| |
Man
has become more and more sedentary. Time was when we were
hunter-gatherers and had to, perforce, walk miles before
we got our next meal. Over a period of time, the
`survival of the fittest instinct’, made our genes
to survive on very few calories. They are called the thrifty
genes. During the last ten thousand years man
started to live in groups and, learnt to sow and reap.
Eventually now some of us in the affluent sections of the
society live in a `food plenty’
environment. It will take another thousand years for our
thrifty genes to adapt to the food plenty environment.
The gene-environment mismatch is the root
cause of many, if not all, of our degenerative vascular
diseases.
To add to the problem, we live in a hi-tech world where
one does not have to move from the chair even to switch
on the idiot box that gives us most of our knowledge -
not wisdom. Even our women do not have to do any physical
effort as we have all the gadgets for the daily chores.
This paradox has put additional burden on our health; so
much so almost every other person in the affluent West is
obese. Weight gain seems to be their only pre-occupation.
Most people in those societies have become
couch-potatoes. With the opening of the doors for
Americanization of our mother India, the new disease is
catching up fast among our rich and the famous. The
tendency, naturally, will become hereditary. Some of us
would have to inherit the tendency from our parents.
I have good news as well as bad news for those rounded
people around:GOOD
NEWS:
Obesity, in its own right, is not a risk factor.
An active obese individual does not run any additional
risk of killer diseases, if he keeps himself active and
exercises regularly. Regular exercise keeps even an obese
person healthy and fit. The latter’s risk of
precocious mortality and morbidity does not go up if when
active.
BAD NEWS:
Once one is obese it is very difficult to get rid of
the extra tyres on the belly ! Heredity, mentioned
earlier, might play a role here.
The `quick-fixes’ advertised everyday for losing
weight without sweat, are only advertisement tricks to
sell their products. It could even be risky to loose
weight very fast. Fat mobilization, a necessary evil in
drastic weight reduction, could be dangerous. Gradual
loss of weight is our best bet.
The only way one could lose weight with profit is to eat
less and, work more. There are no short cuts
at all. Body weight is like bank balance. The more you
spend and the less you deposit, the lower will be your
bank balance. The reverse is also true. This rule holds
good for body weight with but one exception. Some people
who eat a lot may still not put on weight. These are the
lucky ones who were thin babies during infancy. (First
year of life) It is during the first year of one’s
life that the total number of fat depot cells are formed.
If one has been a bonny baby, one would have had large
number of fat cells formed in the first year itself. They
would be waiting to grab any opportunity to store fat
from the extra food that we take. The moral of the story
is not to feed your baby by the clock, but only on demand
- preferably only mother’s milk and not cow’s
or buffalo’s.
Exercise is a very good method to lower weight but is not
a very economical way. One has to walk for an hour, or
swim for fifteen minutes, or dance for 10 minutes, to get
rid of one extra slice of bread eaten during breakfast.
On the contrary regular exercise, coupled with a
parsimonious diet would be an ideal combination.
Similarly to lose weight it is more important to eat
less. Picking and choosing food articles might result in
an imbalance in the diet, giving rise to deficiency
diseases. Mixed diet, preferably vegetarian, with a good
helping of fresh fruits and vegetables, would be the best
bet. The ready-made weight watcher’s junk food could
be dangerous in the long run. Exercise should be
sustained - and not in bouts. Vigorous and strenuous
exercise may even harm the system.
Another new fad, aided and abetted by the media hype of
the drug industry, is to take drugs for losing weight.
While it looks easy, I was always uneasy even to think of
prescribing these drugs. The drug company personnel have
always thought that I was a therapeutic nihilist. Far
from it ! I would always use my intuition, the latter
tells me that one could not possibly have a
"safe" drug to reduce weight.
A recent report, yet to be published, (accepted for
publication by the leading American medical Journal. New
England Journal of Medicine) throws new light on this
drama. The most talked of and advertised weight reducing
drug, Fenfluramine has been implicated in the causation
of a rare heart valve disease, based on very hard
scientific evidence. The Mayo Clinic cardiologists and
cardiac surgeons were non-plussed to see deformed heart
valves in patients taking the above drug on a long term
basis, although with very good reduction in their body
weight. The valves were so badly damaged to be leaky or
even distorted to produce and obstruction, stenosis, to
the onward flow of blood inside the heart. The study of
these valves, taken out during surgery for replacing the
valves with artificial ones, clearly showed that the damage
was drug induced.
With this clue they were able to collect data on more
than forty patients within a short span of time. As this
study will take some time to be published and then get
into medical texts, the editor of the journal took an
unusual step of informing the media in advance to warn
the public and the doctors. I had a talk with one of the
deputy editors recently and was able to collect the
following data, which may help thousands taking that drug
in our country as well.
- Fenfluramine could
cause heart valve damage in the long run.
- The drug should not
be used for weight reduction, except in those
above 200 lb. Having a weight related acute
problem. In the latter situation the drug could
be used purely on temporary basis.
- Those who are already
on the drug should not stop it suddenly, as the
withdrawal effects may even be disastrous. (cold
turkey) The drug could be gradually tapered off
and stopped.
Every drug goes through
different phases during its life. After the initial
discovery of the molecule, animal studies and selected
volunteer studies, the drug is released to the market.
(Of course, with regulatory body’s approval). Then
the drug company mounts a marathon promotion drive and
the medical profession believes that the drug is a
panacea for all ills (the gee phase)
Then someone discovers the dangerous side effect and many
times the drug is labeled as a poison and forgotten. It
has done the damage anyway ! Eventually, years later, the
same drug may come back as a good drug for some other
disease in a limited way. Lot of drugs go through these
phases. We only hope that Fenfluramine will come back in
a different garb after some years.
The best bet for couch potatoes who are overweight is to
remember to share their food with others and work very
hard to be in good health if lucky. Disease and death are
only accidents. Have you read the cowboy song?
I eat
when I am hungry,
I drink when I am thirsty,
If Heavens d’nt fall down,
I shall certainly live till I die.
Remember what Jesus said
"Pass it on, pass it on, it is not for thee
alone" as also. "It is with the sweat of his
brow that he shall eat bread on all days". These are
not simple religious commandments; they are the all time
wisdom for living ! Eat less by sharing, and work
more to live happily as long as you live.
"Nithya
Hitha Mitha Aaahaara Sevi Sameekshakari"
Shushruta Samhitha.
(Eat good food in
moderation daily and work very hard)
[index]
|
