When ‘Good’ can be really bad

The American Association of Clinical Endocrinologists (AACE), Philippine Chapter (PC), currently headed by Dr. Gerry Tan, continues to wage their battle against the “Good” scourge currently afflicting millions of Filipinos. GOOD actually stands for goiter, obesity, osteoporosis and diabetes, which are all endocrine or hormone-related problems that remain prevalent in the country causing a lot of disabling or potentially life-threatening complications.

GOOD is really bad, but the good news is that these endocrine problems could be prevented up to some extent. Sometime ago, the AACE-PC sponsored a fun run to draw awareness to these diseases and to educate the public on the preventive measures that could be taken.

Goiter is one particular disease that has not been given much attention in the country. Based on one of the nationwide nutrition surveys, which covered all 76 provinces in all regions of the Philippines, including eight clusters of cities and municipalities in Metro Manila, goiter is highly prevalent, afflicting close to 7 percent of the entire population across all ages.

So that would be around seven million with enlarged thyroid glands and the most common cause of a diffuse enlargement of the thyroid gland is iodine deficiency which could be easily prevented. The disease is commonly found in parts of the country where the iodine contents in the soil, water and food are deficient. The Cordillera Autonomous Region is one of these high prevalence areas.

Iodine deficiency

Iodine is required by the body for the production of thyroid hormones. When dietary iodine is deficient, less thyroid hormone is produced and the gland enlarges. Iodine deficiency in pregnant women can have serious complications in the baby. There is an increased risk of infant death, and if they survive, they may suffer from mental retardation.

If one looks at the statistics covering Filipinos age 15 years or older, the prevalence of goiter jumps to 18 percent. This is because the likelihood of having a diffuse goiter increases in females during the reproductive age—when they get pregnant or are lactating. The other type of goiter is nodular, which is found only in less than one percent of the population, and is not significantly increased with pregnancy or lactation.

In the early ’90s, iodized oil capsules were being distributed by the government particularly to women of the reproductive age, but this was discontinued sometime in 1996. Considered a better alternative to iodized oil capsules was iodine fortification of salt. Hence, a law  was passed which requires all food-grade salt to be iodized. Republic Act 8172—called An Act Promoting Salt Iodization Nationwide (Asin) also requires all manufacturers to make their iodized salt products available to every Filipino particularly in the rural areas. Iodization machines were even provided to some salt manufacturers through the assistance of the Unicef’s Country Program for Children (CPC).

RA 8172 was signed into law more than 15 years ago, yet we still have a relatively high prevalence of goiter indicating that implementation of the rules and regulations still leave much to be desired as is true of most laws in the country.

Obesity and diabetes are actually related and they’re part of a complex disease called metabolic syndrome, which markedly increases one’s risk to develop heart attacks, strokes, and kidney failure. A big tummy and cholesterol problems come with this syndrome.

Sharing same vision

Diabetes, in particular, remains an alarming scourge among Filipinos. And we commend the efforts of the AACE-PC together with an alliance of other medical organizations sharing the same vision of stemming the seemingly developing global epidemic of diabetes.

Although genetic or familial factors are responsible for the development of diabetes, lifestyle factors are equally important and members of the alliance are doing a great job in educating the public on the kind of lifestyle one should have to retard the onset of diabetes, or ensure its adequate control for those who have it already.

If people would only exercise regularly; eat a diet consisting mainly of grains, cereals, legumes, vegetables and fruits; not smoke and drink in excess; sleep and relax well; and live a stress-free life, diabetes would probably be almost nonexistent. But it’s sad that the people who subscribe faithfully to this kind of diet and lifestyle are almost nonexistent also.

There are so many temptations and distractions in the modern lifestyle that can easily skew one’s focus away from the healthy lifestyle required to prevent diabetes, obesity and other common medical problems including heart diseases and cancers.

A good complement to the efforts of the medical societies in educating the public is the magazine Diabetease which is available at National and other leading bookstores. Edited by endocrinologist Dr. Joy Fontanilla, who is the immediate past president of the AACE-PC, it’s a good read for diabetic patients and all those with family members who have diabetes. Understanding the disease better goes a long way in empowering patients to control it and prevent complications.