Weight gain and physical activity in mid life !


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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.

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  • 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 !

    1. 1. DR.MANINDER AHUJA 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) PUBLICATIONS: 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 HOSPTIAL
    2. 2. How to slow down the hands of time? Control weight gain and exercise Dr.Maninder Ahuja Director Ahuja Hospital &Infertility Centre setor 17 FBD
    3. 3. 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 02/11/14 4
    4. 4. 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 Dr.Maninder ahuja 02/11/14 5
    6. 6. 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 02/11/14 7
    7. 7. WE ARE CHANGING CONCEPTS DOCTOR: A person who kills your ills by pills, and kills you by his bills! Change from pill doctors Change from pill doctors Preventive health Preventive health 02/11/14 Dr.Maninder ahuja 8
    8. 8. FIT AT FORTY STRONG AT SIXTY AND INDEPENDENT AT EIGHTY !! Dr.Maninder ahuja 02/11/14 9
    9. 9. Physical Problems Slowing us down • • • • • • • • • Vaso motor symptoms Hot flushes Mood changes Sleep disorders Musculo Skeletal Sarcopenia Osteoporosis Joint aches and pains osteoarthritis Metabolic syndrome • Cardiac problems • Hypertension • Obesity • Cardiorespiratory Long term • Longevity • Cancers • Alzheimer
    10. 10. FACT SHEET • 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. •
    11. 11. CHANGING TIMES
    12. 12. Which one is Quality life? Dr.Maninder ahuja 02/11/14 13
    13. 13. 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
    14. 14. A SMALL TRUTH TO What makes life 100% MAKE LIFE 100% A small truth to make life 100% and enjoyable! 02/11/14 Dr.Maninder ahuja 15
    15. 15. 02/11/14 Dr.Maninder ahuja 16
    16. 16. 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% 02/11/14 Dr.Maninder ahuja 17
    17. 17. 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 ??? ) 02/11/14 Dr.Maninder ahuja 18
    18. 18. 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% 02/11/14 Dr.Maninder ahuja 19
    19. 19. 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% ! ! ! 02/11/14 Dr.Maninder ahuja 20
    20. 20. Keep laughing !
    21. 21. Throw out all non essential Numbers • That includes Age • What number you should be careful about is your weight and WHR
    22. 22. So to slow down hands of time We have to change our attitude ! B +
    23. 23. 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 HELP !
    24. 24. The rise of non communicable diseases in India
    25. 25. Harmful effects of obesity • • • • • Increased risk of Heart disease, High blood pressure Diabetes Cancer of uterus, cervix and breast cancer and some other cancers • Osteoarthritis • Recovery poor after surgeries and cancer treatment • Sleep apnea and sleep problems • QOL • Logevity decreased • Poor body image • Depression
    26. 26. Causes of obesity • Can be continous from adolescents • Around perimenopause
    27. 27. What worries you most ? • External appearance ? • Over all fitness? • Both ?
    28. 28. External appearance • Can be arranged by spending money but for a limited time only. • Cosmetic surgeries • Laser • Botox • Collagen fillers basket full !
    30. 30. 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. 5-05-2007 Dr.maninder ahuja
    31. 31. The perimenopause and body composition • A more rapid increase in fat mass • Redistribution of fat to the abdomen • Transition from a gyncoid to an android pattern of fat distribution and an increase in total body fat and increased risk of Metabolic syndrome 11/02/14 drmaninder ahuja NARCHI 32
    32. 32. SARCOPENIA-what you can’t see GOOD LEAN MASS 5-05-2007 SARCOPENIA Dr.maninder ahuja
    33. 33. Leisure time increases
    34. 34. Ideal weight and WHR • For asians For others • BMI of 18-23normal. (20-25 ) • BMI of 23-28 is overweight (2530) • BMI of over 28 is obesity (>30) • BMI of over 35 is morbid obesity • BMI is Wt.in Kg /ht in sqM 5-05-2007 Dr.maninder ahuja
    35. 35. 11/02/14 drmaninder ahuja NARCHI 36
    37. 37. WEIGHT CONTROL BY CALORIE RESTRICTION • Caloric restriction, the centerpiece of weight-loss efforts for most women, decreased BMR and loss of fat free mass. NO!!! • Because the resting metabolic rate accounts for nearly two thirds of total caloric expenditure and muscle mass accounts for 20%of REE 5-05-2007 Dr.maninder ahuja
    38. 38. Weight loss • Is it a losing battle? Dr.Maninder ahuja 02/11/14 39
    39. 39. MOTIVATION! Dr.Maninder ahuja 02/11/14 40
    40. 40. 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.
    41. 41. 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 exercise • 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,(
    42. 42. Strongest support for concept that not all calories are the same • 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
    43. 43. Diets
    44. 44. SUGARS??????
    45. 45. Smoking is bad !!
    46. 46. Dynamic Duo !
    47. 47. 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 fractures, • vitamin D intakes much higher than are currently recommended are quite safe. • Raising serum 25(OH)D from 50 to ~80 nmol/L improves Ca absorption, raises BMD, and reduces both fall and fracture risk 02/11/14 Dr.ManinderAhuja chairperson geriatric gynecology committe FOGSI 50
    48. 48. Vit D Def & Risk Of Falls 02/11/14 Dr.ManinderAhuja chairperson geriatric gynecology committe FOGSI 51
    49. 49. Role of calcium 1200-1500 mg/day and Vit 800 IU is undisputed,low salt,low sugar and fat and low High GI Carbs but high fibre
    50. 50. The ABC of Physical Activity for Health: a consensus statement from the British Association of Sport and Exercise Sciences.
    51. 51. 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 vigorous-intensity activities. • Muscle training two or three times a week
    52. 52. Beginners • Beginners should work steadily towards meeting the physical activity levels recommended for all healthy adults • like increasing 10 min of activity every other day for several weeks • They should enjoy
    53. 53. Conditioned individuals • 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 week, • 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
    54. 54. 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.
    55. 55. BANKING OF GOOD HEALTH HAS TO START FROM ADOLELSCENCE 02/11/14 dr.maninder ahuja 60
    56. 56. It is for you to decide now if you want One with stick, one with wiper! 5-05-2007 Dr.maninder ahuja
    57. 57. Structured daily routine activities 11/02/14 drmaninder ahuja NARCHI 62
    58. 58. 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. 02/11/14 Dr.Maninder ahuja 63
    59. 59. Despite all these if you have
    60. 60. Weight lifting is good !
    61. 61. 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, taichi • Body composition. 02/11/14 Dr.Maninder ahuja 66
    62. 62. Types of exercises • Aerobic like walking, swimming, cycling, dancing, taichi, yoga for burning fat • Range of motion or Stretching exercises like Pilatees,yoga • Weight training & resistive exercises build up the muscles and tendons that support your joints • Mindful exercises like meditation 02/11/14 Dr.Maninder ahuja 67
    63. 63. Stretching exercises
    64. 64. Exercises Stretching exercises Resistance and weight bearing
    65. 65. Strength training in osteoarthritis • AFTER 12 WEEK ST TRAINING PROGRAMME • Balance improved by 55 % • Muscle strength increased by 14 % • Flexibility improved by 17% • Self-reported pain decreased by 30% • Tibial cartilage volume increased. • © 2007 Current Medicine Group Ltd, a part of Springer Science+Business Media 02/11/14 dr.maninder ahuja 70
    66. 66. You need stamina for walking! 02/11/14 Dr.Maninder ahuja 71
    67. 67. 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 02/11/14 dr.maninder ahuja 72
    68. 68. SOME GUIDELINES • • 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: http://www.health.gov/paguidelines/pdf/paguide.pdf
    70. 70. What are resistance and wt training exercises • • • • • • • To build up your strength and stamina To increase your BMD To prevent and REVERSE sarcopenia Mood elevation Increased libido Less cancers After cancers QOL Better
    71. 71. Integrated into your life style!
    72. 72. AS A LAST RESORT !!
    73. 73. 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! 02/11/14 Dr.Maninder ahuja 80
    74. 74. Tell the people you love that you love them, at every opportunity. •. Life is not measured by the number of breaths we take, but by the moments that take our breath away
    75. 75. Be together and keep dancing!
    76. 76. 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 । 02/11/14 Dr.Maninder ahuja 83
    77. 77. 02/11/14 dr.maninder ahuja 84