HT ,Mumbai ( 8/11/09) -Women's health

Heart diseases
Heart disease and stroke kill more than 8.5 million women worldwide, which is more than HIV, wide, which is more than HIV, tuberculosis and malaria deaths put together. In India, women account for half of the annual 3 million deaths from the two diseases.

Yet, the risk for women remains under-estimated, both by doctors and women themselves. On an average, women develop heart disease 10 years later in their life than men, but they rapidly catch up after menopause because of ovarian hormone deficiency that favours hypertension, diabetes, hyperlipidemia, central obesity and the metabolic syndrome.

Adding to risk is the fact that nine out of 10 women in India over 50 years have low levels of heart-protective good cholesterol (high density lipoprotein or HDL) and almost half have high blood levels of C-reactive protein (levels of this protein increase during systemic inflammation), both factors that heightens risk.

Obesity in women also plays havoc with their lipids (blood fats such as cholesterol and triglycerides, high levels of which cause heart attacks and stroke). According to the National Institute of Public Cooperation and Child Development, 37.5 per cent women in Punjab, 34 per cent of the women in Delhi and 30 per cent in Kerala are obese, with almost all reporting abdominal obesity (tendency to put on fat around the stomach), both independent risk factors for diabetes and heart disease.

Complicating matters further is the fact that women have atypical heart attack symptoms. Instead of the telltale symptom of angina (burning sensation, tightness or pain in the chest), women may just experience breathlessness, weakness, unusual fatigue, cold sweat, giddiness or neck and shoulder pain. With fatigue or weakness, many do not even realise they are experiencing a heart attack when they get one.

The good news is that the world is waking up to the gender bias in scientific research. Only 50 per cent of the clinical trials conducted in the last three years have enrolled both men and women. They showed an analysis of studies by gender at the Red Alert for Women's Hearts Conference in France on November 5. Professor Stramba Badiale of the Istituto Auxologico Italiano reported that of the 62 randomised clinical trials published in Europe between 2006 and July 2009, only 33.5 per cent of the enrolled participants were women.

Till they get the balance right, women should start getting treated for heart disease even with two of these risk factors: smoking, family history of a parent or sibling having heart disease before 50 years, overweight, hypertension, low good cholesterol, high triglycerides or high blood sugar.

sanchitasharma@hindustantimes.com
A pear shaped body ?
Genetics are responsible for your pear-shaped body, but lifestyle management can help you look your best by Veenu Singh HOW OFTEN have you looked at your friend and longed for a body like hers? Her hourglass form is so gorgeous, but your disproportionate shape, with its wide lower body and slimmer upper body, reminds you of nothing so much as a pear. Body shapes are usually based on the size of your features and the overall balance of your body. Men and women have different body shapes, and women tend to have bodies that are either apple- or pear-shaped. As it happens, a large number of women have pear-shaped bodies. BODY BASICS A pear-shaped body is larger below the waist than above it. If you are a pear, you will find that your hips are slightly wider than your shoulders and that you tend to gain weight below your waist. Pears usually have small chests and flat stomachs. Apples, on the other hand, are generally bigger on the top half of their bodies than the bottom half. They commonly have slim hips and a large chest and stomach. Apples tend to gain weight above the waist or along the back.

"A pear-shaped body makes you prone to storing weight below your waist," says Dr Dr Sandeep Buddhiraja of Max Healthcare, Delhi. "This makes you more prone to problems like osteoporosis as there is extra pressure on the knees, as well as varicose veins. While those with an apple shape are more prone to heart diseases and even some kinds of cancer, pear shapes have to be very careful about their bone health."

Though your body shape is determined more by genetics than anything else, you can control the possible illeffects of your shape with lifestyle management ­ eating the right kind of foods and doing the right kind of exercise.
FIGURE IT OUT "Pear-shaped people need to be cautious about the kind of food they eat and the lifestyle they lead, as refined and junk food together with a sedentary lifestyle can make them look obese," says Brunch columnist Dr Shikha Sharma.

"Eat only minimally at night," says Sachi Sohal, senior dietician at B L Kapur Hospital. "Avoid refined and processed foods, and try to have three servings of fruit and five servings of vegetables on a daily basis. Most important, control your sweet tooth as too much sugar is bad news if you have a pear-shaped body."

As far as exercise is concerned, if you have a pear-shaped body, you need to not just target the lower area, but also work out in a way that helps maintain good body proportions.
"Yoga and pranayam can be beneficial in this regard," says Dr Sharma. "Kapal bhati, anulomvilom, surya namaskar, bhujhangasan, vajrasan, and veerbhard asan, under the supervision of a qualified yoga therapist are useful asanas."

The idea, says Reebok master trainer Nisha Varma, is to focus on exercises that will balance the top half of your body with the bottom half.
"You will also want to try to thin down your lower half," adds Varma. "To achieve this, focus on aerobic activities that work out your lower body, and resistance exercises that will build your upper body to look filled out. For the lower body, use lighter weights and perform high repetitions of exercises."

Some of the best exercises for this include: cycling (with low resistance); jumping rope; leg lifts and dips; push ups and shoulder presses; swimming; brisk walking and cross training.

"If you can't swim, walk about the shal low end of the swimming pool, in about shoulder deep water," says Varma. "If your work requires you to sit for long hours, sit and stand every hour, or walk up and down the stairs as much as possible. And maintain a good posture. That also helps."

veenus@hindustantimes.com SHAPE UP Start your day with two glasses of lukewarm water. Eat at least three servings of fruit a day. Avoid sweets as much as you can.

Drink 10-12 glasses of water including 3-4 glasses of lukewarm water a day. Avoid breads and refined cereals especially at breakfast and dinner.

Drink herbal teas. Don't skip breakfast; make it the heaviest meal of the day. Try to avoid salt after 7.30 pm.

Avoid packet soups, diet drinks, junk foods and fruit juices. Avoid heavy combinations like rajma and rice, chicken and rice.

By Veenu Singh.