Lifestyle diseases are many - hypertension, metabolic syndrome, diabetes, heart diseases, certain cancers and several others. The common thread that connects patients with these problems is their unhealthy lifestyle. Most of these diseases could have been prevented if these patients had adapted a healthier lifestyle.

These are not new diseases and were present when we were less sedentary and more active physically and hadn’t been exposed to junk food. But the big difference then was that older individuals were affected by these problems. Now diabetes, obesity and hypertension effect patients who are very young and the prevalence of this problem is reaching epidemic proportions.

For a physician, it is now common to see a young person in his mid twenties walk into the clinic with elevated blood pressure. He is overweight and has high cholesterol. He would reveal that he frequents fast food restaurants regularly and drinks gallons of soda. He is glued to his computer at work and television at home.

The most appropriate prescription for him is not medication but change in lifestyle.

Indian Perspective

Prevalence of lifestyle diseases in India is much higher compared to most other emerging economies. The leading cardiology journal 'Journal of American College of Cardiology' recently described India as the 'diabetes capital' of the world. Heart diseases are now leading cause of death among Indians having overtaken communicable diseases. Much younger individuals die of heart disease in India compared to most other nations. Number of patients with hypertension is growing both in rural as well as urban setting.

Presciption for a Healthy Lifestyle

Adapting healthy lifestyle at an early age prevents onset of hypertension. In those patients who have hypertension,
it improves blood pressure control.

Healthy lifestyle includes :

		Good diet
		Regular exercise

Diet

Lowering salt intake:

Salt plays an important role in raising our blood pressure levels. Reducing the amount of salt we eat critical in improving blood pressure control. The most common medication for treating hypertension belongs to a class commonly known as diuretics. These are referred to as 'water pill' in lay terminology. These are not water pills, but actually  'salt removing pills'. These are the most effective blood pressure lowering medications. 

If patients with hypertension continue to eat unrestricted amount of salt, most blood pressure lowering medications lose their efficacy.

The common salt that we use is made up of two componets, sodium and chloride. The element sodium is critical in regulating blood presssure within a normal range. Current recommendations suggest, you should have not have more than 2300 mg of sodium a day. One teaspoon of salt has about 2300 mg of sodium. It has also been shown that lowering sodium in your diet to less than half tea spoon a day may help you come off one of your blood pressure lowering medications.

It is also important to know that 60% of salt we eat is 'hidden' from us. We are unaware, it is present in our food. Very high levels of salt is found in preserved foods like pickles, sauce, ketchups. Dried meat, dried fish and papads have a very high concentration of salt as well.

Colas and other drinks also contribute to excess sodium intake. Those who frequently eat out at restaurants are eating food rich in sodium content.

DASH  diet consists of 3-4 servings of fruits and 3-4 servings of vegetables, poultry and fish, low fat dairy products. It is simple and easy to remember and prepare.

DASH reduces systolic blood pressure by almost 12 mmHg.

DASH study was the first major study to evaluate, if readily available food can lower blood pressure.

DASH study also demonstrated that a healthy diet can lower blood pressure even in individuals who have normal blood pressure, indicating that it improves arterial health.

More information on DASH diet is available at  http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf

Exercise:

Regular exercise, walking 20-25 minutes every day will also improve blood pressure control.

Weight Reduction:

Lowering weight by 1 kg lowers your blood pressure by 1 mmHg

Quit smoking:

It's never too late, quit smoking today and within days and months, you will feel the difference.

http://www.heart.org/HEARTORG/GettingHealthy/GettingHealthy_UCM_001078_SubHomePage.jsp

http://www.ash-us.org/For-Patients/Patient-Education-Information.aspx

http://www.hypertension.ca/en/hypertension-home-dp1

http://www.bhsoc.org/Healthy_Eating.stm