Healthy Lifestyle

Noncommunicable diseases (NCDs) are considered a major public health concern worldwide. They account for 60 percent of total deaths globally (with 40 million deaths estimated occurring annually), and contribute to 40 percent of universal disease burden annually. It is projected that if no action is done in the present, these rates would increase to as high as 73 percent to total deaths and 60 percent to disease burden respectively by 2020 (WHO, 2005). The prevalence of NCD continues to rise in the Philippines and promoting healthy lifestyle is very much needed and relevant as ever. More than half (58%) of total deaths in the country in 2003 were caused by NCDs. Diseases of the heart and vascular system made up almost one-third (30.2%) of all deaths (Philippine Health Statistics, 2003). Other NCDs in the top list include malignant neoplasm, chronic obstructive pulmonary diseases (COPD) and diabetes mellitus.

NCDs have replaced the positions of infectious diseases particularly pneumonia and tuberculosis as top-most common causes of deaths. The burden of illness due to NCD is great and the cost of care is something that the country cannot afford. The cost of diagnosis and treatment is generally beyond the resources of the average Filipino and the government’s health budget is inadequate. There is an urgent need therefore to focus all efforts in promoting healthy lifestyle to avoid the major risk factors that cause these diseases. The common risk factors for the major NCDs, which include: smoking, lack of physical activity, obesity, hypercholesterolemia and unhealthy dietary practice can be prevented or modified early through behavior change and environmental support.

The promotion of healthy lifestyle focuses on five areas:

1. regular physical activity and exercise 2. good nutrition and weight control3. smoking cessation and smoke-free environment 4. stress management 5. regular health check up

I. Promoting Physical Activity and Exercise

Sedentary lifestyle, a life spent with or no physical activity, has grave consequence to one’s health. The lack of adequate physical activity has been associated risk of cardiovascular diseases, diabetes mellitus and obesity. It also increases the risk of colon and breast cancer, high blood pressure, lipid disorder, osteoporosis, depression and anxiety. Spending hours sitting, watching television and working on desk and computers contribute to these health problems.

Health Benefits of Regular Physical Activity

Reduces the risk of dying from Coronary Artery Disease Reduces the risk of having second heart attack in people who have already experienced

one heart attack. Lowers both total blood cholesterol and triglycerides and may increase HDL or good

cholesterol Lowers the risk of developing high blood pressure Help reduce blood pressure to those who have hypertension Lowers the risk of developing Type 2 diabetes Reduce risk of colon cancer Helps people achieve and maintain a healthy body weight Reduce the feeling of deppresion and anxiety Promotes psychological well being and reduce the feeling of stress Helps build and maintain healthy bones, muscles and joints Helps older adults become stronger and better abe to move witout falling or becoming

excessively fatigued.

Physical Activity – is something done at home, lie washing the diseases, sweeping the floor and cleaning the house. It is also what is done outside the house, like sweeping or raking the leaves or gardening.

Exercise – is a planned structured repetitive movement doe to improve or maintain one or more components of physical fitness.

II. Promoting Proper Nutrition

Eating a balanced diet s important to health. Studies prove that following nutrition guidelines can prevent major NCDs. Diets high in calories and fats are known to increase the risk of atherosclerosis(disease in the arteries characterized by the dposition of plaques of fatty material on their innerwall) leading to cardiovascular disease. Diets low in fiber and complex carbohydrates are known to increase the risk of cancer and diabetes. Following the nutrition guidelines of low salt, low fat and increased fiber in the diet help decrease the risk.

Nutrition Related Problems that lead to NCD:

1. Obesity – is known to be associated with heart attack, stroke, diabetes , arthritis and cancer.

2. Increase Fat intake – is linked with atheriosclerosis or hardening of arteries, premature hart disease and diabetes.

3. Increase Salt intake, processed and instant food – is realated to hypertension, cancer , atherosclerosis and diabetes.

4. Inadequate Dietary Fiber- decreased intake of sources of fiber annd roughage is also related to micronutrient deficiences and high risk of colon cancer.

Strategies to Promote Healthy Nutrition- Related Practices

There are 3 major strategies to adddress the nutrition problems and practices of filipinos that are related to NCD. These are:

A – Aim for ideal body weight

B – Build healthy nutrition-related practices

C – Choose food wisely

10 Nutritional Guidelines For Filipinos

1. Eat a variety of foods everyday.

The human body needs more than 40 different nutrients for good health. No single food can provide all the nutrients in the amounts needed. Eat a variety of foods, to provide all the nutrients required in the proper amount and balance.

2. Breast-feed infants exclusively from birth to 4-6 months and then, give appropriate foods while continuing breast-feeding.

Infants and children up to 2 years of age are most vulnerable to malnutrition. Breast-feeding is one of the most effective strategies to improve child survival. Nutritional requirements of an infant can be obtained solely from breast milk for the first 6 months of life. After that time, breast milk must be complemented with appropriate foods, but breast-feeding should be continued for up to 2 years of age or longer.

The decision to breast-feed is made by the mother. Nonetheless, the husband and other family members, health workers, neighbors, community organizations, officemates and employers must encourage her to breast-feed her infant.

3. Maintain children's normal growth through proper diet and monitor their growth regularly.

An adequate diet for an active child is one that promotes good health and normal growth.

A well-nourished child is healthy, strong, and alert, has good disposition, and grows at a normal rate.

A poorly nourished child exhibits sluggish if not permanently delayed physical and mental development. In addition, he is lethargic and frequently ill because of low resistance to infection.

Over nutrition on the other hand, may lead to obesity that may cause physical and emotional problems in childhood and later in life.

4. Consume fish, lean meat, poultry or dried beans.

To improve the Filipino diet, not only should the total quantity of food be increased but the quality of the diet should also be improved by including animal products of substitutes.

Including fish, lean meat, poultry, or dried beans in the daily meals will not only enhance the protein quality if the diet but also supply highly absorbable iron, preformed vitamin A and zinc.

Fish, lean meat, poultry without skin, and dried beans, in contrast to fatty meats, are low in saturated fats, which are linked to heart disease.

5. Eat more vegetables, fruits and root crops.

In general, most people do not eat enough vegetables, fruits and root crops. Results of food consumption surveys conducted by the FNRI show that the average consumption of green leafy vegetables, vitamin C-rich fruits and root crops are low in the Filipino diet.

The consumption of more vegetables, fruits and root crops is encouraged to help correct the micronutrient deficiencies consistently noted in national nutrition surveys. Eating root crops will add dietary energy to the meal.

6. Eat foods cooked in edible/cooking oil daily.

In general, Filipinos use very little oil in their cooking. Boiling is the most common method of food preparation. Hence, the total fat and oil consumption in a Filipino diet is low.

Fats and oils are concentrated sources of energy. A low fat and oil consumption results in a diet low in energy value, contributing to chronic energy deficiency. Fats and oils are also essential for absorption and utilization of fat-soluble vitamins, such as vitamin A. A low fat intake may be one of the causes of vitamin A deficiency among Filipinos.

To ensure adequate fat intake, Filipinos should be encouraged to stir-fry foods in vegetable oil or to add fats and oils whenever possible in food preparation. This will guard against chronic energy deficiency and help to lower the risk of vitamin A deficiency.

The excessive use of saturated fats and oils, however, may increase the risk of heart disease. The proper choice of fats and oils therefore is essential.

7. Consume milk, milk products and other calcium-rich foods such as small fish and dark green leafy vegetables everyday.

Nutrition surveys indicate a consistent failure of Filipinos to meet dietary recommendations for calcium. An adequate amount of calcium in the diet starting from childhood all through adulthood will help prevent osteoporosis in later life.

Milk and milk products provide highly absorbable calcium besides being good sources of protein, vitamin A and other nutrients.

Milk and other calcium-rich foods are valuable additions to our rice/plant-based diets, which are not only poor sources of calcium but also contain calcium-inhibiting substances.

8. Use iodized salt, but avoid excessive intake of salty foods.

Goiter and Iodine Deficiency Disorders are rampant in many areas of the Philippines, causing physical and mental retardation in children. The regular use of iodized salt in the table and in cooking in addition to taking iodine-rich foods, will greatly help in eradicating this preventable disease.

On the other hand, excessive intake of salt and salty foods particularly in susceptible individuals increases the risk of hypertension and hence of heart disease. Avoiding too much table salt and overly salty foods may help in the prevention and control of these conditions.

9. Eat clean and safe food.

Food and water are essential to life but they may also carry disease-causing organisms like bacteria, viruses, fungi and parasites, or harmful chemical substances.

It is important to buy foods that are safe. Purchase food only from reliable sources. In addition, care must be taken when preparing and serving meals to prevent food-borne diseases.

Sharing in the efforts to improve environmental hygiene and sanitation in the community will greatly contribute to food safety in the home.

10. For a healthy lifestyle and good nutrition, exercise regularly, do not smoke and avoid drinking alcoholic beverages.

With the changing lifestyle of Filipinos, chronic degenerative diseases are becoming significant public health problems. Healthy diets, regular exercise, abstinence from smoking and moderate alcohol intake are key components of a healthy lifestyle.

Source:Nutritional Guidelines for Filipinos, Revised Edition 2000; Published by the Food and Nutrition Research Institute (FNRI), Department of Science and Technology (DOST)

Reduce From Alcohol use

Drinking alcoholic beverages is a common feature of social gatherings. Nevertheless, there are health risks and social consequences associated to alcohol drinking because of its toxic, intoxicating and dependenceproducing properties. Excessive alcohol drinking is also associated with an increased risk of injuries, including from traffic accidents and has been shown to lead to development of chronic diseases. Promoting an alcohol-free environment is therefore an important component of promoting healthy lifestyle among individuals and in communities.

Reducing the risk of harmful alcohol use:

1. Ensure adequate public awareness of the health and social consequences of the harmful use of alcohol:

Develop and disseminate information on the health and social consequences of the harmful use of alcohol to the public;

Involve other relevant sectors, in particular law enforcement and the criminal justice system to increase public awareness about the harmful use of alcohol;

Provide special prevention programs for high-risk groups (such as young people, women who are pregnant or who are contemplating pregnancy, and certain disadvantaged groups); and

Provide special prevention programs for high-risk situations and in certain settings (such as schools, workplaces, roads and highways).

2. Promote factors that protect against the harmful use of alcohol: Develop and implement health promotion programs dealing with harmful use of

alcohol which empower people to make healthy choices and are appropriately adapted for individual national contexts; and

Provide supportive environments in schools, communities and other social settings that protect people from the harmful use of alcohol, ranging from family support programs, community and school system support programs, and increased access to non- alcoholic beverages.

3. Reduce factors that may facilitate the harmful use of alcohol: Diminish pressures to drink from peer groups and other influences, especially for young

people, other high-risk groups and for those who do not wish to drink; and Provide training in the hospitality sector and retail sector for the responsible service of

alcohol, including enforcing compliance with the legal minimum age for the sale of alcoholic beverages.

4. Regulate and respond to the marketing of alcoholic beverages, including advertising, promotion, and the sponsoring of cultural and sports events, in particular those aimed at young people:

Designate a government agency responsible for enforcement of marketing regulations; Regulate or ban, as appropriate, the marketing of alcoholic beverages;

Encourage greater responsibility among commercial interests, for example through codes of conduct for sale and marketing practices.

5. Promote advocacy for reducing the risk of the harmful use of alcohol: Provide support to agencies that advocate a reduction in the harmful use of alcohol; Engage all relevant government departments in developing and implementing

responses to prevent and respond to the harmful use of alcohol.

III. Smoking Cessation and Promoting Smoke Free Environment

Smoking Cessation

According to the Department of Health, if an individual quits smoking, there is a reduction of 15% seen in the relative risk of all-cause mortality in heavy smokers subjected to intensive clinical cessation interventions. In addition, the risk of lung cancer is 30% to 50% lower than that of continuing smokers after 10 years of abstinence. For smoking-related deaths from coronary artery disease (CAD), lower death rates are reported in persons who quit smoking than in persons who continue to smoke.

Men under age of 65 years who stopped smoking reduced their risk by 50%. And, after 10 years of not smoking, the risk of death from CAD approaches that of a non-smoker. In fact, the physiologic effects of quitting the smoking habit starts in 20 minutes. Within hours of quitting, some of the damage done by smoking begins to reverse. By one year, the risk of coronary heart disease is decreased to half that of a smoker. After five to fifteen years, the risk of a stroke is reduced virtually to that of people who have never smoked. And cancer risk also reduces significantly over the decade after quitting.

When smokers quit -- What are the benefits over time?

20 minutes after quitting: Heart rate and blood pressure drops. 12 hours after quitting: Carbon monoxide level in blood drops to normal. 2 weeks to 3 months after quitting: Circulation improves and lung function increases. 1 to 9 months after quitting: Coughing and shortness of breath decrease; cilia (tiny

hairlike structures that move mucus out of the lungs) regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection.

1 year after quitting: The excess risk of coronary heart disease is half that of a smoker’s. 5 years after quitting: Stroke risk is reduced to that of a non-smoker 5 to 15 years after

quitting. 10 years after quitting: The lung cancer death rate is about half that of a person who

continues smoking. The risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas decrease, too.

15 years after quitting: The risk of coronary heart disease is the same as a non-smoker’s

Promoting Smoke Free Environment

Individual behavioural and pharmacologic interventions to promote smoking cessation are beneficial. However, to have greater effect in eliminating the increasing number of first time smokers and help the current smokers to quit, it is imperative that smoke-free environments be supported. There have been great steps taken in promoting smoke-free environments, such as:

The implementation of the Clean Air Act of 1999 The WHO Tobacco-Free Initiative, the Comprehensive Anti-Smoking Ordinance Republic Act 9211 - an Act regulating the packaging, use, sale, distribution and

advertisement of tobacco products and for other purposes.

These facilitate limiting the access of children and youth to cigarette, limit the advertisement of cigarettes, observance of smoke-free institutions and establishment, and the establishment of Smoking Withdrawal Clinics to provide counseling regarding the hazardous health effects of tobacco. Still a lot more can be done to create physical and social environments that support smoke-free individuals and environments.

Studies have shown that increasing the price of tobacco through increasing tobacco taxation can result to net reduction in tobacco use and related harm. Strict implementation and enforcing of legislation banning all smoking in workplaces and indoor public places (such as transport, schools, hospitals, public buildings) also result to reduction in deaths and illness from exposure to second-hand smoke.

IV. Promoting Stress Management

Stress is an everyday fact of life and everyone experience stress from time to time, Stress is any change that one must adapt to, ranging from the negative extreme of physical danger to exhilaration of falling inlove or achieving some long desired success. And in between, day to day living confronts even the most well managed life with continous stream of potentially stressful experiences. Thus, stress is not only inevitable and essential but also normal part of life. However, normal does not necessarily mean healthy.

Stress triggers hormones that change the way the body works and feels. These changes are nature’s way of helping the person cope with percieve threats. However, some cope with stress by behaving in a way that is unhealthy, like drinking , smoking or overeating. This is the reason why it is important to manage stress appropriately in order to avoid the unhealthy effect of inappropriate coping mechanisms.

Fortunately, stress management is largely a learnable skill. Everybody can learn to effectively handle stress even when pressures persist.It is not possible to live without any stress. But one can learn ways to handle the stress of daily life efficiently, and to manage reactions to stress and minimize its negative impact.However, it is important to remain attentive to negative stress symptoms persist, the risk for serious helath problem is greater because stress can exhaust the immune system. Research demonstrates that 90% of illness is stress related.

People respond to stressful situation in different ways. Stressful situation can trigger different types of responses. These will vary between individuals. Some may be physical, some may be psychological and some may be behavioral.

12 Stress Management Techniques

1. Spirituality

Spirituality is a state or quality of being spiritual, and carries with it the meaning of man's relationship with a world beyond what is felt by the sense –a world beyond himself, others and the environment but which somehow gives meaning, purpose and coherence to one's own existence. The spiritual level holds the entire human person together and points to a relationship with a supernatural being.

Be at peace with your Creator. He is all we have after we leave this life. Forgive and accept forgiveness; forgive yourself and others. Enjoy peace of mind and soul and this can be expressed through prayers or meditation. Meditation is particularly useful when you have been physically active or have been worrying about problems, and you have been under stress for a long time.

Meditation lowers blood pressure, slows breathing, relaxes muscles, eliminates stressful thoughts, improves focus and concentration and reduces headache. It also gives the body time to eliminate lactic acid and other waste products.

2. Self Awareness

Self awareness means knowing yourself, getting in touch with your feelings, or being open to experiences. It increases your sensitivity to inner self and your relationship with the world around you, how you respond to people and what effects you have on them. Always remember the 3 R's: 1) Respect for Self; 2) Respect for Others, and 3) Responsibility for all your actions.

Self awareness is important in: evaluating one's abilities realistically; identifying the areas in which you need to improve; recognizing and building strengths; developing more effective interpersonal relationship; understanding the kind of motivations that are influencing such behavior; developing empathy, and; understanding to recognize both personal needs and the needs of other people.

Live in the here and now, not in the yesterdays and tomorrows. It is only today that we can handle. Yesterday is gone and tomorrow may not even happen.

3. Scheduling: Time Management

Managing time really refers to managing ourselves in such a way as to optimize the time available so that we can achieve gratifying results. Many people refer to time as a resource –something that lies ready for use or something that can be drawn upon for aid. Time is not like other resource, because you cannot buy it, rent it, steal it, borrow it, lend it, store it, save it,

multiply it, manufacture it, or change it. All you can do is spend it. Begin to accept time as your most important resource.

4. Siesta

Siesta means taking a nap, short rest, a break or recharging of "battery" in order to improve productivity. Like a machine, our body needs a little break in order to function well. Siesta helps relax the mind and body muscles, and it relieves tension.

It had been proven in a study that siesta invigorates one's body. The performance of an individual scored high when siesta is observed with a 1530 minute nap. If you exceed 30 minutes in your nap, you will feel groggy and ineffective.

Siesta can be done by having a nap, lying down, closing your eyes and resting your head.

5. Sensible Diet and Exercise

Don't diet, eat normally; when you eat, enjoy your food. Once you finish eating, you should not think anymore about the food. Moderation is very important concept. All you need to learn is normality in eating habits and in lifestyle habits. Food should be one of your enjoyments, but not your only one.

If you eat too many or too few calories, or if you eat too quickly, or if you are choosing the wrong food, you are greatly weakening your resistance to stress. Avoid fad diets because when you are under stress all of the essential nutrients are depleted. People who choose to eat in response to stress freely admit that they don't do it out of hunger.

On the other hand. frequent exercise is probably one of the best physical stress-reduction techniques available. Exercise does not only improve your health, it also relaxes tense muscles and helps you to sleep.

Deep breathing is a very effective method of relaxation. It is a key element of everything from the — take deep breaths" approach to calming someone down, to yoga relaxation and Zen meditation. It works well in conjunction with other relaxation techniques, such as progressive muscular relaxation, relaxation imagery and meditation to reduce stress. A useful method may be to focus your attention on your breathing. Concentrate on breaths in and out – you could visualize health and relaxation flowing into your body when you inhale, and stress or pain flowing out when you exhale.

6. Sensation Techniques

Stress on its simplest level - a little tension - leaves you with butterflies in the tummy as the only physical sign. When you suffer constant, long term stress and mental anxiety you can

end up with headaches. insomnia, loss of appetite, high blood pressure, nausea. loss of libido, low resistance, even a heart attack.

The sense of touch is a powerful and highly sensitive form of communication. It is a natural reaction to reach out and touch whether to feel the shape or texture of something or to respond to another person, perhaps by comforting them. Massage helps to soothe away stress, unknotting tensed and aching muscles, relieving headaches and helping sleep problems. Massage is also invigorating; it improves the functioning of many of the body's systems, promotes healing and tones muscles, leaving with a feeling of renewed energy.

7. Sports

Sports and games are skills which involve the participation of another person or a group of people, competing for a common goal. Stress motivates you to do your best and provides the challenges you need to improve physically, mentally and emotionally.

Sports has been identified as one of the ways of managing, relieving, and preventing stress. It has effects on heart muscle, blood pressure, pulse rate, blood red corpuscles, and the nervous system.

8. Socials

A person is a social being who exists in relationships with his physical environment and in relationship with people and society. Socialization plays a very important role in the development of interpersonal relationships. Through socialization, life becomes meaningful, happy and worthy. On the contrary, without socialization life is boring and empty.

Focus on enjoying people, not on indulging in or accumulating material things. Give people more than they expect and do it cheerfully.

Dance is a form of social activity that expresses gestures and releases tension through rhythmic movement.

9. Sounds and Songs

Music plays an important part in the everyday life of every citizen. It provides a medium of expression of thoughts and emotions. It is through music that a person expresses his/her feelings, moods, happiness, frustrations and sorrows. It is also the best means to relieve tension, stress, fears and anger.

Music is believed to have tremendous moral and social forces, arousing a person into action and giving them awareness of the world of peace and beauty. Sounds encourage fulfillment and meaningfulness to the listener. Songs are the most natural form of music.

10. Speak to Me

Communication is the means by which people make their needs known. It is the way they obtain understanding, reinforcement and assistance from others. Certain responses tend to close or block the communication, like belittling, disagreeing, false reassurance or giving advice.

Sometimes, even when you keep a positive attitude, you may still need to talk to someone. Talk to someone when you feel overwhelmed or unable to deal with stress on your own. Share your feelings to someone who can understand your feelings especially when you feel "helpless".

A helping person needs special qualities like being a good listener, sincere, attentive, empathetic and sensitive.

11. Stress Debriefing

"Critical Incident Stress" debriefing means assisting people in crisis to deal positively with the emotional impact of a severe event/disaster and providing education about current and anticipated stress responses, as well as information about stress management. This is a form of group session wherein people in crisis share their stress reactions, its effects and how they cope with it. The group session provides opportunity to realize, accept and learn from the experiences, identify positive coping mechanisms to help them manage their stress better.

12. Smile

It has been observed that individuals who always "smile" are healthy people. A smile is an expression of pleasure, amusement, affection and happiness. When you smile, muscles are relaxed because 15 muscles are working but when you frown, the muscles are tense because 65 muscles are affected.

It has been found out through research that smiling relieves all kinds of stresses, physical or mental. It is also considered as one of the ingredients or factors that will motivate and encourage people to work harder and improve their level of performance.

V. Regular Health Check up

Purpose of the periodic health examination

o As primary preventiono To identify risk factors for common chronic diseaseso To detect disease that has no apparent symptoms (secondary prevention)o As a way for the doctor to counsel people to promote healthy behavioro To update clinical data since last checkup