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India’s Ikigai: Centennials know the secret sauce to Longevity

It is not just about staying physically healthy-it is also about mental, emotional and social health

Mishrilal Jain, 92 years lives in Bareli in a Madhya Pradesh and still sits in their family cloth store. He totally defies age by being active, healthy and social. Every day, he makes it a point to chat with his friends. He walks on his own with a stick and has no medical conditions or lifestyle diseases. A freedom fighter who has even been to jail in 1947, Jain has a very positive outlook towards life. His granddaughter reiterates his secret to longevity is that fact he has been active throughout his life, eats only homecooked food and is happy and content.

Dr Narsingh Gulvady, 90, lives in Navi Mumbai and is a retired MBBS doctor. He says, “do not do anything to live long. I did nothing”. Born in 1929, in then Madras, Dr Gulvady is active and spends a lot of time with his books apart from enjoying his beloved wife’s company who is also 86 years of age. Dr Gulvady attributes his longevity also to people’s love all along that has kept him happy and healthy. He also does not forget to credit his gene pool for longevity. Both he and his wife have led a very active and simple life. He maintains a diary on a daily basis and does not have any medical issues.  

The above stories are just two of the examples of the many 90 plus people GOQii interviewed for their longevity study. Aging is a natural process and it is inevitable It is precisely the impermanence of life that renders it so precious. But, how about aging gracefully and disease-free? Is this even possible? Are some of the questions we asked and the answers we found were positive. Yes, it is very possible according to the latest India fit Report 2020 titled –– India’s Ikigai: The Old Know Better but the Young Don’t Care’.

As per the report, the above examples highlighted, the 90 plus years and above people attribute their longevity to simple living, being active, eating home-cooked nutritious food and to being socially active with friends and family. For many their years of living have been happy and content.

The India Fit report 2020 is in its 6th edition and it is a result of a year-long study of 5 million GOQii users. The report presents a holistic overview on the health and lifestyle of Indians across different parameters such as steps taken, lifestyle diseases (Diabetes, Cardiac and Hypertension), BMI (Body Mass Index), nutrition, water, stress, sleep, gut health and immunity, allergies, smoking and alcohol consumption; all of which are classified according to gender and key cities. This year India Fit report went a step further and decoded the secret to ‘India’s Ikigai-longevity of life’ from 90 years old and above across the country

Most of the centennials also lead a disease-free life while the younger age groups demonstrated a higher risk profile for lifestyle diseases, the study indicates. As per the health risk assessment (HRA) (framework of the study, 62% of people are either high risk or borderline on the Health-Risk Assessment spectrum. Only 38% of people are healthy. Young adults in the 19-30 age group have the unhealthiest habits and demonstrate a high propensity to be afflicted by lifestyle diseases.

The study indicates that people who report being happy and satisfied with their lives are more likely to enjoy a longer life span with good health and fewer long-term limiting health concerns. Bonding with family and friends appears to enhance health, and even increase longevity. At GOQii, our endeavour is to create awareness about preventive health while providing people with a platform to improve their health and fitness and move a step ahead to increase India’s average lifespan to 80 years and above.

 ALARMING RISE IN LIFESTYLE DISEASES

The report indicates that Diabetes has increased from 7.1% to 12% this year. The incidence of diabetes is highest among older adults at 23.81% and seniors at 36.82%. As per the report, 13.5% of Indians have Cholesterol issues. High Cholesterol can even occur among people who are underweight, or overweight, thin or fat thus regular monitoring is key in keeping cholesterol in check. Currently, 36% of the people who have high cholesterol have heart issues too while 51.7% of the people who have diabetes have abnormal cholesterol too. This past year Thyroid issues have increased from 6.8 to 10.7 %. The report also suggests that 13.4% of the people in India have high blood pressure.

SOME SURPRISES: Healthiest City is Chandigarh and Mumba slips to rank 15 in the list of healthy cities

The survey deep dives into city-wise parameters and has recorded Chandigarh to be the healthiest city in India while Mumbai slips far down in the list of healthiest cities, ranking 15th overall. Kolkata is at the lowest end of the spectrum. 18% of people in Kolkata are diabetic followed by Surat and Bhopal. In terms of allergies, Pune ranks lowest on the allergy index having the least amount of people suffering from allergies. Chennai has the worst BMI rank across all cities, Kolkata has the largest aging population in the country and the highest incidence of lifestyle diseases like diabetes, cholesterol, blood pressure and thyroid. About 60% of people in Lucknow fall in the unhealthy bracket which is just 2 % below the country’s average. Ahmedabad ranks 10th in the overall ranking, manages stress better than many other cities. Bhopal has overtaken all other major cities, having the highest percentage of people who consume alcohol.

The GOQii India Fit Report has been administered across 16 cities in the country and data has been collected from a cross-section of 5 million GOQii app users. The study evaluates the health of users basis the Health Risk Assessment that take and also the data recorded on a daily basis that is tracked by users on the App. HRA considers factors such as current body statistics, medical parameters, current nutrition, physical activity, stress, sleep, alcohol, smoking, current illness, lifestyle diseases, immunity levels, symptoms or health indicators. The data that is tracked by the users on a daily basis is their steps clocked, food logs, sleep, water intake and their vital parameters. This edition of the report has focused on doing in-depth interviews with India’s oldest citizens. Over 100 respondents across the length and breadth of India, between 90 and 100 plus years of age were an integral part of the study.

Download the full report from www.indiafit.org

For more topics on the health benefits of foods, check out our Healthy Reads section within the GOQii App or simply tune in to GOQii Play for LIVE sessions by experts. 

#LevelUp your winter and #BeTheForce 

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The Difference Between Keto, Paleo and Atkins

keto, atkins and paleo

With fad diets running around in full swing, you’re bound to wonder what they are about. To give you a quick gist, Keto, Atkins and Paleo are all low carbohydrate diets that serve different purposes. To understand the difference between them, let’s delve into details first!

1. Ketogenic or Keto Diet

This diet was created in the 1920s as a mode of treating epilepsy. The classic Keto diet requires 90% of the calories coming from fat, 6% from proteins and 4% from carbohydrates. The purpose of this diet is to force the body to go into ketosis, which is a metabolic state that utilizes fat for energy instead of glucose (i.e. from Carbs).

Although the diet is low-carb, its main focus is to be high in fat with some protein. There are no restrictions on the type of fat to be consumed.  So followers can have bacon, avocados, butter, etc.

Pros:

  • High-fat and high-protein foods keep you fuller for longer.
  • You can eat up to four ounces of cheese (For some of us, that’s key).
  • Protein is more limited than on Atkins, so your liver will not end up processing it.
  • Your cholesterol is going to get better as the good cholesterol will go up and the bad triglycerides will go down.
  • It can also help lower blood pressure.
  • The keto diet has been shown, in some studies, to improve the health of women with PCOS (Polycystic ovarian syndrome), reduce cholesterol, decrease seizures in epileptic children, and improve acne.

Cons: 

  • Have you heard of the Keto flu? When you start the diet, you may begin feeling grumpy and foggy while your body and brain adjust to using ketones instead of glucose for fuel. The Keto flu can last from 2 days to 2 weeks.
  • You cannot eat any fruit.
  • As the fiber content in the diet is low, it can cause issues such as constipation.
  • You need to be careful about dehydration.
  • You need to get ketone urine testing strips to confirm you’re in ketosis at regular intervals.
  • If you are accustomed to a high-fiber diet, you might need a supplement.
  • If you are on medication for hypertension, diabetes, or other conditions, you must talk to a doctor before starting the diet.

2. Atkins Diet

This diet is specifically labelled as a low-carb diet. There are 2 versions of Atkins diet: Atkin 20 which is the original diet and Atkin 40, which is a diet created for those looking to lose less than 40 pounds (approx. 18 kg).

The Classic Atkins diet has 4 phases: The 1st phase starts off with having 20-25gms of carbs per day and then slowly progresses to phase 4 in which people are allowed 80-100gms of carbs, which is still considered low-carb.

Atkins focuses on net carb intake. Instead of counting all carbs as the same, this diet takes fiber and sugars into account, whereas Paleo and Keto don’t. So if a food has 10gms of carbs, but 3gms of fiber, and 1gm of sugar, than your net carb intake would be 6gms.

Pros: 

  • You won’t be hungry. You will feel satisfied.
  • Weight comes off quickly, although some of it will be water weight. 
  • The four phases allow you to slowly add some carbs back in, making it somewhat easier to sustain. 
  • Atkins has a line of snack bars, shakes, and frozen meals, which make compliance convenient.
  • There is evidence that the diet helps improve both cholesterol and blood sugar levels.

Cons: 

  • Your initial dramatic weight loss is a whole lot of water — you won’t keep losing at the same level and the minute you eat carbs again it will come back on. 
  • You eat too much protein, which can cause serious liver issues.
  • This can also prevent you from going into ketosis, which means you won’t lose weight. 
  • Eating barely any carbs can, at first, make you feel cranky, lethargic, and even achy — mainly because your brain takes time to adjust from processing glucose to ketones.
  • Being in a state of ketosis causes stinky breath — and since bad breath doesn’t come from your mouth, brushing isn’t going to help.
  • The Atkins line of foods and snacks often contain artificial sweeteners and other processed ingredients.

3. Paleo Diet

The Paleo diet follows the eating pattern followed during the Paleolithic era, 2.6 million years ago, which is basically eating like a hunter- gatherer. It focuses mostly on a high-protein diet with lots of vegetables and fruit. Unlike Keto and Atkins, this diet doesn’t aim to be low-carb. It cuts down the intake of carbs from grains, dairy, legumes, refined and processed foods.

While keto diet doesn’t discriminate between the types of fats that needs to be included, the Paleo diet advises its followers to avoid certain types of oils and trans-fats. Although you can eat all the peanut butter you want to on a keto diet, the paleo diet cuts out the peanut butter because technically peanuts are classified under legumes.

Pros: 

  • The focus of Paleo is on whole, nutrient-dense foods.
  • You can have proteins, fruits and vegetables, and healthy fats (like those from avocado, nuts, and seeds). 
  • Low-glycemic diets have been shown to lower blood sugar and cholesterol and reduce visceral fat. 
  • You don’t have to give up sweets, as long as they are natural (honey, maple syrup, etc.). 
  • People with gut issues may find eliminating wheat, dairy, and processed foods also eliminates digestive discomfort. 
  • It is higher in fiber and other nutrients than Atkins and Keto.

Cons: 

  • The diet is restrictive and difficult to implement. 
  • Be prepared to shop and cook for every meal, because it’s challenging to eat out on Paleo. 
  • This diet might burn a hole in your pockets as grass-fed meats, free-range poultry and organic produce are expensive. 
  • Without dairy, you may need to increase your efforts to consume enough calcium. 
  • Weight loss, if any, may be more gradual than on the other diets.

While GOQii does not advocate, promote or instruct its players to follow fad diets, if you’re still adamant on choosing any one of these, you may want to consult your GOQii Coach within the app, nutritionist or dietician before proceeding as the same diet doesn’t work for everyone. You might even want to check with your doctor in case you have food allergies.

We hope this article helps you! Leave your thoughts in the comments below!

#BeTheForce

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The New Age Health Horror of Diabesity

DiabesityWhen someone says “horror”, what do you imagine? Definitely nothing pleasant but something extremely scary, right? Do you picture ghosts and demons? If your perception of horror is limited to only supernatural occurrences, you might want to take a big step back. While supernatural entities are subjective, health issues are very much real and their stats are horrifying to say the least.

Recently, we came across a study titled ‘Finding a Policy Solution to India’s Diabetes Epidemic‘ by Karen Siegel, K. M  Venkat Narayan and Sanjay Kinra. The study indicated that ‘In India, 35 million people have diabetes—a number expected to more than double by 2025, disproportionately affecting working-age people’. That means over 70 million people. Isn’t that scary?

Diabesity, which is a combination of Diabetes and Obesity, is even worse! Can you picture it? Obesity is a key risk factor for diabetes. India has the world’s largest number of people with Impaired Glucose Tolerance (IGT) and Impaired Fasting Glucose (IFG), which are the precursors for diabetes. Obesity and IGT are mostly found in younger populations.

Major Causes Leading to Diabesity

  1. Globalization: facilitates access to various pre-packaged and processed foods. In fact, there is minimal physical activity as we have one touch access to almost everything! Surely, we are growing economically but at the cost of our health.
  2. Nutrition Transition: There is a major shift observed in the meal patterns of Indians today. People are turning more towards western foods, foods that are pre-packaged, ready to eat foods, high in calories, sugar, aerated drinks, hydrogenated fats over the simple traditional food which are high in vitamins, minerals, fiber and other essential nutrients.
  3. Higher Percentage of Abdominal Fat: Abdominal obesity is the key factor of insulin resistance and development of diabetes.
  4. Malnutrition During Pregnancy: Because of the co-existence of underweight and overweight, children are often born underweight and adapted to a low-nutrition environment. Low-birth weight infants are more susceptible than those of normal birth weight to obesity and diabetes, especially when raised in an Obesogenic environment.
  5. Lifestyle: Most people today lead sedentary lifestyles devoid of much movement. Even at work we’re glued to our desks and laptops. This accounts to minimal physical activity. At the same time, the stress factor is the maximum with respect to targets/goals associated with work, family and social circles.

How To Keep It At Bay

Keeping Diabesity at bay actually involves 3 very simple and basic lifestyle modifications:

  1. Make Healthy Food Choices: Choose whole grains and its products over refined ones. Incorporate more fruits and veggies daily. Opt for products less in sugars, fats and high in fiber. Make a habit of reading nutritional labels before buying a product. Do not forget “MODERATION IS THE KEY”.
  2. Exercise: Make it a point to exercise on a regular basis. Exercising will not only keep you active but also help reduce insulin resistance, improve cardio vascular strength, tone your muscles, and increase Basal Metabolic Rate (BMR). Exercising releases endorphins which is a feel good hormone that will also help you relieve stress(both physical and mental).
  3. Stress Management: Managing time and stress is essential to stop the release of the stress hormone Cortisol which makes you crave for foods that are high in carbs. All that you eat when stressed is stored in the body as fats, especially in the belly. Meditating regularly before going to bed, deep breathing during stressful moments, indulging in your hobbies, exercising, completing your work on time, etc. will help curb stress levels. It is not a single factor that would work but both.

If you want to learn about effective ways to manage obesity and diabetes, or want effective exercises to combat both, tune into GOQii Play and get live coaching from renowned experts you can even interact with.

We hope this article on Diabesity alarms you enough to make necessary lifestyle modifications before its too late! Stay healthy and #BeTheForce!

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Understanding Patient Behaviour Towards Digital Therapeutics

Are we, as patients ready to pay for an app which is intended for Therapeutic Purpose & Helping us manage our lifestyle better?

Digital Therapeutics

What a Patient Thinks

Ideation of this whole article took a shape while having a discussion with my father who is a Type 2 Diabetes patient. I was actually insisting him to install an app to better manage his lifestyle specifically the dietary recommendation (Since he is a banker by profession and also manages family business, day to day life is a complete mess) given by his doctor. Initially he was in agreement but when he asked me if there is any cost associated, I nodded yes. His decision changed immediately. According to him, he knows what to eat, what not to eat and on top of it, he is taking his medication (which he often forgets) so there is no need of a digital intervention. I tried to explain to him multiple times thereafter but all in vain. According to him, it’s just a waste of money.

Patient Compliance Behaviour: Medication vs Lifestyle Recommendation

This is the story of most Chronic Disease patients for whom managing their lifestyle is a crucial need. But it’s really sad to see the poor grades when it comes to be compliant of various lifestyle aspects. According to a study conducted among Indian diabetes patients, only 24.1% were aware and have been following self-blood glucose monitoring appropriately. Similarly, only 37% of the patients are adhered to the dietary prescription made by their physicians and only 35% follow up the physical exercise recommendations.

Why is it important to talk about “Patient’s Compliance Behaviour” before getting into the “Patient’s Commercial Behaviour”? The reason is that patients need a push specifically in case of chronic diseases because it’s all about care, whether it’s done by the patient himself or by a caregiver. In case of medication, the weightage is higher since it’s coming from doctors (with serious words) while in case of lifestyle, it comes as a recommendation rather than a prescription which defines the seriousness.

So, if a patient is serious enough about his disease condition and strictly follows the testing, medication and lifestyle modification, he/she doesn’t need any intervention, traditional or digital to manage his/her lifestyle but the statistics don’t reflect the same. Hence, it becomes important for patients who are not serious or moderately serious to keep engaged and motivated to adhere with the doctor’s recommendation via a push. Digital gives that push.

Now comes the commercial behaviour. There are hundreds of apps available in the market to manage your disease conditions. Some are freely available; some are coming complementary with the devices/treatment and for some, you have to lighten your pockets. Definitely the skewness is higher towards the free ones. Most of us preferred the free apps and uninstall any paid app when it asks for a payment after the trial period. But free apps have their own limitation and for better services/attributes or features, you have to pay. Same goes with the apps which are offering lifestyle management solutions for patients.

A Preliminary Investigation

To get a deeper understanding of patient’s behaviour, I conducted a small survey among diabetes patients. The survey designed on SurveyMonkey consists of 10 questions (5 open ended, 5 close ended) and shared on a few social media & chatting platforms such as Facebook, WhatsApp etc. The key questions are:

  1. Patient’s Name
  2. Age
  3. Is he a diabetic patient?
  4. If yes, is he using any online application to manage his Lifestyle?
  5. Name of the app he is currently using
  6. Is it a paid app?
  7. Approximate cost of the app.
  8. Will he pay for an app which promises to better manage lifestyle (in case the answer of Q6 is no)?
  9. If yes, what is the approximate cost he will pay?
  10. If no, why?

There were 43 responses received in total out of which 32 were diabetics. The outcome of the survey are as follows:

  • ~80% of the total respondents are within the age group of 30 to 60 years
  • Out of total diabetes patients, only 36% are using one or another app to manage their lifestyle
  • Majority of the patients are using MySugar (45%) followed by Apollo Sugar (27%), GOQii (18%) and Wellthy (9%).
  • Only 2 out of the total patients with diabetes who are using an app have paid some amount
  • The approximate cost which they have paid is ~INR 2500
  • 77% of the patients who are using an app (and answered no for Q6) are not ready to pay even if it provides a better solution, while only 23% are ready to pay.
  • The approximate cost which most of the patients feel comfortable to pay is INR 100-200 per month.
  • Free availability, YouTube videos, Advice by friends and family, waste of money etc. are some of the major reasons why people don’t want to pay for an app.

So, if we look closely, patients are quite ignorant when it comes to pay for an app. Reason, they consider it as a waste of money. This outlook needs to be changed. This perception needs to be changed. And it can only be changed when it comes as a prescription and not just a simple recommendation.

Conclusion

If a patient can spend ~INR 9,000 (from an analysis conducted by Lady Hardinge Medical College) annually for his diabetes treatment, he can definitely spend few hundred bucks to manage his lifestyle for better outcomes. But the patient also needs support from other industry stakeholders such as Pharma, Devices and payers so that the cost can be shared and patient will have to bear minimum cost burden.

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