NCDS: The Bad news:
Non-communicable diseases (NCDs) are among the biggest health and development challenges of the century. NCDs, in addition to the loss of lives, exert tremendous strain on the healthcare system and result in a staggering economic toll. In India, the NCD burden is especially alarming:
- 100+ million Indians live with diabetes and 136 million are pre-diabetic,
- In metro cities like Chennai, 3/4 adults are diabetic or pre-diabetic
Indians get diabetes 10 years earlier than Americans, often in their 30s, during peak productive years. - 25% of a poor Indian family’s income is spent on care for one person with diabetes.
- NCDs are ubiquitous: all states, socioeconomic levels, and rural/urban settings are affected, with the poorest most impacted.
The Good news:
There is compelling evidence that NCDs are largely preventable. According to the World Health Organization, 80% of heart disease, 80% of type 2 diabetes, and 40% of cancers can be prevented with 3 lifestyle changes:
- eating right
- exercising and
- avoiding tobacco
Hence simple lifestyle modifications can be instrumental in keeping NCDs at bay. Prevention is the only way forward. We cannot cure ourselves out of the NCD burden.
Eating a balanced diverse diet including local seasonal fruits and vegetables is crucial. Becoming an aware consumer paying attention to nutrition labels to avoid HFSS (High Fat Sugar Salt) ultra-processed foods is important. Engaging in an active lifestyle is easily achievable by including moderate work outs in daily routine as well as consciously choosing active options such as stairs over elevators, limiting sedentary activities- screen time and getting adequate sleep.
Shaping Healthy Lifestyle:
To combat the NCD crisis, studies show adolescents should be prioritized because of their adaptability and because most NCD risk factors are acquired during adolescence. A key recommendation of India’s National NCD Monitoring Framework is school-based programs to integrate good dietary practices and exercise into daily routines. Schools are ideal platforms to improve healthy behaviors in children and adolescents and to mobilize parents/communities around health.
India’s adolescents must improve their lifestyle habits - i. they lead sedentary lives - 3 out of 4 adolescents in India presented “insufficient physical activity”. ii. An alarming 10.4 percent of adolescents (10-19 years) are estimated to be pre-diabetic. iii. a third of teenagers are estimated to have high blood pressure. It is important to intervene before children’s lifestyle habits are set and help them make exercise and healthy eating part of their everyday lives. Otherwise, they will grow up to get diabetes and heart disease at alarming rates and further contribute to India's NCD crisis. Shaping healthy habits is much more effective than changing habits later.
The school setting is a powerful platform for NCD prevention and behaviour change and is a key recommendation from the Government of India. Government of India’s Ayushman Bharat National School Health Curriculum outlines ways to improve eating habits, physical activity, sexual/reproductive health rights, tobacco use. Poshan Abhiyan is a commendable initiative to improve nutrition and the Rashtriya Bal Swasthya Karyakram scheme includes school-based health measurements along with other Health & Education Ministry missions.
A Golden Opportunity:
Programs deploying participatory learning methods compelling age-appropriate activities for children to adopt healthy behaviours are need of the hour. Such programs have shown encouraging effectiveness and fidelity trends (>15% improvement in knowledge, >7.5% in health behaviours). There is a golden opportunity for partnerships involving CSOs, health and nutrition experts and other stakeholders to come together and build healthy lifestyle models delivering at scale for measurable sustainable impact to fight and prevent NCDs.
Dr Smriti Pahwa, Regional Director- Arogya World
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