Since a number of our patients are now youngsters, the process of counselling them has become an interesting experience. Invariably they ask: “Why did I end up getting this disease?” We explain patiently the possible medical causes — diabetes, hypertension, sedentary lifestyle, genetic aspects, family history, and stress. Sometimes, their response to that is: “But, doctor, I do not have any bad habits.”
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Clearly, there is a gross misconception regarding “bad habits”. What are these “bad habits” in the Indian context? Primarily, as far as it “affects cardiology, they think drinking and smoking are bad habits. No doubt, to some extent, they are correct. And the latest trend is the response, “Doctor, I don’t even eat non-vegetarian food.”
For cardiologists, this perception of bad habits, and their impact on human health, is quite worrisome.
To be frank, habit formation is rooted in ancient evolutionary mechanisms in the brain. Obviously, it is modified by the society we live in and influenced by the choices of our family members, peers, and friends.
We have noted, anecdotally, that those who say “I have no bad habits” the loudest generally have a BMI of over 30, even 35, which makes them obese. When we analyse their daily activities, we find one common attribute: they hardly move around except for the most essential household chores and, have no concept of what they eat.
As professionals, it is increasingly astonishing to see the levels of obesity, particularly abdominal obesity, in youngsters. Some of them are morbidly obese: the waist circumference is 120 cm, as opposed to the recommended waist circumference of 90 cm. They also have thin extremities, like thin arms and legs, but a fat-laden chest and belly. This is a very unhealthy body shape. Their body fat is probably in the range of 35–45%, as opposed to 15%, which is ideal.
When we ask our patients, “Do you go for walks?” The immediate response is quite predictable. “I don’t have time to walk, I walk during work.” A study by the Indian Physician Association states that an average office employee in India does not take more than 2500 steps a day. This is quite worrisome. “Everyone has a mobile and can download fitness apps. Remember that it is important to take at least 6,000 steps a day, though 10,000 would be ideal, to say you live a healthy life.”
The Indian diet is traditionally carbohydrate-rich. The addition of fast food to our culture has only made it worse. A radical re-look at our food culture is the need of the hour. The protein component of our food has to be raised. A typical diet of curd rice with pickles is considered simple and healthy, but there is little protein in the curd, and it is carb-rich.
It is also important to bust the myth that non vegetarian food is bad for health. A limited amount of non-vegetarian dishes is recommended. This is the best way to fulfil the protein requirement. If one is a vegetarian, you need to actively look for alternate sources of protein and prioritise increasing that.
Something else that is grossly undervalued is sleep. A third of our lives are spent sleeping. According to statistics, a good proportion of the Indian population works night shifts. But we must realise that sleep deprivation is directly related to mental well-being, obesity, eating disorders, mood fluctuations, diabetes, and finally, heart disease, in the long run.
(The author is Director, Dept. of Cardio-Vascular and Thoracic Surgery, Medway Heart Institute, Chennai. )
Published - April 21, 2024 02:57 pm IST
