2/11, 8:44 AM] : BMI >25 overweight, >30 obesity
[2/11, 8:45 AM] P : It's true in Indian medical system we have far easier and better access to healthcare
[2/11, 8:49 AM] Rakesh Biswas: It's not true. We have better access to low quality care. They have standard access to standard care.
King Charles can get his designer ICU at Buckingham palace alongwith a coterie of concierge physicians
[2/11, 8:49 AM] S : This is the latest data...2019-21...it is increased from 4.02% in 2015-16 to 5.21% in 21
[2/11, 8:51 AM] Rakesh Biswas: Even this would be suspect if they have used bmi as a standard. Trunkal obesity and visceral fat with sarcopenia are much more prevalent
[2/11, 8:51 AM] P : From personal or family experience , common patient s access is far better
[2/11, 8:52 AM] Rakesh Biswas: 👆Nice visual
[2/11, 8:52 AM] Rakesh Biswas: No denying that.
But it's access to low value care.
[2/11, 8:53 AM] P : However above 👆 image of King Charles waiting is apparently an AI generated image it seems
[2/11, 8:54 AM] P : The patients get immediate access, treatment is not poor by global standards and options are plenty with fatter wallets
[2/11, 8:54 AM] Rakesh Biswas: Yes AI has no access to what happens inside Buckingham palace
[2/11, 8:55 AM] Rakesh Biswas: https://www.ncbi.nlm.nih.gov/
It is pretty poor by global standards. Let's face it
[2/11, 8:56 AM] Rakesh Biswas: The treatment our country men get is largely non evidence based. Rest of the globe is marginally better although they could be more hyped than us
[2/11, 8:57 AM] +91 98407 39100: Topic is access - period and access here is really good to great
[2/11, 9:15 AM] Dr Ravi Nayar ENT Dean Hcg Bangalore: There are many Indias
As Veer once said
Why should health care be different
As with money the machine is fed
So compare onions with onions as this suggests
The middle class with middle class..that's a fair slug fest
Kavi Ravi
[2/11, 9:27 AM] Q: What is the standard medical definition of obesity? Is this as per BMI Index?
[2/11, 10:12 AM] R P : Yeah. Personally speaking, I have noticed BMI can be normal but that does not correlate with percent body fat. Reducing PBF to between 10% - 14% is very hard.
Obesity is a huge crisis and we found out tragically from the pandemic. Can this be aligned with preventive healthcare initiative? @~Dr Prashant Sathe
[2/11, 10:29 AM] R P : This is a fascinating chart. What explains the clear remarkable distinction betwen South and majority of North + NE India? Is it eating habits?
[2/11, 10:32 AM] S : sorry, looks like this is the latest. still very clear difference.
[2/11, 10:36 AM] Rakesh Biswas: What's common to consumption in Punjab, Goa and Andhra?
It's the similarity of CHO consumption!
CHO in forms such as C2H5OH and C6H12O6!
[2/11, 10:37 AM] R P : English please 😊
[2/11, 10:38 AM] Rakesh Biswas: CHO in English is carbohydrate
I guess the other chemical formulas are easily googleable
[2/11, 10:53 AM] Dr Ravi Nayar ENT Dean Hcg Bangalore: That's Rakesh for you,
Never satisfied with plainspeak,
If gobbledygook will do,
That's vexing indeed,
the nature of his mental steed,
On C@H#O&..does it feed
So" bash on regardless" pay no heed..
[2/11, 11:43 AM] Rakesh Biswas: The simplest forms
Of carbohydrate
Build on the C@H#O skeleton
C2H5OH is alcohol
C6H12O6 is simplest sugar
All of the above
Are substrates for
Visceral fat and these
Highly active adipocytes
Are soldiers that
wreak havoc daily
into our trillion celled existence
Eating into our endothelium
And our endothelium exists
wherever our organs are
Our trillion celled existence
are divided into special workflows
Some worK as pumps
to drive our endothelial rivers
Some to flush out our effluents
Eventually excess
CHO driven violence
unleashed by the adipocyte army
Block these endothelial rivers
And we are left with organ failure
Fatty liver leading to cirrhosis and failure
CAD leading to heart failure with macro and microvascular dysfunction
Renal vasculopathy leading to renal failure and dialysis
To name just a few of these NCDs
Disease appears to be
A facet of our daily pattern recognition workflow
As these trillion celled
Bodies come and go
Out of the workshop
We call a hospital
We can identify an NCD
From a distance
We don't need Google's retina scan for that
Just need to look
at human Sarcopenia and visceral fat combos
As it's the magic proportion that decides NCD and it's outcomes
Even as BMI beats the dust
...Meanderings of an English language model that couldn't make it large
[2/11, 10:57 AM] Sunil Chandy CMC Vellore: Obesity is a surrogate marker of cardiovascular and metabolic illness. However , you could be pencil thin as still have coronary plaques or be obese and have clean vessels. These outliers are few and far between only emphasise that obesity is a red alert that should be taken seriously. And it is mainly food interventions that will help.
[2/11, 11:04 AM] Uma Nambiar CEO IISc Medical School: 1. I am not sure that data for gujarat is captured well...
2. Most areas with less incidence of obesity like parts of central India and northeast are mostly agrarian communities with limited cash availability... coupled with hard physical labour, good nutrition (usually farm fresh home grown millets with available add ons, hardly any processed food
[2/11, 11:38 AM] Dr Avneesh Khare 🇮🇳: Rajasthan 🤩 benefits of living in a desert
[2/11, 11:45 AM] Rakesh Biswas: 👆Here Rajasthan doesn't appear that deserted contrary to the previous chart! @Dr Avneesh Khare 🇮🇳
[2/11, 11:44 AM] S : The contrast between neighboring states of Rajasthan and Punjab!!
[2/11, 11:46 AM] Rakesh Biswas: I would take these hypertension data with a pinch of salt! 😅
[2/11, 11:59 AM] AGI : Interesting! Rajasthan & UP low on htn but alarming cvd.
[2/11, 12:24 PM] Rakesh Biswas: This data source is from Jl of American Coll of Cardiology
What are the source links to the other visuals?
[2/11, 12:26 PM] S S : National Family Health Survey 2019-21
[2/11, 12:27 PM] Rakesh Biswas: Different data sources but again different perspectives too. The journal of Am Coll of cardiology source is talking about the percent change (longitudinal study?) while the previous source is just the population percentage affected (cross sectional one time look?)
[2/11, 12:29 PM] S S : Global Burden of Disease Studies.. is the data based on which the changes are analysed across the years, including in the JACC article..
[2/11, 1:00 PM] AGI : Does it still not suggest that the two conditions are not as tightly coupled as many of us suggest?
[2/11, 1:05 PM] Rakesh Biswas: Yes they aren't.
Both are merely effects of one root cause and that is visceral adipocyte activity driven by excess CHO intake
[2/11, 1:11 PM] AGI: Data in silos always gives a biased view. In some states, malnutrition and poor public health engineering are the causes of minimal obesity. Additionally, visualizations do not factor in the unavailability of data.
[2/11, 1:20 PM] Rakesh Biswas: The biggest cause of the obese form of malnutrition is poverty
Information poverty doesn't allow a large part of our population to know what is right food
If when they get to know it's too expensive for them unless they are taught to grow them too
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