. Adiposity may be an integral part of the orchestrated adjustments made to support ‘brain preservation’ during intrauterine growth, because brain tissue is predominantly fat. Increased nutrition in the face of a genetic predisposition or multigenerational undernutrition increases maternal insulin resistance in late pregnancy and promotes fetal adiposity even in absence of marked hyperglycaemia. Further research is necessary to define the role of specific nutrients and metabolites in the intrauterine processes promoting adiposity before maternal interventions to curtail the epidemic of obesity and diabetes are planned.

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Corresponding author: Dr C. S. Yajnik, fax +91 020 612 5603, email
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MA Banerji , N Faridi , R Atluri , L Rochelle & HE Lebovitz (1999) Body composition, visceral fat, leptin, and insulin resistance in Asian Indian men. Journal of Clinical Endocrinology and Metabolism 84, 137144.

A Bouchard , J Tremblay , A Deapres , P Nadeau , G Lupien , J Theriault , S Dussault , S Moorjani , A Pinault & G Fournier (1990) The response to long-term overfeeding in identical twins. New England Journal of Medicine 322, 14771482.

M Chandalia , N Abate , A Garg , J Stray-Gundersen & SM Grundy (1999) Relationship between generalized and upper body obesity to insulin resistance in Asian Indian men. Journal of Clinical Endocrinology and Metabolism 84, 23292335.

B Chowdhury , H Lantz & L Sjostrom (1996) Computed tomography determined body composition in relation to cardiovascular risk factors in Indian and matched Swedish males. Metabolism 45, 634644.

D Dabelea , RL Hanson , PH Bennett , J Roumain , WC Knowler & DJ Pettitt (1998) Increasing prevalence of type 2 diabetes in American Indian children. Diabetologia 41, 904910.

M Deurenberg-Yap , SK Chew & P Deurenberg (2002) Elevated body fat percentage and cardiovascular risks at low body mass index levels among Singaporean Chinese, Malays and Indians. Obesity Reviews 3, 209215.

J Eriksson , T Forsen , J Tuomilehto , C Osmond & D Barker (2002) Size at birth, fat-free mass and resting metabolic rate in adult life. Hormonal Metabolism Research 34, 7276.

CHD Fall (2001) Non-industrialized countries and affluence. In type 2 diabetes: the thrifty phenotype. British Medical Bulletin 60, 3350.

CHD Fall , CE Stein , K Kumaran , V Cox , C Osmond , DJP Barker & CN Hales (1998) Size at birth, maternal weight, and type 2 diabetes in South India. Diabetic Medicine 15, 220227.

NG Forouhi , G Jenkinson , EL Thomas , S Mullick , S Mierisova , U Bhonsle , PM McKeigue & JD Bell (1999) Relation of triglyceride stores in skeletal muscle cells to central obesity and insulin sensitivity in European and South Asian men. Diabetologia 42, 932935.

N Freinkel (1980) Of pregnancy and progeny. Diabetes 29, 10231035.

JS Garrow , K Fletcher & D Halliday (1965) Body composition in severe infantile malnutrition. Journal of Clinical Investigation 44, 417425.

CN Hales & DJP Barker (1992) Type 2 (non-insulin dependent) diabetes mellitus: the thrifty phenotype hypothesis. Diabetologia 35, 595601.

JE Harding (2001) The nutritional basis of the fetal origins of adult disease. International Journal of Epidemiology 30, 1523.

WPT James , C Chunming & S Inoue (2002) Appropriate Asian body mass indices? Obesity Reviews 3, 139.

RH Knopp , MR Warth , D Charles , M Childs , JR Li , H Mabuchi & MI Van Allen (1986) Lipoprotein metabolism in pregnancy, fat transport to the fetus, and the effects of diabetes. Biology of Neonate 50, 297317.

G Li , X Chen , Y Jang , J Wang , X Xing , W Yang & Y Hu (2002) Obesity, coronary heart disease risk factors and diabetes in Chinese: an approach to the criteria of obesity in the Chinese population. Obesity Reviews 3, 167172.

A Lucas , MS Fewtrell & TJ Cole (1999) Fetal origins of adult disease – the hypothesis revisited. British Medical Journal 319, 245249.

PM McKeigue , B Shah & MG Marmot (1991) Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet 337, 971973.

DR Matthews , JP Hosker , AS Rudenski , BA Naylor , DF Treacher & RC Turner (1985) Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28, 412419.

A Misra , RM Pandey , R Devi , R Sharma , NK Vikram & N Khanna (2001) High prevalence of diabetes, obesity and dyslipidaemia in urban slum population in northern India. International Journal of Obesity 25, 17221729.

V Mohamed-Ali , JH Pinkney & SW Coppack (1998) Adipose tissue as an endocrine and paracrine organ. Journal of Obesity and Related Metabolic Disorders 22, 11451158.

National Cholesterol Education Program (NCEP) Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Journal of American Medical Association 285, 24862497.

E Oken & MW Gillman (2003) Fetal origins of obesity. Obesity Research 11, 496506.

DJ Pettitt , KA Aleck , HR Baird , MJ Carraher , PH Bennett & WC Knowler (1988) Congenital susceptibility to NIDDM. Role of intrauterine environment. Diabetes 37, 622628.

DJ Pettitt , HR Baird , KA Aleck , PH Bennett & WC Knowler (1983) Excessive obesity in offspring of Pima Indian women with diabetes during pregnancy. New England Journal of Medicine 308, 242245.

DIW Phillips , DJP Barker , CN Hales , S Hirst & C Osmond (1994) Thinness at birth and insulin resistance in adult life. Diabetologia 37, 150154.

A Prentice (2001) Obesity and its potential mechanistic basis. In type 2 diabetes: the thrifty phenotype. British Medical Bulletin 60, 5167.

A Raji , EW Seely , RA Arky & DC Simonson (2001) Body fat distribution and insulin resistance in healthy Asian Indians and Caucasians. Journal of Clinical Endocrinology and Metabolism 86, 53665371.

A Ramachandran , C Snehalatha , D Dharmaraj & M Vishwanathan (1992) Prevalance of glucose intolerance in Asian Indians: urban-rural difference and significance of upper body adiposity. Diabetes Care 15, 13481355.

A Ramachandran , C Snehalatha , A Kapur , V Vijay , V Mohan , AK Das , PV Rao , CS Yajnik KN Prasanna Kumar & JD Nair (2001) High prevalence of diabetes and impaired glucose tolerance in India: National Urban Diabetes Survey. Diabetologia 44, 10941101.

A Ramachandran , C Snehalatha , R Vinitha , M Thayyil , S Kumar , L Sheeba , S Joseph & V Vijay (2002) Prevalence of overweight and obesity in urban Indian adolescent school children. Diabetes Research and Clinical Practice 57, 185190.

S Rao , A Kanade , BM Margetts , CS Yajnik , HG Lubree , S Rege , B Desai , A Jackson & CHD Fall (2003) Maternal activity in relation to birth size in rural India: The Pune Maternal Nutrition Study. European Journal of Clinical Nutrition 57, 531542.

GP Ravelli , ZA Stein & MW Susser (1976) Obesity in young men after famine exposure in utero and early infancy. New England Journal of Medicine 295, 349353.

KS Reddy , D Prabhakaran , P Shah & B Shah (2002) Differences in body mass index and waist:hip ratios in North Indian rural and urban populations. Obesity Reviews 3, 197202.

I Rogers (2003) The influence of birthweight and intrauterine environment on adiposity and fat distribution in later life. International Journal of Obesity and Related Metabolic Disorders 27, 755777.

KM Shelgikar , TDR Hockaday & CS Yajnik (1991) Central rather than generalised obesity is associated with hyperglycaemia in Indians. Diabetic Medicine 8, 712717.

HC Shukla , PC Gupta , HC Mehta & JR Hebert (2002) Descriptive epidemiology of body mass index of an urban adult population in western India. Journal of Epidemiology and Community Health 56, 876880.

BL Silverman , BE Metzger , NH Cho & CA Loeb (1995) Impaired glucose tolerance in adolescent offspring of diabetic mothers. Relationship to fetal hyperinsulinism. Diabetes Care 18, 611617.

EAH Sims (1990) Destiny rides again as twins overeat. New England Journal of Medicine 322, 15221523.

C Snehalatha , A Ramachandran , K Vallabi , MY Satyavani , E Saudax & V Viswanathan (1997) Computed axial tomographic scan measurement of abdominal fat distribution and its correlation with anthropometry and insulin secretion in healthy Asian Indians. Metabolism 46, 12201224.

C Snehalatha , V Viswanathan & A Ramachandran (2003) Cutoff values for normal anthropometric variables in Asian Indian adults. Diabetes Care 26, 13801384.

M Winick , P Rosso & JC Waterlow (1970) Cellular growth of cerebrum, cerebellum and brain stem in normal and marasmic children. Experimental Neurology 26, 393400.

World Health Organization Expert Consultation (2004) Appropriate Body Mass Index (BMI) for Asian Populations and its Implication for Policy and Intervention Strategies. Lancet 363, 157163.

CS Yajnik (2001a) The insulin resistance epidemic in India: fetal origins, later lifestyle, or both? Nutrition Reviews 59, 19.

CS Yajnik , CHD Fall , U Vaidhya , AN Pandit , A Bavdekar , DS Bhat , C Osmond , CN Hales & DJP Barker (1995) Fetal growth and glucose and insulin metabolism in four-year-old Indian children. Diabetic Medicine 12, 330336.

CS Yajnik , CV Joglekar , AN Pandit , AR Bavdekar , SA Bapat , SA Bhave , SD Leary & CHD Fall (2003b) Higher offspring birthweight predicts the metabolic syndrome in mothers but not fathers 8 years after delivery (The Pune Children's Study). Diabetes 52, 20902096.

CS Yajnik , HG Lubree , SS Rege , SS Naik , JA Deshpande , SS Deshpande , CV Joglekar & JS Yudkin (2002) Adiposity and hyper-insulinemia in Indians are present at birth. Journal of Clinical Endocrinology & Metabolism 87, 55755580.

CS Yajnik , KM Shelgikar , SS Naik , MG Sayyad , KN Raut , DS Bhat , JA Deshpande , SD Kale & TDR Hockaday (2003c) Impairment of glucose tolerance over 10yr in normal glucose tolerant Indians. Diabetes Care 26, 22122213.

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