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.
Breeze through menopause while dancing -dr.maninder ahuja VICE PRESIDENT FOGSI
BREEZE THROUGHMENOPAUSE 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
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
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
Comparison of world wide postmenopausal women over the years 1990 2030World wise population 470nmillion 1.2 billionDeveloping countries 40% 24%Developed countries 60% 76% DR.MANINDER AHUJA 01/28/13 4
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
FIT AT FORTY , STRONG AT SIXTYAND INDEPENDENT AT EIGHTY !!Dr.Maninder ahuja 01/28/13 6
WHAT IS MID LIFE CRISIS INTERFERING WITH QOL• Weight gain • Metabolic syndromesVasomotor symptoms• Mood changes • Increased risk of CHD• Hot flushes • Hypertension• Depression • Diabetes.• Sleep disturbances MusculoskeletalUrogenital symptoms • Sarcopenia• Dryness of vagina• Dysuria • Osteoporosis• Frequency of urine, • Late sequelae• Incontinence • Alzheimer• sexual problems Dr.Maninder ahuja 01/28/13 7
Which one is Quality life?Dr.Maninder ahuja 01/28/13 8
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
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
A SMALL A small truth to make life 100% TRUTH TOWhat isand enjoyable! 100% making life MAKE LIFE 100% Dr.Maninder ahuja 01/28/13 11
Hard Work H+A+R+D+W+O+R+K8+1+18+4+23+15+18+11 = 98% Knowledge K+N+O+W+L+E+D+G+E11+14+15+23+12+5+4+7+5 = 96% Dr.Maninder ahuja 01/28/13 13
Love L+O+V+E 12+15+22+5 = 54% Luck L+U+C+K 12+21+3+11 = 47%( dont most of us think this is the most important ??? ) Dr.Maninder ahuja 01/28/13 14
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+P12+5+1+4+5+18+19+9+16 = 89% Dr.Maninder ahuja 01/28/13 15
ATTITUDE A+T+T+I+T+U+D+E1+20+20+9+20+21+4+5 = 100% It is OUR ATTITUDE towardsLife and Work that makes OUR Life 100% ! ! ! Dr.Maninder ahuja 01/28/13 16
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
Change Your Attitude …And You Change Your Life ! ! ! Dr.Maninder ahuja 01/28/13 18
"Happiness keeps you Sweet,Trials keep you Strong,Sorrow keeps you Human,Failure keeps you humble and Successkeeps you glowing, but onlyFaith & Attitude Keep you going... Dr.Maninder ahuja 01/28/13 19
Living a life that matters doesnt happen byaccident. Its not a matter of circumstance but of choice. Choose to live a life that matters!!!
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
Don,t limit Laughing to morning only!Dr.Maninder ahuja 01/28/13 30
Keep only cheerful friends. The grouches pull you down.
Never let the brain idle.• " An idle mind is the devils workshop". And the devils name Alzheimers.
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.
• Be ALIVE while you are alive.• Surround yourself with what you love ,• whether its family, pets, keepsakes, music, plants, hobbies, whatever.• Your home is you refuge.
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.
Dont 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.
Major domains of QOL• Being• Belonging• Becoming Dr.Maninder ahuja 01/28/13 37
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 persons 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
WHEN TO START LIFE STYLE MODIFICATIONS? AT THIRTY FIVE PLUS OR MID THIRTIESdr.maninder ahuja 01/28/13 39
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 onwardsvitamin D receptor, estrogen receptor, transforming growth factor, interleukin-6,interleukin-1 receptor 2, type I collagen genes, and collagenases are for genetic causes
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 dr.maninder ahuja 01/28/13 42
Components of fitnessExercise is designed to improve the five key components of physical fitness:• Body composition• Cardio-respiratory endurance,• Muscle strength• Muscle endurance,• Flexibility• . Dr.Maninder ahuja 01/28/13 45
Other advantages• Mood elevation• Sexuality• Decreased incidence of estrogen dependent cancers• Osteo arthritis• Balance• Fall prevention
Weight loss• Is it a losing battle?Dr.Maninder ahuja 01/28/13 47
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
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.”
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,”
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
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
Weight control in elderly• Caloric restriction,• Exercise.• Strength &Resistance training Dr.Maninder ahuja 01/28/13 54
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 KgsDr.Maninder ahuja 01/28/13 55
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.
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.
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
Types of exercises• Aerobic like walking, swimming,cycling,dancing,taichi,yoga• Stretching exercises like Pilatees,yoga• Weight training & resistive exercises• Mindful exercises like meditation Dr.Maninder ahuja 01/28/13 60
Benefits of resistance exercise builds lean mass which will speed metabolism helps prevent osteoporosis
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! Dr.Maninder ahuja 01/28/13 64
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
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. dr.maninder ahuja 01/28/13 69
You need stamina for walking!Dr.Maninder ahuja 01/28/13 70
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 dr.maninder ahuja 01/28/13 71
It is never too late!Dr.Maninder ahuja 01/28/13 82
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
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/Dr.Maninder ahuja 01/28/13 84