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M. P. Ravindra Nathan


Editor's Note: This series is designed to give you heads up on healthy living and graceful aging.

I know what you are going to say, "I am trying to somehow navigate through this daily grind; how can I find time to exercise?" Right? However, you don't want to wait until you have experienced a warning signal, either. Interestingly, only about a third of adults regularly engage in moderate physical activity.

The key is to find the right type of exercise which is enjoyable, day in and day out; then only you will stay motivated. So, I shall try to give you an easy road map to follow, based on the guidelines established by many reputed national health organizations.

How much total activity a week?

The ideal is 150 minutes of moderately intense physical activity every week. Yes, it is doable and the benefits are substantial. If you can do more, you get additional benefits.

How many days a week and for how long?

All aerobic physical workouts should be spread throughout the week, a minimum of three days a week. This will help to reduce the risk of injury and avoid excessive fatigue. Both moderate and vigorous intensity activities should be performed in episodes of at least 10 minutes. This duration is known to improve cardiovascular fitness and reduce the risk for heart disease and diabetes.

How intense?

To meet the guidelines, you can do either moderate intensity or vigorous intensity aerobic activities, or a combination of both. It takes less time to get the same benefit from vigorous intensity activities compared to moderate intensity activities. A general rule of thumb is 30 min/day, five days a week of moderate intensity activity or 20 minutes/day three days a week of vigorous intensity activity

Examples of aerobic physical activities and intensities

Moderate intensity

" Walking briskly (3 miles/ hour or faster, but not race-walking)
" Water aerobics
" Bicycling slower than 10 miles per hour
" Tennis (doubles)
" Ballroom dancing
" General gardening - yard work

Vigorous intensity

" Race - walking, jogging or running
" Swimming laps
" Tennis (singles)
" Aerobic dancing including vigorous Indian dances
" Bicycling 10 miles/hour or faster
" Jumping rope
" Heavy gardening (continuous digging or hoeing, with increase in heart rate)
" Hiking uphill or with a heavy backpack

Please note that slouching, watching TV, playing computer games, browsing the internet, etc. are not co considered physical activity!

Muscle-Strengthening Activity

Muscle-strengthening activities provide additional benefits not found with aerobic activity that include increased bone strength, muscular fitness and maintenance of muscle mass during a program of weight loss. No specific amount of time is recommended but do them just to the point of tolerance and before exhaustion.

About 2-3 times a week would be ideal. Examples of these exercises, covered in the last column, are stretching, resistance bands, doing calisthenics using body weight for resistance (push-ups, pull-ups, and sit-ups), carrying heavy loads such as laundry or groceries, and heavy gardening (digging or hoeing), yoga and more. Some of you might have watched on CNN the innovative 'laundry basket press,' 'grocery biceps pump' and 'bottle back curl' suggested for busy housewives (and house husbands) with no time to spare! (For more information, log on to:

Inactive adults or those who don't yet do 150 minutes of physical activity a week should work gradually towards this goal. You can start with a light or moderate intensity workout for short periods of time, spread throughout the week. Even if you do less, you will still get some health benefits proportional to the time you put in. Modified aerobic exercise programs are recommended even for patients with heart failure!

Key guidelines for adults

" All adults should avoid inactivity. Some physical activity is better than none.

" Learn about the health benefits of physical activity.

" Understand how to do physical activity in a manner that meets the guidelines.

" Understand how to reduce the risks of activity-related injury.

" Assist others in participating regularly in physical activity.

" Enlist a friend or a team of friends and do group activities - they are more sustainable over the long haul.

During the recent Annual International Scientific Sessions of American College of Cardiology in Orlando, there was a cartoon sign, "Walking is heart healthy," displayed prominently at many areas in the Orange County Convention Center.

So, use every opportunity to walk such as parking your car further away from the shopping mall or climbing the stairs instead of taking elevators, etc. Get started now before it is too late.

* Reference: 2008 Physical Activity Guidelines

Cardiologist Dr. M. P. Ravindra Nathan, director of Hernando Heart Clinic in Brooksville, lives in Brooksville.



We are in an era of fitness, becoming aware of and looking to take care of our health. In the Indian community, we see chronic diseases such as cardiac problems, blood pressure and diabetes by the late 30s and early 40s in men. Here are some steps to make your life active.

1. Most men lose their muscle mass and muscle strength by late 30s because of inactivity. That should be the starting point. Pick up lightweight dumbbells or bar and begin with 5-10 biceps curls and 5-10 bench presses on a regular basis. Start with 1 set and then 2 and 3. Do not perform more than 4 reps. I can promise you will get your muscle strength back at any age. You also reduce the fat content as you increase the muscle mass. Biceps curls and bench press exercises also are a great activity to do with young kids, especially boys. Of course, teenagers wants big bisects and broad chest and it is a good thing to get the youth into a routine of exercise so they can delay health complications in their life.

2. Next step is one extra walk. I understand that folks normally work long hours. However, take a 1-mile walk (about 2,300 steps) alone after dinner or with the family. I think it is a calm way to catch with the family's day. Walk every single day.

3. Then make an actual commitment. Go to a gym. Get on an elliptical for 30 minutes. Then perform serious strength exercise. Work on your biceps, chest, hamstrings and quadriceps. You will clearly see the difference in weight loss and how you feel during the day. Your days will be much energetic. Yes, there will be cramping of muscles and pain after a vigorous exercise but you will overcome it as you work out on a regular basis.

4. At last, work on belly fat. That takes long cardio exercises and 100 sit-ups and crunches a day. You can see your abs at any age. Guaranteed.

Diet. Give up one unhealthy food item and substitute one healthy item every week in your diet.

For example:

Week 1: Give up a bowl of ice-cream that you are in a habit to have at bed time. Substitute with a glass of skim milk or a small ball of berry-plain yogurt. Fat-free frozen yogurt is a good substitute.

Week 2: Give up an extra pickle, papad or any type of salty and oily side dish. Replace with a cucumber or any vegetable. You also can substitute the salty and oily side dish with a vegetable or dry-fruit raita (yogurt with nuts or vegetables).

Week 3: Replace that glass of alcohol with your favorite juice. Begin with pineapple or pomegranate juice. Chilled lemonade would be good too.

Week 4: Hard one! Give up one carbohydrate item. You either should eat rice or a wheat item. Not both. This is tough for many people, including me sometimes because we are used to eating heavily carbohydrate dinner. I would say alter rice and wheat item (roti, bhakhri, puri, etc.) every other day. A good replacement is vegetables such as lettuce, cucumber, tomatoes, boiled potatoes, carrots, etc.

Achut Mashruwala of Fitness Guru Inc. can be reached at (813) 857-5103 or e-mail

Payal Patel

There comes a time in every toddler's life when parents feel it is the right time to start potty training. Therefore, many parents come prepared with a slew of questions about the right time for their child and how to proceed so as not to instill a fear of toilet training.

First, you have to assess whether your child is ready to toilet train or not. This is evident by the child demonstrating the ability to understand what pee-pee, poo-poo, potty or whatever term is used. The readiness is usually demonstrated at 15-18 months of age. Most children are ready by the time they are 2 years old to proceed to be completely trained and most children can be trained by the time they are 3 years old.

A child has to be able to understand what the toilet is for, and this can be learned by watching older siblings or parents using the potty. Also, a child signifies readiness to train when he or she can tell the difference between a dry and wet diaper and shows interest in changing so they are dry. Many children actually are able to tell you when they are about to wet their diaper or when they have to stool as well.

To help your child, read toilet-training books so they understand what they will have to do soon. Let them play with older children who are toilet trained so they see that it will be OK when they use the toilet. Teach them how the toilet works. Be positive and supportive of their trial and errors, and don't get frustrated, which they will be able to sense.

The best way to start training your child is by praising them when they are able to tell you if they want to pee pee or poop. Do not scold or punish them if they hesitate; instead, be patient and try to make it fun. Buy a potty seat together and let the child know why you are doing it. Let them feel like they are in control by purchasing the seat, bringing it home and then experimenting with it.

Let them sit on it with their clothes to get a feel of what it will be when they are ready. Praise them for doing it. Talk about a plan where action will entitle them to a reward such as stickers, or healthy treats such as raisins, crackers, etc. Practice first when you notice your child either saying pee pee or has signs they want to void or stool, and lead him to the potty. Encourage him to take his diaper off and sit on the potty. Try to make it comfortable by either holding a favorite stuffed animal, a toy or even reading their favorite book.

If they are able to do it, praise and reward him appropriately. If it does not go as planned, reassure your child that it's OK and to try again next time.

Your child may continue to have accidents during the day, which is perfectly normal. Let he or she know its OK and mommy or daddy is not mad, and that he/she will get it eventually. Once the child consistently uses the toilet, you can use pull-ups to encourage and give them a sense they are a big boy or girl. If your child refuses to train, stop training, until a few months later, or when they feel ready.

Dr. Payal Patel is a board-certified pediatrician at Sunshine Pediatrics, 18928 N. Dale Mabry Highway, Suite 102, Lutz. For information, call (813) 948-2679.

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