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Why do I feel tiredness and weakness during the day?

Q: I am 44 years old. I work from 9 AM to 6 PM for 5 days a week. I drive for 50 km everyday. Since the last 3-4 years, I feel tired in the evening and sometimes during the day also. I have 2 children of ages 3 & 1.5 years. My children expect me to play with them when I reach home. But I get irritated due to being tired. I have started taking Rivatel on my own and some other multivitamin as per the prescription of a physician. But I discontinued them after a few days as my stomach got upset. My blood pressure normal (80/125) but sometimes it shoots to 92/135. I weigh 98 kg and I am 175 cm tall. My food intake is less. I take 2 chappatis & some rice for lunch and similarly 2 chappatis, dal & subzi for dinner. For breakfast I take an omelette or a paratha and 4-5 cups of tea everyday. I take one glass of full cream milk thrice a week. I don't drink or smoke. I have a sedentary job with a tour once a month. I don't have diabetes. My cholesterol level is slightly high around 190. My LDL & HDL are borderline. My haemoglobin is 12. Please advise.

A:From the information you have provided there are a few things that need looking into: 1. Your weight problem 2. Your low haemoglobin count, which could be an indicator of anaemia 3. You high blood cholesterol 4. Your tendency toward high blood pressure. All these can be tackled together in a very simple manner by consuming a balanced eating pattern and introducing some mild form of exercise in the day. A nutritious diet is one that provides a variety of foods in adequate quantities and combinations to supply essential nutrients on a daily basis. Foods such as rice, wheat, jowar, bajra, ragi etc supply energy or calories, protein, and invisible fats. These foods also contribute iron, thiamine, riboflavin, folic acid and fibre. The pulses and legumes (e.g. beans, Soya beans, peas, Rajmah, Bengal grams etc.) provide energy, protein, invisible fat, Vitamin B1, vitamin B2, folic acid, calcium, iron and fibre. Milk, curd, skimmed milk, cheese, almonds, groundnuts, chicken, meat, liver, egg, fish and other flesh foods supply mainly protein, fat, calcium and vitamin B2. You must replace the glass of full cream milk that you are having with a glass of skimmed milk. Green leafy vegetables, yellow or orange fruits and vegetables such as papaya, mango, carrots, tomato, pumpkin, stems, leaves and flowers of plants, ladies finger, brinjals, bitter gourds and other gourds, cabbage, cauliflower, drumsticks, fruits such as amla, lemons, orange are rich in minerals and vitamins, especially vitamin C and calcium, iron and folic acid. They also contribute half of vitamin A requirement. Other major nutrients are invisible fat, vitamin B2 and fibre. Oils should be used sparingly in the diet to add taste and flavour to the food. To increase your haemoglobin introduce iron rich foods into your diet such as egg, meat, liver. These are however high in fat and will not help you cholesterol problem. So chose more low fat option like enriched breakfast cereals, cooked beans and lentils. Eat more food containing Vitamin C. Vitamin C enhances the absorption of iron into your body. This is very helpful if you are a vegetarian. Vegetarians consume less iron because they obtain it from plant sources. Some plants contain chemicals that bind the iron rendering it more easily absorbed. You can also counteract this being eating foods high in Vitamin C making iron more easily absorbed into the Blood. Foods such as beans, whole grains, spinach, and dried fruits have a significant amount of iron. Please however check with your doctor about the cause of your low haemoglobin first. It can be a symptom of some other condition not just anaemia. So please confirm the condition of anaemia before you embark on the iron rich diet. Diets containing foodstuffs drawn from each of these foods supply all essential nutrients in adequate amounts and will keep you in a good state of health. Vitamin and mineral supplements are no substitutes for good eating habits. You will meet all your nutritional requirements by following a balance diet. Do not take multivitamins without the advice of a physician. Regular exercise can help protect you from heart disease and stroke, high blood pressure, non insulin-dependent diabetes, obesity, back pain, osteoporosis, and can improve your mood and help you to better manage stress. For the greatest overall health benefits, do 20 to 30 minutes of aerobic activity three or more times a week and some type of muscle strengthening activity and stretching at least twice a week. However, if you are unable to do this level of activity, you can gain substantial health benefits by accumulating 30 minutes or more of moderate-intensity physical activity a day, like walking at least five times a week. If you have been inactive for a while, you may want to start with less strenuous activities such as walking or swimming at a comfortable pace. Beginning at a slow pace will allow you to become physically fit without straining your body. Once you are in better shape, you can gradually do more strenuous activity.

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