Humans are evolving, so are diseases. The pattern of diseases changed over time. There has been a time when non-communicable diseases like diabetes, hypertension and ‘heart attack’ were diseases of the rich and communicable diseases like tuberculosis, typhoid and dysentery were considered diseases of the poor.
What are lifestyle diseases?
Lifestyle was coined by Austrian psychologist Alfred Adler. It means in simple words, ‘the way a person lives’. Lifestyle diseases are those diseases (either physical or mental), which increase due to unhealthy lifestyle pattern of an individual or a population. Diseases can be cured, minimized, prevented or improved by following a healthy lifestyle-diabetes, hypertension, cardiovascular diseases (heart attack) and cerebro-vascular diseases (stroke) to name a few. Lifestyle diseases are no longer limited to the upper and upper middle class. A study conducted in 33 nations by WHO indicated that lifestyle diseases are on the rise even in African countries. Malnutrition and obesity coexist. Yes, it is a paradox.
It’s time for some numbers According to International diabetic association, the prevalence of diabetes in India is 8.7 p c. (2015; 20-79 years). More than 50 million are affected by diabetes and according to Diabetes Foundation (India) this is likely to grow up to 80 million by 2025. More than a million people died of diabetes in 2015 in India. Hypertension also tells a similar story. With claim over 12.8 pc of all annual deaths worldwide and ranging from17-21 pc of prevalence in studies conducted in India, hypertension also causes significant loss of money and lives all over the world. A WHO fact sheet last reviewed in September 2016 says 7.4 million people died due to coronary artery (blood vessel supplying heart) disease and 6.7 million due to stroke which ranks cardiovascular disease the number one cause of death.
Kerala has set its own standards in the realm of health. We are proud of our ‘Kerala Model’ of healthcare. We consider ourselves at par with European countries and it is true to an extent. Our birth rate, infant mortality rate, maternal mortality and life expectancy are way above our national standards. But when considering the lifestyle diseases, we have nothing to boast. In Kerala, there is no rural-urban discrepancy in prevalence of diabetes. It almost reaches 2 pc, which is much more than our national level. The prevalence of non-communicable disease risk factors is also high in Kerala.
The concept of risk factors
The disease is caused by a single agent in most of the cases. This may not be true for every disease, especially non-communicable diseases. There comes the concept of risk factors. A risk factor is an attribute, which is associated significantly with the development of disease. Modifiable risk factors play an important role in reducing the chance of development of a lifestyle disease. You might have heard that reduction of smoking, controlling diabetes and obesity reduces chance of cardiac diseases. This is the logic behind that.
What really happened? The Hobbit’s expected journey;
Now we are in the era of touch screen devices. The time we spend on these devices – Computer, TV, mobile, tab – collectively called screen time. More screen time means less calorie spent, more fat is being stored. A rapid shift in food habits occurred. The food part is more significant than you may imagine. An extra 50 Cal/day (2 teaspoon sugar/4-6 nuts) gains you 2.5 kg at the end of the year. Imagine what might happen in 10 years!! Substances like alcohol consumption and smoking are also on the rise in Kerala. Our job patterns also changed. We left the paddy fields and took white collar or less physically demanding jobs. Sleep pattern changed as a result of the ‘night shifts’; night time snacking also increased our BMI.
Increase in stress at the place of work and home also adds to lifestyle disease profile. Knowingly or unknowingly, like Bilbo Baggins opening the door of his hut to the dwarfs, we exposed our life to the risk factors (sedentary lifestyle, increased screen time, unhealthy food habits and uncontrolled obesity) and one by one the lifestyle diseases came to us and we suffered the damage just like what happened to Bilbo’s home. Unlike the hobbit, we were warned of consequences of our actions.
What can we do?
Step one is be as active as you can. Regular exercise means at least 30 min/day for 5 days per week. Activities like dancing, jogging, cycling and swimming may suffice. No, playing goalkeeper in a 30min football match doesn’t count as active exercise. People with any existing disease should seek the advice of their doctor before starting an exercise regime. Step two is maintaining healthy food habit. Follow a balanced diet (which itself is a big topic). Avoid junk food and carbonated beverages.
Avoid smoking and alcohol. Reduce screen time. More importantly, find some time to relax, to spend with family or friends. Not online friends, real friends. Get some fresh air. Relieve stress. Get good sleep. I know this may not be possible always. But at least let’s try You can choose to eat by the sweat of your brow or sweat after you eat. Either way, sweat is a must. Prevention is better than the suffering, right?
(Author works at family medicine unit of Lakeshore hospital and research centre)
