NCDs are food-borne – Newspaper

SINCE the publication of my last column (‘Reversing NCDs’, March 21) on these pages, I have received many messages from readers. Most have expressed amazement at Abu Noaman’s story. Some have shared their personal experience. Some doctors have shared the experiences of patients who have reversed chronic diseases. Others have wanted to get in touch with Abu Noaman for advice and inspiration.

The Indus Hospital & Health Network’s Dr Abdul Basit, a leading diabetologist, shared some case studies of the reversal of diabetes through diet restriction and lifestyle changes. He told me how some of his patients have become medicine-free.

This point about sustainable dietary restriction is important. Some readers have commented that it would be much easier to make such a food transformation living in the US, where you can easily switch to a whole food plant-based diet (WFPB) and that it would be near impossible to follow such radical food changes in a country like Pakistan. The case studies mentioned above dispel this notion. Indeed, it is not easy but it is also not impossible. Determination, improvisation, innovation and following sustained correct advice given by an expert lifestyle doctor can make it possible anywhere. For this diet to be followed more widely, the promotion of lifestyle medicine is needed first — most importantly, within the doctors’ community itself.

A doctor friend quipped: “So, we can say that non-communicable diseases [NCDs] are actually food-borne.” Sometimes an off-the-cuff remark captures deep wisdom so perfectly and profoundly that you end up marvelling at the beauty of such brevity. Think about it; it is so true!

We are the result of what we consume.

Avicenna ascribed huge importance to food, its medicinal uses and its significance in supporting human well-being. The quote ‘you are what you eat’ is attributed to 19th-century philosopher and gastronome Jean Anthelme Brillat-Savarin. He was also a lawyer and politician, but most famously is considered the founder of the modern culinary tradition. His influential book, translated from the original French to The Physiology of Taste, is regarded as a classic in food writing. He goes into almost every aspect of food. He said, “Tell me what you eat, and I will tell you what you are.”

From the Persian Avicenna in the 12th century to the Frenchman Brillat-Savarin of the 19th century to present-day practitioners of lifestyle medicine like our own Dr Shagufta Feroz and Dr Munira Abassi, the same old school of thought prevails. It is now, more than ever before, supported by scientific evidence; ie, food is important, it can affect us positively and negatively, and human beings should exercise mindful eating.

Isn’t it so that we are the result of what we consume? As the poet mused, “It’s a very odd thing/ As odd can be/ That whatever Miss T eats/ Turns into Miss T.” Food is our existence. It makes us how we look, what we do and how we function. It is also responsible for how we feel — good or bad, happy or sad. Food is our fuel. The quality of the fuel determines how the machine works, and for how long it works. It is the type and quality of food which determines how we grow and how it affects our insides — our organs, our cells, our hormones and our neurotransmitters. It can keep them healthy and in a state of equilibrium or it can negatively affect various parts inside us in vicious ways. Scientific research now gives us ample information about the effect of different foods on our body and mind. NCDs, hence, are the result of the food we eat routinely, which can negatively affect our body organs and disturb the highly sophisticated inner workings of our bodies. If we carefully change what we eat, the negative effects would be weaned away even if there is a genetic predisposition. The field of epigenetics is amazing in this context.

This is exactly what Abu Noaman accomplished and what many like him are doing to control food’s negative effects on their body. They are even getting rid of diseases and medicines. Indeed, Abu Noaman’s is an extreme example, but it is of great value as a lesson. We are all on a spectrum between health and disease. What is important is to realise where we stand and accordingly adopt a healthy diet and lifestyle to prevent, control or reverse NCDs. We may not need an absolute WFPB diet, but all of us do need a predominantly WFPB diet.

Food has a central value in our state of health. It can also be said that NCDs are food-borne. Along with food though, the human body and mind are also affected by a number of other factors, the so-called pillars of lifestyle medicine: exercise; restorative sleep; stress management; good social relationships; and avoiding any addictive substances. A new dimension — call it the seventh pillar — is now emerging, ie, how we relate to our environment. At the end, it is the combination and interplay of all these factors that lead to good human health and healthy aging.

Reading the above, a cynic might bluster: ‘What’s the point being healthy or not so healthy or even sick? All of us are going to ultimately die.’ A realist optimist sitting close by would retort by pinching the cynic hard and saying ‘my friend, pain or no pain depends on the choices we make, let us go get a healthy lunch!’

Corrigendum: In my last article, the values of Abu Noaman’s diagnostic tests on July 1, 2021, at the time of the heart attack, were quoted as cholesterol 222 mg/dL and LDL 150mg/dL. There was some confusion pertaining to the source from where I quoted the figures. His actual values at the time were: cholesterol, 122 mg/dL and LDL, 79mg/dL. The rest of the story is the same. The inadvertent mistake is regretted.

The writer is a former health minister and currently a professor of health systems & population health at the Shifa Tameer-i-Millat University.

Published in Dawn, April 4th, 2025