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Surviving the over-diagnosis epidemic

The world has been taken over with health nazis who discriminate against people who don’t come up tops on the wellness barometer, a friend with self-diagnosed gym-aversion disorder informed me earlier this week.

health and fitness Updated: Feb 26, 2011 23:47 IST
Sanchita Sharma

The world has been taken over with health nazis who discriminate against people who don’t come up tops on the wellness barometer, a friend with self-diagnosed gym-aversion disorder informed me earlier this week. “The pressure to stay fit is so great that people with a cold are now treated like fools who should have known better than to get infected. I’ve stopped going to doctors because all they do is tell me how everything I do and not do is killing me sooner than later,” he says.

In his case, his lifestyle is very likely to be killing him — he’s smartly opted for a very expensive health insurance policy — but he does have a point. Medical diagnostics are now so advanced that you don’t have to wait for symptoms to find out what is wrong with you. And if you’ve reached the stage where you have to look for a disease, then you are

likely to find it.

When it comes to disease, say doctors, there is no such thing as too much information. But do we really need so much information, especially when it is information you can do little about? It’s a bit like a competent astrologer predicting you are going to break your bones next Sunday morning, come what will. Well, if staying home in bed doesn’t help because the fan falls down and breaks your bones, the prospect of confirmed pain ends of doing nothing more than adding to your anxiety and stress.

Which, in turn, add to a host of risk factors such as hypertension (chronic high blood pressure) and diabetes, both of which can push you to an early grave faster than broken bones. I have a reasonably healthy lifestyle, within limitations, but refuse to restructure the next 50 years of my life to ensure, say, that my risk of hip fracture would halved when I’m 90 if I have four glasses of milk now! Besides making me overweight — one litre of skimmed milk has 1,250 calories — the warped diet would make me deficient in a host of other nutrients, which would in turn put me at risk of other diseases, such as cancers.

The downside of technology is that we start living in the shadow of death even before we are born. Genetic tests, many of which are done when you’re born, can predict diseases you are likely to be born with. If you are declared fit enough to be born, you are accosted with precision imaging machines that tracks trace of future diseases in every cell in your body. No tumour, cyst, polyps or aberration can escape the probes and scrutiny of tests and scans that predict disease before it occurs.

The rule of the thumb is that if you have the inkling of unease, get diagnosed. And since annual check-ups help diagnose symptomless diseases such as diabetes, hypertension and cancers, it’s a good idea to start at 30 to 35 years, depending on your lifestyle and overall health.

Because now there’s a new category of early-stage disease stages called pre-disease. You are a pre-hypertensive (blood pressure reading of 120-139/80-89 mmHg), which makes you three times more likely to have a heart attack than people with a normal blood pressure of less than 80/120 mmHg. Here, knowing the diagnosis helps, as quitting smoking, losing weight, exercising and eating less salt can help you control hypertension without drugs. Similarly, blood sugar of people with pre-diabetes —fasting glucose level between 100 and 125 mg/dl — can be brought down to the normal count of below-100 mg/dl by losing weight by 5-10% and doing 45 minutes of brisk activity each day.