Be active for life

As Abe Lincoln once said, ‘And in the end, it’s not the years in your life that count. It’s the life in your years.’

IN the last two months, I have lost four friends to cancer. They all died between their mid-50s to early 60s.

While ageing and death are inevitable, the poor health associated with ageing can definitely be delayed until the very end, but there are many things we need to do to achieve this. While the life-expectancy figures keep rising across the world, the prevalence of chronic diseases like cancer, heart disease, stroke, diabetes, etc are also rising rapidly. All these diseases usually start after the age of 40, which means that the unhealthy part of the lifespan is prolonged.

Modern medicine has enabled sick people to survive longer than before. It is rare to find anyone above 65 (senior citizen) who is healthy and fit, and does not require any medication. We have improved the quantity, but not the quality of life.

We should not only aim to live longer, but also to live healthier. In fact, it would be quite torturous to continue living while being ravaged and incapacitated by chronic diseases.

As the proportion of senior citizens increases, the problems of the sick, ageing population will become more prominent, and will be a burden on society and on the nation’s resources. Countries like Japan and Singapore are already very worried because their low birth rates mean these countries are ageing at a fast rate, as are many other countries.

Malaysia is also slowly moving in that direction as our birth rate has also been declining over the last few decades.

Of the many things that need to be done to stay healthy for life, some are absolutely crucial – physical activity/exercise, healthy diet, maintaining an optimum weight, not smoking, not taking excess alcohol, managing stress well and treating any health problems early. These are lifestyle practices that should be inculcated while you are still young, so that you can remain fit and healthy throughout your younger days and prolong the healthy portion of your lifespan.

If you are already old, it is never too late to adopt these healthy practices so that whatever your health status is at the moment, you can still improve. Of these, physical activity and exercise are the most important factors.

Stay fit for healthy ageing

Studies have shown that inactivity is even worse than smoking when it comes to increasing the risk of chronic diseases.

Many are caught in modern day desk-jobs that reduce physical activity drastically.

Some companies have staff gymnasiums and encourage their staff to exercise daily at work, while some others have even installed treadmill “walk-stations” to enable their staff to walk very slowly while doing their work.

Although I think the latter proposition is ridiculous, the health benefits are undeniable. Instead, I would encourage anyone required to sit for prolonged durations to talk a short brisk walk every half-hour or so. This becomes compulsory after two hours (especially if you are on a long-haul flight in an airplane).

Outside of work, the advice to walk at least 10,000 steps a day is applicable into old age if you want to remain fit. That is easy to achieve, if not for the fact that we tend to use the escalator or lift, and use the car, bus or LRT to move from one place to another. So, we have to set apart time to do brisk-walking, jogging or cycling to achieve the equivalent aerobic exercise.

Those who are into dancing and other fun activities can count these too, but the activities must involve physical movements and make you tired. Mahjong, computer games and social-networking on Facebook do not count!

Aerobic exercise

The best is to set aside time for aerobic-type exercises to improve your cardio-pulmonary (heart and lungs) fitness. This will also lead to overall health improvements as the improved blood supply will benefit all cells and organs.

To stay in tip-top health, you should aim for 150 minutes a week (say, 30 minutes, five times a week). If you are retired, you will have plenty of time to do these exercises. However, younger working people have difficulty finding the time to fit in their busy schedules. The minimum you should not default is 30 minutes, twice a week.

If you are unfit and just starting to exercise, make sure to get clearance from your doctor. Start with low impact exercises and don’t end up with a heart attack while exercising!

Once you have gained a reasonable level of fitness and start to enjoy the feeling of being healthy, you may get hooked on exercise, which is good.

Build your muscles

Doing aerobic exercises alone is not enough to remain healthy into old age. As we age, the muscles shrink because we do not do heavy (physical) work like before. The muscles (and bones) will only maintain the sizes required of them to perform their work.

The size of the muscles also helps determine the size of the blood vessels (hint – just look at the size of the veins on body-builders) since muscles work the hardest and need the oxygen and nutrient supply.

Here are five simple exercises that I teach to help build and maintain the important muscle groups – the arms, the legs, and the core muscles (abdominal, back and pelvic floor). You can try these at home.

Vertical and side lift for the arms and shoulders

Men will need a pair of dumb-bells (three to five kilogrammes as a start, depending on your strength) to do this, while women can make do with 1.5 litre water bottles (1.5kg weight). The weights are lifted vertically up from the standing position by starting with flexing the arms (biceps) and then extending (triceps) them as the weights are lifted vertically above the head.

The movements are then reversed to return to the starting position. This is repeated until you get tired. Breathe in with the first movement and just alternate (in-out) with each subsequent movement.

When you use low weights, this also becomes an aerobic exercise as you will be doing many repetitions. The weights can also be lifted side ways to build other muscles. As you increase the weights, the muscle-building component of the exercise will increase.

Push-ups for the arms and upper back

This is a simple and popular exercise, so I need not describe it in detail. My modification is that you should not look down at the floor while performing this, but instead you should look side ways so that you can go right down nearer to the floor as you do the exercise.

Women (and some men too) who are not fit can start with doing half push-ups (resting on the knees instead of the toes).

Squats for the legs, arms and pelvic floor muscles

Start from the standing position (and holding the weights by your side, though you can do this without the weights). Then squat down while you bring your fists (with or without weights) towards your chest.

Squeeze your pelvic floor muscles tight as you go down. Return to the starting position by reversing the movements, and relaxing your pelvic floor muscles. Start with inhaling in the standing position, and then exhale as you go down. Inhale as you stand up and lower your arms.

Repeat until you get tired. Holding the weights will make this exercise good for the arms as well.

Strengthening the pelvic muscles will help prevent stress incontinence and vaginal prolapse in women, and piles in both sexes.

Sit-ups and reverse crunch for abdominal muscles

Most of you are familiar with doing sit-ups, except that many may still make the mistake of putting your hands behind your head and end up using your arms to pull your head to help accomplish the sit-up.

Please note that the aim here is to use only the abdominal muscles to do the sit-ups, so the arms should not be allowed to help you “cheat”! The correct way is to lie down with the knees bent, and your hands resting on your chest. Then sit-up partially (“crunch”) or fully, and return to the starting position gently.

To strengthen both the upper and lower abdominal muscles, you will have to do the sit-up as well as do the “reverse crunch”. This is done while lying down with your arms on the floor beside you. Keep the knees bent, but this time, the feet are held about 15cm above the floor. Then slowly bring the knees half-way towards the chest while lifting the buttocks. Slowly relax and return to the starting position. Repeat until you get tired.

Cobra back-stretch for back muscles

Lie down on your stomach with your head facing sideways and arms stretched just beside your body. Inhale as you arch your back and lift your arms backwards at the same time. Exhale as you relax and return to the starting position. Repeat until you get tired.

Some others teach that you should inhale while you arch the back. My rule is that you should inhale whenever the chest is expanded, and exhale whenever it is compressed.

There are many other exercises and variants of the ones I described above for those who are serious in keeping fit. For beginners, I advise that you repeat the exercises until you get tired. The number of repetitions will increase as you become fitter and stronger. Once you are fit, you can start doing the exercises in sets of 10 or 15, and repeat the sets during your exercise programme.

If you have access to the gym, you should do a wider range of exercises made possible with machines and weights. If you can afford a personal trainer, that is the best.