Physical Exercise - Common questions answered

One's capability for physical exertion and exercise is an important determinant of the health of the heart and lungs. There is no longer any uncertainty that regular exercise of reasonable intensity prolongs the lifespan by improving one's vigor, delaying aging process and preventing chronic degenerative diseases such as heart attack, stroke and cancer.

Persistently sedentary life is associated with significantly higher risk of mortality particularly from heart disease. The risk is even greater if chronic diseases like hypertension and diabetes co exist.

The level of physical fitness can be enhanced by a physically active lifestyle and regular exercise.

The reduction of risk has no relation with the basic fitness level; hence even though anyone has not been active in the past, will gain by physical activity.

How one can gain from physical exercise?


*Physical exercise burns excess calories and keeps body weight to healthy level.

*Keeps the blood sugar
at normal level.

*Improves lipid (fat) profile of blood by elevating the level of good cholesterol (HDL) and lowering the level of bad cholesterol (LDL).

*Lowers blood pressure.
Chance of thrombosis in the arteries of heart, brain, legs, etc. are reduced to a great extant.

*Improves the function of the lungs by opening up air spaces, improving oxygenation of blood and getting rid of excess secretions and phlegm.

*Heart function is also improved by increasing flow of blood in the coronary arteries which prevents build-up of cholesterol deposits, and opens up dormant collateral blood vessels which act as bypasses if arterial obstruction develops.

*Exercising also reduce likelihood of rhythm disturbances of the heart, thus reducing the risk of cardiac arrest.

*General improvement of metabolism and strengthening of immune system, which helps prevent/fight infections and even cancers.


What is the fitness level desired?

Excessive exercise produces oxidative stress and actually may harm; particularly for the elderly.

What is needed is regular exercise of moderate intensity and a physically active lifestyle, so that in course of time you are able to walk at full speed (120 steps per minute) for 20 minutes continuously and cover a distance of one mile (1.6 km) without difficulty.

For a sedentary person, it may require a few months of regular exercise to reach this stage of fitness; allow it to take its own time.

How much one should exercise?


Exercise should be strong enough to produce a bit of rapid breathing and sweating with 70-80 per cent of age-adjusted maximal heart (pulse) rate. Keep up the activity for 20-30 minutes four or five times a week. Before and after exercise there should be warm-up and cool-down periods of a few minutes each.

To arrive at your age-adjusted maximal heart rate subtract your age in years from 220. Thus a t age 50, your maximal heart rate is 220-50=170. You should therefore be exercising to produce a heart rate of 70-80 per cent of 170, i.e. 119 to 136 per minute.

What are the types of exercises we can easily do?


The exercises should be such as to involve large muscle masses like:

• walking,
• dancing,
• swimming,
• cycling, etc.

During and after middle age, walking is the best form of exercise. In old age it is almost the only exercise that one should perform.

All competitive activities should stop by the age of 35. After that, the games may be played only with the idea of fun and exercise.

Modern gadgets don’t offer added advantage except you can do it at your home at your own pace.

To be effective, exercise must be continued for progressively longer periods each week till it can be maintained for 20-30 minutes continuously.

Alternative approach is to accumulate daily activity in segments of 10 minutes each to a total of 30 minutes as described later in the article.

The slow progression is particularly important for the elderly, those unaccustomed to exercise and those with evidence of hypertension, diabetes or heart disease.

The long-term aim is to reach and maintain a minimum level of physical fitness.

Good effects on blood pressure, blood sugar, heart disease, body weight, etc., take time to appear and full effect takes almost one year. Once the effects are felt, it is important to maintain the same level of exercise and not become complacent.


How one can incorporate one’s lifestyle with physical activity?


There are numerous ways in which you can integrate physical activity in your daily life, such as:

• use stairs and not the lift to go upstairs,
• use a cycle instead of a car for distances less than 5 km.
• go to the market on foot or cycle, etc.
• perform household chores yourself such as cleaning the house, making beds, washing clothes.

Accumulated Daily Activity Programme


Practical recommendations of the expert panel of US Institute of Health may suit sedentary persons who find it difficult to allot time for regular exercise:

“All children and adults should gradually build 30 minutes of physical activity of moderate intensity (walking, climbing stairs, gardening, cycling.) on most preferably all, days of the week.”

These 30 minutes can be accumulated through segments of 10 minutes duration.


What are the precautions before starting any exercise program?


Consult your physician before staring exercising

• If you are 40 (men) or 50 (women).
• You have risk factors such as hypertension, diabetes, smoking, etc.
• If you have evidence of ischaemic heart disease or any other disease affecting major organs.

The exercise should be such that it produces a pleasant sense of tiredness which disappears after a little rest.

If you experience any adverse symptoms such as tightness or pain in the chest, undue breathlessness or weakness, immediately stop all activity and consult your physician.

Do not exercise if the blood pressure is uncontrolled, though this is beneficial for those having controlled BP.

If you are a diabetic on treatment with hypoglycaemic drugs or insulin injections; always carry a packet of sugar to tackle any hypoglycemic situation that may arise during exercise.

Testing your limits of tolerance serves no purpose and can be dangerous in old age.

Exercise either before meals or two hours after, never on full stomach because most of the blood is diverted for digestion and not enough is left for use of the heart.

This article is also published in India Study Channel

Obesity and its effect on health

Obesity, overweight or fattiness is a disease of affluence, caused by overeating and lack of physical activity. It is linked to so many serious conditions like hypertension, diabetes and heart attacks, that it becomes necessary to prevent it or cure it if it is present.

Normal Body Weight


A simplified formula is to consider maximum normal weight at a height of 5 feet as 55 kg for men and 52 kg for women, and add 2 kg per inch of extra height. Thus for a man of 5 feet 8 inches, his maximum weight should be 55 + (8 x 2) = 71 kg.

Indicators of Obesity


The best indicator of obesity and need for weight reduction is the girth of the abdomen because it is the abdominal collection of fat which is the most harmful. All you need is a measuring tape; measure at the level of the navel.


All men who have a girth of 94 cm (37 inches) and
women 80 cm (32 inches) should not add weight. At 102 cm (40 inches) for men and 88 cm (35 inches) for women adverse effects of obesity start appearing.

Corresponding figures for bodyweight are 10 per cent above maximum desirable weight. At this level weight reduction becomes mandatory.



Effects of obesity on Health


Effect of obesity on joints and ligaments:

Obesity is a vicious cycle of physical inactivity causing obesity and obesity leading to more inactivity. It perpetuates itself with the following ill effects on the body. The extra weight puts an extra load on your heart and lungs, making you breathless on exertion. Under the heavy weight of the body, the weight-bearing joints of the lower back, hips and knees start creaking and develop degenerative changes and osteoarthritis. The ligaments and muscles around the joints ache.

Obesity may lead to diabetes:

The extra fat makes your body insensitive to the action of insulin (insulin resistance). Insulin resistance leads to poor utilization of sugar, raising blood sugar levels and diabetes. Type 2 diabetes, which accounts for almost 95 per cent cases of diabetes in India, depends to a large extent on obesity for its appearance and perpetuation.

Obesity and the heart diseases:

Obesity elevates and aggravates blood pressure. The lipid profile of the obese is usually disturbed, leading to rise of blood cholesterol; this brings about early degeneration and fatty obstructions in the arteries of the heart and brain. Through its links with hypertension, diabetes and lipid abnormalities, obesity is an important risk factor for heart attacks.

The above mentioned conditions are just the tip of the iceberg. Innumerable diseases including psychiatric illness and cancers are either directly or, indirectly to obesity.

Even a 5 to 10 kg reduction in body weight has a marked beneficial effect on health. Calorie Reduction Required to lose Weight. Each gram of fat is equal to 9 calories. To lose one kg of fat, you have to forego 9000 calories, i.e., 300 calories per day for one month. If you are a sedentary person but physically active, you need about 25 calories per kg of ideal (not actual) body weight to maintain yourself. If you consume 20 calories per kg of body weight and remain physically active, you will lose weight at the rate of about 1 – 1 ½ kg per month. Do not lower the intake below 1200 calories; the body metabolism will be slowed down and it will be counterproductive.

This article is also published in India Study Channel

Managing Stress

How to Deal with Stress

Three ways to deal with stress are:
1. Avoid stress, if possible
2. Utilize stress to your advantage, if you can
3. Cope with stress to prevent disease

How to Avoid Stress

Commonest cause of stress at work is dissatisfaction with job and the commonest cause at home is marital disharmony. Therefore choose your career as well as mate with utmost care. Encourage, develop and strengthen areas of agreement at home.


Learn to enjoy your work by learning everything about your work and doing it to the best of your ability. Have a measure of control over your work—it is important for your happiness. Success may bring jealousies at work and are frequent cause of stress. Modesty and courtesy prevent the circumstances of hostility.

How to Utilize Stress to Your Advantage

• The road to reducing stress in our lives is 'EFFICIENCY'
• Stress provides an opportunity to improve our performance.
• Learn to accomplish more with less effort by avoiding wastage of effort.

• Seize control of success by replacing fear with confidence commitment, dedication and concentration.
• Define what is best to do and do it.
• Take calculated risks.
• Repeat past behavior that produced top performance-the more you repeat this behavior, the more will it become second nature with you.
• "A strong will, a settled purpose and invincible determination can accomplish anything" (Thomas Fuller).
• Each one of us has the potential to become a top performer
• It is top performance which gives happiness and joy and keeps the ill-effects of stress away.

How to cope with stress

• Make a conscious effort to control stress. There should be a daily routine to shed stress.
• To this end listen to music, meditate, develop hobbies, exercise, go for a leisurely stroll, or a joy ride in a bus or car.
• If you cannot go out, indulge in a hobby, e. g. play your guitar, sitar or violin
• Caffeine in any form heightens the stress level. Coffee is the worst offender; others are tea and cola drinks. Restrict their consumption.
• Sometimes circumstances may be beyond your control, a crisis in the family for example, or stress may gradually build up over months. Small irritations, loss of temper and frayed nerves may add up over a period of time. It is then that stress becomes distress and exerts its ill-effects. You should then back off, relax and prevent the situation from overwhelming you. At this point of time forget everything and go on a quiet holiday for a couple of weeks. You will come back refreshed.

• Meditation: Relaxation through meditation is becoming increasingly popular both in India and abroad. It is practiced in many ways. The principles are: Use a simple mental device which may be a 'mantra', a simple word or a visual symbol to relax the mind. Concentrate on the mental device, to the exclusion of everything else. The body will start relaxing. This happens because the mental device blots out all distracting thoughts. The technique is best learnt in a meditation centers.

This article is republished in India Study Channel

How stress affects our health

In the rapidly changing scenario of todays hi- tech world, work is posing incredible demands to the individuals. Speed of work, meeting deadlines, people is having less and less time for them. Job security does no longer exist. Both husband and wife have to work to meet the both ends. Economies of most of the countries are unstable. All these factors are adding to the stress of our day to day life. Stress is there to stay and will increase in the days to come.

Let us see what is stress actually? How stress affects our health and how we can cope up with the inevitable factor “STRESS.”


What is Stress?

• Stress is produced when the human body or mind is acted upon by forces that disrupt its equilibrium and produces strain.
• The adverse factors may be physical in the form of injury and disease or, as commonly understood, psychological such as fear, anxiety or crisis.
• The existence of one form of stress tends to diminish resistance of the body to the effects of other forms of stress.
• When our system is unable to handle the stress, it produces pathological changes and disease.

Reaction of our body to stress:

Our body reacts to stress in three stages:

1. Alarm Reaction, wherein the body recognizes the stressful factor and produces the hormones necessary in fighting it. In this stage, heart starts beating fast, blood pressure and blood sugar rise, pupils of the eyes are dilated and digestion is slowed.
2. Following the first stage is the stage of resistance or adaptation in which the body begins to repair the effects of the first stage; the acute symptoms disappear or diminish.
3. If stress continues, adaptation fails, bringing about disturbances in the balance of hormones in the body. This is the third stage of exhaustion. The body can no longer respond to stress. As a consequence, a variety of diseases appear.

Common diseases develop due to stress.



Human are gifted by god by his intelligence. This intelligence itself has become the major factor for stress in them. Animals are not stressed as they cannot think or predict the danger. Man for his thinking capability can perceive the danger, even when the cause of stress does no longer exist. Ultimately, some of them cannot cope up with the stress and exhaustion sets in, resulting in different pathological conditions or, diseases.

The common diseases encountered in the stressed individuals are

• Emotional disturbances.
• High blood pressure.
• Heart attack.
• Stroke.
• Bronchial asthma.
• Ulcer of the stomach.

All these conditions are strongly related to stress, though many other factors play a part in their causation. Stress diminishes the body's resistance to other factors, thus precipitating the disease or facilitating its development.

This article is republished in India study Channel

Read stress management methods here

Managing Hypertension

Once the diagnosis of hypertension is made few laboratory investigations are mandatory. These tests may come out as normal, but this gives an important baseline guideline for managing hypertension in future. The test are directed to the organs, the high BP commonly affects. These following tests are done and should be repeated every year.

Basic investigations required for a patient with hypertension:

1. Electrocardiogram or, ECG to know the condition of the heart
2. Echocardiography, to see the heart’s function if ECG is abnormal
3. Serum Cholesterol and its fractions, triglycerides – their relevance with heart attack and stroke and diabetes.
4. Blood sugar levels - Hypertension is frequently associated with diabetes.
5. Serum urea, creatinine and electrolytes (sodium, potassium, and chlorides) – These will tell the status of kidney.
6. A routine urine examination – will also tell about the kidney status.


Treating the hypertension:

Hypertension treatment has clearly 2 factors.

1. Lowering of blood pressure by medicines
2. Lifestyle modifications.

Medicines are essential to tide over the immediate crisis and in most of the cases has to be continued for life long. But this is not the ultimate solution. Unless lifestyle modification is done, the drugs may not work properly and much higher doses with all their side effects may be required.

Blood pressure lowering drugs acts in many ways. Some relax the vessel wall; some excretes excess water and thus reduce the load. Drugs has definite time periods of working. Some works 12 hrs. some 24 hrs. The doses are to be given accordingly. The doctor, who is treating you is the best judge for the drugs, which will suite you. He might combine different drugs, fortunately there are many to chose from nowadays, to get better results and lesser side effects. You may be wondered why so many drugs while you have no symptoms at all! Hypertension is rightly named “silent killer”. Even if the person is having no symptoms; the major organs get affected slowly and suddenly produces disastrous outcome. So never ignore the treatment, even if you have no symptoms.

Lifestyle modifications must be given equal importance as the drugs. Wrong dietary habits, no exercise, smoking, excessive alcohol intake, mental stress with no relaxation are all common bad habits found in obese, diabetic and hypertesives. These trio are the major killer these days. They are very much interrelated and thrive on our bad habits.
Changing habits is difficult to start with but, once you get the beautiful feelings after getting rid of them, you will never look back to them. Life is beautiful. Don’t ruin it.

This article is republished in India Study Channel

Clues to control obesity

Obesity is an epidemic disease worldwide. These two term disease and epidemic was never related to obesity earlier. WHO formally accepted the fact in 1997. 11 years passed but the uptrend is continuing.

Health Risks Of Obesity:

The list is really long. Obesity affects every aspects of the body and is one of the major cause of premature death. Here is the list of few conditions related to obesity:

• Low self esteem
• Depression
• Diabetes and its consequences
• Hyperlipidimia (Raised cholesterol and triglycerides) with their complications.
• Hypertension and related consequences.
• Gall stones.
• Cancers particularly breast, endometrium, colon
• Poly cystic Ovarian Disease (PCOD)
• Infertility
• Low back pain
• Sleep apnoea
• Skin problems

let us consider What is weight?

Our body is made up of bones, muscles, fat and water. The lean body mass is the weight of us without the fat and it should be constitute 80 to 85% of our total weight. That means if we want to shed weight we have to shed fat and not the lean body mass.

The two areas where fat tend to accumulate initially are abdomen ( pot belly) in men and around hip, buttocks and thighs of women. The abdominal fat increases the risk of diabetes and hypertension significantly. men can lose weight easily than women; on the other hand they are at greater trouble due to the location of the fat!

How to obtain healthy weight?


Please don't go for any advertised gimmicks - the logic is simple! If your earning is more than you spend your bank balance will grow! so is your fat. There are no other way to obtain healthy weight except healthy diet and regular exercise.

Here are some clues:

• Eat consciously and know what you are eating. Always take food which has some nutritional value in addition to the energy you need. For example avoid simple carbohydrates and rely on the complex one.
• Plan low calorie diet ( 1000 - 1500 Kcal) and the diet should be high in proteins, fibres and low in fat.
• Have regularity in food intake. regular meals keep your blood sugar steady. So you will feel less hungry and less craved for food.
• Please don't skip your meals. Your next meal will tend to store as fat if you do so. Never skip breakfast, which I have seen most of the people do! Eat accordingly as you are spending energy. We spend most of our work before lunch, so breakfast must be heavy and with ample protein. Dinner should be lighter on the other hand. Mostly people do the reverse!
• Try eating five servings of fruits and vegetables daily. They will provide you minerals, fibres, vitamins and phytonutrients.
• Protein should be adequate in your daily food. The requirement of protein for normal individual is 1 gm/ Kg of body weight. In pregnancy, lactation and in children it is 1.5 gm / Kg. Animal source contain on an average 20 - 25% protein of their weight. For example from 100 gm of fish you will get 20 - 25 gm of protein. Give preference to fish over other source while choosing animal source. Soya and grains are excellent source. Soya is the richest source of vegetable protein. I will write about soya in a separate post.
• While choosing dairy products , choose low fat varieties like skimmed milk, yogurt.
• Choose snacks carefully, while you feel hungry between meals. Rely on dry fruits, nuts, salads than chips, burgers, and pastries.
• Reduce the intake of stimulating foods and drinks like chocolate, tea, coffee and alcohol. They stimulate insulin secretion and insulin deposit fat.
• Alcohol in moderation is healthy. Please stress on the word moderation. Red wine is best. Excess alcohol intake on the other hand is one of the major cause of obesity.
• Aerobic exercise at least 5 days a week is essential. Walk briskly, jog, run, swim do whatever you prefer but do it regularly. Lifting weight and gym will help you to increase the muscle mass and thereby your lean body mass will increase.
• Take a multivitamin daily, the cheapest health insurance.
  

Lastly, one must realize that, there is no shortcut in the process of losing weight. It has to be done gradually. Crash dieting should never be tried, as it may cause other grave complications.

The factors, which will help you to reduce your fat / weight are motivation, perseverance, commitment. You have to control your mind first to control your body.

Complex Carbohydrates

Complex carbohydrates are good sugar for our fuel. They are long complex chain of many simple sugars combined together. They break slowly in our body and releases sugar slowly according to our need. They don't produce surge of sugar in our body hence, no assault! These are the food with low glycemic index.

They contain fibers both soluble and insoluble which are very helpful for our normal bowel movements. Soluble fibers control cholesterol and help us to reduce the LDL ( the bad cholesterol) from our body.

These foods also are rich in vitamins and minerals, which are essential for our day to day need.

So it is always a good habit to have whole grain food as our staple diet. Beans are another good source of complex carbohydrates, releases energy slowly.

Simple Carbohydrates

Carbohydrates can be subdivided in two major categories: Simple and Complex.

Simple carbohydrates are simple sugar molecules which assimilates easily and very fast in our body and give us instant source of energy. They have high glycemic index, means they produce a surge of sugar in our blood stream. This sugar also used up rapidly from our blood. They contain least fibers. That's why they did not stay in our stomach long and don't satisfy our hunger.

The sudden rise of blood sugar is harmful for those having compromised pancreas. In other words who has predilection and has potential for diabetes will be harmed badly by the repeated assault of sugar to them. Established diabetics should avoid the high glycemic food totally, otherwise controlling them to euglycemic (normal blood sugar a pattern) is impossible.