Category: Health

Every person must exercise. So many young adults today have insulin resistance and are at risk of developing diabetes mellitus, particularly if one or both of their parents are diabetic. And you know,  if we adopt healthy lifestyles i.e. eat the right foods at the right times in the appropriate amounts, exercise daily and have adequate and healthy sleep, not only can we prevent diabetes but also reverse it .

We can say exercise consists of physical activities that are planned and structured. We repeat the same movements many times or do the activity repeatedly for a specific length/period of time. It helps us to become physically fit.

What does physical fitness mean? Physical fitness means we are able to perform physical activities in a sustained manner with ease and agility and do not feel fatigued within a very short time. It implies that our muscles are strong enough to work against resistance and also have endurance i.e. they are able to contract repeatedly during a given period of time without one’s feeling exhausted. Also the joints should be flexible through a full range of motions. Fitness includes having a good /healthy body composition, have speed, agility and balance, also have good resistance to infection and if injured be able to recover as quickly as possible.

How do we ensure that we are physically fit? By being physically active and to the extent possible incorporating physical exercise in our daily routines.  Physical fitness needs to be developed and does not happen if we exercise sporadically. Exercise should be part of our routine as much as eating and using our cell phones are.

What are the benefits?

Before doing any exercise, it is important to do warm up exercises. These involve simple bending and extending different joints. Doing so helps to improve flexibility and prepares the body for undertaking exercise. Warm up exercises are generally done for 5 to 10 minutes and are not strenuous. Similarly cool down exercises are to be done after the exercise regime/set of exercises is completed for 5 to 10 minutes. These should be an integral part of every exercise regimen.

We can classify exercises as follows:

1. Isometric exercises – Muscles of thigh and leg muscles are contracted without moving the knees or hips. Usually carried out for rehabilitation /special purposes. No special equipment is needed and there is minimal chance of injury.
   
2. Isotonic exercises – Muscles and joints are moved, or their length is increased like bending/stretching the limbs. Sit ups and push ups are examples of such exercises. Such exercises help to improve circulation. In weight training such exercises can be done with dumbbells.
   
3. Isokinetic exercises – Machines are used while exercising, to control the range and speed of motion. These are a combination of isometric exercises and weight training eg working out on an exercise bike set at a particular speed.
4. Strength building exercises – These are basically isometric, isokinetic and isotonic exercises. They help to improve muscle strength and mass, bone strength as well as improve metabolism.
5. Aerobic exercises – These are also called cardio exercises, because they are useful for cardiovascular conditioning. With aerobic exercise, the heart rate increases as does the rate of breathing that should be sustained through the exercise session. This helps to improve fitness of lungs and heart. Familiar examples are walking, jogging, running, spinning, skipping, bicycling, aerobic dancing, etc. This form of exercise involves moving the muscles rhythmically in a sustained manner. Another example is use of cardio machines. Aerobic exercise helps us to burn energy, and in weight loss as well as weight maintenance.
6. Resistance exercise – Muscle groups are moved against exercise or applied force or weight or gravity. This helps to improve muscle mass and strength, with practice and perseverance. In the beginning many individuals particularly older persons or those who are obese or who have less muscle mass may find it difficult to do these exercises.
7. Weight-bearing exercise – Groups of muscles are moved against resistance/applied force/weight/gravity. These exercises help to improve bone mass and to condition the body and give it strength. It is useful for postmenopausal women and persons having osteoporosis. However, person doing this exercise should do so with caution, not have jerky movements as there is risk of injuries. These exercises can be performed in bouts for short periods of time, as they cannot be done for long periods. E.g. weight lifting.
8. Flexibility exercise – These are activities or exercises that are used to preserve or extend range of motion around a joint. Such exercises involved rotating or flexing the extremities. Yoga is an example; most people are familiar with. Zumba, pilates, tai chi and dancing are included as well.
9. Balancing and stretching exercise – These exercises combine activities that aim to increase lower body strength while also trying to reduce the risk of falls. The focus is on harmony and helps the person to relax besides improving physical stability and flexibility. Yoga, dancing, gentle stretching, and tai chi are all balancing and stretching exercises. Such exercises are associated with less risk of injuries.
10. Cardiac exercise – These are body movements that increase the heartbeats and improve the efficiency of oxygen uptake, enhance fitness, and can help to reduce/prevent cardiac disorders or diseases. Exercises like brisk walking, jumping, and cycling are examples. If endurance exercises are done, lower speed and intensity should be used and if done at faster speed and high intensity, it should be not be undertaken without guidance and supervision.

Exercise for specific target age groups: Children and teenagers can undertake and sustain exercise or physical activities for quite a long period of time eg 60 minutes. However, many adults particularly older persons may not be able do exercise for more than 30 minutes. Of course, those who are very physically fit and are used to exercise may be able to sustain it for longer periods. One group which should be considered is pregnant women, who should be advised moderate amount of physical activity daily. Persons with health problems also need to be given exercise prescriptions that are different from those we recommend otherwise. Persons having asthma, high blood pressure, diabetes, osteoporosis or even they are simply obese, need to be evaluated for their ability to undertake exercise first and can be given exercise prescription that is approved by their supervising physicians. For such individuals, simple walking preceded by warm-up exercises can be prescribed.

We have used the word moderate and vigorous when talking about physical activity. Based on the intensity, physical activity is classified into three levels:

The World Health Organization in 2010 has given recommendations for different groups are follows:

If an elderly person has poor mobility, he/she should do exercise at least thrice/week in order to enhance balance and prevent falls. Twice in a week, the individual must do muscle strengthening exercises. There may be persons whose health condition does not allow them to undertake any of these activities. Such persons should do whatever physical activity is possible.

In addition, the American Heart Association states that one should spend less time sitting and even light intensity activities can be useful to offset the risks due to being sedentary. Also, one should gradually increase the amount and intensity of exercises.

A few words about yoga will not be out of place. Yoga is not just physical exercise and performing physical postures. In addition to these it helps one to achieve breath control and metnal focus and besides physical fitness by improving muscle tone and strength, improving flexibilityand health, it will help enhance mental and spiritual health. Other physical benefits are improvement in respiration, and vitality in general.

Life begins at 60 is a famous proverb. It speaks volume. After 60, we may be free from some of the liabilities but we are never free from the race of breath in and breathe out. So, my friends this life stage also have its own beauty and inherent characteristics. Each stage mirrors your previous years of life and old age is a true reflection and reminiscence of that.

A gentleman in his 70s can walk, play, and does all his personal, professional as well as household chores by himself. For him age may just a chronological number. Another woman in her 40s only continues to grumble for aches and pain and blames her age. Both are live examples in our population at large and give us insight to look deeply the scenario of the term “old age”.

World Health Organization (WHO, 2014) defines 60+ years to be referred as the older or elderly persons. Further classification can be done – oldest old (normally those who are 80+) and centenarian (100+) and even super-centenarian (110+).

Age continues to increase in numbers after birth and aging is a natural (normal) biological process that may slow down certain cellular and physiological processes in the body. The rate of deceleration varies in different population for myriad factors. No doubt certain past experiences can’t be reversed but careful attention at early stage is warranted.

Though it is hard to pinpoint the day aging begins but the neglect or the misuse of the body for any unprecedented reason may increase the vulnerability of the body for illnesses, diseases, infections, accidents, or traumas that have a cumulative effect on health and nutritional status later in life. On contrary, perseverance in taking care of the body in given 24 hours along with active life and positive attitude stimulate smooth sailing. Physical, physiological, psychological conditions, social prestige, financial status, personal life style, family composition, family support are the factors which drastically influence health of the elders. Further loneliness, boredom, depression worrying and lack of food accessibility including restricted food intake for any degenerative chronic disease seriously affect the health outcome. Hence it is crucial to address these factors along with seeking help from friends, family or other community services are effective ways to enhance health and quality of life of elders.

Natural bodily Changes in Elders and Associated Problems and Solutions

Functions of most systems and organs diminish with progression of the adulthood. Apparently, these are visible in the speed and robustness in the physical activities, body contour, skin texture and mental turgor. Invisibly there may be less delivery of oxygen and nutrients to tissues of body, decreased elasticity of the cell membranes, poor absorption of nutrients and diminished digestibility of food, frequent nutrient deficiencies, altered distribution of body fat and low muscle mass and low blood supply to different types of muscles. Waist to hip ratio also increases. There may be lack of protein synthesis in the body which impacts voluntary muscular movement. Loss of muscle mass and the reduced muscle strength and function are referred as sarcopenia. It is not always related to body weight. Obese persons can also be sarcopenic.

Many older persons have frequent aches and pains in different parts of the body and there is high risk of frequent falls and fractures. Arthritis, rheumatism, osteoporosis, and other related problems are common in senior citizens. Regular walk, mild exercise, and sun bath support bone health. Resistance exercises improves muscle mass, reverse sarcopenic effect and thereby strength of the body. Dehydration and dryness are common among elders and need constant attention. Therefore, elders need more water than young adults due to decreased thirst mechanism. Elder man needs 2.8 liters of water then a woman in the same age may require 2.5 liters only. More physical work and hot weather increases the fluid requirement. Maintaining the balance in the body fluids, electrolytes and acid-base is critical in old age. Low /high sodium or potassium may be hazardous in certain clinical conditions like high sodium in cardiac disease and potassium in kidney problem. There are marked changes in kidney function that may be due to reduced number of nephrons and reduced glomerular filtration rate (GFR). It may also be due to imbalance in water, electrolytes, and protein intake.

Immunity though is very important in every age but cannot be ignored in old age for better health and fast recovery from any setback. Poor nutrient intakes impair the immunity hence adequate intake of protein, energy, vitamin A, C, E and minerals like copper, zinc, iron, and selenium helps to synthesize immune system components like antibodies, neutrophils, and T- cells. There is decreased secretion of saliva, gastric juices, and stomach acid and digestive enzymes coinciding with loss or altered sensations of taste and flavour which restrict the nutrient absorption. There is slow movement of food in the alimentary canal resulting in constipation. Use of laxatives to prevent constipation should be discouraged because they interfere with absorption of important nutrients. Judicious selection of food may improve the digestion. Elders often face denture problems or swallowing of food that affects the food intake. Soft and soggy textured food may make swallowing easier. Worry and heavy curry and eating at erratic time can exacerbate the problem of indigestion and other health problems. Circulatory system is affected in terms of losing the elasticity of blood vessels and pooling the blood in feet and legs causing edema. Oxygen carrying capacity is reduced by low production of red blood cells. Further pressure on the heart is increased due to narrowed arteries that often result in cardiac problems.  Frequent episodes of headache, vision disturbances, loss of balance, confusion, dizziness for no specific visible reason need attention and connect with the doctor. It is important to know the effects and side effects of medications that are prescribed for the older person.

 Besides all other changes many elders tend to suffer from the loss of hearing and vision and fine and gross motor control (holding and handling of objects).

Among women there is reduction of estrogen during menopause (cessation of monthly periods) and increase in prolactin may lead to fat accumulation.

The loss of short-term memory and disorientation is commonly observed that is due to poor nerve transmission.

Many elder persons are frail which calls for extra concern because the frailty is cumulative decline in multiple physiological systems. The frail person exhibits weakness, exhaustion unintentional weight loss and slowness and clumsiness in various motor and physical activities. Frails are highly susceptible for high morbidity, disability, hospitalization, and mortality.

Factors affecting nutrition of elderly people

Nutritional requirements of elders

 Energy requirement gradually decreases with age due to reduced BMR and physical activities. With age, anabolic rate reduces and catabolic rate increases that leads to degeneration. Repair and regeneration of newer cells occurs at a slower rate. The heart slows down and its ability to pump blood is less compared to a young adult. Consequently, older people have less energy and stamina to work.

Protein requirements are higher 1.0-1.5 g/Kg of body weight. Adequate intake of good quality protein is warranted to avoid loss of muscle mass and support muscle protein synthesis. It is necessary to consume enough carbohydrate and fluid (water) along with protein. Adequate intake of vitamin A, B complex, C, D, E and K as well as calcium, magnesium, selenium, zinc, phosphorus, sodium, and potassium, is must. Sufficient dose of folate, vitamin B₁₂, and vitamin B₆ helps to prevent cognitive decline. Additional amount of fiber which is obtained from several plant foods is highly appreciable not only to prevent constipation but also many complications of chronic diseases.

In addition to the recognized essential nutrients, consumption of phytochemicals will have additional benefits for being anti-inflammatory, anti-microbial, anti-oxidant, and anti-mutagenic and prevention of many chronic diseases like cancer and heart disease. Consuming diverse variety of plant-based foods including whole grains, fruits and vegetables, spices and herbs in suitable forms would be beneficial as they would provide both micronutrients, phytochemicals and at the same time enhance taste, flavour, appearance, and texture in the diet.

 Dietary guidelines for elders: 

• Higher intakes of fruits, vegetables, nuts, dairy, and whole grains may delay muscle strength and cognitive decline which is common in advanced age.
• Older persons have small appetite: hence small, frequent, and nutrient dense (especially micronutrient) foods should be included. Major meals can also be small and with few dishes. Variety of ingredients can be added in one dish only.
• Invite friends and relatives to share meals with the elderly person.
• Nourishing, digestible, easy to chew and easy to swallow foods and beverages are preferred. Milk shakes, fruit yogurt, biscuits, pancakes, idli etc. can be good choices.
• Try to make meal platter or dining table more welcoming and attractive. Offer familiar, well liked foods.
• When an elderly person has poor appetite or complains about digestive problem(s), it should be taken care.
• Ensure 4-5 serving of fruits and vegetables and cut down on fried foods containing trans fats
• Add full cream dairy products. The fat is easily digested, cream increases energy and calcium content of the diet. It can also facilitate the peristalsis.
• Add some amount of butter to vegetables and bread etc to increase energy content and enhance flavour of the diet.
• Consume fat from whole foods such as nuts, seeds, beans, and fatty fish to get high in ω-3 and ω-9 fatty acids
• Avoid refined fats and fatty spreads
• Emphasize healthy traditional vegetable- and legume-based dishes.
• Limit traditional fat rich dishes and heavily preserved/pickled dishes.
• Ensure adequate intake of fluids preferable in the form of gravy in the vegetable or pulse or meat preparation, soups, and other beverages. Of course, regular, and adequate intake of water is advisable, especially in hot weather. Adequate fluid intake is necessary for maintaining body temperature and functioning of digestive system. It will reduce constipation which is quite common in this age due to reduced motility of the intestine and reduced physical mobility.
• Fluid intake may be inadequate because of decreased thirst sensation and reduced ability to conserve water and because they want to avoid frequent urination. Reliance on laxatives, use of prescribed diuretics, infections, immobility and excessive use of caffeine or alcohol put the person at risk of dehydration.
• In case of medical problems such as kidney disease, fluid intake and output should be monitored and fluid intake should be determined in consultation with the doctor.
• Some signs of dehydration are mental confusion, decreased urine output, constipation, nausea, lack of appetite, dry lips, and elevated body temperature.
• Include natural sources fibre (non-starch polysaccharides) such as whole grains, fruits, and vegetables to reduce constipation. It will also help to control better blood sugar control.

Nutritional deficiencies and Related Problems in old age

Nutrition is an important determinant of health in the elderly especially those who may have any illness. Importance of nutrition has been increasingly recognized as a significant factor for persons older than 65 years of age. Malnutrition in the elderly often goes undiagnosed. Common indicators are involuntary weight loss, abnormal BMI, decreased dietary intake and deficiencies of specific micronutrients. Presence of morbidity such as diabetes, heart disease etc. increases the risk of malnutrition. Often the weight loss goes unrecognized, because since some weight loss is expected as muscle mass decreases. Isolation and depression exacerbate the problem. Elderly population has commonly been found to have cobalamin (vitamin B₁₂) and folate deficiency. Intakes of protein and calcium may be low and vitamin D deficiency can occur since the person may not be exposed to sunshine. There may be increased risk of falls and fractures. Low vitamin D status has been linked to higher risk of decline in cognition as well as muscle strength, low moods, and depression.

Low intake of B vitamins, especially folate, B12 and B6 may increase risk of low functionality, cognitive decline, heart disease and stroke. Inadequate intake of dietary protein has been linked with poor muscle function and decline in physical capacity leading towards sarcopenia.

Lower intake of energy and protein rich foods for prolonged period results in PEM and older person become frail and finds difficulty in walking and maintaining balance. Intake of other nutrients like B- vitamins, iron, calcium, zinc and electrolytes also affects the degree of malnutrition and body functioning. PEM not only affects the physical stature but also the mental functioning.

Elders who have limited access to food, living alone, low income and poor transport facilities are vulnerable to PEM. It is important that the elderly live the last stage of life with dignity and have as good a quality of life as is possible.

Exercise in old age:

Exercise is essential to increase muscle strength and muscle mass in older persons to maintain their functional status and independence. Certain aerobic and strength-training exercises are appropriate for individuals age 60 and older. If not done in earlier life they must be undertaken under able guidance and always first be discussed with one’s health care provider. Older persons can do stationary cycling regularly and strength training 2 to 3 days a week, with a day of rest between workouts.

Before undertaking exercise, or before a dietitian advises exercise, it is important that the elderly person be first evaluated for ability and risks by a physiotherapist, who can then advise the type of exercise, its frequency, duration, and intensity.

Besides muscle health, exercise helps a person to feel fresh, improves insulin sensitivity and improves mood. In addition, for those who can go out of the home for exercise, it provides a great opportunity to make friends.

Regular consumption of dairy products, ragi flour, sesame seeds, sweet lime, guava, amla, egg etc. can fulfill the increased demands for protein, calcium, vitamin D and vitamin C. Plain safe drinking water, soups and juices are good. The combination of rice, pulses and one GLV and starch vegetable will do better than fried fast foods. Milk, fruits, and nuts in different forms can be given to provide nutrients and improve digestion. Inclusion of complex carbohydrates, protein, omega 3 fatty acids, vitamin A and C rich in the diet and exclusion of salt, sugar, refined and processed foods and saturated and trans-fats are essential for good cardiac health.

Various physical challenges necessitate special attention like modifying the texture of food or supplying appropriate cutlery.

Regular contact with friends and relatives, through visits and telephone calls, can help prevent these problems. Mental exercises and involvement also support the cognitive functions and attentiveness.

Healthy snacks include those that have significant vitamins, are low in fat, added sugars, and sodium. Examples of healthy snacks include: Fruits, nuts and seeds

Resisting the urge to reach for a burger, candy, or potato chips when you’re hit with a snack attack can make a big difference in your health — regardless of your age.

“Nutrition really is the key to a healthy lifestyle and a healthy life. It goes a long way toward lowering the risk for heart disease and improving overall health. Eat small meals every three to five hours and that they resist the urge to overeat.

“The easy part is the frequent meals; the hard part is keeping them small. We are used to big meals. “If you can match your intake with your output, you’ll be better off with your weight-control goals.”

Eating small, frequent snacks keeps your metabolism revved up and helps normalize blood sugar. Hunger can throw your body into famine mode, which slows metabolism and makes it easier to pack on the pounds.

Foods like fruits, vegetables, nuts, low-fat dairy products, whole grains, and legumes are satisfying and are packed with the nutrients, fiber, and protein your body needs, and they guard against sugar highs and lows, so you are less likely to succumb to your sweet tooth — or whatever your dietary Achilles’ heel may be.

“I tell people to think about food as fuel,”

Such nutrient-poor, sugary snacks as candy bars are like fuel that runs hot and flames out. They give you a quick jolt of energy that is followed by a crash that can leave you hungry, cranky, sleepy, and unable to concentrate.

Healthy snacks are more like slow-burning fuel that helps you keep going all day. Having several snacks a day helps banish that post meal sleepiness that comes from consuming too many calories at one sitting. If you include protein in your snack, you’ll derive an extra mental boost — protein food like soya, peanut, millets contain an amino acid that increases the production of neurotransmitters that regulate concentration and alertness.

Many of us naturally reach for carbohydrates when we’re feeling down because they help lift our mood by boosting the brain chemical serotonin. While processed foods like plain bagels and cookies give a quick high, it’s followed by a sharp low. Good-for-you fruit sugars, honey, low-fat dairy products, whole grains, and many vegetables lift mood and battle fatigue without the roller-coaster effect.

Omega-3 fatty acids are another good nutrient to include in snacks, for your heart as well as your head. Flax seeds, watermelon seeds, walnuts and some other foods contain omega-3s, which helps to fight with high blood pressure and heart disease, as well as depression and anxiety. The effects of omega-3s are also being studied as they relate to a number of other health conditions, including joint diseases, schizophrenia, and attention deficit hyperactivity disorder.

Eat your fruits and eat your veggies, stay in shape and have less wedgies!

Over the past few years there has been a healthy food revolution. Especially, with the increasing health consciousness among people, there has been a rise in the demand of nutrient rich cereals and exotic berries. No wonder why millets have become popular among millennial for its umpteen health benefits

Millets are cereal crops and small seed grasses, which are widely used in African and Asian countries. Since ages, these small crops were used for human consumption as well as a fodder for animals. Majorly cultivated in the semiarid tropical regions of Africa and Asia, around 97 percent of world’s overall millet production happens in these regions.

Health benefits of millets

Since ages millets were commonly used to feed birds and animals, until the health benefits of these super foods were known to the world. However, in various parts of India, millets were used for a variety of dishes. Especially, for their incredible nutrient rich composition.

India is known as the diabetes capital of the world, due to bad eating habits. This has led to the surge in the demand of millets which are low in GI. Moreover, these gluten free millets can play a pivotal role in preventing and curing several health issues. Enriched with the goodness of nature, millets are a rich source of fiber, minerals like magnesium, phosphorous, iron, calcium, zinc and potassium.

Accommodating millets in your daily food routine can be benefitting in many ways.

High in nutrition:

Millets are a good source of nutrients such as copper, magnesium, phosphorus, and manganese. Which are excellent for maintaining a healthy life. A balanced diet full of nutritional properties will also help eradicate the risk of heart problems and other such life endangering diseases.

Low calorie count:

When trying to lose weight, millets are a viable choice to a healthy weight reduction, as their calorie count is very low. Even for the people who are calorie conscious and trying to eat in a manner that will help them maintain their energy levels throughout the day without constantly feeling famished.

Improves immunity:

Weaker immunity can and will be fatal. The weaker the immune system, the more you are inclined towards experiencing health issues time and again. This is due to the serious deficit of protein in the system. Adding millets to your diet on a regular basis will help your body gain back all the protein that your system was short on.

Satiates Hunger:

Many carbohydrates such as rice and wheat are easy to breakdown once consumed, leaving a person hungry within few hours of their meal. This makes people resort to unhealthy eateries to satiate their hunger. Millets have harder structures and does not breakdown easily in the digestive system, keeping you far enough away from unhealthy eating habits.

Reduces Sugar-levels:

Due to its low glycaemic index, millets are an ideal food to consume to pre-empt diabetes from ever occurring in non-diabetic people. It especially aids in keeping type-2 diabetes under control.

Aids heart problems:

Millets contain essential fats, just the right amount to give our body natural fat. This helps prevent excess fat from depositing over muscles which and avoid high cholesterol, heart strokes, and other heart related disease. Millets are the immediate best alternatives to replace with their unhealthy peers, reducing the risk of cardiovascular diseases by a good measure.

Millet is the only grains that contain all the vital nutrients. From proteins to minerals to vitamins, millets have it all. Millets helps you switch to a lifestyle that’s healthy and long lasting.

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