Non-communicable diseases and serious consequences of sedentary lifestyle, wrong diet
Indians are increasingly following sedentary lifestyles, exacerbated in COVID times
Noncommunicable diseases are increasingly recognised as one of the biggest health and development challenges of the century. These serious diseases including heart disease, diabetes, cancers and chronic lung diseases, cause more than two-thirds of deaths in the world. Mental health is also included under NCDs.
Cardiovascular disease is by far the No. 1 killer, for both men and women. Mental illness is a third of the staggering $47 trillion economic fallout of these diseases. All countries are affected and the poorest most impacted. In countries like India, NCDs pose a huge challenge and have now overtaken the combined burden of maternal and child mortality, plus infectious diseases like TB, HIV, malaria etc.
India is a diabetes capital. A total of 77 million people live with the disease, and an equal number are estimated to be pre-diabetic. The recent NFHS 5 shows that obesity affects nearly 25 per cent adults, that the rates are rising and India is among the top five countries in the world with respect to obesity. In metros, upto three out of four adults are either diabetic or pre-diabetic. The epidemic is devastating the poor and underserved and is rapidly overwhelming rural areas too. Around 10 per cent of India’s children as young as five years of age are pre-diabetic. Something must be done.
Fortunately, these diseases are largely preventable. According to the WHO, 80 per cent of heart disease and type 2 diabetes can be prevented with three lifestyle changes – by eating right, increasing physical activity, and avoiding tobacco. We can’t treat our way out of the NCD crisis -- it is simply too widespread. Prevention is a smart solution. For prevention to be effective, it must be deployed at the population level, the government must take action, and consumers must demand and adopt healthy lifestyles.
To guide countries on what to do, the World Health Organisation developed a Global action plan for the prevention and control of NCDs and also endorsed a package of affordable, cost-effective, evidence based NCD interventions, the Best Buys. India was the first country in the world to comply and declared its National Action Plan and NCD Monitoring Framework in 2013 with country-specific targets and indicators to be achieved by 2025. The framework mentions key interventions such as improved dietary habits, increased exercise, and reduction in tobacco and alcohol use.
Eating Right. Unhealthy eating is the topmost cause of death, according to the Global Burden of Disease Report. So, getting this right is most important. According to the EAT Lancet Commission 2019, transformation to healthy diets by 2050 will require substantial dietary shifts: doubling the consumption of healthy foods such as fruits, vegetables, legumes and nuts, and a greater than 50 per cent reduction in global consumption of less healthy foods such as added sugars and red meat.
What efforts are going on around the world? New York City took several bold steps, starting about 2 decades ago: they banned trans fats, educated younger generations about the detrimental health effects of sugary beverages through graphic media campaigns, and required chain restaurants and food establishments to post calorie information about their products on menus, helping customers to know more about what they were eating so they could possibly make healthier choices. In the UK, a group of passionate individuals and a nonprofit worked with government and packaged food manufacturers to gradually bring salt down in packaged food through reformulation. A US effort called Produce Rx is an innovative way to get NCD patients and the poor to access fresh fruits and vegetables through subsidisation.
The efforts of India’s Food Safety and Standards Authority of India in this regard are great. FSSAI reduced the amount of trans fatty acids (TFA) in oils and fats (to 2 per cent by 2022) and will introduce front of the pack labeling for junk foods. The government is also considering bold policy moves such as higher taxation and restrictions on marketing of unhealthy foods. Further, FSSAI’s ‘Eat Right India’ movement and the remarkable “Aaj Se Thoda Kum” ads encouraged people to reduce salt, sugar and fat consumption in compelling ways.
Increasing physical activity is another key factor. Indians are increasingly following sedentary lifestyles, exacerbated in COVID times. Children don’t move enough: 75 per cent of India’s teenagers have insufficient physical activity says the WHO. All of us need constant reminders to invest at least 30 min a day in moderate physical activity – it could include gym time and formal sports but could also include walking, household chores, taking stairs instead of elevators etc. India’s FIT India movement has a lot of potential. We also have much to learn from Agita Sao Paolo, an effort to get whole communities to engage in physical activity.
A lot is being done already in India to build a consumer movement around healthy living.
Chefs and nonprofits collaborate and use social media to educate consumers about what to eat and in what quantities at each meal, and create healthy recipes etc. Health NGOs are collaborating with poverty alleviation, teach adolescents about healthy eating as an adjunct to textbook learning before lifestyle habits are fully set. Both governments and NGOs are using mobile technology in novel ways to get the right education about healthy eating, physical activity and tobacco cessation into the hands of consumers. NGOs are desirous of working with frontline workers and government-led technology platforms to increase the emphasis on NCD prevention everywhere. Business leaders, realising the benefits of a healthy workforce, are following the blueprints from industry associations and nonprofits and investing more in the physical and mental health of their employees.
Multi-sectoral action is key for success. No one entity can tackle NCDs alone – the task at hand is too huge. The academia and administration in a city, state and national level, companies big and small, NGOs and individuals all need to make a commitment to promote healthy living. This is especially important in the post-Covid era to build India back better and is a must for India and the world to meet the SDGs.
The author is founder and CEO, Arogya World. Views are personal.
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