Battling the “Inevitability” of Diabetes through Lifestyle
People who can adopt and maintain simple lifestyle principles—moderate physical activity (like brisk walking) for 30 minutes five times a week, eating less fat calories (butter, ghee, red meats), and more fruits and raw nuts—can slow or even prevent the onset of diabetes.
All of us know or are related to someone who is affected by diabetes. People with diabetes have a higher risk of developing heart disease or stroke, and diabetes is the world’s leading cause of adult blindness, kidney disease, and amputations that are not due to trauma. More and more studies show that a larger proportion of South Asians experience diabetes and its complications compared to Caucasian, Hispanic, or African-American populations. This occurs despite the fact that, in America, South Asians are more educated and affluent than other race/ethnic groups. Also, in South Asian countries like India, Pakistan, and Bangladesh, first heart attacks occur ten years younger, on average, than in other parts of the world.
The reasons that South Asians are so predisposed to these devastating illnesses are many. While we would love to be able to attribute these illnesses to one curable cause, no such target for treatment has emerged. What we do know is that our lifestyle choices—what we eat, our level of physical activity, use of tobacco products—are powerful risk factors. And although South Asians are not large people (in terms of overall weight and height) compared to other race/ethnic groups, this group tends to be less physically active and also carries higher percentage of body fat, especially around the abdomen. In other words, one doesn’t have to be obese by international standards to develop diabetes or heart disease; these occur even in fairly lean, small sized South Asians, too. This peculiarity may be genetic or related to some other biological mechanism.
South Asians are becoming more aware—conversations about how rampant diabetes has become are common, especially at events serving pakoras, mitthai, and sweet chai. Many South Asians attribute getting diabetes or describe themselves as helpless to the inevitability of developing diabetes due to having diabetes “in my family.” However, studies show that even in the presence of potent genes for diabetes, people who can adopt and maintain simple lifestyle principles—moderate physical activity (like brisk walking) for 30 minutes five times a week, eating less fat calories (butter, ghee, red meats), and more fruits and raw nuts—can slow or even prevent the onset of diabetes. And for those already with diabetes, embedding these behaviors into one’s lifestyle can help control blood sugar, pressure, and cholesterol levels, leading to less need for medicines and potentially less diabetes disease complications.
As Johann Wolfgang von Goethe once said, “Knowing is not enough; we must apply. Willing is not enough; we must do.” Reforming one’s lifestyle is achievable and there are increasingly resources to help people succeed. It’s time to stop dwelling on inevitabilities and take ownership of our health….
Mohammed K. Ali is an Assistant Professor of Global Health and Epidemiology at Emory University and an advisor for the Division of Diabetes Translation at the U.S. Centers for Disease Control and Prevention.
[Gulshan Harjee, M.D., is a board certified internist in private practice with an emphasis on prevention. Please email your health and medical questions for consideration in this column to: gharjee@comcast.net. The material in this column is of a general nature, and must not be construed as specific medical advice. This column rotates monthly along with the Fitness Lifestyle column by Aarti Patel.]
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