SUNDAY MAGAZINE

Follow the golden mean

FITNESS MATTERS

ARUNA CHANDARAJU

Be active: Physical activity boosts good health.

Be active: Physical activity boosts good health.  

IT takes 20,00,000 lives every year, worldwide, and most of us don't even know it is a killer. Probably because one doesn't have to catch a deadly virus or terrible infection or come under a vehicle to die this way. In fact, you don't have to do anything for this.

You become a victim by doing nothing. Quite literally. Sounds absurd? Then check this. Physical Inactivity contributes annually to two million deaths globally, according to the World Health Organisation. Again, in combination with improper diet, and tobacco use, the lack of physical activity (PA) is estimated to cause up to 80 per cent of premature coronary heart disease (CHD) and up to 90 per cent of Type 2 diabetes. An alarm bell is ringing loudest for India considering we are in the grip of both these epidemics.

Dr. B. Somaraju, Hyderabad-based cardiologist, says many factors are responsible, but lack of PA is a major culprit. Not only is it a risk factor by itself but it also increases other risk factors like obesity and diabetes. Adds Dr. V. Mohan, Chairman, Madras Diabetes Research Foundation, Chennai: "Besides increased consumption of calories, sugar and fat-rich foods, the major causative factor is decreased PA. Our Chennai Urban Rural Epidemiological Study showed that the risk of diabetes was half in those who exercise regularly. It also revealed that less than five per cent of urban population in India today exercise regularly."

Contributing to this state of affairs are increased mechanisation and computerisation; use of elevators, automobiles/public transport instead of walking; and sedentary-lifestyle-promoting household gadgets including remote controls. Desk jockeys, couch potatoes, computer addicts, machine-dependants — whatever labels a sedentary lifestyle merits, it has serious implications.

There is overwhelming evidence that lack of PA and an unhealthy diet are among the major causative risk factors for not only CHD and diabetes but also for hypertension, cerebrovascular strokes, osteoporosis, obesity and many other chronic diseases and conditions. Under stress, levels of cortisol and adrenaline increase in the blood, both responsible for general tear and wear of the body, leading to psychosomatic disorders like obesity, back pain, certain cancers, joint pains, peptic ulcers and certain types of headaches. Since PA reduces adrenaline and cortisol levels, the implications of physical inactivity are obvious.

Now for the good news. There is a way out. And that is to "Just Move It". Regular PA substantially reduces risk of dying of CHD, while reducing the risk for stroke, cancers, diabetes, and high BP. It also helps control weight avoiding dangerous obesity; contributes to healthy bones, joints and muscles; helps relieve arthritic pain; reduces falls among older adults. Dr. Purivsh M. Parikh, Prof. and Head of Medical Oncology, Tata Memorial Hospital, Mumbai reveals: "PA boosts the immune system and indirectly helps prevent cancer. Good PA is important for all cancers in general and lack of it leads to breast cancer." PA works by increasing oxygenated (oxygen-rich) blood to organs making them healthy since we inhale more than usual during physical activities.

So, just get up and go. If you want another reason, PA even improves mental and emotional health. Dr. C.R. Chandrashekar, Professor of Psychiatry, NIMHANS, Bangalore, reveals: "During PA, there is an increase of dopamine and serotonin levels in the brain. Both are associated with feelings of well being and reduction of negative emotions like anxiety, anger and sadness. In fact, after drugs, PA is a major prescription in all patients with psychosomatic disorders including depression which is the most common psychological disorder, and for anxiety disorders too."

PA also increases patients' self-esteem by increasing perceived energy levels, and positive affect. Dr. Somaraju says PA is of fundamental importance in heart disease because it is not only highly effective in itself but also reduces other risk factors like diabetes, obesity, cholesterol, and frustration and depression.

The best news: PA need not be strenuous or prolonged for it to be effective. Walking is the easiest and most cost-effective exercise and useful for all age groups. Or, play a casual game of tennis and badminton a few times a week. Dr. Chandrashekar prescribes 30 to 60 minutes of regular exercise — walking, outdoor sports, or yoga.

Dr. Mohan says: "Regular stints of moderate exercise will do. A half-hour brisk walk every day suffices to prevent diabetes, especially when combined with some stretching exercises, yoga or meditation." Dr. Parikh's recommendation: "Ideally exercise for about 30 minutes per session with four such sessions a week. The idea is to ensure breathing is streamlined and pulse rate increases (to level based on age, height and weight)."

Also, include exercise in your daily life. Walk at least part of the journey to work, climb stairs whenever possible spurning the lift, do physically demanding household chores, walk down to that nearby store or friend's home or colleague's cabin says Dr. Somaraju instead of taking your car or using the phone. Spurn the remote, get on the stationary cycle/treadmill when watching TV, play with the kids...

However, those who want to enrol at gyms or do structured exercise must consult their doctor. And people with ailments must do so before even simple PA. Dr. Parikh says though PA helps prevent cancer, it is not recommended once the disease is diagnosed because it diverts energy from fighting cancer. "However, once the treatment is over, going back to reasonable exercise will help prevent recurrence of the cancer by promoting general health."

Regularity is a key word. All specialists say to be effective; PA should not be an occasional indulgence, induced by sudden bouts of guilt or health-consciousness. You have got to keep at it every day. Or at least five days a week. Dr. Somaraju says these 40-45 minutes can be broken down into two or three sessions of 20 or 15 minutes each.

The other operative word is Balance. Unaware of this, many people overdo or under do PA and then drop out, disappointed by the lack of results, lament doctors. So, what is that golden balance? Dr. Chandashekar offers a useful guide: "Record your resting pulse rate — it will be about 60 to 70. The right amount and quality of exercise will increase it by 20. A mild sweat on the forehead and armpits is another indicator. Conversely, anything that increases pulse rate by 30 or 40 means you are overdoing it. It will actually be counterproductive leading to what are the other indicators — exhaustion, muscle cramps and loss of salt from the body through excess sweating."

Ignorant of this, people take to PA but do slow walking, and then give up saying it didn't produce any results. Or plunge into very vigorous exercise, straining the body, and similarly drop out complaining it was too much of a strain and not worth it. Those who follow the golden mean, benefit and greatly so. In short: Just Move It. Your body and mind will Just Love It.