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Showing posts with label Revathi Murugappan. Show all posts
Showing posts with label Revathi Murugappan. Show all posts

Monday, February 5, 2024

Just clap your hands a few seconds a day for health

Clap for health

Monday, October 30, 2023

How to lose weight without exercising

 

Most adults need seven to eight hours of sleep every night to restore and repair the body. — TNS


Who doesn’t want to be lean and slim without putting in effort?

Physical activity or exercise has plenty of physical, emotional and mental benefits, but it doesn’t necessarily mean you will shed the kilos easily by partaking in it.

Some people hate exercising and are not motivated to push or challenge themselves – they simply don’t get the same endorphin release as others.

Reluctant exercisers need external motivators to keep going, like the promise of boosting their overall health, to look good, or because their physician has said they must do so to stay alive.

Our ancestors remained active out of necessity, not choice: they had to move to hunt for food.

Once fed, they rested to conserve energy because there was nothing much to do.

When food supply diminished, they’d be on their feet, hunting again.

Resting is a natural human tendency, so don’t beat yourself up if that’s what you like to do.

With advances in technology and labour-saving devices, the world is now accessible with our fingers, and even minimal movement seems to have taken a backseat.

That’s why we are blossoming sideways.

Is that bad?

It depends on how much weight you’re putting on.

One 2021 study published in the Annals of Epidemiology found that people who started adulthood with a body mass index (BMI) in the normal range, and became overweight – but never obese – in later life, tend to live the longest.

Adults in this category lived longer than even those whose BMI stayed in the normal range throughout their life.

However, those who started adulthood as obese and continued to add weight had the highest death rate.

So, a bit of extra weight is okay as long as you don’t balloon out of control.

Any healthy person can lose weight without exercising – you just need a lifestyle tweak and some discipline.

Prioritise what you enjoy doing instead of struggling to achieve unrealistic goals.

Try some of the following tips to help you trim down.

Chew your food thoroughly and savour every morsel before you swallow it to feel full faster. — AFP

> Hydrate with water


Make it a point to drink two glasses of water after waking up to help “activate” your internal organs.

The water will help to remove any toxins before your first meal of the day.

Water helps regulate body temperature, lower blood pressure, carry nutrients and oxygen to various cells, and maintain optimal kidney function.

Replacing sugary drinks and alcoholic beverages with water can help reduce your daily caloric intake.

Whenever you feel hungry, you may actually be thirsty, or even slightly dehydrated.

So don’t reach out for snacks, but drink a big glass of plain water first – and ideally wait 30 minutes before eating.

Drinking water prior to meals can help you feel fuller and reduce your overall food intake, which can lead to weight loss over time.

If plain water isn’t appealing, try adding fruit slices like oranges, or herbs like mint, lemon and rosemary, for extra flavour and nutrients.

> Eat slowly and mindfully


Instead of munching down solid food, especially poultry and meat, chew thoroughly.

Some time back, I attended a wellness retreat where we were told to chew every mouthful 27 times and savour all the flavours before swallowing.

The food almost turns to liquid by the time it goes down the throat.

Not only does this increase the amount of nutrients absorbed by the body, it’s also easier on the digestive process.

Additionally, longer chewing also helps develop a stronger jaw and chin, suppress hunger and gets you full faster, aiding in your weight loss journey.

> Load up on fibre and protein


You don’t have to eliminate all carbohydrates, just minimise overly-processed ones, such as white breads and pre-packaged foods like cookies and crackers.

This is because such foods are rapidly digested and converted into blood sugar.

Instead, consume more protein and fibre.

Protein takes longer to digest and decreases the level of the hunger-regulating hormone ghrelin, making you feel fuller for a longer period.

Fibre expands in your gut like a sponge, so it’s a natural appetite suppressant.

It also moves faster in your intestines, which signals to the brain that you are full.

Along with lean meats and poultry, add on a good mix of fresh fruits, vegetables and whole grains to make up the rest of the meal.

Even a five-minute break to take deep breaths at work can do wonders to bring down stress levels. — AFP

> Scale back on added sugar


Sugar itself doesn’t make the weighing scale jump up, but it tends to be in foods that have too many calories.

Whether it’s soft drinks, teh tarik or desserts, it should be the first thing to go if you’re trying to lose weight.

The sweet stuff is also hidden in all sorts of foods from salad dressing to sauces to canned fruits, so don’t be deceived that you’re eating a healthy salad when you’ve doused the greens with salad dressing.

ALSO READYou wouldn't expect to find sugar in these foods

When it comes to caffeinated beverages, skip the sugar, honey and creamer if possible, as these can quickly add to the calories.

Having your tea or coffee black is best, but if like me, you need to add some milk, opt for skim or low fat over full cream.

By eliminating sugar, you can lower your risk of heart disease dramatically because too much sugar in your diet heightens your risk of high blood pressure, obesity, and diabetes – the three main risk factors for heart disease and cardiovascular decline.

ALSO READWhat you can do to reduce heart attack and stroke risk

> Manage stress levels


This is hard for everyone, but we’ve got to try.

When the body is under pressure, it releases the hormone cortisol, which is linked to increased appetite and fat storage.

Excess cortisol levels can increase appetite and cravings for energy-dense, comfort foods.

High cortisol levels over time have also been linked to abdominal fat gain.

Take time daily to do something to lower the stress levels: laugh, read a good book, play with a pet or just take deep breaths.

Find a quiet corner at work, close your eyes and spend five minutes mid-morning and in the afternoon to do a few rounds of deep breathing by inhaling through the nose and exhaling through the mouth or nose.

Do this again in bed, just before you sleep.

> Get proper sleep


Your body relies on sleep to restore and repair itself, and getting enough rest can also benefit your weight-loss efforts.

There is mounting evidence that people who get too little sleep have a higher risk of weight gain and obesity than people who get seven to eight hours of sleep a night.

Sleep deprivation changes your endocrine function and metabolism by affecting your production of the hunger-regulating hormones ghrelin and leptin.

This can make you feel hungrier than usual, increasing the likelihood of craving for unhealthy snacks.

It’s no surprise that when you’re exhausted, it’s harder to control your impulses for comfort food like cookies, chocolates and ice cream.

Practise good sleep hygiene by sleeping at the same time every day, switching off all gadgets two hours before bedtime and ensuring the room temperature is comfortable.

By Revathi Murugappan who is a certified fitness trainer who tries to battle gravity and continues to dance to express herself artistically and nourish her soul. For more information, email starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.


Friday, December 2, 2022

Inflammatory bowel disease can significantly disrupt a person's daily life

 

IBD comprises of two conditions: CD, which is inflammation of one or more parts of the intestines (left), and UC, which is inflammation of the large intestine. — Images: Prof IDA NORMIHA HILMI

 

Getting the occasional abdominal pain and diarrhoea is common for all of us, but if these symptoms consistently recur, do get yourself checked.

You could have inflammatory bowel disease (IBD) – a term used to describe two conditions: ulcerative colitis (UC) and Crohn’s disease (CD).

Like its name suggests, IBD patients have an inflamed gut, and present with pain at the site that is inflamed.

UC only affects the colon (large intestine), while CD can affect any or several parts of the digestive tract.

Other symptoms may include bloody stools and loss of appetite.

As the symptoms are non-specific, patients are normally treated for acute gastroenteritis or misdiagnosed as having irritable bowel syndrome (IBS) – a functional gastrointestinal disorder characterised by abdominal pain and altered bowel habits.

“IBD is an autoimmune disorder, where your immune cells attack your bowel.

“Our prevalence is low compared to Caucasian or East Asian populations, with less than 10 per 100,000 population; Australia has 125 per 100,000 population.

“But it is still a concern, in line with other growing autoimmune disorders,” says Universiti Malaya Medical Centre professor of medicine Dr Ida Normiha Hilmi.

The senior consultant gastroenterologist adds: “We don’t know why it happens or what triggers it, although there are many postulations.

“These include something in our environment, something we’re doing, changes in our diet that has become more Westernised, one too many courses of antibiotics, stress, smoking, pollution, lack of breastfeeding or a childhood virus.

“Or it could be related to the hygiene hypothesis.

“Your immune system is meant to be exposed to a lot of bacterial pathogens at an early age, but if the environment has been sterile, then it doesn’t know how to process all these things later on and processes them in an abnormal way.

“Once that occurs, it doesn’t switch itself off and there’s no way to reset it.”

One of Prof Ida’s colleagues in India has performed mobile colonoscopies in rural areas of that country and found no cases of IBD; however, the locals there had a lot of worms in their guts.

“Worms are protective against IBD – they sort of modulate the immune system and there is a symbiotic relationship,” she points out.

Late diagnosis

IBD a disease that is diagnosed in the young (ages 15 to 40), with a median age of 29; however, there is an increasing trend in the paediatric population.

An endoscopic image of a normal, healthy colon..An endoscopic image of a normal, healthy colon.>>

It’s not always easy to identify whether the patient has CD or UC, although UC is more common than CD.

“If the doctors don’t know, these patients are placed in the IBDU (IBD unclassified) category,” says Prof Ida, whose youngest IBD patient is 12 years old.

“You’ll be surprised at how many people wait for a year or two before getting treated – the inconsistent pattern of pain often confuses patients and it is normal for them to lose up to 20kg.

“They may go to the general practitioner, get some antibiotics and don’t seek further help.

“Or after several episodes, they finally decide to go to a specialist – maybe all diseases are like that in Malaysia – hence, awareness is very important.

“What they don’t realise is that if the disease is not treated, there is an increased risk of developing colon cancer.”

UC patients can also experience back and knee pain, skin rashes, and liver abnormality – every system can be affected – while CD patients tend to have specific areas affected.

The IBD specialist explains: “The whole gastrointestinal tract is very long, and in a lot of cases, when a CD flare-up happens, it tends to be in the predominant location, i.e. the common location, which is the lower right side (terminal portion of the ileum) – almost the same area as the appendix, which initially raises the suspicion of appendicitis.”

She adds: “There is some old data that shows patterns where if you get IBD once, you will never get it again, but from my experience, it’s rare.

“The disease will recur without treatment.

“It’s not a cure, but with treatment, you can remain in remission.”

Therapy for life

Treatment involves two therapies: induction and maintenance.

This endoscopic image shows deep longitudinal ulcers in the colon of someone with CD.This endoscopic image shows deep longitudinal ulcers in the colon of someone with CD >>

The induction therapy is intended to act fast to provide symptomatic relief, with the mainstay being steroids.

Prof Ida says: “It’s cheap, it works and it works fast, but there are long-term side effects – it thins your bones and causes obesity.”

She notes that the energy boost from the steroids also makes some patients feel better.

However, she adds: “Your adrenal glands that are producing your own steroids are suppressed with chronic steroid use and we have seen patients with Addison’s crisis, where the body is not able to produce steroids any more.

“We never want to give steroids as long-term therapy – we try to stop it within three months.

“If you taper it down and don’t give time for the other immunosuppressive drugs to work, especially slower-acting ones, the symptoms will return, so it’s a balancing act.”

For maintenance, a new group of drugs called biologics work well and have a good safety profile.

The drawback: they’re expensive and range from RM20,000 to RM50,000 annually.

“That’s the difficulty I face with my IBD patients,” Prof Ida laments, “because I’ve to think of costs all the time, especially for the ones without insurance.

“For this reason, I take part in a lot of clinical trials as that allows me to put patients on free drugs.

“Usually, when we get the drugs, we’re already on phase three trials and there are not many concerns as we are not guinea pigs.

“Or we seek funds from charities, non-governmental organisations, etc – that’s the reality.

“The Health Ministry hospitals also have their own free quota, e.g. five patients a year – the rest have to pay.”

For those on clinical trials, the good news is that they can get free drugs for quite a long while.

One of Prof Ida’s patients took part in a landmark IBD study and got free drugs worth about RM48,000 a year for a decade.

Most clinical trials entail a three-month induction and 12-month maintenance timeline.

Every patient usually wants to know when he or she can stop treatment; they think the diarrhoea should resolve with a course of antibiotics.

“The concept of long-term treatment is difficult for them to understand.

“I guess it’s hard when you’re young and have to be on drugs forever, but older people are more accepting,” she says.

“The patient’s function is very much affected as IBD occurs amongst young professionals in high-performing jobs, hence I try to normalise their lives as much as possible.”

For those who don’t succeed with medical therapy, they have to undergo surgery to resect their bowel.

In the past, the figure was 70%, but with better medications these days, the figure has gone down to about 20-30%.

What about foods?

“Before, we didn’t really know what to tell our patients in terms of diet, except to have a low-fibre diet, because when your colon is inflamed, the bowel is narrowed, and if you take too much fibre, it may block your passage.

“Now, we’re looking at anti-inflammatory diets, although we’re still far from anything concrete.

“My paediatric colleagues practise entero-nutrition (delivered into the digestive system as a liquid) for six weeks, but maintenance is difficult as you can’t be on liquid nutrition for the rest of your life,” says Prof Ida.

She suggests, however, that patients try to reduce pro-inflammatory foods, such as those with high fat content.

When it comes to herbs, she says turmeric might help, but the dose has to be right.

“If you have a bad case of UC, you still need biologics as turmeric is not going to save you.

“Everyone is also asking about probiotics.

“Not all probiotics in the market are medical grade, but if my patients want to take it and it makes them feel better, I don’t stop them.

“Our gut consists of trillions of gut microorganisms and taking a tablet or two a day is not going to touch the diversity or repopulate the microbiome.

ALSO READ: Think you know all about probiotics? Then take this quiz

“When the colon is inflamed, the pathogenesis is very complex – we think something is happening at the gut level, maybe a breach of some bacteria into your gut wall – and sometimes, the immune system goes awry.

“But there is also something else that is causing this and we can’t quite pinpoint it.”

The inheritance pattern of this condition is unclear, although some studies show that having a family member with IBD increases the risk of developing the condition.

However, Prof Ida has two sets of identical twin patients.

In one set, only one twin has UC, and in the other, only one twin has CD.

They grew up in the same environment, ate the same foods, and have the same genes, which indicates that some other factor is playing a role in the disease.

Our gut microbiome is developed by the time we’re one-year-old and that’s the one we keep, with minor alterations over the years.

She says: “When you go to another country, it may change a bit, but when you go back to your own country, it generally goes back to your original gut microbiome.”

ALSO READ: The good gut bacteria in our microbiome might be disappearing

Storing and transferring poo

Stool samples being processed for screening during the gut microbiome donation process. — Amili 
Stool samples being processed for screening during the gut microbiome donation process. — Amili

Faecal microbiota transplantation (FMT) is the transfer of faecal material from a healthy individual to another person with the aim of treating a disease.

It can be described as a form of probiotics as it pumps in a much greater number and diversity of bacterial strains than any available probiotic.

The concept is not new and the use of FMT was first described in China in the 4th century by Ge Hong when “yellow soup” – a faecal slurry – was administered for the treatment of severe food poisoning and diarrhoea.

And in fact, this was a practice that continued for centuries.

Bedouin groups also consumed the stools of their camels as a remedy for dysentery.

“FMT is an option for patients with recurrent or refractory Clostridium difficile (an overgrowth of this bacteria, also known as C. diff) as it has a cure rate of over 90% and can repopulate the good bacteria.

“Sometimes, C. diff can be difficult to kill, especially in older patients – it causes inflammation, and in bad cases, even death.

“FMT can also be used as a therapy for IBD, but because it is unable to be sustained long term as your own gut microbiome returns after a while, the disease comes back,” explains Prof Ida.

FMT preparations can be delivered via capsules, colonoscopies, nasoenteric tubes and enemas.

In this region, Singapore is the only country that has a gut microbiome banking service, provided by a company called Amili.

According to Amili’s head of clinical affairs, product lead, Dr Saishreyas Sundarajoo, stool donors must undergo rigorous screening, which includes a lifestyle/health survey, interview with a clinician, blood testing and stool testing.

“In the final stool test, we screen for potential gastrointestinal bacteria, viruses and parasites.

“These include MRSA (methicillin-resistant Staphylococcus aureus), C. diff, SARS-CoV-2 and more.

“The good bacteria we screen for include Bifidobacterium longum, which helps break down food, absorb nutrients and fight off bad organisms that might cause diseases, and Bifidobacterium breve, as studies have linked its shortage to antibiotic-associated diarrhoea, allergies, gas and IBS,” he says.

Applicants who pass the stool testing are qualified FMT donors for a span of eight weeks.

The samples are periodically tested in between the eight-week cycle for quality assurance,

The donor stools are then cryopreserved in Amili’s partner company Cordlife’s facility and shipped to other countries when there is a request.

Once the stool arrives at its destination, the doctor will thaw it out just before administering it into the patient via colonoscopy.

Prof Ida concludes: “Patients need to understand that disease control is important, and if all therapies fail, surgery, despite its drawbacks, is the only option.” - By Revathi Murugappan

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Related stories:

Nine ways that your gut affects mental health

Ditch the sugar substitute, it harms the gut

When your child has tummy troubles

 

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 Although BMI is widely used as a measure of weight, it is not very accurate and can lead to the mistreatment of obesity and eating disorders.

 

 

 

Wednesday, July 14, 2021

Think forward, walk backwards

  https://youtu.be/rMxGVVBUSIc

Walking Backward: Benefits for Mind and Body - Healthline

 
Several studies also show that walking backwards can boost memory power
 

 

Walking in reverse is less stressful on the joints and can add bouts of increased intensity, similar to a brisk walk or an easy run.

LAST month, I wrote about how it is not strictly necessary to walk 10,000 steps a day for better health (Walking 10,000 steps a day, Two Fit, StarHealth, June 13).

Due the way our human brains are wired, we all assume walking always refers to forward motion.

Today, on a reader’s request, I’m going to discuss the effects of walking backwards, also known as retro walking or reverse walking.

Walking as a physical exercise has plenty of benefits: it’s easily accessible (though not in all areas, such as those under the enhanced movement control order), doesn’t require registration fees, and can be done any time at your convenience, indoors or outdoors.

However, walking in reverse makes the heart pump faster and circulates more blood and oxygen to the muscles and organs, including the brain.

Because it places a greater challenge on your body, walking backwards gives you a better cardiovascular workout, and perhaps, faster weight loss if that’s what you’re aiming for, compared to walking forward.

Apparently, 100 steps of backward walking is equivalent to roughly 1,000 steps of conventional walking, which explains why you can burn calories quicker.

Walking backwards also heightens your sense of balance and hearing, as you cannot depend on vision alone to steer you.
 

It’s great for people involved in a sport where they need to change directions rapidly or run backwards.

If you notice footballers in training, their coaches will include drills that include backward running and jumping.

Backward walking training is becoming a popular treatment method for people with musculoskeletal disorders, Parkinson’s disease, multiple sclerosis and cerebral palsy, as well as post-stroke patients.

Brain and pain 

Basically, walking backwards helps fire up the neuromuscular pathways that tend to get sluggish as we age.

One way to keep these neural circuits active is to exercise and slow down the natural rate of their degeneration.

Tests with backward-forward walking are also used for diagnostic purposes as these tests show how well our brain and body can coordinate our balance and mobility.

In addition, geriatricians might use walking backwards as a diagnostic tool to predict the likelihood of a fall in elderly people and patients with dizziness.

By regularly walking backwards, you are exercising the same neuromuscular circuits that these doctors are checking with this test.

Ageing brings about a lot of challenges, especially to our natural ability to “automatically” do things.

You may have noticed older people appearing to concentrate as they lift their feet to walk; this is because it is more difficult for them to “walk without thinking”.

This happens to the best of us when we lose the automaticity of walking.

For those experiencing lower back and knee pain, backward walking is a good alternative as the motion places less strain on the knees.

It may be useful for anyone experiencing pain going up and down stairs, or doing lunges or squats.

Hikers can also give their overused muscles a break by trying something different.

According to a 2019 study published in the journal BMC Musculoskeletal Disorders, a six-week retro walking programme resulted in greater reduction in pain and functional disability, and improved quadriceps muscle strength and performance in individuals with knee osteoarthritis, when compared to the forward walking or control groups in the study.

The subjects completed 10 minutes of supervised retro or forward walking training, in addition to usual care, three days a week for six weeks.

In another study published in the Journal of Biomechanics ,itwas also found that reverse or backward running reduced anterior knee pain.

From heel to toe

During a forward walk, most people will begin with the heel first gait as it is more efficient in transferring stored energy into motion so that our muscles don’t have to do as much work.

With each step, some energy of motion is lost when your feet hit the ground.

When you walk on the balls of your feet, you lose more energy due to these “collision forces” than you do if you walk heel first.

On the other hand, toe-walking, often used by ballerinas, requires activation of certain calf muscles that don’t need to be used in heel first walking, as your weight is directly supported by your heel.

In backwards walking, the toes have to contact the ground first and the heel is lifted off the ground last.

So, even if you have long legs, your strides can’t be too long unless you’re accentuating the movement.

If you’re an early riser (unlike me), you might be able to catch some backward walkers in action at our public parks.

They usually belong to tai chi groups, and while they walk, they will clap their hands as traditional Chinese medicine practitioners believe the palms have many acupressure points that can be stimulated via clapping.

Improved memory

Several studies also show that walking backwards can boost memory power and take you “back” in time.

In 2019, psychologist Dr Aleksandar Aksentijevic at the University of Roehampton, United Kingdom, and colleagues published a study called It Takes Me Back: The Mnemonic Time-Travel Effect in the Cognition journal.

They asked 114 volunteers to watch a video in which a woman has her bag stolen by a passer-by.

Ten minutes after watching the video, the participants were split into groups: one was told to walk forward 10m and another backwards 10m, while those in the control group stood in one place.

They were then asked 20 questions about the events in the video.

It was found that the backwards walking group got two more answers correct on average than the forward-walkers and the non-walkers.

The researchers also did another variation of the experiment, which tested several groups on how many words the volunteers could remember from a list.

One group walked backwards, while other participants simply imagined moving forward or backwards, or watched a video filmed on a train, which created the impression of moving forward or backwards.

In all scenarios, the backwards group or those who imagined walking backwards got the most answers right.

You don’t need to spend a whole lot of time walking backwards to reap its benefits. Just slot it in as a one-minute interval during your regular workout.

Check that the area behind you is clear so that you can walk confidently without bumping into anything.

Or find a partner so that he or she can keep an eye out for potholes and uneven surfaces, as our public roads and parks are full of them.

Better yet, grab a stick and have your friend lead you.

As muscles work in pairs and walking backwards recruits a new pair, you’ll inevitably feel some initial adjustments.

An added bonus is that your posture also improves while walking backwards as you tend to stand taller – it’s practically impossible to slouch while in reverse gear!

Combine both types of walking and add in some lateral walking as well to give all your muscles a workout.

As you get stronger and more confident, try walking backwards on an incline.

Having balanced muscles goes a long way towards reducing joint pain.

Revathi Murugappan is a certified fitness trainer who tries to battle gravity and continues to dance to express herself artistically and nourish her soul. For more information, email starhealth@thestar.com. my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Stroke survivor Betty Ng (centre) being her usual active self at the Walk for Health event before the pandemic. Photo: Nasam   https:/...

 

Sunday, December 27, 2020

That calf of yours


These calf raises required no equipment and one of the simplest exercises to tone your muscles - photo: 123rf.com


STOP Calf Pain | Best Stretches For Calves

https://youtu.be/D327Pwt-ONs

11 Easy Exercises to Slim Your Legs In 2 Weeks

https://youtu.be/YGTCKQU4E7Y


 

Some like them big, some like them small, but either way, the size of your calves can tell a lot about your health.

MEN take pride in having them big, but women want them slender.

It’s a skeletal muscle group that’s difficult to bulk or trim, even though it’s one of the most used in daily tasks.

If you’re unsure which muscles these are, I’m referring to the calves.

Genetics and anatomical structure play a significant role in how the muscle is shaped and how large it can grow.

The calves comprise of two main muscles: the outer gastrocnemius (known as the calf belly with two “heads”, i.e. medial head and lateral head), and the underlying soleus, which is the smaller of the two.

Together, they are responsible for bending the ankle joint upwards (dorsiflexion) and straightening it to point your toes (plantarflexion).

These two muscles taper and merge at the base of the calf muscle, and attach to the heel bone (calcaneus) via the Achilles tendon.

During walking, running or jumping, the calf muscles pull the heel up to allow the body to propel forward.

There is also another small muscle that runs beneath the gastrocnemius and soleus, called the plantaris.

It has a short belly and a long, thin tendon that connects to the Achilles tendon.

Functionwise, the plantaris muscle assists the gastrocnemius, but not significantly.

In fact, in 10% of the population, this muscle is completely absent.

Bigger or smaller?

Basically, the size of your calf muscles is determined by how far your heel bone (calcaneus) projects backwards, i.e. its length.

The longer this bone is, the smaller your calves.

In one 2011 study, researchers studied individuals of similar height, weight, lower limb length and foot length, and discovered that the ones with shorter calcanei had bigger calves.

Meanwhile, those with longer calcanei had more slender calves.

They also looked at the muscle recruitment patterns and found that people with shorter heels and big calves were using their medial gastrocnemius muscle more than the lateral gastrocnemius muscle while walking.

In contrast, those with longer calcanei had more evenly distributed calf contractions.

People with skinny ankles (small girth) will not be able to build bulk in their calves, although they have a lot more agility than their counterparts with thicker ankles.

Sprinters generally have bigger calves due to the extraordinary amounts of explosive power required to sprint short distances.

Long distance runners, on the other hand, tend to have slender, toned calf and leg muscles.

In fact, the calves in animals that move fast are practically non-existent.

Sausage legs

There is no ideal or normal proportion for the calves and ankle – it depends on what is beautiful to the eye.

Aesthetically, we are all wired to desire ankles that are smaller than the calves.

However, there is a condition where the ankle is just as thick or slighter thinner than the calf, making the lower leg look like a cylinder.

This “cankle” – a combination of the words “calf” and “ankle” – is not a medical term, but a word made popular in 2001 when Jason Alexander’s character in the movie Shallow Hal used it to criticise an overweight woman’s lower leg, saying, “It’s like the calf merged with the foot, cut out the middleman.”

When you have cankles, you’ll find it hard to differentiate the calf from the ankle. Some people call this “sausage legs”.

Women are more prone to this as it seems to run in the female line, with mothers, sisters and other female relatives tending to have the same lower leg shape.

Unfortunately, there is just so much you can do to alter it through natural means besides losing the fat that is covering the ankle.

Sometimes, however, these cankles are due to medical conditions like excessive water retention, kidney disease, bad sprains and surgery.

The calves are prone to tightening and cramping, especially after a workout, so be sure to stretch them out.

If your ankles remain swollen over a long period, do seek medical advice as it could be the sign of something sinister, like heart failure.

Managing those muscles

If you’re genetically predisposed to having big calves and don’t want to bulk further, the best you can do is to scale back on high intensity, skipping, plyometric and heavy weight-bearing exercises as they contribute to hypertrophy or muscle growth.

Also, don’t walk, hike or run up on an incline (e.g. hills or uneven surfaces) as these activities force your calf muscles to work harder.

They will definitely get stronger, but could also get bigger.

Instead, stick to running on flat surfaces.

To build your calf muscles, there are only two types of effective, yet simple exercises: heel or calf raises with knees straight (for the gastrocnemius) and with knees bent (for the soleus).

Start with one set of 12-15 repetitions with your feet parallel first.

Then turn your feet out (toes pointed out or away from the body) for the next set.

For the last set, turn your feet in. This forces your muscles to work from different angles.

To target the soleus muscle, repeat the entire sequence seated, perhaps with a light dumbbell on your thighs.

Do three sets, but only with your feet parallel.

You may not see noticeable bulk, but you’ll see some tone and more definition.

Stretch and soak

The calves are prone to tightening and cramping, especially after a workout, so be sure to stretch them afterwards.

The simplest way to do this is to stand at the edge of a step and place the balls of your feet on it.

Keep your legs straight (use the wall or railing for support) and reach your heels to the floor until you feel the stretch in your calves and Achilles tendon. This stretches your gastrocnemius muscles.

To stretch your soleus, do this with one knee bent, then repeat on the other side.

In addition, you can try soaking your lower leg in warm, salt water for 15 to 20 minutes before patting dry with a towel.

Then, apply some oil or lotion to self-massage the calves using stroking motions towards your hip.

Depending on your preference, you can use your fingers, palms, heel of your hand or knuckles.

Strong pressure reduces tension and pain in your muscles, while using a light pressure is more relaxing, especially before you retire for the night.

Benefits in all sizes

Fret not if your calves are big because there are some health benefits associated with it, according to a 2008 study published in the Stroke journal.

Apparently, regardless of age, gender, body mass index (BMI) and other vascular risk factors, those with bigger calves have fewer fatty deposits known as plaques built up in their arteries, thus lowering their risk for stenosis, carotid artery disease and strokes.

Researchers suspect this may be because big calves give the body another place to store fat that could cause problems when they’re floating in the bloodstream.

At the same time, people with bulky calves could also be more prone to non-alcoholic fatty liver disease as the calves act as a proxy for fat deposits.

In a 2013 study in the Journal of Physical Therapy Science, researchers concluded that the smaller a person’s calves are, the higher their resting heart rates might be.

In general, high resting heart rates, or anything above 100 beats per minute, have been linked to an increased risk of death, regardless of physical fitness.

A normal resting heart rate for adults ranges from 60 to 100 beats per minute.

A lower heart rate at rest implies more efficient heart function and better cardiovascular fitness.

So, all is fair whether you have big calves or small.

On that note, here’s to a brighter 2021!

By Revathi Murugappan, who is a certified fitness trainer who tries to battle gravity and continues to dance to express herself artistically and nourish her soul. For more information, email starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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