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Want to live longer? Tame that temper

By |October 6th, 2017|General|

“Anger is an acid that can do more harm to the vessel in which it is stored than to anything on which it is poured,” wrote Mark Twain.

That anger is destructive to our health and well-being is known to most of us. Yet all of us have a difficult time managing our anger. It’s not for the lack of trying, but because anger is a secondary emotion that we use to disguise our less palatable primary emotions. Sorrow, hurt, embarrassment, fear, shame, regret, apprehension, guilt and embarrassment are all cloaked in the far more acceptable “finger pointing” emotion of anger. After all, it is much easier to be angry than to experience and “be with” these other powerful negative emotions.

The health consequences of this behavioural adaptation are damaging and it’s time we learnt to manage our anger better. Medical research has proven time and time again that anger is toxic for our health and well-being. Aashish Contractor, head of department, rehabilitation and sports medicine at Sir HN Reliance Foundation Hospital, Mumbai, says, “Anger and anxiety can trigger heart disease and other chronic diseases as well.” There’s also physiological evidence to suggest that mismanaged anger plays a prominent role in the development of chronic ailments like heart disease and cancer. Studies show that IL-6 (Interleukin 6), a prominent immune molecule associated with inflammation and chronic disease, is released into the blood stream when we get angry. Studies also show that increased IL-6 levels in the blood correlate with the development of heart disease and with early death due to chronic diseases. And research shows that IL-6 is also associated with increased levels of fibrinogen and C-reactive protein (inflammation mediators), both of which regulate the build-up of plaque in the arteries. Taken together all this research shows that IL-6 is a player in heart and chronic disease development and hence we want as little of it around as possible on a regular basis but unfortunately it rises when we get angry.

Another study on IL-6 published in December 2016 in the International Journal Of Behavioral Medicine found that in post-menopausal women, a surge of anger resulted in an immediate spike in IL-6 levels. Interestingly, the study revealed that when these women had social support, the spike in IL-6 post the anger-causing stimulus reduced.

The takeaway from this research is that if we haven’t yet learnt to manage our anger, a way to protect ourselves from its long-term damaging effects is to form deeper friendships, strengthen existing relationships and learn to lean on them in times of stress and challenge. Longevity coach David Buettner makes the case for social support in his book, The Blue Zones: Lessons For Living Longer From the People Who’ve Lived the Longest, as well. From his research, he learnt that people who live long disease-free lives have a strong social network.

Getting a counsellor or a life coach can be helpful to manage anger. Juhi Parmar, clinical consultant psychologist, KEM Hospital, Pune, explains, “It is our interpretation of events that hurt us (and produces anger), not the events themselves. Counselling helps identify our values. Our values like honesty, control or justice are the lens with which we judge the events in our world. We can then work on channelizing unhelpful reactions, since we know why we feel a certain way.” We live in a society where we are taught not to express our emotions. However the health consequences of this behavioural adaptation are so damaging that it’s time we learnt to manage our anger better.

The key lies in expanding our self-awareness, be it through counselling, life coaching or otherwise. What helps is to know what we value: integrity, trust, respect, punctuality, beauty, hard work, freedom, etc. Values are not about right or wrong, but what is important to us as unique individuals. Once we know what we value, we can recognize when that value is not being upheld. We then find a way to regain the value in an alternative way.

What also helps is to choose our battles. And we can learn to forgive, like our mothers tell us to.

Vaccination isn’t just for babies

By |September 28th, 2016|General|

Vaccines taken during childhood don’t provide lifetime protection against diseases. That is why adult vaccination is important

On 14 May 1796, English physician Edward Jenner did a ground-breaking experiment. He injected a child with a biological preparation from a cowpox lesion to see if it would confer immunity against small pox. The child did not get small pox on subsequent exposure to the disease. Jenner concluded, after more such similar experiments, that he had developed a new method to prevent small pox. He called this method of preventing disease “vaccination”.

Vaccines are biological preparations that contain killed or weakened forms of disease-causing microbes or their proteins. Once a person is inoculated with a vaccine, the body mounts an immune response as if it were exposed to the disease-causing microbe. This results in the body producing antibodies and immune cells that then provide immunity to that disease.

There are more than 22 vaccines available today, and many of them are given in infancy to provide protection against diseases through childhood. Public health data, however, shows that some of these vaccines do not protect against diseases throughout a person’s lifetime.

This perhaps explains why diseases that could be prevented during childhood with the help of vaccination are emerging in adulthood. According to a 2011 newsletter of the National Centre for Disease Control (NCDC), there have been outbreaks of measles, mumps and rubella on college campuses and at workplaces in both developed and developing countries.

While data on the number of Indian adults suffering from, and succumbing to, vaccine-preventable diseases isn’t available, Vasant Nagvekar, infectious disease specialist at the Lilavati Hospital and Research Centre in Mumbai, writes in an email that vaccine-preventable diseases like influenza and pneumonia kill 100 times more adults than children in India every year. This happens despite the fact that adult vaccines for these diseases are available. These vaccines can significantly reduce the number of people suffering and dying from diseases like influenza, pneumonia, tetanus and hepatitis.

The rate of adult vaccination, however, is low in India. Atul Biniwale, a physician in Pune, cites two reasons: “It is assumed that in India, adults are exposed to diseases in their environment and thus they build immunity naturally. This assumption doesn’t hold true. Second, people are generally hesitant to vaccinate their children or themselves. They are reluctant to engage in preventive health measures. This could be owing to economic reasons, or the fact that many doctors themselves aren’t aware of the value of adult vaccines and so don’t recommend them to their patients.”

Don’t give in to the myth, however, that a person will be protected against most diseases if he or she is in good health and maintains good hygiene. Though good hygiene does protect against some infections, others can spread regardless of how clean one is.

The World Health Organization’s scientific advisory group of experts’ global programme for vaccines and immunization recommends adult immunization as part of routine immunization services. Both Dr Biniwale and Dr Nagvekar agree. “Adult vaccinations must become a fundamental part of routine patient care,” says Dr Nagvekar.

Some people might have concerns about safety and adverse allergic reactions. A booklet on vaccine safety by the US’ Centers for Disease Control and Prevention (CDC), says, that a life-threatening allergic reaction to vaccines occurs in one in a million cases.

Earlier this year, the CDC published a chart of recommended adult immunization, depending on age. Swati Bhave, senior consultant in adolescent paediatrics at the Jehangir Hospital in Pune, and Dr Nagvekar have their own list (see “Recommended vaccines for adults”). Do consult your physician, however, about the vaccines that would be suitable for you.

Sujata Kelkar Shetty, PhD, is a wellness consultant, life coach, and a clinical scientist trained at the National Institutes of Health in Bethesda, US.

Recommended vaccines for adults

For those above 21

Influenza: Influenza, or flu, is the most common illness experienced by adults. According to the World Health Organization, the flu kills 300,000-500,000 people worldwide every year. Most flu vaccines offer immunity against three of the most prevalent flu strains circulating in a flu season. An annual vaccine is the best way to reduce the chances of getting flu.

Tetanus: Since 1983, all pregnant women in India are given two doses of the tetanus vaccine, as part of the nationwide immunization policy, to prevent infection in the mother and her newborn baby. According to the National Centre for Disease Control, tetanus causes nearly 309,000 deaths worldwide every year.

Swati Bhave, senior consultant in adolescent paediatrics at the Jehangir Hospital in Pune, says there are two vaccines for tetanus—Td and Tdap—and various schedules for adults to take them, depending on whether the person has taken the DPT vaccine in childhood and/or booster doses in adolescence. The Tdap vaccine confers simultaneous protection against tetanus, diptheria and pertussis, while the Td vaccine is only for tetanus and diphtheria.

Hepatitis B: The hepatitis B infection is responsible for a variety of liver diseases, including acute hepatitis or jaundice, as we know it. In India, more than 200,000 deaths related to chronic hepatitis occur annually. The WHO recommends its inclusion in routine immunization of adults. Dr Bhave says: “You can get infected with the Hepatitis B virus through the exchange of bodily fluids. It’s best for everyone to be vaccinated (once in adulthood) as a precautionary measure.”

Hepatitis A: Many Indians from the lower socioeconomic strata get exposed to the Hepatitis A virus through unhygienic surroundings and unsafe drinking water, develop antibodies and are, therefore, protected from the disease. But those from a higher socioeconomic status, who tend to have access to clean drinking water, may not develop antibodies.

To be sure, you can always get your antibody titer checked through a blood test. An antibody titer allows the doctor to determine if you have developed immunity to the Hepatitis A virus. If you have, then there’s no need to get vaccinated. If, however, the test shows that you don’t have immunity, then it’s best to get vaccinated.

Human Papillomavirus (HPV): The HPV vaccine helps prevent cervical cancer, male genital cancer and oral cancer. Cervical cancer is one of the most common cancers among Indian women. There are two vaccines available currently: the quadrivalent, which immunizes against four types of HPVs, and the bivalent, which immunizes against two types.

“There is a new vaccine available only in the US that immunizes against nine types of HPVs. This provides the best protection,” says Dr Bhave.

The primary dose of these vaccines should be taken before one becomes sexually active—the recommended age is 11-12 for all girls and boys. If not then, a dose can be taken any time till the age of 26. After that, it is believed that most adults would already have been exposed to the HPV viral
strains, and the vaccine will be unable to confer 100% immunity. Annual screening for cervical cancer, however, must continue irrespective of whether you are inoculated against HPV or not.

Typhoid: Typhoid is a fairly common disease in India and one that is not to be taken lightly. It affects 21 million people worldwide every year, killing about 200,000. There are two typhoid vaccines—one is oral and the other injectable. Vasant Nagvekar, infectious disease specialist at the Lilavati Hospital and Research Centre in Mumbai, recommends that all adults should take this vaccine.

For those above 60

Herpes zoster: Adults who got chicken pox as children are at risk of getting herpes, or shingles, and a third of those who get shingles are likely to develop serious complications like chronic pain. Sometimes, patients are never able to resume normal activity, and become depressed and reclusive owing to long-term pain and disability. The risk of complications associated with shingles increases with age as the body’s immunity diminishes. Hence, all adults over 60 should be vaccinated against herpes.

Pneumococcal vaccine: The pneumococcal vaccine protects against pneumococcal pneumonia, bacteraemia (presence of bacteria in the blood) and meningitis, all of which have fairly high fatality rates in India. Since an ageing population is particularly susceptible, Dr Nagvekar recommends this vaccine for senior citizens.

Magnesium: the forgotten mineral

By |April 18th, 2016|General|

Magnesium is one of the most crucial minerals for our body. It is required in over 600 biochemical reactions, plays a vital role in the proper functioning of muscles, in maintaining blood pressure and blood sugar, and in keeping the immune system healthy. In other words, our bodies need magnesium to maintain and sustain life.

According to a review in December 2014, 60% of adults in the US do not get enough of this mineral in their diet. The recommended daily amount is 420mg a day for adult men and 320mg for adult women. In the same review, the authors cite studies that show that in the last 60 years, fruits and vegetables in the US have lost 20-30% of their magnesium content because of the depletion of this mineral in the soil. Couple that with the fact that 80-90% of the magnesium is lost when food is processed, and that processed food consumption is on the uptick, and one begins to understand why the US diet is deficient in magnesium.

Data on the consumption of magnesium among Indians is not available. Given the increase in processed food consumption in urban areas, however, magnesium consumption in our country, too, may well be insufficient.

Magnesium insufficiency is associated with a host of diseases, including diabetes, hypertension, migraine and depression. New Delhi-based psychologist Rachna Khanna Singh, who works at the Artemis Hospital in Gurgaon, near Delhi, says that she often finds magnesium deficiency in patients suffering from anxiety. Recently, a 36-year-old patient who consulted her was suffering from anxiety as well as thyroid imbalance. Singh asked her to get a series of blood tests done, including a magnesium test, and the results showed depleted levels of the mineral. The patient was prescribed supplements.

Magnesium is known for its ability to relieve constipation and is commonly used as a laxative in its oxide and citrate forms. It is also good at relieving insomnia because it helps the muscles relax, giving you that calm “sleepy” feeling and helping you unwind after a long day. In fact, soaking in a warm bath with a cup of Epsom salts is relaxing precisely because Epsom salts are magnesium sulphate, another form of magnesium.

Dominic Benjamin, a consultant geriatrician at the Bangalore Baptist Hospital in Bengaluru, writes in an email interview: “I would strongly urge individuals to consume a balanced diet that includes green leafy vegetables, soy beans and fruits as they are all good sources of magnesium. Probiotics help in improving the bioavailability of magnesium in the diet.” Other sources of magnesium include nuts, wheatgerm, cornmeal, soy products, honey, fish, cabbage, avocados, peas, prunes and dairy products.

A study published in the American Journal Of Clinical Nutrition in July found that magnesium supplementation in women with gestational diabetes significantly improved their blood sugar and reduced complications in newborns.

And a review in a diabetes journal in June that examined the role of magnesium in glucose metabolism concluded that “chronic magnesium supplementation may delay the progression from impaired glucose regulation to type 2 diabetes”. In other words, magnesium probably plays a role in delaying the onset of diabetes in pre-diabetics.

Increase the magnesium content in your diet by consuming green leafy vegetables and fruits.

Increase the magnesium content in your diet by consuming green leafy vegetables and fruits.In a healthy person, a diet high in fruits and vegetables is more than adequate to supply the body’s magnesium needs. However, if you think you may be deficient in magnesium or suffer from diabetes, it’s important to discuss this with your doctor. The symptoms of magnesium deficiency include muscle spasms and cramps, seizures, anxiety and irregular heart rhythms. Low levels of magnesium in the body also play a role in migraine headaches, insomnia, depression and chronic fatigue.

Supplemental magnesium can interfere with the effectiveness of prescription medicines like diuretics, chemotherapy agents and certain antibiotics. Also, excess magnesium is excreted through the kidneys, and if your kidneys aren’t functioning well, you could have excessive build-up of magnesium in your system with supplementation. Since magnesium acts as a laxative, diarrhoea is often the first symptom of excessive magnesium in the body. You might also have nausea, vomiting and abdominal cramping. To prevent this, the US Institute of Medicine recommends a maximum dose of 350mg of supplemental magnesium a day for adult men and women. Of course, it’s best to consult a doctor before taking supplements.

Protect your spine

By |March 9th, 2016|General|

The spine is an anatomical design marvel. It is a string of 33 vertebrae, or bony blocks held together by ligaments and tendons and supported by large muscles. The spine encases and protects the spinal cord and the nerve roots to safely relay messages to and from the brain to various parts of the body. The spine’s design allows for flexibility, strength and mobility across planes, and lets us go through our everyday lives without giving much thought to it. Till our spinal health takes a blow.

The spine most often makes its presence felt when the large nerve roots that go to the legs and arms get irritated (this condition is called sciatica). Or when the smaller nerves that innervate, or connect to, the spine get irritated. Or when the back muscles get strained, or the bones, ligaments or joints are injured. Finally, the discs, or the gel-filled cushions between the 33 bony blocks, can slip out of alignment, pressing against the nerve, causing pain—this is called a slipped or herniated disc.

Spinal health problems are on the rise in India’s metropolises. Rajeev K. Sharma, senior consultant (orthopaedics) and joint replacement surgeon at the Apollo Hospital in Delhi, says over the phone: “Over the last decade, the number of people coming in with spinal health problems has gone up three-fourfold. What is particularly disheartening is to see young people in their 20s and 30s with spinal injuries. I first blame work-related stress and the complete lack of exercise. The condition of the roads in cities makes spinal injury inevitable.”

Stress and lack of exercise make the spine vulnerable. And travelling on poor, potholed roads leads to injury. Satish Chandra, chief scientist and head of the National Aeronautical Laboratory’s structural technologies division in Bengaluru, conducted a study last year that showed as much. He runs a lab filled with aerospace engineers who work on aircraft crash safety. His scientists do crash-and-impact tests on aircraft using computer simulation and other equipment. “We realized that we had all this equipment we could use for other purposes. And a basic question that interested us was how damaging to our spines are the roads in Bengaluru?” he says over the phone.

For the study, a seat-pad accelerometer and a 65kg dummy was placed over a sensor that measured the forces acting on the back. An autorickshaw and a car were driven at 25km per hour, which is the speed at which a motorist would drive after spotting a speed breaker or a pothole. Chandra says the study results, which are yet to be published, showed that it took 40 speed breakers or 200 potholes in a car for the spine to be stressed, or become vulnerable. In an autorickshaw, six speed breakers or potholes were sufficient to cause the same amount of distress. “If you are driving over 20 potholes a day in a car, after a while you are likely to have spinal injury. What can help prevent some spinal injuries is wearing a seat belt. We have designed a seat belt that can be retrofitted on an autorickshaw,” says Chandra.

You can also take steps to strengthen your back. One, regular exercise is important. “Just start walking every day, if nothing else. You can follow that up with back-strengthening exercises in the gym or yogic poses,” says Dr Sharma.

Two, stress management is key—a lot of the physical pain people experience is precipitated by stress. Yogic breathing exercises can calm the mind. “The traditional Surya Namaskar is a no-no for people with back problems. (But) there are several yoga poses that are extremely beneficial for the spine,” says Namrata Sudhindra, a yoga instructor in Bengaluru. “It is best to learn the right ones from a trained yoga teacher,” she adds. Meditation too is useful as it has been scientifically proven to reduce blood pressure and heart rate and make the brain waves more coherent—all indications that stress is being kept in check.

Three, a study by Anoop Mattam and George Sunny from Bengaluru’s St John’s Medical College, published in theAsian Spine Journal in February, found a correlation between vitamin D deficiency and lower back pain. Research has found that 60-80% of Indian adults are vitamin D deficient.

While correlation doesn’t imply causation, other studies have reported a similar correlation too. So if you have lower back pain, it may be worthwhile to get your vitamin D levels checked.

Sujata Kelkar Shetty, PhD, is a wellness expert and a certified life coach. She has formerly worked as a clinical scientist at the National Institutes of Health in Bethesda, US.

Demystifying the pause

By |March 9th, 2016|General|

In 2000, when Radhika* turned 42, she found herself feeling uneasy and more fatigued than usual. There were sudden spells when she would feel so hot that regardless of the temperature outside, she would be drenched in her own sweat. Apart from the physical symptoms, she found that she was also feeling less positive than usual.

Try yoga and breathing exercises

She was able to recognize that she was going through menopause because there’s a lot of information available on it in the public domain in Singapore, where she lived and worked. She consulted a doctor, started regular exercise and found that yoga and breathing exercises were helpful in the transition.
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Sujata Kelkar Shetty, PhD, writes on public health issues
and is a research scientist trained at the National Institutes of
Health in Bethesda, US.

Rise, gentlemen

By |March 9th, 2016|General|

Ram Sadhwani* is a banker in his late 40s who spends at least two-three days a week travelling. His long hours at work and travel have had a negative impact on his marital life. A few months ago, while on a short vacation with his wife, Sadhwani found he couldn’t keep an erection firm enough for making love. His wife assured him the situation would resolve itself—after all it had been a while since they had had sex. But when the problem persisted, she suggested they visit a doctor.

The couple’s family doctor suggested he consult an endocrinologist for tests. The endocrinologist asked him to fill out a short questionnaire recommended by the International Index of Erectile Function (IIEF). Sadhwani’s blood was tested for sex hormones, sugar, HDL (high-density lipoprotein), LDL (low-density lipoprotein) and triglyceride levels.

The doctor found his lipid profile to be on the higher side. Higher lipid profiles can lead to heart disease so, as a preventive measure, Sadhwani was prescribed 45-60 minutes of daily exercise and a diet low in fat and rich in fresh fruits and vegetables. He was also prescribed medication to help sustain an erection. In nine months, Sadhwani’s lipid profile was back in a heart-healthy zone and he no longer needed to take the medication.

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Sujata Kelkar Shetty, PhD, writes on public health issues
and is a research scientist trained at the National Institutes of
Health in Bethesda, US

When a cough can turn dangerous

By |March 9th, 2016|General|

Rajinder Singh has been Delhi-based entrepreneur Vinay Gupta’s driver for 20-odd years. He drives him to the office every day, takes care of his dry-cleaning and even replaces the cook on Sundays when Gupta takes his wife and children to their farmhouse in Gurgaon. A little over a year ago, Singh asked for sick leave—he had been suffering from a cough, fever and night sweats that left him drenched for a few days. When his symptoms persisted for two weeks, Gupta’s wife took him to their family doctor. An X-ray and saliva sample showed Singh had tuberculosis (TB). He was immediately put on a six-month course of antibiotics.

Gupta’s doctor advised him to get his daughters, both less than six years old, tested for TB. Adults are not tested unless they show symptoms.

The girls were not infected. Gupta and his wife were advised to watch for the symptoms, though the doctor didn’t expect the children to get the disease since they were both in excellent health.

Vivek Nangia, head of department of pulmonology at Fortis Healthcare, Vasant Kunj, New Delhi, says: “I have seen similar cases and the best thing is to get medical-check ups of the domestic staff done regularly. In case of a persistent cough accompanied with fever and night sweats, it’s best to consult a physician immediately.”
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Sujata Kelkar Shetty, PhD, writes on public health issues
and is a research scientist trained at the National Institutes of
Health in Bethesda, US.

The metabolic monster

By |March 9th, 2016|General|

Arjun Sharma is an IT professional in his mid-40s, working in Bangalore. He used to play squash and tennis but in the last few years the long hours at work have made it difficult for him to play a sport regularly. In the last five years he had put on 20kg, and his wife insisted he get a full medical check-up in December.

His medical reports showed his blood sugar levels were too high, the HDL (high-density lipoprotein or good cholesterol) levels were too low and the triglycerides were too high. The doctor diagnosed him with Metabolic Syndrome and said he was in danger of developing diabetes and/or cardiovascular heart disease if he didn’t lose at least 20kg. Sharma, who weighed 85kg, immediately joined a gym and started working out regularly for an hour every day. He also started eating home-cooked food so he could have a healthy diet low in fat and rich in fresh vegetables. In a year he lost over 15kg and his blood report after the weight loss showed blood sugar, HDL and triglyceride levels were normal. The doctor told him he should get his blood test done every year, but as long as he stayed on course with his exercise and diet, and didn’t regain the weight, there should be no cause for concern.
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Sujata Kelkar Shetty, PhD, writes on public health issues
and is a research scientist trained at the National Institutes of
Health in Bethesda, US.

A micronutrient deficit

By |March 9th, 2016|General|

In her address to Parliament in June, President Pratibha Patil spoke of the enactment of a new law, the National Food Security Act. She said: “Every family below the poverty line in rural as well as urban areas will be entitled, by law, to 25kg of rice or wheat per month at Rs3 per kg.” Given that at least 440 million people in India still live on less than $1 a day, food security is a very important concern. Even more pressing, though, is nutritional security since that impacts our future, our children.
India has the unusual advantage of being one of the youngest countries in the world. In 2000, one-third of our population was under the age of 15 years and by 2020, the average Indian will be only 29 years old. This unique age structure provides us with a demographic dividend that distinguished scholars David Bloom and David Canning argue is conducive to economic growth. However, it will serve us well to remember Bloom and Canning’s caution that “both empirically and theoretically there is nothing automatic about the link from demographic change to economic growth. Age distribution changes merely create the potential for economic growth. Whether or not this potential is captured depends on the policy environment”.
Unfortunately, our policy environment in the area of child health is seriously lacking the initiative necessary to ensure that our children grow in a nutritionally sufficient environment. In children, maximal development of cognitive, social, emotional, physical/motor skills takes place during the years 0-6, and a lack of sufficient nutrition during these years can seriously impact basic skills. Impaired skills in childhood can stunt physical and mental development permanently, making for a young person who is unable to study and work at his or her best capacity. Insufficient nutrition is a combination of a macronutrient and a micronutrient deficit in the diet. Conceptually, the first refers to the total calories or more specifically the carbohydrates, fats and protein in the diet, while the second refers to the essential vitamins and minerals such as vitamin A, zinc and iron. Deficiencies in both can permanently stunt the height, brain development and immune functioning.
We have seen success stories in our battle against malnutrition when the government has shown a commitment to change. One such case is the Marathwada Initiative, launched in March 2002, in eight districts of Aurangabad division. The programme was implemented after 14 children under the age of 6 died from malnutrition in 2000-01 in the village of Bhadhali of Aurangabad district. The anti-malnourishment campaign relied on the infrastructure of the existing Integrated Child Development Services (ICDS) scheme and worked on training and motivating the staff on a regular basis. In just two years, the initiative resulted in the number of children with severe malnutrition going down by 62%. This showed that with no additional budgetary support or no additional staff recruitment by the government, significant change was possible. So the existing government framework can make a difference when local workable solutions are employed and the staff is trained and motivated.
The Copenhagen Consensus 2008, a list of solutions for global challenges created by a panel of leading international economists including five Nobel laureates, identified alleviating micronutrient malnutrition in developing countries as the best development investment. And according to the India Micronutrient National Investment Plan (IMNIP) for 2007-11, an additional investment of just Rs5.40 per capita per year can make the difference. Meanwhile, if we sit back and do nothing, the cost to our gross domestic product from micronutrient deficiencies will be Rs284 per capita, or 50 times more. So a combination of judicious government spending on micronutrient malnutrition while using the existing government framework as a platform could be the answer to removing malnutrition, a public health issue, and a serious threat to our nation’s future.
Sujata Kelkar Shetty was a postdoctoral fellow at the National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), USA. Comment at otherviews@livemint.com

Loving The Wheat Free Life

By |March 9th, 2016|General|

In January, I decided to try a new diet. My energy levels had been on the lower side for some time, and my mind felt sluggish. I needed to do something, but my annual health check-up had found no underlying illness, thyroid fluctuation, or vitamin D deficiency.

There was nothing there to explain my consistent state of brain fog and tiredness. I joked with my friends that I had premature Alzheimer’s disease. I am a hands-on mother of two boys and a health columnist and consultant with a decent (though hardly hectic) social life. Was this fatigue just a result of the normal demands of my life? But I eat mostly healthy food, drink enough water, take multi-vitamins, barely drink alcohol, work out five times a week, do yoga twice a week, and get about 7 hours of sleep on most nights.

I felt I deserved a more energetic body, and a livelier brain for all that effort. I searched the Internet, and that’s where I first came across the wheat-elimination diet. As the phrase suggests, this is a diet free of all wheat-containing foods—no biscuits, cakes, breads, pastas, rotis or puris. Wheat is also found in a range of processed foods and sauces like ice creams, cake mixes, soy sauce and batter-fried foods and stabilizers that are often found in store-bought masalas.

The diet sounded really hard. But the literature was intriguing. David Perlmutter’s book, Grain Brain: The Surprising Truth About Wheat, Carbs And Sugar—Your Brain’s Silent Killers, had been published recently and I devoured it. In a nutshell, Dr Perlmutter, a neurologist and president of the Perlmutter Health Center in Florida, US, writes that the brain is exquisitely sensitive to the foods we eat and there is nothing worse than too many grains and too little fats in your diet when it comes to brain health. While there is a lot more to his book, he is particularly emphatic on the downside of eating wheat and how damaging it can be for the brain.Read More

Sujata Kelkar Shetty, PhD, writes on public health issues and is a research scientist trained at the National Institutes of Health in Bethesda, US.

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