Additional Material on Lifestyle Diseases

7/31/2019 Additional Material on Lifestyle Diseases

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ADDITIONAL MATERIAL ON

LIFESTYLE DISEASES


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OBESITY"Living life to the fullest without enjoying it

is like a man who eats anything and issuffering from obesity."


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Introduction

Increased consumption of more energy-

dense, nutrient-poor, low fibre diet with

high levels of sugar and saturated fats,combined with reduced physical activity,

have led to obesity rates that have risen

more than three-fold since 1980 in manycountries.


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Introduction

The health consequences range fromincreased risk of

premature death,

to serious chronicconditions that reduce

the overall quality of

life. Of special concernis the increasing incidence of child obesity.


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Introduction

This epidemic is not restricted toindustrialized societies; rather is oftenfaster in developing countries than in the

developed world. Coexisting with under-nutrition, obesity is

a complex condition, with serious social

and psychological dimensions, affectingvirtually all ages and socio-economicgroups.


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Economic growth, modernization,

urbanization and

globalization of food

markets are just some

of the forces thought

to underlie the

epidemic.


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Disease Burden

Obesity has reached epidemic

proportions globally

> than 1 billion adults overweight

- at least 300 million - clinically obese

Is a major contributor to the global

burden of chronic disease and disability.


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The importance of central obesity is clear in

populations (e.g. Asian) who tend to have

relatively low BMIs but high levels of

abdominal fat, and are particularly prone to

NIDDM, hypertension and coronary heart

disease (CHD).

An Indian Study recently revealed that almost

20% of adults who were not overweight or

obese still had central obesity, putting them at agreater risk of developing these associated

diseases (Gopalan 1998)


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Classification of obesity as per fat

distribution

Android (or abdominal or central, males)-Collection of fat mostly in the abdomen(above the waist)

-apple-shaped

-Associated with insulin resistance DM and

heart disease

Gynoid (below the waist, females)- Collection of fat on hips and buttocks

-pear-shaped

-Associated with mechanical problems


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Obesity = WHR > 1(Men) & >0.85 (Women)

Indicates abdominal fat accumulation

WAIST HIP RATIO


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ADVERSE HEALTH

CONSEQUENCES- Type II DM

- Hypertension

- Dyslipidemia

- cardiovascular disease.

referred as syndrome X, Insulin resistancesyndrome or the metabolic syndrome


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SURGICAL PROBLEMS

cholelithiasis

varicose veins

osteoarthritis lowbackache

abdominal herniae


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MINOR PROBLEMS

non healing ulcers

flat feet

plantar fasciitis


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Prevention


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WHY?


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BENEFITS OF 10% REDN IN WT

DIABETES

REDUCES RISK BY 50%

FALL OF 30-50% IN FASTING GLUCOSE

FALL OF 15% IN GLYCOCYLATED HB.RHEOLOGY

DECREASES BLOOD VISCOSITY BY 20%

DECREASES RBC AGGREGATION BY 20%


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Mortality

20-25% fall in total mortality

30-40% fall in diabetes related deaths40-50% fall in obesity related Ca deaths

Angina

Reduced symptoms by 90%33% increase in exercise tolerance


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BLOOD PRESSURE

FALL OF 10 MM HG SYSTOLIC PRESSURE

FALL OF 20 MM HG DIASTOLIC PRESSURE

LIPIDS

FALL BY 10% IN TOTAL CHOLESTEROL

FALL BY 15% IN LDL CHOLESTEROL

FALL BY 30% IN TRIGLYCERIDES

INCREASE BY 8% IN HDL CHOLESTEROL


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WHEN TO START ?

CHOOSE YOUR PARENTS!!!

ANTENATAL CAREWT GAIN

GESTATIONAL DM


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GUIDANCE

AVOID SWEETENED BEVERAGE

INTRO MILKINTAKE OF DAIRY PRODUCTS IS

ASSOC WITH REDUCED RISK OF WT GAIN

LOW FAT MILK ( 2%) UPTO 2 Y

LOW FAT MILK ( 1%) >2 Y

AVOID JUICES

NOT INTRODUCE IN DIET < 6M

4-6 OZ PERMITTED UPTO 1-6 Y

12 OZ PERMITTED > 6 Y


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GUIDANCE

ENCOURAGE OUTDOOR ACTIVITY

30 MIN OF STRUCTURED PHY ACTIVITY

FOR TODDLER AND SEVERAL HOURS OF

SPONTANEOUS ACTIVITY LAYDOWN TIME LT FOR MEDIA

ENCOURAGEBOOKS, GAMES,

COLOURBOOK, DIALOGUE ETC


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DIET

ELEMINATE FAT

FAT UP TO 30% OF TOTAL ENERGY

SATURATED FAT 10%

PUFA 10 %

AVOID DESSERTS, PASTRY ETC

SUBSTITUTE

AVOID FRYING, GRILLING, FAT SPRAY

DIETARY FIBER 25-30 GM /DAY


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DIET

REFINED SUGAR TO 10% OF TOTAL ENERGY

FOODS RICH IN STARCH

SALT 5-6 GMS/DAY

ALCOHOL IN MODERATE QTY


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STIMULUSCONTROL

DELAY EATING FOR 2-3 MIN

SLOW PACE OF EATING

YOU EAT MORE IF YOU HAVE MORE CHOICES

PUTTING DOWN CUTLERY BETWEEN BITES CHEW

STOCK VEG/ FRUITS

ADVERTISEMENTS


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STIMULUSCONTROL

EAT SITTING DOWN ONLY AT DESIGNATEDPLACE

LEAVE TABLE AS SOON AS EATING IS OVER

DONOT COMBINE EATING WITH READING/ TV

DONOT PUT BOWL OF SNACKS ON TABLEWHILE WATCHING TV


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STIMULUSCONTROL

IN RESTRAUNTS LAY A LIMIT TO ONE ROLL OF

BREAD

PLAN FOR PARTIES

PLAN MEALS AND SNACKS

DELAYS SNACKS FOR 10 MIN

USE SMALLER PLATE DIVIDE INTO PORTIONS


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STIMULUSCONTROL

SHOP WITH FULL STOMACH

LAYDOWN SHOPPING LIMITS

STORE OUT OF SIGHT STOCK VEG AND FRUITS


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POSITIVESELFTALK

MAINTAIN DIET RECORD

CELEBRATE ACHIEVEMENT

PLAN REWARD


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BEHAVIOURMODIFICATION

ACQUIRE KNOWLEDGE

INFLUENCE FAMILY

ASK OHTERS TO MONITOR

SUBSTITUTE SNACKING WITH OTHERACTIVITY

EXECESSIVE PORTION SIZE ACCEPTED AS

NORM AVOID ENERGY DENSE DIET


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BEHAVIOURMODIFICATION

ACQUIRE SOCIAL SKILLS

LAY DOWN LIMITS

SAY NO


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THE PLATE MODEL

Rice

BreadPulses

Vegetables

Fruits

Meat

Eggs

Fish


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TOBACCO AND CANCER

20 % OF ALL CANCERS 80 % OF LUNG CANCERS

REDUCES 8 YEARS OF LIFEEXPECTANCY

50 % OF THOSE WHOSTARTED SMOKING INTEENAGE ARE LIKELY TO DIEOF CANCER

SITES AFFECTED ARE

LUNGS, ORAL,NASOPHARYNX, LARYNX,OESOPHAGUS, STOMACH,BLADDER, PANCREAS, KIDNEY


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ALCOHOL

RESPONSIBLE FOR 3% OF ALL CANCER DEATH

ASSOCIATED WITH RISK OF OESOPHAGEAL, LIVER,

RECTAL CANCERS

BEER RELATED TO CANCER OF LARGE INTESTINE

SYNERGISTIC AFFECT ON TOBACCO


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CAUTION

SEVEN SIGN TO WARN YOU OF POSSIBILITY OFCANCER

CHANGE IN BOWEL/ BLADDER PATTERN

A SORE THAT DOESNOT HEAL UNUSUAL BLEEDING DISCHARGE

THINKENING OR LUMP IN BREAST

INDIGESTION/ DIFFICULTY IN SWALLOWING

OBVIOUS CHANGE IN SIZE OF A MOLE

NAGGING COUGH OR HOARSENESS


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EXERCISE PREVENTS CANCERS

60 -120 MIN OF EXERCISE PER

WEEK CAUSES 15 % REDUCTION

IN INCIDENCE OF BREAST AND

COLON CANCER


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PLANT BASED DIET HELPS FIGHT CANCER

FEWER CALORIES

MORE FIBRES

LESS FAT

MORE VITAMINS, MINERALS, PHYTOCHEMICALSAND ANTIOXIDANTS


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CANCER OF WOMEN


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OVARY

ENDOMETRIUM

CERVIX

VULVA

VAGINA

FALLOPIANTUBES


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PLANT BASED DIET GOALS

5 - 9 SERVINGS OF FRUIT VEGETABLES

3 - 7 WHOLE GRAINS


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BREAST

1: 8 WOMEN GET

BREAT CA

< 39 Y 1:230

40-59Y 1:25 >60 Y 1:15

Breast Cancer Risk Factors


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Breast Cancer Risk Factors

that cannot be changed

Parity

FamilyHistory

Age

Reproductive

History

Menstrual

History

Genetic

FactorsRadiation

GENDER


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BreastCancer

Risk

Factorsthat can

bechanged

HIGH FAT DIETLACK

OF PHYSICAL

ACTIVITY

WEIGHT

HORMONE

REPLACEMENT

THERAPY

LATE CHILD

BEARING

PROLONGED

OCP USE

SMOKING

NOT BREAST

FEEDING


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PREVENTION

20% LOWER RISK BY EATING 5 OR MORESERVINGS VEGETABLES AND FRUITS PER DAY

30% LOWER RISK IF YOU DONT SMOKE

30-40% LOWER RISKIF YOU EAT A PLANTBASED DIET, MAINTAIN A HEALTHY WEIGHTAND EXERCISE REGULARLY


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CANCER RISK CAN BE REDUCED 60-

70% BY

SENSIBLE FOOD CHOICES

A HEALTHY WEIGHT

PHYSICAL ACTIVITY

NOT SMOKING

h i h i l i i


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What is Physical Activity

Physical activity

Bodily movement produced by skeletal muscles thatresults in an expenditure of energy

Physical fitnessA measure of a person's ability to perform physical

activities that require endurance, strength, or flexibility.

Regular physical activityA pattern of physical activity is regular if activities are

performed in some order

CDC,1997


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Physical activity is something you do. Physicalfitness is something you acquire, a

characteristic or an attribute one can achieve

by being physically active. And exercise isstructured and tends to have fitness as its

goal"

Anonymous


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Spectrum of Physical Activity and

Health

Physically Fit

Physically Active

Physically

disabled

LaPorte RE: Am J Epidemiol. 1984 Oct;120(4):507-17


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Common Reasons Not To Exercise

I dont have the time

I dont like to sweat

Ill look silly It hurts

I dont know what to

do Its not important


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Why Exercise ???

Do you know?


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Do you know?

13.5 million people have coronary heart disease.

1.5 million people suffer from a heart attack in agiven year.

250,000 people suffer from hip fractures each year.

Over 60 million people (a third of the population)are overweight.

50 million people have high blood pressure.

(WHO, 2003)

Do you know that


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Do you know that Childhood obesity has reached epidemic proportions in

most part of the world

Children are eating more and exercising less. Time spent watching television or using computers

This lack coupled with poor dietary habits has led tosignificant increases in the number of children with Type

II diabetes and predisposition to hypertension, coronaryartery disease and others

All of these can be Prevented by Regular


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Physical Activity !!!

How Physical Activity Impacts Health


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How Physical Activity Impacts Health Helps control weight. Reduces feelings of depression and anxiety.

Helps build and maintain healthy bones, muscles, andjoints. Reduces the risk of developing colon cancer. Helps reduce blood pressure in people who already

have high blood pressure. Causes the development of new blood vessels in the

heart and other muscles. Enlarges the arteries that supply blood to the heart.

WHO 2002

Health Risk of Physical Inactivity


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Health Risk of Physical InactivityLeading causes of disease and disability associatedwith physical inactivity

1. Coronary Heart Disease (CHD)

2. Stroke

3. Obesity

4. Type II Diabetes

5. Hypertension6. Colorectal cancer

7. Stress and Anxiety

8. Osteo-arthritis

9. Osteoporosis10.Low back pain

What Can Exercise do for You?


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What Can Exercise do for You? Reduce the risk of the three leading causes of death: Heart Disease,

stroke, and cancer

Control or prevent development of Disease

Enhance Mental Abilities

Improve Sleeping Habits and Increase Energy Levels

Lift Depression and Help Manage Stress

Control Weight, improving self-image, appearance and health

Exercise & Cardiovascular Disease


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FACT

Sedentary lifestyle is a risk factor for CVD, accordingto the American Heart Association

Exercise reduces Blood Pressure

High blood pressure (above 140/90) is the maincause of Heart Attack and Stroke

Exercise prevents Atherosclerosis(cloggedarteries)

Exercise reduces cholesterol plaques that clogarteries and can lead to stroke and heart attack

WHO 2002

Exercise and Cancer


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Exercise and Cancer

The Basics

Exercise helps to prevent obesity, a major

risk factor for several types of cancer

Exercise enhances immune function Exercise activates antioxidant enzymes

that protect cells from free radical damage

WHO 2002

Exercise and Diabetes


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Exercise and Diabetes

Increase insulin sensitivity

Control blood glucose

Control Weight/Lower body fat

Reduce risk of cardiovascular disease

WHO 2002

Exercise and Depression


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Exercise and Depression

Exercise can help prevent depression. In fact,

recent studies have shown that exercise wasfound to be just as effective (despite a slowerinitial response) as antidepressant medicationfor treatment of depression.

Exercise reduces health problems , making you feelbetter

Exercise helps you sleep better

Exercise controls weight, enhancing self-esteem

WHO 2002

Exercise and Your Mind


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Short-term benefits: Boost alertness (possibly by triggering the release of

epinephrine and nor epinephrine) Improve memory

Improve intellectual function

Spark creativity

Long-term benefits: Exercise has been shown to slow and even reverse age-

related decline in mental function and loss of short-termmemory

A report of Surgeon general, Physical Activity and health, 1996


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Opportunities for Physical Activity

At work

For transport

In domestic duties

In leisure time

The majority of people do very little or nophysical activity in any of these domains

Aerobic Activity


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Aerobic Activity

Definition

Continuous movement that uses big muscle groups and

is performed at an intensity that causes your heart,

lungs, and vascular system to work harder than at rest

Cardio respiratory Fitness is built through aerobic

exerciseAerobic exercise conditions and strengthens our heart,

respiratory system, muscles, and immune system

CDC physical activity report 1999

Types of Aerobic Exercise


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Types of Aerobic Exercise

Outdoor Activities

Walking Jogging/running

Bicycling

Swimming Basketball

Soccer

Jumping Rope

Indoor Activities

Treadmill machine Stair climbing machine

Stationary bike

Elliptical trainer Rowing machine

Aerobics, boxing...

How Much and How Hard?


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Frequency: 3-5 days per week Aerobic exercise: a minimum if 3 days a week are

necessary to reach most exercise goals and minimizehealth benefits

Strength training: a minimum of 2 days per week

Flexibility training: a minimum of 3-5 days per week

Duration Aerobic: 20-60 minutes of continuous aerobic activity

Strength: 1-3 sets of 8-12 repetitions

Stretching: Stretch all muscle groups and hold

positions for 10-30 seconds


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Exercise for people with special needs

People with disabilities are less likely toengage in regular moderate physical activitythan people without disabilities, yet theyhave similar needs to promote their health

and prevent unnecessary diseaseExercise is for everyone!!!!!!!

Individuals who have physical disabilities orchronic, disabling conditions such as arthritis

can improve muscle stamina and strengthwith regular physical activity

Exercise for people with special needs


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People with disabilities should first consult aphysician before beginning a program ofphysical activity to which they areunaccustomed

Provide community-based programs to meetthe needs of persons with disabilities.

Ensure that environments and facilitiesconducive to being physically active areavailable and accessible to people withdisabilities, such as offering safe, accessible, and

attractive trails for bicycling, walking, andwheelchair activities.

"You don't stop exercising because you grow old.You grow old because you stop exercising." Anonymous

E i f W i d l i t i


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Exercise for Women in developing countries

There has been several studies which have

shown that less emphasis is given to exerciseespecially in women

The reasons are several and most importantone is awareness.

Women sports are not encouraged in mostof developing countries

There is stigma that women should not beinvolved in outdoor sports


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Exercise is for everyone

There is need for awareness for physical fitness in

developing countries

Exercise is not only for men but for everyone

With commitment, opportunities can be developed.

Even shopping malls provide opportunities for

fitness walking

CDC 1997

Health Risks of Physical Activity


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Health Risks of Physical Activity

Most musculo-skeletal injuries sustained during

physical activity are likely to be preventable

Injuries sustained during competitive sports have beenshown to increase the risk of developing osteoarthritis

Serious cardiac events can occur with physical exertion.

The overall benefit of regular physical activity is lowerall-cause mortality

Summary


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Physical inactivity is one of the top 10 leadingcauses of death and disability in the developed

world Exercise improves our body and minds

Even moderate exercise has many health benefits

It is important to set fitness goals that are realistic

and meaningful for you It takes time to make fitness part of a lifestyle, and

we will all have ups and downs in following ourexercise programs

Exercise feels good!

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