Reinventing how to stay healthy

In the West, nearly 80% of diseases are categorised as ‘chronic’ or non-communicable diseases (NCDs), which include hypertension, diabetes, lung disease, heart disease/stroke, arthritis, neurological diseases (Parkinson’s, Alzheimer’s), and various cancers. Today, more people succumb to chronic illnesses than infectious diseases, a trend observed globally, not just in the West. This alarming rise persists despite advancements in drugs, surgeries and technologies.

Unlike infectious diseases with singular causes like bacteria or viruses, chronic diseases stem from multiple factors. These factors extend beyond genetics to encompass lifestyle choices such as consuming an unhealthy diet rich in ultra-processed foods, excessive sugar, chemically extracted oils and high carbohydrates. Additionally, weak gut bacteria, insufficient physical activity, poor sleep, exposure to polluted air and water, unregulated stress, ineffective emotional management, strained relationships and a lack of purpose in life contribute significantly to the development of chronic diseases.

While medical science has undoubtedly made substantial progress, particularly in treating infectious diseases, orthopedic issues, and improving childbirth and surgical procedures, the increasing prevalence of chronic diseases remains a pressing concern. This trend is evident both globally and in regions like Nepal, despite advancements in drugs, surgeries and technology.

India provides a stark example of this trend. Obesity afflicts 40% of the population, with higher rates in urban areas, among women, and in educated individuals. Type 2 diabetes affects 9% of the population, doubling in just 25 years, and exhibiting the world’s highest growth rate. Obesity is defined as having a Body Mass Index (BMI) over 30.

Did you know this fact:

What seems difficult for both medical experts and the media to accept is that chronic diseases are caused by multiple factors, not just a single agent like a bacteria or virus. These factors extend beyond genetics to encompass lifestyle choices such as consuming an unhealthy diet rich in ultra-processed foods, excessive sugar, chemically extracted oils, and high carbohydrates. Additionally, weak gut bacteria, insufficient physical activity, poor sleep, exposure to polluted air and water, and unregulated stress contribute significantly to the development of chronic diseases. These patterns are evident in our daily lives, often normalised and overlooked.

It’s surprising to note that medical colleges in Nepal allocate less than 20 hours of lecture time to the importance of diet, nutrition, exercise and stress management. Despite the rich traditions of yoga, meditation, Ayurveda, and the value placed on social relationships, medical curricula in Nepal predominantly follow Western pharma-dominated models. This approach often neglects or dismisses traditional practices, focusing primarily on drugs, pharmacology, surgeries and related treatments.

Many doctors have even admitted that hospitals tend to prioritise acutely ill patients, potentially influencing decisions like the high rate of C-sections in Indian private hospitals, which can exceed 45%, compared to the global average of around 17%. This raises questions about the underlying motivations and priorities within the healthcare system.

So, why is this relevant to HR managers and corporate leaders?

I cite two reports to make a case for why the leadership of any company must shift their focus beyond just relying on the medical system (disease care only) approach to employee health and wellness. (Wellness must include physical, cognitive, emotional, stress regulation, proper diet and different physical exercises …in other words, a lifestyle approach to health).

25% of employees worldwide are experiencing symptoms of burnout, that figure is even higher for Asia, nearing 33%, or one in three.

(Note: McKinsey is recognised as the largest and most reputable management/HR company in the world.)

As per a white paper of The Asian Development Bank, IMPROVING WORKPLACE WELLNESS IN ASIA: A BUSINESS CASE, APPROACHES, AND SUCCESSFUL PRACTICES, 2020.

“Chronic disease affects all employers and the overall economy because it reduces the quantity and quality of human capital across all age groups. Beyond direct health care expenses, the indirect or hidden costs of chronic disease to employers include lost productivity because of absenteeism (e.g., sick leave, disability, and time off for medical care) and presenteeism (i.e., when a person at work is unable to perform at full capacity because of illness, stress, or other issues).”

They cite another report that claims “the global economic costs of work-related illness and injury have been estimated at between 1.8% and 6% of GDP across various countries, including 3.2% of Singapore’s GDP in 2011.”

The global surge in chronic diseases over the past 50 years is a pressing concern, despite advancements in drugs, surgeries, hospitals and technologies. This increase coincides with the deterioration of lifestyle factors, including the consumption of poor diets high in processed foods, refined carbohydrates, sugar and chemically refined oils, sedentary lifestyles, insufficient sleep, screen addiction, and poor emotional management.

While the medical system acknowledges these lifestyle factors intellectually, they are often ignored or dismissed. Moreover, doctors lack adequate training to address them effectively. As highlighted in various articles, the medical system exhibits a reluctance to adopt innovative and evidence-based clinical practices.

(It Takes an Average of 17 Years for Evidence to Change Practice, JAMA 2023, PLUS

https://universityaffairs.ca/opinion/in-my-opinion/closing-17-year-gap-scientific-evidence-patient-care/   plus   Why Innovation in Health Care Is So Hard (by Regina E. Herzlinger, HBR, 2006)

In Nepal, shifting clinical practices based on clear evidence seems to be significantly more challenging than in many other countries. The system and its leaders often lag behind scientific advancements by 10-15 years in numerous medical specialties.

While the factors contributing to this global trend are complex, a key issue lies in the nexus between politicians, pharmaceutical companies, insurance providers, hospitals, doctors, government research funding agencies, scientific journals, food and beverage companies, and the media. This interconnected network benefits financially from a sick and unhealthy population. The sicker people are, the more revenue is generated for hospitals, doctors, pharmaceutical companies, insurance companies, research centres, and the media, including politicians. This ‘disease care system’ presents a significant challenge to fundamental reforms. However, paradoxically, this same network holds the potential to drive innovative solutions.

Historically, the holistic health movement gained some traction in the United States during the 1965-1985 period. However, it was initially ignored, then dismissed, and ultimately suppressed. As a result, the term ‘holistic health’ is no longer widely used, particularly within the media, medical system, FDA and NIH.

In the 1990s, medical doctors like Dean Ornish and Andrew Weil introduced integrative medicine to medical universities. Even after 25 years, integrative medicine is taught and practiced in less than 25% of U.S. medical schools. Nepal, despite its rich traditions of yoga, Ayurveda, and meditation, lags even further behind in adopting integrative or holistic approaches to health.

In a subsequent article, I will delve into the lifestyle approach and its various components. It’s crucial to understand that health extends beyond the mere absence of disease. A holistic or integrative concept of health encompasses physical health, mental and emotional balance, stress management, healthy relationships, adequate sleep, and a meaningful purpose in life.

The accompanying diagram illustrates this holistic approach, which is not typically taught in medical schools that primarily focus on diagnosing and treating specific diseases or pathologies. This approach combines the allopathic system with lifestyle interventions.