life style modifications are the main stay of our holistic approach to health through out our life but many of us are ignorant about this and don't know what is right and wrong .This presentation is a step towards that.
In 2008, more than 1.4 billion adults, 20 and older, were overweight. Of these over 200 million men and nearly 300 million women were obese.
Deepak tale andhera people know me in pakistan, they know me in srilanka, but here in Delhi I was wondering
All calories are not same Extreme restriction of fat or carbs can have bad effects. The best long-term approach will be to avoid restriction of any major nutrient—either fat or carbohydrate—and instead focus on the quality of nutrients. This is not to say that the number of calories isn't important, but it's now saying we should also pay attention to the quality of those calories. So the argument that the food industry likes to make—that all foods can be part of a healthful diet as long as you watch calories—is really misleading at best.
Neither total physical activity nor time spent in moderate- to vigorous-intensity physical activity differed among the diets.)
All healthy adults should also perform muscle-strengthening activities on two or more days a week. Weight training, circuit classes, yoga, and other muscle-strengthening activities offer additional health benefits and may help older adults to maintain physical independence
Even small increases in activity will bring some health benefits in the early stages and it is important to set achievable goals that provide success, build confidence, and increase motivation. For example, a beginner might be asked to walk an extra 10 min every other day for several weeks to slowly reach the recommended levels of activity for all healthy adults. It is also critical that beginners find activities they enjoy and gain support in becoming more active from family and friends.
Adults who find it difficult to maintain a normal weight and adults with increased risk of cardiovascular disease or type 2 diabetes may in particular benefit from going beyond the levels of activity recommended for all healthy adults and gradually progressing towards meeting the recommendations for conditioned individuals. Physical activity is beneficial to health with or without weight loss, but adults who find it difficult to maintain a normal weight should probably be encouraged to reduce energy intake and minimize time spent in sedentary behaviours to prevent further weight gain. Children and young people aged 5-16 years should accumulate at least 60 min of moderate-to-vigorous-intensity aerobic activity per day, including vigorous-intensity aerobic activities that improve bone density and muscle strength.
Our body’s metabolism slows as we age, but moderate to vigorous exercise can counteract this decline by lessening weight gain. According to a study published December 14 in JAMA, people who begin moderate to vigorous physical activity in their 20s and continue through middle age gain less weight.
Weight gain and physical activity in mid life !
AHUJA NURSING HOME & INFERTILITY CENTRE
SECTOR 17 FARIDABAD
Vice President FOGSI(Elect 2013 )
Secretary General IMS
Chairperson Mid Life Management Committee FOGSI
Web site and E-connect Co ordinator SAFOMS
President Faridabad Obst.&Gyne Society
Founder Chapter Secrertary IMS Faridabad Chapter
Secretaty women wing Haryana State IMA (past)
Step by step management of Menopause
Many chapters in many publications and books
Author of 3 DVDs On Exercise.
ON PANEL WITH AIMS , METRO HOSPITALS AND SARVODAYA
How to slow down the hands of
Control weight gain and exercise
Director Ahuja Hospital &Infertility
Centre setor 17 FBD
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.
Health issues 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
QUALITY OF LIFE IS IMPORTANT
• In these Golden Years
she wants to have her own
AAJ PHIR JEENE KI TAMMANNA
AAJ KUCH KARNE KA IRADA
WE ARE CHANGING CONCEPTS
DOCTOR: A person who
kills your ills by pills,
and kills you by his
Change from pill doctors
Change from pill doctors
FIT AT FORTY
STRONG AT SIXTY
AND INDEPENDENT AT
Physical Problems Slowing us
Vaso motor symptoms
Joint aches and pains
• Cardiac problems
• Worldwide obesity has more than doubled since 1980.
• 65% of the world's population live in countries where
overweight and obesity kills more people than underweight.
• More than 40 million children under the age of five were
overweight in 2010.
Obesity is preventable.
Which one is Quality life?
Purpose of presentation
Sensitization about QOL Issues
Different life style modifications
Different types of exercises
Intensity of exercise
Duration of exercise
Frequency of exercise
Different types of diet.
Carry home message
What makes life
MAKE LIFE 100%
A small truth to make life 100%
Throw out all non essential
• That includes Age
• What number you should be careful about is
your weight and WHR
So to slow down
hands of time
We have to
Cherish your health:Your first
Temple is your Body!
If it is good, preserve it.
If it is unstable, improve it.
If it is beyond what you can improve, get
The rise of non communicable diseases in India
Harmful effects of obesity
Increased risk of
High blood pressure
Cancer of uterus, cervix and
breast cancer and some
• Recovery poor after
surgeries and cancer
• Sleep apnea and sleep
• Logevity decreased
• Poor body image
Causes of obesity
• Can be continous from
• Around perimenopause
What worries you most ?
• External appearance ?
• Over all fitness?
• Both ?
• Can be arranged by spending money but for a limited time
• Cosmetic surgeries
• Collagen fillers basket full !
What is happening?
• Obesity (BMI)in adult women rises significantly
each decade, until it begins tapering off late in life
in seventies.on average gain 2.5kg.
• Increased central adiposity during menopause
• Fat increases &lean muscle mass decreases 30% to
40% relative to total body mass as we age.
• Altreration in waist hip ratio
• Decrease in BMD,peak till 35 yrs.
The perimenopause and body composition
• A more rapid increase in fat
• Redistribution of fat to the
• Transition from a gyncoid
to an android pattern of fat
distribution and an
increase in total body fat
and increased risk of
drmaninder ahuja NARCHI
SARCOPENIA-what you can’t see
GOOD LEAN MASS
Ideal weight and WHR
• For asians
• BMI of 18-23normal.
• BMI of 23-28 is
• BMI of over 28 is
• BMI of over 35 is
• BMI is Wt.in Kg /ht in
WEIGHT CONTROL BY CALORIE
• Caloric restriction, the
centerpiece of weight-loss
efforts for most women,
decreased BMR and loss of
fat free mass.
• Because the resting
metabolic rate accounts for
nearly two thirds of total
caloric expenditure and
muscle mass accounts for
• Is it a losing
Three types of diets
• After losing 10% to 15% of body weight during a run-in phase,
participants were allocated to a low-fat diet (20% fat, 60%
carbohydrate, 20% protein),
• a low-glycemic-index diet, and
• a very low-carbohydrate diet (10% carbohydrate, 60% fat,
30% protein) in random order, each for four weeks. The
primary outcome was resting energy expenditure with
secondary outcomes of total energy expenditure, hormone
levels, and metabolic syndrome components.
Effects of energy expenditure
• Those on the low-carb diet burned 350 calories per day more
than those on the low-fat one, even though they consumed
the same amount of calories on all these diets. That's
equivalent to one hour of moderate-intensity physical
• And those on the low-glycemic-index diet lost about 150
calories per day more than those on the low-fat one, "equal
to about an hour of light physical activity,(
Strongest support for concept that not all calories are
• Low-carb diet : increases in CRP, a measure of chronic
inflammation, and 24-hour cortisol, the key stress hormone,
"suggesting that any initial advantages were eroded over time
by these biological stressors,“
• Low-fat diet :as well as resulting in the least energy
expenditure—"exacerbated many of the components of the
metabolic syndrome, so insulin resistance, triglycerides, and
HDL cholesterol were all worse on this diet,“
LOW GYLCEMIC INDEX DIET IS BEST
Role of Vit D
Serum 25 D should be 80 nmol/L or higher
Low levels of vitamin D are highly prevalent
Vitamin D plays a key role in normalizing PTH levels
Vitamin D deficiency is associated with increased risk of falls and
vitamin D intakes much higher than are currently recommended are
Raising serum 25(OH)D from 50 to ~80 nmol/L improves Ca absorption,
raises BMD, and reduces both fall and fracture risk
Dr.ManinderAhuja chairperson geriatric
gynecology committe FOGSI
Vit D Def & Risk Of Falls
Dr.ManinderAhuja chairperson geriatric
gynecology committe FOGSI
Role of calcium 1200-1500
mg/day and Vit 800 IU is
sugar and fat and low High
GI Carbs but high fibre
The ABC of Physical Activity for Health: a consensus statement from the British
Association of Sport and Exercise Sciences.
Recommendations for total activity
• All healthy adults aged 18-65 years should aim to
take part in at least 150 min of moderate-intensity
aerobic activity each week
• or at least 75 min of vigorous-intensity aerobic
activity per week, or
• equivalent combinations of moderate- and
• Muscle training two or three times a week
• Beginners should work steadily towards meeting
the physical activity levels recommended for all
• like increasing 10 min of activity every other day
for several weeks
• They should enjoy
• Conditioned individuals who have met the physical activity
levels recommended for all healthy adults for at least 6
months may obtain additional health benefits by engaging in
300 min or more of moderate-intensity aerobic activity per
• 150 min or more of vigorous-intensity aerobic activity each
week, or equivalent combinations of moderate- and
vigorous-intensity aerobic activities.
• Those who want to lose weight or like diabetes should go
beyond health goals for adults along with calorie restriction
Weight gain in midlife
less if started early
• Our body’s metabolism slows as we age, but
moderate to vigorous exercise can counteract this
decline by lessening weight gain.
• Those who begin moderate to vigorous physical
activity in their 20s and continue through middle
age gain less weight.
• Women particularly benefited from 20 years of high
activity, gaining on average 13 pounds less than
those with low activity, says the study.
BANKING OF GOOD HEALTH HAS TO START FROM ADOLELSCENCE
It is for you to decide now if you
want One with stick, one with wiper!
Fat loss is all about long-term goals
HOW LONG EXERCISE?
• It takes 20 minutes for an unconditioned
person to actually start burning fat.
• An average conditioned person will take
about 10 minutes Aim is 45 min/day
• It takes a fit person about 11 sessions of a 45minute fat-burning exercise period to burn
1lb of fat, which is 3,500kcal.
Components of fitness
Exercise is designed to improve the five key
components of physical fitness:
• Cardio-respiratory endurance,
• Muscle strength and loss of bone mass
• muscle endurance,
• Flexibility and stretching exercises are like yoga,
• Body composition.
Types of exercises
• Aerobic like walking, swimming, cycling, dancing,
taichi, yoga for burning fat
• Range of motion or Stretching exercises like
• Weight training & resistive exercises build up the
muscles and tendons that support your joints
• Mindful exercises like meditation
You need stamina for walking!
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
• Learn proper way of stair climbing
• Split it up ,use pedometre
U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP
Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online:
What are resistance and wt training exercises
To build up your strength and stamina
To increase your BMD
To prevent and REVERSE sarcopenia
After cancers QOL Better
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!
Tell the people you
love that you love
them, at every
Life is not measured by the
number of breaths we take,
but by the moments that take
our breath away
Don,t be left behind!
Turn back the clock !!!!!
नीद भी खुल ी न थी िक हाय धूप ढल गई ,
पाँव जब तलक उठे िक िज़नदगी िफसलगई ,
और हम झुके झुके ,
मोड़ पर रके रके
उम के चढ़ाव का उतार दे ख ते रहे ।
कारवाँ गुज़ र गया, गुब ार दे ख ते रहे ।