2006

1) Know your fats

(By Lisa Sarah John, Courtesy Bangalore Times, Jun 12, 2006)

Cholesterol is present in all animal fat like cream of milk, butter, ghee, cheese, paneer, egg yolk and poultry. It is also manufactured in the body from saturated fats like coconut, dalda, vanaspati. Consumption, in large quantities, will increase cholesterol levels in the blood. Cholesterol levels above 170 are in the danger zone and precautions have to be taken. This cholesterol will stick to the walls of the arteries and block blood vessels, leading to a heart attack.

Triglyceride is another fat in the blood and is the simplest form of storage fat. Excess oil and carbohydrates, as well as excess sugar or alcohol is converted to triglycerides. Triglycerides can be deposited on the walls of the arteries causing blocks and heart attacks. Levels above 150 are dangerous.

HDL, LDL & VLDL are fat carriers or vehicles used to transport cholesterol and triglycerides from the liver to the rest of the body. HDL is called good cholesterol because it carries cholesterol away from the heart towards the liver. The level should be above 40mg/dl.

If heart diseases run in the family, HDL levels may be even below 30 mg/dl. The only way to raise this is to walk regularly. Besides this, eat plenty of fibre like atta, ragi, bajra and jowar instead of rice and maida. Also, eat 1-2 cups of salad at lunch and dinner.

Pulses like channa, rajma, and sprouted moong are also healthy. This helps lower total cholesterol, triglycerides, LDL and VLDL. LDL is the transporter of cholesterol towards the heart and other parts of the body. Levels higher than 120-150 are dangerous. VLDL is the transporter of triglycerides from the liver to rest of the body. Its levels should not be above 40mg/dl.

When it comes to reducing lipid levels in the body, reduce total fat consumption. Stop eating milk cream, butter, ghee, paneer, cheese. Only skimmed milk and curd made from skimmed milk must be consumed. Avoid all nuts. Bakery items are a no-no as they contain saturated fats. Only 2-3 teaspoons of oil may be used for seasoning food. Avoid fried foods and sweets. For lowering triglyceride and VLDL, the total fat in the diet must be lowered. Strictly measured quantities of rice and rice items must be eaten. At dinner eat only phulkas. For breakfast eat ragi dosa, stuffed chapatti, and whole wheat bread as alternatives.

2) It’s sweet to say no

(By Lisa Sarah John, Courtesy Bangalore Times, Jun 19, 2006)

Today, children want to eat chocolates and sweets all the time, as well as eating large amounts of rice or bread. Childhood is a time of growth and the need for energy is great, so the craving for sugar and starch is understandable. However, a proper balance of nutrients — carbohydrate and protein — is important to ensure good growth and prevent unhealthy eating habits from setting in.

When the protein in a child’s diet is low, children get hungry as the stomach feels empty an hour or so after a meal. That’s when they start looking out for sweets to eat.

Here’s what carbohydrate and protein foods are: carbohydrates are sugars and starch. Sugar is found in fruits, regular sugar, jaggery, honey. Starch is found in all vegetables and cereals — rice, wheat, corn, ragi, jowar, bajra. Protein is found in dal, pulses, milk, milk products, egg, fish, chicken, meats, and nuts.

First check if your child is getting both carbohydrate and protein in his diet. Only a glass of milk for breakfast is not balanced. Milk with bread or cereal and milk or porridge with milk would be ideal. Similarly, milk and egg alone is not good, milk, egg and bread or a chappati would be ideal. Bread and jam or bread and butter alone is not good as the protein is missing. Egg or milk must go with it.

Idli and sambar or dosa are good as they are in themselves a rice and dal combination. However, a glass of milk can be drunk even with an idli or dosa for breakfast. Upma must be eaten with curd or a glass of milk.

Most often, lunch and dinner are also poorly balanced. Lime rice, tamarind rice or pulav and a subji or chappati and subji are only carbohydrate — the protein is missing. Often, dal and pulses are given very little importance. Dals and pulses like sambar, channa, rajma, moong palya or curry, are a good source of protein as well as vitamins and minerals. They must be eaten at least once or twice a day. So ensure that your child drinks 2-3 glasses of milk a day, with two servings of dal/pulses, and an egg a day.

Carbohydrate foods get digested one to two hours after being eaten. Protein foods take three to four hours. If there is protein in every meal, you will feel hungry closer to the next meal. That is the secret of resisting sweets between meals. Feel hungry? Try to eat a fruit and wait for your meal.

Stop bringing sweets home and teach your child to enjoy fruits. Veggies are a must and a fresh salad should be included at least once a day.

3) Win the battle of the bulge

(By Lisa Sarah John, Courtesy Bangalore Times, Jun 26, 2006)

Most people are confused about what to eat for dinner. Some starve all day and overeat at night. Others skip dinner completely, and some have only soup or salad. Many eat at 6 pm and some don’t eat at all. The big question: what’s healthy?

Today, when most of us sleep after 10 pm, eating dinner at 6 pm is a bad idea. You may be tempted to snack late at night or you may not be able to sleep out of hunger. The ideal time to eat is at least two hours before bedtime, so 8.30 pm is fine. In two hours, most of the carbohydrate (chappati, bread, rice or potato) in the food is digested.

It’s not good to skip dinner or any other meal completely as you will only eat larger quantities of food later. You may wake up hungry at 2 am and raid your fridge. That will cancel all the good work (dieting and exercise) you may have done all day.

Feeding your self good, nutritious meals and fruits and milk throughout the day is the biggest weapon in fighting the battle of the bulge. As you eat regularly, the cravings for sweet and fried snacks disappear in a week or two. The secret: never miss a meal. Eat even if you’re not hungry.

Just a soup or salad for dinner or lunch is wrong. In a day, a person requires calories or energy to function normally. However, it is not only calories that one needs, but also a balance of nutrients that come from a variety of food. The total amount of nutrients one requires for one day can never be properly used if eaten only at one or two meals. Every meal should contain carbohydrate or cereal like bread, chappati or rice along with protein like dal/pulse, milk/milk products or egg or non-veg. Vegetables and fruits can be added.

The ideal dinner would be phulkas, with dal/channa/rajma and a big bowl of salad with curd dressing. Whole-wheat toast and a thick vegetable soup with sprouts or channa or baked beans and a bowl of salad is also good. The sprouts must be cooked to make the protein available.

4) Don’t play with your health

(By Lisa Sarah John, Courtesy Bangalore Times, Jul 3, 2006)

Many sportspeople suffer from high uric acid levels. This often results in gout, causing a shooting pain in the wrist, elbow, shoulder, ankle or toes.

When protein-rich foods, especially non-vegetarian like fish, seafood, mutton, chicken and beef, are digested in the body, uric acid is formed as a breakdown product. This must be flushed out of the body with plenty of water. If not, urate crystals form and lodge themselves in the cartilages of the joints like the wrist, elbow and ankles, resulting in a shooting or pricking pain.

This occurs more frequently in summer or when the weather cools suddenly and a person’s normal water intake drops. When players go into a camp or a special training session where
workouts are very intense and they don’t drink enough water to compensate the heavy losses in sweat, this problem may arise. The first step is to drink more water than normal.

Also, Control the amount of non-vegetarian eaten. Try to eat it only once a day, preferably only at lunch so that there is time to digest it. Soups and gravies of meat or fish produce high levels of uric acid, so avoid them.

Sportsmen like athletes, tennis, badminton and cricket players seem quite susceptible to this. This could be due to increased perspiration during training and insufficient water consumption. Also, players in training camps eat large amounts of non-veg thinking it will build their body. But don’t eat more than two-three pieces of chicken or fish. When you do, the excess gets converted into fat and uric acid is also produced. You need protein but try and drink milk, eat egg white and dal along with the nonveg so that you eat lesser quantities of meat, fish and poultry.

Custard apple, chickoo, beans, peas, pulses like channa, rajma, moong sprouts and spinach must be avoided when there is pain. These foods contain high amount of purine, which gets converted into uric acid in the body. Sudden gout attacks of pain also occur after the consumption of too much alcohol.

Any kind of fasting and feasting can bring on an attack of pain. When fasting, tissues in your body are broken down and uric acid is formed from this. When you overeat, excess food is broken down uric acid concentrations rise and attacks of pain occur.

Men are more prone to this condition than women. The level in the blood should not be more than 6mg/dl for men and 5mg/dl for women. Some women develop this after menopause.

5) Candy gets converted to fat!

(By Lisa Sarah John, Courtesy Bangalore Times, Jul 10, 2006)

One big question that puzzles many of us is whether we should completely cut out sugar from our diet when trying to lose weight.

The first point is to check whether you have diabetes or not. All those over 35 years of age must have a blood test done once a year, to check blood and lipid levels (cholesterol and triglyceride, etc). This must be done after 12 hours of fasting.

If your fasting blood sugar is over 120, you could be borderline diabetic. In that case, you must eliminate refined sugar from the diet. Otherwise, irrespective of age, you don’t have to eliminate sugar in coffee, tea, milk, etc. to achieve weight loss.

Sugar, by itself, does not contain fat in its chemical composition. Also, when taken in a cup of coffee/tea, milk/curd does not register as fat in the body. In these cases, it enters the body as a carbohydrate, which gets immediately used as energy. Jam, jelly or honey, too, if consumed a couple of teaspoons at a time, converts to energy. But, one piece of candy, consumed by itself, contains the equivalent of 3-4 teaspoons of sugar. A soft drink (300 ml) contains seven teaspoons of sugar and this excess can be converted to fat.

Moreover, sweets, chocolates, ice-cream, pastries, cookies, cakes or desserts, are all sugar combined with ghee, cocoa butter, cream, starch and saturated fat. This is surely the most dangerous combination. You will put on weight overnight!

Finally, you may safely consume 3-4 teaspoons of sugar daily distributed over the whole day in 2-3 cups of milk, coffee, curd, etc. and still lose weight. But you can’t eat even a single piece of chocolate or mithai and lose fat properly and healthily from your body. A diabetic has the freedom to completely give up sugar or use sweeteners in coffee, tea, etc. However, many sweeteners on long term use can have harmful side effects, so try and avoid these.

Give up sweets completely, but go ahead and use sugar. I lost 25 kg by giving up all sweets for one year but used sugar in the milk that I drink everyday.

6) Forget fibre during typhoid

(By Lisa Sarah John, Courtesy Bangalore Times, Jul 17, 2006)

Everyone seems to be down with typhoid, and that’s because people are eating out so often these days. You can get typhoid by consuming contaminated water, milk or food, and it’s a salmonella infection resulting in a high fever for a short duration. In typhoid, the lining of the small intestines are infected and damaged. Sometimes, ulcers are formed, diarrhoea occurs and a stomach ache and fever are common. Absorption of food nutrients is hindered and due to this you will feel hungry, weak and complain of a headache. You want to eat, but feel nauseous and so the weakness continues.

When down with typhoid, stick with a high calorie intake with plenty of carbohydrate, and fruit juices with glucose, coconut water, barley water, porridge, rice kanjee, rava, etc. High protein is also required, so if there is no diarrhoea, milk, custard, fruit milkshake, thin dal, eggs, tender cooked fish and chicken may be eaten. Mashed potato and other wellcooked vegetables and fruits like banana must be given. As there is an intestinal inflammation all fibre is to be eliminated from the diet so that the intestine is not further irritated. Also, a bland diet is to be followed without any spice or masala.

The water balance may be affected because of the fever. So drink plenty of water and fluids. Fat intake has to be as low as possible so that the digestive process isn’t burdened and the fever is kept down. Too much fat in the food during fever causes it to rise. It may also cause vomiting, which leads to a further loss of nutrients and more weakness.

Foods to be strictly avoided are butter, ghee, chillies, spices and all fibre. Also, rich pastries, deep fried snacks, desserts and thick cream soups must be avoided. But as mentioned earlier, much care must be taken to get a high quantity of calories otherwise there is hair-loss and loss of muscle tone. Small frequent meals of juice, fruit, milk or lassi, bread and jam and light biscuits may be tried. Be patient when feeding a person recovering from typhoid. It may take half an hour to 45 minutes to complete one meal.

7) Wonderful salads and fruits

(By Lisa Sarah John, Courtesy Bangalore Times, Jul 24, 2006)

As refined and fast foods flood our markets, TV screens and bodies, natural fibre seems to disappear. Many parents say their children don’t eat fruits and salads, even vegetables. The question is, do we eat them ourselves? Are they are part of our own dining tables?

We are all busy, and what’s convenient, fast and tasty is what’s eaten. It’s easier to eat a chocolate or ready dessert after dinner than to wash and cut a fruit. At the end of a long working day, women are too tired to cut salad. Eating rice or pasta or calling for a pizza is easier than slogging over making rotis.

People should eat both cooked and raw food, whole fruits and salads, and natural foods like grains of wheat, ragi, jowar, bajra, corn, oats and whole beans like channa, rajma, moong, lobia, etc. They are packed with vitamins and minerals which help us to keep well and and fight off infections. Adults and children regularly eating these fall ill less often. Secondly, extra vitamins and minerals help body processes function efficiently, giving a feeling of high energy and fitness which no tonics can supply.

Finally, these foods are a source of natural fibre which protects against obesity and its connected problems, like hypertension, diabetes or heart disease. And they give relief from constipation and acidity.

How does fibre work? Fruits, salads, rotis, beans, fill us up so we eat less high calorie or fatty foods. Eating a salad helps cut down on overeating. Two phulkas are healthier than one cup of polished rice.

Also, every time you consume fibre, your body has to work hard to digest it. To digest whole wheat bread or phulkas, for instance, your body has to work harder, so it will burn stored fat, break down some cholesterol in your blood, or use up extra glucose, lowering your blood sugar levels. Your body hardly works to digest apple juice. But if you eat an apple, you chew for 10 minutes, a form of internal exercise. You feel fuller, fresher and feel lighter and healthier in the bargain.

8) Obesity and genetics

(By Lisa Sarah John, Courtesy Bangalore Times, Aug 7, 2006)

There is a marked difference between being a few kilogrammes overweight and having an obesity problem. The earlier obesity is identified the better. At five, a child’s average weight should be about 20 kgs and height about 110 cm. By 10, the weight should be about 25-30 kgs and height about 130 cm.

Signs of obesity start showing around 7-8 years. If by now, the child is already 30 kgs or more, then parents need to look into her/his diet and lifestyle seriously. Thinking that it is only puppy fat which will disappear is not the solution. Today, children come with obesity problems at age 10, 11 and 12, weighing 60-80 kgs. I also see teenagers who are 80-100 kgs.

Overweight is 5-10 kgs more than your ideal weight. Anything above this must be dealt with very seriously as early as possible. It’s observed that there is a very strong connection between gland-related problems like diabetes, thyroid and imbalances of reproductive hormones.

Also, adults who are 20-30 kgs overweight must consider the health and weight status of parents, grandparents and close relatives on both sides. Those with close relatives having diabetes might observe a tendency to be plump since childhood. They might also gain weight rapidly, half to one kg in 3-5 days of holiday eating.

Those with a thyroid or reproductive hormone imbalance will see the same weight gain or weight loss pattern and also find themselves feeling lethargic and sleepy, even during the day. What is the solution? Obese people must work much harder than others to be normal.

The first step is to start regular exercise. Hormones take no holidays, so take no holidays from exercise. Walk everyday for 20-30 minutes, twice a day if possible, and you can lose weight. Children can do 20-30 minutes daily for a start. But there is no way to balance hormones without regular walking. Walking is the best exercise because it can be done anywhere, even when you travel.

9) Cancer and after

(By Lisa Sarah John, Courtesy Bangalore Times, Aug 14, 2006)

The occurrence of cancer is more common today. It is affecting people of all age groups, young and old alike. There is no choice but to accept and treat it. The common procedure is to surgically remove the tumour and then to follow this up with radiation, chemotherapy, etc.

Following certain dietary principles can help you to feel more comfortable, strong and help you recover.

Drink plenty of water and liquids to cool the body as it is heated through chemotherapy and radiation. Two litres of water, buttermilk, lemon juice or tender coconut water are a must.

Eat sufficient protein to build tissue and that will keep your muscle tissue from wasting and breaking down. Dals and pulses must be eaten for both lunch and dinner. Two or three glasses of skimmed milk and curd are necessary. Two egg whites a day are a good source of high quality protein. A piece of chicken or fish may be eaten at lunchtime.

Eat 2-3 fresh fruits daily to get a good supply of vitamins B and C. This keeps your immunity up and increases your resistance to colds, coughs and the flu. Eat a salad of cucumber, carrots, onions, radish for lunch and dinner. Raw vegetables and fruits must be washed thoroughly to protect against diarrhoea. Cut down on total fat intake. Keep weight down to ideal as more fat in the body could develop the cancer again. Excess fat in the body serves as a medium for the cancer cells to grow in it.

Eat plenty of fibre in the form of whole cereals — atta, ragi, oats, pulses like channa, rajma, moong and salads and fruits.

Moderate but very regular exercise is a must. A 20-30 minute walk daily helps to give you a good blood circulation, builds your resistance to infection and helps to keep fat from accumulating in your body.

If you consume alcohol, limit consumption of alcoholic beverages to a maximum of 1-2 drinks, once or twice a week. However, it is best to avoid it completely.

Limit consumption of smoked foods, tandoori and barbecued items. Stop smoking and chewing of tobacco and paan. All this can be summed up in our Miracle Formula: Walk — 20-30 minutes, 6-7 times a week Water— 2-3 litres. Diet— Eat 3 regular balanced meals. Eat plenty of fibre. Restrict intake of fatty foods.

Avoid:

* Cream of milk, butter, cheese, ghee and paneer. * Nuts and coconut chutney. * All fried foods — mixture, muruku, chaat, chips, bonda, vada, poori, paratha, pickles and papad. * Cakes, pastries, cookies and puffs. * Ice cream, chocolates, mithai and desserts. * Red meats — mutton, beef and pork.

There is a marked difference between being a few kilo grammes overweight and having an obesity problem. The earlier obesity is identified the better. At five, a child’s average weight should be about 20 kgs and height about 110 cm. By 10, the weight should be about 25-30 kgs and height about 130 cm.

Signs of obesity start showing around 7-8 years. If by now, the child is already 30 kgs or more, then parents need to look into her/his diet and lifestyle seriously. Thinking that it is only puppy fat which will disappear is not the solution. Today, children come with obesity problems at age 10, 11 and 12, weighing 60-80 kgs. I also see teenagers who are 80-100 kgs.

Overweight is 5-10 kgs more than your ideal weight. Anything above this must be dealt with very seriously as early as possible. It’s observed that there is a very strong connection between gland-related problems like diabetes, thyroid and imbalances of reproductive hormones.

Also, adults who are 20-30 kgs overweight must consider the health and weight status of parents, grandparents and close relatives on both sides. Those with close relatives having diabetes might observe a tendency to be plump since childhood. They might also gain weight rapidly, half to one kg in 3-5 days of holiday eating.

Those with a thyroid or reproductive hormone imbalance will see the same weight gain or weight loss pattern and also find themselves feeling lethargic and sleepy, even during the day. What is the solution? Obese people must work much harder than others to be normal.

The first step is to start regular exercise. Hormones take no holidays, so take no holidays from exercise. Walk everyday for 20-30 minutes, twice a day if possible, and you can lose weight. Children can do 20-30 minutes daily for a start. But there is no way to balance hormones without regular walking. Walking is the best exercise because it can be done anywhere, even when you travel.

10) Lose weight? Get on the job

(By Lisa Sarah John, Courtesy Bangalore Times, Aug 21, 2006)

Asedentary job with long hours is dangerous from the health point of view. But one cannot say, “I have no time for exercise”. Most young people, throwing themselves into their careers and working from 9am to 10pm, seem to say that more often. This can be detrimental to health, leading to low metabolic rates and increasing waistlines.

Many in their late 20s and early 30s have also developed heart diseases, diabetes, hypertension, etc. and the contributing factors are long work hours, stress at work and unhealthy eating habits. Earlier, only 50 or 60 year olds complained of health problems, probably because they never worked such late hours.

It’s now time for people to choose between health and wealth. When you are thinking of weight control, you may see it as an hour of working out at a gym or an aerobics class which will take up two hours of your day —to get there, get back, shower and head to work. This is okay for those who have the time for it. But here’s some good news: you can find success from a system where you take a brisk walk for 20-30 minutes, daily. Doing this regularly can keep you fit and lead to steady weight loss. Go for a walk at any time of the day, before or even after a meal. So if you’re working till 10pm, take a 20-30 minute break at 6pm and go for a brisk walk around your building or at the nearest park and get back to work. Here’s what’s a must: Walk: 20-30 minutes Water: 2-3 litres Diet: eat regular, balanced meals, plenty of fibre and cut out the fatty food.

Another dangerous habit is eating late at night and sleeping soon after. There should be at least a gap of two hours between dinner and bedtime. In many cases where the husband comes home very late, the wife waits to eat with him. Instead, they should eat earlier to prevent obesity. Men must make an effort to come home earlier and break this pattern of eating late as it contributes to obesity. This habit, combined with work pressure can lead to high blood pressure, diabetes, raised cholesterol and triglyceride levels and finally, heart diseases.

11) ANDE KA FUNDA

(By Lisa Sarah John, Courtesy Bangalore Times, Sep 04, 2006)

Eggs are nutritious and contain a number of the nutrients that our body requires — protein, fat and also a number of vitamins like A, B2, B12, D and E. It also has minerals like iron, calcium and phosphorus.

It is safe for children from the age of one to 12 years to eat a whole egg every day. All the nutrients packed into it make it wholesome, and good for the growing years.

Adults may eat an egg two to three times a week. However, if one has a strong family history of high cholesterol levels, test your cholesterol and eat whole eggs only if it’s below 170mg. It’s the egg yolk which contains more than 100mg of cholesterol and must be completely avoided if blood levels contain above 200mg of cholesterol. After it has been brought down to 170-180mg then one whole egg may be eaten once a week. Nobody should eat two whole eggs at one time as the cholesterol consumed would be over 200mg at a time.

Egg white is absolutely safe for consumption. It may be eaten every day and is the best source of quality protein for our body. It is low in calories and at the same time filling, so it’s good for weight reduction diets. Even two to three egg whites may be eaten at one time.

A whole egg, medium sized, is about 80 calories whereas egg white has only 20-22 calories. Therefore, we usually recommend this for young athletes as well as elderly people who feel weak and who are on a weight reduction diet.

Each egg white has approximately 4.5 to 5.0 gm of protein. An ideal breakfast would include two to three slices of whole wheat bread with two egg whites, a sliced tomato and a glass of skimmed milk. This may be eaten up to five times a week and substituted with cereal and milk or idlies and sambar on the other two days.

Eggs shouldn’t be eaten raw, as raw egg white is not digested properly and is just be eliminated from the body and therefore will be wasted. The egg must be cooked properly to destroy salmonella, which can cause a serious digestive tract illness. Therefore, half-boiled eggs or a raw egg beaten with milk should be strictly avoided. We do not recommend the use of diet eggs for people with cholesterol as the yolk is still present and will provide the 100mg of cholesterol which is harmful to the heart. You just need to eat normal eggs, avoiding the yolk.

12) Ways to de-stress!

(By Lisa Sarah John, Courtesy Bangalore Times, Sep 11, 2006)

Hypertension is the most common chronic disease of industrialised societies, particularly among middle and old age groups. It’s a major contributor to the development of cardiovascular disease, strokes and renal failure. The higher the systolic or diastolic pressure the greater the risk of coronary heart disease.

Though the cause of essential hypertension is not known, certain factors are known to predispose us to it. They are heredity, obesity, and the stress and strain of modern life. Recently, a schoolboy of 17, weighing 120 kg, was diagnosed with high BP during his school medical check-up. This is common with young corporates working under high pressure. Since vegetarians tend to have lower blood pressure as compared to non-vegetarians, reducing one’s fat intake from 35 per cent of the total calories to 25 per cent shows a slight reduction in pressure.

Weight reduction in the obese, and sodium reduction in the diet along with regular walking for 30-40 minutes a day have the most significant effect in lowering BP. Besides this, stopping smoking and alcohol consumption also have a significant effect.

Weight
Every additional kilogram of flesh means that much extra area through which the blood has to be pumped and this further raises the BP. If you are overweight reducing your weight will definitely bring down your BP too. If your weight is normal make sure you maintain it, for if you gain weight your BP will go up too. A low calorie and low fat diet with plenty of fresh fruits and salad is the answer.
Salt intake
Many BP patients believe that if they are taking tablets for their BP they don’t have to restrict their salt intake. This is the reason for continued fluid retention, which makes one sluggish. You feel like lying down all the time and this slows down your metabolism, making you put on weight.

Reduce the salt in your food and avoid the following foods on a regular basis — papad, pickle, chutney, mixture, chips, chaat, bakery items (as they contain baking powder and sodas), and cold storage food (which has a lot of salt added as preservatives).

Fluids
With a free flow of urine, fluid restriction is not necessary. With water accumulation (edema) following heart failure, fluid intake should be regulated according to the urine output.

Potassium
Those on diuretic treatment for hypertension need to be conscious about potassium levels in the body. Potassium levels tend to drop due to losses which occur with the use of the diuretic and this must be consciously supplemented with the consumption of fruits rich in potassium like sweet lime, lemon and oranges daily.

Alcohol
Alcohol is a risk factor in those with high BP. If drinking daily, consumption should be restricted to two small drinks or one glass of beer or wine. Alcohol is high in calories and also causes fluid retention which can get the BP to shoot up.
Smoking
Smoking raises the risk of a BP patient getting a stroke. Those who stop smoking completely see a remarkable effect on their BP and reduce risk of complications like blockages in the arteries and having a heart attack or stroke.
Walking
Regular walking or aerobics are a must to improve circulation, reduce weight and relieve depression. Walking daily is a must — 20 minutes is needed to raise your heart rate, 30-45 minutes is ideal. However, if you are pressed for time, walk later the same day. Even late in the evening or half an hour after dinner is fine. Walking raises the metabolic rate twice in the day and has a tremendous effect in reducing BP, obesity and lipid and blood sugar levels. It also raises HDL levels which protect the heart.

13) The best of all food groups

 (By Lisa Sarah John, Courtesy Bangalore Times, Sep 25, 2006)

Minerals and vitamins not only supply energy or calories but they also help regulate several essential body processes. For example, calcium (a mineral) is important for proper muscle contractions so that our heart beats properly and limbs move easily. It also makes up our teeth and bones and it’s essential in our daily diet. Iron is necessary for oxygen to be properly carried from our lungs to all parts of the body. Iron from the food goes into the blood to make up haemoglobin (Hb), which is the oxygen lorry of the body. If your haemoglobin count is 10 instead of 12 it’s like saying you have only 10,000 lorries instead of 12,000. Your oxygen supply to the whole body is less and you will feel tired and weak. This is called iron deficiency or anaemia.

Sodium and potassium are also minerals essential for the water or fluid balance of the body. Similarly, vitamins also play an important role. If we have calcium in the diet but not have enough vitamin D, the calcium won’t be absorbed properly. If we have enough iron coming from our food but not enough vitamin B and C then the iron cannot be absorbed fully. Most minerals and vitamins are required in small amounts but are required everyday. They can be easily obtained from food if one eats a balanced diet everyday and never misses a meal.

Foods can be broadly classified into food groups such as fruits, vegetables, cereals, dals and pulses, milk and milk products, egg, fish, poultry, meat, nuts, oilseeds and fats. Eating foods from all these groups is the secret of getting a good supply of all mineral and vitamins. In addition, one must consume at least 2-3 cups of milk/curd daily as the quantity of calcium that the body requires can only be met from this source. There’s a common belief that milk is fattening, but only if had with the cream. Instead, use skimmed milk or curd made from skimmed milk.

Iron is another nutrient that is required in significant amounts. Non-veg food, eggs, dals, pulses and greens are a rich source of iron. If you eat only one or two meals a day then you will be anaemic. Most vegetarians believe that palak and other greens are their main source of iron. Latest research shows that though greens contain good amounts of iron they also contain an inhibitor which prevents the iron from getting absorbed into the human body. Therefore, better sources are whole wheat products like atta rotis and atta bread which are to be eaten daily at least in 1-2 meals, and dals or pulses to be eaten both at lunch and dinner.

14) Game on? Try carbs!

(By Lisa Sarah John, Courtesy Bangalore Times, Oct 30, 2006)

Today, research shows that besides your own natural talent for a sport, what you eat on a long-term basis as well as your meals three days before your event have a tremendous influence on your performance. It is very important for a cricketer, for instance, to concentrate on a high carbohydrate diet three days before a match. Over 60-70 per cent of the food should be carbohydrate (fruit, sugar, vegetable and cereals). This gets converted to glycogen and stored in the muscles, from where energy is taken for the spurts of high-intensity activity — bowling, batting, or fielding.

For this, make a conscious effort to cut down on fatty food three days prior to the event. Your ideal breakfast should be a glass of skimmed milk with bread and jam, or idli and sambar, or oats porridge or cereal and milk. A boiled egg is fine but sausages, bacon, etc should be avoided. Top up the breakfast with fruit or fruit juice.

Carry juice diluted with glucose or a sports drink, but avoid concentrated or aerated drinks during the event. Between events, snack often on fruit — banana, dates, raisins. Jelly and crackers are also fine. Chocolates and nuts are definite no-nos as they are high fat and feel heavy in the stomach. Lunch too, should be high in carbohydrate, moderate in protein but low in fat. Curd rice, dry roti with dal, vegetable sandwiches, macaroni and tomato sauce with a little cheese added are some options. But try to increase your rice or roti intake and avoid the non-veg or keep it to a minimum.

Many eat less during the event saying they don’t want to feel heavy. If you fill up on carbs, they are digested fast. Only fat takes 6-8 hours to get digested and feels heavy in the stomach. After the event too, do not neglect your eating. You should eat 100 gms of carbohydrate with 5-10 gms of protein within half an hour of an event. This can be a milk shake or lassi plus four slices of bread and jam or 5-6 idlis with sambar and some fruits. Later that night, dinner too must be a high carbohydrate meal that’s low on fat. Fruit and milk at bedtime is also a good way to load up on carbohydrates.

On a match day, eat thrice before the game — milk and fruit at 6am, breakfast at 8am, and juice and some glucose biscuits at 9.30. During play — have plenty of water, juice, a sports drink and fruits. Have a good lunch and continue to drink water or juice till the game is over. Follow this with eating thrice again. That is, milk at 6pm, sandwiches and fruit and a good carbohydrate dinner at 8pm and milk and fruit at bedtime.

15) Watch your glycemic index!

(By Lisa Sarah John, Courtesy Bangalore Times, Nov 13, 2006)

Recently, a man with diabetes mentioned that his fasting blood sugar was controlled, but despite very strict exercise and diet control, the post prandial sugar levels were not coming down. Diabetics must know that insulin in the body is lower in the mornings and at nights. Therefore you need to be very conscious of food choices at breakfast and dinner. For example, it is safer to eat whole grain cereals like whole wheat bread, dry rotis, ragi-based foods or oats at breakfast rather than rice items like idli, dosa, poha, etc which have a high glycemic index.

The glycemic index is an index classifying the glycemic response to carbohydrate rich foods. It’s a measurement of how quickly one’s blood sugar rises after eating a particular food. Blood sugar rises slowly after eating a chappati in contrast to a rice meal. So rice has a higher glycemic index than whole wheat flour. Rice’s glycemic index is 88, wholewheat flour index, 60. Similarly rava has a high glycemic index while ragi is lower. Among vegetables and fruits, potato has a very high GI of 88, mango is 55 and banana 53, while an orange is 43 and apple is 36. So diabetics may eat apples or oranges but should avoid bananas or mangoes.

Among dals and pulses, urad dal (black gram dal) has a GI of 46 and red gram dal is 32, while rajma is only 19 and channa 33.

Diabetics might feel it’s safer to eat rice-based idlis and dosas made of rice and urad dal. This is a misconception. What’s better is whole wheat bread, stuffed dry rotis, oats or ragi porridge, wheat or ragi puttu or ragi dosa. Rava upma, avalakki and semolina should be strictly avoided till sugar levels are below 150. These have a high glycemic index. While rice could be eaten at lunchtime, it’s preferable to have rice with some roti. At dinner, avoid rice and eat only dry rotis, whole wheat bread or dalia (broken wheat) cooked like rice.

Raw salads consisting of tomatoes, cucumber, onion, cabbage, radish, and capsicum are high in fibre and when added to meals can play a major role in preventing blood sugar from rising suddenly. Lemon juice, vinegar, salt, pepper and low fat curd may be used to season salads but avoid oily dressings. A salad consisting of only carrots or beetroot also has higher calorie level than other vegetables.

16) Chew on this: fruits are best

(By Lisa Sarah John, Courtesy Bangalore Times, Nov 20, 2006)

Some people never munch in-between meals. Many, however, need to snack frequently. The big question is whether there’s any food that is absolutely healthy to snack on. Fruits, actually, make the best snack. They are fresh and full of vitamins and minerals. Since they are eaten without much cutting, storing or cooking, there isn’t much nutrient loss. So besides filling your stomach and giving you energy, you get a quick dose of vitamins, minerals, some fluid from the juices and also some fibre. So it not only fills you up, but also refreshes you.

Fruits are low in energy or calories when compared to other foods. An average sized apple, pear, guava or orange gives you 50-60 calories. Whereas one medium samosa, vada, etc. are 150-200 calories, 10 pieces of chips are 110 calories, 2 butter cookies are 150 calories, a piece of Indian sweet or a pastry is 150-200 calories.

Besides this, fruits are made up of two sugars — glucose and fructose. These are also called monosaccharides. Mono meaning one, single step of breakdown or digestion, and it enters the blood steam as energy in 20-30 minutes. Therefore, this is the best choice whenever one feels hungry, tired, giddy, faint or has low blood sugar.

If we pop a sweet or chocolate into our mouth instead of a fruit, the sugar in these (sucrose) is a disaccharide, and takes two steps of digestion and 45 minutes to give energy. Also, these contain fat which will make your weight go up as well as make you feel sluggish. Some prefer biscuits, bread or snacks. These mainly contain starch, a polysaccharide, which uses many steps of breakdown, and takes 1-2 hours before energy is made available. This is dangerous because you keep eating biscuit after biscuit, slice after slice but don’t feel satisfied. Sometimes you come home from work very hungry, thinking you want to eat five chapattis instead of two or three. If you eat a fruit before you start your meal, you find it gives energy fast and cuts down hunger and your are able to stick to two or three chapattis.
   

Have a fruit everyday at about 11am or 12 noon and at 6pm or 7pm when you get back from work.
   

Another good snack is milk, curd, lassi or buttermilk (all skimmed or cream removed, of course). Milk contains a natural sugar called lactose, which is a disaccharide. Milk/buttermilk is both filling and refreshing, so if just a fruit is not enough have buttermilk, cold coffee or milkshake along with it. It is preferable to make this at home where the milk is skimmed. Milkshakes and lassi from restaurants and cafes usually have additional cream or ice cream added to it, which is fattening. Regular coffee or tea too may be had. They are healthier than eating oily snacks or sweets.
   

Late at night too, a fruit or skimmed milk are best choices. Avoid eating bread and biscuits late at night as they cause the weight to go up easily.

17) Stay fit as you grow older

(By Lisa Sarah John, Courtesy Bangalore Times, Nov 27, 2006)

Winter is setting in and it’s a tough time for older folks. It is cold and dark in the mornings, muscles and bones feel stiff and painful and it’s not unusual to feel reluctant to get out for your morning walk. This sets off a vicious cycle of decrease in appetite and a reduced desire to drink water. Finally, you are left feeling weak, tired, dehydrated, constipated and acidic.

But it’s mind over matter. Tell yourself that if you can brush your teeth and bathe in winter you can even walk, drink plenty of water and eat well for the next few months. First, make sure you go for a walk. As far as possible try to make it happen in the mornings, but if this does not work, it can be anytime, but don’t go to bed without having done your walk for the day. A walk is the key to making you feel warmed up, muscles relaxed, with a feeling of well-being and strength. Your appetite increases, you feel thirsty and your body cycle moves smoothly.

The first principle is to never skip a meal and never let a meal consist of just fruits, soups, milk or boiled veggies. Every meal must be a balance of carbohydrates like bread, rice, chapati etc, and proteins like milk, curd, dal, egg, non-veg etc.

Elderly people need more protein to protect their bodies against muscle and tissue breakdown which happens with aging. This can be got from 2-3 cups of skimmed milk or curds daily. Also, half a cup dal or sambar or pulses are essential for lunch and dinner. A piece of fish or chicken at lunch and 1-2 egg whites daily with breakfast or in a sandwich at tea or in any meal, is an excellent source of protein.

Calcium is important, as there is increased bone loss after the age of 50 and therefore 2-3 glasses milk or curds are a must for all elderly people. Skimmed milk is ideal as it is not fattening. A good supply of iron is got from eating balanced meals, therefore meals must never be skipped. Those with iron deficiency can change from rice to a wheat diet, which improves the iron levels remarkably, as do pulses. Also, eating fresh salad at lunch and dinner increases the vitamin B and C levels, which help in higher iron absorption.

Vitamin B, C and D are required in higher amounts as the absorption of these decreases with age. They can be obtained by eating fruit at 11 am and 6 pm daily. Choose apple, pear, guava, pomegranate, oranges, and musambi as they are safe for diabetics, too, and contain plenty of fibre which will helps relieve constipation. Finally, walking 20-30 minutes everyday will keep you fighting fit.

18) Just knock it off!

(By Lisa Sarah John, Courtesy Bangalore Times, Dec 04, 2006)

There’s a miracle formula for weight reduction — it’s made up of three words — walk, water, and diet. But ensure you do all three together. The biggest cause for failure to lose weight is when people do one but not the others.

Those who enthusiastically work out and still eat everything might lose weight because of their heavy workout. Another group, on fruit-only diets, or boiled vegetables, cabbage soups, etc, might not exercise. They are too busy, or feel too weak to exercise. And finally 95 per cent of them don’t drink enough water. These groups might initially see some weight loss, but soon that will stop and they get frustrated.

There is only one way to lose weight — to walk 20-30 minutes daily, drink 2-3 litres of water and eat a balanced diet with plenty of fibre with no fatty food.

Walking is one of the best exercises as it uses 90 per cent of the body’s muscles at one time. It can be done by everyone. If you enjoy aerobics, swimming, jogging, you must do it continuously for 20-30 minutes. In a gym workout, ensure you are on the treadmill for about 20 minutes continuously. It is not enough to exercise only 3-4 times a week, 6-7 days a week is a must.

Don’t walk regularly and suddenly stop; this is the worst thing to do. A regular walker builds up a higher metabolic rate, burning more calories. A break in the walking routine causes the metabolic rate to go down again and it can take another couple of months to rise again. Do a shorter walk, if necessary, but don’t miss it.

Also, drink 2-3 litres of water daily. If you are dehydrated, your muscle movements are slow, so you burn less calories. Also, ketone is formed when fat breaks down which must be flushed out of the body, so water is essential. Finally, your diet: you must eat all three meals and every meal must be a balance of carbohydrates and proteins. Eat plenty of fibre which helps raise metabolism and burn fat.

19) Lower those triglycerides

(By Lisa Sarah John, Courtesy Bangalore Times, Dec 18, 2006)

Triglyceride is the commonest form of fat present in foodstuffs as well as in stored fat in our body. Triglyceride is formed when extra glucose enters the blood, and insulin converts it to triglyceride and sends it to the fat cells to store. When this storage mechanism breaks down, the triglyceride remains in the blood.

Factors contributing to raised triglycerides:

• Family history: Those with a history of heart disease in the family, who have had a heart attack, or have high blood lipid levels should regularly check their blood lipid profile. You may be thin and active, yet have high triglyceride levels.
• Severe stress: Long working hours, family and financial problems etc, can cause triglyceride levels to shoot up without warning.

• Obesity: Overweight people are at risk, as well as those already suffering from high BP, diabetes or gout.

• Lifestyle: Those who have had a very active childhood, done strenuous sports and suddenly become sedentary, have chances of seeing triglyceride levels rising.

• Smoking: Heavy smokers may find the lipid picture drastically changing for the worse.

• Diet: Finally, your diet and eating habits have a profound effect on your body and can be the one biggest contributing factor to changing or raising your triglycerides.

Everything we consume — fats, carbohydrates, proteins and alcohol are all digested to form glucose. One teaspoon of sugar or starch gives us 20 calories of glucose, while a teaspoon of fat gives 45 calories of glucose.

All excess glucose, no matter what its origin, converts to triglycerides. With excesses coming into the body, the triglycerides rise in the blood, and block the blood vessels and a heart attack could be around the corner. The answer is moderation. You have to stop bingeing on food or drinks of any kind. Too may sweets or fruits can do the same. The only things you can binge on are salads and water! Salads lower your triglycerides through fibre.

2007

11) Oh that bloated feeling!

(By Lisa Sarah John, Courtesy Bangalore Times, May 14, 2007)

There is a normal water-mineral balance in the human body. However various factors have the capacity to change this balance and then water — which would normally be eliminated via urine, perspiration etc — gets held back in the body. This causes great discomfort and can severely disrupt our normal routine.

Salt and alcohol impact the balance and so do large amounts of sugar or sweets, fatty foods and fried snacks. Even too much starch at one time can make you suddenly feel bloated.

When these foods are consumed in more than normal quantities the blood concentration rises and the body receives a message to hold back water to dilute the blood and bring it back to normal. There can be weight gains of1 kg overnight in those who have eaten a huge Chinese meal (loaded with salts) or those who've binged on alcohol the night before.

The second factor is your own body make up. Some people are born with a constitution that reacts more to some foods and have a greater tendency to water retention. If so, you need to be aware of this and try to be more conscious of what you are eating and drinking.

So how does water retention affects us? First of all, you tend to feel puffy in your feet, fingers, face and eyes. You may feel sleepy and as if you are having a hangover. This will first affect your concentration at work or at a game. Your knees and back may retain more water and start hurting. Some have the water collecting in the head leading to depression, weepiness, headaches or migrane. There are even people who lose coordination, drop a glass, tip a bottle over, fall down easily or miss a step, in this condition.

The worst effect is on those trying to lose weight and are monitoring their weight regularly. Suddenly you see the scale shooting up when you are working very hard at weight loss and you get so demotivated. Next time, check what you ate or drank the night before.

Female hormones controlling our menstrual cycle also cause bloating. Irrespective of anything you do or consume there could be a bloating of 1/2 to 3kgs at the time of ovulation when the egg is released, usually mid-cycle. This may subside after a week and again rise close to the date of your period. In some cases it lasts for the whole 15 day period, from ovulation upto the period.
 

All the above symptoms and also severe breast pain and back pain may occur during this time. Don't lose heart for your weight will normalise after the period. Don't get upset about the weight, and be careful not to binge on any of the above mentioned foods. Keep your water intake upto 2-3 litres. You may feel too heavy to exercise but push yourself to go as the sweating helps to relieve the bloating.

12) Dietary guidelines for jaundice

(By Lisa Sarah John, Courtesy Bangalore Times, Monday May 21, 2007)
 

The summer season is a time when many are prone to attacks of jaundice caused by Hepatitis A virus. This type of jaundice is usually caused due to contaminated food or water. Hence one should be careful since the food gets spoiled easily in the summer.

Jaundice damages the liver cells. The liver is the organ where fat is metabolised and if it is damaged then fat in the diet must be restricted. All fatty foods should be restricted for at least 90 days. Cream of milk, ice cream, ghee, cheese, butter, desserts, nuts, Indian sweets and fried foods must be avoided. Marie biscuits, arrowroot and glucose biscuits may be eaten but all rich cookies are to be avoided. Coconut chutney and curries as well as all non-veg are best avoided.

Liver also consists of breakdown products of protein metabolism, which are metabolised, so we have to be careful about protein intake too. However for the damaged liver cells to heal and be regenerated, protein food is necessary. Hence a moderate intake of protein is recommended.

This can be skimmed milk about 3-4 cups per day in the form of milk, curd or made into porridge or custard.

Thin dal may be given which is not spicy. This can be cooked with various vegetables to give variety and flavour. All beans and peas must be avoided at this time. If tolerated, soft cooked eggs like scrambled eggs and pouched eggs may be given.

The main focus at this time is to give plenty of carbohydrates so that energy levels are kept high. Large quantities cannot be tolerated so frequent intake of smaller meals besides breakfast, lunch and dinner is advised. You can eat dry fruits, jelly and lassi.

Idli , is probably the only south Indian item safe to eat at this time. Rice, bread, soft chapati or wheat porridge may be had at meals. Plenty of soft cooked vegetables like potato and cauliflower must also be eaten, as there is a special need for vitamin B and C for recovery.

If there is a lot for vomiting the sodium and potassium may be lost. Salt can be used as needed. Banana and sweet lime are good sources of potassium. Vegetable soups and juices can be consumed. Alcohol should be strictly avoided.

13) Why you need more water in summer

(By Lisa Sarah John, Courtesy Bangalore Times, May 28, 2007)

THOUGH we make lifestyle changes in the peak of summer like wearing cool clothes and keeping the fans running we forget to increase our water intake. The body adapts to the heat by perspiring excessively but we don't compensate this with sufficient water. We may drink extra cool drinks or juices but these are no substitutes for plain, unadulterated water.

During this season many suffer from constipation which can even become complicated and result in bleeding and pain. You have to drink 2.5 to 3 litres of water daily. This may seem impossible but it only requires a little planning. Drink half a litre of lukewarm water on rising. From breakfast time up to lunch time keep a one litre bottle with you and see to it that you have emptied that bottle before you eat your lunch. From lunchtime to 6pm in the evening you should drink another one litre. From 6pm to bed time try to finish another half litre and you would have consumed 3 litres. If you are still constipated your personal water requirement may be more, in which case add 2-3 glasses to your intake.

As for food, try to eat whole grain cereals like whole wheat (atta) chappatis and ragi instead of rice at all meals. This increases the fibre in the diet. The dietary factor most affecting bowel movement is the fibre content or roughage in the diet. Whole pulses like channa, rajma, moong add additional fibre — more so if they are sprouted.

Also, increase your vegetable intake. Make sure you are eating a sabji or palya for lunch, plus a salad and at dinner a large bowl of raw salad is a must. Increase your fruit intake to 2-3 fruits per day. You can have a banana or orange at 11 am. An apple, pear or guava at 6.30 pm and some papaya after dinner. Always try to eat a whole fruit instead of juice and whole vegetables instead of soup, so that you get the fibre. Avoid very rich and oily food. Reduce your salt intake, by cutting down on fried salty snacks like papad, chips, namkeen and mixture.

Heavy consumption of alcohol and aerated drinks must be avoided. These create fluid retention and worsen constipation. When you drink a bottle of cola you are consuming 150 cals or 7 tsp of sugar. Three large pegs of whisky is 450 cals or 22 teaspoons of sugar. When such large amounts of sugar or salt enter the blood, the concentration rises. This causes water that is to be excreted to be retained so that the blood concentration can be brought down to normal. This will result in constipation.

Also important is exercise. You must have a regular 20-30 minutes walk planned in your daily schedule. This exercise also helps to regularise the bowel movement.

14) Eat smart while at college

(Courtesy Bangalore Times, Jun 11, 2007)

MOST college students rush out in the morning without breakfast. By 9- 10 am they start feeling weak and giddy and during the mid morning break they indulge in an aerated drink, coffee or packet of chips. Lunch is a vada or samosa and then they come home and eat a huge meal at 4- 5 pm. This spoils their appetite at dinner, which ends up as a snack, glass of milk or fruits. This is certainly not the diet you should be following at a time when studies are your focus. You need food not only to nourish your body but also to keep your mind healthy and active.

The above diet will also result in hair loss because you are not getting enough protein, vitamins and minerals during the day from properly balanced meals. You may also develop pimples due to too much oil from the chips and snacks. Even in a rush you can quickly eat a bowl of cornflakes with milk, or bread with egg, or even two slices of bread with a glass of milk. If time permits idli, dosa, or chapati and a glass of milk are good alternatives. Ragi or oats porridge with milk or buttermilk are also quick and easy to consume.

Also, carry a fruit like an apple or guava to munch at break time and avoid cola and chips. Colas are very bad for your weight, teeth and chips. They add to your weight and are responsible for pimples.

However difficult it may be, lunch must be carried from home. Chapati with dal or pulses (chole, sprouts sabji or rajma) and a vegetable sabji like beans, ladies finger, cauliflower are a must. Non-veg too can be eaten at lunch along with the above mentioned. One more alternative is to carry two chapatis — one rolled with vegetable and one with an egg, non-veg or some paneer. Just a snack or sandwich is not advisable at all. Lunch has to be a proper balanced meal and is to be eaten at 12 or 1pm, not at 4pm. If eating lunch from a canteen please try to choose the above food and keep the carbohydrate, protein and vegetable balance. At tea time, 4 pm, you may eat a snack or sandwich and also a glass of milk in any form must be consumed. At your age, 2-3 glasses of milk is absolutely essential for your bones, teeth and hair.

Have a fruit at 6 pm. Do not skip dinner or just have a soup, salad or glass of milk. Dinner must be a balanced meal like roti, dal, sabji and curd. A big bowl of salad is a must at dinner to keep you fresh and healthy and give you a good complexion.

Last but not the least you need 2-3 litres of water daily. Take 2 glasses before you leave the house. Carry 1 litre of water to drink through the day at college. Back home finish another litre before bedtime. Plenty of water, fruits and salad is the secret to a glowing complexion

15) Those painful stones

(By Lisa Sarah John, Courtesy Bangalore Times, Jun 18, 2007)