…like the fabled frog in lukewarm water, the world has also been undergoing a continuous 40-year history of the progressive pandemic of chronic diseases, but which very few notice. However, unlike the sudden and possible fatal consequence of infectious diseases, chronic diseases take decades before the infliction of disability and/or death.
The boiling frog fable has it that a frog would instantly jump out of a pot if suddenly put in boiling water, but would be boiled alive if placed in lukewarm water whose temperature is slowly increased till it reaches the boiling point. Bear with me a bit as I digress: Humans have limited energy stores of about 2,300 calories and therefore cannot afford prolonged external or internal threats to life. In short, the so-called fight or flight situation is mostly to conserve and protect limited energy resources, and therefore any threat to these resources must be resolved within minutes or hours to avoid death. In the process of fighting or running, as the case may be, the existing immunological substances, such as antibodies and antimicrobial lactoferrin, are quickly mobilised to the saliva and bloodstream to heal potential wounds and incapacitate any infectious agents that gain entrance to the body. In traditional societies, fighting acute infections could last about 43 days, till the body exhausts its energy stores, leading to eventual death.
Therefore in the race against time to bring about recovery and prevent energy conflicts among different organs and systems, the body goes into a phenomenon called “sickness behaviour” in which the body, not the antigens, initiates a shot down of physical movements by inducing weakness to cause sleep and loss of interest in pleasurable endeavours such as food, drink, sex, leisure activities, etc. In other words, life threatening injuries and severe infections bring about spontaneous rest or minimal physical activities for full activation of the energy gulping immune system to restore recovery before the body runs out of energy within 41-43 days. The energy demand of the immune system may be so great that there is an unusual decrease in energy allocation to the selfish brain, leading to confusion, delirium, and forgetfulness.
In terms of COVID-19 and chronic diseases, the spread of coronavirus infections was declared a pandemic in March, and like the fabled frog tossed in boiling water, the world has been in an unprecedented race to neutralise this virus. Therefore, the interest about what the immune system is and does have been high in the last 10 months, but unbeknown to us, everyone lives instinctively to avoid a full deployment of the immune system, with an overbearing sickness behaviour and possible fatal consequence. This disease avoidance includes tossing out rotten foods, hesitation to taste unfamiliar foods, obeying traffic lights to prevent avoidable wreck, the careful choice of sex partners and yes, fight or flight.
If I may invoke the frog metaphor in lukewarm water again, the acceptance of the explosion of chronic diseases is mainly due to the fact that they do not inflict pain at the onset or cause quick deaths, and more importantly, big food and big pharma industries respectively make billions of dollars on retailing processed foods and monthly refills of maintenance medications.
The world has been through many viral pandemics in the past and the controversy and resistance to wearing mask during Spanish flu incidence of 1918 was no less intense than the present unwillingness to don protective covering in 2020. The San Francisco Chronic ran a public service announcement in 0ctober 1918 stating that, “the man or woman or child who will not wear a mask now is a dangerous slacker”. Again, like the fabled frog in lukewarm water, the world has also been undergoing a continuous 40-year history of the progressive pandemic of chronic diseases, but which very few notice. However, unlike the sudden and possible fatal consequence of infectious diseases, chronic diseases take decades before the infliction of disability and/or death. Both COVID-19 and chronic diseases are caused by exposure, with the former relating to viral exposure. Like the 1918 incidence, this too will pass in a short while, given modern medical miracles that include antiviral agents, supportive therapy and the new vaccines.
Sadly, chronic diseases have no germ origin, but they are caused by “false germ alarms” that mimic infection and deploy the immune system at a low level, with unresolved inflammation that may go on for decades, leading to the development of several conditions collectively called the metabolic syndrome. Not a disease in itself, metabolic syndrome, according to Mayo Clinic, is a cluster of risk markers that include high blood pressure, high blood sugar, obesity and abnormal cholesterol that bound together to promote chronic pathologies such as heart disease, stroke, type 2 diabetes and cancer. As at the time of writing this article, there have been 1.7 million COVID-19 deaths and 80 million cases worldwide but according to World Health Organisation, chronic diseases kill 41 million people every year. Diabetes, a single chronic condition, was projected to rise from 171 million cases in 2000 to 366 million in 2030. According to the International Diabetes Federation, 463 million adults, aged 20 years and above, currently live with diabetes and a whopping 310.3 million of them live in urban areas.
Unlike exposure to germs, modern man is exposed to highly dense foods (the metabolic part), which he does not labour for and therefore escapes the musculoskeletal stress associated with livelihood that promotes fitness and health (the physical part) in traditional societies. If metabolic syndrome is the precursor to chronic diseases, shouldn’t there be heavy emphasis on a metabolic intervention? Not so long ago, a 1967 study described six patients with moderate obesity as having, “carbohydrate-induced hyperlipemia” and diabetes, and they lost weight and had their fasting blood sugar and serum triglycerides normalised with low carbohydrate diets. How did metabolic intervention in 1967 transform into a multibillion-dollar polypharmacy within a few decades?
…there will always be the need for medications but if we have a situation where millions are dying every year from food diseases, the core intervention ought to be infrequent food consumption, occasional fasting and of course regular physical activity as potent housekeeping weapon to prevent fuel overload.
If I may invoke the frog metaphor in lukewarm water again, the acceptance of the explosion of chronic diseases is mainly due to the fact that they do not inflict pain at the onset or cause quick deaths, and more importantly, big food and big pharma industries respectively make billions of dollars on retailing processed foods and monthly refills of maintenance medications. For diabetes alone, there are currently 10 classes of anti-diabetes drugs targeting different organs, with several agents under each class. In addition, there are five types of injectable insulin which are rapid-acting, short-acting, intermediate-acting, mixed insulin and long acting insulin. One would expect a yearly precipitous decline with all these agents. Yet, according to the American Diabetes Association, the total cost of diagnosed diabetes rose from $245 billion in 2012 to $327 dollars in 2017. Follow the money, as they say.
For sure, there will always be the need for medications but if we have a situation where millions are dying every year from food diseases, the core intervention ought to be infrequent food consumption, occasional fasting and of course regular physical activity as potent housekeeping weapon to prevent fuel overload. As the saying goes, if you are in a hole, stop digging.
Mukaila Kareem, a doctor of physiotherapy and physical activity advocate, writes from the U.S.A and can be reached through This email address is being protected from spambots. You need JavaScript enabled to view it.
