Regular exercise can keep lifestyle diseases away

April 5, 2015

Apr 5: Cardiovascular disease, diabetes, and osteoporosis - Indians are facing an unhealthy future burdened with a slew of lifestyle diseases. But instead of expensive medication and therapy, the cure lies in making exercise a compulsory part of everyday life, health experts say.

"Indians are increasingly leading a sedentary and machine-dependent life, which may seem comfortable but has extremely adverse effects on health," T.S. Kler, Head of the Department Cardiology, Fortis Escorts Heart Institute and Research Centre said.

Regular exerciseKler said with increasingly hectic lifestyles, most Indians in urban areas nowadays do not walk to the neighbourhood store but rather order groceries on phone for home delivery or drive down.

"We do not climb stairs any more, with lifts being omnipresent. Riding bicycles to work or to school is not cool in urban areas any more. Forget adults, this conditioning begins with children who prefer to stay indoors watching television or playing video games rather than spending time in the playground," he added.

"We all know that cardiovascular diseases are today a major health concern in India. They are the single largest leading cause of deaths in the country, and relatively younger people are today afflicted by coronary artery disease," the noted cardiologist said.

Various surveys done in India have shown that the incidence of coronary heart disease is 8-10 percent in urban areas and 5-6 percent in rural areas.

Kler said regular exercise can help prevent risk factors for cardiovascular diseases such as hypertension and type II diabetes. It also keeps the weight in check.

"Incidences of coronary artery disease can be reduced substantially if the entire Indian population religiously takes to physical exercise. Even 30 minutes of moderate exercise daily can be immensely beneficial. We need a national focus on this less-talked about subject," Kler said.

According to Rajeev K. Sharma, senior consultant orthopedics and joint replacement surgery, Indraprastha Apollo Hospital: "Adequate levels of physical activity decreases the risk of a hip or vertebral fracture and helps control weight. In fact, exercise is very crucial for maintaining good bone health, besides adequate intake of calcium."

"WHO estimates that globally, one in four adults is not active enough while more than 80 percent of the world's adolescent population is insufficiently physically active. This is a dreadful scenario as all these inactive people are making themselves vulnerable to several health issues," he said.

Osteoporosis-related injuries such as vertebrae fractures not only cause pain but also degrade the quality of life, curtail movement and increase dependence. Since the bone is a living tissue, it becomes stronger when subjected to exercise, Sharma said, adding that loss of bone mineral density that begins during the 30s can be curtailed by exercising regularly.

"People who exercise are found to have greater peak bone mass as compared to people who do not exercise."

According to the International Osteoporosis Foundation, the malaise annually causes more than 8.9 million fractures around the globe.

"Though exercising can, to a large extent, help in building strong bones, there is a general lack of an exercise culture in India. This needs to change. Schools, colleges and other institutions should take the lead in nurturing an exercising culture."

Harvinder Singh Chhabra, medical director and chief of spine services at Indian Spinal Injuries Centre, Vasant Kunj, said Indians generally do not realize the importance of exercising unless hit by an ailment.

"Many patients start walking regularly after back pain or osteoarthritis has already set in their bodies. We tell them they could have delayed it by being active all their lives," he added.

According to Chhabra, in the West, there is a lot of focus on physical activity and people are moving away from sedentary ways of life. "They are junking television and going for cycling, running, or adventure sports such as rock climbing. This shift is yet to take place in India."

To make exercise a national culture, apart from awareness, many enabling policy measures are also needed.

"In urban areas, several environmental factors discourage people from leading more active lives even if they want to. Lack of public spaces such as parks and grounds, safety issues on the roads, pollution and irksome traffic do not allow many people to step out of homes to run or walk. This needs to change," he said.

The latter half of the 20th century has brought substantial progress in disease control due to expansion of health infrastructure. With food and nutritional consumption also improving for a vast majority of population, life expectancy in India has gone up over the years. Experts say that deaths due to communicable diseases have decreased while those from non-communicable diseases (NCDs) have risen.

NCDs at present account for 53 percent of all deaths and 44 percent of disability adjusted life-years lost. Projections indicate a further increase to 67 percent of all deaths by 2030. Cardiovascular disease is the major contributor to this burden, attributable to 52 percent of NCD-associated deaths and 29 percent of total deaths.

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Agencies
July 4,2020

The Union health ministry on Friday revised the dosage of anti-viral drug remdesivir to be administered to coronavirus patients in the moderate stage of illness from the earlier six days to five days as it issued an updated 'Clinical Management Protocols for COVID-19'.

The drug, administered in the form of injection, should be given at a dose of 200 mg on day one followed by 100 mg daily for four days (total five days), the new treatment protocols stated.

The Health Ministry on June 13 had allowed the use of remdesivir for restricted emergency use in moderate cases under "investigational therapies".

"Under emergency use authorisation, remdesivir may be considered for patients in moderate stage requiring oxygen support," the document stated.

It is not recommended for those with severe renal impairment and high level of liver enzymes, pregnant and lactating women, and those below 12 years, it said.

The ministry also okayed off-label application of tocilizumab, a drug that modifies the immune system or its functioning, and convalescent plasma for treating COVID-19 patients in the moderate stage of illness as "investigational therapies".

It also recommended hydroxychloroquine for patients during the early course of the disease and not for critically-ill patients.

On June 27, the ministry had included an inexpensive, widely used steroid dexamethasone in treatment protocols for COVID-19 patients in the moderate to severe stages of their illness among other therapeutic measures.

The ministry advised use of dexamethasone, which is already used in a wide range of conditions for its anti-inflammatory and immunosuppressant effects, as an alternative choice to methylprednisolone for managing moderate to severe cases of coronavirus infection.

India's COVID-19 cases soared by over 20,000 in a day for the first time taking the country's total tally to 6,25,544 on Friday while the death toll climbed to 18,213 with 379 new fatalities, according to the Union Health Ministry data updated at 8 am.

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News Network
February 12,2020

Washington, Feb 12: People who are optimistic may contribute to the health of their partners, staving off the risk factors leading to Alzheimer's disease, dementia and cognitive decline as they grow old together, according to a study.

The research, published in the Journal of Personality, followed nearly 4,500 heterosexual couples from the US Health and Retirement Study for up to eight years.

The researchers found a potential link between being married to an optimistic person and preventing the onset of cognitive decline, due to a healthier environment at home.

"We spend a lot of time with our partners.They might encourage us to exercise, eat healthier or remind us to take our medicine," said William Chopik, an assistant professor at the Michigan State University in the US.

"When your partner is optimistic and healthy, it can translate to similar outcomes in your own life. You actually do experience a rosier future by living longer and staving off cognitive illnesses," Chopik said.

An optimistic partner may encourage eating healthy foods, or working out together to develop healthier lifestyles, the researchers said.

For example, if a person quits smoking or starts exercising, their partner is close to following suit, they said.

"We found that when you look at the risk factors for what predicts things like Alzheimer's disease or dementia, a lot of them are things like living a healthy lifestyle," Chopik said.

"Maintaining a healthy weight and physical activity are large predictors.There are some physiological markers as well. It looks like people who are married to optimists tend to score better on all of those metrics," he said.

The researchers said there is a sense where optimists lead by example, and their partners follow their lead.

They also suggest that when couples recall shared experiences together, richer details from the memories emerge.

Chopik noted while there is a heritable component to optimism, there is some evidence to suggest that it's a trainable quality.

"There are studies that show people have the power to change their personalities, as long as they engage in things that make them change," Chopik said.

"Part of it is wanting to change. There are also intervention programs that suggest you can build up optimism," he added.

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Agencies
May 19,2020

New York, May 19: Cigarette smoke spurs the lungs to make more of the receptor protein which the novel coronavirus uses to enter human cells, according to a study which suggests that quitting smoking might reduce the risk of a severe coronavirus infection.

The findings, published in the journal Developmental Cell, may explain why smokers appear to be particularly vulnerable to severe COVID-19 disease.

"Our results provide a clue as to why smokers who develop COVID-19 tend to have poor clinical outcomes," said study senior author Jason Sheltzer, a cancer geneticist at Cold Spring Harbor Laboratory in the US.

"We found that smoking caused a significant increase in the expression of ACE2, the protein that SARS-CoV-2 uses to enter human cells," Sheltzer said.

According to the scientists, quitting smoking might reduce the risk of a severe coronavirus infection.

They said most individuals infected with the virus suffer only mild illness, if they experience any at all.

However, some require intensive care when the sometimes-fatal virus attacks, the researchers said.

In particular, they said three groups have been significantly more likely than others to develop severe illness -- men, the elderly, and smokers.

Turning to previously published data for possible explanations for these disparities, the scientists assessed if vulnerable groups share some key features related to the human proteins that the coronavirus relies on for infection.

First, they said, they focused on comparing gene activity in the lungs across different ages, between the sexes, and between smokers and nonsmokers.

The scientists said both mice that had been exposed to smoke in a laboratory, and humans who were current smokers had significant upregulation of ACE2.

According to Sheltzer, smokers produced 30-55 per cent more ACE2 than their non-smoking counterparts.

While the researchers found no evidence that age or sex impacts ACE2 levels in the lungs, they said the influence of smoke exposure was surprisingly strong.

However, they said, the change seemed to be temporary.

According to the data, the level of the receptors ACE2 in the lungs of people who had quit smoking was similar to that of non-smokers.

The study noted that the most prolific producers of ACE2 in the airways are mucus-producing cells called goblet cells.

Smoking is known to increase the prevalence of such cells, the scientists said.

"Goblet cells produce mucous to protect the respiratory tract from inhaled irritants. Thus, the increased expression of ACE2 in smokers' lungs could be a byproduct of smoking-induced secretory cell hyperplasia," Sheltzer explained.

However, Sheltzer said other studies on the effects of cigarette smoke have shown mixed results.

"Cigarette smoke contains hundreds of different chemicals. It's possible that certain ingredients like nicotine have a different effect than whole smoke does," he said.

The researchers cautioned that the actual ACE2 protein may be regulated in ways not addressed in the current study.

"One could imagine that having more cells that express ACE2 could make it easier for SARS-CoV-2 to spread in someone's lungs, but there is still a lot more we need to explore," Sheltzer said.

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