aging gracefully

Old isn’t always gold Your Health DR GITA MATHAI The Indian population (1.27 billion at present) is projected to overtake that of China in another 10 years, with more births and steadily climbing life expectancy (65 years at present). Between 2000 and 2050, the total population will increase by around 60 per cent but the number of senior citizens (that is, people above the age of 60) will increase by a mind boggling 360 per cent. At that time, they will comprise 20 per cent of the total population. This group is likely to be “feminised” as women tend to outlive men. Also, 70 per cent of the women in that age group would have lost their husbands, whereas only 30 per cent of the men would have lost their wives. Some of these men may remarry, but the majority of women remain single. Many of these old men and women lose their independence and liberty. They are told (often out of kindness) to take rest, relax, watch television and not venture out on to unsafe roads. They may lose control of their resources and suffer neglect or abuse, even though the government has declared that any Indian citizen over the age of 60 is entitled to maintenance from their children. That is all very well in theory but newspapers are inundated with horror stories of abuse, neglect, starvation and even murder. It is a fact that our health deteriorates as we age. “Slowing down” seems a normal process with decline in cognitive skills, muscle strength, and endurance. Finally, the elderly become dependent on caregivers physically and financially. We cannot totally halt this process but it can be slowed down if unhealthy and dangerous behaviour and habits are curtailed while we are still young and fit. Smoking is one of the biggest offenders. It is responsible for bone loss, breathing difficulties, early dementia, heart failure and cancer. No one really likes to look after a wheezy, breathless elder who can barely move around the house. It is a habit that needs to be stopped (not reduced) as soon as possible. Drinking is a double-edged sword, especially as you get older. The drinkers argue that moderate drinking, that is, one drink a day for women or two drinks a day for men, (one drink means 12 fluid ounces of beer, five fluid ounces of wine and 1.5 fluid ounces of 80 per cent proof spirits) has health benefits. It has been credited with a reduction in the risk of getting a heart attack or stroke. It may prevent formation of gallstones and delay diabetes. It may be of benefit in older adults who already have high cholesterol or are at risk for heart disease. Doctors, on the other hand, feel that drinking does not have positive effects for everyone. It can lead to addiction and abuse. Long-term drinking can damage the heart, liver, brain and nervous system. It can lead to personality change. Since the jury is still out, if you do drink do so in moderation and have a day off a week. If you don’t drink, please don’t start. A balanced diet goes a long way towards preserving health. Proteins, fats and carbohydrates should be eaten with four helpings of fruits and vegetables a day. This will keep muscles and bones healthy, prevent constipation, and provide roughage, fibre, vitamins, trace elements and disease fighting anti-oxidants. Regular habits, with at least seven hours of sleep, keeps the brain functioning like a well-oiled machine and gives it enough time to recuperate. As the messages travel again and again through the same internal circuits, the transmission and execution become efficient. The unused areas of the brain tend to atrophy. To prevent this from happening, they need stimulation. Learning a new skill like chess, dancing or music can do this. This may not be possible if a person is house bound and unable to attend a class or a social group. Religious books are usually always available in the house. Committing parts of it to memory and then trying to recall it or learning poetry are excellent ways to stimulate the brain. Crossword puzzles and Sudoku also accomplish this, but then again books need to be provided. The benefits of physical exercise are immeasurable. Regular aerobic activity such as walking, running, jogging, swimming for an hour a day builds muscle and bone strength. This in turn helps balance and that prevents falls and fractures. It also prevents cognitive decline. We owe it to our children to give up unhealthy lifestyles and become physically and mentally fit. That way, we are unlikely to become elderly burdens financially and emotionally. 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 Share on emailShare on printShare on facebookShare on twitterMore Sharing Services

doping kids

Foul play Your Health DR GITA MATHAI “This is my son,” said the man, as he walked into my clinic, “He is a district level sprinter. He is to compete at the state interschool athletics meet. Can you give me a certificate saying he is 16 years old? “Don’t you have a birth certificate?” I asked. “Yes,” said the man, “According to that he has completed 19 and will have to compete in another age division”. “Is he 19 years old?” “Yes” confessed the father, “he started school late. Also his coach feels that he is underweight and his muscles are not well developed. He gets tired easily. So he wants him to take these vitamins and supplements.” He produced a plastic bag that contained a mini pharmacy: capsules with vitamins and minerals in mega doses, pills containing anabolic steroids and testosterone, a jar of a “food supplement” with high doses of amino acids and creatine and even injections of long-acting testosterone. Apparently the entire team, including the girls, were on these supplements and injections! Athletes have to practice day in and out for years to build up stamina and muscle to excel in their chosen sport. There are no short-cuts. Some of our young athletes are naturally talented and are spotted by coaches at the school level. Others have parents who pay for coaches and training. After all, if you can compete in a sport at the national level, it will guarantee you a place at college (even with lower marks) and a job under the “sports quota”. In India, the focus is on academics since it is thought to be the only thing that will help a child get a good job. Many parents feel that sports are a waste of time and money. After all, how many Dhonis or Milkha Singhs does the country produce? This means that many talented children do not achieve their potential in sports. So with no access to (or interest from) the talented, coaches look for shortcuts to produce national level athletes. One way is to fudge the age. A 19-year-old always has a good chance of performing better than a 14-year-old. The other is doping. Last year, the International Association of Athletics Federation caught 52 Indians doping. Even more frightening, in last year’s National Schools Championship, 11 student athletes were caught doping. Often the athlete and the parents are ignorant about what is there in the health supplement prescribed by the coach. Creatine powder is one of the things widely used by coaches as it is believed to speed up recovery and increase muscle mass and strength. Since creatine occurs in the body naturally, it is thought to be harmless but the truth is very different. Consuming creatine leads to weight gain and irreparable kidney damage. Steroids and steroid precursors (usually medications ending with “abol”) and DHEA (d ehydroepiandrosterone, a hormone) are misused to better performance. They, however, also cause pimples, damage the heart and liver, precipitate diabetes and high blood pressure and cause short stature by interfering with bone growth. Girls can also develop a deep voice and become hairy and sterile. No one can progress in the chosen field (even if it is only lifting weight in the local gym) without putting in hard work. If you take dangerous supplements as a shortcut to success, you will either be caught or the dangerous side effects will quickly cut short your career and perhaps even your life. If parents and athletes knew what exactly they were consuming in their “health supplements” and what the long-term effects were, most of them would probably decide not to take this “short-cut” and choose to work hard. An athlete’s diet needs to have adequate calories and proteins. The calorific requirement can be roughly calculated by multiplying the ideal weight in pounds by 13. Then add the calories expended in the sport. Running is 350-500 calories an hour, swimming 550-600 and weightlifting 450-500 calories. Depending on the intensity of the training, these calories can be added to the daily requirement. Infants require about 10gm of protein, teenage boys 50gm, girls 46gm, adult males 55gm and women 45gm a day. Meat, fish, eggs, nuts and dairy products are good and healthy sources. Sports is about developing personality, dedication and discipline in children. It is not about winning by any means, fair or foul. It is about instilling ethics, not chasing short-term gains by a devious route at the cost of future health. 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 Share on emailShare on printShare on facebookShare on twitterMore Sharing Services