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At 39, getting pregnant was almost out of the question for Sharmilee (name changed) when she met her doctor. Morbidly obese, stressed out at work and hooked to her stress busters—smoking and drinking—she had lost whatever chance she had to conceive normally. She had a love marriage but her changing physique left them with no love in the relationship, and she had huge fibroids in the uterus. That was in 2009.
Four years later, Sharmilee is still working hard to get back in shape but a lot has changed for the better since then. After undergoing treatment, she conceived and in January this year, the couple celebrated their 'miracle' daughter's second birthday.
Thanks to advancements in medicine, the couple could fulfil their dream of becoming parents. While such breakthroughs have helped people like Sharmilee overcome limitations imposed by nature, has it improved the quality of life?
We live longer than we did 30 to 40 years ago, but the world's population today loses more years of healthy life to disability now than it did 20 years ago, revealed HALE, the first-ever global estimate of healthy life expectancy developed by the World Health Organisation that measures how many years a person at a specific age could expect to live in good health between two time points—1990 and 2010—across 187 countries.
The study also observed that a large component of years lived with disability (YLD) stemmed from mental and behavioural disorders (major depression, anxiety and alcohol and drug use), obesity epidemic, neurological conditions (Alzheimer's/Parkinson's) and musculoskeletal disorders that include lower back pain and osteoarthritis.
India has reasons to be concerned for we are highly vulnerable to such disorders, thanks to our bad lifestyle, says Dr S. Sivaramakrishnan, lifestyle management consultant at PD Hinduja Hospital in Mumbai. “Indians, by nature, are reactive not proactive,” he says. “It is not about the time we get but the priority that we set for ourselves. Even kids are not free from stress.”
More youngsters are developing osteoporosis and osteoarthritis, conditions known to affect the elderly. Blame it on excessive weight and lack of physical activity that make the bones—the fulcrum for healthy muscle activity—weak.
“Today, a child falling from 2 to 4ft suffers a severe fracture,” says Sivaramakrishnan. “Four decades ago, even a fall from 10ft resulted in only minimum injuries.” Low exposure to sunlight is another reason for poor bone quality.
No doubt, there is increasing awareness. The fast mushrooming health clubs and lifestyle management clinics are proof enough. They could play a pivotal role in averting premature onset of lifestyle-related diseases. Unfortunately, a majority of people turn to them only after they are in the grip of a disease.
In most cases, it is the `educated' and 'well-settled' youngsters who come for these expensive wellness packages only to be taught the basics of breathing right, eating well, staying fit and sleeping well.
According to Dr Issac Mathai, a renowned holistic health consultant, 2010 saw an 'increasing viral effect' not just in terms of infectious diseases like dengue and bird flu but also in the number of people in their 30s and 40s falling ill due to chronic ailments like heart disease, diabetes and hypertension. “The 'I may get It' syndrome—watching your colleague or family member suffer—has had a positive impact in correcting many people on bad health habits,” says Mathai. “We just need to make some small corrections.”
The timing could not have been better. Let this new year be the time when you say goodbye to a unhealthy lifestyle and say hello to a healthy you. Give it your BEST.

B for Breathing right
Do you pull the stomach in while inhaling and jut it out on exhaling? If the answer is yes, then your breathing technique is all wrong. Don't think it is a harmless mistake. Bad breathing habits can make you sick as the body is denied the oxygen it needs. As a result, a number of systems in the body, particularly circulation, immunity, endocrine and nervous, get affected, say experts. It is also reported to cause severe headaches, irritable bowel movement, dizziness, numbness, anxiety and chest pain.
Most often, people who hyperventilate do not realise that their breathing is out of sync. “The cases of hyperventilation syndrome (panic breathing) among women aged 16-25 is on the rise,” says Dr Manoj K. Goel of Delhi Heart & Lung Institute. “It's more of a physiological condition that can lead to retention of excess carbon dioxide in the system leading to dizziness and electrolyte imbalance, especially when the breathing is very fast. A healthy way to cope with it is to get sufficient sleep and doing breathing exercises.”
Mouth-breathing and breathing that is too rapid or too shallow are a no-no. Whenever possible, breathe through your nose.
Breathing right has a positive effect on the body. It rejuvenates the organs, cells and tissues. The body gets energised, concentration improves, it promotes detoxification, increases immunity, improves bowel movement, reduces stress and anxiety and creates a feeling of calmness.
Very often, deep breathing exercises are used to effectively control one's emotions. Breathing techniques are also used to lower blood pressure and aid weight loss via improved metabolism.
Doing deep breathing exercises (for 3-5 minutes) every day is a must. It will help you feel your own body better and increases lung capacity. Just put in 30 to 50 per cent extra effort while breathing and feel the difference.

E for eating 
and exercise
Lifestyle diseases are on the rise. A major reason for it is bad eating habits. For a normal person, a minimum four-hour gap between two meals is mandatory. On the other hand, delay by more than six hours will result in the person eating at least 20-50 per cent extra which could lead to obesity and related problems in the long run. Drink plenty of fluids, especially water, milk, buttermilk or herbal/green tea. Avoid aerated drinks completely.
A healthy eating habit has to go hand in hand with a suitable workout regime. While yoga ensures holistic wellbeing, burning of calories is equally important. An ideal fitness regime would be a combination of yoga and other exercises like swimming, jogging, treadmill and some weight lifting. A one-day rest per week is compulsory so is a minimum of 40 to 60 minutes of exercise on other days. Missed one day? Don't panic. Start again.

S for sleep, stress & sex
Almost 90 per cent of people need 7-8 hours of sleep a day. Some may need less, others more. However, if you repeatedly wake up after eight hours of sleep feeling tired or exhausted, it is clear that something is not functioning right in your body and it needs your attention.
It is when we sleep that our body undergoes repair along with many other crucial metabolic activities that affect our emotional and psychological well-being.
Stress is something that could give you sleepless nights. Not only does it mess up the functioning of the brain but it also has an adverse physiological effect. Stress is often a key factor when women experience either absence of menstruation or abnormal bleeding.
Often people feel the effects of stress as fatigue, various aches and pains or as emotional 
disorders such as anxiety and depression.
One cannot do away with stress, the only way out is to learn to handle it. The first thing to do is to make a list of situations that you think are stressful for you. Then, focus on eliminating them. Practise yoga or any other meditation technique that encourages positive thinking and relaxes your mind.
At work, take small breaks. This will help you rethink your thoughts and find a solution for the problem at hand. Make time for family and friends. No, chatting online with them won't do.
Don't let stress affect your sex life. In fact, a healthy sex life could help you combat stress. It is even good for the heart as it helps in reducing blood pressure.
Having sex once or twice a week could boost the level of immunoglobulin A or IgA, an antibody, in the body which will protect you from getting a cold and other infections.
So, make sure you take out time for it. Go on a holiday. Sadly, even planning a holiday has become quite stressful today. So, skip the planning bit and go on an impromptu trip.
While the trend of wellness holidays is on the rise, experts suggest that a compulsory two or three days of 'do nothing' holidays once in three months are highly beneficial. Remember, it should be nothing less than three days for the body takes minimum two days to relax and transform.

T for thoughts
The word sounds philosophical and spiritual that best suits the aged. But today, even youngsters are thinking about 'how one reacts to situations' or 'what happens in the mind', as counsellors put it.
Keeping a positive frame of mind is very important to face the day-to-day challenges of life. It could be something as simple as balancing two things at a time as it happened in the case of Dr Amit (name changed), 27. Life went well until he fell in love during his college days. In no time, the good student got completely stressed out trying to balance his studies and the demands of love life. He ended up putting on 6kg. Much of it showed up as ugly inches.
“Before I could start off as a doctor, I needed a doctor myself,” he says. “It took me six months to regain my lost health. The biggest lesson I learnt was to learn to set my priorities right.”
A lot of people face a similar situation. What fails them is the lack of mental will.
Along with keeping the body fit, it is equally important to do things to keep the mind in a fighting-fit condition.
The good news is, we have the power to change negative thoughts and feelings into positive, rational and motivating thoughts. So, say no to all negativity and bring out the BEST in you this new year.

Weight and watch

By Dr Anupam Sibal and Dr Akshay Kapoor
Obesity has become an increasingly worrisome problem in children and adolescents in India. Hypertension, type 2 diabetes, pulmonary complications (for example, asthma and sleep apnoea), growth acceleration, dyslipidaemia, musculoskeletal and psycho-social problems are among the most common conditions associated with primary childhood obesity. Diseases due to fat deposition in the liver are also being increasingly seen.
In a study conducted by Indraprastha Apollo Hospitals, Delhi, 23 per cent of the 1,000 schoolchildren who participated were found to be obese. They mostly belonged to the higher socio economic strata. Most of them spent majority of their time in sedentary activities (studying, watching TV or playing games on the computer). They predominantly had fatty food.
Physical inactivity is identified as an important contributing factor in childhood obesity. Traditional Indian meals not only satisfy the palate, but also provide health benefits. Eating small meals at regular intervals, regular physical exercise, regulation of television and computer timings, especially in adolescents, can contribute immensely in building a physically fit nation.
Dr Anupam Sibal is group medical director at the Apollo Hospitals Group and Dr Akshay Kapoor is paediatric gastroenterologist and hepatologist at the Indraprastha Apollo Hospitals.

Paying a heavy price

Out of pocket (OOP) spending for medication has remained consistently high in India. Estimates from the consecutive Consumer Expenditure Surveys (CESs) have revealed that the greatest share of OOP spending has been on medications in urban India—81.6 per cent in 1993–94, 74.8 per cent in 1999–2000, and 71.2 per cent in 2004–2005.
A detailed study on the 'Deepening health insecurity in India: Evidence from National Sample Surveys (NSS) since 1980s' by Selvaraj S. and Karan A.K. reports that for the last two decades, financial constraints have remained the second major reason for not seeking health care in India, which explains the 20 per cent of non-treated ailments in urban India in 2004.
The numbers have only increased with time. A 2012 study by Upendra Bhojani, faculty and PhD scholar at the Institute of Public Health (IPH), Bangalore, highlights the impoverishing impact of OOP expenses on chronic diseases. The number of poor almost doubled in one month at K.G. Halli in Bangalore. Reason: OOP payments made on outpatient care of chronic conditions.
Of the 9,299 families surveyed here, 3,202 families (34.4 per cent) reported having one or more family members (total 3,844 individuals) with a chronic condition. Total 69.6 per cent of the households made OOP payments on outpatient care for chronic conditions. As a result, 16 per cent of households were financially strained.

Breathing right
* Good breathing involves using your diaphragm. Observe that your abdomen comes out while inhaling and goes in while exhaling.
* Keep taking deep breaths at designated times through the day. It helps keep panic attacks at bay.
* If you often tuck your tummy in to make it look flatter, then you are not using your diaphragm while breathing.
* Improves brain function * Cleanses lungs
* Calms an agitated mind * Improves sleep
Check how you breathe
Keep your right hand on your chest and left hand on your abdomen. Take a deep breath slowly and observe which hand rises. Did your right hand rise much higher than your left hand? If yes, then you are a chest breather. You don't effectively use your diaphragm. It's time to breathe right.

Eating, exercise
E for eating
Eating disorder can manifest as eating too less or overeating. Distress and concern about body weight or shape also leads to eating disorders. It coexists with depression, substance abuse or anxiety disorders.

E for exercise
Make it a point to walk for at least 40 minutes a day.

Benefits of walking:
* Weight loss
* Prevents heart disease, high blood pressure and diabetes
* Prevents anxiety and depression
* Boosts mood

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