A very common condition, arthritis, though having multiple types [such as rheumatoid, poly, osteo, etc.] affects millions of individuals worldwide, making its management demand a multidimensional approach. The cornerstone of pharmacological intervention must be supplemented and enhanced by lifestyle changes for individuals.

These are a few modifications individuals can implement in their daily life-

Dietary alteration

Individuals must be encouraged to have an anti-inflammatory diet. Omega-3 fatty acid-containing foods, which include fatty fish like salmon and mackerel, nuts, and seeds, reduce inflammation. Fruits and vegetables, especially those rich in antioxidants, such as berries and leafy greens, should also be encouraged. Consumer intake of packaged foods, sugars, and saturated fats must be minimized to minimize the production of inflammatory agents and keep the patient's health good.

Regular Exercise

Low-impact exercises should be performed, such as swimming or walking or cycling, because these clearly do not severely strain the joints, but also promote both flexibility and strength. In cases where the joints are inflamed, physiotherapists recommend NO exercise but proceed with non-weight bearing exercises to strengthen the muscle and reduce the load once the inflammation has reduced.

If degeneration has occurred, exercises are performed in a pain-free range, focusing on muscles and limited movement of joints. A tailored exercise program, possibly with a physiotherapist, can help the patient gradually and safely increase his endurance and mobility. "Do it regularly rather than intensely" may be an effective motivational tactic to encourage compliance.

Weight Loss

Excess weight may exacerbate joint pain, especially in weight-bearing joints such as the knees and hips. It is worth working with individuals to have controlled weight loss goals through diet and exercise. A physiotherapist can encourage individuals by providing access to basic materials, such as nutrition counselling or weight management programs, for them to make fundamental changes that benefit their health.

Stress Management

Chronic stress can enhance pain sensitivity and intensify inflammation. Providers should encourage individuals to find stress-reducing practices, like mindfulness meditation, yoga, or deep-breathing exercises. These practices could be a huge way to empower individuals to take control of their lives and thus improve their mental well-being.

Sleep Hygiene

Qualitative sleeping is a must in recovery and pain management. Providers should assess the patient's sleep habits as well as recommend how to improve the hygiene of sleeping so that they can maintain regular sleep hours, sleep in a restful environment, and avoid screens before bedtime. Resolving sleep problems would make a big difference in individuals' quality of life.

Support Systems

Support groups help to build emotional support by engaging other individuals. Basically, your experiences will be matched with others who are experiencing the same set of experiences. This can help in improving coping mechanisms and promoting a more positive outlook toward the management of arthritis.

All of these measures, together, allow the affected individuals to have a better quality of life and obtain relief from the irritation and pain that arthritis can be.

Long considered a standard tool for assessing body weight, Body Mass Index (BMI) may not be as reliable as once believed. A new study shows that relying on BMI can incorrectly classify people as overweight or obese.

When a team of Italian researchers used the gold standard technique of dual-energy X-ray absorptiometry (DXA) to measure body fat in the general population, they found that the traditional WHO-approved BMI classification system misidentified a significant number of people as having overweight or obesity.

How Is The BMI Wrong?

A total of 1,351 adults of mixed gender aged between 18 and 98 years were checked for their body weight using the DXA system.

The results, published in the journal Nutrients, revealed that more than one-third (34 percent) of those with obesity defined by BMI had been misclassified and should be in the overweight category.

For those with an overweight BMI, DXA showed that more than half – 53 percent – had been misclassified – three quarters of those misclassified fall into the normal weight category, while the other quarter should have been classified as having obesity.

The DXA analysis found that the prevalence of overweight and obesity across the cohort was around 37 percent overall (23.4 percent overweight, and 13.2 percent obesity, compared to 26.2 percent and 14.1 percent with BMI).

“In the past few years, there has been a lot of criticism of the BMI system due to its inability to accurately capture body fat percentage or distribution, to correctly categorise weight status based on adiposity,” said Professor Marwan El Ghoch, of the Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Also read: Your BMI Does Not Reflect Your Health: New Study Warns How It Misses A Key Health Aspect

Despite these concerns, BMI as a weight classification system continues to be used in the general population in primary healthcare (i.e., general practitioners) and non-clinical (i.e., policy and health insurance) settings, he added.

The researchers urged revising public health guidelines to consider combining direct body composition or their surrogate measures, such as skinfold measurement or body circumference, with the waist-to-height ratio, with BMI, while assessing weight status in the general population.

Waist-to-Height Ratio May Be More Accurate: The India Story

In January 2025, India revamped its obesity guidelines, and the new approach focused on abdominal obesity and comorbid diseases, rather than just BMI.

According to the redefining team, it was essential to move beyond BMI-only approaches to tackle the ever-growing number of people related to other major health risks. They stated that while BMI can be a screening tool, obesity must be defined by body fat.

“BMI should be used for screening purposes, but obesity should be confirmed ideally by a measure of body fat wherever feasible, or another measure such as waist circumference, WHR, or Waist-to-height ratio,” Dr. Naval Vikram, Professor of Medicine, at AIIMS, New Delhi, was quoted as saying to IANS at the time.

Also read: 41 million children aged 5-19 living with high BMI in India: Study

What Do The New Guidelines Say

It recognizes abdominal fat — closely linked to insulin resistance — as a key factor in the diagnosis. It integrates the presence of comorbidities — such as diabetes and cardiovascular disease — into the diagnostic process.

The revised guidelines also introduce a two-stage classification system, addressing both generalized and abdominal obesity.

Stage 1 Obesity: Increased adiposity (BMI > 23 kg/m²) without apparent effects on organ functions or routine daily activities.

Stage 2 Obesity: Advanced state of obesity with increased BMI more than 23 kg/2, and abdominal adiposity; excess Waist Circumference or Waist-to-Height Ratio.

What if your gym routine is doing far more than helping you stay fit? Research is increasingly showing that exercise, especially strength training, plays a powerful role in keeping your brain sharp, focused and resilient over time. In fact, Dr Sudhir Kumar, a neurologist at Apollo Hospital in Hyderabad also pointed this out by quoting the study Randomised Controlled Trial of Resistance Exercise and Brain Ageing Clocks.

The study showed that resistance training could reduce brain age by up to two years. This means strength workouts could help the brain maintain characteristics that are seen in younger people.

It Is Not Just About Muscles

For a long time, workouts were seen as a way to build muscle or lose weight. Now, experts suggest that resistance training can also support brain health in meaningful ways. Regular strength training has been linked to slowing down brain ageing, with some studies suggesting it may even reduce the brain’s biological age by a couple of years.

This means that beyond physical strength, your brain could function more efficiently, particularly in areas like memory and reasoning.

Sharper Focus And Better Memory

One of the most noticeable benefits of working out is how it improves everyday thinking. People who engage in regular strength training often report better focus, improved memory and stronger decision-making abilities.

It becomes easier to stay on track with tasks, manage distractions and process information more clearly. Over time, these small improvements can make a big difference in both personal and professional life.

What Happens Inside Your Brain

The real transformation happens beneath the surface. Exercise triggers the release of chemicals that support brain cells and strengthen the connections between them.

This helps improve neuroplasticity, which is the brain’s ability to adapt, learn and form new memories. It also supports white matter, the network that allows different parts of the brain to communicate effectively.

In simple terms, your brain becomes faster, more flexible and better at handling challenges.

A Natural Way To Reduce Brain Fog

Exercise also helps tackle inflammation in the body, which is often linked to brain fog and cognitive decline. Strength training supports anti-inflammatory processes that protect brain health over time.

This is why many people feel mentally clearer and more energized after a consistent workout routine.

You Do Not Need Intense Training

The best part is that you do not need extreme workouts to see benefits. Experts suggest that even two to three strength training sessions a week can support brain health.

Simple movements like squats, push-ups or resistance band exercises are enough to activate both your body and mind.

Today, the fitness scene has gained much traction among the Gen Z population. With more and more young people spending time in the gym and working out, it is important for fitness enthusiasts to remember the importance of leg stiffness and its impact on spine health. Leg stiffness has the potential to cause unnecessary strain on the spine and back during workouts.

From a neurosurgical point of view, we see that the spine is not just a mechanical support structure but a sensitive pathway through which the spinal cord and nerve roots run. Repeated micro-strain caused by poor flexibility can cause young patients to suffer early degenerative changes that may cause nerve irritation.

We also see that strengthening the abdominal muscles is essential in stabilizing the spine, thereby preventing disc injuries. Early intervention in minor complaints, such as back stiffness or nerve pain, is essential in preventing more serious problems that may need surgical intervention.

The Link Between Leg Stiffness And Spine Health

The muscles in your legs are important for your spine's health. The hamstring, hip flexor, and calf muscles are all significant players in the movement and positioning of your spine. Leg stiffness has the potential to cause unnecessary strain on the spine and back. Leg stiffness limits the movement and positioning of the hips and the spine.

When these muscle groups are tight, they alter pelvic alignment and increase load on the lumbar spine. Over time, this abnormal biomechanics can lead to disc stress and facet joint overload.

In neurosurgical practice, we often see young patients presenting with early symptoms of nerve compression where underlying muscle imbalance and stiffness play a contributory role.

Common Gym Mistakes That Increase The Risk

For young people, the main focus in the gym is on strength training, while flexibility and rest are ignored. This makes the condition of the legs stiffer. Another common error is improper posture while performing certain exercises in the gym. When the legs and hips are inflexible, proper posture is difficult, which causes pressure on the spine.

Sitting for a long time, studying, playing games on gadgets, etc., causes the hip flexors and the hamstring muscles in the legs to become stiffer, which causes pressure on the spine.

From a clinical standpoint, improper lifting techniques combined with stiffness can increase the risk of lumbar disc prolapse and nerve root irritation, conditions frequently encountered in spine clinics.

Tips to Prevent Spine Problems In The Gym

• Warm-ups: It is important to warm up the body before performing weightlifting exercises in the gym. It is recommended that the warm-up process take at least 5–10 minutes.

• Flexibility: It is important to include flexibility exercises in the gym routine, as they help in the proper movement of the legs, which in turn helps in preventing spine problems.

• Proper Posture: It is important to maintain proper posture while performing certain exercises in the gym, like squats, deadlifts, etc.

• Stretching After Workouts: This will help in the release of tension in the muscles and prevent the buildup of stiffness.

• Balance of Training and Recovery: This will help in maintaining the flexibility of the muscles and the spine.

Additionally, from a neurosurgical perspective, core strengthening plays a crucial role in stabilizing the spine and reducing the risk of disc-related injuries. Early attention to minor symptoms like back stiffness or radiating pain can prevent progression to more serious conditions requiring intervention.

Common Spine Problems To Avoid

Common spine problems to avoid during gym workouts include Herniated Disc, Sciatica, Spondylolisthesis, and Muscle Strain. These can occur from poor form, heavy lifting, or lack of warm-up.

In advanced cases, such conditions may lead to nerve compression requiring specialized evaluation and, rarely, surgical management. However, most of these issues are preventable with correct technique and conditioning.

Fitness enthusiasts in the Gen Z generation need to understand that it is very important to develop strength in the body while at the same time maintaining flexibility. The solution to the problem of a stiff leg is the foundation of protecting the spine and improving workout performance. This is achievable through the right warm-up, correct workout, and correct lifting.

Dr. Gaurav Batra is a Consultant - Neurosurgeon (Brain & Spine) at Max Hospital, Vaishali.