Combatting chronic diseases

In today’s fast-paced world, chronic diseases like heart disease, diabetes, and obesity are alarmingly prevalent. The World Health Organisation (WHO) reports that non-communicable diseases account for about 74% of global deaths, largely due to poor lifestyle choices.

Poor dietary habits, sedentary behaviour, and chronic stress can disrupt metabolic processes, leading to insulin resistance and increased risks of obesity, type 2 diabetes, and cardiovascular disease. Lifestyle medicine, an evidence-based approach, is emerging as a key method to prevent, manage, and even reverse these conditions.

Nutrition is fundamental in lifestyle medicine. The traditional Indian diet is often high in carbohydrates and low in fibre and protein, frequently featuring overcooked vegetables, fried foods, and refined sugars. The rise of processed and ultra-processed foods has exacerbated unhealthy eating patterns, contributing to an increase in overweight children in India — projected to reach 17.5% by 2030.

Studies show that a plant-predominant diet rich in whole grains, fruits, vegetables, nuts, and seeds can significantly lower chronic disease risks. Conversely, the WHO classifies processed meats as Group 1 carcinogens and red meats as Group 2 carcinogens. Emphasising whole foods allows individuals to gain essential nutrients while avoiding excess sugars and unhealthy fats, making this dietary shift a cornerstone of lifestyle medicine. Adequate hydration is also crucial.

Physical inactivity is linked to 70% of all deaths, a stark reminder for those spending long hours at desks. Increased sedentariness raises the risk of conditions like high blood pressure, diabetes, and overall mortality. In India, nearly 75% of adolescents, 30% of adults, and 40% of older adults are inactive. Regular exercise is especially vital in India, where there is a higher tendency for early and more severe heart disease, diabetes and obesity. It is recommended to aim for at least 60-90 minutes of physical activity daily to mitigate these risks.

We spend about one-third of our lives asleep, during which critical restorative processes occur. Adults require 7-8 hours of restorative sleep per night for optimal health. Chronic sleep deprivation is linked to obesity, diabetes, cardiovascular diseases, and higher mortality rates. Improving sleep hygiene through regular routines and limiting screen time before bed can greatly enhance health.

Chronic stress contributes to various health issues, including heart disease and mental health disorders. Certain life stages — like adolescence and pregnancy — can heighten vulnerability to stress. The National Mental Health Survey 2015–2016 indicates that about 1 in 20 adults in India suffer from depression, with substance use disorders affecting 25.5% of adults. Despite the prevalence of mental health conditions, there is a significant treatment gap of 84.5%, driven by a lack of awareness and societal stigma. Lifestyle medicine promotes mindfulness, meditation, and exercise to help reduce stress and improve resilience, and cognitive and behavioural therapies to manage mental health conditions.

Additionally, lifestyle medicine emphasises avoiding harmful substances like tobacco and excessive alcohol. In India, 1 in 5 men and 1 in 16 women who consume alcohol develop dependence (addiction). The country is a leading producer and consumer of tobacco, with 28.6% of the population using it in some form.

Lifestyle-based approaches to addiction can complement traditional treatments by incorporating exercise, better diet, sleep, stress management, and healthy relationships.

Strong social connections significantly influence health and well-being. Studies show that in individuals with substance use disorders, those in committed relationships and community settings are more likely to thrive than those who are socially isolated.

Meaningful relationships can reduce stress, improve mental health, and even enhance life expectancy. Social interactions provide emotional support, alleviate loneliness, and foster a sense of belonging, all contributing to better health outcomes.

The key pillars of lifestyle medicine — healthy diet, regular physical activity, quality sleep, stress management, avoiding harmful substances, and nurturing positive relationships — alongside a sense of purpose, offer a preventive and therapeutic approach that goes beyond symptom management. This shift in healthcare emphasises prevention rather than solely relying on medications and surgeries. By empowering individuals to adopt sustainable daily habits, lifestyle interventions can lead to reduced medication reliance, improved health outcomes, and lower healthcare costs.

Integrating lifestyle medicine into standard healthcare not only helps individuals lead healthier, more fulfilling lives but also alleviates pressure on healthcare systems. This holistic approach fosters long-term well-being, reflecting a necessary evolution in how we view health and disease management.

(Dr Alexander Thomas & Divya Alexander are the editors of Lifestyle As Medicine: The Science of Healthy Living, along with Dr Samuel Hansdak and Dr Herbert Giebel. They are organising the National Health Conclave on Lifestyle Medicine (www.nhc2024.com) to be held at CMC Vellore on Oct 15 and 16.)