“The poor can't afford salads, fresh fruits or gyms. The cost of managing the disease is so high it affects the whole family. The compromised immunity also makes them more prone to infectious diseases,“ said dialectologist Dr Anil Boraskar, who sees many patients from Dharavi slums at Raheja Hospital.

At the Urban Health Centre in Dharavi slums, nearly 12 per cent of patients treated in the last five months had diabetes, 17 per cent had hypertension.

“We checked the Body Mass Index of 100 women from the slum.Around60percentofthem were overweight, around 10 percent obese,“ said Dr. Pallavi Shelke.

Doctors said these figures are the “tip of the iceberg“ as no survey has been conducted to ascertain the burden of lifestyle diseases in the city's slums.

KEM Hospital doctors are trying `lifestyle medicines' to help Malvani's slum dwellers tackle lifestyle diseases. They conduct yoga sessions at the Urban Health Centre where patients are taught pranayam, asanas and also get diet tips free of cost. “India faces a triple burden -- infectious diseases, non-infectious and lifestyle diseases, and deaths due to violence and injuries,“ said health activist Ravi Duggal.

He added that while China is almost free of infectious diseases, the Indian government is still struggling to control malaria and TB. “And while infectious diseases can be cured and eradicated, lifestyle diseases are chronic. They can only be controlled, not cured.“ RURAL POOR ALSO FALLING PREY TO LIFESTYLE DISEASES IT IS not just the urban poor but also people from rural and tribal areas who are falling prey to lifestyle diseases.

Many farmers from across Maharashtra line up at the Ramakrishna Mission Hospital in Khar every Sunday for treatment of diseases such as diabetes and hypertension, according to doctors.

When Sion Hospital started a Rural Health Training Centre in Vaitarna in January 2009, the doctors were surprised to find that many tribals had high blood sugar level.

“We have started a survey to establish the prevalence of Type 2 diabetes in the adivasis,“ said Dr RM Chaturvedi, who heads the Preventive and Social Medicine Department at Sion hospital.

“The adivasis labour all day and often eat only a few bhakris.
In their case, diabetes is linked with poor nutrition rather than with overeating,“ said Chaturvedi. An emerging public health problem Infectious diseases like malaria and tuberculosis may be still killing count- less Indians every year. But we can't afford to ignore non-communicable diseases, say experts.

“It is time for the government to make lifestyle diseases an equal priority in its health programmes,“ said Dr Anil Boraskar, who heads the Diabetes Association of India.

It is estimated that by 2020 chronic diseases like diabetes, hypertension, cancer and AIDS would account for over 65 per cent of deaths in India compared to 53 per cent in 2005.

Lifestyle diseases include obesity, diabetes, hypertension and high cholesterol are considered `silent killers' because they precipitate heart attacks, strokes and organ failure.

The government also seems to have woken up to the fact that lifestyle diseases are becoming a public health problem. Union Health Minister Ghulam Nabi Azad has proposed to make diabetes and hyper- tension check-ups mandatory for the rural popula- tion.