Lifestyle Diseases & Islam: Religious View on Healthy Living

 Lifestyle Diseases and Awareness by Religious Perspective

 ABSTRACT

“There are two types of blessings which many people lose. They are health and free time for doing good.” (Muhammad Pbuh) [1]

“Science is blind without religion; religion is blind without science.” (Albert Einstein)

Lifestyle diseases are those diseases that are caused partly by unhealthy behaviors and partly by other factors. These occur more often in industrialized countries where people live longer. These can be prevented with changes in living style habits and occur as a result of poor exercise, diet and sleep habits. 7 million new cases of lifestyle diseases present each year. Today, fewer people are dying from tetanus and diarrheal diseases in Pakistan, according to a new, comprehensive analysis of trend data from 188 countries. Mortality from tetanus dropped 93% between 1990 and 2013. At the same time, a number of diseases, including chronic kidney disease and diabetes, claimed more lives in Pakistan in 2013 than in 1990. Statistics show that lifestyle diseases are gradually accumulating as the technology and easiness is advancing. The need of the hour is awareness to the masses regarding these health issues. If masses are resistant to change even on the scientific facts, let them be aware of what their religion has said. Studies show that impact of religion and spirituality on physical and mental health is largely beneficial. Mechanisms for the positive effect of religion and spirituality are proposed. [2]

 INTRODUCTION

In a research paper published in 2013, out of the top 10 causes of deaths in Pakistan, 8 are lifestyle diseases. But in 1990, only 5 lifestyle diseases were the leading causes of death among 10 in Pakistan. It shows that as the technology and industrial advancement is occurring, it is leaving implacable losses to people’s health unless an awareness campaign is run. Of all the deaths that occurred in the year 2013 in Pakistan, 24% were due to ischemic heart disease, 17% due to stroke and 13% due to pneumonia. So the top 3 causes of death are lifestyle diseases.

Other lifestyle diseases include depression, obesity, chronic renal failure, metabolic syndrome, type 2 diabetes, chronic obstructive pulmonary disease, and chronic liver disease, some kinds of cancer, atherosclerosis, Alzheimer’s disease, asthma and osteoporosis.

Ischemic heart disease will become the leading global cause of total disease burden by 2020 [4]. Major risk factors of atherosclerosis include:

• Cigarette smoking

• Hypertension

• Low HDL cholesterol

• Diabetes mellitus

• Family history and age

• Lifestyle risk factors including obesity, physical inactivity and atherogenic diet. [5]

Note that all the risk factors can be prevented by following special guidelines which are discussed under the discussion section.

Stroke is a form of cerebrovascular diseases. Stroke is the 2nd major cause of death in Pakistan. Risk factors for stroke include:

• Hypertension

• Atrial fibrillation

• Diabetes

• Smoking

• Hyperlipidemia

• Carotid stenosis

Hypertension is the most significant of the risk factors.

Diarrheal Diseases include a group of diseases like diarrhea, dysentery, inflammatory bowel syndrome, irritable bowel syndrome. Risk factors for all these diseases are:

• Malnutrition

• Early Weaning

• Lack of Toilets

• ​

COPD (Chronic obstructive pulmonary disease) has been defined by the Global initiative for Chronic Obstructive Lung Disease (GOLD) as a disease state characterized by airflow limitation that is not fully reversible. COPD includes emphysema, chronic bronchitis and small airways disease. By 2020, it is expected to become the 3rd leading cause of death worldwide [6]. Risk factors include:

• Cigarette smoking

• Respiratory infections

• Occupational exposures

• Ambient air pollution

• Passive Smoking

Diabetes mellitus is becoming increasingly notorious as a death and complication hazard. It is a disease of the rich in poor countries and a disease of the poor in rich countries, obesity being the common factor. Risk factors for type 2 diabetes mellitus, which is the most common form of diabetes mellitus, include:

• Family History

• Obesity

• Habitual physical inactivity

• Hypertension

• HDL cholesterol level <35 mg/dL and/or triglyceride level>250 mg/dL

• History of vascular disease

Most of the risk factors of diabetes are related to diet and lifestyle issues and can be effectively prevented.

Chronic kidney disease(nephritis, nephrotic syndrome and nephrosis) is a condition in which the kidneys are damaged and cannot perform its functions properly. Risk factors enhancing chronic kidney disease are:

• Drinking alcohol

• Maintaining an unhealthy weight

• Smoking

Cancer has been shown to occur increasingly in the person's shifting from one demographic region to another. Diet-related factors are thought to account for about 30% of cancers in developed countries according to a research published in Lancet 2003. Risk factors for cancer occurrence are:

• Alcohol

• Obesity

• Inadequate intake of fruits and vegetables

• The importance of other factors, including meat, fibre, and vitamins, is not yet clear.

Depression and other psychogenic disturbances which ultimately lead to suicide, are the 10th leading cause of death in US. Lifestyle disturbances particularly following are the risk factors for developing depression:

• Smoking

• Substance abuse

• Improper diet lacking essential mood stabilizers

• Improper exposure to the atmosphere and sun

• Inadequate sleep and disturbed biological clock

Alzheimer’s disease can be fatal if left untreated or uncared. Lifestyle problems like

• Obesity

• Smoking

• Alcohol

• Mental inactivity

These can promote Alzheimer’s disease. Still the exact causes of Alzheimer’s are not fully known.

DISCUSSION

According to a research paper published in Lancet, there is corroborative evidence that diet and lifestyle is playing a major role in predisposition to various diseases like cancer [7].

Of all the lifestyle diseases, prevention/treatment is common. It includes changes in DIET, PHYSICAL ACTIVITY, SLEEP and HEALTH HABITS (smoking, drug abuse, cleanliness). They are discussed one by one:

DIET:

Almost all the lifestyle diseases are linked to obesity in one way or another. Obesity is a disease in itself. The only thing that is needed to fight obesity is controlling the amount of food we eat. They say:

“A moment on your lips; forever on the hips.”

“Eat wrong; suffer long.”

These 2 proverbs were the leading sentences used by American revolutionary campaigns on diet.

Regarding quantity of food, to understand the basis of diet, a thorough understanding and knowledge on the science of eating is to be established. Scientific evidence shows that once adipocytes are formed, their destruction doesn’t occur easily. Average lifespan of an adipocyte is 10 years. So the number of adipocytes doesn’t decline, their mass may decline. So obesity/adiposity is fairly irreversible. If we eat much, digestive problems can occur owing to the fact that stomach has a limited capacity of holding food. Greater the food in stomach, greater the stretch reflex and more the emptying of stomach contents. So the excess food is not processed in the stomach leading to storage of excess food and later complications particularly obesity.

When it comes to the quality of food, which means what should be eaten, the answer is balance. A balanced diet is best to fight diseases. Balanced diet excludes highly processed food. Diet of common masses exposed to diseases contain snacks, heavy oily foods, excessive protein, egg yolks. According to the USDA, Americans consume empty calories most often in:

Bacon and sausages, cakes, cheese, cookies, doughnuts, energy drinks, fruit drinks, pizza , ice cream, sports drinks and sodas. A diet based on starchy foods such as potatoes, bread, rice and pasta; with plenty of fruit and vegetables; some protein-rich foods such as meat, fish and lentils; some milk and dairy foods; and not too much fat, salt or sugar, will give you all the nutrients you need. It is the fat that is the culprit. We have to cut short our fat intakes. Now comes the problem of fat management. And the best solution for fat management is the use of olive oil and omega-3 fatty acids which are found in some fish oils. Particularly, olive oil contains mono-unsaturated fats and an increase in uptake of these fats is associated luckily with lowering of total plasma cholesterol and LDL cholesterol but maintenance or increase in HDL cholesterol.

When people are dissatisfied by the scientific evidence, are irritated by developing controversial theories and controversies and are resistant to understanding scientific concepts, awareness in the form of religious perspective should be given. What Islam says on overeating is evident as follows:

“… eat and drink, but do not be excessive. Indeed, He likes not those who commit excess.” (Quran 7:31)

““The son of Adam does not fill any vessel worse than his stomach. It is sufficient for the son of Adam to eat a few mouthfuls, to keep him going. If he must do that (fill his stomach), then let him fill one third with food, one third with drink and one third with air.” (Muhammad Pbuh) [8].

It is evident how the religion pays stress on eating less to prevent disease. Similarly, religion also stresses upon the quality of food. As is in Holy Quran:

“The parable of His Light is as (if there were) a niche and within it a lamp, the lamp is in glass, the glass as it were a brilliant star, lit from a blessed tree, an olive, neither of the east (i.e., it neither gets sun-rays only in the morning) nor of the west (i.e., nor does it get sun-rays only in the afternoon – but it is exposed to the sun all day long), whose oil would almost glow forth (of itself), though no fire

touched it..” (Quran 24:35)

So both science and religion uplift the importance of olive oil.

EXERCISE:

American college of sports and medicine, best in sports medicine and research in the world, recommends following types of exercise:

Cardiorespiratory Exercise

• Adults should get at least 150 minutes of moderate-intensity exercise per week.

Resistance Exercise

• Adults should train each major muscle group two or three days each week using a variety of exercises and equipment.

Flexibility Exercise

• Adults should do flexibility exercises at least two or three days each week to improve range of motion.

Neuromotor Exercise

• Neuromotor exercise (sometimes called “functional fitness training”) is recommended for two or three days per week.

Similarly when seen from a religious perspective, the same are the teachings of Islam. Regular prayers and sports like swimming, archery and horse-riding as are seen in various hadiths which not only offer enjoyment but exercise too.

SLEEP:

Better sleep leads to better cognitive enhancement, improved memory, living longer, curbing creativity, warding off inflammation and preventing endless diseases. NSF is a well-known organization of researchers and scientists working on sleep.

Younger adults (18-25): Sleep range is 7-9 hours (new age category) Adults (26-64): Sleep range did not change and remains 7-9 hours

Siesta, a very beautiful aspect of sleep, is highly recommended. It is seen in history that many great men used to take naps in the noon and advised their soldiers to do so. It is also recommended when seen from the aspect of Islam.

“Do siesta as satins don’t do so.” (Muhammad Pbuh)

Sleeping too much is also highly discouraged both scientifically and religiously. It has a long list of side effects including headaches, depression and hypertension.

SMOKING:

Active and passive smoking both lead to an increased nicotinic stimulation in the body and its irritant effects. Smoking and excessive smoking is highly discouraged in Islam.

 CONCLUSIONS

“There has certainly been for you in the Messenger of Allah an excellent pattern for anyone”. Quran

Lifestyle diseases are engulfing the society and the good news is that they can be prevented with just a little effort and particularly awareness. Best strategies to overcome the lifestyle diseases are changes in DIET, EXERCISE, SLEEP and HEALTH HABITS.

 CITATIONS

1. Sahih Bukhari

2. Department of Psychology, Grove City College, 100 Campus Dr., Grove City, PA 16127-2104; e- mail: ksseybold@gcc.edu. Kevin S. Seybold1 andPeter C. Hill

3. Reproduced from facts published on Agha Khan University website. http://www.aku.edu/aboutaku/news/pages/mortality-rate.aspx

4. Harrison’s principles of internal medicine p.1430

5. Harrison’s principles of internal medicine p.1430

6. Harrison’s principles of internal medicine p.1547

7. Key TJ, Allen NE, Spencer EA. The effect of diet on risk of cancer. Lancet. 2002;360:861–8.

8. Tirmidhi

9. 33:21

Government Action on Healthcare Privatization In Punjab

Authorities have decided to outsource the Basic Health Units (BHUs) and Rural Health Centres (RHCs) in all 37 districts of Punjab, including the Rawalpindi district, under the status of Maryam Nawaz Health Clinics (MNHC), retain current regular staff of these centers at other government hospitals, regularise non-regular staff, and terminate the employment of staff working on specific health projects once the projects are completed (via The Express Tribune 13th March 2025). Privatization or outsourcing of government hospitals is not a new concept. Public-private partnerships (PPPs) have gained popularity around across the world for a long now. Those institutions that are state-run are handed over to private organizations/individuals to look after their matters and are governed by them, yet monitored by the state. This is also known as outsourcing. Some individual affairs of the institution can also be outsourced rather than the whole institution. 

The question is what are those employees who have served for decades going to do? What is their future? Sudden terminations will bring havoc to their state of affairs. Also, the transfers of those regular employees working for long at their home stations are going to be cumbersome. Especially when someone is not prepared for such a drastic change. Policies are made, approved, announced and implemented with a methodical approach. We can learn it from civilized nations. For instance, like the United States, the UK also wanted to make their foreign medical licensing exams like USMLE rather than Plab. But, to do so, they adopted a somewhat reasonable methodology, a model for many. Policymaking should be a joint task. All stakeholders should be taken into confidence. The public should be made well aware. Implementation should be in phases, with the pilot phase replaced by the mass phase. What is happening here is too quick and too late. Too quick for health professionals to handle, and too late in what we might call public interest. 

For an institution that has failed, there should be no fault in seeking help from some other institution. Public and private sectors working in harmony for their mutual interests should not be a problem. Many types of research have shown the benefits of Public-Private Partnerships. Countries that followed the healthcare outsourcing framework had far better results in terms of efficiency, improved patient outcomes and financial security. KP province of Pakistan also followed this model for many years which led to better results in every aspect. 

Maryam Nawaz Health Clinics is a name given to all government hospitals. Isn't it a mediocre decision? Naming a public property, a public welfare scheme by oneself and in the best of one's own "political" interests is no more than a 

kingly decision, a monopoly and a political scoring. This melodrama is to stop otherwise the future of this province and country is not going towards progress and development!

In addition to BHUs and RHCs, future models of THQs and DHQs are also being prepared for outsourcing and privatization. These models need to be refined and in the best public interest.