Dyslipidemia and obesity management; lifestyle modification: an Indian perspective


  • Yasmee Khan Department of General Medicine, AIIMS Bhopal, Madhya Pradesh, India
  • Manal M. Khan Department of Plastic Surgery, AIIMS Bhopal, Madhya Pradesh, India
  • Arati L. Chandani Department of Medicine, GMC, Kannauj, Uttar Pradesh, India
  • M. Raza Farooqui Department of Surgery, MMC, Muzaffarnagar, Uttar Pradesh, India




Dyslipidemia, Life style modification, Obesity


In India, obesity is an emerging health problem, along with its co morbidities. This is due to change in life style and dietary patterns of people in developing world. In India, there is rapid rise in number of deaths due to CVD and its prevalence in society is at an alarming rise. Around half of these deaths are of the people in there productive years leading to loss of productive workforce. This has occurred not only due to reduction in physical activity but also due to increased intake of saturated fats and decreased intake of staple foods. There is a rapid increase in cholesterol, triglycerides, and LDL levels while HDL levels are low. This can be curbed at an early stage by changes in lifestyle and diet. Though various diets have been advised and are being used in western individuals but it is a less looked upon topic in Indians, so in this article we try to look upon physical activity guidelines and dietary patterns advised for Indian population.


Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP. The spread of the obesity epidemic in the United States, 1991-1998. JAMA 1999;282:1519-22.

Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab. 2008;93:S9-30.

Gupta R, Gupta VP, Sarna M. Prevalence of coronary heart disease and risk factors in an urban Indian population: Jaipur Heart Watch-2. Indian Heart J. 2002;54(1):59-66.

Gupta R, Misra A. Type 2 diabetes in india: Regional Disparities. Br J Diabetes Vascular Dis. 2007;7:12-6.

Sample Registration System, Million Death Study: Preliminary Report on Causes of Death in India 2001-2003. New Delhi: Registrar General of India; 2007.

Enas EA, Yusuf S, Mehta J. Prevalence of coronary artery disease in Asian Indians. Am J Cardiol. 1992;70:945-49.

Omran AR. The epidemiologic transition. A theory of the epidemiology of population change. Milbank Mem Fund Q. 1971;49:509-38.

Groundy SM, Small LDL. Atherogenic dyslipidemia and the metabolic syndrome. Circulation. 1997;95:1-4.

Haffnar M. Diabetes, hyperlipidemia and coronary artery disease. Am J Cardiol. 1999;83(Suppl):17F-21F.

Preventing noncommunicable diseases in the workplace through diet and physical activity; WHO/World Economic Forum report of a joint event; 2008.

ASSOCHAM; Study on Priventive Healthcare, 2009.

Wilson RW, Drury TF. Interpreting trends in illness and disability: health statistics and health status. Ann Rev Pub Health. 1984;5:83-106.

Iyengar SS, Puri R, Narasingan SN. Lipid association of India expert consenses statement on management of dyslipidemia in Indians 2016: part 1 Supplement to Journal of The Association of Physicians of India; 2016.

World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation presented at: the World Health Organization; June 3-5, 1997;Geneva, Switzerland. Publication WHO/NUT/NCD/98.1.

Misra A. We need ethnic-specific criteria for classification of BMI. In: Progress in Obesity Research: 9. (Eds: Medeiros-Neto G, Halpern, A, Bouchrad C). Proceedings of the 9th International Congress on Obesity, Sao Paulo, Brazil. John Libbey Eurotext Ltd, London; 2003:547-553.

Misra A. Revision of limits of body mass index to define overweight and obesity are needed for the Asian ethnic groups. Int J Obes and Relat Metab Disord. 2003;27:1294-6.

Misra A. Body composition and the metabolic syndrome in Asian Indians: a saga of multiple adversities. Natl Med J India. 2003;16(1):3-7.

Misra A, Vikram NK. Insulin resistance syndrome (metabolic syndrome) and obesity in Asian Indians: evidence and implications. Nutrition. 2004;20(5):482-91.

Raji A, Seely EW, Arky RA, Simonson DC. Body fat distribution and insulin resistance in healthy Asian Indians and Caucasians. J Clin Endocrinol Metab. 2001;86(11):5366-71.

Chandalia M, Abate N, Garg A, Stray-Gundersen J, Grundy SM. Relationship between generalized and upper body obesity to insulin resistance in Asian Indian men. J Clin Endocrinol Metab. 1999;84(7):2329-35.

Misra A, Choubey P, Makkar BM. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for asian indians and recommendations for physical activity, medical and surgical management. JAPI; 2009.

Misra A, Alappan NK, Vikram NK. Effect of supervised progressive resistance-exercise training protocol on insulin sensitivity, glycemia, lipids, and body composition in Asian Indians with type 2 diabetes. Diabetes Care. 2008;31(7):1282-7.

Nelson ME, Rejeski WJ, Blair SN. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39(8):1435-45.

Physical activity guidelines for Americans, 2008. Available at www.health.gov/paguidelines/guidelines/default.aspx.

National physical activity guidelines for Australians at www.asso.org. au /profiles /profs / reportsguides / activity, 2008.

Comprehensive rehabilitation of patients with cardiovascular disease. Braunwald’s Heart Disease.A Textbook of Cardiovascular medicine (7th Edition). 2005:1085-1102.

Misra A, Bhardwaj S. Management of the metabolic syndrome and the obese patient with metabolic disturbances: south asian perspective Misra A. The Importance of Nutrition as an Integral Part of Disease Management. Nestlé Nutr Inst Workshop Ser; 2015;82:61-73.

Bhardwaj S, Passi SJ, Misra A. Overview of trans fatty acids: biochemistry and health effects. Diabetes Metab Syndr. 2011;5:161-4.

Strychar I. Diet in the management of weight loss. CMAJ. 2006;174:56-63.

Misra A, Luthra K, Vikram NK. Dyslipidemia in Asian Indians: determinants and significance. J Assoc Physicians India. 2004;52:137-42.

Mohan V, Deepa R, Rani SS, Premalatha G. Prevalence of coronary artery disease and its relationship to lipid in a selected population in South India. J Am Coll Cardiol. 2001;38:682-7.

Misra A, Gulati S. Dietary approach to management of dyslipidemia in Asian Indian subjects. J Prevent Cardiol. 2014;3(4).

American Heart Association. Whole Grains and Fiber. Available at http://www.heart.org/ HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/ Whole-Grains-and-Fiber_UCM_303249_Article.jsp#. Tyl_65hZDe4.

Administrative Committee on Coordination/Subcommittee on Nutrition (United Nations). Second Report on the World Nutrition Sanitation. Hyderabad, India: National Institute of Nutrition; 1992:2.

Vessby B, Unsitupa M, Hermansen K, Riccardi G, Rivellese AA, Tapsell LC, et al. Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU Study. Diabetol. 2001;44:312-9.

Ghafoorunissa. Fats in Indian diets and their nutritional and health implications. Lipids. 1996;31 Suppl:S287-91.

Ghafoorunissa. Requirements of dietary fats to meet nutritional needs and prevent the risk of atherosclerosis- an Indian perspective. Indian J Med Res. 1999;108:191-202.

Livingstone MB, Black AE. Markers of the validity of reported energy intake. J Nutr. 2003;133 Suppl 3:895S-920S.

National Institutes of Health; National Heart Lung, and Blood Institute; National Cholesterol Education Program. 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): Final Report. NIH Publication No. 02-5215; 2002.

Narayan KM, Echouffo-Tcheugui JB. Analysis of the Indian council of Medical Research-India Diabetes (ICMR-INDIAB) study. J Diabetes Sci Technol. 2011;5(4):915-7.

World Health Organization, "Diet, Nutrition and Prevention of Chronic Diseases". WHO Technical Series. 2003;916.

Misra A, Nigam P, Hills AP. Consensus physical activity guidelines for Asian Indians. Diabe Technol Ther. 2012;14:83-98.

Committees of the American Diabetes Association Inc. and American Dietetics Association, A Guide for Professionals: The Effective Application of “Exchange Lists for Meal Planning.” New York: American Diabetes Association; Chicago: American Dietetic Association; 1977.

William SR. Nutrition and Diet Therapy. 6th Ed. St. Louis: Times Mirror/ Mosby; 1989.






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