This summer I spent a few days on holiday in South Wales. Two things stood out. The first was the amazing beauty of the coastline. The second was the incredible percentage of holiday makers who were overweight.
This short blog is about what, “in the trade” we know as non-communicable diseases (NCDs). What are those? Mainly overweight, raised blood pressure, diabetes and raised cholesterol. But read on, the story for each of us personally may not be as bad as you think.
Two years ago when I was working at InterHealth, there was an audit of 500 leaders and their spouses who attended for routine medical reviews-what we often call “Wellness Medicals”. In other words you feel OK but think it’s a good idea to have a regular medical check.
We found these alarming figures:
30% of men and 26% of women had raised blood pressure with just under 1 in 10 needing to start medication as soon as possible
23% of men and 26% of women were either obese (BMI 30 – 34) or “morbidly obese” (≥35). Only 37% of men and 48% of women had a Body Mass Index (BMI) within the healthy range
57% of men and 66% of women had a Total Cholesterol of > 5 mmol/L- (or 193mg/dl) in other words higher than it should be
Worrying results such as these are found worldwide. For example latest statistics from the medical journal, the Lancet, show that more people die from raised blood pressure than any other disease. In fact these NCDs have become our commonest cause of death in nearly all countries.
I spend most Monday’s working at a Thrive Worldwide clinic in London seeing missionaries, aid workers and others who are trying to help our troubled world. The range of problems as you would expect is huge, especially when we set aside 60 minutes to talk with each person about their health concerns. These medicals are important both for the individual and to their employing agency. The view that medical screening of the depth we do is unnecessary is profoundly and dangerously untrue.
I try to make these medicals as user-friendly as possible. But two things usually bring out a frown on people’s faces. The first is “will you kindly stand on the scales so I can check your weight”. And the second is putting on the blood pressure cuff, as I try to chat about something cheerful.
So you may be wondering where the good news is in all of this. The answer is that it’s largely with you.
The suggestions below may seem a bit simple, but for most of us simple is best. This is what I recommend to friends, family and patients. It’s also the advice I try to follow for myself.
First, find out your body mass index. Type ‘BMI calculator’ into a search engine and put in your weight and height and it will calculate this for you. If it’s over 25, prioritise losing weight. If it’s over 30, make this a top priority.
Second, know your blood pressure. Either see a health professional, or buy a machine to self-measure. Then, if the reading is more than 140/90 on 3 or more occasions you may need to start medication. See your healthcare professional for further investigation and consideration of this. Reducing salt and losing weight will probably help too. If you did need medication, it may be lifesaving and is usually lifelong - don’t assume than taking it for just a year will do the job.
Third, know your blood sugar. A health professional or pharmacy can arrange this to be checked. You can also buy a glucose monitor which uses a finger prick test to measure this yourself. If it’s raised see your doctor and take action.
A personal story. 6 months ago my very attentive doctor phoned me and told me I should come in and have my blood sugar tested. As I considered myself quite fit with no family history, I thought that was a bit unnecessary. But being quite an obedient sort of person (usually) I did what I was told. To my horror I was told I was pre-diabetic and needed to take immediate action. I did. I started to put just half a spoon of sugar, or none, rather than two in my tea and coffee. I increased my exercise to 25 minutes of a brisk walk a day. I actually lost 5Kg of weight by doing this and watching my diet.
And yes, you’re right. When I had it rechecked a month ago it was normal. Recent studies suggest almost half of those with type 2 diabetes can self-cure by simple measures and strict dietary control and of course we can all be doing these things to help prevent it.
We’ve nearly finished, but...
Fourth, knowing your cholesterol is important. Have this checked at a good lab. Increasingly you can also buy a cholesterol home test kit. The figures are a bit confusing and the figures vary from country to country. Ask or check to see if the total is raised and also if the less healthy sort, the LDL, is also raised. If so, do something about it. Find good advice about foods you should avoid, have it rechecked and if it’s stubbornly high you may have to consider taking life-saving statin tablets.
So there’s a lot almost all of us can do.
Finally back to my own story. 30 years ago I was slightly overweight, had poorly controlled blood pressure and a high cholesterol. But I didn’t realise this. As most of us do, even us doctors, I assumed I was fit and healthy because that’s the way I felt. Two heart attacks and a coronary bypass in 2001 showed me the real situation and became a wake-up call. Since then I have taken all these simple adjustments seriously.
A few weeks ago I managed to trail run nonstop for 20 kilometres with a cumulative climb of nearly 300 metres.
I know that was a bit drastic but it illustrates two things - first, we should know about the risk of NCDs for ourselves (and our family members) and secondly, that there is a great deal we can do about it ourselves and increase the chance of living a long, healthier and thriving life.
Now excuse me - I need to put on my walking shoes….