'You are what?' asked Shah (pseudo name), dropping his jaw and turning his head away from the computer monitor toward me (TC). I was standing by his office door at Imperial Oil Research Centre, Calgary. We were talking about running --- he, tall and muscular, more intent on weight training, saying running hurt his knees'; I, short and slender, saying it strengthened my knees, even healing a nagging soccer (football) injury from BUET university days I incurred in an inter-hall tourney. My age slipped out of mouth during that discussion, inadvertently.
Shah knew I ran marathons all over the world. He had seen on my office doorthe2014 Antarctica Marathon 22-mile marker --- an eye-catching yellow souvenir board, enlivened with a black penguin with a red nose. Next to the door on the wall, he had also seen the 2015 Daily Star article 'BUET Alumni greets Dr Tapantosh for his feat', with an attention-grabbing colour photo, showing four distinguished current and former VCs of BUET and UAP, Dhaka, one of whom (Dr Patwari) awarding me a distinguished alumnus crest (plaque) for completing marathons in seven continents and for professional accomplishments. The photo belied my age, by a big margin.
'65,' I said sheepishly, thinking once of back-tracking on divulging my rather old biological age to a relatively new and young colleague. A healthy 65 to a 75 is still a spring chicken. But 65 to Shah, in his early thirties, would be a 'corporate elder', with some negative connotations.
After confirming what he had heard first, Shah knocked on his desk to praise my look --- not my handsomeness, my apparent age. I appreciated both his praise and show of good will in trying to keep bad luck at bay by knocking on wood. Since childhood, I have been somewhat sensitive to too much praise. An elderly person once praised me profusely for placing first in a class eight (Matlab) school final. Since then, I had difficulty studying for many years, either because of that or poor health. Mother was not pleased at all with the face-to-face praise of her son without his saying jinx-cleansing 'With ashes and soil in my mouth', like other Bengali Hindu villagers would have said in a similar situation. (The phrase sounds harsher in English than in Bengali.) A Bengali Muslim would have just said 'Marshallah', meaning by grace of God.
Shah was not alone in his surprise and praise, though. Many colleagues underestimated my age by 10 to 15 years. One BUET alumnus once wrote: 'Tapan seems to have found the elixir of life,' after hearing of my running one adventure marathon after another. Another BUET alumnus wondered in Facebook if I was using formalin. (Formalin is a hazardous chemical used by a few unscrupulous businessmen in Bangladesh to keep fruits and fish fresh for longer.)
All these compliments and brouhaha notwithstanding, I know the 'killer stroke' has been lurking around me, waiting for a weak moment to swoop onto and snatch my soul away to a faraway place, somewhere in the Milky Way. Already it had taken away my mother and then my brother when he was my age. Stroke, heart attack, and type 2 diabetes are not infectious diseases; they are what I call 'family-focussed' diseases. They pick a family and stick with it for generations.
I, like others, am ageing, both externally and internally, apparently at a slower rate, thanks to my running and following a patented protocol --- a 'drug-less elixir'--- as elucidated later.
Scientists think they know why we age. The tiny mitochondria in our cells decay as we grow older (Scientific American Blog, 11 March, 2015). Mitochondria are vital to us, because they make energy from glucose and oxygen, both supplied by blood.
Glucose in blood comes from carbohydrates (sugar and starch) in the food we eat and digest. We need glucose for energy. But too much glucose is detrimental to mitochondria. They become dysfunctional and their DNA mutate to another form, accelerating ageing(World Journal of Cardiology, 26 May, 2012).Too much glucose also causes type 2 diabetes, obesity, stroke, and heart attack, among other maladies. Metformin is a drug that reduces glucose level in blood. The side effects of a drug, many known and some unknown, worries me and others.
'Is there a drug-free solution to type 2 diabetes and ageing?' I used to ponder while running.
Then one day during a run, out of the blue, it occurred to me that our digestive system is nothing but a very complex chemical reactor. As a chemical engineer, I know the importance of keeping reactant feed rates continuous and constant (or within a narrow range) to avoid reactor upset and to maintain product quality within a target range. Three meals we feed to our human reactor in a day deviate from that approach. The result is three significant post-meal glucose spikes, each spike mimicking a large mound of glucose in our blood. Those spikes are tolerable when we are young and when all the systems are functioning well. But as we grow older, those recurring glucose spikes, cumulatively, may lead to type 2 diabetes and ageing.
The solution for type 2 diabetes and ageing may lie in suppressing those spikes of blood glucose, I reckoned.
An ideal solution to suppress the glucose spikes would be to eat our meals continuously throughout the day, like an industrial chemical reactor. But an industrial chemical reactor is an immobile lifeless entity, which has one purpose: make a desired product to make money for its owner. A human reactor, by contrast, is part of a mobile and alive, multi-purpose individual, who has to earn a degree; get a job; get married; raise kids; play sports; run marathons (in my case); run for offices (politicians); say prayers; and sleep at night. Continuous eating at a constant rate is impractical, unless the individual is in a hospital on intravenous feeding, which takes away the greatest pleasure of eating: the taste.
An engineering solution would be to keep the glucose spikes within a target range by combining meal splitting --- splitting the carbohydrates in each big meal: breakfast, lunch, and dinner into smaller portions ---with moderate post-meal exercising.
With those thoughts, the work to develop the solution started. The pace was frenetic. The energy and enthusiasm were those of a 35 in the body of a 65. I developed a mathematical model for glucose spike suppression. I designed an experiment to determine two metabolic parameters in the model. I poked my finger with a lancet to make a blood drop that got sucked into a tiny chamber in a plastic strip, which was then inserted to a glucose meter. I did it multiple times. I was on a mission. I split my meals into smaller portions. I went for a run after each meal. My son, an APEGGA Gold medallist software engineer, developed a person- and meal-specific glucose spike suppression (GSS) software.
Backed by solid science and implemented with sound chemical and software engineering, the drug-free GSS protocol was praised, rather unprecedentedly, by the patent examiner for its novelty and significance. A US patent was granted, with Neilin Chakrabarty as the lead inventor, making the effort, which started with a question and an idea while running, worthwhile.
The drug-free GSS protocol is as follows:
1. Split the daily recommended calories (converted to carbohydrates) into several smaller meal portions, such that each portion generates a glucose spike within a target range, either by itself or in combination with the second step(may skip the first step, if meal splitting is not possible on a given day).
2. Exercise within 45 to 90 minutes of ingesting each full or spilt meal to keep the glucose spike within a target range, either alone by exercising or in combination with meal splitting of the first step (may skip the second step, if the first step was sufficient).
3. For meal- and person-specific glucose suppression, use the trained or tuned GSS software and its outputs of meal and exercise plans (may skip this step, if the first two steps were sufficient).
The drug-free GSS protocol does not require clinical trial or approval from regulatory bodies like Federal Drug Administration (FDA) in US. It has the flexibility of incorporating a prescribed drug for type 2 diabetes. People already using Metformin or other glucose drugs may follow the GSS protocol by taking the drug in the first step, and tapering its dosage off as the benefits from meal splitting and post-meal exercise take effect as days go by. On days when meal splitting or exercise is not possible, Metformin can be used exclusively.
Although can be practiced at any age between 10 and 100, it is recommended that the protocol be started at high schools or universities.
If implemented with care, the GSS protocol will have a palpable impact on reducing a country's cost of health care ---be it private, public, or mixed as in BD.
In a 2015 US presidential primary debate, Mike Huckabee, a Republican candidate and a former governor of Arkansas, pushed for prevention rather than treatment of some diseases in order to rein in the escalating cost of health care, a hot-button issue in all US presidential elections in the recent past. Four diseases she mentioned were: obesity, type 2 diabetes, heart attack, and stroke. All four are linked to high blood glucose level and all are manageable using the proposed GSS protocol.
In Bangladesh, where costs of treatment of the high glucose level related diseases are beyond the means of many, GSS protocol is a winning strategy. In a government- or a non-government-sponsored initiative, main costs incurred will be in educating the masses on the benefits and use of the protocol, and making the GSS software available through a trained health care provider. Education should also focus on selecting carbohydrates that generate lower levels of glucose upon digestion and, more importantly, on developing a habit of practicing meal splitting and performing post-meal exercises. The habit should be as natural as brushing and flossing our teeth.
Education notwithstanding, the drive to take action will have to come from within. Visiting a stroke victim in a rehabilitation facility may drive home the point that action before is better than being on a wheel chair after and being dependent on loved ones, care providers, and physicians. A phrase to get inspiration from, while practicing the GSS protocol could be: 'An ounce of prevention is worth a pound of cure' coined by Benjamin Franklin, one of the founding members of US and a prodigious inventor.
Benefits from using the GSS protocol, on a personal level, may include spending less money on treatments of type 2 diabetes, obesity, stroke, heart attack, and other high blood glucose related diseases; looking younger; and living longer and healthier. A prolonged and pleasant conjugal life may be a windfall for some. A blissful spiritual life with a healthy body may be another windfall to many.
For me, personally, the family 'killer stroke' will have to keep on lurking, as I keep on practicing the GSS protocol and running. Because, to quote Robert Frost:
'The woods are lovely, dark and deep, ?
But I have promises to keep, ?
And miles to go before I sleep, ?
And miles to go before I sleep.'
Tapan Chakrabarty --- a chemical engineering PhD, a seven-continent marathon finisher, an inventor and innovator --- writes from Calgary, Canada. Neilin Chakrabarty --- a software engineer, the lead inventor of GSS protocol, a rental property owner cum manager --- lives and works in Calgary, Canada