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Lifestyle Management at Different Stages of Life by Dr Geeta Asthana • Role of care, cure and self sufficiency ‘ Where care fails, the search for a cure begins.’ • “Control” is the appropriate lifestyle requirement to maintain health, given our genes, predispositions and environmental conditions. Health at 20’s • The best years of our lives. It's time to have fun and explore. It's also time to develop some healthy habits. Sex Matters Male/Female Birth Control Methods Common Sexually Transmitted Diseases Staying Fit Abdominal Exercises Your Mind Eating Disorder Warning Signs Health at 30’s • 30 is SOMETHING. Life, work, and family all come into play here. Why not take a few simple steps to ensure your health and your family's health and wellbeing! Healthy Pregnancy: Seeing Your Doctor Before You Get Pregnant Planning a Healthy Pregnancy Staying Fit: Weight Training Your Mind: You are wound like a clock, you rush everywhere, your boss is demanding, your kids are fighting, your spouse isn't listening, and you're about to kick the dog. Time out. You need a retreat. Do You Need a Retreat? One Minute Retreat Yoga: Uniting mind body and spirit Yawn, just yawn. This retreat is for relaxation. Yawning increases the amount of oxygen in your system, and Scientologists think it helps to shift your level of consciousness. Health at 40’s • The 40s can be the best decade as you settle in to your life. Make the most of these years by maintaining a healthy and active lifestyle. • Key points • Cholesterol • Hypertension • Exercise • Nutrition • Smoking • Menopace What is Cholesterol? • Cholesterol is a soft, fat-like substance that is found naturally in all of your body's cells. It plays an important part in building healthy cells. • Cholesterol in the right quantity is not harmful. In fact it has many vital functions like formation of certain hormones and tissue. Where Does Cholesterol Come From? Li v Large Intestine er Small Intestine Animal fats Milk, Egg Yoke, Cheese, Butter How is cholesterol transported Cholesterol is transported through lipoproteins in the blood Types of cholesterol VLDL (Very Low Density Lipoprotein) LDL (Low Density Lipoprotein) HDL (High Density Lipoprotein) VLDL • VLDL mainly contains triglycerides (TG Fats) mostly derived from the food we eat. LDL – Bad Cholesterol • It carries most of the cholesterol in your blood. • High levels of LDL lead to blockage of arteries. HDL – Good Cholesterol • As it removes excess of cholesterol from the blood vessels thus prevents the hardening of arteries and protects your heart. • For healthy heart, It is desirable to have LDL/HDL ratio of 2:1 in the blood. How Does Cholesterol Cause Problems? • If too much LDL-cholesterol is in the blood, it can slowly build up on the inner walls of the blood vessels. • It can clog an artery like grease clogs your kitchen sink drain. • If the clogged artery happens to be in your heart, it can lead to a heart attack. If the clogged artery is in your brain, it may cause a stroke. What Factors Increase the Risk of Heart Attack? • Factors You Can't Control • Sex and Age (Male or those over 55) • Family history of heart attack at an early age • Race (higher risk among Indians) • Factors You Can Control • • • • • • • Smoking High Cholesterol High Blood Pressure Physical Inactivity Obesity Diabetes Inability to handle stress How Do I Find Out If I Have A Problem With My Cholesterol? • By a simple blood test called Lipid Profile. What Do My Test Results Mean? • Desirable • • • • TC < 190 mg per dl LDL< 130 mg per dl HDL >= 35 mg per dl * TG < 200 mg per dl • • • • TC < LDL< HDL TG < • • • • TC >= 240 mg per dl LDL>= 160 mg per dl HDL< 35 mg per dl * TG >= 400 mg per dl Border Line High Risk • High Risk 190 –239 mg per dl 130 -159 mg per dl 200 - 399 mg per dl How Can I Improve My LDL-Cholesterol Level? • Follow a low fat, low cholesterol diet. To lower your dietary intake of fat you might try the following: • Reduce saturated fat in your diet. Saturated fat is found in butter, whole milk, cheese, ice cream, red meat, palm oil, and coconut oil to name a few. • Avoid organ meats (liver, brains, and kidney). • Use a more vegetarian style of eating. Eat more fruits, vegetables, and whole grains (bread, rice, pasta) in place of fatty meats and bakery goods. How Do I Improve My HDL-Cholesterol? • Physical activity, for example aerobic exercise for 30 minutes 3 or 4 times per week may raise the HDL-cholesterol. * • For best results (LDL/HDL ratio) one needs to develop a life-style that includes both a low fat diet and an ongoing exercise program that you enjoy. • Tips • Mediterranean diet – enriched with fruits, vegetables, whole grains, olive oil and legumes • Increase fish and reduce carbohydrate • Quit smoking – HDL may increase 15-20% • Wines 2-6 Ounces with evening meals What If Changing My Diet and Exercising Isn't Enough? • If your doctor has decided that your cholesterol is not adequately being controlled, he/she may recommend medication. * Normal blood vessel Deposition of ‘bad cholesterol’ Increased deposition of ‘bad cholesterol’ This is known as atherosclerosis Blood Pressure • High blood pressure, if left untreated, is a hidden time bomb waiting to explode. * • Between one-fourth and one- third of adults in the U.S. have high blood pressure. Nearly one- half of the people with high blood pressure don't even know they have it. • Only about 11 percent of people with high blood pressure have their blood pressure under control. HEART AT WORK What Is Blood Pressure • As your heart beats (contracts) it squeezes blood into the arteries and creates pressure in them. This pressure (blood pressure) causes the blood to flow to all parts of the body. When the heart pumps blood into arteries and the pressure increases. When heart rests between beats your pressure decreases. • Blood pressure normally goes up and down depending on your activity and emotions. • When your blood pressure is taken, the upper number (systolic) is heart contracting. The lower number (diastolic) is your heart the resting. Blood Pressure Readings and Categories Category Systolic Diastolic Hypertension Systolic Diastolic Optima Below l (best) 120 Below 80 Stage 1 (mild) 140159 90-99 Normal 120129 80-84 Stage II (moderate) 160179 100109 High 130Normal 139 85-89 Stage III (Severe) 180209 110119 High Over 90 Stage IV (Very Severe) >=210 >=120 Over 140 Why Should I Worry? • Blood pressure that goes up and stays up all the time is known as high blood pressure or hypertension. • It causes your heart to overwork and results in damage to your arteries. • It is one of the BIG THREE (along with smoking and high cholesterol) risk factors for heart disease. • Hypertension speeds the clogging of the arteries and is the biggest risk factor for strokes. • It also increases the risks for kidney disease. What Factors Increase Your Risk? • • • Factors You Can't Control • Heredity or Family History • Age - Over 35 • Sex - Men are more at risk if under 65; after 65 sex is not a factor • Race - Indians are more at risk • Medical History - of diabetes or kidney disease • Pregnancy Factors You Can Control • Obesity • Eating too much salt • Alcohol consumption of more than 2 drinks per day • Physical inactivity • Inability to control stress • Smoking or use of tobacco • Birth Control Pills If you have any of the risk factors listed and don't know your blood pressure, please have it checked by a professional. Preventive Measures • Stop smoking or any use of tobacco • Lose weight, if necessary • Participate in regular, moderate physical activity • Keep alcohol intake low • Use salt in moderation * • Eat a healthy, low-fat diet high in potassium rich foods (i.e. apples, carrots, broccoli, etc.) Do I Need Medicine? • Doctors often use a three to six month trial of diet and exercise for initial treatment in case of mild hypertension. • If your doctor decides that you need medicine to help lower your blood pressure, follow those directions exactly. • Medicine is a need and not a habit. * PREVALENCE OF HEART DISEASES IN INDIANS 14 12 10 8 Indians Others 6 4 2 0 Africa U.S.A. India Others What is Exercise? • Exercise can be defined as any activity that raises your heart rate and works the large muscle groups (like the legs). Why Should I Care About Exercise? • Lack of exercise plays a large role as high blood pressure, high cholesterol or smoking in the development of heart disease. • Some of the health benefits of exercise include: • weight control • improves self esteem * • strengthens bones, joints, muscles* & lowers the risk of osteoporosis and arthritis • decreases stress • increases heart and lung strength • reduces deadly cholesterol and other fats • increases HDL ("good" cholesterol) and prevents heart disease Aerobic exercise • Any exercise that is done for about 15 minutes or longer, raises your heart rate to a "target level" during that time, and uses large muscle groups (like your arms or legs). The more consistent your efforts at exercise, the greater the benefits. • You don't have to be an athlete to enjoy the benefits of aerobic exercise. You can wash the car or vacuum the house. You can go swimming, biking, or dancing. Select an activity you enjoy. What is Anaerobic Exercise? • When you exercise very hard, you raise your heart rate higher than the target level. • This activity is usually difficult to continue for very long. Heart Rate Age Target Heart Rate (Beats / Min.) Maximum Heart Rate (Average) 20 25 30 120 - 150 117 - 146 114 - 142 200 195 190 35 40 45 111 - 138 108 - 135 105 - 131 185 180 175 50 55 60 102 - 127 99 - 123 96 - 120 170 165 160 65 70 93 - 123 90 - 120 155 150 Recommendations for Fitness • The American College of Sports Medicine makes the following recommendations for quality and quantity of training for developing and maintaining fitness: • Frequency: 3-5 days per week • Intensity: 60% to 90% of maximum heart rate • Duration: 15 to 60 minutes of continuous aerobic activity. Lower to moderate intensity of longer duration is better for the non- athletic adult. • Mode: Any activity that uses large muscle groups that can be maintained continuously and aerobic in nature. How to Get Started: Things to Consider • Health and physical ability • Interests and type of activities you enjoy • Competence in doing the activity • Can access the activity on regular basis • What is needed to do the exercise you choose. (gym, equipment, courts, showers and cost) • Weather conditions • Time involved How to Get Started: Do I Have to Get a Physical Exam? • Men over the age of 45 years and Women over the age of 50 years and who are not used to regular exercise should probably have a physical examination before they begin their exercise program. • Other conditions that may indicate that you need a physical examination are: • heart disease, condition or previous heart attack • pain or pressure in your chest, neck or shoulder • bone or joint problems How to Get Started: Set Some Goals • Start small * • It is not the day or the week that matters as much as the years and the decades of regular exercise. • Too busy at work? * Examples of Exercise • Light (less than 280 calories per hour) • walking less than 2 m.p.h. • cycling (stationary) • golf using a power cart • home chores (vacuuming) • Moderate (280-420 calories per hour) • walking quickly (3-4 m.p.h.) • outdoor cycling (10 m.p.h.) • table tennis • golf pulling a cart or carrying clubs • house cleaning • Hard/Vigorous (420 or more calories per hour) • walking quickly uphill or with a load • cycling quickly (more than 10 m.p.h.) • racket sports: singles tennis or racquet ball • moving furniture Nutrition- Dietary Guidelines • Carbohydrates: bread, cereal, rice, pasta, grains • Proteins: beans, nuts, beef, pork, fish, chicken, eggs, milk, etc. • Fats: divided into • Saturated: associated with increasing blood cholesterol levels and heart disease-- found in animal fat, coconut oil, palm oil, and cocoa butter • Unsaturated: does not effect blood cholesterol, e.g. Sun Flower, Cornola, Sufola, Peanut Oil. • Vitamins: divided into: • Fat-soluble (A, D, E, and K)- requires fat to make it usable by the cells • Water-soluble (B group and C)- requires water, not fat , to make it usable by the cells • Minerals: i.e. calcium, iron, zinc, etc. • Water Daily requirement of calories 1500-2000 Eat healthy to stay healthy • Have a balanced diet • Should we eliminate fat completely ? • Cooking Media • • • • • • • • • • • 55% Carbohydrate 25% Protein 20% Fat Nuts, fruits, vegetables and whole grains can each reduce risk of C.V.D. by 15% to 45% Brain recognizes fat as the only nutrition Vitamin A, D and K require Fat Fat are required for quality sperm production Liquid fats are better than solid 15 ml / per head per day Mixed and match oils Occasional ghee is permissible Sesame Soybean Corn Olive Oil Mustard Oil Cooking Media Canola Sun Flower With Olive oil coronary artillery disease is least Latest trend is to rotate the media every 2/3 months Eat healthy to stay healthy • Avoid too much of salt to give longer life to your heart. • Do not overeat, have small meals 5-6 times a day at a fixed interval. This will help in keeping you a check on your weight. Eat slowly do not rush through your meals. Eat healthy to stay healthy Eat more fresh vegetable, especially, green and leafy, e.g. cabbage, cauliflower and broccoli to lower the risk of lung, stomach and other cancers. Recommended ½ serving per day. Eat healthy to stay healthy Spinach and mustard greens contain lutein and zeaxanthin phyto chemicals that may protect your eyes as you get older (Macular degeneration a leading cause of blindness). Recommended 5-6 serving per week. Eat healthy to stay healthy •Tomatoes contain lycopene • prevents prostate, lung and stomach cancer • lowers the risk of heart disease. • Other sources of lycopene are apricots, water melon and papaya. • Recommended 5-6 serving per week. Add more high fiber food in diet … Eat healthy to stay healthy • To lower your cholesterol try one or more cloves a day chopped or crushed. • Tea alone is found to be rich in anti-oxidants and flavonoids is associated with a reduced risk of C.V.D. but with the additional of milk beneficial effects of tea are neutralized. • Drinking coffee does not increase the risk of heart diseases but consumption of large amounts of unfiltered coffee increases total cholesterol level. SOYA BEAN AND SOYA PRODUCTS • It is the perfect health food for Indians soya bean offers a balanced diet and keeps life threatening ailments away • Prevents heart disease • Prevents cancer : specially breast and prostate • Fights osteoporosis • Reduces diabetes • Soya is available in forms such as oil ,flour ,tofu , sauces, nuts and beverages Eat healthy to stay healthy • Vitamin A, C, E, B6, B12, selenium, and Folic acid not only protect your body against Cancer but also act as anti oxidant and boost your immunity system. Natural sources of anti-oxidants vitamins and minerals Vitamin/Mineral- sources Significance A Mango, carrots, tomato juice, sweet potatoes, pumpkin, beef liver A fat soluble vitamin which fights free radicals and boosts immune response. C Spinach, tomato juice, mango, orange, grapefruit juice, strawberries One of the most essential water soluble antioxidant. It reacts with and inactivates free radicals in plasma and extra cellular fluid E Polyunsaturated plant oils, wheat germ, sunflower seeds, sweet potatoes, cod The most effective lipid soluble antioxidant. It acts as a free radical scavenger. Selenium Seafood, meats, grain Helps in activating a natural anti-oxidant enzyme of the body. B6 Bananas, watermelons, tomato juice, spinach, potatoes, white rice, chicken breast Lowers levels of plasma homo cysteiene. Helps in reducing the clogging of the arteries. B12 Meats, poultry, fish, milk, eggs, shellfish Folic acid Tomato juice, green beans, spinach, lady’s finger, lentils Importance of Calcium • If we look at peak bone mass in women -the time our bones are strongest -- we peak at about age 35. • After this age, we start to lose bone. At menopause, if we do not intervene, this loss accelerates significantly. • Bone strength comes from calcium, and we need about 1000 mg a day. • The richest sources of calcium are dairy products. Low fat products are just as good as full fat for your calcium intake (and better for your heart!). Do I Get Rewards? • Sure! Rewards that last a lifetime! • You will have • more energy, • fewer infections, • less negative response to stress, • quicker healing rate, • and feel better overall both mentally and physically. Don't forget your body's need for water. • Your body’s requirement for water are second only to air.* • Drink lot of water so that your cells will thank you as they like to be made up of 50% water. • Benefits • the kidney remains flushed. • It helps in reducing constipation. • Keeps skin, moist, supple and tight. Overview Fats • Saturated fats: • Completely saturated; “villain” of fats • High fat dairy products, meats, chocolate, butter, coconut oil • Raises blood cholesterol • Trans fats: • produced when liquid oil is made into a solid fat through hydrogenation • Act like saturated fats • Found in processed foods (Samosa, Kachori, Puri, chips), baked goods (cookies, muffins), margarine • Unsaturated Fats • Monounsaturated fat • Olive oil, canola oil, peanut oil • Polyunsaturated fat • safflower oil, sunflower oil, fish oil • Essential Fatty Acids Essential Fatty Acids [EFAs] • Necessary fats humans cannot synthesize • Must be obtained through diet • There are three families of EFAs: Omega-3, Omega-6, and Omega-9 • EFAs support the cardiovascular, reproductive, immune, and nervous systems Omega 3 vs. Omega 6 Fatty Acids • • Omega-3 Fatty Acids: • EPA (eiocosapentaenoic acid) and DHA (docosahexaenoic acid) • Found primarily in fatty fish: fresh tuna, salmon, mackerel • ALA (alpha-linolenic acid) • Green leafy vegetables, • flaxseed, • some vegetable oils (canola, Soy and Olive), Walnut • Body can convert ALA to DHA or EPA Omega-6 Fatty Acids: Linoleic Acid • Corn oil, eggs [chicken fed on insects and grass], seeds, milk • legumes [Peas, peanuts, Soy Seeds] The cardiologist's diet: If it tastes good, spit it out. ~Author Unknown Foods high in Omega 3 Fatty Acids • • • • • Fish Walnuts Flax meal Canola oil Soy foods and oil He that takes medicine and neglects diet, wastes the skill of the physician. Finding an Appropriate Balance • Importance of balancing ratio Omega-3: Omega-6 fatty acids • Most people on traditional diet consume LOTS Omega-6 fatty acids • Inappropriate balance contributes to development of disease • Healthy diet = 2-4 times more Omega-6 than Omega-3 Health Benefits Omega-3 Fatty Acids • Stroke/Heart • Diabetes • Depression • Other Mental Illness • Weight loss • Arthritis • Osteoporosi s • Cancer • Alzheimer’s Recommendations • Patients with CHD, about 1g of EPA+DHA per day • Capsules [EPA+DHA/g] Low Potency - 300 mg High Potency - 500-700 mg (CardioTabs, Triomega, OmegaRx) Pharmaceutical – 850 mg (Omacor, Reliant Pharmaceuticals) • Cod Liver Oil • 1 tsp (RDA for Vit. D; 2x RDA Vit. A) What is Obesity? • Obesity is defined as an increase in body weight beyond what is necessary for health and is usually the result of excessive accumulation of fat in the body. What is OBESITY? Ideal weight for age Height in cm – 100 = ideal weight in Kg > 20% of ideal weight Imbalance between the Two main components of Wt. Balance; Energy Intake and Energy Output What is OBESITY ? Body mass index (BMI) Weight in Kilograms Height in meters squared What is OBESITY ? WAIST HIP RATIO Circumference of Waist Circumference of Hip Obesity in man >1.0 Obesity in woman >0.8 ‘Apple – shaped’ body morphology ‘Pear – shaped’ body morphology Let's Look at the Numbers • Obesity is rated by the body weight percent (%) over normal, and the health risks involved. • 20%-40% over normal is considered mild; • 41%-100% over normal is considered moderate; • and more than 100% (>2X) over normal body weight carries the most severe health risks. Android Gynoid Standard Height and Weight for Indian Men and Women Height Men Women Cm Ft Kgs Lbs Kgs Lbs & in 152 5’ 0” 50.8 - 54.4 112 - 120 154 5’ 1” 51.7 - 55.3 114 - 122 157 5’ 2” 57.3 - 60.3 124 - 133 53.1 - 56.7 117 - 125 159 5’3” 58.1 - 61.9 127 - 136 54.4 - 58.1 120 - 128 162 5’4” 58.9 – 63.5 130 - 140 56.3 - 59.9 124 - 132 165 5’5” 60.8 - 65.3 134 - 144 57.6 – 61.2 127 - 135 167 5’ 6” 62.2 - 66.7 137 - 144 58.9 - 63.5 130 - 140 177 5’ 7” 64.0 - 68.5 141 - 151 60.8 - 66.3 134 – 144 172 5’ 8” 65.8 - 70.8 145 - 156 62.2 - 66.7 137 – 147 175 5’ 9” 67.6 - 72.6 149 - 160 64.0 - 68.5 141 – 151 177 5’ 10” 69.4 - 74.4 153 - 164 65.8 - 70.3 145 - 155 180 5’ 11” 71.2 - 76.2 157 - 168 67.1 - 71.7 148 – 168 182 6’ 0” 73.0 - 78.5 161 - 173 68.5 - 73.9 151 – 163 185 6’ 1” 75.3 - 80.7 166 - 178 187 6’.2” 77.6 - 83.5 171 - 190 6’ 3” 79.8 - 85.7 176 - 189 184 What Causes Obesity? • The vast majority of obesity is caused by eating more than we need to supply the normal energy requirements of our bodies. • Those who put on weight as adults are increasing the size of their fat cells, but not the number. • Those who begin to be obese in childhood increase both the size and number of fat cells in their body. • The number of fat cells cannot be reduced, however, the size of fat cells decreases with weight loss. Reasons • For a very few people there are other reasons for obesity. These include • metabolic disorders, • endocrine and hormonal disorders, and • some forms of brain injury. • There are also medications that have the side effect of weight gain. Such as, • antidepressants, antihistamines, blood-pressure medication, and Are there Other Reasons for Obesity? • Simply, yes! Genetics and environment play a part. • Economics and education also can effect how and what we eat. * • Stress, depression and low selfesteem may also be involved. Additional factors … • Males are automatically at higher risk due to their lack of estrogen. • Those who get no exercise or who smoke are at greater risk. • If you already have high blood pressure, high blood cholesterol, heart disease or diabetes, our overall health risk is increased even more. Weigh the Risks Obesity is more than a Cosmetic Problem; It is a health hazard Diabetes mellitus Hypertension Coronary Heart Disease Stroke Cancer (Colon, rectum, Prostate) mortality; 20% in men. 10% in women Mechanical effects of the mass of extra tissue on function of various organs & systems Weigh the Risks Gall bladder disease and gallstones Liver disease Osteo arthritis Gout Pulmonary (breathing) problems PICKWIAN SYNDROME Reproductive problem in women, including menstrual irregularities and infertility Psychological and Social effects Emotional suffering , feels unattractive, feeling of rejection, shame or depression Prevention and Treatment Basic Principles Match intake of energy (calories) to overall energy needs, Limit consumption of foods with a highcalorie density and / or low nutritional quality, including those with a high content of sugars Maintain a level of physical activity that achieves fitness and balance energy expenditure with energy intake; for weight reduction, expenditure should exceed intake Treatment For Obesity Diet Exercise Psychotherapy Behavioural Modification Alternate Therapy Pharmacology Surgery QUIT SMOKING ! Smoking is a disease “Nicotine is the most dangerous addictive drug of choice. The highest single cause of death is tobacco which will world-wide related kill than diseases, more any people other single cause by the year 2030” LINDA FERRY Tobacco abuse AIDS + Alcohol abuse + Other drug use + Homicide + Suicide + Motor vehicle accidents + Fires combined NICOTINE PROPERTIES THAT CONTRIBUTE TO ITS ADDICTION 1. Pleasure, relaxation 2. Arousal 3. Increase attention 4. Facilitate working memory and learning 5. Cope with feelings of tension, anxiety 6. Decrease food consumption and metabolism in both humans and animals. Smoking is Addictive Nicotine reaches brain Stimulates release of two chemicals A smoker smokes a cigarette Dopamine ‘Good’ feeling Noradrenaline Alertness & energy The Vicious Cycle of Smoking When one stops smoking Lights another Cigarette Dopamine, NA Relief from •Withdrawal symptoms •the pleasure again •Withdrawal symptoms •Lack of pleasure Thus, ADDICTING the smoker to the Cigarette TOBACCO IN INDIA THERE ARE 240 MILLION TOBACCO USERS IN INDIA – 194 MILLION MEN AND 45 MILLION WOMEN USE TOBACCO IN SMOKED AND SMOKELESS FORMS IN INDIA INGREDIENTS OF CIGARETTES Cigarette - “A dirty syringe” Nicotine Carbon Monoxide Tar Cadmium Acetone Arsenic Hydrogen Cyanide Each puff has more than 4,000 chemicals + 40 cancer causing substances ACUTE ILL-EFFECTS OF SMOKING • Shortness of breath • Worsening of asthma • Impotence • Infertility • Increased serum carbon monoxide levels • Greater absenteeism from work • More bedridden days or days of restricted activity. THE HEALTH RISKS OF CIGARETTE SMOKING Stroke Cancers of the mouth, throat and oesophagus Cancers of the larynx Coronary heart disease Chronic obstructive pulmonary disease Lung cancer Pancreatic cancer Ulcer Bladder cancer Cervical cancer Low birth weight baby Peripheral artery disease Normal Lung Smoker’s Lung Above:Abdominal Aorta in Non-Smoker Below:Abdominal Aorta in Smoker Smoking leads to Gangrene & Limb amputation According to the World Health Organization (1994), smoking is responsible for • 90 per cent of lung cancer deaths • 45 per cent of all cancers • 75 per cent of chronic obstructive lung disease • 20 per cent of deaths due to cardiovascular disease. ENVIRONMENTAL TOBACCO SMOKE (PASSIVE SMOKING) how smoking effects my family !!! Environmental tobacco smoke is a mixture of • Sidestream smoke + • Exhaled mainstream smoke + • Contaminants that diffuse from the cigarette paper and mouth end of the cigarette between puffs. ETS contains more than 3800 chemical compounds;Passive smoke contains more carcinogens than active smoking !!! WHO report on “International consultation on ETS and Child Health” notes that: • 700 million children, almost half of all children worldwide, live in the home of a smoker. • ETS causes wide variety of adverse health effects in children including pneumonia, bronchitis, coughing, wheezing, worsening of asthma and middle ear infections. TOBACCO KILLS TOBACCOSIS KILLED MORE THAN 100 MILLION WORLDWIDE IN THE 20th CENTURY!! BENEFITS OF SMOKING CESSATION HEALTH BENEFITS OF QUITTING • Within 20 minutes of your last cigarette • Blood pressure drops to normal • Pulse drops to its normal rate • The body temperature of your hands and feet increases to normal. • Within 08 hours • CO level in your blood drops to normal • Oxygen level in your blood increase to normal • Within 24 hours • The chances of heart attack decreases HEALTH BENEFITS OF QUITTING • Within 48 hours • Nerve endings start regrowing • Abilities to smell and taste things are enhanced • Within 72 hours • Bronchial tubes relax, making breathing easier. • Within 2 weeks and 3 months • The circulation improves and walking becomes easier • Lung function increases by upto 30% Benefits of Quitting • Evident in one year • Risk continues to declines thereafter • The risk goes down by 60% in two years • And falls to non smokers levels in 10 years Benefits of Quitting 100 90 80 70 60 50 40 30 20 10 0 Risk NonSmoker Now After 1yr After 2 yr after 5 after 10 yr yr HOW TO QUIT SMOKING ? SMOKING CESSATION PHARMACOLOGICAL INTERVENTIONS PSYCHOLOGICAL INTERVENTIONS •NICOTINE REPLACEMENT THERAPIES (NRT) •Nicotine patch •Nicotine gum •Nicotine nasal spray •Nicotine inhaler •ZYBAN THERAPY •OTHER MEDICATIONS •Clonidine •Silver acetate •MOTIVATION ENHANCEMENT THERAPY •COGNITIVE THERAPY •BEHAVOURAL PROGRAMS •Coping skills training •Aversive therapy •Cue exposure •Social support •Self help materials •RELAPSE PREVENTION Cancer and Its Warning Signals • Early discovery : Early recovery • Cancer is completely curable if detected at an early stage. That’s why it is important to have a regular check up at least one a year. Watch out for the seven warning signals C hange in bowel or bladder habits. A Sore that does not heal. U nusal bleeding or discharge. T hickening or lump in breast or elsewhere. I ndigestion or difficulty in swallowing. O bvious change in wart or mole. N agging cough or hoarseness. To Conclude… • Its never too late or too early to change lifestyle to reap benefits for tomorrow.