A report by Swachh Bharat Mission says that 74.5 per cent of public places are equipped with toilets. Another report by the Ministry of Jal Shakti states that there are 2.23 lakh Community Sanitary Complexes built across all States and UTs under the Swachh Bharat Mission (SBM) since October 2014. Over 92 lakh toilets have been constructed since the launch of SBM Gramin (SBM (G)) in April 2020.

While toilets are there, are they accessible? This is the question one should ask. The National Family Health Survey (NFHS) focuses on 131 health indicators, but not until the NFHS 5 survey did they include the question of accessibility of toilets in the survey. This happened after the inputs from the Department of Drinking Water and Sanitation (DDWS) and the Ministry of Health & Family Welfare questioned the accessibility.

One might ask, why is the question of accessibility so important? The answer is quite simple. Access to water, sanitation and hygiene is the most basic human need and is also included under the Sustainable Development Goals by the UN.

Are These Numbers Real?

This thought crossed my mind because back in 2021, I went on a solo trip, on a bus to Udaipur from Delhi. There, the bus made two stoppages. This was done so people could get a quick dinner and freshen up, relieve themselves and be prepared for the rest of the journey. This was a nightmare. The bus only stopped for 10 minutes. While some men used the washroom, others went to the bushes.

For the women, there were three cubicles. One of them was broken, and the other one did not have a light bulb, which meant only one was usable. There was a long queue for that cubicle, and time was short. There was no point in trying to find an isolated corner, because it was past midnight, in an unknown area.

I waited anxiously. When finally, my turn came, I saw an overused, dirty washroom. The toilet seat is in a horrible condition. I wanted to touch nothing there. But I had to pee. So, I used my mask to cover my nose from the odour, folded my pants so they did not touch the floor and squatted. It was quite a task to balance.

On my way back to Delhi, I made sure to not drink any water for over a 13-hour bus journey. I dehydrated myself so I did not have to use the washroom. When I did reach, I was severely dehydrated and was sick for three days.

I shared my experience with my friends only to realise that many women have faced the same. There are no washrooms for women.

A friend of mine told me that it is because these roads and dhabas are mainly designed to serve men. They are the ones who travel at night or are on the roads most of the time. As a result, the few women who do travel or are on the road suffer.

Health Risks Women Are Prone To

Well, it is true, but partially. While holding your pee for too long can lead to health risks, peeing on a dirty toilet seat cannot lead to infections unless your urethra is in contact with the bacteria present on that toilet seat. However, nobody wants to sit on a dirty toilet seat, even if you do not get an infection. A safe and hygienic toilet is a basic need.

One of the regular saleswomen, Usha, who visits my house shared her experience with me. “Being on the road constantly means I must use the dirty public washrooms. But I do not want to use them. So, sometimes I ask my regular customers to let me use their washrooms. Some say yes, and some say no. I understand they are also concerned about their safety and privacy,” she says. As a result, Usha spends most of her day not drinking enough water and holding her pee when she is at work. Due to this, she also suffered from a Urinary Tract Infection (UTI).

Her friend, Halima too faced similar problems and due to increased levels of uric acid in her body, she suffered from Hyperuricemia.

Other health risks are kidney stones and other kidney problems, headaches, dull skin, xerostomia or dry mouth, fatigue, and urinary incontinence, which means losing control over your pelvic floor muscles leading to uncontrolled leakage of urine, seizures and weakness.

What Can You Do?

Wear comfortable clothes and capris. Capri pants are comfortable and are short in length, which means this won’t touch the toilet floor when you squat or sit.

Carry Essentials

Even though you cannot get a UTI alone from sitting on a toilet seat, it is always safe to carry a toilet seat sanitiser. If nothing, it can help you get rid of the bad odour so you can use your stand and pee device inside the toilet. You can also use disposable toilet seat covers if your knees are weak, and you cannot squat. Always flush with your seat down.

Always keep disposable gloves, a portable bidet (fill it with water before use), a pocket liquid handwash, wet wipes, tissues and sanitiser handy. Do not forget to keep extra sanitary pads. It might sound a lot, but I promise that it all fits in one pouch. Use this travel-friendly pouch every time you are on the road, or using a public washroom.

What Can We Learn From Others?

However, in case we do not get these technologically advanced toilets here, you can always pack a travel-friendly toilet kit!

Morning walks are a popular part of many older adults’ daily routines. But is walking alone enough to maintain bone strength and prevent osteoporosis as we age?

Walking 30–40 minutes every day is a good habit. However, it may not be enough to maintain bone and muscle strength as we age. A person may walk daily and still struggle to get up from a low chair or maintain balance on an uneven surface. These are important signs of functional strength that deserve as much attention as daily step counts, experts said on World Osteoporosis Day.

Falls are a significant concern among older adults worldwide. A 2022 systematic review and meta-analysis of 104 studies estimated that 26.5% of older adults globally experienced falls. In India, a 2026 analysis of data from the Longitudinal Ageing Study in India found that 11.56% of adults aged 60 and older reported a history of falls. Chronic joint disease was among the factors independently associated with falls.

Why Walking Alone May Not Be Enough

Also read: Osteoporosis Affects Nearly 20% Of US Women Aged 50+: Why Screening Is Key

Dr. Siddhart Yadav, Senior Consultant, Orthopedics and Joint Replacement Surgery, Apollo Hospitals, Navi Mumbai, told HealthandMe that bone density and muscle mass tend to decline with age.

“In women, bone loss can accelerate after menopause, while men too are at risk of age-related bone loss. When weaker bones are combined with reduced muscle strength and poor balance, even a relatively minor fall can result in a fracture, particularly around the hip or wrist,” he said.

“While women are hit hardest, often assuming household chores are adequate exercise, men are equally vulnerable as muscle mass silently declines after 50. In both, excess weight paired with weak muscle leaves weaker bones exposed to fractures during simple falls,” Dr. Thineshchandar Andiappan, Senior Orthopaedic and Joint Replacement Surgeon, Athulya Geriatric Hospital told HealthandMe.

What Exercises Should Adults Over 60 Include?

A casual morning walk alone may not provide enough stimulus to maintain bone density, muscle strength, and balance. Experts recommend combining walking with progressive resistance and strength training. Starting in your 40s can help preserve strength, but it is never too late to begin an appropriate exercise routine.

Along with regular walking, older adults should include simple strength and balance exercises in their routine.

Dr. Siddhart suggested chair sit-to-stands, supported squats, heel raises, and resistance-band exercises to help maintain the strength needed for everyday activities. Light dumbbell exercises for the upper body can also help strengthen the arms, shoulders and other upper-body muscles.

Exercises should be introduced gradually and tailored to individual health and mobility, particularly for people with osteoporosis or a history of fractures.

A 30-40-minute walk is beneficial, but it does not have to be completed in one stretch. If the muscles begin to feel tired, taking a short break of two to three minutes before resuming the walk is reasonable.

Diet and Vitamin D Also Matter

Read More: Osteoporosis Drugs Offer New Hope For Back Pain By Blocking Disc Mineralisation: Study

Along with exercise, adequate nutrition supports bone and muscle health. Calcium-rich foods such as milk, curd, paneer, ragi and sesame, together with adequate protein, can help meet nutritional needs. Vitamin D levels should be assessed when clinically indicated.

“Falls in elderly persons happen more often due to instability, muscle weakness, and other reasons. It is very important to address all the issues in addition to the management of osteoporosis for preventing such fractures. The comprehensive treatment will include a good diet, adequate sunlight exposure, in addition to exercises, which must involve weight training and stability-building training,” Dr. V Singaravadivelu, Senior Consultant and Academic Lead, Orthopaedic Surgery, Kauvery Hospital told HealthandMe.

A sugar naturally found in red meat may help explain why beef and lamb have long been linked to type 2 diabetes, according to a large new study presented at the European Association for the Study of Diabetes’ Annual Meeting in Milan.

Researchers tracked nearly 90,000 adults with no history of diabetes or cancer through NutriNet-Sante, a long-running French health study, according to a release from the European Association for the Study of Diabetes (EASD). Over a median follow-up of 7.2 years, 966 participants developed type 2 diabetes.

The focus was a sugar called N-glycolylneuraminic acid, or Neu5Gc, found mainly in beef and lamb. People with the highest intake of meat-derived Neu5Gc had a 63% higher risk of developing type 2 diabetes than those with the lowest intake, the EASD reported. The risk rose steadily with intake: the second-highest group already carried a 41% higher risk.

“This is a relative risk: people in the top fifth of meat-derived Neu5Gc intake had a 63% higher risk than those in the bottom fifth, after accounting for many other factors,” said lead author Dr. Leopold Fezeu of Universite Sorbonne Paris Nord told Medical News Today. “It does not mean that 63% of high consumers will develop diabetes.”

Also Read: World Osteoporosis Day: Why Women Face A Higher Risk of Osteoporosis As They Age

Why Scientists Suspect Inflammation

Most mammals produce Neu5Gc naturally, but humans lost that ability after an ancient genetic mutation, according to the EASD. The sugar can still enter the body through food and get absorbed into human tissue. Because the body doesn’t recognise Neu5Gc as its own, the immune system may treat it as foreign, producing antibodies against it in a prolonged immune response called xenosialitis, previously linked to cardiovascular disease and cancer.

“Our findings support chronic inflammation as a specific mechanism linking red meat consumption with T2D, partly beyond the amount of red meat a person eats and partly independent of body fat,” Fezeu said.

What Are The Key Findings?

Not just weight: Notably, obesity accounted for only about 13% of the link between Neu5Gc intake and diabetes risk, the EASD reported, suggesting the sugar’s effects may extend beyond weight gain alone.

Dairy showed no link: Despite also containing Neu5Gc, dairy products showed no association with diabetes risk, likely because cow’s milk contains far smaller amounts than red meat.

An important caveat

When researchers additionally adjusted for total red meat intake, the Neu5Gc-diabetes link weakened and was no longer statistically significant, though it pointed the same direction.

“There may be differences between sources, or other components of red meat may contribute,” Fezeu said, meaning the study can’t fully separate Neu5Gc’s effect from red meat generally.

What comes next

Since the study is observational, it cannot prove Neu5Gc causes diabetes. Fezeu’s team plans to measure antibodies against Neu5Gc directly and study how it interacts with iron in red meat.

“Future research should explore whether reducing exposure to meat-derived Neu5Gc, for example by favoring poultry or plant-based proteins over beef and lamb... could help prevent T2D,” Fezeu said.

As we brace ourselves for another bout of winter, we can’t help but feel wary about the changes the dip in temperature brings on our mood and mental well-being. You are not imagining winter depression when you start to feel sudden loss of joy.

Seasonal depression is more than feeling gloomy. You may no longer enjoy the activities you once relished, like listening to music, exercising or meeting friends. This isn’t just another effect of winter. Experts have designated a term for it: anhedonia.

Anhedonia refers to the loss of pleasure or interest in something you once enjoyed. It is one of the symptoms of depression, including seasonal affective disorder (SAD). Unlike sadness, anhedonia can render someone feeling disconnected with or indifferent towards things they once enjoyed.

A person experiencing anhedonia may still participate in activities they enjoy but will no longer reap emotional rewards from it.

“Anhedonia is not the kind of sadness where you’re feeling down but still have moments of enjoyment,” Dr Deeksha Kalra, Associate Consultant, Psychiatry, Artemis Hospital, Gurugram, explained to HealthandMe.

Dr Samant Darshi, Consultant Psychiatrist and Neuromodulation Expert at Yatharth Hospitals, told us, “While sadness entails the state of feeling unhappy about something, anhedonia pertains to the lack of enjoyment.”

Dr Kalra said, during SAD, anhedonia may be experienced during the affected season like winter.

“This can happen at the same time as low mood, but it can also be one of the clearest symptoms. In SAD, these changes are usually present during the affected season and resolve with the resolution of the depressive episode. So anhedonia is about muted pleasure, not just feeling sad,” Dr Kalra explains.

Effects Of Winter On Pleasure And Motivation

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Changes that come with SAD, a type of depressive phase, usually pertains to specific seasons, like mostly winter. Due to less duration of daylight, the body’s internal clock, known as circadian rhythm, may get affected. Along with circadian rhythm, poor diet, irregular sleep pattern and limited physical activity can also contribute to SAD.

This could cause one to feel difficult to initiative activities they enjoy as they no longer feel motivated, affecting the brain reward system.

“Seasonal affective disorder (SAD) causes disturbance of mood, sleep, energy, and motivation. Activities which were pleasurable before become less rewarding because of this. The changes in daylight hours may affect the body clock or the physiological processes related to mood control. The decrease in energy and motivation makes doing the activity even harder and less pleasurable,” said Dr Darshi.

Dr Kalra explains that there are a lot of phases to experiencing ‘enjoyment’. It involves identifying something rewarding, anticipating it, experiencing pleasure and learning from the experience. Depression can affect all these phases, making previously enjoyable activities feel less rewarding.

“Brain networks including the striatum and nucleus accumbens, contribute to the valuation of rewarding experiences and the motivation of behavior. When their responses are dulled and something that was once naturally rewarding may not have the same emotional resonance,” she says.

Dopamine’s Role In SAD

Also read: Children’s Mental Health Often Goes Unnoticed: Can India’s New School Policy Change That?

Dopamine is a neurotransmitter in the brain responsible for motivation, rewards, learning, and directing behaviour as per goals. When we talk about SAD and anhedonia, dopamine comes into the picture as it is related to motivation and rewards.

Dr Kalra explained, “Dopamine is involved in motivation, reward anticipation, learning and determining the value of pursuing something. That’s why dopamine has been looked at when researchers have investigated anhedonia and low motivation.”

But doctors say that anhedonia is not characterised by shortage of dopamine. According to research, SAD has been reported to affect dopamine signalling, including lower dopamine transporter availability in the striatum during symptomatic depression.

Dr Darshi also emphasises that dopamine is only a part of the process.

He said, “Studies concerning depression and anhedonia indicate that changes in the activity of dopamine result in the decrease in motivation and reward sensitivity. However, anhedonia encompasses many brain processes.”

SAD And Anticipatory Pleasure

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Anhedonia makes one indifferent by directly affecting the anticipatory pleasure mechanism. Anticipatory pleasure is the excitement one feels before an event. Consummatory pleasure is the enjoyment experienced while the event is in progress.

“Anhedonia can affect the anticipatory pleasure you feel when you look forward to something and the consummatory pleasure you experience when it actually happens. Someone might know that a favorite meal, holiday or meeting with friends should be enjoyable but feel little excitement beforehand. The pleasure might also feel weaker than expected when the event happens,” Dr Kalra explains.

Not Everyone May Experience Same SAD Symptoms

Everyone with SAD experiences anhedonia in different ways. While some may lose interest and pleasure, others may withdraw socially, sleep excessively, eat more, feeling more tired among other symptoms.

“SAD doesn’t affect everybody in exactly the same way any more than depression is a single biological process. Different people can experience different combinations of changes in mood regulation, circadian rhythms, sleep, appetite and energy and reward processing,” says Dr Kalra.

She also said that multiple symptoms may interact. For example, poor sleep could result into daytime sluggishness, making energetic activities less tempting.

Dr Darshi explained, “Individuals with SAD have different presentations since biology, genetics, circadian rhythm, and psychology are unique for each person. Some individuals have disturbances in reward and motivation, whereas others have sleep disturbances or carbohydrate cravings, or even fatigue. Symptoms might be overlapping and are a reflection of various underlying mechanisms.”