Thursday, July 19, 2012

Inactivity kills as many as smoking!

Its official.  Inactivity kills.  A recent article in the Lancet estimates that inactivity now causes the same mortality world-wide as smoking does!

That's 5.3 million deaths per year attributable to the lack of exercise.  5.3 million people dying every year because we are not getting enough exercise.

Is this something that is just plaguing the West?  Hardly. 

India has an estimated 40.9 million cases of diabetes.  We host a mind boggling 118 million cases of hypertension (if all the hypertensives in India formed a country it would be the 11th largest in the world - right after Japan's 127 million).  An estimated 8-10 percent of our above 30 years urban population has coronary heart disease already!  (All figures from Prabhakaran and Singh 2011).  


In the same series, the Lancet calls for physicians to include 'exercise' as one of the vital signs (Khan et al. 2012).  Exercise can no more be seen as a pleasant diversion.  It is clear that it is vital for our health.


In India we are seeing a sea-change in our country's disease profile - and a lot has to do with what we call 'progress.' The WHO now estimates that 53% of deaths in India are now from non-communicable diseases (WHO 2011). One of the key reasons for this increasing burden of disease is our increasingly sedentary lifestyles - combined with the stresses that our ever more aspirational life-styles.  

The tripling of our average per capita income from Rs. 19,040 in 2003 to Rs. 53,331 in 2010 (World Bank 2010) has not resulted in an immediate improvement in urban health outcomes.  In fact, we can argue that   aspirational issues of ‘modernity’ may be contributing to our national epidemic of suicides.  We have seen national rates of suicides increasing from 7.9 to 10.3 per lakh in the last 2 decades (Vijaykumar 2007).  A leading study estimated 187,000 people die of suicide in India each year – with the largest number among youth.  Most sobering of all – a 15 year old male in south India has a 3.5% chance of dying of suicide over a 65 year period (Patel et al. 2012). 

So what are we to do?

Well, we can start by being healthy in body and mind ourselves.  There is no use for death health-care practitioners.  The age old saw of prevention being better that cure is never more true for us today.

Get up and walk.  20 minutes every morning.  Get to bed on time.  Pray.  Spend time with the Lord.  Eat moderately and at the right times.  Model a balanced life of work, worship and leisure.  If we are not able to do this, how can we advise others to so?

The Bible tells us that 'your bodies are temples of the Holy Spirit, who is in you, whom you have received from God? You are not your own!' (1 Cor. 6.19). Our bodies are very important in God's sight. Paul tells us that "We know the body, however, is not meant for sexual immorality but for the Lord, and the Lord for the body." (1 Cor. 6.13). What an amazing statement - Jesus Christ is 'for the body!'  Doesn't that liberate us to serve Him through our health-care?  Through our work in restoring and repairing His creation - as well as making sure that these bodies do not fall ill in the first place?

Let us not fall into a platonic trap of seeing only the 'spiritual' as important.  The Christian message that we believe is that Christ is Lord of all. We worship Him not only when we sing songs - but when we have a brisk walk and are good stewards of the beautiful bodies He has graciously given us.  We worship Him when we set our minds on things above - and do not allow ourselves to be conformed by the things of this world, but rather are transformed by the renewing of our minds (Rom 12.2).

And we have a task as guardians and promoters of our health in our nation to share these truths with those around us. Can we see a new generation of doctors who step out of being body-mechanics to addressing life-style issues.  A new set of interactions with our patients and neighbours and church-members where we see the Shalom of the Kingdom lived out in every area of our lives - and reap the benefits of health rather than distruction?

Inactivity kills as many as smoking!  The campaign against smoking has world-wide reaped rich dividends in lives saved (though there is still work to be done of course).  Lets get moving!