Close on the heels of International Women's Day 2011, comes the news of a path breaking research which puts the onus of a healthy generation on women. The research, by scientists from the University of Cambridge, provides important insight into why children born to mothers who consumed an unhealthy diet during pregnancy have an increased risk of health problems later in life. According to this research, poor diet can lead to abnormal development of the pancreatic beta cells which make insulin, the hormone vital for regulating blood sugar levels. This can trigger diabetes in adulthood as the cells "wear out" sooner than usual, said Susan Ozanne of the University of Cambridge, co-leader of the team.
"Having a healthy well-balanced diet any time in your life is important for your health," she said, "but a healthy well-balanced diet during pregnancy is particularly important because of the impact on the baby long-term and potentially even on the grandchildren as well."
The warning comes after research found that rats that had poor nutrition during pregnancy gave birth to young with a high risk of type 2 diabetes, an illness that typically strikes in middle age.
As is it, diabetes in women, especially pregnant women, is already having far reaching health ramifications in India. According to Dr Anoop Misra, "Women should be more addressed not only for diabetes but also for heart disease and should be targeted in a special way for prevention programmes. They gain weight in each pregnancy. As their age increases, weight also increases and so do chances of high blood sugar. Events preceding blood sugar elevation are more prevalent in women than in men. So we foresee that in future diabetes will be more prevalent in women."
"Hence it is very important for every woman to be screened for diabetes, which needs to be controlled on an emergency basis in case of pregnant women. If a woman living with diabetes becomes pregnant, her blood sugar needs to be controlled in a more effective manner, as even a slight increase in it will result in an ill effect on the foetus—increase in weight, abortion, malformation, etc. so very often it is advisable to start on insulin during pregnancy and switch over to oral agents later on. This warrants the need to integrate diabetes screening for women in the existing health systems, especially when a woman visits a health centre during pregnancy. Unfortunately, this is not happening at the moment" further adds Dr Anoop Misra.
Dr Anoop Misra is the recepient of Padma Shri - one of the highest national civilian awards in India, and also the prestigious Dr BC Roy Award - the highest award for medicine in India. He is the Director and Head, Department of Diabetes and Metabolic Diseases, Fortis Hospitals, Delhi, and President of National Diabetes Obesity and Cholesterol Foundation (N-DOC).
On one hand women are more prone to have diabetes, but on the other hand they can help more than men in controlling this epidemic. If a young woman, on the threshold of marriage, is made aware of and educated about diabetes, it will benefit a lot many people. If she becomes aware of the importance of proper nutrition and physical exercises, she would be well equipped to control, not only her own health, but of her entire family. She is then likely to take more care of herself during pregnancy, the benefits of which will pass on to the unborn child.
Unfortunately women are a neglected lot, especially in developing countries. They are taught from early childhood to care for others at the cost of their own health and well being. It is unlikely for a common Indian woman to go for mandatory health checkups, unless there are serious external symptoms of a disease. And then perhaps it becomes too late to take corrective action.
The tide of diabetes is rising in urban as well as rural India, with nearly 51million Indians currently suffering from the disease. This number is expected to increase by 150% during the next 15 years. Jason Gale talks of India's diabetes paradox – "In a land where chronic hunger plagues a fifth of the population, a deadly scourge, most often linked to years of affluence, is striking millions as soon as they escape poverty. A perverse twist of science makes Indians susceptible to diabetes and complications such as heart disease and stroke as soon as their living conditions improve. As a decade of 7 percent average annual growth lifts 400 million people into the middle class, bodies primed over generations for poverty, malnutrition and manual labour are leaving Indians ill-prepared for calorie-loaded food—or the cars, TVs and computers that sap physical activity. Researchers are finding the pattern begins before birth: Underfed mothers produce small, undernourished babies with metabolisms equipped for deprivation and unable to cope with plenty."
"If the world doesn't wake up, this thing will knock down generations," said David Barker, a British doctor whose research has helped explain the origins of so-called lifestyle ailments and why they're exploding in India and China. His hypothesis shows that nutrition and growth before birth and during early childhood alter the development of the heart and that people who had low birth weight are at greater risk of developing coronary heart disease.
Maternal health now has a proven impact on future generations. Women who have a poor diet during pregnancy may have children who are more susceptible to age-related diseases than those who have a healthier diet. The issue of maternal nutrition should be taken seriously, as it could become a key diabetes and heart disease prevention strategy. With 55% of Indian women being anaemic and 48% of them being malnourished, Government efforts need to focus more on maternal and child health, and intervene at the maternal and foetal level. Whether the mother is excessively thin/malnourished or overweight—both conditions are fraught with danger for future generations. The diet which a mother eats has to be a balanced one. One must remember that a proper diet does not consist of expensive or fancy/exotic food items. It comprises locally grown/available vegetables, fruits, grains, lentils and dairy products.
So all ye women out there please eat well and live well - if not for your own sake, then for the sake of your children and grand children. (CNS)
Shobha Shukla - CNS
(The author is the Editor of Citizen News Service (CNS) and also serves as the Director of CNS Diabetes Media Initiative (CNS-DMI).She is a J2J Fellow of National Press Foundation (NPF) USA. She has worked earlier with State Planning Institute, UP. Email: [email protected], website: www.citizen-news.org)