Harm reduction through physical activity can ward off diseases

Health Care, Heart Care Foundation of India, Medicine Comments Off

Indians lack adequate exercise and need to get a little more active

New Delhi, 15 February 2019: A published in The Lancet found that 4 out of 10 Indians were not sufficiently active. Some studies have even said that 52% of Indians are physically inactive. Another study has indicated that sedentary lifestyle is worse than smoking, diabetes and heart disease. While it is common knowledge that physical inactivity is a leading cause of disease and disability, the study emphasizes the extent to which it can impact health.

Any activity is better than none. It is recommended that people get 150 minutes of moderate exercise per week, but some researchers argue that this recommendation may set the bar too high for some people. They indicate that guidelines should instead focus on getting people to be just a little bit more active. This was discussed at the first-ever harm reduction conference held on 30th January 2019 at the India Habitat Centre.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “Lack of exercise affects the human body right up to the cellular level. Modern and advanced technology has certainly made life easy and convenient for us – online shopping, online payments, accessing information, etc., all of which can be done from the comfort of our homes. But, has technology really made our life better? What it has also done is change our lifestyle pattern at the cost of health; we are less physically active now – sitting at a desk for a long time working on the computer, using social media on smartphones, watching TV or sitting in a meeting, all these activities promote sedentary behavior.”

‘Exercise’ is not synonymous with ‘physical activity’. The former is planned, structured and repetitive while any other physical activity that is done during leisure time, for transport to get to and from places, or as part of a person’s work, also has a health benefit (WHO Fact Sheet, February 2017).

Adding further, Padma Shri awardee, Dr K K Sethi, said, “Walking is the best form of exercise, which requires no investment, no special training. Walking in natural environments such as parks also reduces mental stress and fatigue and improve mood via the release of the ‘feel good’ endorphins. This proximity to nature also helps in the inward spiritual journey and shifts one from the sympathetic to parasympathetic mode manifested by lowering of blood pressure and pulse rate.”

Some recommendations

  • Take the stairs as often as possible.
  • Get off the bus one stop early and walk the rest of the way.
  • Have “walk-meetings” instead of “sit-in” meetings.
  • Walk to the nearby shops instead of driving.
  • Stand up and walk while talking on the phone.
  • Walk down to speak to your colleague instead of using the intercom/phone.
  • Walk around your building for a break during the work day or during lunch.
  • Buy a pedometer.
  • Walk 80 minutes each day; brisk walk 80 minutes a week with a speed of 80 steps per minute.

Should cannabis (Bhang) be used as a medicine? The answer lies in more scientific research

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Recently, the scientific community is focusing on the possible medical uses of cannabis.

Many states in the United States have legalized marijuana for medical purposes. It may potentially help fight the opioid epidemic due to their use in chronic pain. In India, Bhang is not restricted under the Narcotics Act.

Cannabis leaves-based drugs were found to be effective in alleviating pain and other symptoms in cancer patients after chemo- and radiotherapy in a pilot study conducted in 2018 by Central Council For Research in Ayurvedic Sciences (CCRAS), a research body under the Ministry of AYUSH in collaboration with the Gujarat Ayurved University, Jamnagar on cancer patients undergoing treatment at the Tata Memorial Hospital in Mumbai.

Further to this pilot study, another study is proposed to be conducted at AIIMS to examine and validate the efficacy of cannabis in reducing side-effects in patients suffering from breast and cervix cancer. (The Week-PTI, Nov. 25, 2018, https://www.theweek.in/wire-updates/national/2018/11/25/des7-ayush-cannabis-cancer-aiims.html).

However, two international studies published in the Journal of Addiction Medicine and the American Journal of Psychiatry in 2018 reported increased risk of use of prescription opioids and nonmedical prescription opioid use with the medical use of cannabis.

Cannabis is derived from the cannabis plant, Cannabis sativa. It is mainly used as charas, hashish, ganja and bhang.

The Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985 has defined cannabis as below:

“(iii) “cannabis (hemp)” means-

charas, that is, the separated resin, in whatever form, whether crude or purified, obtained from the cannabis plant and also includes concentrated preparation and resin known as hashish oil or liquid hashish;
ganja, that is, the flowering or fruiting tops of the cannabis plant (excluding the seeds and leaves when not accompanied by the tops), by whatever name they may be known or designated; and
any mixture, with or without any neutral material, of any of the above forms of cannabis or any drink prepared therefrom;”
Bhang is prepared from the leaves (and seeds) of the cannabis plant. Hence, it is not covered under the NDPS Act, 1985, which bans the production and sale of cannabis resin and flowers, but permits use of leaves and seeds.

Mixing of bhang with any part of flowering tops or the resin produced from the cannabis plants, however, is a punishable offence under relevant provisions of the NDPS Act, 1985.

The National Policy on Narcotic Drugs and Psychotropic Substances allows cultivation of cannabis, with permit, for purposes of research and not for medical purposes. “Cultivation of cannabis will not be permitted given its limited proven uses for medical purposes. Cultivation shall be permitted for research including trials of various varieties of cannabis (20).”

“Section 14 of the NDPS Act empowers the Government to, by general or special order, permit cultivation of cannabis exclusively for horticultural and industrial purposes (23).”

More scientific research is needed on the medicinal properties of cannabis within the regulatory framework.

The Indian Council of Medical Research (ICMR), which is “the apex body for the formulation, coordination and promotion of biomedical research” in the country, should spearhead the research on this to authenticate the medicinal properties of cannabis and then come out with recommendations on medical cannabis use.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA