*Relations between Dietary Habits, Lifestyle and Leading Obesity DOI: http://dx.doi.org/10.5772/intechopen.98307*

of the entire populous under observation were diabetic, where the men suffered from this metabolic disorder far more than the women. Around 10.58% out of the 85 men in this study were diabetic. 8.51% of the overweight and obese women gained weight due to metabolic and hormonal imbalance of the blood-sugar; whereas 8.57% of the overweight/obese men gained weight due to the very same reason. One of the major reasons for weight gain in women of the age range of 15 to 50 was due to PCOS and Hyperthyroidism. Around 15% of the women involved in this study were suffering from PCOS and around 19.14% females who were either overweight or obese had this syndrome as a contributing factor for the weight gain. People who abnormally put on a lot of weight or by lineage, have a high chance of developing polycystic ovaries and that inherently causes hormonal disbalance, fat accumulation, hair loss, facial hair growth and weight gain amongst other things. Women above the age of 50 showed a hike in weight either due to diabetes or menopause. Although there is no proof that menopause is the sole reason for weight gain. These women gained weight despite sleeping properly, eating well, having a proper gap between supper and bedtime, and exercising; thus, further research is required to understand the weight gain in elderly women.

Amongst the overweight/obese women, around 48.93% of the females did not suffer from any sort of major health problems, and still gained weights due to amalgam of reasons, like lesser sleep time, less water intake, lesser gap time between the last meal and bedtime, no exercises. On the other hand, 57.14% of the obese or overweight men who did not have any major health issues, were following a very healthy lifestyle in all aspects. The extra weight could be muscle mass or heavier bones rather than fat accumulation, a factor which is not transparent with a BMI reading.

**Figure 2** shows that 16.66% of the women and 10.58% of the men suffered from Depression and 21.66% of women and 11.76% of the men were plagued by anxiety. Lack of sound sleep of at least 7 hours was observed mainly in the youth (15–35) with a 24.39% and 34.14% overall. Although, 17.07% of the study populous

#### **Figure 2.**

*Graphical representation of women and men, who suffer from mental disorders such as Anxiety, Sleep apnea, Depression and other disorders such as Hypertension, Blood pressure dysregulation, Diabetes, Asthma,Thyroid and others (n = 120 for females and n = 85 for males).*

*Relations between Dietary Habits, Lifestyle and Leading Obesity DOI: http://dx.doi.org/10.5772/intechopen.98307*

#### **Figure 3.**

*Graphical representation of women and men, who sought the help of health and nutrition specialists like dietician or a nutritionist (n = 120 for females and n = 85 for males).*

complained of suffering from Sleep Apnea. Amongst all the subjects 43.95% of the individuals suffering from mental disorders of anxiety and depression showed irregular BMI. The study was conducted in the city, while few subjects hailed from the underprivileged part of the city who earned their keep by manual labour, most of them belonged to the upper middle-class part of the society. Despite this from **Figure 3** we can see that only 22.92% of these people sought the professional guidance of a dietician or nutritionist, out of which 26.66% were women and 17.64% were men.

From **Tables 1** and **2**, another interesting fact is pointed out was 80% of the labourers involved in this study were either in the normal or underweight BMI range despite having a high carbohydrate diet. The working class consume high energy dense food, a lot of vegetables all freshly prepared. On the other hand, 62.5% of the homemakers were overweight and obese despite following all the healthy habits considered to maintain a healthy BMI.

#### **4. Discussion**

The prevalence of obesity has vigorously increased in the past three decades speculating the composition of current diet, decreasing levels of physical activities, changes in energy intake versus the expenditure to be the cause. Tackling this problem has to be the main priority as the rate of obesity refuses to settle down. Therefore, conducting field physical examination surveys that provide robust measurements as well as routine surveys which collect self-reported heights and weights is necessary. A combination of both these methods shall reveal a better periodic assessment of self-report bias and strengthen surveillance over the general public. Member States of WHO in 2013 made a resolution of stopping the rise in obesity by 2025, although noble this target is overambitious considering no countries showed downwards trend in the past 3 decades [5].

In this survey as mentioned earlier, BMI index has been used as the determining factor to understand overall wellbeing of an individual. Body mass index (BMI) is the ratio between body weight and the square of body height, and is commonly used to assess bodily mass in epidemiological studies [7]. This entire survey was

conducted to understand the rise in obesity, especially in the youth and thus was conducted in colleges primarily to observe the physical activities of students as well as their eating habits. Overweight is defined by a BMI equal to or higher than 25 kg/ m2 and obese is 30 kg/m2 or higher [7, 18].

Due to the socio-economic strata, it is observed that the minority and low-income individuals are disproportionately affected by obesity as the cheapest and accessible food is high in fats and sugar. Due to rapid changes in socioeconomic status and demographic in a developing country like India, the adoption of an energy- and fatrich diet and a sedentary lifestyle has become the norm [1]. In the study itself, it was observed that the youth especially the college going students, indulged in junk food possibly for two reasons, as they are not earning, they prefer cheaper food on a daily basis, also due to 'Westernization' of lifestyles [4]. People who have more financial resources combat these circumstances more easily and, consequently, are more physically active and less obese than those with fewer resources [9].

From these results, it's evident that the rise in mental disorders like depression, anxiety and hypertension is quite prevalent. Mood disorders and anxiety, and weight gain are closely related and recognized as common conditions among adolescents and young adults [19]. The weight gain after diagnosing depression, lower HRQOL and anxiety is just as common as developing depression and other mental issues due to obesity [20–22]. There is a common factor between obesity and depression, i.e., the lower availability of rewarding dopamine D2 receptors. This leads them towards emotional eating as means of feeling better in response to negative emotions, which intake is proven as one behavioural mechanism between depression and subsequent development of obesity [20]. The brain treats high palatable foods that are energy-dense, especially high sugar and fat food as rewards. People under stress usually are attracted towards sugar and fat concentrated food to cope with negative emotions or confusing internal states of hunger and satiety with physiological changes associated with emotions, also called as the 'comfort food hypothesis' [6, 23]. Obstructive sleep apnea (OSA) accompanied with elevated blood pressure is extremely common in patients with obesity, due to fat deposition around the upper respiratory airways, chest wall, and truncal fat, which leads to a decrease in the functional residual capacity [3, 6]. Mechanistically, partial sleep modulates with hormones leading to increased serum ghrelin and reduced serum leptin, both of which result in elevated appetite [23].

From this survey, many girls were seen suffering from PCOS, which now has been declared as a rising epidemic among young girls. Usually children, before hitting puberty do not have gonadotropic and/or ovarian disorder, but have an excess of central that triggers an adaptive mode of accelerated growth and adaptive mode of subfertility (PCOS) [14]. PCOS shows clinical features of insulin resistance (IR), hyperandrogenism. The presence of IR appears as impaired insulin-mediated suppression of lipolysis and lipid oxidation, resulting in increased serum free fatty acids, which is associated with obesity [24, 25].

Weight gain after achieving menopause is a very common occurrence, although studies conducted on these aspects are quite contradictory. Women have been shown to gain weight the most between the ages of 25–34, rather than postmenopausal. Menopause does influence the body composition due to ageing but not any distinct increase in weight gain [16] From this survey, we do observe that women are extremely health conscious in their 30s and on the other hand men especially take major steps of looking after their health in comparison to the women in their 50s. From the study we can also deduce that both men and women prefer to walk for at least half an hour (Females - 59.16% and Males- 45.88%) over exercising in the gyms (Females- 8.33% and Males - 15.29%).

*Relations between Dietary Habits, Lifestyle and Leading Obesity DOI: http://dx.doi.org/10.5772/intechopen.98307*

One interesting observation noticed in this survey study was that men and women doing labour work in the field, by default follow a high carbohydrate diet and stay healthy. The labourers do not have the privilege of consuming four whole meals a day, due to shortage of time and workload. Therefore, they were seen consuming high carbohydrate foods like rice, beets, potatoes etc. twice a day to endure the entire day's labour. The high carbohydrate food acts as a fuel for their sane functioning. The key is naturally occurring high carbohydrates to keep them full, provide energy, improve insulin function and heavy labour to create calorie deficit. Another interesting hypothesis is that the dramatic decrease in smoking could also likely be a cause of global increase in BMI. Smoking impairs appetite as well as causes chronic obstructive pulmonary disease, which itself results in a lower body mass [8].

#### **5. Conclusion**

In Summary, the prevalence of obesity is greater in women than men which increases with age. Overweight and obesity rates have increased considerably during the past 35 years to the extent that more than one-third of the world's population is now classified as overweight or obese [1]. Though a mammoth task, it's imperative that obesity epidemic is reversed through prevention. Countries need to get involved and effectively intervene against major determinants such as excessive caloric intake, physical inactivity, active promotion of food consumption by industry and stopping the gradual weight gain in children [5, 9]. These interventions could help resolve the increase in BMI associated with mood disorders especially in females [19]. According to WHO measures to prevent obesity by individual's choice of healthy foods and regular physical activity are the easiest, most accessible and affordable ones [4]. At the same time sleep also should be incorporated into management plans for obesity [26].

This study has few limitations which provide a scope for further investigation. BMI was considered as a classification source of the populous under scrutiny which is a rather poor indicator of percent of body fat and deposition [1, 8]. There is a known subset of the obese population devoid, of cardiometabolic complications such as diabetes mellitus, IR, and cardiovascular disease who show normal BMI yet have excess visceral adiposity, and are known as metabolically healthy obese (MHO) which is particularly observed in Asian men [6]. Also, in this survey we observed men leading a rather healthy life in all aspects yet having a higher BMI, as BMI doesn't differentiate between muscle or fat mass. Also in this study, we have considered mental health disorders such as depression, anxiety, sleep apnea along with lifestyle habits. As the survey was done to understand the all-round behaviour of the public to maintain a healthy lifestyle, we could not delve further into eating disorders such anorexia and bulimia, which has a wide scope of understanding the increase in the rate of obesity especially amongst the youth [17].

Apart from the country taking rigorous surveys and collaborating with the industries to balance the socio-economic situation to steadily bring down the growth curve of obesity, individuals too can lead and maintain a healthy life and BMI. Grains should be consumed in a minimally refined, high-fibre form, and intakes of refined starches and sugars should be minimized. Non hydrogenated dietary fats must be consumed. Vegetables and fruits must be eating in abundance while red meat should be considerably reduced. Daily exercise of any sort is always recommended [27].
