Women’s waistline can affect lifeline!
Dr Meenal

Obesity leads to various medical problems

Unable to conceive, exasperated Pooja begs for IVF (assisted fertility) from her gynaecologist. “All you need is to shed 10 kg weight, and within one year you will have the cries of a newborn in your house”, the doctor counselled with a smile. It is unbelievable but true! In India, 15-20 per cent of the population is obese. Those affected face an increased risk of problems like infertility besides diabetes, hypertension, heart disease, gallbladder stones, knee joint problems, neck and lower back pain, respiratory ailments and cancer. They also suffer from low self-esteem and lack of confidence, depression and binge eating disorder, miscarriage and difficulties in performing assisted reproduction.

Women-centric problems

Studies have proved that obesity hampers the fulfilment of sex and reproductive life. Such women suffer from an irregular menstrual cycle from early age. It has been observed that a high percentage of babies die during the first month of their birth if they have obese mothers.

Obesity is associated with an increased risk of death in both the baby and the mother. It raises the risk of maternal high blood pressure by 10 times.

Excessive weight in pregnant moms is associated with a higher risk of hypertension, gestational diabetes, urinary infection, Cesarean section delivery and toxemia.

Infants of those women who are obese during pregnancy are more likely to be high birth-weight, which means a higher rate of Cesarean section delivery.

Obesity in pregnancy carries an increased risk of birth defects such as neural tube disorders.

Female obese patients are 13 times more likely to have overdue births, longer labours, induced labour and blood loss.

Obesity-related health problems occurring after childbirth include a higher risk of wound and endometrial infection, and urinary tract infection. Weight loss is effective in improving menstrual regularity, ovulation, hormonal profiles and pregnancy rates.

What is obesity?

Obesity refers to belly fat around the waist, surrounding the internal organs, which is out of proportion to the total body fat. Indians are more susceptible to this type of obesity. Belly fat is a proven independent risk factor for the medical conditions listed above. BMI higher than 30 also puts you in the ‘Mottapa’group.

When caloric intake exceeds the calories burned, extra calories get deposited as fat, especially around the waist. A study has revealed that 25 per cent of the children above eight years of age and 19 per cent in the age group of seven years and below are obese. These children will grow into unhealthy adults.

Tips to lose weight and abdominal fat

1. Reduce your daily caloric intake by 500 kilo-calories. Don’t overfeed children.

2. Eat frequent, smaller meals but avoid large meals, skipping meals and fasting.

3. Make breakfast one of the most important meals of your day.

4. Avoid ghee, ice cream, chocolates, sweets, deep-fried foods, pizza, burgers, bakery products, biscuits and aerated drinks. Add brown rice, whole wheat, ragi, jowar, bajra, vegetables, oats, sprouts, salads, dals.

5. Foods rich in omega-3 fatty acids help manage sugar and cholesterol levels in blood.

6. Nuts are good in small quantities, so limit their consumption.

7. Eat more fruits and vegetables. Take five servings daily.

8. Drink at least 10 to 12 glasses of water daily.

9. Make exercise an integral part of your weight loss programme. Walking is one of the best, easily accessible and low-cost options.

10 Aim for a reduction of about half a kg per week, which is scientific.

The writer is a Chandigarh-based senior gynaecologist. Email

drkumar232@ho mail.com

High uric acid? First change your lifestyle
Dr R. Vatsyayan

During the normal metabolic functioning of the body, a certain type of natural substances called purine, present in all the body cells and virtually in all foods, get converted into uric acid. It is healthy and normal for the uric acid to be formed in the body because it serves as an anti-oxidant and helps prevent damage to our blood vessels lining. Under varied conditions when the concentration of uric acid becomes high, resulting in its accumulation in the body, it may lead to many health problems which include gouty arthritis and urinary stones.

Since long time, rise in uric acid has been associated with diet. Many centuries ago, Acharya Charaka had counted the dietary indiscretion, faulty lifestyle and to an extent genetic predisposition among the major reasons for the emergence of ‘vata rakta’ or the high uric acid- like-conditions in the body. Health scientists today conclusively show that improper metabolism of purine, whether dietary or originating in the process of normal physiological wear and tear, is the basic reason for the formation of high uric acid.

Ancient ayurvedic texts mention the excessive intake of food articles which are acidic, bitter and salty in taste and hot and unctuous in effect among the dietary reasons for the uric acid build-up. Similarly, high intake of non-vegetarian food consisting of red meat and poultry products and in certain cases even vegetarian diet of peas, lentils and beans can lead to this problem. Regularly taking such eatables as are incompatible to each other also do not go well with the body. Regular use of alcohol, especially beer and its accessory diet rich in protein, additionally contribute to raising uric acid levels. That is why it has also been described as a disease occurring among the opulent sections of society.

Men tend to be more susceptible to the rise of uric acid at an earlier age, and studies show that in women it is mostly reported at menopause. Not only this, the symptoms related to high uric acid are more severe and pronounced in men, and a clear understanding of the risk factors which trigger or precipitate an attack of gout gives an insight to manage the problem appropriately. Since in most cases the set-off factor is the wrong diet, for a person suffering from the problem of high uric acid, it becomes imperative to adopt a disciplinary approach towards food as in the long run self-care proves to be more helpful than any other medication. First of all, restrict the intake of non-vegetarian food, especially red meat, fish and eggs. There is a misconception that meat has a monopoly over protein. It is a well-acknowledged fact that plant-based proteins are more body friendly and are better metabolized. Limited intake of tea or coffee is not a problem, but alcohol intake not only interferes with the natural excretion of uric acid but is also accompanied by such food as directly leads to uric acid build-up.

On the vegetarian side, taking low-fat milk products and diminishing the use of cheese help reduce high uric acid. Vegetables with an exception of mushroom, brinjal , spinach, peas and dried beans, and cereals such as brown rice and whole wheat ‘atta’ are on the recommended list. Lentils are generally high in purine contents and these can be taken only in polished form. Similarly, red beans and black grams also do not find a place in the uric acid lowering diet plan. Adequate water intake activates the kidneys to excrete uric acid. During fasting one should be careful to consume sufficient quantity of liquids before or afterwards. Obesity is also a risk factor for gout, so adequate exercise and following a proper daily schedule is always helpful.

To facilitate the body maintain normal metabolic activity, two gm of the Triphala powder can be taken mixed with honey intermittently two or three times a week. Similarly, taking two gm powder of Giloy, Gorakhmundi and Harad crushed in equal parts everyday lowers the increased uric acid. Other classical ayurvedic medicines like Kaishore Guggul, Amrutadi Guggul and Brihad Manjishthadi Qwath, too, give very good results in the cases of high uric acid and gout, but these should be used only under the guidance of an expert physician.

The writer is a Ludhiana-based senior ayurvedic physician and Guru at Rashtriya Ayurveda Vidyapeeth. Email-ayu@live.in 

Watch your back
Dr Ravinder Chadha

There are individuals who walk with a limp or by tilting their hip to one side. This mostly happens when a person tries to avoid pain in the lower back. Initial experiments with medicines such as local application of an analgesic ointment helps temporarily in the case of such patients. Long-term effective treatment requires accurate diagnosis to pin-point the cause.

In the normal healthy spine, there are three curves:

l Cervical inward curve at the neck.

ll Thoracic outward curve in the middle

ll Lumbar curve at the low back.

These curves are visible while looking at an individual from the side.

The shape of the spine is such that it enables one to walk, run, bend and sit without exerting any stress on the muscles/ligaments of the body. Spine is stabilised in the normal position by the abdominal muscles on the front side and on the back. In situations where alignment of any part of the spine is altered, the areas like the hip, the buttock or legs have to bear the load.

Lumbar lordosis or swayback is caused by excessive weight, pregnancy, low-back problems like lumbar canal stenosis, sitting for extended periods performing desk jobs, driving car, etc.

Lordosis can be confirmed when standing aside a mirror. The curvature of the lower back will be pushed inside with protruded abdomen and hips swayed backwards. Individuals with lordosis look unattractive and often complain of pain during prolonged standing, sitting, walking, etc.

In cases of people with a pot-belly or pregnant women, the low-back curvature is increased which stretches the abdominal muscles, making them weak. This enhanced curvature exerts undue pressure on the entire back, particularly muscles, ligaments and discs causing pain and discomfort. Certain muscles around the spine and buttocks become tight and some become weak and stretched, creating an imbalance. The muscles which become often tight and require stretching are the following:

l Low-back extensors (Quardratus lumborum, erector spinae)

ll Hip flexor — iliopsoas muscle.

The muscles which become weak and require strengthening are the abdominal muscles and hip extensors - hamstrings and gluteus maximus.

Certain tips, if practiced, can lead to good posture:

ll When you are standing for an extended period, rest one leg on a step/stool to support/relax the back.

l When you are sitting, place a small pillow at the hollow of the back for support with your feet flat on the floor.

l It is not advisable to lock the knees while standing.

l When you are sleeping on the back, place a pillow under the knees.

l Wearing shoes with heels of less than one inch. High heels tend to pull the spine forward, leading to instability of the back.

l Avoid sitting in a static position for prolonged periods. Get up every 20 or 25 minutes.

EXERCISES are required to stretch the tight muscles and strengthen the weak ones.

Pelvic tilt — Lying on the back with your knees bent; tighten the abdomen muscles to flatten the back. Hold for a count of 10 and repeat 10 times.

Sit-up — Lying on the back with knees bent and arms across the chest. Lift the upper part of your body for not more than 45 degrees and return back. Repeat 10 times.

Hip flexor stretch — While standing, place one leg forward. Bend the front leg and push the hip of the back leg forward. Stay in this position for a count of 10. Return back and repeat five times.

Lower back stretch — Lie on the back and place your eet on the floor. Slowly pull your knees into your chest. Stay for a count of 10. Repeat 10 times.

Supine hip extension — Lie on the back, place the feet flat on the floor with the arms on the sideways. Squeeze the gluteus muscles and lift the buttocks off the floor and hold in the position for a count of 10. Repeat five times.

The writer is a former doctor/physiotherapist, Indian cricket team. E-mail

chadha_r 2003@yahoo.co.in