Top health resolutions to consider in the New Year 2012

Posted by: Ramesh Venkatraman

With 2012 round the corner, resolutions are the flavor of the season. Below is my own list of the top health resolutions for the year:

Invest in your health:
I am not talking about health insurance here, what I am talking about is Time, Commitment, Planning, Perseverance, Determination, and Effort. These are the essential ingredients that will determine the success or failure of your health resolution for the year. Write a personal mission statement and commit it to memory and recall it every single day of the year for your health plan to succeed. Let us now look at the essential ingredients of a good "Health Mission Plan"

Exercise:
The single biggest game changer in any health plan. A sedentary lifestyle is a major risk factor for developing diabetes, hypertension and cardiovascular diseases. Plan your own exercise regimen - you are the best judge of what your body can and cannot do - do not fall for any of the gimmicky ads that tell you how you can develop wasboard abs and Arnold arms in 10 days. Do not spend money enrolling in a gym or health club. There are several exercises that can be done without spending a dime. Remember to include the following 3 things in any personalized exercise program you design for yourself:

1. Stretching: Stretch before and after your session. Stretching helps prevent injury and also prepares your body before an exercise and helps soothe sore muscles after a session
2. Cardio: Walking, jogging, swimming, skipping or any exercise that increases oxygen consumption of your body - again start slowly and increase as you get better
3. Resistance: Pushups, pullups, squats, weight training, help build and strengthen muscles. Muscles burn more calories and therefore will aid faster weight loss and weight maintenance

Eat Watchfully: 
I think this is the only diet advice that needs to be given. Fad diets, calorie-restrictive diets, fashionable one week regimens, etc. need to be thrown into the trash can where they belong. None of these work in the long run and only end up creating disappointment or worse depression, rebound binge eating, and Yo-Yo patterns of weight-loss and weight-gain that cause greater harm than good. Follow 3 simple rules:

1. Watch everything you eat and every morsel that goes into your mouth
2. Eat slowly - when you wolf down your food and eat like you are in a race, you do not give your brain time to signal satiety, this is one of the reasons why people who eat quickly realize that they have overeaten only sometime after they have completed their meal
3. Hold the two palms of your hand together - this is roughly the size of your stomach and approximately the quantity you must be consuming during one meal 

Reduce Stress: 
Stress is inherent in the lifestyles we lead and is by itself an independent risk factor for various lifestyle diseases. Take up any activity (it could be your hobby) which you truly enjoy and which can help calm your mind - meditation, pranayama, reading, writing, social service, are all examples of activities than can help relieve stress.

Sleep:
So many of us go through our days like zombies flying from one task to the next, sparing little time for one of the most important activities of our lives - a good night's sleep. So many of us struggle to keep up with the demands of multitaking, being always available and/or on call, answering every email that drops into our inbox... The first thing that most people need to do is to catch up on lost sleep and then commit to at least 7-8 hours of undisturbed sleep every night. The changes you will see in your life will be nothing short of a miracle - Try it this new year

Health Checkup:
If you are male, lead a sedentary lifestyle, are overweight/obese, over the age of 40, and/or smoke, then get yourself checked for hypertension (elevated BP), cholesterol levels (lipid profile) and diabetes.
If you are female, peri or post menopausal, above 45 years of age, lead a sedentary lifestyle, and/or smoke then get yourself checked as above and in addition start taking a calcium (Calcium citrate is best) with Vitamin D-3 supplement to prevent osteoporosis

Weed out harmful habits:
If you smoke, chew tobacco/gutka, consume alcohol then commit to change your habits slowly BUT steadily - give up smoking, chewing tobacco/gutka, and exercise moderation in consuming alcohol - choose Wine instead of stronger drinks like Whiskey/Scotch/Rum/Vodka (BTW' Wine is no longer a "Women's-only drink").

Season's greetings and Happy New Year to all!

Varicose veins: causes, symptoms, and management

Posted by: Ramesh Venkatraman

Introduction: Veins are blood vessels that carry/return deoxygenated (impure blood or blood lacking in oxygen) blood from the various parts of the body to the heart and then the lungs. Veins have valves that help in propelling the blood forward towards the heart and prevent backflow.
Varicose veins appear swollen, twisted, bluish-purple in color, and slightly raised above the surface of the skin. Generally, the following are true of varicose veins: (a) more common in women than in men (b) can form anywhere in the body, but most commonly located in the legs, particularly visible on the calves (c) Usually painless and harmless but can sometimes become painful (d) tend to be inherited and become more prominent as one ages (e) statistics show that 1 in 2 people above the age of 50 develop varicose veins (f) typically it is the superficial veins present closer to the skin that usually become varicosed.

Causes: Although several theories exist, the commonest and most accepted cause is “defective valves” These defective valves do not perform their function of ensuring that the blood keeps moving forward. Veins with defective valves allow backflow of blood causing the blood to pool and stagnate - this causes the veins to enlarge and lose their characteristic shape causing “varicosities” in the vein. Some other causes of varicose veins include heredity and congenital (born with) abnormalities of the vein-wall which can cause the valves to malfunction.

Hemorrhoids (piles) is a very common type of varicosity that occurs in the anal/rectal region usually due to chronic constipation

Conditions and factors that can trigger or aggravate varicose veins:

1. Pregnancy: Increased blood volume and increased weight are the primary reasons along with the effects of the hormones estrogen and progesterone which cause relaxation of the vein walls
2. Prolonged standing
3. Obesity, particularly people with a distended belly
4. Chronic constipation, chronic cough, urinary retention due to an enlarged prostate and any other condition that causes you to strain and exert yourself over prolonged periods of time
5. Surgery and/or trauma to the leg

When varicose veins become serious and when to seek medical care: Varicose veins in general are harmless and the only problem that you may face is the occasional itching besides the unsightly appearance. However go to a doctor when you experience the following:

1. Unexplained pain, discoloration, swelling, and/or ulceration on or around the region of the varicosity - this could signify the beginning of a clot and warrants a thorough medical examination. Individuals who have been diagnosed with DVT (deep vein thrombosis) should exercise greater caution.
2. Constant ache in the legs, centered on or around the varicosity that is preventing you from getting a good night’s sleep.

Your doctor may advise a Doppler scan to determine how serious your problem is and if you need treatment/medication. A Doppler scan is essentially an ultrasound scan that is painless and uses high frequency sound waves to provide an image of the affected part. The Doppler scan can provide information on the direction of blood flow inside the veins, how well your veins are functioning, and the presence of clots (if any).

Treatment and management of varicose veins:

1. Compression stockings: Compression stockings are specially designed to steadily squeeze your legs and encourage blood flow towards your heart (i.e. normalize blood flow in your affected veins). Compression stockings are usually tightest at the ankle and get gradually looser as they go further up your leg and may help to relieve the pain, discomfort and swelling in your legs.
2. Surgery: Surgery may be required if the varicosity is spread over a large surface area or if the affected veins are particularly large, or if the diagnosis shows a possibility of increased risk of developing complications. Some individuals may also choose to go in for surgery for cosmetic reasons.
3. Simple interventions that can provide relief include: exercising, losing weight, avoiding prolonged periods of standing, avoiding tight-fitting clothes, elevating your legs when resting, and not crossing them when sitting.
4. Yoga: Yogasanas such as UTTHAN-PADASANA, CHAKRA PADASANA, PADA SANCHALANASANA, and PAWANMUKTASANA can be extremely beneficial in people with varicose veins. These are simple asanas that you can learn on your own. Check out these sites to read about these asanas:
   http://yogadeep.blogspot.com/2010_06_01_archive.html
   http://shilpamoreshwar.weebly.com/yogasanas.html

Even very minimal physical activity is beneficial and can improve survival

Posted by Ramesh Venkatraman

It has been known for quite some time now, that even moderate physical activity such as 30 minutes of walking, 6 days a week significantly improves health outcomes and reduces mortality (i.e. increases life span). The public health recommendation in most countries is to walk for 30 minutes (or indulge in an equivalent activity) for 5 to 6 days of the week (approximately 150 to 180 minutes per week).

A recent study published in The Lancet (Chi Pang Wen and colleagues) now shows that even as little as 15 minutes of physical activity per day for 6 days a week reduces:

1. All-cause mortality by 14%
2. Cancer mortality by 10%, and
3. Cardiovascular disease mortality by as much as 20%

What would be ideal is for all of us to spend about 300 minutes per week doing some form of moderate physical activity (approximately 60 minutes of walking or an equivalent activity per day). There seems to be a direct relationship between the amount of time devoted to exercise and the benefits that accrue thereof - See graph below. 

However studies on individuals and exercise patterns, have consistently shown that very few individuals can actually measure up to even this requirement of 60 minutes of walking/day - a reflection perhaps of the times we live in.

The key take away is that we must find ways to incorporate some form of physical activity into our daily lives - this could mean simple lifestyle interventions such as stepping out of our office cubicles for a brisk 15 minute walk during lunch break, walking to the grocery shop instead of driving, using public transport on certain days of the week... - it is for each one of us to decide what is best for ourselves.

Reference: "Survival benefit associated with low-level physical activity". Published online: Published Online

August 16, 2011 DOI:10.1016/S0140-6736(11)61029-5

Full article: The lymphatic system and lymphedema following breast cancer

Posted by Ramesh Venkatraman

I have had several mail requests and feedback that it is cumbersome reading the entire article as it is spread across three parts and readers have to click through several links or scroll down the page to read the entire article. Additionally, some readers have also suggested that the article be available as a download for them to read/refer offline.

Therefore I have combined the 3 parts into a single article and it is now available as a word doc that can be downloaded for offline reading. BTW, it can also be viewed/read online in case you don't want to save a copy to your system. Go to the link below to access the document: 
FULL ARTICLE