A consultation lasts an hour or so. The weeks in between are where most of life happens: what you eat, how you sleep, how much you move and how you handle worry. None of this replaces treatment, but small, steady habits can make a real difference to how you feel. Here is practical, evidence-based advice suited to daily life in Bangladesh.
Sleep: the habit that supports all the others
Adults generally need seven or more hours of sleep a night, according to the US Centers for Disease Control and Prevention. Poor sleep affects mood, appetite and concentration, and can make other symptoms feel worse.
A few changes help:
- Go to bed and get up at roughly the same time every day, including weekends and holidays.
- Keep the bedroom as quiet, dark and cool as you can. A fan, a mosquito net and thick curtains are simple, affordable helps.
- Put the phone away at least 30 minutes before sleep.
- Avoid a heavy meal just before bed, and limit tea, coffee and other caffeinated drinks in the afternoon and evening.
If you snore loudly, wake up gasping, or feel exhausted however long you sleep, mention it to your physician. These can be signs of a problem that needs proper assessment.
Eating well, the Bangladeshi way
A traditional Bangladeshi meal already has many of the right parts: rice, dal, vegetables and fish. The usual question is balance and portion size, not giving up familiar food.
Build a balanced plate
A simple rule of thumb used in many nutrition guides is to fill about half your plate with vegetables, a quarter with rice or roti, and a quarter with protein such as fish, dal, eggs or chicken. For many people that means less rice and more shak, lau, potol, begun or other seasonal vegetables.
- Rice: it is a good source of energy, but large portions add up quickly, especially if you are not very active.
- Dal: lentils provide protein and fibre at a low cost.
- Fish: a valuable source of protein. Small fish eaten whole, bones and all, also provide calcium.
- Fruit and vegetables: the World Health Organization (WHO) recommends at least 400 grams of fruit and vegetables a day for adults. Seasonal fruit such as guava, papaya, banana or mango is a better snack than biscuits or sweets.
Go easy on salt and sugar
WHO advises adults to eat less than 5 grams of salt a day. Much of it comes from cooking, pickles, chanachur and packaged snacks, and from extra salt at the table. Cut back slowly; taste adapts within a few weeks. When you do use salt, WHO recommends that it be iodised.
For sugar, WHO recommends keeping free sugars below 10 per cent of total daily energy, which for an adult eating about 2,000 calories a day is around 50 grams, or about 12 level teaspoons. Going below 5 per cent may bring additional benefits. Free sugars include sugar stirred into cha and the sugar in sweets, soft drinks, packaged juices and honey.
WHO also advises limiting total fat to 30 per cent or less of energy intake, and saturated fat to no more than 10 per cent. In practice this means going lighter on deep-fried snacks and ghee, and measuring cooking oil with a spoon rather than pouring from the bottle.
Water: drink enough, and drink safely
Hydration in the heat
Bangladesh's hot, humid months make dehydration easy, especially for people who work outdoors, older people and anyone with heart, lung or kidney problems. WHO's advice for hot weather is to drink water regularly through the day, around one cup an hour and at least 2 to 3 litres a day. Do not wait until you feel thirsty. Check on elderly relatives and neighbours who live alone.
One caution: if your doctor has told you to limit fluids because of a heart or kidney condition, follow that advice and ask how it applies in hot weather.
Heatstroke is a medical emergency. Someone who becomes confused, collapses or has a very high body temperature after heat exposure needs urgent medical help.
Safe drinking water
Boil water if you are unsure of its source, or use a reliable filter, and store it in a clean, covered container.
Arsenic in groundwater is a particular concern in Bangladesh. WHO lists Bangladesh among the countries where inorganic arsenic occurs naturally at high levels in groundwater, and long-term exposure can cause skin lesions, several cancers, diabetes and heart disease. Boiling does not remove arsenic. If your household uses a tube well, find out whether it has been tested. Many wells have been tested and marked with paint, commonly red for unsafe and green for safe. If yours has not been tested, ask your local public health engineering office or union parishad about testing.
Keep moving
WHO recommends that adults do 150 to 300 minutes of moderate-intensity physical activity a week, or 75 to 150 minutes of vigorous activity, plus muscle-strengthening activity on at least two days a week. Older adults are advised to add activities that improve balance and strength on three or more days a week to help prevent falls.
That is only 30 minutes on five days. Moderate activity means you are breathing faster but can still talk. Some ideas:
- A brisk walk in the early morning or after the evening meal, when it is cooler.
- Walking or cycling for short trips instead of taking a rickshaw or CNG.
- Simple strength exercises at home, such as standing up from a chair repeatedly or lifting filled water bottles.
If you have a heart condition, joint problems or have been inactive for a long time, ask your physician which kind of exercise is suitable before you start.
Stress and mental wellbeing
Worry about money, family, work or health is part of life, but long-lasting stress affects sleep, appetite and the body as a whole. Small routines help: a regular walk, time with people you trust, prayer or quiet reflection, and less time on news and social media.
Talking about how you feel is not a weakness. If low mood, anxiety or loss of interest lasts for more than a couple of weeks, or starts to affect your work and relationships, tell your physician. If you ever have thoughts of harming yourself, seek help immediately from a doctor, a hospital or someone you trust.
Tobacco in every form
In Bangladesh this includes not only cigarettes and bidi but also smokeless tobacco: jarda and sada pata in paan, gul rubbed on the gums, and khaini. According to the 2017 Global Adult Tobacco Survey, more than one in five adults in Bangladesh used smokeless tobacco.
Smokeless tobacco is not a safe alternative to smoking. It is linked to cancers of the mouth and to gum disease. Gul is sometimes used like a tooth powder, and some users do not think of it as tobacco at all. If you use any of these products and want to stop, say so at your next appointment. Quitting is hard, and support makes it more likely to succeed.
Keep track, and keep your check-ups
Keep a simple health diary
A notebook or a note on your phone can be very useful between consultations. Write down the date and a few words about:
- Your main symptoms and how strong they were, perhaps on a scale of 1 to 10.
- Sleep, appetite, energy and mood.
- Anything that seemed to make things better or worse, such as a food, the weather or a stressful day.
- Any new medicine, supplement or change in routine.
- Blood pressure or blood sugar readings, if you check them at home.
At your next visit, the diary gives a clearer picture than memory alone.
Regular check-ups
Some important conditions cause no symptoms for a long time. WHO notes that most people with high blood pressure have no symptoms, and that the only way to detect it is to have it measured. Ask a health professional to check your blood pressure regularly, and ask your doctor how often you should have your blood sugar tested, especially if diabetes runs in your family, you are overweight, or you had high blood sugar during a pregnancy.
If you already have a diagnosed condition, keep taking your prescribed medicines and keep your follow-up appointments with the doctor managing it.
Healthy habits work best as a partnership. Bring your questions, your diary and your honest account of what has and has not changed, and plan the next steps together with your physician.
Cover photo: Photo by Abhishek Sanwa Limbu on Unsplash
