Better to act young than to look young

[email protected] (New York Times )
October 7, 2013

Young_than_to_look_youngJane E Brody, Oct 7: At a party I recently attended, a woman in her 60s proudly announced that her periodic facial treatments “have made me look 10 years younger.” A man of similar vintage said he was considering “facial tucks” to raise his sagging jowls.

Some days it seems everyone I meet is afraid of getting old - or at least of looking as old as they are. Occasionally, I see women who have had so many face lifts that they can barely move their lips when they talk, let alone smile.

Business is booming in the anti-aging market. Plastic surgeons who specialise in lifts, tucks and fillers barely noticed the recent recession. Cosmetics with anti-ageing properties fly off the shelf, and new concoctions appear almost weekly.

I admit to supporting the multi-billion dollar skin care industry with my long use of night creams, as well as a slew of daytime lotions that purport to “smooth out” aging skin while protecting it with sunscreen. I also colour my hair, which in its natural state is now about 80 per cent gray.

But I draw the line at injectable fillers and muscle relaxants, face lifts and tummy tucks. I’ll do everything I can to stay out of an operating room. My anti-aging measures, if and when they are needed, will be limited to cataract removal, a hearing aid and glasses for driving.

I wear clothes that suit my personality and activities, not necessarily my age. Shorts and tank tops anchor my summer wardrobe. And I wear colours near my face that are right for my skin tone, avoiding those (like yellow) that are unflattering. Still, cosmetic fixes go only so far to counter the effects of time.

True youthfulness - or, I should say, appearing younger than your age - is much more than skin-deep. Research has shown that youthfulness must come from within.

In one study, a team at Case Western Reserve University in Cleveland analyzed the facial photographs of 186 pairs of identical twins, determining which sibling looked older and why. Factors that contributed to looking older included smoking, sun exposure, stress and depression (or the use of antidepressants), the researchers reported. Other studies have linked depression to higher levels of inflammatory markers and oxidative stress, which can accelerate aging.

The team also found that among those younger than 40, a woman with a heavier body looked older than her leaner twin, but in subjects older than 40, a higher body mass index was associated with a more youthful appearance. Fat fills out wrinkles and makes the face - and presumably other parts of the body - look younger. But there’s a limit to its benefits: obesity is associated with more rapid biological aging.

Another study published last year by researchers at Brigham and Women’s Hospital in Boston found a biological link between stress and accelerated aging. Dr. Olivia I. Okereke and colleagues examined the chromosomes of 5,243 women ages 42 to 69 participating in the Nurses’ Health Study. They found that women with phobic anxiety - irrational fears of anything from social situations to spiders - had shorter telomeres on their chromosomes.

Telomeres are DNA-protein complexes on the ends of chromosomes that are considered biological markers of aging. Shortened telomeres are thought to underlie many of the adverse health effects of aging, and perhaps even to contribute to looking older than one’s years.

Lifestyle changes

A pilot study published online by The Lancet Oncology last month underscored the benefits of limiting stress. Dr. Dean Ornish and colleagues at the Preventive Medicine Research Institute and the University of California, San Francisco, tested the effects of lifestyle changes on the length of telomeres.

Ten men were asked to make changes that included adopting a whole-foods plant-based diet, moderate exercise, stress management techniques (like yoga and meditation), and seeking greater intimacy and social support. After five years, changes in the length of their telomeres were compared with those among 25 men who were not asked to make such changes.

In the men who made lifestyle changes, telomere length increased by an average of 10 per cent; the more changes the men made, the greater the increase in length. But telomere length decreased in the control group by an average of 3 per cent.

Still, youthfulness is not just a question of biology. People are perceived to be younger than their years if they smile and laugh a lot (be proud of those laugh lines!) and are generally cheerful and upbeat, the kind of people who smile at strangers and wish them a good day.

I occasionally pass an older couple who walk together three times a week. With their dour expressions and grudging acknowledgment of my “good morning,” I thought they were in their mid-90s. So one day I asked, only to learn that she was 80 and he was 83.

It also helps to pursue personal and professional activities you enjoy as you get older. My role models include the actress Estelle Parsons, who continues to perform on stage (and can do yoga headstands) at 85, and Dame Judi Dench, 78, who stars in movies despite having to learn her lines orally because macular degeneration has caused her vision to deteriorate.

My dear friend Margaret Shryer, 86, starred in a documentary about age discrimination and performed a one-woman show she wrote at a theater festival in Minneapolis this summer. Another friend, the award-winning broadcaster Lucy Jarvis, cane in hand at 96, still travels abroad to make television documentaries.

To my mind, it is far better to act young than to look young. Of course, it helps to be physically fit.

Too often, those who spend liberally to counter the superficial signs of age neglect their bodies below the neck and become physically old before their time. Muscle tissue inevitably declines with age, but much can be done to minimize and even reverse a loss of strength.

Try using free weights or resistance machines. If these don’t appeal, lift cans of soup (better for lifting than consuming) and continue to do chores that require strength, like digging in the garden or carrying groceries.

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Dr G K Sudhakar Reddy
August 4,2020

Being overweight or obese is now recognised as a serious cause of ill health and disability. There is a significant positive association between orthopaedic disorders and the level of obesity causing pain, deformity and difficulty in walking.

Excess body weight accumulation increases pressure on joints, particularly the hips, knees and ankles.

Here are a few type of  arthritis:

Osteoarthritis

It is a condition of damage/ wear and tear of the joint lining or cartilage. Obesity triggers this by loading excessive weight on the weight bearing joints like the knee and the hip. 

Knee Osteoarthritis

This is the most common arthritis especially in the Indian subcontinent.

While walking, an individual exerts 3 to 6 times pressure that of the body weight on the weight-bearing knee joint, which means in an obese with excess body weight, larger forces are exerted, which lead to higher risk of deterioration of cartilage.

In addition, there are excessive fat tissues that produce hormones and other factors that affect the joint cartilage metabolism and cause inflammation of the joints giving rise to joint pathology.  Leptin is one of the hormones causing knee osteoarthritis. 

Hip osteoarthritis

The force exerted across the hip is 3 times that of body weight. Hip osteoarthritis is caused by factors such as joint injury, increasing age and being overweight.    

Hand osteoarthritis

The observation that obese individual has a higher risk in having hand osteoarthritis has led to a hypothesis that the metabolic effect produced by fat tissue is the underlying factor. 

Osteoporosis

It is a progressive bone condition of decrease in bone mass and density (Bone Mineral Density or BMD) which can lead to an increased risk of fracture. Recent research suggests that obesity may accelerate bone loss. It is the amount of muscle mass which is seen in an active person, which accounts for bone strengthening effects and not due to the fat seen in a heavy person.

Low back pain

Low back pain from degenerative disc disease of the lumbar spine is one of the most disabling conditions in the community and overweight and obesity have the strongest association with seeking care for low back pain.

Managing Hip and Knee Osteoarthritis

Life style changes

If one is overweight, try to lose weight by doing more physical activity and eating a healthier diet. Regular exercise keeps you active and mobile and builds up muscle, thereby strengthening the joints and can improve symptoms. 

Pain Killers

Painkillers help with pain and stiffness for short term. They don’t affect the arthritis itself and won’t repair the damage to your joint. Creams and gels can be applied directly onto painful joints.

Nutritional Supplements

Glucosamine and chondroitin are nutritional supplements. Animal studies have found that glucosamine can both delay the breakdown of and repair damaged cartilage. However, there is insufficient evidence to support the use of glucosamine in humans and one can expect only a mild-to-moderate reduction in pain

Joint injections

If pain from osteoarthritis is severe joint steroid injections are injected into the joints that can reduces swelling and pain. The injections can start working within a day or so and may improve pain for several weeks or months. 

Hyaluronic acid injections, which help to lubricate your knee joint also give short term relief. In early stages. Stem cell treatment or cartilage regeneration procedures are being tried in young people with small defects, however it is still experimental and lacks long term evidence.

Surgery

May be recommended if you have severe pain or mobility problems.

Arthroscopy

If one has frequent painful locking/stiffening episodes especially in the knee joint, an operation to wash out loose fragments of bone and other tissue as joint can be performed by a minimally invasive key hole procedure called Arthroscopy.

Arthrodesis

If hip or knee replacement is not suitable, especially in young people who do heavy manual work, one can consider an operation known as an arthrodesis, which fuses your joint in a permanent position. This means that your joint will be stronger and much less painful, although you will no longer be able to move it.

Osteotomy

In young, active people in whom a knee joint replacement would fail due to excessive use one can consider an operation called an osteotomy. This involves adding or removing a small section of bone either above or below your knee joint.  This helps realign your knee so your weight is no longer focused on the damaged part of your knee. An osteotomy can relieve your symptoms of osteoarthritis, although you may still need knee replacement surgery eventually as you grow old

Joint replacement surgery

Joint replacement therapy is most commonly carried out to replace hip and knee joints. It involves replacing a damaged, worn or diseased joint with an artificial joint made of special plastics and metal.

For most people, a replacement hip or knee will last for at least 20 years, especially if it is cared for properly and not put under too much strain.

Dr G K Sudhakar Reddy is a Sr Consultant Orthopaedic Surgeon at Citizens Speciality Hospitals, Hyderabad

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Agencies
June 19,2020

While coughing, fever and difficulty in breathing are common symptoms of COVID-19, a new case study has found that pink eye is also a reason to be tested for the disease.

The study, published in the Canadian Journal of Ophthalmology, determined that conjunctivitis and keratoconjunctivitis can also be primary symptoms of COVID-19.

The researchers noted that in March, a 29-year-old woman arrived at the Royal Alexandra Hospital's Eye Institute of Alberta with a severe case of conjunctivitis and minimal respiratory symptoms.

After the patient had undergone several days of treatment with little improvement -- and after it had been determined that the woman had recently returned home from Asia -- a resident ordered a COVID-19 test.

The test came back positive, according to the researchers.

"What is interesting in this case, and perhaps very different to how it had been recognised at that specific time, was that the main presentation of the illness was not a respiratory symptom. It was the eye," said Carlos Solarte, an assistant professor at the University of Alberta in Canada.

"There was no fever and no cough, so we weren't led to suspect COVID-19 at the beginning. We didn't know it could present primarily with the eye and not with the lungs," Solarte said.

Academic studies at the outset of the pandemic identified conjunctivitis as a secondary symptoms in about 10 to 15 per cent of COVID-19 cases, he said.

Since then, scientists have gained greater knowledge of how the virus can transmit through and affect the body's mucous membrane system, of which the conjunctiva -- the clear, thin membrane that covers the front surface of the eye -- is an extension.

While the finding provides important new health information for the public, it also makes eye exams more complicated for ophthalmologists and staff, the researchers noted.

"The patient in this case eventually recovered well without any issues. But several of the residents and staff who were in close contact with the patient had to be under quarantine," said Solarte.

"Fortunately, none who were involved in her care also tested positive," he said.

Patients coming into an eye clinic with conjunctivitis and keratoconjunctivitis are now treated as potential cases of COVID-19 and extra precautions are taken by staff, according to the researchers.

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