Dil Walk - Mosaic Primary Care Network

VOLUME 1 • ISSUE 1 January 2015 jnvrI 2015

From Our Heart to Yours swfy idl qoN quhwfy idl q~k

BREAKFAST IS A MUST • nwSqw lwjmI hY • ACTIVE LIVING • AYkitv ilivµg nu~kr • Salt & Your Health • lUx Aqy quhwfI ishq •

MOSAIC

mosaicpcn.ca

dilwalk.ca

DIL WALK MAGAZINE

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World Health Sunridge in North East Calgary Life is busy and we often don’t have much time for ourselves. Meetings, deadlines and social events leave us running from one commitment to the next. We want to be active and eat healthy; however, time demands and priorities leave us lacking the follow through.

That was the case for Randy Lavallee, the owner of a flooring company. As he moved to a management role, he was not doing the physical work anymore. He took on the stress of owning his own business, his lifestyle became much more sedentary and his nutritional choices were based on convenience items like soda and fast food, instead of health and nourishment.

One day he was out doing some work on the side of a house, hauling heavy equipment. After the job was complete, he felt some soreness on the side of his body like he had pulled a muscle.

That Friday while attending his grandkid’s hockey game he felt the same tightness. After the game, he told his wife he thought they should go to the Peter Lougheed Centre. He was admitted to Emergency.

Randy went through an ECG and gave a blood sample before being sent to the waiting room with a few aspirin. The tests revealed a minor heart attack.

With no family history of heart disease, Randy started to think of his kids, five grandkids and one on the way.

“I want to see them grown up,” he said.

The next day an angiogram revealed the extent of his heart attack: two arteries were 100% blocked, one was 90% blocked, and one was 70%. The following week he had quadruple bypass surgery.

“They fixed me up and I was able to go home five days later.”

That’s when things got worse. Randy couldn’t relax at home; he was unable to sleep in his own bed since his heart had to be elevated and ended up sleeping in a recliner.

After rest and recuperation, Randy was given the okay from his doctor to get back to activity. Not knowing where to start, he was scared to shovel the snow, and felt helpless.

Randy’s son then suggested he look into the Total Cardiology Cardiac Rehabilitation Program, saying a friend’s dad attended and thought it was a great program.

It is catered to individual needs to change lifestyle habits and provide knowledge, skills, motivation and confidence to pursue a healthy and active lifestyle.

Randy joined the satellite cardiac rehabilitation program at World Health Sunridge in North East Calgary. Mosaic Primary Network and Cardiac Wellness Institute partnered with World Health in setting up this location to help reduce some of the traditional participation barriers such as travel time and convenience of location to help increase utilization of the effective program.

On his first day he was anxious - scared but excited to become active and feel like his old self again. Randy started with 30 minutes on a treadmill, closely monitored by the nurses who ran the program. They slowly increased his intensity as each session passed. He enjoyed the program, the people and the nurses. He felt the support of those in the program, and also from the staff and members of World Health.

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DIL WALK MAGAZINE

Randy began incorporating the healthy habits he learned with Total Cardiology into his life. He changed his nutrition, and cut Pepsi out of his diet.

“Stay away from the fast food and try not to overeat,” he adds.

After the 12-week program, Randy decided to continue working on his fitness at World Health and joined the club.

He began working with a Personal Trainer, Bonnie. She created a plan that would start him out slowly and work up to a strength training program, all while keeping his heart and previous knee injury in mind.

“Don’t be scared to join a gym,” said Randy, recalling his own nerves before starting the program. “You won’t use the treadmill at home, but here you have the members, the staff, the support and the motivation. Once you start exercising, it really does get better.

“If you don’t know where to start, work with a trainer to help teach you how to exercise properly.”

Randy feels his strength and endurance improving. At 62 years old, Randy is strength training for the first time in his life and boasts the accomplishment of now deadlifting 245 pounds. He’s back to work and back to normal life.

Thanks to exercise and balanced nutrition Randy’s medications are even lower than before, he isn’t tired and has more energy throughout the day, and hasn’t had to use his nitroglycerin spray.

“I’ve lost 20 pounds and am feeling a lot better. I’m going to keep going.”

Background

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Mosaic Primary Care Network is a group of family physicians in partnership with Alberta Health Services to provide comprehensive care to members of the community in northeast and southeast Calgary. Created in 2006 as part of the Primary Care Initiative of Alberta, Mosaic PCN’s mission is “Better Health for All” Primary care is the care patients receive at their first point of contact with the health care system, usually provided by family physicians or allied health care providers. Patients receive care for their everyday health needs, including health promotion and prevention, diagnosis and treatment of health conditions.

mojæyAk pRwiemrI kyAr nYtvrk PæYimlI fwktrW dw ie~k smUh hY jo ik Albrtw hYlQ srivisjæ nwl sWJIdwrI kr ky nOrQ eIst Aqy swauQ eIst dy vsnIkW ƒ muk~ml ishq pRdwn krdw hY[ ieh 2006 iv~c pRwiemrI kyAr nYtvrk ienIiSAitv AwPæ Albrtw dy ih~sy vjoN hoNd iv~c AwieAw[mojæyAk pRwemrI kyAr nYtvrk dw imSn hY “sB leI ibhqr ishq”[ pRwiemrI kyAr auh syvw sµBwl huµdI hY jo ik mrIjW ƒ ishq sµBwl ivvsQw nwl pihly sµprk smyN imldI hY, Aqy ijAwdwqr PæYimlI fwktrW Aqy hor ishq sµBwl krqwvW duAwrw pRdwn kIqI jWdI hY[ mrIjW ƒ hr rojæ dIAW ishq dIAW loVW ijvyN cµgI ishq ivc vwDw Aqy rogW qoN bcwau krnw, rogW dI jWc Aqy aunHW dy ielwj dI syvw imldI hY[

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DIL WALK Magazine is a partnership between Mosaic PCN and DIL WALK Foundation that creates a publication aimed at educating patients of member physicians on new programs and initiatives available to them and their families.

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6 CONTENTS

ivSy

4 Hearth Desease and Stress

6 nwSqw lwjmI hY

6 Breakfast is a must!

7 sofIAm (lUx) Aqy bl~f prYSr dw sµbµD

4

7 The Link Between Sodium (Salt) and Blood Pressure 8 South Asians and Heart Disease 10 Active Living Corner

8 d~KxI eISIAweI BweIcwrw Aqy idl dw rog

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Published for Mosaic PCN by

dilwalk.ca Mosaic Primary Care Network Sunridge Professional Centre 306 - 2675 36 Street NE Calgary, Alberta T1Y 6H6 Tel: 403.250.5059 Fax: 403.250.5227 mosaicpcn.ca

idl dw rog Aqy qxwa

Calgary, Alberta Tel: 403.287.9818 ads@paragonpublish.com paragonpublish.com

AYkitv ilivµg nu~kr

Editors Jacquie Maurice Communications Coordinator Mosaic Primary Care Network

Co-Editor Anmol Kapoor, MD, FRCPC Cardiologist Advanced Cardiology

Raman Kapoor RD President, DIL Walk Foundation dilwalk@gmail.com

Art Director Richart Bocxe Publisher Jim Thornton

DIL WALK e-magazine version is available at mosaicpcn.ca, dilwalk.ca and by free subscription at dilwalk@paragonpublish.com.

All rights reserved ©2015. Printed in Canada. Member of the Canadian Federation of Independent Business.

DIL Walk Foundation is DIL Walk is an acronym for Do It for Life (DIL) and is more than just a walk. DIL Walk is about Wellness, Access, Linkages and Knowledge (WALK). DIL Walk is a way of life. This primary prevention approach targets individuals before they have a heart attack by providing access to resources (medical, community, print resources, testing and self-management), further lessening the burden on the health care system.

DIL Walk is a registered charity (BN: 848225439RR0001) and is dependant on the donations made by community members, organizations and businesses. DIL Walk is unique in that it is 100% volunteer run, with no paid positions. This magazine is funded through your kind donations and support. To help sustain this publication, and other DIL Walk events, please donate generously. Visit www.dilwalk.ca for more information.

DIL WALK MAGAZINE

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Heart Disease and Stress

BY Clare Byrne, RN, BN, MSA, Mosaic Primary Care Network

A

lthough stress can sometimes be a good thing, too much stress can actually harm your health and increase your risk of heart disease and stroke. Many life events such as beginning or leaving school, moving, changing jobs, and experiencing losses can cause stress. However, day to day chronic stress can often cause a greater negative impact on health than do more acute, traumatic events which generally have a start point and an end point. Dealing with things such as daily traffic hassles, finishing homework assignments, or facing constant deadlines can cause more harm. Studies have also shown that chronic stress is often associated with much higher risks of cardiovascular disease. This occurs because of a compromised immune system.

Humans experience stress, or perceive things as stressful, when they do not believe they can cope with what they are facing. Symptoms may include a sense of being overwhelmed, irritable, insecure, nervous, lack of appetite, experiencing panic attacks, exhaustion, skin rashes, insomnia, migraine, or digestive symptoms. It may also cause more serious conditions such as heart problems - as some people with prolonged or high levels of stress may have higher blood cholesterol, increased blood pressure, or be more prone to developing atherosclerosis (narrowing of the arteries). People under chronic stress are prone to more frequent and severe viral infections, such as the flu or common cold - and vaccines such as the flu shot are less effective for them. Long-term

exposure to stress can also lead to mental health problems such as depression and anxiety.

Responding to stress with anger can also be harmful, since it sets off a series of physical changes including increased heart rate and elevated blood pressure levels which can increase your chance of having a heart attack. People who are prone to anger are also more likely to turn to unhealthy behaviours such as smoking, excessive alcohol consumption and overeating leading to increased risk of heart disease and stroke. So it is important to identify the source of your stress and take steps to manage it.

If your life is stressful, it can be difficult to lead a healthy lifestyle, however, there are lots of ways to relieve the stress you may be feeling; talk to friends and family, take time for yourself, laugh, eat well, and take vacations. Being physically active is a great stress reliever too. Be sure to talk to your physician before starting any activity program.

Mosaic Primary Care Network has resources to assist you and help you to learn coping strategies to manage stress and decrease the harmful effects on your health.

You can sign up for a workshop on Stress Management by calling 403.276.1555, check mosaicpcn.ca for more information, or if oneto-one counselling is needed, talk to your physician about a referral to a Mosaic Mental Health Therapist. All these resources are free to patients of Mosaic member physicians. q

GENESIS MEDICAL CLINIC Genesis Centre, Lower Level 7556 Falconridge Blvd NE Calgary, AB T3J 0C9

Dr. Preet Pal Sekhon MD CCFP Dr. Jagdeep Badhesha MD CCFP ABFM MON - FRI 9 AM - 8 PM • SAT & SUN 9 AM - 5 PM 4

DIL WALK MAGAZINE

T: 403-475-2500 F: 403-475-2504

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DIL WALK MAGAZINE

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Breakfast is a Must!

BY Raman Kapoor BSc RD, Advanced Cardiology Consultants and Diagnostics Inc.

E

verybody’s heard it before... breakfast is the most important meal of the day. It’s true – and when you eat is as crucial as what.

When you wake up in the morning your body has been fasting for a number of hours (hence, breakfast = break the fast).

Give yourself time to wake up. Most people aren’t hungry right away. Rushing puts pressure on breakfast eating. Wake up earlier, or try to prepare breakfast the night before, so that it’s ready to go in the morning. Another good reason to eat breakfast is that it helps ensure you’re getting enough vitamins and minerals, as research has shown we often do not get enough from lunch and dinner alone. By adding breakfast, we’re more likely to get the vitamins and minerals we need.

Eating breakfast regularly is also an important habit to instil in children when they’re young, so that it lasts a lifetime. The breakfast habit is more easily acquired if it’s a regular part of the household routine, so eat breakfast yourself. “Showing” teaches more than simply “telling.” Your child will follow what you do.

Sometimes, as parents we feel that grabbing a quick bite is sufficient for breakfast. However, it is important to remember that in school, students are learning new concepts and ideas on a daily basis, requiring them to have higher energy requirements than doing something routine or familiar, which is what most people do at work every day. Also, remember that in a work environment, the luxury of getting up and “grabbing a bite” is always available to adults - however in a school setting this is not often the case.

Children who don’t eat a good breakfast become tired in school and have shorter attention spans, especially late in the morning. In fact, in one study, test scores of children who did not eat breakfast were generally lower than those who had eaten a well-balanced morning meal.

Breakfast does not need to complicated or fancy, just balanced and nutritious. A good breakfast should be nutritionally dense. What this means is that it should include one food from at least three of the four food groups. Here are some ideas: • I t takes minimal time to put a slice of cheese between two slices of whole grain bread on the way out the door!

•K eep convenient foods on hand, such as yogurt, fruit, cheese sticks, quick-cooking oatmeal, bags of trail mix, roti and whole grain bread.

•H ave ‘breakfast-to-go’ on the bus, in the car, or while walking to work. This might include a smoothie with a whole grain muffin.

•P eanut butter and banana sandwich and a carton of milk – the sandwich can be made the night before. Try a whole wheat hot dog bun or a roti for variety and fun!

• Bowl of cereal (look for those with more than 4 g fiber/serving), with fresh berries or cut up fruit with milk • Oatmeal (try the quick-cooking instead of instant: they both cook in 1½ minutes in the microwave, and you save on the salt), add raisins and nuts for extra fiber and iron. Make it with milk instead of water. q

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DIL WALK MAGAZINE

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The Link Between Sodium (Salt) and Blood Pressure

Is salt really that important?

BY Raman Kapoor BSc RD, Advanced Cardiology Consultants and Diagnostics Inc.

Y

ES! Limiting salt is very important, especially for South Asians with high blood pressure. People of South Asian descent are particularly sensitive to the effects of too much salt and therefore are at higher risk of health conditions such as coronary heart disease and stroke.

Salt has many negative effects on health. Of these, salt is one of the most important risk factors for high blood pressure. High blood pressure can increase the risk of heart attacks, strokes and heart failure as well as stomach cancer, osteoporosis, and renal failure. High blood pressure is a silent killer, and usually has no obvious symptoms.

In addition, once we are diagnosed with high blood pressure, our bodies hold onto the sodium more, further having a negative effect on the blood pressure.

Where does the salt in our diets come from?

In the North American diet, about 75% of salt comes from processed foods such as: pre-packaged foods like frozen pizza, fast foods (french fries, burgers, hot dogs and deli meats), canned goods (soups) and snack foods (potato chips, french fries, salted nuts). Interestingly, in the South Asian population, in addition to the processed foods, a large amount of the salt consumed is added during cooking or at the table. Many add salt to their food without even tasting it first!

In South Asian cooking, the true level of salt added to food is often disguised by the hot spices used, or in the prepared spice mixtures available, such as MDH. Some research shows that South Asian people consume very high quantities of salt, almost 10 grams per day - this is almost three times the daily need for adults.

What can you do?

• Remove the salt shaker from the table, or substitute it with fresh herbs and spices • Cut down the amount added during cooking.

• If the food still tastes good, the salt is still too high. When your food tastes bland to you, then you have reduced the salt. If you gradually add less salt, your taste buds will adjust (after only about 3 weeks) and you will not notice the difference • Sea salt, rock salt and garlic salt have the same negative effect as table salt and should all be avoided • Most sauces and achars used at the table are also very high in salt, e.g. Pachranga, chilli sauces, tomato ketchup and soy sauce. Look for reduced-salt versions or use less • When cooking, do not add salt to the water used for cooking vegetables, pasta and rice. Add herbs and spices to boost the flavour.

• Cut down on high-salt snacks such as nachos, chips, french fries, salted nuts, and South Asian snacks such as namkeen, Kurkure, and pakoras.

• Check food labels when you are in the grocery store. Find the Sodium and aim for less than 10% DV • Butter and ghee are both high in salt and fat. Cut these out of your cooking by replacing them with olive, or canola oil.

• Choose fresh fruits, vegetables, low-fat dairy and natural foods prepared from home. q

sofIAm (lUx) Aqy bl~f prYSr dw sμbμD kI lUx Asl iv~c bhuq jrUrI hY[

hW! lUx ƒ G~t krnw bhuq jrUrI hY, Kwskr d~KxI eySIAweI BweIcwry dy lokW leI[d~KxI eySIAweI mUl dy lok lUx dy pRBwvW pRqI ivSyS sμvydnSIl hn[ies leI ienHW ƒ kOronrI hwrt ifjæIjæ Aqy idmwg dw dOrw pYx dw Kqrw dUijAW qoN ijAwdw hY[ lUx dy ishq qy keI nkwrwqmk pRBwv huμdy hn[ienHW iv~coN ie~k ieh ik lUx hweI bl~f prYSr leI sB qoN Kqrnwk kwrk hY[hweI bl~f prYSr nwl hwrt AtYk, idmwg dw dOrw, hwrt PylH, pyt dw kYNsr, AOstoporoiss Aqy gurdy PylH hox dw Kqrw v~D ho jWdw hY[ hweI b~lf prYSr ie~k KmoS kwql hY Aqy Aksr ies dy koeI pRq~K l~Cx nhIN huμdy[ies qoN Alwvw jdoN ie~k vwr bl~f prYSr vDx l~g pvy qW srIr iv~c sofIAm ƒ pkV ky r~Kx dI smrQw vD jWdI hY ijs nwl bl~f prYSr qy hor ijAwdw nkwrwqmk Asr huμdw hY[ Where does the salt in our diets come from? swfI Kurwk iv~c lUx AwauNdw ikQoN hY? au~qrI AmrIkw dy Bojn iv~c 75% lUx prosYs kIqy BojnW ijvyN pYk kIqw Pærojæn ipjæw, Pæwst PæUæf (PærYNc PærweIjæ, brgr, hOt fOg Aqy fYlI mIt), f~bwbμd Bojn (sUp) Aqy snYk Bojn (AwlU dy icps, PærYNc PærweIjæ, lUx lwey nt) iv~c huμdw hY[ idlcsp g~l ieh hY ik d~KxI eySIAweI BweIcwry dy lokW dI Kurwk iv~c prosYs kIqy BojnW ivcly lUx qoN Alwvw bhuq swrw lUx pkwaux smyN jW vrqwaux Aqy Kwx smyN pw ilAw jWdw hy[ keI lok Kwxy dw svwd ley ibnw hI hor lUx pw lYNdy hn[ BojnW iv~c ijnμw lUx Asl iv~c pwieAw hY ieh aus Bojn iv~c pwey grm mswly kwrn, jW iqAwr kIqy grm mswilAW dy imSrx ijvyN MDH kwrn pqw hI nhIN l~gdw[ kuJ KojW qoN pqw l~gdw hy ik d~KxI eySIAweI lok lUx dI bhuq ijAwdw mwqrw iv~c vrqoN krdy hn, qkrIbn 10 gRwm pRqIidn – ieh bwilgW dI ie~k idn dI loV qoN iqμn guxw ijAwdw hY[ What can you do? qusIN kI kr skdy ho?

• swlt Sykr ƒ Kwx dy tybl qoN htw idau, jW aus dI QW qwjæIAw jVIbUtIAW Aqy mswly r~K lvo[ • Kwxw pkwaux smyN pwey jwx vwly lUx dI mwqrw Gtw idau[ • jy Kwxw hly vI suAwd l~gdw hY qW ies dw mqlb hoieAw ik lUx hly vI ijAwdw hY[jdoN quhwƒ Kwxw Pokw l~gy qW smJo ik hux qusIN lUx Gtw id~qw hY[jy qusIN holI-hOlI kr ky lUx pwauxw G~t krdy ho qW quhwfy tyst bf Awpy hI aus Anuswr Fl jwxgy (qkrIbn 3 hPæiqAW iv~c) Aqy quhwƒ Prk mhsUs nhIN hovygw[ • SmμdrI lUx, p~QrI lUx Aqy lsx vwly lUx dy vI auhI nkwrwqmk pRBwv huμdy hn jo ik Awm lUx dy; ies leI ienHW qoN vI prhyj krnw cwhIdw hY[ • Kwx dy tybl qy vrqy jwx vwlIAW ctxIAW Aqy AcwrW iv~c vI lUx bhuq huμdw hY, ijvyN pcrNgw Acwr, imrcW dI ctxI, tomyto kYcAp Aqy soieAw dw sOs[ ienHW cIjæW ƒ G~t vrqo jW ienHW dy auh vwly nmUny vrqo ijnhw iv~c lUx G~t hovy [ • pkwaux vyly ijs pwxI iv~c sbjIAW, pwstw Aqy cOlW ƒ pkwauNdy ho aus iv~c lUx nw rlwau[ svwd Aqy mihk vDwaux leI jVI-bUtIAW Aqy mswly pw lvo[ • ijAwdw lUx vwlIAW cIjW ijvyN nwco, icps, PærYNc PærweIj, lUx lwey nt Aqy d~KxI eySIAweI snYk ijvyN nmkIn, kurkury, Aqy pkOVy G~t kro[ • grosrI dI dukwn qy Kwx vwlIAW cIjæW qy lybl cYk kro[ auh Kwx vwlIAW cIjæW KrIdo ijnHW qy 10% fI vI qoN G~t soifAm iliKAw hovy[ • btr Aqy iGau - dovW iv~c hI lUx Aqy PæYt ijAwdw huμdw hY[ ienHW ƒ Kwxw pkwaux iv~c nw vrqo Aqy ienHw dI QW jYqUn dw qyl jW knolw qyl vrqo[ • qwjæy Pl, sbjIAW, G~t PæYt vwlI fyArI Aqy Gr qoN iqAwr kIqy kudrqI BojnW dI cox kro[ DIL WALK MAGAZINE

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South Asians and Heart Disease

BY Anmol S. Kapoor MD FRCPC Medical Director Advanced Cardiology Consultants and Diagnostics Inc.

D

espite advances in medicine and technology, heart disease is one of the leading causes of death in Canada and worldwide. It has been shown that the impact of coronary artery disease (CAD) differs among various ethnic groups, and within this, the South Asian population is considered to be at highest prevalence and worst outcomes after a cardiac event.

South Asians are those whose ethnic roots originate from the Indian subcontinent: a large geographic area including India, Pakistan, Sri Lanka, Nepal, and Bangladesh.

Collectively, they represent one-fifth of the global population. Multiple studies of migrant South Asian populations have confirmed a 3- to 5-fold increase in the risk for myocardial infarction and cardiovascular death, as compared with other ethnic groups in the western world.

Why is heart disease so common in South Asians?

Although research in this area is limited, some explanations have been offered by various studies. These include: excess exposure to cardiovascular risk factors such as diabetes, poor diet and lack of exercise; high rates of metabolic syndrome; cholesterol abnormalities; genetic variations in emerging risk factors; and inflammatory biomarkers. It is very important to do further studies to identify these risk factors.

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What is Metabolic Syndrome?

The metabolic syndrome identifies people who are at increased risk of developing both type 2 diabetes mellitus and CAD. The diagnostic criteria for this syndrome includes abdominal obesity, glucose intolerance, hypertension, reduced HDL cholesterol, and increased triglycerides.

People with the metabolic syndrome have 2-times greater risk of death and a 2-3 times increased risk of cardiovascular death.

Are abdominal obesity and Body Mass Index (BMI) different for South Asians?

South Asians have increased abdominal visceral fat (extra fat around the stomach area) and their numbers are different when compared to other ethnicities. It has been suggested that men should have a waist circumference of not more than 90 cm and women not more than 80 cm. South Asians also have different BMI - body mass index numbers (the individual’s body mass divided by the square of their height – with the value given in kg/m2), and are classified as below: Normal: 18.5 - 22.9 Overweight: >= 23 Obese: > 25 How can you reduce your risk of heart disease?

It’s very important to be aware of your

overall risk status. Your doctor can help you understand this status, and will use different scoring values.

If you’re interested to learn more about your risk, visit www.qrisk.org. For the QRISK questionnaire you’ll need to know your weight and height, blood pressure, family history, and other questions. Ignore the UK postal code, and enter all information required. After submitting, you will get your risk of heart attack. If it comes up in the intermediate or high risk range, it is important to discuss with your doctor to see if you would benefit from cholesterol and other medications. Your doctor will also advise you about increasing your physical activity.

In the meantime: • Stop smoking • Take control of your diabetes • Monitor your blood pressure • Slowly increase physical activity up to 30 minutes 5 times a week • Increase fresh fruits and vegetables intake • Limit salt and trans fat intake • Keep your weight in check - Waist Circumference and BMI • Take medications as prescribed by your doctors, and do not self-medicate. If you use medications from overseas, discuss them with your doctor to see if they are appropriate for you. q

d~KxI eISIAweI BweIcwrw Aqy idl dw rog ishq ivigAwn Aqy qknIk dw bhuq ivkws hox dy bwvjUd kYnyfw Aqy bwkI swrI duinAw iv~c idl dw rog mOq dy muK kwrnW ivcoN hY[ ieh g~l jæwhr ho geI hY ik kOronrI AwrtrI ibmwrI (CAD) dw pRBwv Al~g Al~g nslW dy lokW qy Al~g - Al~g pYNdw hY[ Aqy ienHW iv~coN d~KxI eySIAweI mUl dy lokW iv~c ieh rog sB qoN v~D Aqy idl dy dOry qoN bwAd nqIjy sB qoN mwVy huµdy hn[ BwrqI mhwdIp dy mUl lokW ƒ d~KxI eySIAweI ikhw jWdw hY : auh v~fw swrw Boiqk ielwkw ijs iv~c Bwrq, pwiksqwn, sRI lµkw, nypwl Aqy bµglwdyS AwauNdy hn[ kul imlw ky ieh ies DrqI dI AwbwdI dw pµjvW ih~sw hn[ p~CmI duinAw (kYnyfw) iv~c rihx vwly d~KxI eySIAweI BweIcwry dy iemIgRn† lokW iv~c dUijAW nslW dy lokW dy mukwbly idl dy dOry nwl mOq dw Kqrw 3 qoN 5 guxw v~D hY[ Why is heart disease so common in South Asians? d~KxI eySIAweI BweIcwry iv~c idl dw rog AYnw ivAwpk ikaUN hY? BwvyN ies Kyqr iv~c G~t hI KojW hoeIAW hn, lyikn kuJ AiDAYnW qoN kwPæI sMkyq imldy hn[ ienHW iv~c Swiml hn idl dy rog dw Kqrw vDwaux vwly kwrkW dw vDyry hoxw ijvyN ik fwieibtIjæ, mwVI Kurwk Aqy ksrq dI kmI; mYtwbOilk isµfrom dI vDyry dr; AsDwrx kolYstrOl; vDdy Kqry dy kwrkW iv~c jnYitk iviBnµqw; Aqy ienPælymytrI bwieaumwrkr[ ienHW Kqry dy kwrkW qy hor AiDAYn krnw bhuq jrUrI hY[ mYtwbOilk isµfrom kI hY? mYtwbOilk isµfrom aunHW lokW dI pCwx krdw hY ijnHW ƒ twiep 2 fwieibtIjæ mYlwiets

Aqy kOronrI AwrtrI ifjæIjæ, dovyN hox dw vDyry Kqrw huµdw hY[ ies isµfrom dI pCwx krn dy mwpdµfW iv~c Swiml hn pyt dw motwpw, glUkos pRqI AshnSIlqw, v~D bl~f prYSr, G~tHDL kolYstrOl, Aqy vDy hoey trweIgilsrweIfjæ[ ijhVy lokW ƒ mYtwbOilk isµfrom huµdw hY aunHW iv~c mOq dw Kqrw 2 guxw Aqy idl dy rog nwl mOq dw Kqrw 2 qoN 3 guxw v~D huµdw hY[ kI pyt dw motwpw Aqy bOfI mws ieµfYks(BMI) d~KxI eySIAweI lokW leI v~Krw hY? d~KxI eySIAweI BweIcwry dy lokW dw AbfOimnl ivsrl PæYt (pyt dy duAwly vwDU crbI) ijAwdw huµdI hY Aqy dUijAW nslW dy mukwbly ijAwdw hY[ieh suJwau id~qw jWdw hY ik purSW dI kmr dw Gyrw 90 sYNtImItr Aqy AorqW dw 80 sYNtImItr qoN ijAwdw nhIN hoxw cwhIdw[ d~KxI eySIAweI BweIcwry dy lokW dy vI v~Kry - v~Kry (BMI) bOfI mws ieµfYks nµbr (ivAkqI dy Bwr ƒ aus dy k~d dy vrg nwl vµf ky inklI sµiKAw- ijs dI kImq iklogrwm / vrg mItr iv~c mwpI jWdI hY) hn[ ies ƒ ies qrHW kRmb~D kIqw jWdw hY: TIk: 18.5 - 22.9 ijAwdw Bwr: > = 23 motwpw: > 25 qusIN idl dw rog hox dw Kqrw ikvyN Gtw skdy ho? quhwƒ Awpxy KqirAW dy drjy bwry sucyq hoxw jrUrI hY[ quhwfw fwktr quhwƒ ies drjy ƒ smJx iv~c mdd kr skdw hY Aqy auh v~Kry mu~lWkx dy pYmwny dI vrqoN kr skdw

hY[ jyy qusIN Awpxy Kqry bwry hor jwxnw cwhuµdy ho qW,www.qrisk.org. ƒ Kolo[QRISKpRnwvlI leI quhwƒ Awpxw vjæn Aqy k~d, bl~f prYSr, pirvwr dI ishq dw pCokV Aqy hor kuJ jwxkwrI hoxI jrUrI hovygI[ UK postl kof Brnw jrUrI nhIN hY[bwkI swrI jrUrI jwxkwrI Br idau[ies ƒ sbimt krn qoN bwAd quhwƒ hwrt AtYk dw Kqrw ikµnw hY, ieh inkl Awvygw[ jy ieh drimAwny jW v~D Kqry dI h~d iv~c AwauNdw hY qW ieh jrUrI hY ik Awpxy fwktr nwl g~l kro ieh pqw lwaux leI ik kI quhwƒ kolYstrol dI dvweI Aqy hor dvwieAW qoN Pæwiedw hovygw[ quhwfw fwktr quhwƒ srIrk ksrq vDwaux leI vI slwh dyvygw[ iesy smyN dOrwn: • isgrt pIxI bµd kr idau[ • AwpxI fwieibtIjæ ƒ kwbU kro[ • bl~f prYSr dw iDAwn r~Ko[ • hOlI-hOlI kr ky srIrk ksrq vDw ky hPæqy iv~c 5 idn 30 imµt dI kr idau[ • qwjy PælW Aqy sbjæIAI dI vrqoN vDw idau[ • lUx Aqy trWs PæYt dI vrqoN ƒ G~t kr idau[ • Awpxy vjæn ƒ kwbU iv~c r~Ko – kmr dw Gyrw Aqy BMI • dvweI Awpxy fwktr dI slwh Anuswr lvo, AwpxI mrjæI nwl dvweI nw lau[ qusIN iksy hor dyS qoN leIAW dvweIAW lY rhy ho qW ieh XkInI bxwayx leI ik auh quhwfy leI TIk hn aunHW bwry Awpxy fwktr nwl g~l kro[

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9

Active

Living Corner

BY Clare Byrne, RN, BN, MSA, Mosaic Primary Care Network

B

eing physically active is great for your health. From relieving stress to improving fitness, having an active lifestyle provides lots of benefits, including reducing your risk of heart disease and stroke. Regular activity helps prevent and control high blood pressure, high cholesterol, type 2 diabetes, osteoporosis, certain types of cancer, and obesity.

The Canadian Physical Activity Guidelines (csep.ca/guidelines) recommend that adults accumulate at least 150 minutes of moderate to vigorous intensity aerobic physical activity a week, in bouts of 10 minutes or more to achieve health benefits. The best approach is to participate in activities that you find enjoyable as you are more likely to sustain the habit once established. Some examples of aerobic activity are brisk walking, running, swimming and bicycling. Adults should accumulate this activity over and above the activities of daily living, such as housekeeping, preparing meals and shopping. Be sure to consult your physician before starting any activity program.

If you’re just starting out, go slow and work up gradually… and then keep at it, and within 10 DIL WALK MAGAZINE

three months or less, you’ll notice a big difference in your fitness level. You’ll feel better, have more energy, sleep more soundly, and reduce your stress.

During the fall and winter there are many other things to do both indoors and outside such as bowling, dancing, hiking, ice skating, weight lifting, hockey, sledding, snow shoeing, stretching, and yoga. And walking is always an excellent activity that can be virtually injury-free and a great starting point.

When the weather is too unsettled to venture outside you can always participate in Mosaic’s Marlborough Mall Walking Program (Monday, Wednesday, and Friday from 0800 to 1000) or join the Mosaic Active Adults Program at the Genesis Centre (Monday to Friday 0900 to 1200). Both of these programs are year round, free, fun, sociable and a great way to stay active surrounded by others interested in doing the same.

Using a pedometer can motivate you to walk more and challenge your friends and family.

You can get a pedometer from the Mosaic Active Living Coordinators at both the Walking Program and the Active Adults Program. q

AYkitv ilivNg nu~kr srIr ƒ ikirAwSIl r~Kxw quhwfI ishq leI bhuq cµgw hY[ qxwau qoN rwhq pwaux qoN qµdrusqI vDwaux q~k ikirAwSIl jIvnSYlI hox dy bhuq lwB hn ijvyN idl dw rog Aqy idmwg dw dOrw pYx dw Kqrw Gt jWdw hY[ nym nwl ksrq krn nwl hweI bl~f prYSr, hweI kolYstrOl, tweIp 2 fwieibtIjæ, austoporoiss, keI iksm dy kYNsr Aqy motwpw kwbU ivc r~Ky jw skdy hn[ knyifAn iPæjæIkl AYykitivtI gwieflweInjæ (www.esep.ca/guidelines) dI isPæwrS hY ik bwilgW ƒ ibhqr ishq dy lwB lYx leI ie~k vwr iv~c 10 imµt kr kw hPæqy iv~c 150 imµt drimAwnI qoN qyj AYyroibk ksrq krnI cwhIdI hY[ sB qoN vDIAw nIqI hY ik aunHW gqIivDIAW iv~c ih~sw lvo jo quhwƒ cµgIAw lgdIAW hn ikaUNik ienHW gqIivDIAW dI Awdq ƒ kwiem r~Kx dI sµBwvnw ijAwdw huµdI hY[ AYyroibk ksrq dy kuJ audwhrx hn qyj qurnw, dOVnw, qYrnw Aqy swiekl clwauxw[bwilgW ƒ ieh gqIivDIAW rojænw dy kµm kwr ijvyN Gr dI SPæweI, Bojn pkwauxw Aqy SwpiNg qoN Alwvw krny cwhIdy hn[ koeI vI srIrk ksrq dw pRogRwm SurU krn qoN pihlW Awpxy fwktr nwl g~l jrUr kro[ SurUAwq iv~c sihjy c~lo Aqy Pyr qyjI hwisl kro...Aqy ies ƒ kwiem r~Koo[ iqµn mhIinAW jW aus qoN vI G~t iv~c qusIN Awpxy Awp ƒ vDyry

qµdrusq mihsUs krogy[ qusIN vDIAw mihsUs krogy, quhwfy iv~c ijAwdw aUurjw hovygI, gUVHI nINd AwvygI Aqy qxwau Gt jwvygw[ pqJV Aqy srdI dy mUsm iv~c Aµdr qy bwhr krn leI hor keI cIjW hn ijvyN ik bwauilNg, fWisNg,hwieikNg, Awies skyitNg, vyt ilPæitNg, hwkI, slYijNg, snoA SoieNg, strYicNg Aqy Xogw[ vwikNg bhuq vDIAw ksrq huµdI hY ijs iv~c s~t l~gx dw koeI vI Kqrw nhIN huµdw, ieh vDIAw SurUAwq ho skdI hY[ jdoN mUsm bwhr ivcrn leI bhuqw Krwb hovy qW qusIN mwlbro mwl iv~c mojyæAk dy vwikNg pRogRwm(somvwr, buDvwr Aqy Su~krvwr 0800 qoN 1000) iv~c ih~sw lY skdy ho jW jYnyiss SYNtr ivKy AYkitv Aflts pRogRwm (somvwr qoN Su~krvwr 0900 qoN 1200) iv~c Swiml ho skdy ho[ ieh dovyN pRogRwm swrw swl c~ldy hn, muPæq hn, nwl hI mnprcwvw Aqy smwijk myl jol vI ho jWdw hY[ dUjy quhwfy vrgy SNok r~Kx vwly lokW nwl iml ky ikirAwSIl rihx dw ieh ie~k vDIAw qrIkw hY [ pIfomItr dI vrqON nwl quhwƒ hor qurn dI pRyrnw imldI hY Aqy qusIN Awpxy dosqW Aqy pirvwr ƒ hor qurn leI cuxOqI dy skdy ho[ vwikNg pRogRwm Aqy AYkitv Aflts pRogRwm iv~c mojyæAk dy AYkitv ilivNg kOAwrfInytr qoN qusIN pIfomItr lY skdy ho[

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