lifestyle diseases

Life style diseases: 

Life style diseases Medical wing MH Pithoragarh

Introduction: 

Introduction Understanding of health – basis of all health care Narrow view – machine – breakdown – repair Holistic concept – promotion & protection of health

Determinants of health: 

Determinants of health Biological Behavioural & sociocultural Environmental Socioeconomic

Responsibility: 

Responsibility Individual Community State

Concept of causation: 

Concept of causation Germ theory Multifactorial causation

Slide 6: 

Changes in life style Stress Abundance Lack of of food physical exercise Smoking Emotional disturbance Aging & other factors Obesity Hypertension Hyperlipidemia Inc CA, thrombotic tendency Change in walls of arteries Coronary atherosclerosis Coronary occlusion Myocardial ischemia Myocardial infarction

Lifestyle: 

Lifestyle Diffuse concept – the way people live Reflecting – social values, attitudes, activities Learnt through social interaction with parents, peer groups, friends and siblings throgh school & mass media Health requires – healthy lifestyle Many current-day health problems are asso with lifestyle changes

What are lifestyle diseases: 

What are lifestyle diseases

The problem: 

The problem Leading cause of death in developed countries Upward trend in most countries

Reason : 

Reason Increase in life expectancy Changes in lifestyle

Changing patterns: 

Changing patterns 1900 2004 Pneumonia Heart disease TB Cancer Diarrhoea CVA Heart disease COPD Stroke Accidents CKD Diabetes Accidents Pneumonia Cancer Alzheimers Certain diseases of infancy CKD Diphtheria Septicaemia

Risk factors: 

Risk factors A determinant that can be modified by intervention, thereby reducing the possibility of occurrence of disease An attribute or exposure that is significantly associated with the development of a disease Types Modifiable Nonmodifiable

Prominent risk factors: 

Prominent risk factors Disease Risk factors Heart disease Smoking, high BP, elevated S.cholesterol , diabetes, Obesity, physical inactivity, Ty-A personality Cancer Smoking, alcohol, solar radiation, ionizing radiation, work-site hazards, environmental pollution, medications, infectious agents, dietary factors Stroke High BP, Elevated cholesterol, smoking Diabetes Obesity, diet RTA Alcohol, no-use of seat belts, speed, roads Cirrhosis Alcohol

Risk groups: 

Risk groups Identification of high risk groups Targetted appch Helps to define priorities and points to those most in need of attention

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Levels of prevention Primary prevention Secondary prevention Tertiary prevention Modes of intervention Health promotion Specific protection Early diagnosis & treatment Disability Limitation Rehabilitation

Levels of prevntion: 

Levels of prevntion Primordial prevention Discouraging children from adopting harmful lifestyles Primary prevention Secondary prevention Tertiary prevention

CAD: 

CAD Modern epidemic Expected to be the single most important cause of death in india by yr 2015 25.1% of total deaths in urban areas Risk factors Not modifiable-Age, Sex, Family history, Genetic factors, Personality Modifiable- Smoking, Htn, Dyslipidemia, Diabetes, Obesity, Sedentary habits, Stress

Slide 18: 

Changes in life style Stress Abundance Lack of of food physical exercise Smoking Emotional disturbance Aging & other factors Obesity Hypertension Hyperlipidemia Inc CA, thrombotic tendency Change in walls of arteries Coronary atherosclerosis Coronary occlusion Myocardial ischemia Myocardial infarction

HTN: 

HTN 59.9 & 69.9 per 1000 in males & females respectively in urban population Risk factor for CVA, CAD, kidney disease

Cancer: 

Cancer Males – Mouth/oropharynx, esophagus, stomach, lower respiratory tract Women- Cx, breast, mouth/oropharynx, esophagus Tobacco is a major cause of cancer of upper digestive & respiratory tract 91% of oral cancers – tabacco One million premature deaths each year Alcohol- esophageal/liver /rectal cancer 3% of all cancer deaths

TOBACCO: 

TOBACCO THE KILLER UNSEEN

Facts ?: 

Facts ?

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TOBACCO First Indian Cigarette factory 1906 For every 300 Cigarettes One Tree brought down. Probably this is the only product which is sold without even mentioning the contents.

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Would you take all these in your daily diet

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MAGNITUDE OF PROBLEM

Tobacco use is increasing in the developing world: 

Tobacco use is increasing in the developing world US 28 % (was 61% in 1939) East Asia 61 % Europe, Central Asia 57 % Latin America, Caribb 40 % South Asia 41 % (cigs + bidis) Sub-Saharan Africa 29 %

Slide 28: 

Which lifestyle would you choose?

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H uman History has been documented for 8500 years. Man always wanted to remain ….. STRONG HAPPY YOUNG BEAUTIFUL ENERGETIC & HEALTHY

Slide 30: 

Life Style Changes

Slide 31: 

Tobacco Begining My heroes are doing it ?

Slide 32: 

TOBACCO THE EFFECTS

Slide 33: 

Tobacco Health Effects

Slide 34: 

Consequences Various types of fatal diseases which will affect the lifestyle

Slide 35: 

Heart Attacks Smoking may cause your arteries to clog up which stops the oxygen in your blood reaching your heart properly. This can seriously damage your heart or may even cause myocardial infarction

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Breathing Problems Smoking makes your heart beat faster and makes you short of breath – If you enjoy sports then smoking will spoil your chances of performing well.

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Lung Cancer Smoking may cause lung diseases which can have a serious effect on your health .

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Bad Breath Smoking makes your breath smelly .

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Yellow Teeth Smoking turns your teeth yellow by leaving sticky tar deposits which can also cause brown stains. Just look at what could happen to your teeth!

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Smelly Clothes The smell of stale smoke tends to linger - not just on people's clothing, but on their hair, furniture, and cars. And it's often hard to get the smell of smoke out .

Tobacco related health hazards: 

1) Arteriosclerosis & Atherosclerosis Tobacco related health hazards Healthy artery Damaged artery

Tobacco related (continued)……: 

Tobacco related (continued)…… 2) Heart Attack 3) Peripheral Vascular Disease Smokers are twice as likely as Nonsmokers to have a heart attack

Tobacco related (continued)……: 

Tobacco related (continued)…… 4) Stroke 5) Emphysema This brain shows stroke damage, which can cause death or severe mental or physical disability Healthy lung Emphysematic lung

Tobacco related (continued)…… : 

Tobacco related (continued)…… Lung cancer kills more people than any other type of cancer 6) Lung Cancer

Tobacco related (continued)……: 

Tobacco related (continued)…… 7) Laryngeal Cancer Over 80% of deaths from laryngeal cancer are linked to smoking

Slide 46: 

If you won’t give up smoking for your lungs, heart or throat, maybe you’ll do it for your p …. Erectile Dysfunction

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COMPARED TO SMOKERS, YOUR… Stroke risk is reduced to that of a person who never smoked after 5 to 15 years of not smoking Cancers of the mouth, throat, & esophagus risks are halved 5 years after quitting Cancer of the larynx risk is reduced after quitting Coronary heart disease risk is cut by half 1 year after quitting and is nearly the same as someone who never smoked 15 years after quitting Chronic obstructive pulmonary disease risk of death is reduced after you quit Lung cancer risk drops by as much as half 10 yrs after quitting Ulcer risk drops after quitting Bladder cancer risk is halved a few years after quitting Peripheral artery disease goes down after quitting Cervical cancer risk is reduced a few years after quitting Low birth weight baby risk drops to normal if you quit before pregnancy or during your first trimester the benefits of quitting

Immediate health benefits of Giving up Tobacco: 

Immediate health benefits of Giving up Tobacco AFTER 20 Minutes BP & pulse ↓↓ to a normal rate Temperature of hands & feet ↑↑ to normal 8 Hours CO level in blood ↓↓ to normal O 2 level in blood ↑↑ to normal 24 Hours Chance of heart attack starts ↓↓ 48 Hours Nerve endings start growing again Smell & taste begin to improve

Short-term health benefits of Giving up Tobacco: 

Short-term health benefits of Giving up Tobacco 2 Weeks to 3 Months Circulation improves Walking gets easier Lung function improves up to 30% "I can talk again when I walk upstairs!" "It's great not have to clear my throat all the time."

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Short-term health benefits of Giving up Tobacco 1 Month to 9 Months ↓↓ coughing, sinus congestion, tiredness & shortness of breath Cilia (small hairs) grow back in lungs to better handle mucous, clean the lungs & reduce infection "I get fewer colds and sore throats." “I’m not bogged down with headaches" "I concentrate much better."

Long-term health benefits of Giving up Tobacco: 

Long-term health benefits of Giving up Tobacco 1 Year Risk of coronary artery disease is 1/2 that of a smoker “No more heaviness in my chest in the morning"

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Long-term health benefits of Giving up Tobacco 5 Years Lung cancer death rate  by 1/2 Risk of stroke = as non-smoker Risk of cancer of mouth, throat, esophagus, bladder, kidney and pancreas  . In addition: Quitting can dramatically improve chronic illnesses ( diabetes, asthma or kidney failure)

Slide 53: 

Tobacco- This presentation During this time of presentation About 40 people have died in India due to smoking. About 600 children tried tobacco About 14 Lakh cigarettes have been smoked in India HAPPY BIRTHDAY Today is the first day of rest of your Life

Diabetes: 

Diabetes Rising prevalence in developing countries Diabetic population – will triple in 2025 in SE-Asia Host factors Age Obesity Physical inactivity Diet Malnutrition Alcohol Stress

Obesity: 

Obesity Greatly increased Moderately increased Slightly increased NIDDM CHD Cancer( breast,endometrial,colon ) GB disease HTN PCOD Dyslipidemia OA Infertility Insulin resistance Hyperuricemia & gout LBA Breathlessness Increased risk of anaesthesia complication Sleep apnea Fetal defects

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Prevention of obesity – start in early childhood Obesity is harder to treat in adults Mgmt Dietary changes Physical activity Drugs & Sx

RTA: 

RTA Human factors Environmental factors Precipitating factors

Prevention: 

Prevention Identify high risk group Motivate – set practical time frame Modify the risk factors Treatment Legislation Smokers room Audio-visuals

Diet: 

Diet Say No to Refined carbohydrates High starch food Non Veg Fried food Chips, kurkure, burgers, samosa Ghee, Butter Snacking while watching TV Skipping meals for wt reduction

Healthy food intake: 

Healthy food intake Fruit day Vegetable day Take seasonal fruits as snacks

Regular exercise: 

Regular exercise Even 30 min of activity can help Do not use the lift-Take the stairs Walk/cycle to the wk place from home No MT day Meditation – 1100hrs

What constitutes a sedentary lifestyle: 

What constitutes a sedentary lifestyle Engaging in no leisure-time physical activity such as exercises, sports, physically active hobbies in a two-week period. Source - Leisure-time physical activity among adults: United States, 1997-98. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, 2002 .

Physically active lifestyle: 

Physically active lifestyle Physical activity simply means movement of the body that uses energy.

Walking : 

Walking

jogging: 

jogging

gardening: 

gardening

Washing clothes: 

Washing clothes

Briskly pushing a baby stroller : 

Briskly pushing a baby stroller

Climbing the stairs : 

Climbing the stairs

cycling: 

cycling

Playing soccer: 

Playing soccer

Dancing the night away: 

Dancing the night away

: 

Are all good examples of staying physically active

Health benefits of physically active lifestyle: 

Health benefits of physically active lifestyle Regular physical activity Avoiding tobacco Balanced diet Least expensive Multiple health benefits Best protection against lifestyle diseases

Health benefits of physically active lifestyle..: 

Regular physical activity Improves longevity and prospects of healthy living Protects against IHD, hypertension and dyslipidemias Protects against colon and breast cancer Helps prevent type 2 diabetes, as well as its complications Helps prevent osteoporosis Relieves symptoms of depression and anxiety Improves mood Controls weight Health benefits of physically active lifestyle..

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Physical activity evokes acute stress like responses with respect to pulse rate, blood pressure etc. Such repetitive activity conditions the body to accept more and more challenges with less and less adrenaline rise. Persons who are physically active have a less intense adrenaline response to mental or emotional challenges and cope better with stressful situations. Benefits of p hysical activity in stress

Prevalence of risk factors for CAD: 

Prevalence of risk factors for CAD Reference:- Y K Yadav.Exercise in the management of Coronary Artery Disease.MJAFI 2007;63,353 - 367.

Physical activity and the obesity gene: 

Physical activity and the obesity gene People of European descent with two copies of the FTO gene on average weigh nearly 3kg more. University of Maryland study - those who had the FTO gene but were very physically active weighed about the same as others who did not carry the gene.

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health benefits of a physically active lifestyle are undisputed

Armed Forces: 

Armed Forces Long tradition of physically active lifestyle Physical fitness is propagated and tested…

At the time of recruitment: 

At the time of recruitment

In the academies & regimental centers: 

In the academies & regimental centers

Throughout service life: 

Throughout service life

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POSITIVE INFLUENCE ON FAMILY

Yet….: 

Yet…. We are witnessing increasingly sedentary lifestyles amongst all ranks and families

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Obesity and associated co morbidities such as IHD Hypertension,NIDDM,Arthritis,Dyslipidemias and other stress diseases are on the rise!!!

Slide 88: 

Time for introspection

Slide 89: 

Where are we faltering?

Non adherence to laid down norms: 

Non adherence to laid down norm s Regular PT and games are on the verge of extinction They have been replaced by morning briefs and evening conferences BPET,PPT AME/PME

Paradigm shift in work culture : 

Paradigm shift in work culture Automation Techno savvy soldier

Families…: 

Families… Farming Desk jobs

Families…: 

Families… Household chores Home appliances

children: 

children

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We need to modernize and embrace new technologies At the same time, be alive to the negative fallout and take corrective measures

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WHAT IS THE ANSWER?

Slide 97: 

LIFESTYLE MODIFICATION

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How do I begin?

: 

A JOURNEY OF A THOUSAND MILES BEGINS BY A SINGLE STEP CHINESE PROVERB

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Start slow, and gradually build up the length and intensity of your workouts over time.

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For health benefits, physical activity should be of moderate intensity for at least 30 minutes a day on 5 days of the week or vigorous and minimum of 20 minutes on three days of the week.

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30 minutes of moderate-intensity aerobic activity a day is an excellent starting point , not an upper limit .

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MODERATE PHYSICAL ACTIVITIES VIGOROUS PHYSICAL ACTIVITIES Running/jogging (5 miles per hour) Bicycling (more than 10 miles per hour) Swimming (freestyle laps) Aerobics Walking very fast (4 ½ miles per hour) Weight lifting (vigorous effort) Basketball (competitive) Walking briskly (about 3 ½ miles per hour) Hiking Gardening/yard work Dancing Golf (walking and carrying clubs) Bicycling (less than 10 miles per hour) Weight training (general light workout)

Emphasis on “fitness” : 

Emphasis on “fitness” Physical exercise should be undertaken to improve the “fitness” by doing it with reasonable vigour, not to simply burn off the calories.

METs vs Calories: 

METs vs Calories MET is defined as the ratio of a person's working metabolic rate relative to the resting metabolic rate. One MET is the caloric consumption of a person while at complete rest. Since each individual has a varying Basal Metabolic Rate, a MET is, therefore, variable from one person to the next.

METs vs Calories…: 

While exercising at 6 METs, 90 kg man would burn considerably more calories than his 55 kg son doing the same exercise. Minimum level should be 4.5 TO 6 METs . Most ideal would be to exercise at level of between 6 to 9 METs METs vs Calories…

MET LEVELS OF COMMON EXERCISES: 

MET LEVELS OF COMMON EXERCISES ACTIVITY MET ACTIVITY MET WALKING 3.2 KM PER HOUR 4.8 KM / HR 2.0 3.0 CYCLING 16 KM PER HOUR 20 KM/ H 7.0 8.8 JOGGING 7.5 KM / HR 8.0 KM / HR 7.5 8.7 SWIMMING 20 MTRS / MT 40 MTRS / MT 6.0 12.0 RUNNING 9.6 KM / HR 11.2 KM / HR GOLF NOT CARRYING EQPT 10.0 11.5 3 TO 4 RACQUET GAMES ( SINGLES) TENNIS, NON COMPETITIVE TENNIS, COMPETITIVE SQUASH,NON COMPETITIVE SQUASH, COMPETITIVE BADMINTON,NON COMPETITIVE 6 TO 7 8 TO 10 7 TO 10 11 TO 14 4 TO 7

ENERGY EXPENDITURE ON VARIOUS PHYSICAL ACTIVITIES: 

ENERGY EXPENDITURE ON VARIOUS PHYSICAL ACTIVITIES ACTIVITY KCAL/HR ACTIVITY KCAL/HR CLEANING/MOPPING GARDENING WATCHING TV CYCLING 15 KM/HR 210 300 86 360 BADMINTON TT TENNIS VOLLEY BALL 350 250 400 180 RUNNING 12 KM/HR 10 KM/HR WALKING 4 KM/HR 750 655 160 DANCING SHOPPING TYPING SLEEPING STANDING SITTING 375 200 110 57 130 86

Slide 109: 

The lifestyle prescription

For the men: 

For the men Back to basics Provide a gym close to the PT Ground Set an example Encourage unit level sports activities Do not shelter, hide overweight personnel Destigmatise categorization Provide adequate support, opportunity for lifestyle modification Set achievable targets JCOs/warrant Offrs need special attention

Officers: 

Officers Get exercise into your daily life Purposefully park your car a little further from the office, mall or store Use the stairs instead of elevators and escalators whenever possible.

Officers…: 

Officers… Get exercise into your daily life Consider buying a piece of cardiovascular equipment for your home (e.g. treadmill, bike). Try to combine your exercise with something that you do routinely like while watching TV, reading the newspaper, or returning phone calls.

Slide 113: 

Make it fun! Try a new sport like tennis or golf. The more that you enjoy exercise, the more likely you are to stick to it. Make it social. Keep an exercise log. Get exercise into your daily life…

Get exercise into your daily life… : 

Get exercise into your daily life… Hire a personal trainer Set short-term goals. Try targeting a specific event, such as a road race or a walk-for-charity Reward yourself for achieving short-term goals

Yoga and physical fitness : medical opinion.: 

Yoga and physical fitness : medical opinion . “Yoga” as a part overall fitness program is useful, when combined with various other exercises it helps in management of stress postural exercises help improving flexibility and suppleness May help in management of certain diseases like backache.

For the ladies: 

For the ladies Do some household chores yourself Develop a physically active hobby Walk around the house during television commercials. Dance, if you enjoy it! it also releases stress. Work on your garden Try to use the cycle to go to the market.

Slide 117: 

Learn and practice Yoga.

Slide 118: 

For the kids

A supportive environment: 

A supportive environment Even as we make personal choices to become more physically active, we also need a supportive environment in workplaces, schools, and community settings: Safe and encroachment free pedestrian paths. Parks and playgrounds in residential areas Playgrounds + sports equipment in schools, colleges and other institutions. Protected time for school sports.

Overweight parents could be paid to walk their children to school – the govt of UK initiative: 

Overweight parents could be paid to walk their children to school – the govt of UK initiative people who exercise would receive supermarket-style vouchers to spend on sports gear and healthy food. Those attending keep-fit classes or weight loss clubs could be eligible for rewards, as well as those walking to bus or train stations. machines would be placed in schools or stations so parents or commuters could swipe their cards to tot up points. pilot project in Manchester

Slide 122: 

Improve employee health Reduce employee stress Reduce organizational conflict Create a healthier organizational culture

Stay happy: 

Stay happy

THANK YOU: 

THANK YOU