Saturday, April 11, 2015

Best time for exercise is all time.

This path was not made by machines but by men and women who walked on it daily. Make your own roads be a hero.

Many times patients ask which is best time to exercise, however in today's era we have to make a distinction between two types of exercise first being work out and second daily activity.

Workout is usually intense exercise for brief period of time,varying from 20 to 30 minutes. Involves focussed exercise for particular part of the body or involving whole body. The timing for this exercise is dependent on the each individuals preference. Morning, noon or night all are suitable as long as you develop a routine and maintain it. Body starts expecting and preparing for it. Workouts are good the pump endorphins in blood and makes you feel good and all positive effects. 

Group Workouts like laughter clubs, Zumba,  cross fit etc take advantage of another mystery I would like to call it community endorphins.  Human being are social animals. In the prehistoric period we use to hunt in groups, now we run companies and do farming together. Whenever we are together in one act we multiply the end effects. Same goes for exercise we are sure to exponentially elevate the effects of exercise Workouts in groups.

On the other hand daily activity is different aspect of exercise. Overall human daily activity is reduced as we have adopted urban lifestyle and moved to manufacturing from farming. We find our selves in closed spaces more often. Sedentary lifestyle is the new pandemic. However this malady has very simple solution increasing your daily activity level. This needs a conscious effort and hence I consider this as type of exercise. 
  1. Taking a longer route while walking to washroom. 
  2. Instead of carrying a bottle get up drink water at the nearest fountain or edible water source. 
  3. Park you car further so that you can walk. 
  4. Take stairs all the time if you have to go up to 20 levels. 
  5. Post lunch / dinner walks/stroll in neighbourhood for 10-15minutes. 
  6. Walking meetings between two colleagues are far better than lunch meetings. 
  7. Office group workout for 20 minutes in midday or mid morning is also viable option. 

This man all by himself broke the mountain, salute to him. Don't underestimate yourself.
(This picture is borrowed from http://www.odditycentral.com/news/dashrath-manjhi-the-man-who-moved-a-mountain.html)

Sustained high daily activity level is mild for of exercise with far reaching cardiovascular and cognitive benefits.

High daily activity level is as important rather more important and essential than workouts. Inactivity of 10 hours neutralizes the workout of 30 min. So workouts and improved daily activity levels are synergistic.

Global trends of Health Expenditures :shocking and begs action

https://agenda.weforum.org/2015/04/five-global-health-trends-you-just-cant-ignore/

Monday, April 6, 2015

List of Movies Which have Depicted Characters with Stroke.

Reference Article for Pedometer Activity

 2004;34(1):1-8.

How many steps/day are enough? Preliminary pedometer indices for public health.

Abstract

Pedometers are simple and inexpensive body-worn motion sensors that are readily being used by researchers and practitioners to assess and motivate physical activity behaviours. Pedometer-determined physical activity indices are needed to guide their efforts. Therefore, the purpose of this article is to review the rationale and evidence for general pedometer-based indices for research and practice purposes. Specifically, we evaluate popular recommendations for steps/day and attempt to translate existing physical activity guidelines into steps/day equivalents. Also, we appraise the fragmented evidence currently available from associations derived from cross-sectional studies and a limited number of interventions that have documented improvements (primarily in body composition and/or blood pressure) with increased steps/day.A value of 10000 steps/day is gaining popularity with the media and in practice and can be traced to Japanese walking clubs and a business slogan 30+ years ago. 10000 steps/day appears to be a reasonable estimate of daily activity for apparently healthy adults and studies are emerging documenting the health benefits of attaining similar levels. Preliminary evidence suggests that a goal of 10000 steps/day may not be sustainable for some groups, including older adults and those living with chronic diseases. Another concern about using 10000 steps/day as a universal step goal is that it is probably too low for children, an important target population in the war against obesity. Other approaches to pedometer-determined physical activity recommendations that are showing promise of health benefit and individual sustainability have been based on incremental improvements relative to baseline values. Based on currently available evidence, we propose the following preliminary indices be used to classify pedometer-determined physical activity in healthy adults: (i). <5000 steps/day may be used as a 'sedentary lifestyle index'; (ii). 5000-7499 steps/day is typical of daily activity excluding sports/exercise and might be considered 'low active'; (iii). 7500-9999 likely includes some volitional activities (and/or elevated occupational activity demands) and might be considered 'somewhat active'; and (iv). >or=10000 steps/day indicates the point that should be used to classify individuals as 'active'. Individuals who take >12500 steps/day are likely to be classified as 'highly active'.

100, 000 Steps in One Week: Be Active.

Positive Feedback of Numbers for Activity.
Sedentary life style has been considered by many the new tobacco or our generation. A low active lifestyle increases the risk of stroke and coronary artery disease. The easier way is to increase the activity. This is easier said then done. I experimented on myself and current devices are helpful.

In last few days, I have experienced effect of positive feedback. I started using the pedometer in my mobile device. I am using Noom walk.

If you look at my avg number of steps in first few days they were in the sedentary lifestyle index (<5000 steps per day) (Tudor-Locke and Bassett , http://www.ncbi.nlm.nih.gov/pubmed/14715035). This was shocking to me.
Those numbers motivated me to increase my activity gradually to average of 7500 steps which was still a low active phase.

I started thinking of walking all time. Ten minutes before and after the meals. While watching TV or movie or serial. Dont sit walk. After coming back home first ten minutes walk. 

It was easy to reach the next stage of 11000 steps a day over a period of 4-5 days. This would be categorised as active life style. But I found it easy to break the next barrier as well >15000 a day.
Now I clock 100, 000 steps a week, this would be indeed considered a highly active life style.

Now I am able to get time 30 minutes at stretch to walk to achieve my daily target. 60-80 minutes of walking divided in two times will be sufficient. Excess of anything is bad. so you have to consult you doctor for you limitations and setting up the target. The numbers below will help.

So in numbers usually 10, 000 steps per days are recommended
this is roughly equivalent to 500 cal
in terms of distance its approximately 5 miles or 8 km
in terms of time its is approximately 30-45 minutes of brisk activity

This was a personnel revelation for me in terms of effect of positive feedback.
First the numbers gave me a baseline activity. Then I had a target to reach highly active life style (>12500 steps per day).

I am developing a hypothesis, numbers are objective and effective to deliver positive feedback. 

To be active and reduce the burden of coronary artery disease and stroke we have to monitor our daily activity and try to be highly active.

I will post my thoughts once I reach one million steps.