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Letter to the Editor

When the DHOL is Beating, BHANGRA comes to the Rescue!

Priya, Gagan,; Grewal, Emmy1

Author Information
Indian Journal of Endocrinology and Metabolism: May–June 2021 - Volume 25 - Issue 3 - p 253-254
doi: 10.4103/ijem.ijem_303_21
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South Asia is facing an epidemic of metabolic syndrome and cardiometabolic disorders.[1] This has been described as “DHOL” [Table 1], akin to the loud beating of the traditional musical drum, the Dhol.[1] Diabetes mellitus, hypertension, obesity, and dyslipidemia significantly contribute to increased cardiovascular and mortality risk.[2]

Table 1:
BHANGRA as a strategy to tackle the rising challenge of DHOL

There is a need to develop targeted therapeutic approaches to tackle this modern health crisis with focus on nutrition, lifestyle, behavior modification, optimal glycemic management, and cardiometabolic risk reduction as well as abstinence from substance abuse.[2] Bhangra is the most vibrant folk dance of the Punjab region of North India that is performed to the beats of the Dhol.[3] Unnikrishnan et al.[4] suggested that walking, yoga, and folk dances could be easily acceptable approaches to increase physical activity. Bhangra is one such spirited dance form which involves vigorous physical activity and is also fun.[3] Dance, indeed, has been considered a safe and effective exercise alternative.[5]

We propose that the acronym BHANGRA is also the answer to the challenge when the cardiometabolic DHOL is beating [Table 1]. Bhangra, being a jubilant and energetic dance that it is, can thus be true to its name, both literally and metaphorically.

The management of cardiometabolic disorders requires focus on healthy nutrition, increased physical activity, stress reduction, maintenance of optimal body weight, abstinence from substance abuse, and behavior modification.[24] Behavior modification is, indeed, the most important component for any therapeutic strategy to succeed.[3] In addition, a multifactorial disorder requires a multifactorial risk management. There is a need to address individual components of metabolic syndrome including hyperglycemia, hypertension, dyslipidemia, and prothrombotic state.[1] In addition, these measures should also be encouraged and implemented at the population level to prevent the occurrence of overweight and obesity and the clustering of cardiometabolic risk factors. This requires active involvement and engagement of government, health-care professionals, and the general public.[3]

In South Asia, the primary care physician (PCP) is the first point of contact for most patients with metabolic syndrome, who provides counseling as well as treatment.[3] The concept of BHANGRA and DHOL can be a simple and effective way to educate and motivate the PCPs and general public about strategies to maintain optimal cardiometabolic health (personal observation). When the DHOL is beating, BHANGRA comes to the rescue!

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Conflicts of interest

There are no conflicts of interest.


The authors would like to thank Dr. Sanjay Kalra for his support and suggestions.


Copyright: © 2021 Indian Journal of Endocrinology and Metabolism