this presentation is for all those who believer in quality of life issues for mid life women and men and believe in preventive strategies, can be used for public awareness or for health care providers.

1. BREEZE THROUGH
MENOPAUSE WHILE DANCING!
Dr.Maninder Ahuja
Chairperson Mid Life Management committee of
FOGSI
President FOGS(Faridabad Obst&gyane society)
Founder Secretary IMS Faridabad chapter(Past)
chairperson Public awareness committee of IMS
Secretary General IMS
Ahuja Hospital &Infertility Centre 526 sector 17
Faridabad

2. WOMAN IS THE PIVOT OF
UNIVERSE!
• Woman is the axle
around whom the
family, society nay!
The whole universe
is revolving .So her
health is of utmost
importance at all
stages of life more
so in Menopause.
Dr.Maninder ahuja 01/28/13 2

3. Why important?
• Life expectancy is increasing!!!
• Remember - in 1900 people were
considered old in their 40s; just 40
years ago people seemed old in their
60s; but today many do not feel old in
their 80’s – a phenomenon and we say
never feel old and remain walking till
the final recall!
• From 30 yrs to 76 years
Dr.Maninder ahuja 01/28/13 3

4. Comparison of world wide
postmenopausal women over the years
1990 2030
World wise population 470nmillion 1.2 billion
Developing countries 40% 24%
Developed countries 60% 76%
DR.MANINDER AHUJA 01/28/13 4

5. QUALITY OF LIFE IS IMPORTANT
• In these Golden Years
she wants to have her
own identity!
AAJ PHIR JEENE KI TAMMANNA
HAI ,
AAJ KUCH KARNE KA IRADA
HAI!!!!!!!
Dr.Maninder ahuja 01/28/13 5

6. FIT AT FORTY ,
STRONG AT SIXTY
AND INDEPENDENT AT
EIGHTY !!
Dr.Maninder ahuja 01/28/13 6

7. WHAT IS MID LIFE CRISIS
INTERFERING WITH QOL
• Weight gain
• Metabolic syndromes
Vasomotor symptoms
• Mood changes
• Increased risk of CHD
• Hot flushes • Hypertension
• Depression • Diabetes.
• Sleep disturbances Musculoskeletal
Urogenital symptoms
• Sarcopenia
• Dryness of vagina
• Dysuria
• Osteoporosis
• Frequency of urine, • Late sequelae
• Incontinence • Alzheimer
• sexual problems
Dr.Maninder ahuja 01/28/13 7

8. Which one is Quality life?
Dr.Maninder ahuja 01/28/13 8

9. Bhagwati oza 72 !this is QOL
 Age and sex are no
deterrent’
 At 70, she cycles 30km
for a swim.
Amountaineer who
trained under Tenzing
Norgay, a qualified
pilot and a doctor,
Bhagwati Oza, who is
set to represent India
in an international
swimming meet, says
she lives to make her
life ‘worthwhile’
dr.maninder ahuja 01/28/13 9

10. My role is motivation!!
• Initially only tools man had
was his own hands
• In this mechanised world
the only muscles we are
using are our fingers for
various controls.
• The only weight we are
carrying is our own body
weight.
• In all, a sedentary lifestyle
accounts for some 250,000
premature deaths annually
Dr.Maninder ahuja 01/28/13 10

11. A SMALL
A small truth to make life
100%
TRUTH TO
What isand enjoyable! 100%
making life
MAKE LIFE 100%
Dr.Maninder ahuja 01/28/13 11

12. Dr.Maninder ahuja 01/28/13 12

13. Hard Work
H+A+R+D+W+O+R+K
8+1+18+4+23+15+18+11 = 98%
Knowledge
K+N+O+W+L+E+D+G+E
11+14+15+23+12+5+4+7+5 = 96%
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14. Love
L+O+V+E
12+15+22+5 = 54%
Luck
L+U+C+K
12+21+3+11 = 47%
( don't most of us think this is the most important ??? )
Dr.Maninder ahuja 01/28/13 14

15. Then what makes 100% ?
Is it Money ? ... NO ! ! !
M+O+N+E+Y
13+15+14+5+25 = 72%
Leadership ? ... NO ! ! !
L+E+A+D+E+R+S+H+I+P
12+5+1+4+5+18+19+9+16 = 89%
Dr.Maninder ahuja 01/28/13 15

16. ATTITUDE
A+T+T+I+T+U+D+E
1+20+20+9+20+21+4+5 = 100%
It is OUR ATTITUDE towards
Life and Work that makes OUR
Life 100% ! ! !
Dr.Maninder ahuja 01/28/13 16

17. Every problem has a solution,
only if we perhaps change our
attitude.
We can’t help you if you don’t
have positive attitude !
what we really need to go
further... a bit more...
Dr.Maninder ahuja 01/28/13 17

18. Change Your Attitude …
And You Change Your Life ! ! !
Dr.Maninder ahuja 01/28/13 18

19. "Happiness keeps you Sweet,
Trials keep you Strong,
Sorrow keeps you Human,
Failure keeps you humble and Success
keeps you glowing, but only
Faith & Attitude Keep you going...
Dr.Maninder ahuja 01/28/13 19

20. Live A Life That Matters

21. Living a life that matters doesn't happen by
accident. It's not a matter of circumstance but
of choice.
Choose to live a life that matters!!!

22. MENOPAUSE AND DETRIMANTS
OF QUALITY OF LIFE
• The researchers conclude that
strategies that may help to improve the
quality of life of postmenopausal
women:
• Positive attitudes toward aging.
• Encourage a healthy lifestyle

23. Don,t limit Laughing to
morning only!
Dr.Maninder ahuja 01/28/13 30

24. Keep only cheerful
friends.
The
grouches
pull you
down.

25. Never let the brain idle.
• "
An idle mind is the
devil's workshop".
And the devil's
name Alzheimer's.

26. Enjoy the simple things.
• Laugh often, long and loud. Laugh
until you gasp for breath.
• The tears happen.
• Endure, grieve, and move on. The only
person, who is with us our entire life, is
ourselves.

27. • Be ALIVE while you are alive.
• Surround yourself with what you love ,
• whether it's family, pets, keepsakes,
music, plants, hobbies, whatever.
• Your home is you refuge.

28. Cherish your health:
• If it is good, preserve it.
• If it is unstable, improve it.
• If it is beyond what you can improve,
get help.

29. Don't take guilt trips.
• Take a trip to the mall, even to the
next county; to a foreign country
but NOT to where the guilt is.

30. Major domains of QOL
• Being
• Belonging
• Becoming
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31. Being – this would help you to breeze
through menopause ( Health PLUS
Forum)
Physical Being includes aspects of
 Physical health, personal hygiene,
 Nutrition,
 Exercise,
 Grooming, clothing, and physical appearance.
Psychological Being includes the person's
psychological health and evaluations concerning
the self, and self-control.
Spiritual Being reflects personal values, personal
standards of conduct, and spiritual. beliefs which
may or may not be associated with organized
religions
Dr.Maninder ahuja 01/28/13 38

32. WHEN TO START LIFE STYLE
MODIFICATIONS?
AT THIRTY FIVE PLUS OR MID
THIRTIES
dr.maninder ahuja 01/28/13 39

33. Bone mass with age

34. What happens in mid thirties !
35 yrs onwards you lose
bone mass at 0.5 to 1%
per yr(initial quality Imp)
Around menopause loss
is upto 4-5 % per year
You also lose muscle
mass from 35 years
onwards
vitamin D receptor, estrogen receptor, transforming growth factor, interleukin-6,
interleukin-1 receptor 2, type I collagen genes, and collagenases are for genetic causes

35. WHAT ARE LIFE STYLE
MODIFICATIONS?
• ATTITUDE CHANGE
• DIET
• EXERCISE
• CALCIUM
• VIT D OR SUN EXPOSURE
• Alcohol NOT MORE THAN30 ml/day
• No smoking neither active nor passive
• Meditation
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36. Components of fitness
Exercise is designed to improve the five
key components of physical fitness:
• Body composition
• Cardio-respiratory endurance,
• Muscle strength
• Muscle endurance,
• Flexibility
• .
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37. Other advantages
• Mood elevation
• Sexuality
• Decreased incidence of estrogen
dependent cancers
• Osteo arthritis
• Balance
• Fall prevention

38. Weight loss
• Is it a losing
battle?
Dr.Maninder ahuja 01/28/13 47

39. MOTIVATION!
Dr.Maninder ahuja 01/28/13 48

40. WEIGHT LOSS BY CALORIE
RESTRICTION IS BIG NO!
• AS YOU LOSE
MUSCLE ALONG
WITH FAT
• MUSCLES ARE NO!!!!!!!!!!!
RESPONSIBLE FOR
20% OF YOU
RESTING ENERGY
EXPENDITURE
Dr.Maninder ahuja 01/28/13 49

41. Cause for weight gain
• Your metabolism slows by 5 percent
each decade.
• Compared to age 25, you’ll burn about
100 fewer calories a day at 35 and 200
fewer at 45.
• Do nothing, and you could gain eight
to 12 pounds a year.”

42. Fat burns less cakories
• The metabolic difference between a
pound of muscle and a pound of fat is
dramatic: Muscle burns at least three
times more calories. “A woman who
weighs 130 pounds and has a healthy
25 percent body fat will burn about 200
more calories per day than a 130-
pound woman with about 40 percent
body fat — a typical level for women at
midlife,”

43. Important tricks
• women who skipped breakfast were 30
percent more likely to be overweight.
• When things get extra-hectic, your
levels of cortisol, a stress hormone,
shoot up.
• Sleep deprivation increases the
appetite-stimulating hormone, ghrelin,
and decreases the satisfaction
hormone, leptin,so meditation or walk

44. SARCOPENIA(MUSCLE
WEAKNESS)
By the age of 70, you only have about 50% to 55% of your muscle mass left
Dr.Maninder ahuja 01/28/13 53

45. Weight control in elderly
• Caloric restriction,
• Exercise.
• Strength &Resistance training
Dr.Maninder ahuja 01/28/13 54

46. Ideal weight and WHR
• BMI of 18-23normal.
(20-25 )
• BMI of 23-28 is
overweight(25-30)
• BMI of over 28 is
obesity(>30)
• BMI of over 35 is
morbid obesity
• BMI is Wt.in Kg /ht in
sqM
• Ideal WHR 0.8
• Ht in cms-100 is wt in Kgs
Dr.Maninder ahuja 01/28/13 55

47. New factor neck thickness
• 1. Average neck • 4. For every nearly-3 cm
circumferences were more of neck, men had 3.0
40.5cm in men and 34.2 cm mg/dl more blood glucose
in women. levels.
• 2. For every nearly-3 cm • 5. For every nearly-3 cm
more of neck, men had 2.2 more of neck, women had
mg/dl less good HDL 2.1 mg/dl more blood
cholesterol. glucose levels.
• 3. For every nearly-3 cm
more of neck, women had
2.7 mg/dl less good HDL
cholesterol.

48. implications
• 3. In patients with a BMI ≥ 35
• 1. 1% reduction in HDL kg/m2, measurement of waist
cholesterol increases the circumference is less helpful
chances of heart attack by since it adds little to the
predictive power of the disease
3% and vice versa.
risk classification of BMI;
• 2. In adults with a BMI of almost all individuals with this
22.9 to 34.9 kg/m2, a waist BMI also have an abnormal
circumference greater than waist circumference.
85 cm for men and 80 cm for • 4. A neck circumference of >
women is associated with a 42.5 cm is also associated with
greater risk of snoring with sleep apnea and
hypertension, type 2 subsequent high blood
diabetes, and dyslipidemia, pressure.
and heart disease.

49. Calculate calories
banking of calories!
For maintanance For losing weight
• Multiply your current weight • To lose one pound a
by an activity factor week, subtract 500
between 10-20. Use a
higher number (15 - 20) if
from your maintenance
you are younger, caloric level
moderately overweight or of • To lose two pounds a
ideal weight and moderate week, subtract 1000
to very active. The less
active and more overweight calories from the
you are, the lower the maintenance level
number should be, (10-14).
dr.maninder ahuja 01/28/13 59

50. Types of exercises
• Aerobic like walking,
swimming,cycling,dancing,taichi,yoga
• Stretching exercises like Pilatees,yoga
• Weight training & resistive exercises
• Mindful exercises like meditation
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51. Benefits of resistance exercise
builds lean mass which will speed
metabolism
helps prevent osteoporosis

52. Resistance exercises are
must!
• Resistance exercises causes
increase in muscle mass,
• decrease in fat
• increase in BMR
• . Evidence now indicates
that one is never too old to
benefit from exercise; this is
true even for frail
institutionalized women as
old as 100 years
• our women were doing
them!
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53. This is the way you would be
losing height!

54. Exercise and sexuality
• For proper sexual function you need
exercise, cardiorespiratory, strength
building ,endurance and flexibility of
yoga.
• Sex is also an exericse burning about
88 cal. / hr.
• Relaxation of mind is there and quality
of life and good interpersonal
relationships

55. Strength training in osteoarthritis
• After 12 Week Strength Training
• Balance improved by 55 %
• Muscle strength increased by 14
%
• Flexibility improved by 17%
• Self-reported pain decreased by
30%
• Tibial cartilage volume
increased.
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56. You need stamina for
walking!
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57. INTENSITY OF EXERCISE
• Moderate to severe in intensity
• How to know about intensity
• MHR : 60-80 % of MHR and MHR is 220
_ age in yrs. At 50 yrs 220-50 = 170 and
60 % is 102-136
• Borg test of SPE
• Talk test
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58. PILATES
• Low impact non aerobic
stretching and strengthing
exercises
• reducing muscle tension
• reducing joint pain
• improving posture
• improving back strength
• improving coordination
• promoting relaxation
improving overall muscle
tone
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59. Exercises
Resistance and weight
bearing
Stretching exercises

60. Leg press for leg muscles
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61. This is one way of doing lunges !!!!
Breeze through life while dancing !!!

62. Every body loves dancing!

63. Sexuality is a major contributor for
QOL
• Kegel’s exercises can’t be ignored !

64. Sharmila Tagore
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65. It is never too late!
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66. Don,t be left behind!
नींद भी खली न थी िकि हाय धूप ढल गई,
ु
पाँव जब तलकि उठे िकि िज़िन्दगी िफिसलगई,
और हम झुकिे झुकिे,
मोड़ पर रुकिे रुकिे
उम्र किे चढ़ाव किा उतार देखते रहे।
किारवाँ गुज़िर गया, गुबार देखते रहे।
Dr.Maninder ahuja 01/28/13 83

67. If you want to be free and flying!
Make the journey of life beautiful!
Come and exercise ,change attitude ,eat properly!!!!
You don’t have to lose anything except your fat!
http://indianwoman35plus.com/
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