Fatty liver, diabetes and stress are just a few of the ailments of the 21st century
as people are more sedentary and have an unhealthy diet

Coined decades ago, the saying “You are what you eat” seems ever more real in today’s stress-filled yet sedentary work culture and lifestyle.

Ten years into the 21st century, poor eating habits – together with modern day stress and even our increasingly highly connected world – give rise to illnesses that were once uncommon.

“With improved economic status, we adopt a Western diet that is high in fat and low in fibre with excessive red meat and preservatives,” said Dr Law Ngai Moh, a gastroenterologist at Raffles Hospital.

That is why colorectal cancer is now more prevalent than 10 years ago, as it is primarily linked to the Western diet, he said.

Colorectal cancer is today the top cancer in Singapore, data from the Singapore Cancer Registry show.

While we are also seeing genetically modified (GM) foods on supermarket shelves, the many myths surrounding it, such as GM food being harder to digest, have yet to be proven through scientific research, said Dr Law.

Unhealthy meals and a busy lifestyle with little time for exercise lead to a rise in obesity, which triggers a litany of health issues.

At the top of such a list would be type-2 diabetes, when the body becomes more resistant to insulin, resulting in an inability to maintain the normal blood sugar levels it once did.

There is also type-1 diabetes, a result of low insulin production.

There has been a huge rise in the number of patients with type-2 diabetes in recent years, said Dr Cho Li Wei, an endocrinologist at Changi General Hospital (CGH). Insulin resistance is caused by obesity which is increasing here and worldwide, she said.

Dr Chionh Chang Yin, a consultant in renal medicine at CGH, is not surprised. “The medical literature is rife with cases of a sudden rise in diabetes, when largely agrarian communities exposed to modernisation switch to a sedentary lifestyle and a diet rich in sugars and carbohydrates,” he said.

Singapore, no longer a Third World country, is not spared.

The Health Ministry’s National Health Surveillance Survey 2007 said that 5.7 per cent of the population aged 18 to 69 is obese, compared to 4.3 per cent in 2001. The number of diabetics also rose, from 3.7 per cent to 4.6 per cent of the population in the same period.

Closely linked to diabetes is kidney disease. “In Singapore, more than 50 per cent of the patients on dialysis developed kidney disease from diabetes,” said Dr Chionh. She added that kidney disease has seen a significant rise over the past few years and the trend does not appear to be abating.

In contrast is the slide in well-known diseases like hepatitis B, which is not diet-related and for which vaccination is available.

Singapore started hepatitis B vaccination in 1987, said Dr Desmond Wai, a gastroenterologist and hepatologist at the Asian Centre for Liver Diseases and Transplantation, which is at Gleneagles Medical Centre.

Similarly, medical advances have led to the dip in peptide ulcer disease, known commonly as stomach and intestinal ulcers.

The breakthrough was the discovery of the bacterium behind the disease, which permitted researchers to develop antibiotics, said Dr Law.

But even as some modern-day diseases fade, others have emerged.

An example is fatty liver disease, which is now an “epidemic” here, said Dr Wai. This condition refers to the liver having accumulated fat, which can cause inflammation and other liver diseases. It usually affects obese or overweight people.

“The turning point for fatty liver disease here was around the year 2000,” he said. “We are now seeing more patients with liver cancer caused by fatty liver.”

No local studies have been done but Dr Wai estimates that one or two in every 10 Singaporeans have a fatty liver.

Meanwhile, the trend of people being less active, coupled with an ageing population, has amplified bone ailments such as osteoporosis.

Dr Lim Yeow Wai, an orthopaedic surgeon at Raffles Hospital, noted that there has been a five-fold increase in hip fractures locally in the 1990s compared to the 1960s.

Our sedentary lifestyle also spells bad news for our muscles, said Associate Professor Suresh Nathan, a consultant in adult reconstructive surgery at National University Hospital.

“The increased amount of time spent in front of computers and with ever-smaller personal digital devices has led to extremely non-ergonomic work practices,” he said. “As a result, there has been a sharp increase in aches and sprains of the neck, lower back, knees and hand joints.”

Also, when work involves long periods of sitting or standing, varicose veins – where veins become enlarged due to blood pooling – may develop, said Dr John Tan, a vascular surgeon at The Vein Clinic.

Varicose veins stem mainly from hereditary factors and events like pregnancy, but lifestyle also plays a role. He now see four to five times more patients than 10 years ago.

“It is hard to say if it’s due to an unhealthy diet or better awareness of treatment options, but there are definitely more people who are obese, who wear high heels and sit with their legs crossed for prolonged periods – all of which can contribute to varicose veins,” he said.

Having this condition also increases one’s risk of getting deep-vein thrombosis (DVT), where a blood clot forms in a deep vein and stays there, Dr Tan added.

DVT is blamed for the deaths of several people on long-haul flights. He added: “With increased air travel, DVT has become an emerging problem of the modern era.”

Today’s highly connected world has also raised cross-border infection risks, as witnessed in the recent global outbreak of swine flu, said Dr Limin Wijaya, an infectious disease specialist at Singapore General Hospital.

Urbanisation has also worsened environmental pollution. Air pollution, for instance, aggravates respiratory diseases such as asthma and is estimated to cause about two million premature deaths worldwide per year, according to the World Health Organization.

People are also falling victim to diseases that can be minimised if not for their time-pressed schedules, even among the young.

An example is dental caries, or tooth decay. Dental surgeon Neo Tee Khin of Specialist Dental Group noted that there are now more teenagers with multiple tooth decays – a trend that appeared only recently.

“As people have less time, they tend to skip regular meals and resort to frequent snacking while studying, watching television or working on the computer,” said Dr Neo, adding that such snacks often contain refined sugars that aid the growth of caries-causing bacteria.

Higher stress levels have also made a mark on our mental health, said Dr Mok Yee Ming, a psychiatrist at the Institute of Mental Health.

He said: “This is because we have less time to devote to keeping healthy and have less time for ourselves to de-stress.

“With our hectic pace of life and our drive to succeed, it is easy to forget that our physical and mental health is just as important as material success.”