OPINION | Let’s manage our lifestyle diseases

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  • Obesity is the single most important co-morbidity to cancer, cardiovascular disease and type 2 diabetes
  • Together with cardiovascular diseases, obesity and type 2 diabetes, also known as lifestyle diseases, are the number one causes of death globally
  • We have to look closely at our lifestyle today to combat obesity, type 2 diabetes and cardiovascular diseases


Seventy percent of deaths worldwide are attributable to inflammation-linked chronic illnesses like cancer, cardiovascular disease and diabetes. Every year, 15 million people suffer a stroke caused by cardiovascular disease.  In 2019, the top 10 causes of death accounted for 55% of the 55.4 million deaths globally.

Nearly 70% of South African women and 31% of South African men are overweight or obese. Obesity is the single most important co-morbidity to cancer, cardiovascular disease and type 2 diabetes.

Together with cardiovascular diseases, obesity and type 2 diabetes, also known as lifestyle diseases, are the number one causes of death globally. And fatalities continues to rise, with no end in sight. Many people reading this article will have personally experienced the loss of a friend, family member or colleague due to cancer, cardiovascular disease or diabetes.

Today, 7 April, is World Health Day, a global health awareness initiative sponsored by the World Health Organization and other institutions that are tasked with promoting health and wellness for all people. Given that this year’s theme is Building a Fairer, Healthier World, we all should look a bit closer at our own wellness and lifestyle choices, especially now that we find ourselves in the midst of a devastating pandemic.

Over the past year in particular, we have been openly confronted by the knowledge that poorer countries and poor individuals in rich countries, may not necessarily have access to basic healthcare. “Fair” and “Health” in the same sentence therefore seem to be two conflicting terms. 

However, every person can contribute towards World Health Day 2021, as the challenge of building a healthier world starts with each of us.

It is very simple; we have to look closely at our lifestyle today to combat obesity, type 2 diabetes and cardiovascular diseases, which are driven by systemic inflammation, and the presence of circulating inflammatory molecules called inflammatory biomarkers. 

Well-known inflammatory biomarkers are cholesterol and glucose. There are many other inflammatory biomarkers that are increased in circulation, and that are present in blood when your lifestyle is compromised by, among others, a lack of exercise, eating too much fat or sugar, smoking and stress.

These inflammatory biomarkers may cause severe damage to your blood vessels and blood clotting proteins. 

It should be pointed out that blood clotting is crucial when you’ve, for example, suffered a cut or an internal injury. When this happens a physiological process called the coagulation (clotting) cascade kicks in.

Platelets (a type of blood cell) and soluble proteins (fibrinogen) in your plasma (the liquid part of blood, called blood plasma) work together to stop the bleeding by forming a clot over the injury. 

The platelets stick to one another and to the wound site to form a plug. Small local injuries may also occur inside your blood vessels. Here the blood vessel immediately narrows, and this narrowing of the vessel limits blood flow through the injured vessel.

During the clotting process, blood changes from a liquid to a solid at the site of an injury (and soluble fibrinogen changes to insoluble fibrin that looks like a net  ?  see Figure). As the wounded blood vessel wall starts to heal, the clot will dissolve.

With cardiovascular disease or other co-morbidities associated with chronic and systemic inflammation, abnormal clotting and clumping of platelets may occur.

Inflammatory biomarkers may also interact with red blood cells, causing their membranes to become less elastic and compromising their oxygen-carrying capacity (see Figure). This may lead to be a life-threatening event like heart attacks, strokes or deep vein thrombosis.

What people, who follow an unhealthy lifestyle, sometimes don’t realise is that abnormal blood clotting, increased inflammatory biomarkers, as well as damaged blood vessels, may all be present long before these conditions occur.

The presence of pathological inflammatory biomarkers in your blood can give you an indication of disease risk, and the chance of developing a life-threatening heart attack, stroke or deep vein thrombosis.  

Overwhelming evidence has linked lifestyle diseases to abnormal blood clotting. In fact, thromboembolic complications are among the leading causes of disability and death in many these diseases.

Therefore, if you regularly test your levels of inflammatory biomarkers (even the most basic ones like cholesterol and glucose levels), you can prevent debilitating disease consequences, and even save your life. 

Research has shown that the early identification of disease risk, followed by preventive lifestyle interventions, can slow down the progression  of lifestyle diseases, and prevent abnormal clotting, the  hyperactivation of platelets and clumping, as well as abnormalities in red blood cells.

We have learned an important lesson during this pandemic, namely that obese individuals, and those with co-morbidities like type 2 diabetes and cardiovascular disease, are severely compromised when contracting Covid-19.

Clotting and immunity were long regarded as separate entities but recent studies have showed molecular underpinnings of a significant interconnection between abnormal blood clotting and immunity. 

So, on World Health Day and beyond, let’s take time to manage our own health and wellness because if we don’t, we will surely, in future, have to spend more time dealing with lifestyle diseases.

*Prof Resia Pretorius is Distinguished Professor and Chair of the Department of Physiological Sciences in the Faculty of Science at Stellenbosch University

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