Shashank Joshi writes: How type-2 diabetes can be reversed in young people without medication – The Indian Express

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Modern lifestyles have led to sedentary habits in virtually all parts of the country. Improved economic conditions and the easy availability and lower cost of cereals, especially polished rice, wheat flour, apart from the consumption of excess sugars, starches, salt and fats/oils have led to dietary changes in both urban and rural communities. In general, people eat more, and eat fast, today. All this contributes to weight gain. Fast food items – in both global and local cuisines – give scant respect to health. That’s why people today are vulnerable to diseases like Type 2 diabetes.
Milk and milk products remain the only protein sources in our predominantly vegetarian economy. They must be fortified with Vitamin D. Food and health safety regulations are urgently needed to ensure that foods are free from pesticide residues and chemicals that can not only contribute to the development of diabetes but also cause cancers, apart from other non-communicable diseases.
Traditional, as well as modern Indian diets, have excess carbohydrates and fats and lack protein. This is compounded by a lack of fibre and poor intake of fruits and vegetables in urban diets.
There is a need to use less oil in cooking – it should be restricted to less than half kg per person per month — eliminate transfats like vanaspati and avoid reheating oils or food. Indians across regions use different edible oils. No oil matches the right criteria for health. So we, currently, recommend blending at least two edible oils with rice bran oil. Cooking habits like excess frying should be discouraged.
There is a need to encourage locally-grown healthy fruits and vegetables. It’s time we promote local millets, herbs and nuts grown in the country, and eschew imported nuts. Groundnuts, pulses and soya are excellent economical sources of protein for vegetarian diets. Egg white, fish and chicken are excellent sources of non-veg protein but red meats should be avoided.
Rather than promoting global diet pyramids, food fads and fast foods, we should tweak our traditional diets to make them tasty and healthy, and eat mindfully — eat on time, slowly and less. A large breakfast, moderate lunch and light dinner make us lose weight while the reverse leads to weight gain.
Diet fads that have gained popularity, via social media, are backed by little science. Some can even be harmful. Keto diets, intermittent fasting, and protein diets have short-term gains but can lead to serious health concerns later and must be taken under expert supervision. Science has shown the salience of calorie restriction. Everything else, from carbohydrate control to eating excess protein or fat, may work only in experimental conditions but the data is still conflicting. Remember, no diet works unless it’s in conjunction with a healthy lifestyle and exercise.
Break your sitting posture every 30 minutes. Experts agree that short spells of five minutes of a brisk walk could make you live longer by four years. Ten thousand steps is what is recommended but current data says do at least 6,000 to 8,000 steps. Indians have less muscle mass. Classical surya namaskar and sit-ups can build muscle mass. Even when we are stationary we should do movements or be fidgety — it burns some fuel. But it’s also important to be fit and have stamina. Jog, run, swim or play a sport or do physical activity approved by a medical doctor. Many people have regular gym memberships. But we often hear of fit gym-goers dropping dead suddenly. Before enrolling in a gym, a thorough medical check-up, as advised by a doctor, is necessary. Done under expert supervision, yoga provides several benefits. Meditation, mindfulness and chanting of mantras, including the Gayatri Mantra, go a long way in reducing stress, anxiety and promoting good quality sleep.
Stress has a huge impact on health. Adapting to stress or stressful situations with a smile and positive energy is an art. Sleeping on time, for at least seven hours from 10 pm to 5 am, is important for our biological clock. Sleeping less than five hours or more than 10 hours is detrimental to health. If you snore, please get a proper sleep study done and see an expert.
Dealing with tobacco and alcohol addictions requires clear-cut de-addiction protocols. Behaviour therapy, counselling as well as shared decision making play a key role in the modern-day care of a person living with diabetes.
Type 2 diabetes can be reversed without medication by restricting calories (less than 800 kcals). Unfortunately, drastic diets are difficult to follow. Digital diabetes care has become an enabler in suggesting apt treatments. Artificial intelligence and the Internet of Things can be used to create digital body digital twins of patients with the help of teams of professional coaches and doctors. Personal healthcare solutions are delivered after receiving inputs from sensors that provide information on glucose, weight, body composition, food, activity, sleep habits as well as heart health and blood pressure – all these create a health signature of a person with diabetes. These AI-generated signatures, with the help of a personal coach and medical doctors, allow precise advice that enables the patient to handle the disease better and enables the elimination of medication in most cases.
It’s mandatory to do an hour of digital detoxification – stay away from mobile phones, computers or television screens and engage in music or hobbies. The theme of the International Diabetes Foundation this year is to educate, empower and create awareness about diabetes. The biggest challenge is that every second person does not know that she/he has Type 2 diabetes. The disease can be easily reversed in younger people. The key is to sensitise everyone.
Mental health is equally important in dealing with the disease. Happiness, gratitude and kindness must replace distress, anxiety and negative recklessness. Let’s all work in the 75th year of Indian Independence to make the lives of people living with diabetes happy and healthy.
(The writer is Chair International Diabetes Federation Southeast Asia Region)
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Shashank R JoshiThe writer is the dean of Indian College of Physicians and a well-know… read more

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