Fifteen Tips on Exercise that you can use

Let us recapitulate a few essential points about the role, aims, targets and methods of exercise that should keep you fit and well. In case you have missed the previous columns, here are the key points:

1. Exercise comes next only to food as an essential component for ensuring good health and longevity.
2. It tones up the heart, lungs, muscles and joints. People who exercise regularly have healthier hearts and tend to live longer.
3. People with diabetes, obesity and fatty liver can do very well with exercise. Aerobic exercise improves insulin sensitivity, brings down blood sugar levels, help burn extra fat and prevents clogging of arteries of the heart with cholesterol
4. The type of exercise that is good for the heart is called cardio-vascular or aerobic exercise. It involves movement such as brisk walks, jogging, cycling, swimming, treadmill or playing outdoor games.
5. A good point is to calculate your Body Mass Index (BMI). It should be between 20 -23 for Indians. If it is more than 23 you are overweight and need to shed weight.
6. The amount of exercise should be adequate to obtain good results: at least 30-40 minutes a day, most days of the week and should achieve a heart rate of 70% of the Maximal heart rate for that age.
7. Muscle building exercise like weight lifting or bull-worker is called isometric exercise. People above 40 years should avoid this form.
8. Choosing the right exercise should take into account your body needs, your personality type as well as the opportunities and circumstances where you live
9. While brisk walking is a good exercise, you should assess the safety of this form from traffic and crime in your locality.
10. If you are not a very determined person, an exercise regime which has to be undertaken by you alone, often does not sustain. A group activity may be more sustainable.
11. Games have the additional advantage over walking and running, in that it provides entertainment and challenge too.
12. You must take into account your special problems and limitations when choosing the right exercise. People with knee pain, for example, should avoid weight bearing exercise.
13. Joining a gymnasium or fitness centre works well for many. It shelters you from the extremes of weather, provides a variety of methods and instruments to work on, and is safer than walking on city roads in dark hours.
14. Aerobic exercise improves your basal metabolic rate, making your mind sharper and more alert. Students preparing for examinations will find their learning abilities to be enhanced if they leave their books and work-out for half an hour,
15. Keep changing the type of exercise from time to time. Variety adds that extra bit of interest to help you sustain it for all your life.

As published in HT City ( Hindustan Times) dated 16th March, 2014.

Way to Wellness through Yoga

Our series on exercise and wellness would be incomplete without a column on Yoga. At the outset I must confess that I am not an expert on yoga and will offer my sceptic observations as a medical scientist.

Of the numerous reports in the literature on the effects of Yoga on various aspects of health such as insulin resistance, heart and fatty liver, very few stand up to scientific scrutiny as the trials have not been designed in line with modern medical requirements.

 

When asked to review this topic for an international conference a few years back, I could find only 25 eligible studies of which just 4 were randomized controlled ones (considered to be scientifically well designed), 6 were non-randomized controlled trials (these studies are subject to bias in evaluating outcome), and 15 were uncontrolled studies (likely to be biased by the person conducting it as there are no controls).

Having explained the limitations and lacunae let me turn to the positive side: what did the studies show? Nineteen of the 20 studies that looked at the effect of Yoga on insulin resistance (the key underlying factor responsible for coronary heart disease, type 2 diabetes and fatty liver) showed significant improvement.  Regular yoga brought about a 6-34% reduction in fasting glucose levels and significantly improved HbA1C levels in diabetics!

The improvement in health parameters with Yoga in fact went beyond to significant improvement in lipid profile (reduction in bad cholesterol and increase in good cholesterol levels), decrease in weight and enhancement in cardiac function.

Further, yoga has several additional benefits. It tones up all the muscles, joints and nerves of the body, and provides a great sense of fitness and energy. The real advantage of yoga over other forms of exercise, that often gets overlooked, is that it focuses on breathing, making it coordinated, rhythmic and invigorating, exerting a positive effect on the mind in turn.

Despite the growing popularity of Yoga in several parts of the world, Yoga, unlike modern medicine, still unfortunately remains scattered, fanciful and whimsical largely due to lack of uniformity and standardization. Every yoga teacher seems to have an individualistic approach, lays claim to his being not just the best but often the only right way of doing it, and spares little effort in denigrating other teachers and methods, causing considerable confusion in the minds of aspirants.

It is time that Yoga gurus held a conference and thrashed out their claims and differences, and presented a unified realistic balanced picture of this precious Indian therapy to the world. I have seen several faithful followers suddenly stopping their blood pressure and diabetes medications on the exalted claims of their Yoga gurus that they can cure everything, and land up in the emergency in crisis.

To get the maximum benefit from Yoga, choose the right asanas that you need and pay due heed to its emphasis on breathing and focussing of the mind.It could be transformational experience!

As published in HT City ( Hindustan Times) dated 9th March, 2014.

Make the right choice of exercise

Having been convinced that exercise is necessary for well-being and that an appropriate amount of daily dose of aerobics is the requirement, we need to move to the very important issue of choosing the right one that suits your requirements and constraints. Here are a few tips:

• Brisk walks: This is the form most frequently prescribed by doctors. What you need to assess is where can you take your walk, and how safe is it for you? If you are in a gated campus or near a park or the botanical garden, you are lucky. If you wander on the streets especially in the early pre-dawn hours. You could be in for trouble. Enthusiastic walkers being knocked down by rogue drivers or attacked by criminals is increasingly becoming common. Hence safety should be a pre-condition. Also, the vagaries of weather, during monsoons, foggy winters and desiccating summers should not cause long interruptions.
• Going to the Gym. I think it is a good method for 3 reasons: the weather cannot play spoil-sport; you have several options to add variety to your exercise, and last but not least, provides a sense of compulsion once you have paid up. Further, when you see others struggling too, you realize you are not alone in your endeavour.
• Cycling: Excellent exercise, especially for those with creaky knees as it is non-weight-bearing. The safety concerns mentioned under walking, however apply here too.
• Games: Games such as shuttle, tennis, squash or golf are excellent because they add the extra value of entertainment that the previous three do not. When you play a game, you cannot help but challenge your opponent, and in doing so, your own body as well. Further, group activities are more motivating. Our tennis session in the morning was the best way to start the day for many years. Golf is unique in the sense that you do not need a partner or an opponent, as you challenge your own self. It is however time consuming and expensive and the family may resent the long hours you spend away from home on weekends.
• For out-door games, weather does become an interrupting factor. Our paunches used to become prominent during monsoons and the foggy winter weeks. Switching to an alternative (shuttle for instance) that could be played indoors, was an effective strategy.
• Gadgets at home: This can be very effective and practical, provided, and let me state it in capitals, PROVIDED, you are the disciplined type with loads of will power. I have seen several people clutter their homes with treadmills and cross-trainers that they do not put to use.

This list is neither complete nor exhaustive, but should help you decide how to approach the issue of choosing the right exercise. Also it is good to change the form every few months so that it does not become repetitive and boring.

Pant your way to healthy excitement!

As published in HT City ( Hindustan Times) dated 2nd March, 2014.

Exercise: Aerobic or Isometric?

The human body requires at least 1 hour each day being devoted to its care to keep it fit and strong. Of these 60 minutes, a good 40 should be spent on exercise of the body and 20 on exercise of the mind. Remember, a weak restless mind in a strong body does not make for happy living!

There are broadly 2 types of exercise: aerobic or isotonic, and isometric

Aerobic exercise:  This form is characterized by movement and includes walking, running, cycling, swimming or working out on the treadmill or games that involve movement. The heart rate and breathing goes up but no single group of muscles is put to too much strain (compare with isometric). It is also known as cardio-vascular exercise as it keeps the heart charged and fit.

Aerobic exercise is a must for people across all ages, and should be the only form for people above 50. Apart from keeping the heart toned by improving the blood circulation in the coronary arteries, it helps burn fat and increases the basal metabolic rate. Those who exercise are therefore not just physically more fit, but appear more alert and sharp. Those who are overweight or have fatty liver, need to concentrate on this form of exercise to burn their extra body fat.

The main challenge is that most conventional forms of aerobic exercise depend on the use of our legs, a feature that makes people with painful knees or hips to avoid it. This is where a good physical instructor or a gym could make all the difference. There are several gadgets and machines now available that could make you have a good work out without having to put your weight on your creaking lower limbs.

Isometric exercise:  In this form, primarily used for muscle building, certain muscle groups are put to strenuous stretches to make them stronger and bulkier. Body builders develop their shoulder muscles by lifting weights or chest muscles by using the “bull-worker” for instance. Young people keen to build their bodies can try this form. They should however take care not to overdo it and also to ensure that the development is proportionate. We have all seen some body-building fanatics with hugely bulging biceps but weak legs, making them look silly!

Isometric exercise puts a lot of pressure on the heart, and can make the blood pressure shoot up; hence it is best avoided by people with high BP, people above 50 and those with heart disease.

Opinions differ about whether a small judicious component of isometric exercise (lifting light weights) should be included in a weight reducing program. It probably helps by redistributing body mass – by melting the fat pads in our bellies and buttocks and making the muscles in the upper torso become stronger, and may fast track “inch loss” regimes.

Start with the 40 minutes of exercise each day for your body. I will tell you how to use the remaining 20 to charge your minds, next week. 

As published in HT City ( Hindustan Times) dated 23rd February, 2014.