Taming Chronic Diseases (Part 1)

  • Jaspal Bajwa
  • India
  • Apr 24, 2015

By 2020, Chronic or Lifestyle diseases will account for almost three-quarters of all deaths worldwide. The earlier perception that this is merely a problem faced by affluent countries has very quickly been replaced by a grim reality: on a global basis, 60 -70 % of the burden of Chronic Diseases (or NCDs - Non Communicable Diseases) will occur in developing countries. As per WHO, the number of diabetic people in the developing world will increase by more than 2.5-fold - from 84 million in 1995 to 228 million in 2025. The rate at which obesity is increasing is alarming. In developed countries, excess weight and obesity is estimated to cause 20% of cancer mortality, one third of heart diseases and 60% of hypertensive disease. It is now becoming a serious problem throughout Asia, Latin America and parts of Africa, despite the widespread presence of under-nutrition in these countries. Obesity has doubled, or even tripled, in some areas over the past decade. All this will have a devastating effect on quality of life as well as personal and public healthcare expenditures. The ‘Early Warning Indicators’ (EWIs) of ill health are all around us – for example, the burgeoning mid-sections of large numbers of the ‘well-to-do’. While idolising fit models, in our personal lifestyle choices we tend to veer towards ‘soft’ options. From a dietary perspective, we must break the spiral of an ever-increasing number of people adopting high-fat, energy-dense diets that have a substantial content of animal-based foods. However, this veritable tsunami is largely preventable – though there is no silver bullet, no quick fix. Without taking away the important contributions made by innovative and affordable medicines, it has to be recognised that the net impact of medication and surgical treatment at ground level has been very small. What seems to be working far better, in large measure, is community action and consumer awareness, and choice thereof. But we are still not there. We have to strongly overcome the ill effects of rapid urbanisation; we have to get away from a sedentary lifestyle and get back to wholesome diets (like our earlier traditional, largely plant-based diets). An inspirational example comes from the Republic of Korea. The community has largely maintained its traditional high-vegetable diet, despite major social and economic change. Not surprisingly it has lower rates of chronic diseases and obesity than other industrialised countries with similar economic development.

Tip of the Week

Taking a cue from WHO Europe, we need to be alert to seven risk factors that account for 60% of the chronic disease burden. These are tobacco, alcohol, low fruit and vegetable intake, physical inactivity, high blood pressure, high cholesterol, excess weight and obesity. For managing the early indicators of chronic diseases, the monitoring of BMI (Body Mass Index) is key. It is the waist-to-hip measurement, which determines how much fat surrounds vital central organs located in the waist region of the body. Certain foods (like red meat) need to be minimised and many others, which can even be described as ‘non-foods’, need to be avoided or eliminated altogether. Some examples are: highly processed meats, trans and saturated fatty acids, partially hydrogenated vegetable oils, overly refined carbs, salt and refined sugar. When shopping at the super market, be alert to the sodium content in the food. When eating out, it is wise to choose baked or grilled food, instead of fried. When cooking, consider using herbs and spices, instead of salt, to add flavour. Sugar should ideally not exceed more than 10 % of the total energy intake. It is imperative to control ‘portion-size’. Using smaller plates, with high-contrast colours, and not heaping them high, can be a great habit to cultivate. Portion size must be calibrated according to age, gender and the activity level of the individual.

Nature’s Wonder Food(s) of the Week:  Chronic Disease Taming Foods – Part 1

A well-balanced, varied and wholesome diet, which is alkalising, mainly plant-based and whenever possible fresh and organic, is indeed the best for overall health. When combined with a healthy activity level, this tends to cultivate the right kind of immunity-enhancing micro-flora in the gut. However, over-reliance on any single nutritional supplement or ‘superfood‘ needs to be guarded against. Using creativity to make a colourful plate of anti-oxidant rich foods, is not only satisfying for the senses but also tremendously enjoyable and vitality enhancing. In Part 1 we take up Fruits & Vegetables, which ideally should make up at least one-half of your plate. Low fruit and vegetable intake has been estimated to account for 4.4% of the burden of disease. WHO recommends 400 g/day or upward of 10 portions/day. 

Powerhouse Fruits & Vegetables (PFV): When exercising choice in favour of anti-oxidant and nutrient rich natural foods, we now have excellent advice from some latest research. In June 2014, a groundbreaking study – ‘Preventing Chronic Disease’ - was published in the CDC journal. Thanks to the efforts of Dr. Jennifer Di Noia and researchers of the William Paterson University (New Jersey), for the first time fruits and vegetables have been ranked by their nutritional density. As a yardstick, 17 nutrients of public health importance, chosen by Food and Agriculture Organisation (FAO) and the Institute of Medicine, were measured. These are: potassium, fibre, protein, calcium, iron, thiamine, riboflavin, niacin, folate, zinc and vitamins A, B6, B12, C, D, E and K. Nutrient-dense foods (defined as those with scores ≥10) were classified as PFV. On an average, PFV foods provide 10% or more Daily Value per 100 kcal of the 17 qualifying nutrients. In the ‘Top 10’ PFV list, Watercress interestingly was tops, with a score of 100. The next five PFVs are Chinese cabbage, chard, beet greens, spinach and chicory (see Chart alongside, and you can also click on http://www.cdc.gov/pcd/issues/2014/13_0390.htm#table2_down

To sum up, depending on seasonal availability, choose colourful red, orange and dark-green vegetables like tomatoes, sweet potatoes and broccoli, along with the other vegetables for your meals. Innovate and use creativity to mix vegetables into your main dishes. Add fruit as part of the main or side dishes or as a delightful dessert. For a healthy and handy snack, always have the refrigerator well stocked with ready-cut, bite-sized fruits and vegetables like carrots, peppers or orange slices.

To be continued: In the next article we will cover other foods that can help prevent chronic diseases – e.g. grains, fibre, polyunsaturated & monounsaturated fatty acids, dairy products, lean protein foods, antioxidant rich spices and healthy beverages.

Taking a cue from WHO Europe, we need to be alert to seven risk factors that account for 60% of the chronic disease burden. These are tobacco, alcohol, low fruit and vegetable intake, physical inactivity, high blood pressure, high cholesterol, excess weight and obesity

For Education purposes only; always consult a Healthcare Practitioner for medical conditions


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