Tuesday, May 8, 2012

Combating the Diabetes Epidemic

By The Nigerian Voice, May 6, 2012

As our society increasingly becomes a sedentary one, coupled with over-nutrition as it obtains in most Western societies, many more people will become obese and develop diabetes. Our society, which is still very much under the burden of diseases due to infections, is now adding on diseases, which used to be synonymous with the West. The raison d'etre for this is the increasing westernization of our diet here in Nigeria and the widespread erosion of the culture of exercising.

The old aphorism that 'prevention is better than cure' still holds true as it pertains to the diabetes epidemic. The cost of managing diabetes is enormous to the individual especially here in Nigeria, not to talk of the burden on the economy of the country due to many man-hours lost. Considerable attention is being focused worldwide on strategies not only to delay but also to prevent the development of diabetes in persons who are at a high risk of developing it.

There is incontrovertible evidence that lifestyle changes that include exercise and diet are key preventive strategies not only for obesity but also for diabetes as it has been clearly demonstrated that accumulation of fat and lack of exercise increase the risk of developing these diseases. The seminal Diabetes Prevention Study showed that people who underwent reduction in calorie intake coupled with exercise had a 58% reduction in the risk of becoming diabetic. This lifestyle intervention was found to have worked particularly well for people older than 60 years as it reduced their risk of developing diabetes by 71%! Lifestyle changes are currently the standard recommendation for people at high risk of becoming diabetic.

Sustained changes in lifestyle can substantially reduce the development of Type 2 diabetes in middle-aged adults at high risk of diabetes. These lifestyle changes, which may be notoriously challenging to make, includes starting an exercise regimen which should last at least 30 minutes for a minimum of 4 days in a week, stopping smoking, taking alcohol in moderation, eating a low salt and low fat diet, increasing intake of fresh vegetables, moderate consumption of cereals and fruits, reducing intake of fruit juices and carbonated drinks in favour of water, stopping use of remote controls to change television channels or switching on air conditioners, stoppage of intake of for example pop corn while watching a TV programme, reducing the amount of time children use to watch TV or play computer games which is not only detrimental to their health but also their academic performance, use of stairs instead of the elevator, walking or bicycling instead of driving if your destination is not particularly far, standing up to go pick an object instead of sending your house-help or orderly to do so, and volunteering for community service, to mention just a few. Not to forget dancing! Yes, stand up often and just dig it! It has salutary effects!

The challenge is for individuals to make every effort to maintain a healthy weight and be physically active. New public health strategies are needed to combat the ongoing epidemic of obesity and diabetes in Nigeria, the strategies to be focused upon by policy makers include healthy eating which would involve closer monitoring of the caloric content of foods served at fast food outlets, weight control and increased physical activity which would entail provision of recreational facilities in neighbourhoods to include swimming pools, basket ball and lawn tennis courts among others. There is also the need to mandate all schools to have playing fields for children, and the creation of special lanes on roads where people can safely walk and bicycles can be safely ridden as obtains in most well planned societies. Individuals should also incorporate exercise facilities into their homes such as stationary bicycles, table tennis facilities and good old gardening! Work place exercise should be greatly encouraged in Nigeria as is currently done in other climes.


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