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HindustanTimes Wed,20 Aug 2014
Borderline diseases need lifestyle fixes
Sanchita Sharma, Health Editor, Hindustan Times
April 06, 2013
First Published: 23:16 IST(6/4/2013)
Last Updated: 23:27 IST(6/4/2013)

Journalists — both reporters and photojournalists — make it to the Forbes’ list of the “Most Stressful Jobs of 2013”, as do army personnel in conflict situations, senior corporate executives, PR executives and taxi drivers (all are far more stressed than cops, who barely make the list at number 10).

This partly explains why most cops look unruffled about rising crime and why some of my younger colleagues pop pills to control their skyrocketing blood pressure and diabetes, which a decade ago affected people in their 40s and 50s, if at all.

The trouble is that apart from fretting over the diagnosis and taking prescription medicines regularly, at least for a while, they do little else. Few take the trouble of making lifestyle changes — eating healthier, getting more active and losing weight — necessary to stay healthy.

More than them, it’s their physicians who are at fault. Most doctors focus on treatment and, at best, advise patients to go for morning walks and eat less of salt and sugar. Some even assure patients not to worry about diagnosis as newer drugs have fewer or no side effects and can be taken safely for life.

Now there’s an explanation for their attitude. Treatments, not prevention, dominate global diabetes research, shows a massive analysis of diabetes-related trials released this weekend. Of 2,484 trials reviewed, two-thirds focused only on drug therapy while only one in ten addressed prevention or behavioural therapies. Almost one in three — 63% — interventions involved a drug, while only 12% were behavioural. The findings, published in the journal Diabetologia, suggest that research efforts do not adequately address disease prevention  or management without medicines.

What is true for diabetes holds true for almost all lifestyle diseases. If you take hypertension, the theme for today’s World Health Day, just adopting a salt-restrictive DASH diet (Dietary Approaches to Stop Hypertension) lowers blood pressure and weight. The DASH diet is not only rich in nutrients and fibre but also in foods high in potassium (bananas, oranges, pears, prunes, tomatoes, dried peas and beans, nuts, potatoes), calcium (milk, dairy products, green leafy vegetables, salmon, sardines), and magnesium (rice, wheat and oat bran, seeds and nuts, dark chocolate) and low in sodium (salt) . These dietary changes alone lower blood pressure and weight, sometimes within weeks.

Yet many physicians still focus on pushing medicines, often expensive and not needed in the early stages of almost all lifestyle disorders.

Another interesting finding of the Diabetologia study was that older adults (over 65 years) were explicitly excluded from 31% of the trials, and were the main focus of only 1% of the studies. Similarly, just 4% of diabetes trials were aimed at people ages 18 and younger, a clear indication that most new treatment options being developed are for people who can afford to pay for them.

The way to outsmart the pharma industry is to focus on prevention, which remains the cheapest, though not easiest, option to keep your body up and running. And getting more active is a good way to start. Joining the neighbourhood gym and eating a high-fibre low-salt dinner helped another young colleague to shed 8 kg and keep them off for over a year. His waist shrunk rapidly, as did his high blood pressure to a healthy 120/80 Hgmm without medication.

What surprised me, though, was that politicians did not make it to the Forbes Stressful Jobs list, which makes you wonder why almost all of India’s senior politicians have diabetes, high blood pressure, heart disorders and almost no hair on their heads.  If it’s not job stress, then it’s definitely their lifestyle that’s to blame, so perhaps what they need is a prescription to turn over a new leaf. For a robust population and a healthy polity are just the booster shots India needs to make the most of its young demographics.


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