Raveena has decided to take her health goals seriously. She has a strong family history of diabetes. She has now been diagnosed as having pre-diabetes, a condition preceding diabetes, where the blood sugar levels are starting to go up but are not high enough to be called diabetes. She has also received a series of minor shocks lately: her husband has just been diagnosed as having high blood pressure and her best friend's husband has been admitted to the hospital with a suspected heart attack. Raveena is 40. Is it too late for her to set and achieve her health goals?
In the 21st Century, Indians are being overwhelmed by what are termed ‘lifestyle diseases': diabetes, hypertension, high levels of cholesterol and triglycerides and increasing rates of heart attacks. As Indians, we are genetically hardwired to develop these diseases, if we do not adopt strict and sensible measures. Modifying your lifestyle can help prevent or at least postpone the onset of these conditions. Genetics may have loaded the gun but it is you who can decide if and when the trigger is going to be pulled!
Achieving and maintaining normal sugar levels
Glucose provides energy to every cell in your body. The maintenance of normal levels of glucose in the blood stream requires a complex number of regulatory mechanisms. The control of blood sugar levels is determined by the hormones insulin and glucagon , which are secreted into the blood by the pancreas. These hormones maintain blood sugar levels within fairly strict limits. If these mechanisms fail, hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar levels, as in diabetes) can result.
Eating foods with a low glycemic load is a good way of keeping sugar levels normal. Foods low in glycemic load are typically fruits and vegetables, whole grains, legumes, and lean proteins.
Eating small quantities at short intervals, typically every two to three hours (‘grazing'), reduces the risk of over-eating and overloading with calories. The blood sugar levels are maintained at ideal levels without dipping too low or rising dangerously. Adding protein and fibre to your diet slows the absorption of glucose.
While eating a healthy, balanced diet helps to control blood sugar, weight loss and exercise also play a crucial role in keeping blood sugar under control.
Achieving and maintaining normal blood pressure
Normal blood pressure usually means a level of 120/80 mm Hg or less. Blood pressure higher than 140/90 mm Hg is considered detrimental to your health.
Risk factors for developing high blood pressure include diabetes, a family history of hypertension, being obese or overweight, and leading a physically-inactive, sedentary lifestyle.
As the pressure increases inside the arteries, veins and capillaries, the heart is overworked. With the addition of obesity, diabetes or smoking to the mix, the risk of heart attack, stroke or kidney disease increases dramatically for those with high blood pressure.
Exercise is extremely valuable in controlling blood pressure. Moderate physical exercise, such as brisk walks and climbing stairs instead of taking the lift, can be effective strategies in preventing or controlling hypertension. Make it a family affair by getting away from television sets and the computers, and start your children exercising early in their lives.
Avoid foods high in fat and cholesterol and cut your salt intake drastically. Indians consume too much salt. Remember that most snacks and packaged foods are loaded with salt.
Achieving and maintaining a normal lipid profile
A lipid profile measures total cholesterol, HDL (“good” cholesterol), LDL (“bad” cholesterol), and triglyceride levels. Total cholesterol levels should be under 200; 200 to 239 is borderline high; and 240+ is considered high. High triglyceride levels are considered a ‘rice eater's disease'.
Control cholesterol
Abnormal cholesterol levels are one of the main risk factors for heart disease and stroke, both diseases that are rapidly increasing in the Indian population. Cholesterol is a soft, fat-like, waxy substance found in the bloodstream that performs a number of essential functions in the body. When the levels become higher than they should be, cholesterol blocks blood vessels in the heart and the brain.
High concentrations of HDL can be protective against cardiovascular diseases. HDL levels should be over 50 mg/dL in women. LDL cholesterol of less than 130 mg/dL is optimum. A high LDL level, more than 160mg/dL, has been shown to increase the risk of developing heart disease.
A healthy diet and regular exercise can help control high cholesterol and triglyceride levels. Your physician may, in addition, prescribe medication (statin) to help control your cholesterol.
The author is an obstetrician and gynaecologist practising in Chennai and has written the book 'Passport to a Healthy Pregnancy'.
