If you look at the exponential growth of chronic lifestyle diseases then it is not difficult to understand why Health Minister, Dr Aaron Motsoaledi, maintains chronic diseases such as hypertension and diabetes are putting a huge strain on the country’s health care system.

Obesity and being overweight are major risk factors for the development of chronic diseases.

Testing for lifestyle diseases such as diabetes and heart disease is essential in the face of a steadily deteriorating health status in our country. Gerhard Van Emmnenis, Principal Officer of Bonitas Medical Fund says, ‘Get tested, know your numbers and take action now!’

The Bonitas Clinical Team explain why you need to keep your finger on the pulse of your ‘big four’ wellness numbers and what they are.

1. Cholesterol

What is cholesterol?

It is a soft, waxy substance – one of the blood fats made naturally in the body. It helps to form cells, hormones and bile (that helps us digest food). Cholesterol is found mostly in animal products such as meat, cream and butter.

What is high cholesterol?

This is when you have too much ‘bad’ cholesterol in your blood. This, in turn, can cause narrowing and blockages of the arteries – the blood vessels that carry blood to your heart muscle and to other parts of your body. In time, the narrowing of the arteries to your heart can lead to a heart attack, while blockages in the arteries of your brain can cause a stroke.

The test

Called a fasting lipogram it measures the exact amount of different types of cholesterol you have.

Good to know

• If your total cholesterol is greater than 5mmol/L on your fasting lipogram this indicates raised cholesterol
  
• Your low density lipoprotein (LDL) – the ‘bad cholesterol’ – should not be greater than 3mmol/L. LDL causes the build-up of cholesterol in the arteries which means a greater chance of heart disease
  
• High density lipoprotein (HDL), if less than 1.2mmol/L, means you don’t have enough good cholesterol which prevents build up in the arteries and transports cholesterol to the liver
  
• If your triglycerides (fat stored in the body) are higher than 1.5mmol/l, this is also indicative of a possible cholesterol problem.

2. Weight and BMI

Your Body Mass Indicator (BMI) calculator checks if you’re at a healthy weight.

The test

You can calculate yours by:

• Dividing your weight in kilograms (kg) by your height in metres (m)
  
• Then dividing the answer by your height again to get your BMI.

Underweight	less than 18.5
Normal weight	18.5 – 24.9
Overweight	25 – 29.9
Obese	30 or greater

3. Diabetes

What is diabetes?

Our bodies produce insulin all day – a hormone that creates energy by converting sugar, starches and other foods. Without insulin, cells cannot absorb sugar (glucose), which they need to produce energy. When there isn’t enough of this hormone in your body, or it’s not used as it should be, sugar (or ‘glucose’) can’t be moved to your other body cells to supply them with energy. This means that you have higher than normal blood-glucose levels, resulting in diabetes.There are two main types of diabetes: Type 1 and Type 2. They are different conditions but are both serious and need to be treated and managed properly.

• Type 1 diabetes occurs when the pancreas stops producing insulin. It usually starts very quickly and in younger people. If you have Type 1 diabetes you need insulin injections to survive as well as having a carefully balanced food intake and exercise programme
  
• Type 2 diabetes (formerly called adult-onset or non-insulin-dependent diabetes) occurs when the pancreas makes too little insulin or your body can’t use the insulin effectively. It usually develops in adulthood and is often caused by being overweight and not exercising. Approximately 85–90% of all people with diabetes have Type 2 and many people who have this condition are undiagnosed. This can result in serious damage to the delicate parts of the body and lead to blindness, heart attack\stroke, kidney failure, impotence and amputation so it’s vital to be checked.

The tests

Test 1: The Fasting blood glucose test – blood glucose is taken before you eat in the morning.

Normal	3.9 to 5.5 mmols/l
Prediabetic or Impaired Glucose Tolerance	5.6 to 7.0 mmol/l
Diabetic	More than 7.0 mmol/l

Test 2: HbA1c test. The HbA1c levels determine your blood sugar control over time.

Normal	Less than 6%
Prediabetic	6 – 6.4%
Diabetic	6.5% or more

4. Blood pressure

What is blood pressure?

Blood pressure is the pressure of blood in your arteries – the blood vessels that carry blood away from your heart.

The blood pressures numbers mean the following: The first (or top) number is your systolic blood pressure. It is the highest level your blood pressure reaches when your heart beats. The bottom figure is your diastolic blood pressure and is the lowest pressure exerted as your heart relaxes between beats.

What is high blood pressure?

High blood pressure or hypertension is when blood pressure stays elevated over time. Hypertension is often known as the “silent killer”, since nearly 33% of people who have it, don’t know it. The only way to know if you have high blood pressure is to have yours measured. 

	Range
Normal	120/80 to 129/84
Upper end of Normal	130/85 to 139/89
Mild hypertension	140/90 to 159/99
Moderate hypertension	160/100 to 179/109
Severe hypertension	More than 180/110

If your blood pressure is too high, it puts extra strain on your arteries (and your heart) and

if it’s not treated, hypertension can cause kidney failure, eye problems, heart disease and stroke.

Van Emmenis says, ‘When you consider that one in every three people in South African has high blood pressure and every eight minutes one South African has a heart attack, it makes sense that we have our blood pressure taken regularly either at your local pharmacy or clinic or when you visit your GP.’

He urges all South Africans to be proactive and take control of their health by getting regular wellness tests done. ‘Knowing your numbers will help you manage your health better and making sure your ‘big four’ are under control will go a long way to reducing the costs of healthcare.

‘This is why Bonitas offers all members an annual wellness screening which includes the big four tests. The check is paid for from risk so it won’t impact a members savings or day-to-day benefits. We strongly urge our members to make use of the benefit and take control of their health.’