practical suggestions to manage lifestyle diseases

Lifestyle Management

OBESITY

OBESITY

Know Your Ideal Body Weight

=

=Overweight – Present Body Weight > 10-20% IBW

=Obese - Present Body Weight > 20% IBW

Causes

=Energy Dense Foods

=Lack of Exercise

=Genetic Predisposition

=Certain medications

=Medical Problems

=Lack of sleep

=Slow metabolism

=Psychological stress

=Unhealthy eating habits, like Skipping breakfast,

Nibbling, Excessive consumption of junk food, Distress

eating

Ideal Body Weight (IBW) = Height in cm – 100

Just for HeartsHealth, Heart, Lifestyle and more

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= Social pressure to eat

=Holidays & Special Events

=Marketing/Advertisements

=Paired eating activities

Health Risks

=High Blood Pressure

=Diabetes

=Gall Bladder Disease

=Certain Cancer

=High Cholesterol Levels

=Cardio Vascular Diseases

=Joint Problems


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Self Control

Physical Activity Dietary Modification

Weight Management

Dietary Modification

=

loss program, which puts you on a good, nutritious,

weight loss diet. No crash diets.

=Identify and avoid food triggers.

=Keep a watch on portion size.

=Eat a minimum of 500gms of fresh vegetables (less of root

vegetables) in the form of soups (no butter, corn flour, white

sauce), salads (without dressing), boiled and cooked in

minimum oil.

=High fiber foods like whole-wheat flour, bajra, jowar, millets,

oatmeal should be preferred to make your chapatis. Food

products made from maida (refined flour) like breads,

pastries, bhaturas, rumali rotis, naans, etc to be restricted.

=Pulses in the form of dals, whole pulses, usals, and sprouts

salads should be incorporated in the diet.

=Fruits like apple, orange, watermelon, papaya pomegranate,

peach, pineapple, pear, etc can be safely eaten as snacks.

=Always use skimmed milk. Remove the fat by refrigerating

the milk for 6-8 hours.

=Nutritious low calorie drinks like tomato juice, cucumber

juice,coconut water, lime juice, thin buttermilk, dudhi soup

can also be taken in between meals.

=Cut off sugar from your diet; avoid soft drinks, chocolates,

sweets, jams, ice creams, canned juice, mithai, cakes and

pastries.

To begin with, it is imperative to go on a monitored weight


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=

=Avoid deep-fried foods like wafers, puries, samosas,

wadas, bhajia, cutlets, farsans,etc

=Consume about 6-8 glasses of water every day.

=Prefer lean chicken, fish, egg white etc to high fat non-veg

foods.

=Use alternative cooking methods for frying like baking,

steaming, grilling, poaching, etc

=Festive seasons like Diwali, Christmas, and New Year are

times when people just let go. Always remember that

festivals can be enjoyed in a healthy way.

Limit your fat intake to two teaspoons a day.


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Practical Suggestions for Weight Reduction

=

weight loss program.

=Eat when you are actually hungry. Try not to eat snacks in

front of television.

=It is important to follow a regular meal pattern. Consume 6

small frequent meals. The gap between two meals should

not exceed to 3-4 hours.

=Never skip meals. If you skip a meal with the idea of losing

weight, you tend to eat next one in more quantity.

=Eat slowly. Savor each bite. Take fifteen to twenty minutes

to finish your meal as your brain needs twenty minutes to

register satiety.

=Eat wisely and learn to say NO to temptations.

=Maintain a diary where you record what you have eaten for

the day. This way you will be able to find out the increase or

decrease in your caloric intake.

=Stick to your treatment plan

= Remain motivated and confident =Set the goal that is realistic. =Adjust the rate of weight loss to 0.5kg week. =Take the help of visual tool (weighing machine) and motivation techniques.

Prudence and self-control are the keys to a successful


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=Increase your physical activity to about 45-60 minutes in a

day. Exercise is excellent to burn calories and improve both

mental and physical health.

=Anticipate plateaus. They are common to all. They occur due

to accumulation of water as fat is used up. Increase exercise

in this period to restart weight loss.


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DIABETES MELLITUS

Diabetes Mellitus is a condition where the amount of blood

glucose is too high because the body cannot use it properly.

Contributing Causes

Non-Modifiable:

=Heredity

=Age

Modifiable:

=Obesity

=Poor diet

= Sedentary lifestyle coupled with lack of physical

activity.

Symptoms

=Frequent urination

=Excessive thirst

=Unexplained weight loss

=Extreme hunger

=Blurry vision

=Tingling/ numbness in hands/ feet

=Feeling tired much of the time

=Dry skin

=Sores that are slow to heal


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DIABETES MELLITUS

Complications

Diabetes affects the various systems of body and leads to the following complications

=Neuropathy (affects the various nerves)

=Retinopathy (affects eyesight/ vision)

=Nephropathy (affects the functioning of the kidneys)

=Leads to heart problems in the long run

=Stroke (injury to the brain)

=Diabetic foot leading to amputation

PrediabetesPrediabetes is the state in which some but not all of the diagnostic criteria for diabetes are met.

Impaired fasting glycaemia or impaired fasting glucose

(IFG) refers to a condition in which the fasting blood glucose

is elevated above what is considered normal


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Glucose Levels

Normal Impaired Fasting Glycaemia

Impaired Glucose Tolerance

Diabetes Mellitus

(IFG) (IGT) (DM) Venous Plasma

Fasting 2-Hour

Fasting 2-Hour

Fasting 2-Hour

Fasting 2-Hour

(mg/dl) <110 <140 = 110 & <126

<140 <126 = 140 = 126 = 200

levels but is not high enough to be classified as diabetes

mellitus. It is considered a pre-diabetic state.

Impaired glucose tolerance (IGT) is a pre-diabetic state

which may precede type 2 diabetes mellitus by many years.

ManagementThe steps for effective management of diabetes include: -

onitoring

ducation

iet

xercise

edications

=Regular monitoring of blood sugar levels

=Know about the proper care that needs to be taken

=Follow regular eating habits

=Make the right food choices

=Include exercise and physical activity in daily routine

=Medications help in maintaining desired blood sugar

levels.

M

E

D

E

M


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Diet Guidelines:

=

=Take small frequent meals/snacks at regular intervals and

dine on time. Eat slowly

=Watch out for words like JUMBO, GIANT, DELUXE or SUPER-

SIZED. Larger portions mean more calories, more fat,

cholesterol and salt. Prefer regular/medium instead.

=Replace fried foods with grilled, roasted, steamed or baked

items.

=Avoid smoking and consumption of alcoholic drinks.

=Opt for fruits and salads as healthy snacks instead of

munching on to something which in the long run could harm

you like fried and bakery products.

=Limit the frequency of eating out. Always choose healthy

options.

No fasting, no feasting.


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Exercise tips:

=Consult your doctor before starting any exercise

program.

=Wear shoes that fit well and protect your feet.

=Start gradually to avoid stiff or sore muscles and joints.

=The type of exercise should be individualized for every

person.

=It may include

Aerobic exercise – 30 to 45 mins a day, atleast 5 days

a week

Flexibility exercise – 30 mins a day, 5 days a week

=Walk instead of drive whenever possible.

=Take the stairs instead of the elevator

=Test your blood glucose before and after exercise.

=Always carry a carbohydrate snack with you in case of

hypoglycemia.

=

=


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Foot care:

=

=Dry your feet well, especially between the toes.

=Check your feet for blisters, cut sores, swelling and

infected toenails.

=Trim the toe nails straight across and smoothen them.

=Never walk barefoot indoors or outdoors. Examine your

shoes everyday for crack, pebbles, nails or anything that

could hurt your feet.

Wash your feet daily with lukewarm water and soap.

“The Diabetic Who Knows the Most, Lives the Longest’’


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Hypertension

Hypertension is defined as persistently high pressure in blood

vessels, wherein the systolic pressure is >120 mmHg and the

diastolic pressure is> 80 mmHg.

It is also called as a silent killer because people with

hypertension generally remain asymptomatic for years and

then have fatal stroke or heart attack. It is a lifestyle disorder.

Causes:

=Hereditary

=Stress

=Obesity

=Smoking

=Cardio vascular diseases

=Renal diseases

SYMPTOMS:

Usually it is asymptomatic.

=Headache

=Dizziness

=Impaired vision

=Failing memory

=Shortness of breath

=Pain over the heart

=Gastrointestinal disturbances

=Unexplained tiredness


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ADVERSE PROGNOSIS:

=Cardiac enlargement

=Ischemia (inadequate flow of blood)

=Left ventricular hypertrophy (thickening of muscle of heart)

=Left ventricular malfunction

=Myocardial Infarction (heart attack)

=Congestive heart failure (heart's pumping function is altered)

=Hemorrhages

=Impaired renal function

=Stroke (disturbance in the blood supply to the brain)

Recommendations:

= Weight reduction: It is very necessary to manage weight and Body Mass Index. The BMI should be in range of 18—23

2kg/mt .

=Physical Activity: Aerobic exercises and brisk walking help to reduce blood pressure.

=Stress Management: It can be done by mediation, yoga, some change in regular activities and pursuing some hobbies.

=Alcohol and Smoking: These can lead to cardio vascular diseases.

=Low fat diet is advised as the patient is susceptible to cardio vascular diseases.

=Diet should include adequate amounts of potassium, calcium, magnesium, vitamin D and K.

=Limit caffeine containing to 1 cup per day.

=Restrict alcohol beverages.

=Include DASH diet ie low in fats and cholesterol and rich in vegetables, fruits and low-fat dairy products.

=Avoid pickles, preserved foods, papads, canned foods, Chinese foods, frozen foods, salty foods, ketchups.


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Your heart is the center of your cardiovascular system, and

it is vitally responsible for just about everything that gives

your body life ranging from the oxygen supply to

strengthening your immune system. However, the foods

you eat and the amount of activity you choose to take part in

can dramatically affect the overall health of your heart and

many other tissues that make up your cardiovascular

system.

The term "heart disease" is often used interchangeably with

"cardiovascular disease." Cardiovascular disease generally

refers to conditions that involve narrowed or blocked blood

vessels that can lead to a heart attack, chest pain (angina) or

stroke. Other heart conditions, such as infections and

conditions that affect your heart's muscle, valves or beating

rhythm, also are considered forms of heart disease.


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Cardiovascular Diseases

The various diseases that fall under the umbrella of heart disease include –

·Myocardial infarction(interruption of blood supply to a part of heart causing heart cells to die)

·Coronary insufficiency(insufficient blood flow through one or more coronary arteries supplying heart)

·Angina(chest pain)

·Ischemic stroke (impaired oxygen supply to heart tissue)

·Hemorrhagic stroke(bleeds resulting from weakened vessels in the surrounding heart tissue)

·Transient ischemic attack(mini stroke with symptoms appearing for short time)

·Peripheral artery disease(formation of plaques in the arteries) heart failure


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The more risk factors you have, the more likely you are to

develop heart disease. Some risk factors can be changed,

treated, or modified, and some cannot. But by controlling as

many risk factors as possible, through lifestyle changes

and/or medicines, you can reduce your risk of heart disease.

Major Symptoms:

·Breathlessness

·Palpitations

·Chest pain

·Decreased urine output

·Abnormality in heart rhythm

·Syncope(sudden blackout)


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Diagnostic Investigations

·

· Stress Testing

· Thallium Stress Test

· Echocardiography

· Doppler Study

· Coronary Angiogram

Electrocardiogram (ECG)


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Target Goals

Some preventive measures you can take:

Don't smoke or use other tobacco products.

· Eat a varied diet, rich in fruits, vegetables and low-fat

foods.

· Maintain a healthy weight.

· 30 minutes of exercise daily is a must.

· Keep your cholesterol levels in normal ranges.

· Control your blood sugar if you have diabetes.

· Control your blood pressure.

Diet Guidelines for Cardiovascular diseases

·Be liberal on raw and green leafy vegetables, fruits.

·Make use of the oven or tandoor more than frying- pan

by baking, grilling or roasting foods.

·Choose lean chicken and fish over mutton and red meat.

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FACTOR

Total Cholesterol

LDL (Bad)Cholesterol

HDL (Good)Cholesterol

Triglycerides

Blood Pressure

Fasting Glucose

Body Mass Index (BMI)

Waist Circumference

Exercise

GOAL

<200 mg/dL

<100 mg/dL

>50 mg/dL

<150 mg/dL

<120/80 mmHg

<100 mg/dL

<25 kg/dL

<35 Inches

Minimum of 30 minutes alldays.

·Eat more fish. Fish is a good source of protein. It also

contains Heart friendly fats, omega-3 fatty acids,

which may help reduce the risk of heart disease and

stroke.

·Thin buttermilk, coconut water, clear soups, kokam

sarbat can be included in diet liberally.

·Vegetable oils such as safflower oil,rice bran oil,

soyabean oil, sesame oil are most recommended. Use

combinations of oil.

·DO NOT Mix two oils together. Learn with your Diet

counselor how to use combinations of oil.

·Control the salt in your diet. Restrict your salt to half a

teaspoon per day

·Avoid salted foods, namkeens, pickles, chutneys,

dried papad, ketchups and canned foods.

·NO ALCOHOL and SMOKING.

·Have a healthy weight loss and maintain our ideal

body weight.

·Sustain your diet as well as workout.

·Exercise is the key!

.


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Physical Activity

Regular physical activity is one of the most important things you can do for your health.

It can help to-

· Control weight.

· Reduce risk of cardiovascular diseases.

· Reduce risk of type 2 diabetes and metabolic syndrome.

· Reduce risk of some cancers.

· Strengthen bones and muscles.

Approximately 30-60 min of moderate intensity

physical activity per day is recommended.

There are various types of physical activity that help you to

achieve overall fitness.


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Physical activity and health

Types of activity Benefits Examples

1. Aerobic or cardiovascular exercises.

a) Increases stamina. b) Helps to decrease

body fat . c) Improves

cardiovascular function & reduces blood pressure by increasing blood flow to the muscles.

d) Improves blood sugar control by increasing the sensitivity of the body to insulin.

Walking , jogging, bicycling, climbing stairs, dancing, swimming, tennis, zumba, kick boxing, Spinning.


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2) Strength or weight

training

a) Helps to increase

your metabolism so

that you burn more

calories.

b)Helps to make

bones stronger

c) Improves balance

d) Increases muscle

strength

Lowers the risk of

fractures and

lessens arthritis

pain.

use weight machines, lift

free weights, push-ups,

pilates. Can use

household items like

bottles filled with water as

weights.

3) Stretching or flexibility

a) Helps to ease

movement.

b) Improve flexibility

c) Prevents muscle

sprain and injury.

Gardening, moping the

floor, vaccuming, Bowling,

yoga, curling.

Always keep yourself motivating by:-

·losing few kilos just to fit in the old favorite dress.

· Finding a workout buddy so that both can push each

other to try a bit harder.

· Getting indulged in any sports activity of your choice.

· Making it a fun – Don't make exercise regime bore and

sad. Try something different like Zumba Aqua exercises,

aerobics, Flexibility, Yoga, etc.

Setting Small, Realistic and Achievable goals — it might be

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·Remember the rewards should be healthy like a healthy

snack, spa, hair spa, etc

· Buying a new dress for the next birthday, a size smaller. Let

the thought of fitting in to it motivate you.

· Stick to the workout plan. Print it out and put it somewhere

you can see it daily.

· Keeping a backup plan ready in case of weather problems.

· Avoid exercising on an empty stomach or immediately after

taking insulin.

· Carry a fast acting source of energy (CHO) with you ,such as

glucose or raisins just in case of low blood glucose.

All the Best!!

Rewarding yourself on successfully achieving a goal —


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practical suggestions to manage lifestyle diseases

Health & Medicine