When 42-year-old Ranjan Das, SAP India’s high-achieving managing director, who was known for his fitness and healthy eating habits, collapsed suddenly on 21 October, reportedly after a workout on a treadmill, there was much shock and conjecture. Was he yet another victim of a burnout, over-exercise or of sleeping too little?
SAP spokespersons are unwilling to go into the cause of Das’ death, which was reported in different publications as “heart attack”, “stroke” and “massive cardiac arrest” (all three have different medical implications). If it was indeed a cardiac arrest, then cardiologists are unwilling to link what they term “a one in a lakh” phenomenon to work stress.
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Yet, across executive ranks, people are now asking themselves if being conscious of diet and regular exercise is really enough of a buffer against the inevitable stress of a high-pressure job. While there are no definitive answers, the way ahead is definitely linked to understanding what works for your body and what does not.
Treadmill or ‘tread kill’?
One-third of all sudden cardiac deaths (SCD) outside homes and hospitals occur in fitness clubs or sports facilities, says Balbir Singh, consultant, interventional cardiology and electrophysiology, Indraprastha Apollo Hospitals, New Delhi. Although most researchers downplay the risks of SCD during exercise—the American Heart Association pegs it at one in 100,000-200,000 cases—three deaths during the 18 October Boston marathon this year, the death of popular American basketball hero Randy Smith in Connecticut this June and, closer home, Das’ demise have highlighted the issue again.
Photo: Raajan / Mint
Men are at higher risk of collapse during exertion than women, says Dr Balbir Singh. An October 2007 article published by the Canadian Society for Exercise Physiology in its newsletter pegs the risk for men at 1 SCD per 19 million hours of exertion.
Despite apparently low levels of risk, people such as Vishal Bali, CEO, Wockhardt Hospitals—who describes a CEO’s life in India as a “run-chase”—do guard against excessive exercise. “I do hit the treadmill and it helps me cope with stress. But obviously exercise also takes its toll on the body, so one has to do it in the right balance,” says the 41-year-old, adding, “When you do it under supervision, with a trainer, your protocol is set out for you. The regime varies according to your current health condition and current body parameters.”
Bali has hit the nail on the head. Body parameters do keep changing—a flu attack can weaken the heart muscles, making you a candidate for SCD. Which is why regular check-ups are a must.
Exercise without knowing your limits, without proper supervision, and without following safety protocols, such as getting medical clearance first, can have life-threatening consequences. “You must treat exercise as a super-speciality and while getting into it, you should know what you are getting into,” says Gaurav Sharma, a fitness and sports medicine specialist heading the Optima Wellness Centre, Gurgaon.
Unfortunately, most people don’t bother. Nor is supervision or knowledge of safety protocols in gyms adequate. Dr Balbir Singh says: “My own instructor often urges me to increase speed—he wants me to burn 300 calories in 6 minutes, which is dangerous.”
He believes every gym should have written protocols on how to use a treadmill and a process of graded increase should be followed. But first, he adds, “Anybody who goes to (a) gym should have a basic cardiac check-up”.
Take it easy
Amitav Mukherji, a 37-year-old, Bangalore-based senior human resources executive in an Indian multi-business conglomerate, is a case study of somebody who over-exercised, without supervision and paid for it. About a year ago, in his enthusiasm to train for a marathon, Mukherji suddenly upped the time he spent on the treadmill. Going from 20 minutes of running to 40 minutes and then to 1 hour, he suddenly found his knee caving in.
It took two months of physiotherapy and a period of rest before Mukherji could start exercising again. This time he sought advice from a professional trainer and now exercises only five times a week, and never more than an hour a day. “One month with a trainer who can set the right regimen is sufficient for a self-motivated person,” he says.
Friends and colleagues describe Das as a fitness freak who was so compulsive about his exercise regime that even when travelling, he sought out gyms for his daily workout. “It seems like Mr Das was a Type A personality. Such people have such high motivation levels that they tend to overachieve at everything. Chances are they will take even exercising to extreme levels,” says Rachna Singh, lifestyle management expert, Artemis Health Institute, Gurgaon. (In the 1950s, cardiologists Meyer Friedman and R.H. Rosenman propogated a personality type theory categorizing people according to their coronary artery disease (CAD) risk. Contemporary psychologists reject this theory totally but according to it, Type A personalities, described as “stress junkies”, are high-achieving workaholics who multitask, drive themselves with deadlines, and are unhappy about delays. They are supposed to have double the risk of CAD than others. Type B individuals are patient, relaxed, and easy-going. Type AB is a combination of both.)
Overachievers often forget that in its own way, exercise is physical stress, too. In fact, just as a six-pack is no benchmark of good health, a great deal of time spent on the track or treadmill is no guarantor that it will lead to maximum fitness.
Raghav Pande, a health and fitness coach for Mynutrition.in (a portal that provides personalized diet and fitness packages), says all individuals must take into account their current fitness levels before embarking on a fitness plan. “Overweight individuals should not get on to a treadmill and individuals suffering from hypertension should not pursue a regime which uses 60% (or more) of (their) maximum heart rate.” To avoid injury (the possibilities are wide-ranging), don’t push yourself through discomfort, pain or weariness.
“Ranjan and I recently exchanged notes on how little we were sleeping. He observed that all the ‘great guys like Einstein did 4 hours a day’,” says Prasanto K. Roy, president and chief editor, CyberMedia. It has been widely reported that Das slept for only 4 hours.
“Most high achievers in their productive years give far more than they should, thinking that nothing will happen to them when they are young. So they work at the cost of sleep,” says Samir Parikh, well-known psychiatrist and head of mental health and behavioural sciences department, Max Healthcare, New Delhi.
“Sleep is the most important rejuvenation tool,” says Rachna Singh. But deadline pressures can leave sleep and rest as the biggest casualties. You cannot postpone rest, nor can you fruitfully “catch up” on it later.
“We are going to see a lot more fatal incidents happening at fitness centres as people start pushing their limits, without paying attention to the rebuilding tools,” says Sharma, adding, “After a bout of intensive exercise, you need to constantly keep rebuilding your overworked body parts with more proteins, nutrients, proper sleep.”
In short, you need a holistic approach. The complete wellness prescription entails not just the physical aspects, such as good diet, adequate exercise and sound sleep, but also the emotional and spiritual aspects. And there lies the rub. “You can’t be smoking like a chimney or eating rotten food or sleeping less and then trying to compensate this lifestyle by exercise. The approach to well-being has to be holistic,” says Neeraj Bhalla, consultant cardiologist, Max Healthcare, New Delhi.
Behaviour specialists say there are several warning signs of a life out of balance that families, friends and colleagues can catch. Parikh says: “The kind of time I have for my family and friends is the biggest warning signal. If I cannot find time to do something I am fond of, surely that means something is wrong.” And it is these small things the “work hard, play hard’” mentality can overlook.
Rachna Singh says HR departments can be a bit more proactive and address work-life balance on a priority. “Management of stress and burnout is always termed a ‘soft skill’ by the corporate sector,” Parikh says ruefully. “This itself undermines the importance that (companies) pay to this issue. These are not “soft” areas but are “hard facts” and life and death issues.”
Archana Rai contributed to this story.
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