India is currently on the cusp of an economical, demographical and epidemiological shift as far as health is concerned. In the last decade, we have made tremendous progress economically, which has also translated to improvements in our health sector. The average life expectancy has been raised to 67 years, infant and under-five mortality rates have declined and diseases like polio, guinea worm disease and tetanus have been eradicated. However, it's still too early to call for celebrations since we are still fraught with many health challenges in the country. Diseases, both communicable and non-communicable, pose a threat to our quality of life. Communicable diseases like tuberculosis, malaria and other tropical diseases continue to vex health care in the country.
Non-communicable diseases like cancer, cardiovascular diseases and diabetes have been contributing to 60 percent of deaths, making them the leading cause of deaths in the country.
A combination of factors such as genetics, lifestyle diseases, accessibility of medical treatments and climatic conditions have been compounding the health situation in India. On World Health Day 2018, we look at some of the commonest killer diseases in India. Our panel of experts helps us decode the current situation and how we can stay safe from them.
India was safer than the west when it came to cancer incidences, but trends suggest that the country is catching up. Dr Sudesh Pandse, Consultant Surgical Oncologist at SL Raheja Hospital, a Fortis Associate says that the changes in demography are to be blamed. "As the population increases, a number of cancer cases also increase," he says. Urbanisation and the shift in lifestyle choices are also the causes of rising cancer incidences in the country. Lately, cancer has also been hitting more women than men in India. "More and more women have been opting for late marriages and late pregnancies, causing a spike in cancer cases among the females. Factors like faulty diet and obesity has been linked to breast ovarian and colon cancer," says Dr Pandse.
How to stay safe from cancer
To reduce the risk of cancer among the Indian population, Dr. Pandse prescribes a healthy diet and maintaining a good body weight. Clean up your food habits by ensuring a nutritious diet, eating organic, using turmeric and having plenty of fresh fruits and vegetables. "Maintain a good body weight. One must have a BMI less than 25 on an average. Reduce consumption of tobacco and alcohol, which will help in maintaining the body weight," adds Dr. Pandse.
Dr. Anil Bhoraskar, Secretory Diabetic Association of India and Senior Diabetologist, SL Raheja Hospital –A Fortis Associate says that India's dubious tag of 'The diabetes capital of the world' is wrong. "China is ahead of us in that matter. India should take pride in calling ourselves as ‘Diabetes Care Capital," he says. But he does add that that we are facing veritable diabetes "tsunami." He rues, "The reason is mainly due to the widespread radical change in our diet and lifestyle. From infancy to early childhood, our diet has changed completely. High intake of Omega-6 fats, refined carbohydrates, fast and junk food, all these have made our society vulnerable to all the killer diseases. Lack of physical exercises and more screen time for growing children, has resulted in an epidemic of childhood obesity, which is the forerunner of diabetes. Diabetes during pregnancy is increasing (gestational diabetes mellitus), these women have higher chances of developing."
How to prevent diabetes complications
Since diabetes is a lifestyle disease, the surefire way of tackling is by making changes in the way we live. "Eating habits have to be changed. Avoid oily food. Consume ample seasonal fresh vegetables and fruits, avoid sugar- dense colas and shakes, eat whole grain bread and avoid refined carbohydrates and sugars," he says. And as in any case, physical activities is a must for good health, especially for children and adolescents. "Reduce screen time to less than 2 hours in the whole day. Stress management is important, learn to laugh and smile and don’t take life too seriously!" he says. To avoid complications, regular check-ups, testing blood parameters and eye health, undergoing ECG, monitoring insulin dosages and blood pressure, and inspecting feet for early lesions is a must. "Visit diabetes care centres like you visit temples!" he quips.
India contributes to a quarter of the global TB cases in the world. And worldwide, the country leads in incidences of both TB and Multidrug-resistant TB. Mycobacterium tuberculosis, a type of pathogenic bacteria, is responsible for causing tuberculosis. Dr. Prashant Chhajed, Chest Physician and Pulmonologist at Hiranandani Hospital, Vashi -- A Fortis Network Hospital, says, "When a person with active lung disease coughs, the exposed person inhales the cough droplets, containing the TB germs." He adds that although everyone is vulnerable to the TB bacteria, people who have weakened immune systems -- HIV or diabetes patients, chemotherapy patients, those with poor diet and nutrition and those who abuse alcohol and drugs -- are more at risk.
How to prevent tuberculosis
Dr Chhajed says, "The most measure in TB prevention is the proper and complete treatment of individuals with active TB, so that the spread can be prevented. An individual with active TB infection should take steps to avoid spreading the infection to others. Those with active lung TB should wear a paper mask (disposable - not to be reused after pocketing." Spitting in public places should be prohibited. It's also important to cover nose and mouth while coughing or sneezing. They should avoid going to crowded or closed spaces and maintain good ventilation at home. Skipping work or school is recommended until the person gets better. Do not neglect sleep and ensure at least 7-8 hours of rest. Here are some steps to prevent TB.
People who don't have TB should follow preventive measures by following a good diet with plenty of fruits, vegetables and whole grains. They should avoid spending a long time with anyone who has active TB, especially when they have been receiving treatment for less than two weeks.
Mental health problems
Cases of self-harm and suicides are on the rise. Tanvi Sardesai, Counselling Psychologist, Dept. of Mental Health and Behavioural Sciences, S.L. Raheja Hospital-A Fortis Associate believes that the stigma associated with mental health in India is stopping people from taking professional help. " Mental wellbeing is taken very lightly, as a result, when help is not received it often increases the intensity of the symptoms and the disorder. Another reason is the changing lifestyle which has made life more stressful. There isn’t enough time to take care of ourselves, to reach out for some social support. This isolates us and that has a negative impact on our mental wellbeing. There is also a lack of awareness about mental health care. People often don’t know what resources are available, who to approach, how to go about it etc.," she says.
What should be done to reduce the mental health burden?
The first step is to reduce the stigma. The second step is to recognise and accept that you may have a problem and it is important to seek help. Taking care of yourself, building and maintaining social support with loved ones and talking about your own mental health and encouraging others to speak is what will work at the individual level, according to Tanvi.
At a community level, she recommends: "Including mental health with other public health strategies would help since that would reduce the stigma, and also be more cost-effective. Having mental health professions at schools, workplace and other organisations would make access to mental health easier. Providing people information about access to mental health is necessary."
Heart diseases have become one of the leading causes of deaths in India. A quarter of all cases of deaths in India can be attributed to cardiovascular health. Other concerning problems include the accelerated build-up of the disease, early onset of heart disease in the population and high case fatality rate. Even poorer sections of the society from the interior parts of the country are not safe from the bane of cardiovascular illnesses. Sedentary life, characterised by limited physical activity and sitting for long hours in front of the computer screen, is compounding the problem of heart diseases in the country.
How should you keep your heart healthy?
Dr Bhaskar Semitha, Consultant cardiothoracic & vascular surgeon Fortis Hospital Kalyan says that there is a ten-fold increase in cardiovascular events and death in people who have sedentary jobs. It's important to a sedentary lifestyle and engages in some physical activity. He recommends 150 minutes of moderate intensity exercise per week to keep your heart fit. Getting a good night's sleep, for seven to eight hours, is required for a healthy heart. Avoiding smoking and passive smoking. "Tackling weight issues by sticking to a healthy, balanced diet low in fat and sugar and having plenty of fruits and veggies is also important," he adds.
When it comes to obesity, the West gets most of the bad rap, but India isn't too far either. Indians are genetically more predisposed to obesity! Dr. Sweta Budyal, Consultant Endocrinologist and Diabetologist, Fortis Hospital, Mulund, says, "Obesity has reached epidemic proportions in India. rapidly changing lifestyle is primarily responsible for this problem. India has experience steep rise in average caloric intake per individual as a result of increased middle-class income, easy access to fast food and unhealthy processed food, and lack of nutrition-related knowledge. At the same time, the physical activity has gone down drastically, leading to kind of energy imbalance." Dr. Budyal also cites mental stress due to work and personal problems, reduced hours of sleep and change in eating patterns in children as causes worsening the epidemic.
How to prevent or tackle obesity
Calling obesity a chronic problem, Dr. Budyal says that it's not easy to revert it once it sets it. "Prevention is better than treatment. Every individual should focus on having a balanced diet with plenty of vegetables and an appropriate amount of protein. "Regular physical activity can further help to maintain healthy body weight. The importance of stress management, adequate sleep and reducing screen time in children cannot be overemphasised. Obesity can be treated with a change in the lifestyle pattern or with an addition of certain medications amongst appropriate candidates," says Dr. Budyal.
Fertility clinics in India are being thronged with people who have had little or no luck conceiving. Dr. Hrishikesh Pai Consultant Gynecologist and IVF specialist, Hiranandani Hospital Vashi- A Fortis Network Hospital say that one of the problems leading to the rise in infertility is ironically the population explosion. "The incidence of infertility has increased from 5 percent to 10 percent in the general public," he says. Increase in sexually-transmitted diseases increased incidences of tuberculosis, late marriages which affect the fertility of female partners and contamination of food and water, which impairs ovarian and sperm health, are some of the causes, according to Dr. Pai. "Luckily, the awareness is increasing and people are seeking treatment for the same," he adds.
How to prevent infertility
As in any case, a healthy lifestyle is a prerequisite for good fertility. Dr. Pai recommends safe sexual practices to prevent infertility-causing STDs, regular exercises and avoiding alcohol and tobacco. "Get yourself checked for Anti-Mullein Hormone (AMH). It should not be less than 1.5mg/NL," adds Dr. Pai. With age, fertility in women can wane. That's why it's important to get married at the same time.
India is a vast country, housing people who belong to different socio-economic backgrounds and ethnic makeup. That's why our health issues are also varied. Despite the many challenges, awareness about health conditions, a good lifestyle, healthy diet, physical activities, eschewing alcohol and regular checkups can bring down the burden of diseases, some of which have been the leading causes of mortality in India.
(The above story first appeared on LatestLY on Apr 07, 2018 02:41 PM IST. For more news and updates on politics, world, sports, entertainment and lifestyle, log on to our website latestly.com).