panacea for all illnesses

An aspirin a day keeps the doc away

Your Health
DR GITA MATHAI

No one likes to be ill, and once the inevitable occurs, one does not want to swallow a large number of multicoloured tablets of all shapes and sizes.

Can you not reduce the number of tablets? I am sure if I take all these I will suffer side effects! Can I not alter the disease process with diet alone? Can I switch to a different system of medicine?

Common queries that busy physicians seldom address patiently.

Anyone who does not wish to have a chronic disease (and swallow tablets for the rest of his or her life) has to take care of his or her health from an early age.

Today, lifestyle diseases such as obesity, diabetes, hypertension and heart disease are rampant. Unfortunately, these diseases usually occur in combination. One of the diseases, say hypertension or diabetes, may start alone as a result of obesity and abnormal lipid profiles, which are often due to inactivity and an improper diet. Then there is a cascading effect — obesity leads to an abnormal lipid profile to diabetes or hypertension to heart disease.

So a person ends up taking tablets several times a day to keep the sugar under control, the blood pressure within limits and the lipids in check. Add a B complex and calcium supplement and you are looking at around 5-6 tablets a day.

The pharmaceutical industry has been working overtime to make life easier for such patients. They have come up with fixed drug combinations so that patients can take one tablet instead of two or three. The idea is good but combination medicines often fail to live up to their potential. This is because the dosage ratios are fixed; so too much or too little of one or more of the medications may be taken. Drugs that need to be taken before and after food may also be inappropriately administered. Sometimes combinations are irrational, with two antagonistic drugs being combined. Occasionally, both medications compete for the same site in the intestine for absorption so that eventually neither works! In fact, if you are prescribed combination tablets, ask your doctor if it is possible to take the tablets individually.

The combination tablets are a response to people’s demand for a “magic bullet”, a single medication that at a low dose, with a wide margin of safety, and few or no side effects, will cure all their ailments. Actually centuries ago, ancient cultures like that of the Indians, the American Indians, the Chinese, the Egyptians and the Greeks did have something like a magic bullet. Medicine men or healers brewed infusions or teas with the petals of a flowering plant — the Spiraea ulmaria — which relieved pain caused by injury, toothache, headache, and arthritis. Hippocrates even successfully administered it to ease the pain of childbirth. Eventually, about a hundred years ago, Felix Hoffmann, a chemist working for Bayer, synthesised the active ingredient in Spiraea ulmaria — salicylic acid. And that has evolved into the aspirin we use today.

Aspirin reduces pain, fever and headaches. It can be used to prevent clotting of blood, which helps prevent strokes, heart attacks and miscarriage. Aspirin also retards the onset and progress of Alzheimer’s and dementia. And it has been shown to reduce the incidence of many types of adenocarcinomas, especially that of the colon. That does make it magic but aspirin can’t cure a lifestyle disease. An aspirin a day, however, can keep lifestyle diseases away.

The other thing that can prevent them is maintaining ideal body weight, which is calculated by measuring the body mass index or BMI (weight in kilograms divided by height in meter squared). Values up to 24 are normal, 25-29 is defined as overweight, 30-34 obese and anything above that as extremely obese.

A person’s weight starts the upward climb because of an imbalance between food intake and physical activity. Environmental factors are important as both these factors are strongly influenced by habits learnt in childhood. Families that enjoy excessive amounts of calorie-dense food with refined sugars and oil and inadequate amounts (less than the recommended 400mg) of pulses, vegetables and fruits tend to have overweight children who grow up to be obese. To avoid addiction to high-calorie foods, stock fruits and vegetables as snacks. Have plain water instead of carbonated drinks and pack home-cooked food for school lunches instead of the packaged variety.

In addition, exercise is essential. It conditions the body, improves immunity, and delays, and sometimes prevents, the onset of lifestyle diseases and some cancers. Adults require an hour of aerobic activity (walking, jogging, running or swimming) followed by 20 minutes of flexion, core strengthening or yoga a day.

In short, a balanced diet, exercise and 75mg of aspirin a day should keep you healthy!

Before popping an aspirin, however, remember that it is contraindicated in children, people with bleeding disorders and those with gastric or duodenal ulcer. Aspirin is available without a prescription but please check with your doctor before you start taking it.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in