Physical Activity and Obesity

Obesity is a major risk factor for development of type two diabetes. An inactive lifestyle also predisposes for type two diabetes and both physical activity and obesity are therefore, important topics in relation to prevention of type two diabetes. 

1)Explain health benefits of being physically active.

2)Describe how physical training affects energy balance and metabolic health and discuss the
potential of physical training in prevention and treatment of obesity and diabetes.

3)Demonstrate methods that can be used to evaluate physical fitness, body fat distribution and 
    insulin sensitivity. 

Physical activity should preferably be part of a healthy lifestyle on a daily basis. Major health agencies like the World Health Organization recommend that adults throughout the week should do at least 150 minutes of moderate intensity or at least 75 minutes of vigorous intensity aerobic physical activity or a combination.

The activity should be performed in bouts of at least 10 minutes duration and preferably be spread on days throughout the week. Additional health benefits can be obtained with a high activity level.

Additionally, muscle strengthening activities should be performed two or more days a week.
Examples of physical activity include dancing, hiking or swimming in leisure time, walking or cycling for transport, occupational activities and daily activities as household chores, games and sports activities. Seniors aged 75 and above are recommended to aim for similar activity level as other adults and in addition to exercises to enhance balance and prevent falls, at least three days per week. When older adults cannot do the recommended amount of physical activity due to health conditions, they should be as physically active as their abilities and conditions allow.


Children and young people up to the age of 18 years should accumulate at least 60 minutes of moderate to vigorous intensity physical activity per day. Activities include games, sports, transportation, chores and many more activities in the context of family, school and community.
At least three times per week, the intensity of the activities should be vigorous and aim at strengthening skeletal muscle and bone.  

Additional physical activity provides additional health benefits.

A practical way of assessing one's activity level is by wearing a pedometer. A number of 10,000 steps has been marketed as a magic number of steps. Walking ten thousand steps per day will most certainly be beneficial to health, but it's difficult to directly relate numbers of steps to minutes of exercise and health benefits as this depends on walking, running speed, body weight and composition, physical fitness and other individual factors. Physical fitness can be evaluated
by a variety of methods. Some are easy to use and cheap, but not very precise. Other methods are more precise,but require special equipment and are not feasible in larger groups of subjects.

A simple way to evaluate physical activity level is by using a questionnaire in which the subject responds to questions about his or her exercise. Examples of such questionnaires are the International Physical Activity Questionnaires, IPAQ and the Recent Physical Activity Questionnaire, RPAQ. The validity of physical activity questionnaires depends heavily on the eagerness of the subject to give an unbiased assessment of his or her physical activity habits. A more objective measure of activity levels can be obtained by activity sensors worn by the subject. A simple, over the counter sensor is a pedometer by which the daily number of steps can be evaluated. An accelerometer is a more sophisticated activity sensor, which can detect movement in several directions.

Accelerometry can be combined with heart rate monitoring and all GPS to increase the ability of the measurement. Lately, detection of heat flux has been included as a parameter for increasing the precision of the activity estimation. Most activity sensors can easily detect simple activities, like walking, jogging and running, but movements during cycling are more difficult to quantify  Detection of swimming activity requires that the sensor is waterproof.

An expensive, but unbiased way to measure physical activity level is by the doubly-labelled water method. The subject is to drink a glass of water labelled with stable isotopes at both the hydrogen and the oxygen atoms. Hydrogen is excreted from the body owner's water, but oxygen is excreted both via water and carbon dioxide. During physical activity, carbon dioxide is produced due to combustion of energy rich substrates. The higher the activity level, the higher the excretion of carbon dioxide. After the initial distribution of labeled water in the body and one to two weeks after drinking the labelled water, urine or saliva samples are taken and analyzed for concentrations of labeled hydrogen and oxygen. So concentration of labeled substances in these fluids reflects the concentration in the water faith of the body. The carbon dioxide excretion and hence, the total energy expenditure can be calculated as the difference between the rate of decline of labeled oxygen and hydrogen. The physical activity level is calculated by subtracting the basal metabolic rate and the thermic effect of food from total energy expenditure.

Physical performance can be assessed by testing the subject in a gym, the clinic or the laboratory. Many simple tests exist. For example, for determination of walking speed, hand grip strength or balance. The state of the art test for assessment of physical fitness is quantification of maximum oxygen uptake by indirect calorimetry during a biking or running test to exhaustion. During physical exercise, skeletal muscles require energy to contract. The main substrates expended during exercise are fat and carbohydrates, but a small amount of protein is also used. At low exercise intensity, the main substrate used is fat either from intramyocellular lipidstores or supplied by the blood. Blood lipids are either  triacylglycerol from the liver or the gastrointestinal tract or free fatty acids derived from adipose tissue stores. At an exercise intensity of approximately 40 to 50% of maximal oxygen uptake, fat oxidation reaches its maximum rate. As exercise intensity increases, more energy is needed in the contracting muscles.

At higher exercise intensities, less fat and more carbohydrate will supply the energy for muscle contractions. Carbohydrates are derived from skeletal muscle glycogen stores or provided by the blood as glucose. Blood glucose stems from liver glycogen stores or from the gastrointestinal tract after carbohydrate containing drink or meal. Body glycogen stores are limited and when exercise time is increased, less and less glucose and more and more fat will be used. The energy stored in fat can only be released aerobically, meaning by use of oxygen for combustion. In contrast, glucose can be degraded both aerobically and anaerobically. Therefore, both fat and carbohydrate can supply the muscles with energy at low exercise intensities when the aerobic demand is low versus high intensities. Mainly glucose is used. When degraded anaerobically, glucose is turned into lactate. At higher exercise intensities, the aerobic demand is increasing and at a certain intensity called the anaerobic or the lactate threshold. Lactate will start to accumulate in the blood. Untrained individuals have a low anaerobic result at approximately 50 to 60% of maximal oxygen uptake, but physical training can increase this. That means that well-trained individuals can sustain a given exercise pace for a longer period of time. At very high exercise intensities and at the onset of exercise, energy is supplied by local muscle stores of keratin phosphate and ATP. These stores contain very limited amount of energy. I will now explain in detail health benefits of being physically active. Physical activity is healthy for young and elderly, slim and obese, healthy and sick. Muscles are meant to be used and if you don't use them, you lose them. Also, the rest of the body will degenerate, if it's not stressed regularly. Physical activity will affect nearly all organ systems of the body and keep you used both in prevention and treatment of a variety of diseases and physical activity prolongs life. Load bearing physical exercise will increase the bone mineral content and reduce the risk of osteoporosis. Also, tendon and skeletal muscle strength will increase after physical exercise. 
Similarly, the heart muscle will become stronger and can hence deliver a higher stroke volume during every heartbeat. This will decrease heart rate, the blood pressure can be lowered by physical exercise. More in hypertensive than in non-hypertensive persons. The plasma concentration of the good lipoprotein, HDL cholesterol is increased. Various the concentration of the bad lipoprotein, LDL cholesterol and triglyceride in blood have decreased. The risk of atherosclerosis is reduced by physical exercise and thereby, the risk of cardiovascular diseases and stroke. Energy is expended during exercise moving the energy balance in a favorable direction for prevention and treatment of obesity. Moreover, insulin sensitivities increased by physical exercise, both acutely and in the long-term and this effect of physical exercise is effective both in preventing and treatment of type two diabetes. Physically fit persons also have a lower
probability of developing some cancers, especially breast and colon. Additionally, physical exercise can increase mood and self-esteem and maybe also libido and reduce the risk for depression.

 

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Glaucoma Disease and Glaucoma Treatment

Glaucoma disease is a serious eye condition characterised by an increase of pressure within the eye ball, called intraocular pressure. It is similar to high blood pressure in the body. The condition is therefore, also known as hypertension of the eye. A certain amount of intraocular pressure is considered necessary, but too much can cause damage to the eye and may result in vision loss. Glaucoma disease is the major cause of blindness among adults today. One out of every eight blind persons is a victim of glaucoma. Far sighted persons are more prone to develop this disease than near sighted ones.
Glaucoma Symptoms
The first symptom of glaucoma is the appearance of halos or coloured rings round distant objects, when seen at night. In this condition, the iris is usually pushed forward, and the patient often complains of constant pain in the region of the brow, near the temples and the cheeks.
Headaches are not uncommon. There is gradual impairment of vision as glaucoma develops, and this may ultimately result in blindness if proper steps are not taken to deal with the disease in the early stages.
Causes of Glaucoma
Medical science regards severe eye-strain or prolonged working under bad lighting conditions as the chief causes of glaucoma. But, in reality, the root cause of glaucoma is a highly toxic condition of the system due to dietetic errors, a faulty life style and the prolonged use of suppressive drugs for the treatment of other diseases. Eye-strain is only a contributory factor. Glaucoma is also caused by prolonged stress and is usually a reaction of adrenal exhaustion. The inability of the adrenal glands to produce aldosterone results in excessive loss of salt from the body and a consequent accumulation of fluid in the tissues. In the region of the eyes, the excess fluid causes the eye ball to harden losing its softness and resilience. Glaucoma has also been associated with giddiness, sinus conditions, allergies, diabetes, hypoglycemia, arteriosclerosis and an imbalance of the autonomic nervous system.
Treatment of Glaucoma
The modern medical treatment for glaucoma is through surgery which relieves the internal pressure in the eye due to excess fluid. This, however, does not remove the cause of the presence of the excess fluid. Consequently, even after the operation, there is no guarantee whatsoever that the trouble will not recur, or that it will not affect the other eye. The natural treatment for glaucoma is same as that for any other condition associated with high toxicity and is directed towards preserving whatever sight remains. If treated in the early stages, the results are encouraging. Though cases of advanced glaucoma may be beyond a cure, even so certain nutritional and other biological approaches can prove effective in controlling the condition and preserving the remaining sight. Certain foodstuff should be scrupulously avoided by patients suffering from glaucoma. Coffee in particular, should be completely avoided because of its high caffeine content. Caffeine causes stimulation of vasoconstrictors, elevating blood pressure and increasing blood flow to the eye.
Bear and tobacco, which can cause constriction of blood vessels, should also be avoided. Tea should be taken only in moderation. The patient should not take excessive fluids, whether it is juice, milk or water at any time. He may drink small amounts several times with at least one hour intervals.
The diet of the patient suffering from glaucoma should be based on three basic food groups,namely, seeds, nuts and grains ; vegetables and fruit, with emphasis on raw vitamin C-rich foods, fresh fruits and vegetables. The breakfast may consist of oranges or grapes or any other juicy fruits in season and a handful of raw nuts or seeds. A raw vegetable salad with olive oil and lemon juice dressing, two or three whole wheat chappatis and a glass of buttermilk may be taken for lunch. The dinner may comprise of steamed vegetables, butter and cottage cheese. Certain nutrients have been found helpful in the treatment of glaucoma. It has been found that the glaucoma patients are usually deficient in vitamins A, B,C, protein ,calcium and other minerals. Nutrients such as calcium and B complex have proved beneficial in relieving the intraocular condition. Many practitioners believe that intraocular pressure in glaucoma can be lowered by vitamin C therapy. Dr. Michele Virno and his colleagues reported recently at a meeting of the Roman Opthalmological Society in Rome, Italy, that the average person weighing 150 pounds be given 7000 mg. of ascorbic acid, five daily, acquired acceptable intraocular pressure within 45 days. Symptoms such as mild stomach discomfort and diarrhoea from the large doses of vitamin C were temporary and soon disappeared. It has also been suggested that some calcium should always be taken with each dose of ascorbic acid to minimise any side effects of the large dose. The patient should undertake various methods of relaxing and strengthening the eyes. He should avoid emotional stress and cultivate a tranquil, restful life style. He should also avoid prolonged straining of the eyes such as occurs during excessive T.V. or movie watching and excessive reading. The use of sun glasses should be avoided.

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