We all must have come across the phase: this is why women live longer than men. These are all over the social media, where men are performing more often than not, some experiments, without gears, just for fun, "in the name of science". The caption reads: this is why women live longer. However, is there really a science to it, other than the fact that women choose to do things more safely?

In the United States, women have a life expectancy of about 80, whereas men have 75. Women outlive men and this holds true regardless of the country women live, the money they make, and other factors. In fact, it is true for most other mammals too.

Dr Dena Dubal, a professor of neurology at the University of California, San Francisco told the New York Times, "It is a very robust phenomenon all over the world, totally conserved in sickness, during famines, during epidemics, even during the times of starvation."

But what are the reasons? These reasons are often more complicated and less established. It is important to note that only because women are outliving men does not mean they are living a better life. In fact, women tend to have shorter health spans, which means the number of healthy years in a person's life is less in women than men, confirmed Bérénice Benayoun, an associate professor at the U.S.C. Leonard Davis School of Gerontology.

As per a 2021 study titled, Sex differences in frailty: Comparisons between humans and preclinical models, found that women are more physically grail than men in old age. They are also more vulnerable, especially after menopause and are at more risk of developing cardiovascular issues and Alzheimer's disease because of age.

The key is in figuring out what makes one sex more resilient or vulnerable.

Genetics

For things which do not find easy explanations, scientists look for their answers in genes. Many research, including a 2020 study titled, The sex with the reduced sex chromosome dies earlier: a comparison across the tree of life, suggests that the XX set of female sex chromosomes may impact longevity. However, there has not been any clarity on how it affects longevity.

Another 2018 study titled, Female XX sex chromosomes increase survival and extend lifespan in aging mice, which was conducted by Dr Dubal's lab, looked at genetically manipulated mice with different combinations of sex chromosomes and reproductive organs. It was found that those with two X chromosomes and ovaries lived longest, followed by mice with two X chromosomes and testes. Mice with XY chromosomes had shorter life spans.

"There was something about the second X chromosome that was protecting the mice from dying earlier in life, even if they had testes. What if there was something on that second X chromosome that was in some ways a sprinkle of the fountain of youth," says Dr Dubal. While scientists have not yet looked at this factor in humans, Dr Dubal suggests that humans have the same hormones and sex chromosomes, and similar reproductive system that could corroborate the similar findings in people.

Hormones

Plenty research has shown that estrogen is responsible for longevity also effect on the immune system. The data also shows that before menopause, the female immune system tends to do better. In fact Dr Benayoun said that males tend to do much worse in response to infection.

Another 2017 study titled, Ages at Menarche and Menopause and Reproductive Lifespan As Predictors of Exceptional Longevity in Women: The Women's Health Initiative, found that women who experienced menopause later in life over the age 50 lived longer than those who experienced it earlier.

Lifestyle and Behavior

There are also disparity in behavioral patterns between men and women. This includes smoking, drinking heavily, which can contribute significantly to mortality. Women also have more "health promoting behavior", believe experts. Women are also more likely to socialize than men and thus it protects them from detrimental effects of social isolation and loneliness. In fact, a 2023 analysis published in Jama Network, titled, Widening Gender Gap in Life Expectancy in the US, 2010-2021, found that women are less likely to die by drug overdose or suicide.

Knee problems were once considered an issue associated with old age. However, an increasing number of Indians in their 30s are experiencing knee pain, stiffness, and cartilage damage similar to arthritis. Doctors are reporting more cases of young adults seeking treatment for knee-related issues that can affect mobility and quality of life.

Sedentary Lifestyle And Lack of Physical Activity

One of the biggest reasons behind early knee damage is a sedentary lifestyle. Many young professionals spend long hours sitting at desks, working on computers, or using mobile devices. Lack of regular movement weakens the muscles around the knees, reducing the support they provide to the joint.

At the same time, some individuals suddenly engage in intense workouts without proper conditioning. This puts excessive stress on the knees, increasing the risk of injuries and long-term wear and tear. Maintaining a balanced exercise routine with strength training and stretching can help protect knee health.

Rising Obesity And Excess Weight

India has witnessed a rise in obesity among young adults. Excess body weight places additional pressure on the knee joints, which are responsible for supporting most of the body’s weight. Even a small increase in weight can significantly increase stress on the knees during activities such as walking, climbing stairs, or running.

Over time, this extra pressure can lead to cartilage deterioration, inflammation, and chronic pain. Maintaining a healthy weight through proper nutrition and regular exercise can reduce the risk of developing arthritis-like symptoms at an early age.

Poor Posture And Nutritional Deficiencies

Poor posture while sitting, standing, or exercising can also contribute to knee problems. Improper movement patterns may cause uneven stress on the joints, leading to gradual damage. Additionally, untreated sports injuries or ligament tears can accelerate knee degeneration if not managed properly.

Nutritional deficiencies, particularly low levels of vitamin D and calcium, are another concern. These nutrients play a vital role in maintaining strong bones and joint health. Deficiencies can weaken the musculoskeletal system and make individuals more susceptible to knee-related issues.

Steps to Protect Knee Health

Preventing early knee damage requires a combination of healthy habits. Individuals should engage in regular low-impact exercises such as walking, swimming, or cycling to strengthen the muscles around the knee. Maintaining a healthy body weight can significantly reduce pressure on the joints.

It is also important to follow an ergonomic posture while working, take frequent breaks from prolonged sitting, and avoid sudden high-intensity workouts without proper preparation. A balanced diet rich in calcium, vitamin D, protein, and anti-inflammatory foods can support bone and joint health. Most importantly, persistent knee pain should not be ignored, and timely consultation with a healthcare professional can prevent minor issues from becoming serious conditions.

Conclusion

The growing incidence of arthritis-like knee damage among Indians in their 30s is a result of multiple lifestyle factors, including inactivity, obesity, poor posture, injuries, and nutritional deficiencies. While the problem is becoming more common, it is largely preventable. Regular exercise, maintaining a healthy weight, following a balanced diet, and seeking timely medical attention can help preserve knee health and reduce the risk of long-term joint damage.

Prime Minister Narendra Modi proposed the idea of a dedicated yoga day during his address to the 69th session of the UN General Assembly in 2014. On December 11, 2014, all 193 UN member states unanimously agreed to observe the International Day of Yoga on June 21.

The primary objective of the International Day of Yoga is to raise awareness about yoga as a holistic practice for mental and physical well-being. Yoga originated in India, and it has a history of more than 5000 years. Some people regard it as a fashionable fitness, but it can be beneficial in various chronic diseases, including diabetes, hypertension, and chronic kidney disease.

The Challenges Faced by Dialysis Patients

Dialysis is a life-saving treatment for stage 5 CKD patients. It has to be done 2- 3 times/week. It has been seen that these patients become physically inactive, which leads to poorer outcomes. They also have a lot of comorbidities like hypertension and diabetes, besides stress. Over the last few years, scientific studies have shown that regular exercise in patients improves outcomes. These patients are a captive audience as they spend 8-12 hours in a dialysis unit every week.

Hence, many dialysis units have incorporated exercise into the dialysis sessions. Yoga has been purported to have multiple health benefits. Over the last few years, even Western science is starting to provide some concrete clues as to how yoga works to improve health, heal aches and pains, and keep sickness at bay.

Yoga: Benefits For Heart Health

Research studies have shown that Yoga lowers blood pressure and slows the heart rate. Two studies of people with hypertension, published in the leading scientific journal The Lancet, compared the effects of Savasana (Corpse Pose) with simply lying on a couch.

After three months, Savasana was associated with a 26-point drop in systolic blood pressure (the top number) and a 15-point drop in diastolic blood pressure (the bottom number), and the higher the initial blood pressure, the bigger the drop. A slower heart rate can benefit people with high blood pressure or heart disease, and people who've had a stroke. Yoga lowers LDL (“bad”) cholesterol and boosts HDL (“good”) cholesterol.

Yoga: Diabetes and Weight Management

In people with diabetes, yoga has been found to lower blood sugar in several ways: by lowering cortisol and adrenaline levels, encouraging weight loss, and improving sensitivity to the effects of insulin. If your blood sugar levels improve, there is a reduced risk of diabetic complications such as heart attack, kidney damage, and blindness.

Researchers have also found that people who practiced yoga for at least 30 minutes once a week for at least four years gained less weight during middle adulthood. People who were overweight actually lost weight. Overall, those who practiced yoga had a lower body mass index (BMI) compared with those who did not practice yoga. Researchers attributed this to mindfulness. Mindful eating can lead to a more positive relationship with food and eating.

Yoga also acts as a stress buster. It quells the fluctuations of the mind, according to it, slows down the mental loops of frustration, regret, anger, fear, and desire that can cause stress. And since stress is implicated in so many health problems—from migraines and insomnia to lupus, MS, eczema, high blood pressure, and heart attacks—if you learn to quiet your mind, you’ll be likely to live longer and healthier.

Yoga: Evidence For Dialysis Patients

There is a lack of good scientific data about the direct benefits of yoga in dialysis patients, but the absence of evidence does not mean evidence of absence. Some people regard it as a fashionable fitness, but it can be beneficial in various chronic diseases, including diabetes and hypertension. Diabetes and high blood pressure are among the commonest comorbidities in Dialysis patients. These patients are under great stress due to their kidney failure.

In another study, a 6-month yoga program was found to be a safe and effective measure as adjuvant therapy to conventional treatment modalities in reducing blood pressure, improving renal function, and improving QOL in these patients.

For the last 5 years, we have been celebrating World Yoga Day in our Dialysis unit and encouraging our Dialysis patients to regularly practice Yoga. Even after a kidney transplant, the better the blood pressure control, the longer the life of the transplanted kidney. Thus, there is enough indirect evidence that yoga is beneficial in patients with kidney diseases.

Yoga: Benefits for Kidney Disease Patients

However, it should be done under expert supervision. There are many other poses in yoga; you can choose those that are suitable for you under the guidance of a professional practitioner. In a word, practicing yoga can promote metabolism, blood circulation, and help discharge more metabolic wastes and toxins. It can improve endocrine functions and help repair damaged tissues.

It can strengthen physical fitness and enhance immunity. It can make the mind peaceful and ease pressure and chronic pains. They also assist in managing water retention in the body. This enables sound sleep schedules and hence better rest. A well-rested body is better able to perform functions such as regulating water in the body and stabilizing the heartbeat.

Precautions Before Practicing Yoga

Though yoga is safe, not every kidney failure patient can do all the poses. For example, if the patients have polycystic kidney disease, bending and other positions that can cause pressure on the abdomen and back should be avoided. If the patients have high blood pressure or lower back pain, leg lifts should be avoided. It is necessary to practice yoga under the guidance of a professional practitioner if you have kidney disease. Yoga asanas are known to increase relaxation.

There are many poses in yoga that are suitable for dialysis patients. Some of these could be done safely during dialysis sessions. However, special care should be taken to ensure that no arm movement on the side has an AV fistula where dialysis is taking place. For those patients who have a permacath (or permanent catheter), these restrictions are not that severe. Of these, I recommend the following, which can be done during the dialysis sessions, preferably before taking snacks and tea.

Yoga During Dialysis

1. Anulom vilom: A person needs to inhale through the left nostril and exhale through the right nostril, and then inhale through the right nostril and exhale through the left one. These alternate nostril breath exercises can promote blood circulation. All these are best done first thing in the morning

2. Kapaal Bhaarti: In this, the person exhales forcefully and then inhales passively. This is repeated a few times as per convenience, followed by a break and 3 – 5 sessions.

3. Bhastrika: In this, a person inhales deeply, followed by forceful exhalation. This is then reapted 3-5 times maximum.

4. Shavasana: In this one lies flat on the couch and is absolutely listless on the couch for a few minutes, with arms and legs lying loosely.

Yoga For Non-dialysis Days:

1. Vrikshaaasan: In this one stands straight and then places the right foot on the inner side of the left thigh, joins the hands, and raises them above the head. After a few minutes, the hands are brought down, and now the left foot is placed on the inner side of the left thigh, and the hands are joined and raised above the head.

2. Tada Asaan: In this, a person stands on his toes and stretches his arms above his head, and joins his hands. In this posture, he then breathes freely and holds as long as possible.

3. Cobra pose: In this, a person lies on his belly with hands flat on the floor on each side and inhales and extends the spine forward, lifts the chest and head off the floor. One needs to make sure that the legs and feet are parallel and hold this position for several breaths. This can help put mild pressure on the kidneys and revitalize the kidney functions.

4. Camel pose: In this asana, the person kneels on the floor, extends the spine, opens the chest, and reaches for the feet. One needs to make sure that the thighs are perpendicular to the floor and the toes are tucked. This posture can help improve blood circulation as well as the body’s circulatory system.

5. Paschimottanasana: In this asana, you bend forward and try to touch your toes.

6. Surya Namaskaar: It is one of the best Yogic aasanas as it involves a combination of 11 steps. You can see details on YouTube.

7. Kati chaakra aasan: in this one lies on the floor and stretches the hands on the sides and legs kept 3 feet apart. The head is turned to one side, and the knees are in the opposite direction

Thus, yoga keeps the internal organs healthy, balances the various systems in the body, and effectively controls the stress of the body and mind. Some of the yoga asanas and pranayamas facilitate internal cleansing rituals that ensure the flushing out of toxins from the body.

The life of a woman can be called a cycle of various physical and hormonal changes occurring at particular points throughout life. From menstruation at puberty up to menopause, there will be numerous changes experienced by the female body, which can bring about consequences for her physical and psychological well-being.

Being a healthcare professional, I should mention that although medication is sometimes unavoidable, there is no point in neglecting alternative ways, including yoga.

Yoga Can Help Women

Yoga is an exercise that involves asanas, pranayamas, and meditation. There is now scientific evidence indicating that yoga aids in coping with certain conditions in women. It achieves this by positively influencing the neuroendocrine, autonomic nervous system, and stress responses.

A significant number of women are victims of menstrual conditions such as dysmenorrhea, PMS, abnormal menstrual cycle, and heavy menses during their reproductive age. The conditions may become worse due to stress, since it affects hormone levels.

Yoga reduces the amount of congestion in the pelvic area, increases blood flow, increases body flexibility, and reduces stress hormones such as cortisol. Consequently, most women have painless and psychologically stable menstruation.

Yoga Can Improve PCOS Symptoms

Moreover, yoga can prove highly helpful in the case of women who are suffering from Polycystic Ovary Syndrome (PCOS). It is the most prevalent endocrine disorder that affects women of childbearing age.

The condition has insulin resistance, obesity, irregular menstruation, and metabolic conditions as its symptoms. Thus, yoga, along with healthy living, can provide some assistance in terms of improving insulin levels, maintaining weight, reducing stress, and balancing hormones.

Yoga in Pregnancy

Yoga has many advantages during pregnancy. It will ensure good posture, decrease lower back pain, increase flexibility, improve breath control, and prepare the body for delivery. In addition, prenatal yoga helps with dealing with emotional and mental issues related to pregnancy, which will have a positive effect on the mother and her baby.

Yoga During Perimenopause And Menopause

With the onset of perimenopause and menopause, the reduction in levels of estrogen is known to cause side effects like hot flashes, insomnia, irritability, exhaustion, aches in the joints, and thinning bones. All these factors have significant impacts on both the daily life activities and the emotional state of women.

The research shows that yoga may be helpful in overcoming the symptoms of menopause through relaxation, improvement in sleep, muscle strengthening, and better handling of emotions. Breathing techniques and meditation help in lowering stress and positively influencing the mental state of patients.

Apart from the specific diseases that yoga can alleviate, it promotes self-awareness, which plays an important role in managing one’s emotions. Nowadays, women tend to have a large number of duties, such as working, taking care of children, and doing housework. Chronic stress leads to many diseases, for instance, high blood pressure, obesity, heart issues, and psychological problems.

For all phases of female development, from menstruation until menopause, the emphasis should be on not just the treatment of diseases but the maintenance of wellness. While yoga cannot replace medical care, it remains an important supplement that aids in achieving physical fitness as well as mental and spiritual well-being. Through regular yoga practice, a woman will develop her resilience and become stronger in every phase of life.

(By Dr. Ruchi Bhandari, Director- Obstetrics & Gynecology, Yatharth Hospital, Noida)