This is a provocative statement and one that should wake us up from our reverie. A common social statement for someone who does not look like a ‘pear’ is to wonder if he belongs to a so-called khaata-peeta khaandaan. A slight bulge around the waist is almost unanimously accepted as an inevitable sign of middle age and is associated with a sign of good health and finally being ‘settled’ in life; an aspiration for all Indians.
However, a cursory glance at figures for cardiac disease should be taken serious notice of. The Registrar General of India reported that the contribution of coronary artery disease to over mortality and adult mortality rose by nearly 29% and 23% respectively in 2010-2013 compared to 2001-2003. This figure does not even include other cardiac diseases contributing to mortality.
Factors contributing to this include the usual perils of overeating and under-exercising; but more importantly is the under-recognised culture of fitness or rather the lack of it. The fad of going to a gymnasium aside, our society simply does not have the attitude towards fitness. Fitness does not mean building muscle or achieving a svelte figure. Instead it is a concern about keeping oneself at peak activity. It is not a reflection of one’s ability to look good at a point in time but instead is the maintenance of peak or near-peak activity at all ages.
A case study in question would perhaps be the so-called metamorphosis of our cine stars. A study into their fitness levels at peak popularity and in their later years would perhaps reflect a waning performance. For that matter, a study comparing the fitness levels of employees in the last year of their professional activity and five years later may show marked deterioration in their fitness levels. Lack of cardiac fitness is taken to be an inevitable attribute of aging and alternative medical routes are sought after for relief instead of preventive measures at the outset.
A culture of fitness needs an idol in the public eye; an aspirational personality to look up to and emulate. While the youth do have their trail-blazers of their age; the middle-aged and elderly do not have someone to look up to. A Milind Soman or even Shekhar Suman do not a summer make. The ageing Indian population looks at their cohort, sees a mirror image and plods on. Absence of information, changing lifestyles and an increasing disparity between work and leisure makes them more tolerant to fitness-related issues and due importance is not given to them until too late.
As a society, we need to sit up and take notice. We need to place a premium on our fitness. We need to ensure that we push ourselves and our partners to take the time out to exercise. Shaming someone for exercising religiously or even body shaming someone needs to be avoided.
Since all of us do not have the luxury of personal trainers or buddies helping us adhere to fitness regimens, perhaps we can be guardians of the fitness of our spouses. It could work in a mutual reinforcement scenario and would remain a step at a time. Where we would perhaps be lazy to exercise ourselves, or give a middling reason for the lack of fitness, we could perhaps take better decisions when it comes to our spouses. We could assume responsibility for their fitness, research exercise regimes suited to their needs and keep track of their compliance.
Eating habits could perhaps be moulded gradually, small nudges can be given and perhaps responsibility for chores can be taken just to ensure that fitness goals are met. This system utilises the innate concern and care we have for our spouses and leverages the possibility that one may look for inspiration from within than without.In larger families, it is conceivable that family members at various age groups could in turn assume responsibility for others and thereby provide the necessary enthusiasm and encouragement
Establishments could take charge of the fitness of their customers and employees providing incentive on the maintenance of fitness goals. Corporate responsibility could be directed towards provision of aids and special time for the same. Insurance companies could provide incentives towards their customers who demonstrate a certain level of fitness. Government employees could perhaps be given extensions based on fitness levels in addition to just an age. For the traveling executive, loyalty programmes could write fitness criteria into their conditions, with additional incentives provided towards those who achieve them.
Changing the all-pervasive fatalistic perception of health and illness in our country will take its time; however, the time to initiate action was yesterday. We need to embrace the concept of disease prevention being a therapeutic intervention rather than an optional measure towards health. The first step towards it must be recognition of the problem followed by a concerted effort at the grassroots to change the prevailing scenario. Waiting for measures to arrive in the vertical distribution may not happen and may be a case of ‘too little, too late’.
( The views expressed in this article are not those of Fortune India. )
The author is a clinical electrophysiologist from Bangalore with interests in translational research and innovations in healthcare. He is DM (Cardiology) and has completed fellowships in Clinical Electrophysiology and Advanced Adult Cardiology from Mayo Clinic, Rochester, Minnesota, USA.