Friday, 16 March 2018

This doc advises to cut doctor-dependency for a healthy life

I was invited to meet Dr. Jeffrey I Mechanick, Division of Endocrinology, Diabetes, and Bone Disease, Mount Sinai School of Medicine, New York, USA, when he recently visited Chennai for a conference. He was accommodated in a star hotel in Guindy where I was asked to meet him. I went at around 4 in the evening and was waiting for a long time. Though our meeting was scheduled at 4, I had to wait for an hour to meet him, who finally showed up at 5 pm, after getting done with his conference with a few doctors in town.

His conference witnessed a very less turn out. Only a couple of doctors from the city were there to listen to his speech. I was really surprised on seeing the turnout, as I have already seen how these allopathy doctors from corporate and profit minded hospitals are obsessed to such conferences which has any random Caucasian facilitator.  Frankly speaking, I am totally against allopathy and, the doctors practising it, as well. And, so I was seriously pissed off as the meeting was delayed.

Finally, when we started interacting after my one hour wait.

A perfect healthy life is the one that has less doctor-dependency. With this objective running along the crux of his speech, Mechanick, started to elaborated on how the Indian population is suffering from diabetes and cardiovascular disease. And there, I started to listen with a curiosity, as I finally could find an allopathy practitioner speaking against doctor-dependency.

He furthered,

“A lot of modifications have to be made in the lifestyle of an person from the Indian-subcontinent, especially his diet,” he said.

According to him, the health of a person living in the subcontinent gets lost when his diet is influenced by food that does not belong to his soil. “People say about westernised food causing health complications. But, even north Indian food can lead to a severe health issues for a south Indian.”

Speaking on the methods to be adopted in the diet, he said, “As time goes by, the carbohydrate diet has been leading to all these health complications. When it comes to rice, on an average, a south Indian diet comprises of rice all three meals a day, in some form. But, when you take up a protein content like nuts, beans or seeds, it adds up a balance to the insulin resistance of the body.

When I interrupted with the scenario of early 1900s when a very negligible number of the subcontinent's population had diabetes, he said, “Your grandparents and ancestors, though ate a lot of carbohydrate, their physical activity was equally high. But, the present generation is totally off physical activities. That is how diabetes came into existence.”

On physical activities that can help generation-X from developing diabetes, he said, “By saying increase your physical activity, I do not mean that you have to exercise, which is a structured physical activity. A rather unstructured physical activity like walking for a long distance, using stairs than lifts can balance your life.”

He said, “Your cultural roots have it all. For an instance, when you get a glucose enriched prasad at temples, you eventually go around the corridor of the temple at least nine times, which balances the glucose content. Likewise, every festival has a feast diet and also has a lot of physical activity along with that.”

Further when I asked about the genetically modified rice and polished rice, Mechanick said, “We cannot land in a simple conclusion on this. But any form of a refined food like polished rice, maida, sugar or powdered salt, indeed are really hazardous to health. But, they are not the only hazardous factors. A balance always has to be there in diet and lifestyle. This balance is the message for this society.”

Mechanick said, “When you have this balance, the occurrence of diabetes and doctor dependency would be ultimately very less.”

At the end of our one hour interaction, all that was running in my mind was, I had been waiting for over an hour to listen to a doctor coming all way from the USA and advice me to eat what my grandparents actually taught me to. Literally. Also I realised why his conference had such a turnout. How can one expect a doctor, who speaks about practical and healthy way of living life, to have a spectator sourced out from corporate hospitals that function on a vice-versa ideology - simply to make money out of people's sickness, and not-even-sickness-but-fear. Well, that would be beyond the bounds of possibility.

Post interaction

Mechanick, apparently shared some of his research works with me. Here is the abstract of that.

According to a recent study by Dr Mechanick, and four other doctors from the subcontinent, “India and other countries in Asia are experiencing rapidly escalating epidemics of type 2 diabetes (T2D) and cardiovascular disease. It shocks that India stands only in the second place next to China with the maximum number of T2D victims. The dramatic rise in the prevalence of these illnesses has been attributed to rapid changes in demographic, socio-economic and nutritional factors.”The rapid transition in dietary patterns in India – coupled with a sedentary lifestyle and specific socio-economic pressures – has led to an increase in obesity and other diet-related non-communicable diseases. The study has shown that nutritional interventions significantly enhance metabolic control and weight loss.

The doctors also have shown in their study that current clinical practice guidelines (CPGs) are not portable to diverse cultures, constraining the applicability of this type of practical educational instrument. Therefore, a transcultural Diabetes Nutrition Algorithm (tDNA) was developed and then customised as per regional variations in India.

“The resultant India-specific tDNA reflects differences in epidemiologic, physiologic, and nutritional aspects of disease, anthropometric (systematic measurement of the physical properties of the human body) cutoff points, and lifestyle interventions unique to this region of the world. Specific features of this transculturalisation process for India include characteristics of a transitional economy with a persistently high poverty rate in a majority of people, higher percentage of body fat and lower muscle mass for a given body mass index, higher rate of sedentary lifestyle, impact of festivals and holidays on adherence with clinic appointments, and the role of a systems or holistic approach to the problem that must involve politics, policy, and government.”

The doctors’ Asian Indian tDNA promises to help guide physicians in the management of pre-diabetes and T2D in India in a more structured, systematic and effective way compared to previous methods and currently available CPGs.

Some vital facts about diabetes - Source: WHO
  • The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.
  • The global prevalence of diabetes among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014.
  • Diabetes prevalence has been rising more rapidly in middle- and low-income countries.
  • Diabetes is a major cause for blindness, kidney failure, heart attacks, stroke and lower limb amputation.
  • In 2015, an estimated 1.6 million deaths were directly caused by diabetes. Another 2.2 million deaths were attributable to high blood glucose in 2012.
  • Almost half of all deaths attributable to high blood glucose occur before the age of 70 years. WHO projects that diabetes will be the seventh leading cause of death in 2030.
  • Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes.
  • Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications.
What is T2D?

Type 2 diabetes (formerly called non-insulin-dependent, or adult-onset) results from the body’s ineffective use of insulin. Type 2 diabetes comprises the majority of people with diabetes around the world, and is largely the result of excess body weight and physical inactivity.
Symptoms may be similar to those of type 1 diabetes, but are often less marked. As a result, the disease may be diagnosed several years after onset, once complications have already risen.Until recently, this type of diabetes was seen only in adults but it is now also occurring increasingly frequently in children.

- Santhosh Mathevan,
Chennai, Mar 16, 2018.