Life's too short to be wasted on choices that make it shorter, yet most of urban middle and upper-middle class India seems to be doing just that. An HT-C fore 10-city survey of 25- to 50-year-olds shows that two in five people lose their temper each day, while just one in three get a full night's sleep. One in four smoke, while more than half drink alcohol, though only 3% drink every day.
"Anger and sleeplessness are the two most easily identified signs of stress. Contrary to popular perception, letting it rip is the worst thing is the worse thing you can do in a stressful situation as it escalates aggression and does nothing to resolve the situation," says Dr Rajesh Sagar, associate professor, department of psychiatry, All India Institute of Medical Sciences, New Delhi.
Anger triggers biological changes in the body. "The energy hormones, adrenaline and noradrenaline, shoot up, as does the heart rate and blood pressure. A persistently angry situation is not just emotionally disruptive but can put too much stress on the body and cause diabetes and heart attack over time," adds Sagar. More than 3 million people die of heart disease every year, making it India's number one killer. Diabetes affects 50.7 million people, the largest number in the world.
People with short fuses usually claim their 12-hour workday leaves them stressed, but despite being different, the work stresses are fairly similar for most people in the corporate sector, except perhaps Niira Radia and her close associates.
While there are no large studies from India, the HT-C fore findings reflect a global trend. An International Labour Organisation pre-recession study of workplaces in Finland, Germany, Poland, UK and US found that one in 10 workers suffered from depression, anxiety, stress or burnout, which lead, in some cases, to unemployment and hospitalisation. The Integra survey of 50 US cities reported that one in 10 Americans worked in an atmosphere where physical violence has occurred because of stress, with 42 per cent saying yelling and verbal abuse were common. Almost one in four Americans (23 per cent) said they had been driven to tears because of workplace stress.
Too stressed to work out
Since the stressors cannot be wished away, they have to be dealt with by channelling anger in an assertive, as opposed to aggressive, way to avoid becoming hostile instead of confronting people head-on. "Walking, running or playing a sport are effective stress-busters, as is laughing out loud or taking a break," says Sagar.
And that's just what people are not doing. Seven in 10 people surveyed said they did not exercise, with almost half not even managing to walk for one km without getting breathless. Instead, they are buckling under and turning to perceived stress-busters such as alcohol and smoking. "The reverse is true. Smoking causes chronic stress and a study from the London School of Medicine and Dentistry showed that quitting smoking led to a 20% reduction in stress levels as compared to when they smoked," says Sagar, quoting a study from the international medical journal Addiction in June 2010.
Indians – and all south Asians – need one hour of physical activity seven days a week to stay healthy, recommend India's National Guidelines for Physical Activity released in October this year. "Most people tell me it is impossible to keep an hour aside for exercise. So I give them the poly-exercise option: 30-45 minutes should be brisk walking or running, 10 minutes resistant-training using weights and 10 minutes of work-related exercise, such as cleaning your car," says Dr Anoop Misra, director, department of diabetes and metabolic diseases, Fortis Group of Hospitals.
It's not that tough to find the time. "You have to convince yourself a healthy body is worth the hard work, then factor in your schedule and choose an exercise that interests you, be it walking your dog, working out in a gym or popping in a virtual fitness disc into a console," he said.
Don't ignore warning signals
The survey showed that most people know what they need to do to be healthy but do little about it. One in three thought lifestyle diseases could be managed with yoga, yet only one in three can touch their toes, an astoundingly small number considering all the respondents were under 50 years. (see box on methodology)
Similarly, though one in six suffered chronic pain and one in four had uncontrolled blood pressure and/or diabetes, only one-fourth of the people surveyed had got a health check-up done in the last two years. One in 10 had no clue about the state of their health.
This is in keeping with the findings that most people wait to be diagnosed with a problem such as heart disease or diabetes before putting on their walking shoes or watching what they eat, if at all. In the case of diabetics, says Misra, some do not do so even after being told daily activity is part of the prescription. "Data from patients show that 40 per cent have fruit only twice a week – it's recommended every day – and one-fourth do no exercise even years after being diagnosed with diabetes," says Misra.
The findings of the HT-C fore survey were similar. Only one in 20 – 6% – ate enough fruits and veggies, defined as eating a mix of five fruits and vegetables in a day. Junk and packaged food, however, found its way on the menus of over half the people surveyed every day.
Another two in three wrongly believed that nuts and dried fruits had cholesterol, which is found only in foods of animal origin, such as meats, egg, butter and cheese. The new nutrition mantra celebrates the high satiety value, good fats and complex carbohydrates found in nuts — once shunned for being high on calories — and recommends them to people to better manage blood sugar levels and lose weight.
Recognising the benefits of heart-healthy fats found in nuts, the US Food and Drug Administration allowed packaged nuts — such as almonds, hazelnuts, pistachios, walnuts and peanuts — to declare: "Scientific evidence suggests that eating 1.5 ounces (28 gram) per day of most nuts, such as almonds, as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease."
Last action hero
Persistent stress impairs memory, lowers libido and triggers chronic problems such as diabetes and high blood pressure.
"That apart, pressurised people are more likely to reach for cigarettes, unhealthy snacks and alcohol to cope with their BlackBerrys and laptops taking over their leisure time," says Misra.
"Since most people have to live with some amount of pressure, taking time out for your health becomes imperative, be it a dental check-up, taking a walk or simply stocking the fridge with carrots and oranges," added Sagar.
When it comes to health, people swing between extremes. The majority would rather not know what's wrong with them. And when they do get to know, they take action only under extreme duress.
A small majority, whom doctors have learnt to fear almost as much as getting their medical licences cancelled, are health junkies who knock at hospital doors after trawling the internet looking for infections, disorders, diseases or syndromes, real and imaginary. "There's too much information available and it's often difficult for a non-medical person to decipher. A lot of health information posted online is incorrect. The best sites to go to are the ones run by institutions, such as hospitals, and societies, that also offer information on support group," says paediatrician Dr Anupam Sibal, group medical director, Apollo Hospitals.
Googling for five child-related problems showed 11% of the 500 results gave inaccurate information, and 39% gave the right answer, reported The Archives of Disease in Childhood in April this year. It confirmed Sibal's recommendation: that government-run sites were reliable sources of information, followed by hospitals.
For the study, the five words googled were 'MMR autism', 'HIV breastfeeding', 'mastitis breastfeeding', 'baby sleeping position' and 'green vomit'. The most incorrect replies were on MMR and autism, followed by HIV and breastfeeding. "It's always important to whet what you've read with your physician," says Sibal.
Infection outbreaks bring out the worst in worrywarts, making them aggressive, even annoying. The annual dengue outbreak in Delhi is an example. "People think all fevers are dengue and insist on being admitted to a hospital even when there is no need for it," says a doctor at the All India Institute of Medical Sciences.