At a time when we are focused on curbing the rapid spread of a plethora of communicable diseases such as dengue, swine flu, chikungunya and Japanese encephalitis, it is easy to overlook the effects of the other silent epidemic that is afoot: that of non-communicable diseases (NCDs). Yes, modern day ailments such as diabetes, hypertension, ischemic heart diseases, stroke, cancer and respiratory problems are affecting the quality of lives of millions of Indians, and reducing the overall lifespan.
The World Health Organisation (WHO) estimates that about 5.8 million Indians die every year from NCDs, which translates to 1 in 4 deaths before 70 years of age. In 2014 alone, 60% of deaths in the country were attributed to NCDs. In general, saturated foods, sedentary lifestyles, consumption of alcohol and tobacco products, and air pollution have contributed to the rise of NCDs. It is imperative that we cast a discerning eye over some of these disorders so that we could make changes in our lives to reduce their impact on our health and quality of life. Let us consider each of these disorders separately.
Diabetes: In a recent study published in the journal Diabetes Care, it was found that despite having lower body-mass index and waist circumference than their emigrant counterparts, Indians living in India had a higher prevalence of Type 2 diabetes. In addition to age and body size, the roles of genes, environment and lifestyle are to be considered as causative and perpetuating factors of diabetes in India. Type 1 diabetes mellitus is insulin dependent, begins early in life, and is non-preventable. Whereas Type 2 diabetes is non-insulin dependent, generally begins in adult life, and is preventable. Since the majority of cases of diabetes are of Type 2 variety, it becomes incumbent upon us to make suitable changes in our lifestyle and environment to prevent the condition.
Heart diseases: Hypertension, hypercholesterolemia, coronary artery diseases (CAD) and strokes could be considered together as they are all inter-related. A blood pressure of more than 140/90 mmHg is considered to be hypertensive. Hypertension by itself is responsible for a significant number of deaths due to strokes and CAD. As much as a third of urban dwellers have hypertension, which often goes undetected until it leads to any one of its complications. This has earned hypertension the unsavoury sobriquet of ‘silent killer’. Having both diabetes and hypertension significantly increases the risk of not only heart diseases, but also renal failure. A diet rich in salt, saturated fat, alcohol intake and smoking have been blamed as causative factors for all heart diseases, which when combined with lack of exercise and weight gain could have devastating effects on the heart.
Cancers: India has over a million cancer patients currently, and every year 680,000 deaths occur due to cancer. This number is expected to shoot up to 845,000 by 2020, and nearly one million by 2025. A staggering 30-40% of cancer cases can be attributed to just one particular cause: smoking. Apart from the physical suffering, psychological disturbances, carer burden, and socioeconomic impoverishment are also associated with cancer. Since treatment of cancer is time consuming, likely to have variable outcomes, fraught with adverse effects, and expensive, it is imperative that the condition is prevented from occurring in the first place.
Respiratory diseases: Cases of asthma, chronic obstructive pulmonary disease, interstitial lung disease, pneumonia and pulmonary tuberculosis are on the rise in India. WHO has estimated that as much as 11% of deaths in the country are due to lung disorders. India also has the dubious distinction of being ranked first in the list of countries with high death rates due to lung diseases. A combination of rising levels of air pollution (due to industrial activities and vehicular emissions), and smoking has led to this state of affairs. Experts estimate that particulate matters – fine particles of soot or dust – are responsible for poor lung health. Further, an increase of 10 microgram/mm3 of particulate matter in the air could increase the risk of lung disorders by 5.1%.
Despite this woeful picture, there is hope. India recently became the first country to set specific national targets and indicators to reduce the global premature deaths due to NCDs by 25% by 2025. This is part of WHO’s Global action plan for prevention and control of NCDs 2013-2020. Apart from promoting healthy lifestyle, the action plan also advocates banning tobacco and alcohol advertising, salt restriction, replacing trans-fats with polyunsaturated fats, promoting breastfeeding, and screening for diabetes, hypertension and cancers. India has also implemented WHO’s Framework Convention on Tobacco Control by banning the sale of tobacco products near educational institutions, restricting tobacco-related imagery in popular media, developing tobacco-free guidelines, and increasing the pictorial warning size on tobacco products to cover 85% of the package.
No doubt, governmental and non-governmental measures are necessary, but at the individual level, if we could make a conscious effort to inculcate and promote a healthy lifestyle and a salubrious environment, we will be doing ourselves and the nation a huge service.