In May 2015 Mohammed Ali (58) was driving his taxi up Hughes Road, near Mumbai's iconic Marine Drive. It was a hot summer’s day and Mr. Ali, who was severely overweight at the time, was sweating profusely and finding it difficult to breathe.
The young lady sitting in the passenger seat that day happened to work in the office of a doctor who treated patients with obesity. Seeing his obvious discomfort, she convinced him to stop by the clinic for a consultation. It was a chance encounter that may well have saved his life.
The consultation revealed that in addition to obesity leading to high blood pressure, Mr. Ali also had a dangerous condition called sleep apnea that had caused him to doze off while at the wheel and had led to three accidents in the past.
After undergoing bariatric surgery with Dr. Sanjay Borude, the surgeon whom he consulted that day, Mr. Ali’s weight is now under control.
On life before the surgery he recalls that he was caught in a cycle that he couldn't escape. “I got very little sleep and then I was out on the road from morning to night to make enough money for the day. I'd end up stopping only to eat snacks like vada pav or bhajiyas or something so that I could save both time and money,” he explains.
Like millions of other Indians Mr. Ali was a victim not of lifestyle choices but of lifestyle compromises. It is a trend that is redefining how we think of lifestyle diseases, which are fast becoming one the country's most alarming healthcare crises.
According to research by the WHO an Indian today has over twice the odds of dying of a non-communicable disease than a communicable disease.
New disease patterns
The spurt in the number of patients affected by lifestyle diseases shows that the incidence of such diseases is moving down the social and age ladder.
At the government-run KEM hospital, for instance, hospital Dean Dr. Avinash Supe says that the numbers and profiles of patients who come in with lifestyle diseases have increased by 30 to 40 per cent over the past ten years.
“As people have moved further away from the city as it gets more crowded most of their day goes in commuting up and down. There is no time for exercise or for relaxation,” he points out. He adds that among younger professionals, long hours spent indoors lead to problems like demineralisation and osteoporosis.
Changes, he said, have also been observed in specific wards. “Over the years we have found that in the liver ward there are more cases of fatty liver and fatty acid, which are both lifestyle related. Earlier the large majority of patients used to come with liver disease caused by alcohol.”
The surge in NCDs in India stems as much from today’s hectic lifestyle as from unplanned urban development.
The food connection
In the paediatric ward, Dr Supe explains that about 95 per cent of children used to come with gastroenteritis but there are now several cases of obesity, endocrinology disorders and even some cases of juvenile diabetes.
Dr. Tushar Bandgar, Professor of Endocrinology at KEM says that the easy availability of calorie-dense foods is perhaps the biggest cause for the increase in lifestyle diseases and also suggests that policy around such foods should be our first line of defence.
“When we were kids and you wanted to eat something like bhel puri you would have to go to Chowpati Beach. That was the only option. Now you can get these kinds of foods anywhere but these are not natural foods,” he explains.
A countrywide tax on calorie-dense foods, such as the ‘fat tax’ recently implemented by Kerala, he suggests, could be one possible approach.
This is the sixth and final part of the series, Malady Nation, on India's multi-dimensional healthcare crisis. This part explains the alarming trends in lifestyle diseases and their link to individual choice and public policy.
