National Diabetes Obesity and Cholesterol Foundation (N-DOC)” with support from Department Of Science & Technology, Ministry Of Science & Technology and Chronic Care Foundation had organized a Consensus Conference of physicians, endocrinologists, metabolic specialists, cardiologists, paediatricians, sports specialists, nutritionists, public health specialists to deliberate on data on physical activity in Indians, and to generate appropriate guidelines for all age groups and for patients suffering from coronary heart disease, diabetes and hypertension etc.
On this occasion Dr. Anoop Misra, Director and Head, Department of Diabetes and Metabolic Diseases, Fortis Hospitals, New Delhi, Chairman, National Diabetes, Obesity and Cholesterol Foundation (N-DOC), said that, in view of significant escalation of NCDs, there is a need to have appropriate physical activity among Indian population. However, no recommendations are available for physical activity for the Indian population. Thus, to draw up consensus guidelines on physical activity in Indian populations and to generate awareness about the benefits of physical activity among health professionals and in general public the guidelines will play a vital role.
Dr. Misra further said that, numerous scientific studies from various parts of India have reported the rising prevalence of lifestyle-related diseases such as type 2 diabetes mellitus (T2DM), the metabolic syndrome, hypertension, heart disease etc., often in association with overweight or obesity. According to WHO, globally non-communicable diseases (NCDs) currently represent 43% of the burden of disease and are expected to be responsible for 60% of the disease burden and 73% of all deaths by 2020. About two fifth (40.4%) of deaths were attributable to NCDs in 1990 and it was projected that this will increase to 66% in year 2020.
Prof Andrew Hills, Professor, Energy Metabolism Group, Institute of Health and Biomedical Innovation Queensland University of Technology, Brisbane, Australia, said, ‘the health benefits of physical activity are well established. Positive outcomes of moderate-intensity physical activity include long-term maintenance of weight loss, increasing high-density lipoprotein, reducing blood pressure, and decreasing the risk of death from lifestyle-related diseases. Importantly, the impact of lifestyle-related diseases could be significantly ameliorated with an increase in the level of physical activity. This is most noticeable in sedentary individuals who introduce regular physical activity into their lifestyle.’
The guideline suggested some suggestions for Non-communicable Diseases:
All decisions regarding initiating elderly in exercise program should be taken in consultation with a physician/cardiologist.
All patients with cardiovascular disease must undergo a pre-activity evaluation. Those with established coronary artery disease should undergo a symptom-limited exercise test before entering in a training program. The exercise test is required to exclude important symptoms, ischemia (low blood flow to heart), or arrhythmias (heart rhythm irregularity) that might require other interventions before exercise training.
Most of the patients with hypertension and other modifiable risk factors for atherosclerosis should get started by doing 30 minutes of a moderate-intensity level activity on most, preferably all, days of the week.
All such persons (particularly those in cardiac rehabilitation program) should have 5 minutes of warm-up followed by at least 20 minutes of aerobic exercise training and 5-15 minutes of cool-down.
High-intensity exercise, sudden start up of exercise, and exercise in extreme weather conditions should be avoided.
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