Lankans across the island are getting ready for the New Year with the festive season of Christmas just over. This is the time when nutritionists and diabetologists raise concerns over the health impacts that could occur mainly in elderly persons with compromised immune systems who put their prescribed diets on hold and indulge in the rich festive meals prepared for the family table.
Leading Consultant Endocrinologist and Diabetologist, University of Colombo, Vidya Jyothi Dr Prasad Katulanda tells our readers how over indulging in high fat, oily, sugary and salty foods that are traditionally served at this time around can develop early non communicable diseases while aggravating pre existing conditions such as diabetes, cholesterol and heart disease in those with compromised immune systems. He called upon readers to exercise more, eat plenty of green vegetables and fruits, drink boiled cooled water rather than sweetened drinks and avoid smoking and drinking alcohol to be able to enjoy a healthy New Year.
Excerpts:
Q. The festive season is now in full swing. With Christmas just behind us and the New year only a few days away, the tendency of most revellers enjoying this season is to put their usual diets on hold and indulge in a surfeit of rich food high in sugar and carbohydrates. Studies have shown that such indulgence, even though temporary, if taken to unhealthy levels, could undermine one’s health irrespective of age or gender which could have long lasting effects. Do you agree?
A. Yes, during this period most people whatever their religious beliefs, have parties and get-togethers and go on trips. Therefore, many people would consume more calories and sugar rich food compared to usual times. However, during this festive period due to the Covid-19 epidemic there are restrictions for such activities. In addition some may take alcohol more than usually. This also would have adverse impacts.
Q. It has been said recently in a local study that most Sri Lankans suffer from Non Communicable Diseases (NCDs) which could have been prevented by adhering to healthy diets Do you agree? Could eating rich food high in sugar, cabohydrates and transfats lead to NCDs which are now overtaking the number of communicable diseases in the country? What are the health consequences?
A. Definitely such practices would have adverse implications because the excess calories consumed would make you obese and result in the development of diabetes, high cholesterol, high blood pressure, fatty liver disease as well as some cancers.
Q. Can over indulging in rich foods also trigger digestive symptoms such as heartburn, indigestion and diarrhoea?
A. Foods high in fat, carbohydrates and oil would cause upper gastrointestinal problems like heartburn and indigestion. Sometimes too much oil can cause diarrhoea as well.
Q. Who are those most at risk age wise –the young or the old? Or do these risk factors cut across all age barriers?
A. The risk behaviours are mostly seen in the young and the middle aged and hence the effects are mostly on them. But if the older people take too much sugar and alcohol it can make them acutely ill, especially, if they already suffer from diabetes or liver disease.
Q. Studies have also shown that younger persons and children are less prone to develop an NCD because they are physically active and the vascular systems are still not damaged. Do you agree? Give us some examples.
A. This is wrong. We see lot of youngsters with diabetes and fatty liver. In addition risk factors for diabetes, high blood pressure and heart diseases start in the young age and these youngsters can get non communicable diseases in their teens or in young adulthood. However as I said earlier, in the case of older persons, especially, those with chronic illnesses who tend to put their usual controlled diets on hold during the season, especially, people with diabetes, high blood pressure or liver disease losing control of their usual limited diets even temporarily could have very serious consequences on their health.
Q. Are there specific seasonal foods we consume that can pose a health risk if taken in excessive quantities?
A. Almost all the traditional Christmas and New Year meals we partake including kiribath, fried rice, fried chicken, kavum, kokis and asme have high carbohydrates, refined sugar and oils. The bites such as, cutlets and murukku that we serve before a meal have a higher amount of salt as well which could raise one’s hypertension levels. They can cause obesity, diabetes, fatty liver, high blood pressure, abnormal cholesterol as well as heart attacks in the long term.
Q. Tell us how this happens. How do they impact on persons who already have compromised systems?
A. The conditions of those who already have diabetes, fatty liver, high blood pressure would definitely worsen.
When the body gets fatter the heart would have to work more, especially, in those who already have high blood pressure, so that it could even cause heart failure.
Q. Studies have shown that many elders also eat less fruit and vegetables at this time around. What happens to a person with diabetes or heart conditions if he eats less fruit and vegetables at this time? Will it affect his bowel movements?
A. Lower levels of green vegetables, especially, green fruits lead to obesity and bowel abnormalities including bowel cancer. Also, green vegetables and fruits help to control blood pressure.
Q. Obesity is now a widespread problem in Sri Lanka. In the case of elders, who are most at risk of weight gain during the festive season? Men? Women? Why? Where is this excessive fat distributed in the body?
A. Both men and women can get obese during the festive period. But it’s worse in women in Asia. This may be due to their lower level of exercise.
Q. As many Lankans who prefer western diets at this time, could this excess fat affect the gut? Can you develop fatty liver?
A. Of course, as explained earlier. We see people getting their fatty liver worsened during this period.
Q. Leftovers. Some families refrigerate their cooked festive meal to eat on another day. What can happen to a person with a weak stomach and digestive system when eating this food? Can he get food poisoning?
A. If food is not properly refrigerated people can develop food poisoning. In addition when leftovers are kept for long and eaten obesity also gets worse.
Q. Children too have become obese due to various factors. The Health Ministry recently said that around 13 percent of children, some below 12 years were pre-diabetic.
A. Of course children become obese due to excess calorie consumption and due to lack of exercise. I think since last March as most children are confined to their homes this may get worse.
Also as children are unable to go out they may get addicted to screen related activities such as watching screen games on TV.
Q. The festive season is a time when most children indulge in excessive consumption of sugary, oily foods even being given the nod by their indulgent parents that it won’t hurt them. Your comments?
A. You are correct, similar to adults this happens in children as well.
Q. Many people focus on the short-term effects of overindulgence during the festive season, but there is a risk that a longer-term change in regular lifestyle habits can lead to more serious health problems too. According to the British Heart Foundation, the build up to Christmas can be stressful, not to mention the festive season itself, causing people to slip back into unhealthy behaviours, such as smoking and drinking more alcohol, in the New Year. Your comments?
A. Yes, these habits may continue longer sometimes. Once you get into bad habits it’s difficult to get rid of them. Therefore, healthier habits such as, healthy eating and more fun with physical exercise are important.
Q. Your message to the readers on how to minimise risks of developing NCDs during the forthcoming festive season?
A. Try to eat lesser amounts of high carb, oily, sugary food with high salt. Reduce portion sizes. Add greener vegetables and fruits to your diet. Drink more water.
Try to walk and engage in physical activities. Smoking is really bad so don’t start and immediately try to give up. If you are a teetotaler try to remain so. If you are someone who takes alcohol try to limit as much as possible.