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Slowing down diabetes

The two most potent weapons against diabetes continue to be regular physical activity and healthy eating habits. But with new evidence, medical research has strengthened the view that the burden of Type 2 diabetes mellitus is rising because of expanding urbanisation accompanied by changing food preferences, a sedentary entertainment-oriented lifestyle, rising automobile dependence, and a pedestrian-unfriendly physical environment. Many experts think these factors raise the risk among Indians who may be genetically predisposed to diabetes; the Indian Council of Medical Research estimates the prevalence of diabetes among adults to be 11.8 per cent in urban areas, compared to 3.8 per cent in the rural. The negative impact of non-traditional choices of food and a couch-bound lifestyle seems to be evident in the Philippines and Cambodia, besides India. A lower percentage of rural residents develop diabetes in these countries compared to their urban counterparts, according to an article on epidemic obesity and Type 2 diabetes published recently in The Lancet. These findings point to a strong link between poorly planned urbanisation, now happening in many states, and the onset of chronic conditions such as diabetes.

While those who have already developed diabetes must depend on advances in medical care and a disciplined lifestyle to maintain a good quality of life, millions of others can avoid or delay onset of the disease. The answer lies in reshaping urban development models. The World Health Organisation has emphasised the good outcomes for public health under its Healthy Cities Programme, which envisages municipal bodies actively integrating urban planning and health concerns. A framework for action is available in the forward-looking policies of the United Progressive Alliance Government on urban renewal, transport, and public health. These have to be translated into ground-level results with incentives available for good practice. Of equal importance is the Union Health Ministry's initiative to ensure that the packaged food industry adopts labelling that provides accurate nutritional and calorific values of products. Combined with an awareness-building programme on obesity-related diseases (in which the medical community can play a major role), this measure will enable everyone, especially the youth, to make healthy choices. The experience of many developed economies shows that encouraging physical activity and other health-seeking behaviour contributes in part to a lower burden of chronic diseases. The battle against diabetes in India has a better chance of success if the combat strategy includes opening of more parks, playgrounds, gymnasia, stadiums, and pedestrian and cycling facilities.

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