Know thyself: the adage is as relevant to philosophy as to one’s own health.
Elders often bless people younger than them by wishing them a long life. In my last article, I discussed a few general measures that can help in fulfilling a cross-cultural desire to live long. The present article will discuss three specifics measures, from among many others, which could help one in achieving this goal of a longer and healthier life. I must emphasise that these courses of action not only compliment each other, but they also supplement the general measures discussed in my previous article.
Prevent (or treat) diabetes. At all costs!
Blood sugar levels in the body are kept under control by a hormone called insulin. Diabetes is a metabolic disease which causes higher than normal blood sugar. Diabetes either results from a failure of production of adequate insulin by the body or insulin resistance (when the circulating insulin is not effective). Most adults with diabetes have a combination of both.
We often hear that our country is the diabetes capital of the world. We not only have the dubious distinction of having the largest number of diabetics in the world, but many of them are also completely unaware of their disease. Not surprisingly therefore, it is called a silent killer with a powerful negative impact on longevity. The disease was earlier thought to be a predominantly urban affliction among affluent people. This is also changing rapidly. While the numbers in urban India continue to remain high, the rural-urban divide is narrowing with a larger percentage of rural Indians also developing this disease.
Why does India have such a high prevalence of diabetes? Many genetic factors (about which little can be done) contribute to the perverse statistical distinction of having the largest number of diabetics in our country. Nevertheless, an equally ominous role is played by our lifestyle choices and our approach to effective treatment. Lack of exercise, overindulgence in a carbohydrate rich diet and a lackadaisical attitude towards treatment, all contribute to the epidemic.
How does diabetes result in a reduced life span? Joseph K Perloff, in his book of clinical cardiology, describes the physical characteristics of an infant born to a diabetic mother as one who has just emerged from the “metabolic furnace of diabetes mellitus”. No phrase describes the malady better than this. It is a metabolic disease which burns (harms) almost all organs of the body. The major contributors to early disease and death are the cardiovascular system with early and advanced coronary blockages, higher incidence of brain strokes, kidney failure and a higher predisposition to life threatening infections. These four complications have such a huge impact among diabetics, that in clinical practice, it is unusual to encounter an octa or a nonagenarian with uncontrolled blood sugars. People with sustained and uncontrolled blood sugars simply don’t live long enough!
What needs to be done? The answer, as I mentioned in my previous essay, is in our own hands. If one doesn’t have diabetes, one should prevent or delay it as much as possible. If one has diabetes, then it should be monitored and managed under care of a good professional.
Smoking? No (actually never) please!
Health-wise, cigarette smoking is perhaps the most widespread human behavioural weakness across generations. While historical evidence of smoking dates back to 5000 BC, it’s usage became widespread only around 16th century with extensive cultivation of tobacco. By the late 19th and early 20th century, ill effects of smoking were well documented. However, it took another 100 years of hard work against vested interests, before legislative regulations could be brought against the use of tobacco. With years of hard work, the number of new smokers now seems to be reducing. The present worry is a higher percentage of women and underage smokers.
How does smoking affect our body? Direct ill effects of smoking result from harmful chemicals contained in tobacco which damage the respiratory passage making it more prone to infections and cancers. It also affects distant organs such as blood vessels, urinary bladder and intestines. Indirect effects of smoking are due to high blood pressure and low oxygen saturation among smokers. All these result in a higher incidence of cancers (predominantly lung cancer), heart and brain strokes and chronic respiratory illnesses such as chronic obstructive pulmonary disease (COPD).
What needs to be done? Quit smoking. Period. No other manoeuvre will help. And half measures such as a reduction in the number of smoked cigarettes won’t help.
Find Disease (before it finds you)
Illness, like life in general, follows the iceberg principle. Only 10% is overt, the remaining 90% remains occult. Hence, we ideally need to detect disease before its clinical impact and complications become evident. That is where the role of preventive health checkups (PHC) comes in.
Regular and annual PHCs were previously restricted to high-risk jobs such as serving armed forces personnel or pilots. Others, in our society dealt with disease as and when it happened. Increasing awareness about disease, coupled with human curiosity about one’s health have resulted in a greater penetration of PHCs in contemporary Indian society.
PHCs, however, must follow two caveats. They need to be dovetailed to an individual’s risk and sickness profile. It is a good strategy to devise a specific PHC plan after consultation with one’s personal physician. Secondly, they need to be done with a periodicity determined by one’s overall health status.
The ancient Greek Temple of Apollo in Delphi contains an inscription stating gnōthi sauton, which means Know Thyself. On a spiritual path, one must know himself, before judging others. The same, undoubtedly, holds true for matters of health and disease as well.
Prof Hemant Madan is an Interventional Cardiologist and Programme Head, Cardiac Sciences for Narayana Health.