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Dieting ups TB risk
A cashier in a private bank for the past four years, 25-year-old Amrita Shah’s stress levels have always been high. Always the first to reach work, she sat glued to her desk till lunch time. And this for her was invariably at 3.30 pm when the cash counter closed for the day.
One day, she felt excruciating pain in her lungs. A consultation with the family physician and later with a pulmonologist confirmed that she was suffering from pleural pulmonary tuberculosis. Recalling that
moment, Shah said, “My first reaction was — how can I have TB? Doesn’t it happen only to the ‘lower class’, specially those who have no money to eat and puff away on hookahs and beedis? Am I going to cough up blood just like they show in the movies?” That’s when her doctor informed her that a “faulty lifestyle” like the kind she’d adopted was the cause. “But he assured me that I could be cured. And now after six months of treatment, I am fine,” she adds.
According to Shah, the stress of handling cash in the bank and the pressure of being accurate with the accounts is what affected her health. “I had no time to eat. That’s why I changed my workplace and now make it a point never to miss a meal.”
TB is no more a poor man’s disease. It is fast becoming common among the upper crust as well. Cases are being reported from not only college-going youngsters but also the middle-aged working population. As Dr L S Chauhan, director general of India’s revised TB control programme, says, “TB is an airborne disease. It can happen to anyone irrespective of their social strata. But, fortunately, it is completely curable.”
Experts say stress and unscientific dieting is causing this spurt in TB cases among India’s urban population. Adds Dr Chauhan, “To counter that, one must eat sensibly. Dieting is good only up to a point because the body needs vital nutrients. If the body doesn’t get those, its immunity system will get affected and thus increase its chances of getting infected by TB. In fact, at present, the prevalence of TB is higher in the urban population (80 cases per lakh population) than rural (75 cases per lakh population).”
According to Dr Nevin Kishore, a pulmonologist at Delhi’s Max Hospitals, what is happening is reactivation of TB. “About 90 per cent of those infected with mycobacterium tuberculosis have asymptomatic latent TB infection with only a 10 per cent lifetime chance that a latent infection will progress to TB. So when there is a decrease in the intake of nutritious food causing weight loss, our body becomes more prone to it.”
He, too, feels that tuberculosis is on the rise among the urban youth. “It’s because of this fad of
dieting that is backfiring and reactivating the TB bacteria inside us. Young girls who starve themselves to stay thin are now coming to me with full-blown TB — majority of them suffering from TB of lung tissue, lymph node and pleural TB. This is indeed alarming.”
According to experts, low body weight is often associated with the risk of tuberculosis. Body Mass Index (BMI) below 18.5 increases the risk by three times. Patients with diabetes, too, are at an increased risk of contracting the disease as they have a poorer response to treatment due to poorer drug absorption.
Experts say that a person with active, but untreated, TB can infect 10-15 other people per year. But this transmission can happen only from people with active and not latent TB. The progression from TB infection to TB disease occurs when the TB bacilli overcomes the body’s immune system’s defences and begins to multiply. In reactivation of TB, the bacteria often lies dormant but when conditions become favourable for it — like lower immunity because of dieting — the bacteria becomes active.
Studies state that an estimated one-third of the world’s population is already affected with TB leading to 8 million new infections and 2 million deaths every year. Thirty five per cent of the global figure is in the South Asian region and 20 per cent of the global disease burden in India alone, according to the World Health Organization (WHO).
Of all TB patients, the sputum positive ones (those who produce sputum containing bacteria) are the most dangerous. And 25 per cent of these get cured “by themselves” even without medical intervention due to regained immunity advancement. And that’s when better nutrition and a fair amount of exposure to sunlight recharge the immune system.
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