Preventive and
Lifestyle Medicine
Lifestyle disorders such as cardiovascular disorders (heart disease, stroke, kidney disease), diabetes, mental health problems, breathing problems and cancer are the leading cause of death and disability in India. The highest number of diabetics in the world, and 60% of the global burden of cardiovascular disorders are in India. These disorders are expected to rise significantly in the next 25 years.
This is why Preventive and Lifestyle Medicine is important. Our vision is to detect and prevent disease before it starts. Make an appointment with us today and take advantage of our services.
This is the heading
People are less physically active. They are walking less, and for many people office work has replaced physically demanding agricultural labor. Even in the rural areas, other than agricultural labor, most people have motorized transport as well as mechanical gadgets in their kitchen. The need to gather water and wood, grind flour and other tasks have come down significantly. People are spending a lot more time engaged in sedentary activities such as watching television and using social media.
This is the heading
People are less physically active. They are walking less, and for many people office work has replaced physically demanding agricultural labor. Even in the rural areas, other than agricultural labor, most people have motorized transport as well as mechanical gadgets in their kitchen. The need to gather water and wood, grind flour and other tasks have come down significantly. People are spending a lot more time engaged in sedentary activities such as watching television and using social media.
This is the heading
People are less physically active. They are walking less, and for many people office work has replaced physically demanding agricultural labor. Even in the rural areas, other than agricultural labor, most people have motorized transport as well as mechanical gadgets in their kitchen. The need to gather water and wood, grind flour and other tasks have come down significantly. People are spending a lot more time engaged in sedentary activities such as watching television and using social media.
LIFESTYLE DISEASES -
CAUSES FOR THE RISE
Why are lifestyle disorders increasing?
People are less physically active. They are walking less, and for many people office work has replaced physically demanding agricultural labor. Even people living in rural areas, other than agricultural labor, have motorized transport and mechanical gadgets in their kitchen. Therefore the need to gather water and wood, grind flour and other tasks have come down significantly. People are spending a lot more time engaged in sedentary activities such as watching television and using social media.
Malnutrition is still a major problem for below poverty line people in India. At the same time, obesity has become a problem in the urbanized and more affluent populace. Indians have always consumed a diet rich in carbohydrates (rice, rotis), which was not a problem in the past, when we were engaged in hard physical labor. However, now that we are less physically active and are consuming more salt, sugar, preservatives and junk food, our diet is predisposing us to diabetes. Evidence also shows that Indians are susceptible to having a greater degree of insulin resistance. All of these factors are leading to an increase in obesity, hypertension, high cholesterol and diabetes, known as the metabolic syndrome
82% of Indians suffer from stress resulting from work, health and financial concerns (Cigna 360 Well-being Survey, 2019). Moving from close knit communities to a city where relations and support systems are less strong, and changes in family structure, may contribute greatly to this. Compared to the joint family structure, we are seeing more nuclear families, divorce and single parenting.
We have become a 24-hour society with 24-hour availability of electricity, television, video on demand, social media and internet. This, together with other poor lifestyle habits, has resulted in an increase in poor sleep patterns in India.
This is prevalent in both urban and rural areas.
Air pollution and poor waste management leading to poor quality of air and water can lead to breathing and heart problems as well as cancer. This includes asthma, COPD, bronchitis, lung cancer and heart attack.
Once you or a family member develops a chronic illness, the cost of hospitalization, medications, loss of productivity at work due to disability or absence will be extremely high. A single hospitalization may cost lacs of rupees.
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Dr. Harshitha Reddy P
Consultant General Medicine
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Dr. Varun M
Consultant General Medicine
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Nurse Specialist, Preventive & Lifestyle Medicine
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Clinical Therapeutic Nutritionist & Dietician
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HELPING YOU LIVE BETTER
ADDRESSING YOUR CONCERNS
Who is at risk?
Depression is a common and serious illness which negatively affects the way you feel, think and act.
Table 2. Who is at risk for developing depression?
| Vulnerable Groups | Reasons |
|---|---|
Age 10-19 years | Adolescents face new stressors such as exams, college admissions, leaving home for college, peer pressure |
Major life changes | Death or illness in family, divorce, victim of crime |
Pregnancy and postpartum | Hormonal and significant lifestyle changes |
Elderly people living alone | They may feel isolated and left out with loss of purpose in life. This is seen more commonly in men. |
Financial problems | Loss in business, getting fired from job |
Social Isolation | Especially after relocation to a new place |
Many of us may have suffered from depression, but may not be aware of it.
Table 1. What are the symptoms of depression?
- Feeling sad
- Feeling empty
- Difficulty enjoying things
- Restlessness, irritability
- Difficulty with concentration and memory
- Reduced performance in work/ school
- Loss of appetite or overeating
- Difficulty sleeping, fatigue or oversleeping
- Headaches, pain, aches, digestive problems
- Suicidal thoughts, attempts
- Family history of psychiatric illness
Depression can present differently in women and men. Women present mostly with sadness, while men may appear angry and tend to use alcohol and drugs more. Some people are also more vulnerable to depression (table 2)
Are you depressed? Take a test:
https://depression.org.nz/is-it-depression-anxiety/self-test/
https://patient.info/news-and-features/quiz-am-i-depressed
- Stay connected. Have a strong network of family and friends. Meet and spend time with them regularly. Eat at least 1 meal with your family each day. Don’t isolate yourself.
- Learn strategies to deal with stress.
- Exercise regularly: endorphins are released from your brain during and will improve your mood.
- Practice meditation and yoga, which will help you relax and think positively.
- Eat a healthy diet, which includes fresh vegetables and fruit. Drink plenty of water.
- Have regular sleep wake times and bedtime routine.
- Avoid alcohol, drugs and smoking.
- Try to create a positive environment for yourself and think positive thoughts daily.
Depression can drain your energy, making it difficult to work, take care of your home/ children and enjoy yourself. If your symptoms are severe, you should visit your doctor.
Being depressed, does not mean that you are weak. Some people are genetically more prone to become depressed, but treatment is available. With appropriate medication treatment and counselling, most people will feel better and can return to living a normal and happy life.
YOUR GUIDE TO HEALTHY LIVING
Importance of eating a balanced diet
Eating a healthy, balanced diet is an important part of maintaining good health. This means eating a wide variety of foods in the right proportions. Not eating the right type and correct quantity of food can lead to nutritional deficiencies, obesity and other health problems. Being overweight or obese will increase your risk of diabetes and metabolic syndrome.
My healthy plate
One way to plan your daily diet is to use MY HEALTHY PLATE for your 2 big meals of the day. This is an easy to understand visual guide for creating balanced and healthy meals, using a 11-inch plate. If you have diabetes, kidney disease or any condition with special diet requirements, this advice may not apply to you and you will need to speak with your doctor.
Choosing the right food
| EXAMPLES | COMMENTS | ||
|---|---|---|---|
Carbohydrates | Millets
(Ragi, Jowar, Bajra, Jonna, Sajjalu)
Pulses (Dals)
(Toor, Urad, Chana, Moong)
Rice, Cereal, Wheat, Oats.
Starch:
Potatoes, Sweet Potato, Yam, Chamadumpa | Brown, red or parboiled rice is better than polished rice.
Pulses and Millets have a lower glycemic index and more fiber - eat more of these.
Avoid too much starchy vegetables. | |
Protein | Eggs, Meat, Fish, Poultry,
Kidney Beans, Chickpea, Black/Yellow Lentils, Moong, Toor and Chana Dal
Peanuts, Goruchikkudu, Chikkudu | Eat protein daily. There are also many vegetarian sources of protein. | |
Fruit | Mango, Papaya, Banana, Apple, Guava, Grapes, Pomegranate, Pineapple | ||
Vegetables | Roots
- Beetroot, Radish, Carrot,
Green Leafy Vegetables
- Spinach (Paalak), Drumstick Leaves, Fenugreek Leaves, Coriander and Curry Leaves
Other
– Cauliflower, Ridge Gourd, Bottle Gourd, Snake Gourd, Cabbage, Tomatoes, Onions, Bell Pepper, Drumstick | Different colored fruits and vegetables have different vitamins, minerals and antioxidants. Choose a rainbow of colors to eat. They are also a rich source of fiber. Select seasonal varieties. | |
Milk Products + Fats | Milk, Yogurt, Cheese, Buttermilk,
Paneer, Oils | Rich source of calcium and protein | |
HEALTHY EATING
| Do's | Dont's |
|---|---|
Drink plenty of water | Avoid sweetened sodas, juices and cool drinks. |
If you are hungry between meals, eat small quantities of fruit, seeds or nuts. | Avoid frequent snacking.
It is okay to be hungry for a while. |
It is okay to have these items occasionally during festivals or special occasions. | Do not eat junk food like biscuits, cakes, sweets, chips, and savory items regularly. |
Portion control is key to healthy eating. | Avoid eating large quantities of food,
especially rice. |
Home cooked food is the best! | Avoid eating outside food frequently. |
Breakfast: Try to use millets and pulses. Add fruit, vegetables and protein to your recipes.
Lunch should be your bigger meal and dinner should be light. Eat dinner 2-3 hours before bedtime.
It is important to incorporate protein and fiber in your diet. Nuts, fruit and vegetables have fiber.
Plan a 7-day menu, so that you are not eating the same items daily.
Why is exercise important?
Physical activity and exercise are important in maintaining good health. Regular exercise will help you feel energetic, strong and happy. It will help you sleep better and have stronger bones.
A sedentary lifestyle (with no physical activity) increases risk of diabetes, hypertension, heart disease, depression, osteoporosis and some cancers.
What are the different types of exercises?
Aerobic exercise is low to high intensity physical activity, which allows your heart and lungs to supply oxygen to your body.
Muscle strengthening and stretching exercise will strengthen your muscles and bones. It will also improve your flexibility.
What is the difference between moderate and vigorous exercise?
Exercise does not have to be planned, it can also be incorporated into work and daily physical activity.
MODERATE
- Brisk walking
- Slow running
- Slow cycling (level ground)
- Slow dancing
- Light gardening
- Housework (sweeping, dusting, vacuuming)
- Sports: throw ball, volleyball, shuttle and tennis (doubles)
- Water aerobics
- Using wheelchair with hands
VIGOROUS
- Fast running
- Fast cycling
- Cycling or hiking uphill
- Fast swimming
- Fast dancing (Zumba or Bollywood)
- Heavy gardening (digging, planting)
- Heavy housework (washing floor, cleaning bathrooms)
- Jumping rope
- Martial arts (Karate, Tae Kwan Do)
- Sports: Basketball, tennis (singles), football
How much exercise do I need?
Aerobic exercise | Moderate aerobic exercise for 150 minutes / week (or)
Vigorous exercise for
75 minutes / week* | You may start with
10-minutes / day, then slowly increase the time you exercise
You can combine moderate and vigorous exercise. |
Muscle strengthening and flexibility exercise | At least 2 days a week for
15 minutes each time.** | Include all major muscles of your body: neck, shoulders, arms, chest, abdomen, back, hips, knees, thighs and legs. |
If you have heart disease, breathing problems, restriction or severe pain with movement, you should see a doctor before starting to exercise.
While exercising, if you develop chest pain, severe shortness of breath, dizziness or severe pain, STOP EXERCISE immediately and see a doctor immediately.
*American Heart Association, ** American College of Exercise
Walk and use the stairs as much as you can.
If you do not have time to exercise at one go, split it into bouts throughout the day.
Always warm-up and cool down before and after aerobic exercise
What is stress?
Stress is the body’s response to changes in the environment. Stress can be positive, keeping us alert, motivated and ready to respond to danger. Stress becomes negative when a person faces continuous challenges without relief, or when a person is extremely sensitive to stress.
What are the effects of stress?
How to manage stress
Although not all stressful circumstances can be changed, you can learn to manage your stress
and lead a healthier and happier life. Some tips are:
- Always think positively
- Accept that there are things that you cannot change.
- Communicate your feelings clearly, without becoming angry, defensive or upset.
- Eat a proper diet.
- Exercise regularly.
- Make sure that you get a good night's sleep.
- Time management: learn to manage your work more efficiently.
- Make time for hobbies and interests that you enjoy.
- Don't rely on alcohol, drugs or compulsive behaviors to reduce stress.
- Have a strong network of family members and friends. Spend time with them, take their help and be ready to help when needed.
- Practice relaxation techniques like yoga and meditation.
- If you continue to feel poorly, seek treatment with a psychiatrist or a psychologist trained in stress management.
What is sleep?
Although we spend nearly 1/3rd of our day sleeping, a proper definition for sleep is not available. Kryger, Roth and Dement textbook describes it as “a state of behavioral quiescence, where you are unaware and unresponsive to the environment.”
