live to be a 100

Live to be a 100

http://www.telegraphindia.com/1150824/jsp/knowhow/story_38713.jsp

---

Your Health - Dr. Gita Mathai

---

• 

Living to be a 100 years old is a very real possibility in the near future. After all, now there are sprightly 80 year olds running businesses, managing their finances and living independently (with a little help from friends and relatives)!

Health is the key to a long and happy life. The effort to achieve and maintain health has to start when you are young, before disease sets in.

A great deal of research has gone into understanding aging, as the world's population is getting older. In one study, senior citizens were divided into three groups. The first group did an hour of aerobic activity (such as running, jogging, walking or cycling) a day combined with weight training with weights of 1-2 kilos. The second group did only flexing and stretching exercises. The third continued with their usual sedentary life. After a period of six months, the first group was found to not only have gained muscle but also developed a positive outlook on life and become mentally sharper. There was no noticeable difference in groups two and three. Uniformly though, they had lost muscle mass and "slowed down" mentally and physically.

After research and several studies, 10,000 steps a day was declared a magic figure to maintain health. It works out to about five miles a day. Most people actually walk only 3,500 steps a day. The new smartphones, some watches and pedometers are able to track daily activity accurately. The other way is to get up every hour and walk for a minute. This can be added to, or alternated with, stair climbing - a 1,000 calorie per hour activity. Swimming, walking, jogging and running use about 300 calories per hour depending on the intensity, the distance covered and the speed.

Our body requires a certain amount of energy to stay alive even if we sleep all day. This can be calculated as the weight in kilos multiplied by 2.2 multiplied by 11. It works out to around 1,500 calories for a 60-kilo adult. 1,500 calories a day is a "restricted diet." It is barely enough to enjoy a good meal or indulge even occasionally in tasty, high calorie snacks. To be able to eat more and enjoy it, you need to increase activity. Then the calories utilised in the activity can be added to the total daily consumption.

Every decade the metabolic rate falls by five per cent in men and three per cent in women. Muscles atrophy and become insidiously replaced by fat if they are not used, and with increasing age. Muscle, even at rest, consumes more energy than fat. This lowers the metabolic rate. It also reduces strength and affects balance. Weight training needs to be done. A litre bottle can be filled with water and held in each hand and the traditional school drill should be done using this. This consists of five up and down and side-to-side movements with the arms. Gradually work up to twenty repetitions of each circuit.

Mental activity like puzzles, Sudoku and learning verses by heart alone will not keep the brain sharp, it will only marginally delay the onset of Alzheimer's and dementia. It has to be combined with an hour of physical activity a day, preferably outdoors in the sunshine. Even walking up and down a portico or around a block of flats is all right.

The effect of an hour's effort today and everyday will make a hundred fold difference in a lifetime. The other fact - you are never too old to start.

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

foti and tofi

http://www.telegraphindia.com/1150817/jsp/knowhow/story_37515.jsp

Fat outside, thin inside

---

Your Health - Dr. Gita Mathai

---

• 

Human beings do not roll off a factory line like cars, identical in appearance. They vary in shape and size. They may be classified in the case of women as pears, apples or bananas or as upside down triangles, upright triangles, hour glasses, diamonds, rectangles or the number 8. These classifications are self-explanatory.

Males are classified as ectomorphs (very thin), endomorps (medium) or mesomorphs (positively obese). The athletic mesomorph is most attractive to women.

Our body type is genetic. Less than 15 per cent of the population is blessed with their perceived ideal body type. The other 85 per cent are unhappy with their shape and want to change it. Most are unsuccessful. Changing body shape requires great effort.

For years the gold standard for health was the BMI (body mass index), the weight in kilograms divided by the height in meters squared. For Indian adults the ideal BMI is now 23. If you have a BMI of 30 or more, you are obese. The fallacy is that some fit individuals like sumo wrestlers and kabbadi players have a high BMI. They are not obese - just fit and muscular. So many people fell outside the spectrum that total body fat became the new mantra for measuring health. No one should have more than 25 per cent body fat.

Total fat content of the body is not easy to measure. It requires an MRI scan. When heavy weight sumo wrestlers were checked during studies, they were found to have most of their fat deposited under the skin. They had little or no visceral fat. In short, they were FOTIs (fat outside thin inside). This was in sharp contrast to many thin individuals and size zero women who were TOFIs (thin outside fat inside).

In everyone, including FOTIs and TOFIs, extra fat gets deposited around the abdominal organs as visceral fat. This precipitates lifestyle diseases like hypertension and diabetes. The extra fat in the body acts as an independent organ. It releases chemicals and hormones. These alter mood, reduce lucid and deductive thinking and prevent restful sleep. It also increases the propensity to develop cancer. It changes the reproductive hormonal profile leading to lower fertility - and even sterility - in men and women.

People cannot change their body type - but they can work with it. This requires a controlled diet as well as exercise. For it to be effective, you should exercise non-stop for at least 40 minutes a day.

As people get older, their weight slowly climbs. This is because the metabolism slows down. Increasing the exercise and marginally reducing the food can circumvent this.

Quick look

• You may be born with an unattractive shape but you CAN work with what you have
• FOTI is healthier than TOFI
• Everyone should exercise for at least 40 minutes every day

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

http://www.telegraphindia.com/1150803/jsp/knowhow/story_35024.jsp

---

• 

A "stroke" is exactly what the word conjures up in the mind - a sudden catastrophic physical event because of a deficiency in blood supply to the brain. The brain cells begin to die when deprived of blood. This leads to a loss of function of the body parts controlled by those parts of the brain.

The loss of blood supply may be because a blood vessel leaks, bursts, or becomes blocked. If there is a disruption in the right side of the brain, it affects the left side of the body and vice versa. The centre for speech is situated on the left side, so if the stroke has affected the left half of the brain, the person will have paralysis or weakness on the right side of the body and be unable to speak as well.

A person who is developing a stroke may suddenly have slurred speech and be unable to comprehend instructions. There may be loss of vision in one eye. There may be weakness or total loss of strength in one half of the face, the arms or the legs. The weakness may cause the patient to lose his balance and fall down. There may be a headache, giddiness, loss of consciousness or even a seizure.

If the block is not complete, the person may appear to recover rapidly. Within 24 hours it is almost as though the stroke never occurred. This often means that the person and relatives do not take the symptoms seriously. These episodes are called TIA (transient ischemic attack). It is followed by a full-blown stroke in the next 24 to 72 hours in 40 per cent of cases.

The risk of having a stroke increases with age, going up exponentially after 55 years. It is commoner in men. Women are more likely to have a stroke if they are on hormone replacement therapy. Pregnancy increases the likelihood of blood clots. Emboli may occur during childbirth. In both sexes, the risk factors for strokes are obesity, physical inactivity, smoking, use of tobacco products or high alcohol consumption. Diseases like high blood pressure, diabetes and elevated lipids can increase the risk of a stroke. Irregular and rapid heart beats can occur as a result of hyperthyroidism, as an aftermath of rheumatic heart disease, heart attacks or because of congenital abnormalities of the heart. This can cause clots to form in the heart itself, which can move to various parts of the body.

The disabilities resulting from a stroke can be temporary or permanent. There may be weakness or loss of movement to one side of the body, making walking, eating and self-care difficult. Speech may be slurred or impossible. There may be loss of memory for recent events. Words may be elusive even with clarity in the thought process. This makes communication difficult. The paralysed parts of the body may have strange sensations or paradoxical pain. Judgment, rational thought and reasoning may be affected.

A stroke is a medical emergency. Prompt treatment and follow up management helps to minimise deaths and complications.

Aspirin prevents blood from clotting further. A tablet of aspirin dissolved in 100ml of water is the emergency treatment for a stroke resulting from a clot. Clot busting drugs like TPA (tissue plasminogen activator) can be given intravenously. Administration should be a maximum of 3-4 hours after the event to be effective. Clots may be removed surgically, stents can be inserted into narrowed arteries and bulging blood vessels clipped.

Rehabilitation with physiotherapy and occupational therapy needs to be started as early as possible.

Rewiring of the brain is possible with training of the nerve cells. This way, other areas of the brain take over some lost functions and the surviving brain cells can be efficiently and optimally utilised.

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