Health Problems In The Globized World

Dr. Sunita Gupta, M.D. Mob: 9810233017 Email: [email protected]

Dr. Salil Gupta

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In this presentation

,

we will discuss:

 What are the major health

threats with our busy and changing lifestyle today? Why do such diseases occur? what are lifestyle diseases? Recommend changes to avoid them And how good and balanced nutrition helps to avoid such

Dr. Salil Gupta

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Numbers that speak aloud Cardio Vascular Disease Risk of Cardio Vascular Disease after quitting smoking 15 yrs after quitting Strokes High BP No. of smokers blood cholesterol level to prevent Cardio Vascular Disease overweight people in India overweight people in the world Diabetes in India Diabetes worldwide

Dr. Salil Gupta

16.7 million (29 percent 2003 of all deaths globally)

WHO

Men - 53 % Women - 47 % 11.1 million deaths

2005

WHO

In 2020

WHO Internet

2002 - 2004

WHO

2025

Tulane University School of Public Health, 2005 Internet Internet

Decreases by 50 percent Equal to non-smoker’s suffer - 15 million disabled - 5 million deaths - 5.5 million 1.56 billion 1.3 billion Less than 5.0 milli-moles per litre

current current

increase from 9 % to 24 % 1.5 billion

between 1995 and 2025 by 2015

WHO

40.9 million Increase from 2.1 % to 3 % 200 million adults

between 1995 and 2025

Internet

current

Internet

Internet

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Diseases that cause maximum deaths -

heart related disease,

Obesity

- Stroke, Cerebro-vascular diseases Osteoporosis, - hypertension - several cancers, - Type 1 & 2 diabetes, - Chronic Obstructive Pulmonary Disease, - chronic renal failure, Alzheimer's disease, - Chronic liver disease or cirrhosis, Depression

Dr. Salil Gupta

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Why do lifestyle diseases occur?

Sleep and wake pattern –Wrong and Unhealthy

Poor Environment- Air and Water pollution, Adulterated Food - Fertilizers, Pesticides,

Chemicals High Level Of Stress – Mental & Physical No Quality Time -For Family & Personal development Dr. Salil Gupta

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Globesity The global epidemic of overweight and obesity "globesity" – rapidly becoming a major public health problem in the world. Paradoxically, obesity and undernutrition coexist many diet-related chronic diseases including  diabetes mellitus,  cardiovascular disease,  stroke,  hypertension and  certain cancers

associated with prevalence of overweight and

obesity.

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Obesity related major Health problems on Earth today WHO also points to same diseases causing maximum deaths. Not a surprise! We attribute prevalence of such diseases to change in our lifestyle and living standards Lifestyle diseases.

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HUMAN CELLS, FREE RADICALS AND DISEASE A cell is the basic unit of our

life. Our body is made up of more than 10 trillion of these cells. “Free Radicals” are foreign toxins (poison) to our bodies. Air and water pollution and food adulteration in today's environment, are the main sources of free radicals These free radicals attack our systems at cell level This breaks down our Dr. Salil Gupta body’s regulatory

The basic human

cell

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ANTIOXIDANTS Vs FREE RADICALS

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HOW FREE RADICALS INHIBIT NUTRIENT INTAKE AND CAUSE DISEASE

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ANTIOXIDANTS AND FREE RADICALS  The vitamins A,C, and E and

Selenium that have one electron less to be stable  They “steal” away electrons from the free radicals.  Antioxidants donate one of their own electrons and neutralize free radicals  Antioxidants end the electron-"stealing" reaction.  Thus all of them protect the body against the destructive effects of free radicals.  They act as scavengers, prevent cell and tissue damage Dr. that Salil Gupta  Stop the process could lead

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Risk factors for lifestyle diseases Risk Factors

Obesity

1 Hypertension .

1. Unhealthy diet 2. Physical inactivity

Deaths/ year (millions)

1. Smoking 2. 3. 4. 5. 6. 8.

overweight physical inactivity Excess salt in diet alcohol use Stress Chronic kidney disease 9. Adrenal and thyroid disorders Dr. Salil Gupta

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Risk factors for lifestyle diseases Risk Factors 2 .

Heart/ cardiovascular problems

3 .

Diabetes

Deaths/ year (millions)

1. 2. 3. 4.

unhealthy diet, 17.5 physical inactivity Obesity high blood pressure, glucose and Cholesterol 5. 1. tobacco Obesity use 1.1 2. High BP, Cholesterol 3. Smoking 4. Sedentary lifestyle 5. Pollution 6. Stress, fatigue 7. Improper nutrition

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Risk factors for lifestyle diseases Risk Factors 4 .

Stroke and Cerebro-Vascular diseases

5 .

Cancers: b.Lung cancer c.Prostate cancer d.Breast cancer e.Colon cancer f.Stomach cancer g.Cervical cancer

Deaths/ year (millions) 5.7 7.6

1. tobacco use 2. overweight, obese or physically inactivity 3. harmful alcohol use 4. sexually transmitted infection 5. occupational carcinogens (pollution) Dr. Salil Gupta

1.8 0. 274 0.351 0.325 0.152

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Under/ over weight or obese? BMI classification:  Body Mass Index (BMI) index of weight-forheight to classify underweight, overweight and obesity in adults. BMI = Weight (kg) / (height in m)2 Example, if for an adult , weight = 70kg and height = 1.75m BMI = 70 / 3.0625 = 22.9

(In India if person’s BMI is 23, he is overweight and if BMI is 25, he is obese). Dr. Salil Gupta

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Growing Obesity epidemic in India States above National average States

Males Males Females Female (%) rank (%) s rank

States below National average States 14 Uttarakhand

Males Males Females Females (%) rank (%) rank 11.4

15

14.8

14

10.6

16

12.5

19

9.9

17

12

18

8.7

18

11.1

5

1

Punjab

30.3

1

37.5

1

2

Kerala

24.3

2

34

2

3

Goa

20.8

3

27

3

4

Tamil Nadu

19.8

4

24.4

4

17

5

Andhra Pradesh

17.6

5

22.7

10

18 Bihar

8.5

19

10.5

29

6

Sikkim

17.3

6

21

8

19 Nagaland

8.4

20

10.2

22

7

Mizoram

16.9

7

20.3

17

20 Rajasthan

8.4

20

9

20

8.2

22

8.9

26

8

Himachal Pradesh

21 Meghalaya

16

8

19.5

12

22 Orissa

6.9

23

8.6

25

9

Maharashtra

15.9

9

18.1

13

23 Assam

6.7

24

7.8

21

10 Gujarat

15.4

10

17.7

7

24 Chattisgarh

6.5

25

7.6

27

11 Haryana

14.4

11

17.6

6

25 West Bengal

6.1

26

7.1

16

14

12

17.3

9

26

Madhya Pradesh

5.4

27

6.7

23

13.4

13

17.1

11

27 Jharkhand

5.3

28

5.9

28

12.1

14

16

15

28 Tripura

5.2

29

5.3

24

12 Karnataka 13 Manipur Avg India

15

Arunachal Pradesh

16 Uttar Pradesh

Jammu and Kashmir

causes The urban population of India Start using refined

• Stop using coarse grains and millets as the staple food, • Cereal intake declines • Sedentary life • Lack of exercise and fresh air

wheat and rice Increase the intake of sugar and fats. Convenience and fast foods find increasing acceptance. Reduction in •fibre content in the diet •content of micronutrients such •vitamin B-complex, •zinc and chromium, etc.

Cause s  

•

Genetic factors – –

•

Genetic inheritance influences your chance of becoming fat more than any other factor. Your genes enhance the storage of fat when food is limited and cause an increased risk of obesity when food is more and you don’t use your energy.

Eating Habits – – –

–

–

Certain eating habits of people may lead to obesity. Nibbling between meals is a potential cause for obesity. Some people consume food faster, without enough time to chew, therefore tend to consume more food. Obese people respond to external signals to eat rather than internal hunger signals. They eat when it is mealtime or when they are surrounded by tasty foods instead when they are hungry. People tend to overeat when they are depressed or in order to avoid wastage of food.

 

 Physical activity  Obesity is found in persons who

lead sedentary lives and pay less importance to physical education.  this is more common during middle age when physical activity decreases without corresponding decrease in food consumption.

 Endocrine factor  Obesity is found in

hypothyroidism, hypogonadism and Cushing's syndrome.

 Trauma  Obesity may follow due to

damage of hypothalamus after head injury because it is not able to regulate appetite or satiety.

 Prosperity and civilisation  Obesity is common in

prosperous countries like UK, USA, and in people of the higher economic strata of society, in developing countries.

STROKE

 A stroke is caused when the blood supply to the brain is

interrupted, usually because a blood vessel bursts or is blocked by a clot, cutting off oxygen and nutrients supply to the brain tissue, causing damage.  The most common symptoms of a stroke are  sudden weakness or numbness on any one side of the face, arm

or leg,  confusion,  difficulty in speaking or understanding speech;  difficulty seeing with one or both eyes;  difficulty walking,  dizziness,  loss of balance or coordination;  severe headache with no known cause;  fainting or unconsciousness.

 The effects of a stroke depend on which part of the brain is Salil Gupta injured and howDr.severely it is affected. A very severe stroke

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Onset of CVD – formation of Atherosclerotic plaque

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Factors influencing CVD

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Cholestrol levels and CVD

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Risk factors influencing CVD

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Lifestyle diseases influencing CVD

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Multiple CVD Risk Factors

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CVD prevalence between sexes

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Diabetes Insulin - principal hormone in

body plays a key role in all forms of

diabetes mellitus. regulates uptake of glucose from the bloodstream into every muscle and all fat cells, But not into the cells of the central nervous system.

Deficiency of insulin or inability

to absorb it properly Causes Diabetes Miletus Dr. Sunita Gupta

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functions normally • food is converted to glucose before blood and body use it as fuel. • blood glucose levels rise in the body. • Pancreas release Insulin in blood. • about two-thirds of the body's cells use Insulin to • absorb glucose from the blood • To use as fuel and • To convert to other needed chemicals, or • for storage. Dr. Sunita Gupta

The normal food processing cycle

The different organs involved in 30 the normal food processing cycle

malfunction… The defective food processing cycle

Glucose, after food is absorbed

from the intestines and distributed to all the body

cells through the bloodstream.

The glucose concentration in

the blood body keeps constant and avoids

extra glucose right after every meal and starves the body between the meals and overnight.

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malfunction… When glucose in the body is excess stored in the liver and muscles as glycogen. When glucose is in short supply, the body stimulates to eat food

and/or mobilizes the stored glycogen.

To maintain a constant blood-

glucose level, the body relies on pancreas to

produce two hormones insulin and glucagon

Such metabolic disorder is known Dr. Sunita Gupta

Insulin vs Glucagon cycle – A comparison 32

CAUSES of Diabetes mellitus Type 1 diabetes - when the pancreatic cells

are destroyed due to autoimmune system of the body. Type-2 diabetes - when due to high levels of blood sugar, the body is unable to utilize it’s insulin and move blood sugar into the cells to produce energy.  Gestational diabetes: the hormones produced during pregnancy can cause insulin resistance in women, genetically prone to develop Diabetes. Dr. Sunita Gupta

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SYMPTOMS The characteristic symptoms

are excessive urine production (polyuria) due to high blood glucose levels, excessive thirst and increased fluid intake (polydipsia) attempting to compensate for increased urination, blurred vision due to high blood glucose effects on the Dr. Sunita Gupta eye's optics,

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Diabetes and Obesity Here's how all those burgers and shakes add up: •Worldwide, more than 1 billion adults are overweight or obese, •Roughly 300 million considered obese. •In 1985, about 30 million people had diabetes. • By 2025, 350 million, or more than 10 times as many will suffer from this disease. •Worldwide, the disease is the fourth leading cause of death.

Dr. Sunita Gupta

The diabetes - an epidemic

because in such a short time, like infectious diseases, it has spread so quickly. •Excess body fat is the leading controllable risk factor type 2 diabetes. •Indians lead the world in the number of diabetic patients. •Alarming rise in obesity and diabetes around the world – • Diets high in saturated fat and refined carbohydrates and the modern sedentary 35 lifestyle.

Complications - Impact of Diabetes on other diseases

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Complications from Diabetes Careless treatment or its poor

management lead to serious complications ….. Diabetes causes: • Damage to eyes • heart disease and stroke, • retinal damage (blindness), • chronic renal (kidney) failure, • Poor healing of wounds

(gangrene) • amputations • Impotence and difficulty passing urine in adults. Dr. Sunita Gupta 37

Acute complications from Diabetes If Diabetes is not controlled properly, acute complications may occur, like dehydration hypoglycemia, ketosis, acidosis. Coma and Even death

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SITUATION IN INDIA •The prevalence of heart attacks in Kerala was 51.6% •Diabetes prevalence among those above twenty years of age is alarmingly high at 8.2 % •30 % of those above twenty years have hypertension •Percentage of smokers above 20 years is 40% •35 %people above 20 also suffer from high cholesterol.

Dr. Salil Gupta

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Blood pressure : It is the force that the blood circulating exerts on its walls of our blood vessels . It decreases as the blood moves through the arteries, the capillaries, and the veins. Blood pressure is the arterial pressure in the larger arteries

Dr. Sunita Gupta

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The measure of blood pressure: It changes in response to a person’s stress, nutritional factors, drugs, etc.

High blood pressure, or Hypertension, It is a medical condition in which the blood pressure becomes chronically elevated.

Low blood pressure, or hypotension It is a medical condition, in which a person’s blood pressure falls much below the normal levels. Dr. Sunita Gupta

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Hypertension can be classified either Essential (primary), Secondary, or Pregnancy induced

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Several factors and conditions play a role in the development of hypertension: Smoking Being

overweight Lack of physical activity Too much salt in the diet Too much alcohol consumption Stress Older age Genetics Family history of high blood pressure Chronic kidney disease Adrenal and thyroid disorders Dr. Sunita Gupta

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The late phase of hypertension (accelerated or malignant hypertension) is characterized by headaches, Confusion and mental tension, stress and anxiety. nausea and vomiting visual disturbances and blurred vision and end-organ damage. Dr. Sunita Gupta

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Preliminary tests are necessary to identify: • possible causes of secondary hypertension, and • to seek evidence for any end-organ damage to the heart  the eyes (retina) and kidneys.

• Additional risk factors must also be tested for Diabetes raised cholesterol levels and development of cardiovascular disease Dr. Sunita Gupta

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Blood tests include: Creatinine (renal function) Electrolytes (sodium, potassium) Glucose - to identify diabetes mellitus Cholesterol

Additional tests required: Urine Test for proteinuria. Electrocardiogram (ECG) – to access normal heart function. Chest X-ray - for signs of cardiac enlargement or evidence of

cardiac failure. Dr. Sunita Gupta

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Hypertension is a serious condition that can damage the heart and blood vessels, and can eventually lead to several other conditions, including: Stroke Heart failure Heart attack Kidney failure Vision problems Dr. Sunita Gupta

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for treating mild to moderate hypertension: Weight reduction and regular exercise (like, jogging). Reducing Sugar in diet Reducing sodium (salt) in the diet decreases blood pressure in about 60% of people Increasing daily calcium intake has been shown to be highly effective in reducing blood pressure. Dr. Sunita Gupta

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Discontinuing tobacco use reduces the risk of stroke and heart attack. Discontinuing alcohol consumption Discontinuing Coffee (caffeine) (its use does not produce chronic hypertension). Additional dietary changes, like taking  

fruits and vegetables and low fat or fat-free dairy foods

These are all beneficial in reducing high blood pressure. Dr. Sunita Gupta

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HEALTHY FOOD PYRAMID

Dr. Sunita Gupta

Eat lots of fruits and vegetables

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i.

Relaxation therapy reduces environmental stress, like from  

 

meditation, reducing high sound levels and overillumination. Muscle Relaxation paced breathing

Life Style changes can reduce the blood pressure to a safe level, But Drug Therapy can still not be avoided. Dr. Sunita Gupta

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When hypertension is mild or severe, a suitable drug therapy, as recommended by doctor and lifestyle changes need to go on side by side This may reduce the blood pressure even by 5-6 mmHg, which can thus decrease the risk of   

stroke by 40%, coronary heart disease by 15-20%, dementia, heart failure, and mortality from vascular disease.

So taking proper and regular medication, as advised, at best ONLY CONTROLS YOUR BP AND NOT TREAT 53IT Dr. Sunita Gupta

Yes/ No ?

Yes, one can. But, how?

The answer my friend, is to make your own body system strong to fight the same root cause that triggers such a disease Conclusion: Diseases are caused because our body has lost strength and ability to fight external factors triggering disease, or

body has developed immune deficiency! Solution: Build your body’s immunity to diseases. Dr. Sunita Gupta

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•

An immune system is a mechanism of organs, cells and chemicals that • •

•

differentiates “self” from “external”, identifies potential dangers and eliminates them through an immune response.

Some infections cause • • • •

No harm, serious diseases, permanent damage to your body and death (sometimes).

Disorders in the immune system can result in • Serious diseases, and also • Death. Dr. Sunita Gupta

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• Immune deficiency is a state in which the ability of our body’s immune system to fight diseases is either compromised or entirely absent . Dr. Sunita Gupta

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• Two of the most common causes

of immune deficiency. Diets with insufficient protein • MALNUTRITION •

Dr. Sunita Gupta

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nutrition and immune deficiency

Poor immunity is therefore due to…. deficiency of many nutrients

And also….

ron;

enetic mutation

opper;

urgeries, leading to greater chances of infection.

inc; amaged cells, elenium; and others oor blood cell function and itamins A, C, E, oor antibody concentrations itamin B6

Dr. Sunita Gupta

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What can improve our immunity? Things you should take

Things to avoid Sugar

Whole grains

Coffee

Fresh fruits

Alcohol

Herbs and Vegetables,

especially green and leafy Proteins Mineral and vitamin supplements Anti-oxidants

Tobacco Raw meat and food Fats and oils Allergy causing foods

Which one product that nature produces contains all “should take” things in it? Dr. Sunita Gupta

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What is Nutrition? A Balanced diet consists of all nutrients in a required

proportion with water and roughage. What we eat is our (or our organism’s) diet. Nutrition provides the materials necessary (as food) to support life in our cells and organisms. Good nutrition can prevent or alleviate common health problems. Similarly, a poor diet can have an injurious impact on health, causing deficiency diseases ,such as  scurvy, beriberi, and kwashiorkor;

health-threatening conditions like  obesity and metabolic syndrome, and cardiovascular disease,

diabetes, osteoporosis

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Benefits of Good Nutrition  The benefits of good nutrition

are multiple.  A healthy diet provides energy,  promotes good sleep,  and gives the body what it needs to stay healthy.  It is essential for the body and all its systems to function well for a lifetime.  Good nutrition helps you maintain a healthy weight too  Benefits of good nutrition can thus be traced to good physical and mental Dr. Salil Gupta health.

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Nutrients that our body requires They are seven major classes of them: Proteins Carbohydrates fats,  fiber,  minerals, vitamins,  and water Dr. Salil Gupta

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Micronutrients

Micro Nutrients are nutrients needed in small quantities’ for life . They include•Minerals ,such as Antioxidants •iron, Essential fatty acids•chromium, Phytochemicals •copper, •iodine, •manganes e, •selenium, Dr. Salil Gupta

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Aloe Vera contains 2.200 nutrients 3. 21 amino acids 4.Anti-septic agents 5.Anti-microbial agents 6.Vitamin B1, B2, B3, B5, B6, B12, C, D, E 7.Carbohydrates 8.28 Different minerals 9.All enzymes the body needs 10.Fibres Dr. Sunita Gupta

Aloe Vera the only naturally available source of all immunity enhancing nutrients64

What makes Aloe Vera a wonder plant? 1. Cleaning toxins and

dead cells from the body 2. Healing and regenerating the sick cells 3. Nourishing the cells, the tissues, the organs, the systems, and the body . Improving the

Dr. Sunita Gupta

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300 verities of Aloe

475 samples of Aloe

Vera Vera produced commercially 11 of them Only 1 of the poisonous samples contains 85 Only 4 possess %Aloe Vera: medicinal properties 1 (FLP) (0.02%) 85 Only The Barbados % Miller variety out of 1 (FLP) (0.02%) the 4, used by FLP 95% contains maximum 9 ( 1.8%) useful and Which Aloenutrients Vera to take, which one 41-50% you will choose, is evident 66 62 medicinal (13%) Dr. Sunita Gupta

Our Choice

Will it your Choice too? 67

The doctor of the future will give no medicine. He will rather interest his patients in the care of human frame, diet, and the cause and prevention of disease.

Thomas Alva Edison THANK YOU Dr. Sunita Gupta

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Recommendations for lifestyle changes

The most important recommendations for lifestyle factors in relation to potential health gains are as follows:  Don’t smoke.  If you use alcohol, do so in moderation.  Be moderately vigorous and physically active (eg, brisk walking, biking, or gardening) at least 30 minutes each day. The most important dietary recommendations are as follows:  Keep energy balance (body mass index) - below 25 kg/m2.  Energy from saturated fat - Consume less than 10%  Energy from trans fat - Consume less than 2% .  Eat (fatty) fish at least once a week.  Eat vegetables and fruits 400 g per day.  Limit salt consumption to less than 6 g/d.

Dr. Salil Gupta 69

BEST SOURCES OF ANTIOXIDANTS

70 Dr. Salil Gupta

Yes/ No ?

Yes, one can. But, how?

The answer my friend, is to make your own body system strong to fight the same root cause that triggers such a disease Conclusion: Diseases are caused because our body has lost strength and ability to fight external factors triggering disease, or

body has developed immune deficiency! Solution: Build your body’s immunity to diseases. Dr. Salil Gupta

71

•

An immune system is a mechanism of organs, cells and chemicals that • •

•

differentiates “self” from “external”, identifies potential dangers and eliminates them through an immune response.

Some infections cause • • • •

No harm, serious diseases, permanent damage to your body and death (sometimes).

Disorders in the immune system can result in • Serious diseases, and also • Death. Dr. Salil Gupta

72

• Immune deficiency is a state in which the ability of our body’s immune system to fight diseases is either compromised or entirely absent . Dr. Salil Gupta

Dr. Sunita Gupta

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• Two of the most common causes

of immune deficiency. Diets with insufficient protein • MALNUTRITION •

Dr. Salil Gupta

74

nutrition and immune deficiency

Poor immunity is therefore due to…. deficiency of many nutrients

And also….

ron;

enetic mutation

opper;

urgeries, leading to greater chances of infection.

inc; amaged cells, elenium; and others oor blood cell function and itamins A, C, E, oor antibody concentrations itamin B6

Dr. Salil Gupta

75

What can improve our immunity? Things to avoid

Things you should take

Sugar

Whole grains

Coffee

Fresh fruits

Alcohol

Herbs and Vegetables,

Tobacco Raw meat and food Fats and oils Allergy causing foods

especially green and leafy Proteins Mineral and vitamin supplements Anti-oxidants

Which one product that nature produces contains all “should take” things in it? Dr. Salil Gupta

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AYURVEDA ON DIET 77

“IF THE DIET IS WRONG,

THEN MEDICINES ARE OF NO USE, IF THE DIET IS RIGHT, THEN MEDICINES ARE OF NO NEED. Dr. Salil Gupta

A TEXT FROM

Dr. Salil Gupta

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Any questions? Dr. Salil Gupta

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THANK YOU Dr. Salil Gupta

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