10 steps to a long life
YOUR HEALTH
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DR GITA MATHAI
As we grow older and mature, the habit of reading the newspaper too grows. Everyday we find a wealth of information on health in newspapers, books and magazines, and wonder: what do we really need to do to stay fit?
1 Body weight
Body weight is a dynamic equation between the calories consumed and the level of activity. At all ages, we need to maintain our BMI (body mass index) — which is calculated by dividing the weight in kilograms by the height in metre squared — at 23.
Obesity (BMI over 30) is associated with a host of diseases like arthritis, diabetes, hypertension and cancer. It can be tackled by reducing the food intake and increasing the amount of exercise.
Being “size zero” with a BMI of 20 or less (underweight) may be fashionable if you are a model, but actually it’s a sign of ill health. It is associated with menstrual irregularities, poor pregnancy outcome and weak bones. Such a condition is often due to inadequate food intake. Correction of the diet will cause a weight gain. It may also be due to caries in the teeth, diabetes, thyroid problems, malabsorption, cancer and other chronic illnesses.
The number of calories needed a day varies from person to person. For weight loss it is 20 calories / kg, maintenance requires 30 calories / kg and for weight gain it is 40 calories / kg. These are approximate values and need to be adjusted according to activity levels.
2. Heart disease
Heart disease now affects men even in their thirties. Women are protected by their hormones till menopause. After that there is no difference between the sexes. You can take charge of your heart by not smoking as well as preventing exposure to second hand smoke. Include at least an hour of walking, jogging or running every day. Reduce stress with yoga or meditation.
3. Diet
The diet should be rich in vegetables, fruits, whole grains, fibre and fish (in the case of non-vegetarians). Snacking on readymade foods high in saturated fat and sodium is unhealthy.
4. Exercise
The current recommendations are an hour of aerobic activity like jogging, walking or swimming and 20 minutes of stretching or yoga every day.
5. The big C
Prevention and early detection of cancer can increase the lifespan considerably. Correct weight, regular exercise, a healthy diet, not smoking, and drinking in moderation contributes to the prevention of cancer. Hepatitis B immunisation protects against liver cancer, and HPV (human papillovirus virus) vaccine against cervical cancer. Regular “pap smear” tests, breast self examination and mammography detect cancers early in women. For men over 50, colonoscopy (in high-risk individuals) and PSA (prostate specific antigen) test should be regularly done.
6. Injuries
In India, over 80,000 persons die in road accidents annually, over 1.2 million get injured seriously and about 3,00,000 disabled permanently. Many motorbike accidents can be prevented if both the rider and pillion rider use crash helmets. While travelling in a car, everyone should use seat belts, not just on the highway but even for short distances within the city.
In the house, falls can occur on staircases and in bathrooms. These areas should be well lit. In addition, bars should be fixed in the toilet so that older people can grasp it firmly for support.
7. Master health checkups
A physical examination should be done every year, recording the height, weight, blood pressure, general condition of the heart, lungs and abdomen. The eyes and teeth should also be evaluated annually. Routine master health checkups offered by laboratories often have tests that are not required for a particular person. Some of the “package deals” may be unnecessarily expensive. It is best to go to your physician and do the tests you require. Some tests like haemoglobin, blood sugars and a lipid profile have to be repeated every year.
8. Chronic disease
If you have diabetes, kidney disease or some other chronic ailment, adhere to your diet and take your pills regularly. Keep all your follow-up appointments and do the blood tests on schedule. Complications of disease set in when patients are non-compliant.
9. Immunisations
Older people need influenza injections in September-October. The vaccine protects against the strain causing “flu” that year. When there is a pandemic (as there is this year of swine flu), that particular vaccine should also be taken. For those over 65, pneumococcal vaccine needs to be taken as a single dose.
10. Health supplements
Bone loss occurs in older people, in both men and women. Calcium supplements (around 1,200 mg a day) are needed to prevent this.
Tonics and protein supplements are not needed.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Monday, October 25, 2010
Saturday, October 9, 2010
stop dengue
Stop dengue in its tracks
Your Health
--------------------------------------------------------------------------------
DR GITA MATHAI
India has had a good monsoon this year. Rivers are flooded and stagnant water can be seen everywhere. Urbanisation has resulted in a proliferation of improperly planned cities — with slums, and poor sanitation and sewage. This has provided mosquitoes with excellent breeding grounds. The population explosion in the insects has resulted in epidemics such as dengue.
Dengue fever is caused by the Aedes egypti mosquito. Culex and Anopheles mosquitoes (which cause diseases like malaria and filaria) are nocturnal — that is, they emerge and bite at night. They can be effectively kept at bay by using mosquito nets while sleeping at night. Aedes egypti, however, is a daytime urban insect. It cannot live above 1,220m or fly more than a hundred metres. It is easily identifiable — its body is striped like that of a tiger. It lives in houses and breeds in stagnant water. This could be in flower vases, old tyres, upturned bottle caps, and even water that collects on leaves and plants.
Eradication of their breeding grounds is, therefore, a Herculean task, which cannot be achieved by the government alone. Citizens need to do their bit, awaken their civic sense and keep their neighbourhood garbage free. At home, flower vases, water cooler trays, and all sorts of open containers — including broken mugs and bottle caps — should be emptied.
The government often uses “fogs” or sprays of insecticides to reduce the population of Aedes egypti in populated areas. The sprays need to be used every eight to 10 days to interrupt the cycle of virus transmission. Also, people must leave their doors and windows open so that the insecticide can penetrate indoors, into the nooks and crannies where the mosquitoes rest. We often close all openings to prevent the “harmful chemicals” from entering inside. This negates the effects of spraying.
Once an infected mosquito bites, there is an asymptomatic incubation period of five to six days. After this, dengue sets in abruptly with headache and high fever. There is pain behind the eyes and on moving the eyes. Severe body ache makes it difficult for the person to move, giving dengue the nickname “back breaking” fever. There may be rashes on the skin and inside the mouth. There may also be bleeding into the conjunctiva of the eyes, making them appear blood shot.
After three or four days, the temperature returns to normal. But this is only a temporary respite; the fever returns a few days later with all the previous symptoms but in a milder form. Dengue is, therefore, also called “saddle back” fever.
Unfortunately, there is no specific treatment for dengue. There is no vaccination (as yet) to prevent infection or specific antiviral medication to combat the condition. Affected persons have to ride out the disease with supportive treatment, hoping for the best. Treatment is symptomatic with paracetamol for lowering the fever and fluids for hydration. Aspirin and non-steroidal anti-inflammatory agents like brufen must be avoided. Blood transfusions may have to be given if there is bleeding and shock.
The first attack of dengue usually takes a few weeks to completely recover from. Overall, the disease has a five per cent mortality. It is especially dangerous in children. The dangerous form, called dengue haemorrhagic fever, which is accompanied by shock and bleeding, occurs with subsequent infections with the virus, especially if they are of a different “serotype”.
Humans are infective during the first three days when the virus is multiplying in the blood. During this period, it’s important they lie inside a mosquito net all day and night. This is to prevent them from infecting other members of the household.
The diagnosis is made by excluding other causes of fever. Blood tests may show a low white cell count and platelets. There are, however, some confirmatory tests, like complement fixation, Elisa and an increasing number of antibodies.
Dengue is a self-limited disease. The severity of the symptoms depends on the serotype of the virus, immunological status of the host and, to some extent, genetics.
Herbal products — such as fresh leaves and extracts of neem and tulasi — are being investigated for their anti viral and immune boosting properties. The results are not conclusive. Claims and counterclaims about the efficacy of herbal products are difficult to evaluate. Double blind control studies have not yet been done to prove or disprove their efficacy.
One can prevent mosquito bites to a certain extent by wearing long-sleeved clothing, sleeping inside a mosquito net, and using mosquito meshes for windows and doors. Water should not be allowed to stagnate in containers in and around residential areas. Adding a handful of rock salt or pouring kerosene into stagnant water prevents mosquitoes from breeding.
Remember, no vaccine or specific treatment exists — the only way to escape dengue is to prevent being stung by these pesky insects.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
--------------------------------------------------------------------------------
DR GITA MATHAI
India has had a good monsoon this year. Rivers are flooded and stagnant water can be seen everywhere. Urbanisation has resulted in a proliferation of improperly planned cities — with slums, and poor sanitation and sewage. This has provided mosquitoes with excellent breeding grounds. The population explosion in the insects has resulted in epidemics such as dengue.
Dengue fever is caused by the Aedes egypti mosquito. Culex and Anopheles mosquitoes (which cause diseases like malaria and filaria) are nocturnal — that is, they emerge and bite at night. They can be effectively kept at bay by using mosquito nets while sleeping at night. Aedes egypti, however, is a daytime urban insect. It cannot live above 1,220m or fly more than a hundred metres. It is easily identifiable — its body is striped like that of a tiger. It lives in houses and breeds in stagnant water. This could be in flower vases, old tyres, upturned bottle caps, and even water that collects on leaves and plants.
Eradication of their breeding grounds is, therefore, a Herculean task, which cannot be achieved by the government alone. Citizens need to do their bit, awaken their civic sense and keep their neighbourhood garbage free. At home, flower vases, water cooler trays, and all sorts of open containers — including broken mugs and bottle caps — should be emptied.
The government often uses “fogs” or sprays of insecticides to reduce the population of Aedes egypti in populated areas. The sprays need to be used every eight to 10 days to interrupt the cycle of virus transmission. Also, people must leave their doors and windows open so that the insecticide can penetrate indoors, into the nooks and crannies where the mosquitoes rest. We often close all openings to prevent the “harmful chemicals” from entering inside. This negates the effects of spraying.
Once an infected mosquito bites, there is an asymptomatic incubation period of five to six days. After this, dengue sets in abruptly with headache and high fever. There is pain behind the eyes and on moving the eyes. Severe body ache makes it difficult for the person to move, giving dengue the nickname “back breaking” fever. There may be rashes on the skin and inside the mouth. There may also be bleeding into the conjunctiva of the eyes, making them appear blood shot.
After three or four days, the temperature returns to normal. But this is only a temporary respite; the fever returns a few days later with all the previous symptoms but in a milder form. Dengue is, therefore, also called “saddle back” fever.
Unfortunately, there is no specific treatment for dengue. There is no vaccination (as yet) to prevent infection or specific antiviral medication to combat the condition. Affected persons have to ride out the disease with supportive treatment, hoping for the best. Treatment is symptomatic with paracetamol for lowering the fever and fluids for hydration. Aspirin and non-steroidal anti-inflammatory agents like brufen must be avoided. Blood transfusions may have to be given if there is bleeding and shock.
The first attack of dengue usually takes a few weeks to completely recover from. Overall, the disease has a five per cent mortality. It is especially dangerous in children. The dangerous form, called dengue haemorrhagic fever, which is accompanied by shock and bleeding, occurs with subsequent infections with the virus, especially if they are of a different “serotype”.
Humans are infective during the first three days when the virus is multiplying in the blood. During this period, it’s important they lie inside a mosquito net all day and night. This is to prevent them from infecting other members of the household.
The diagnosis is made by excluding other causes of fever. Blood tests may show a low white cell count and platelets. There are, however, some confirmatory tests, like complement fixation, Elisa and an increasing number of antibodies.
Dengue is a self-limited disease. The severity of the symptoms depends on the serotype of the virus, immunological status of the host and, to some extent, genetics.
Herbal products — such as fresh leaves and extracts of neem and tulasi — are being investigated for their anti viral and immune boosting properties. The results are not conclusive. Claims and counterclaims about the efficacy of herbal products are difficult to evaluate. Double blind control studies have not yet been done to prove or disprove their efficacy.
One can prevent mosquito bites to a certain extent by wearing long-sleeved clothing, sleeping inside a mosquito net, and using mosquito meshes for windows and doors. Water should not be allowed to stagnate in containers in and around residential areas. Adding a handful of rock salt or pouring kerosene into stagnant water prevents mosquitoes from breeding.
Remember, no vaccine or specific treatment exists — the only way to escape dengue is to prevent being stung by these pesky insects.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
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