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Meditate and live better

By |March 9th, 2016|General|

Out of pure curiosity, I tried it—and loved it because when you meditate, you very quickly discover this sense of marked inner calm. And when you are not meditating—the other 23 hours and 20 minutes—you feel more alert and less bothered by the small insignificant irritations of life,” writes Richard A. Friedman, director of the Psychopharmacology Clinic at the US’ Weill Cornell Medical College, in an email interview.

Meditation as a spiritual practice has been around for thousands of years, and over the past two decades there has been a growing interest in using it to improve mental performance, emotional balance and physical well-being. The word for meditation in Tibetan is gom and the meaning is best conveyed as “cultivating intimacy with the full spectrum repertoire of what it means to be human”. Medical research is beginning to show us that this ancient practice can improve both mental and physical health parameters.

“There is good empirical data that meditation lowers the heart rate, blood pressure, and promotes more coherence in electrical activity in the brain. This is to say that just by entering into a meditative state, one can induce measurable physical effects (that are beneficial),” says Dr Friedman.

Researchers are beginning to get an inkling of how meditation produces these profound effects. At Israel’s Weizmann Institute of Science, researchers discovered that meditation reduces the brain’s electrical activity, literally “quietening it”. This reduction correlates with a reduction in the number of thoughts experienced and the researchers argue that this is what produces the calming effect that meditators experience and relish.

Psychosocial stress is a known risk factor for all lifestyle diseases, including heart disease, depression, diabetes, hypertension and various cancers, and practising meditation can limit their progression. A US study, published in November 2012 in the journal Circulation: Cardiovascular Quality And Outcomes, found that meditation helped reduce the risk of all heart disease-related events, including heart attacks, strokes and death, by 48%.

George Chrousos, professor and chairman of the First Department of Pediatrics at the University of Athens School of Medicine in Greece, agrees with the findings. He says on email, “Chronic stress plays two very major damaging roles in the body.” First, through classic hormones such as catecholamine and cortisol, it elevates arterial blood pressure, causing fat accumulation and glucose intolerance while it changes the body composition, decreasing muscle and bone mass and increasing fat deposits, especially in the abdomen. Second, stress increases inflammatory cytokine secretion (cytokines are hormones of the immune system) by stimulating the immune cells and increasing body fat, which itself produces pro-inflammatory molecules.

In a nutshell, stress makes us fat, increases our blood pressure and predisposes us to diabetes and heart attacks. Dr Chrousos, who has conducted research on stress-related illness at the US’ National Institutes of Health, adds that meditation, by calming the brain and stabilizing emotions, helps combat the effects of chronic stress, allowing the body to stave off disease.

To initiate a meditation practice, it is worth paying heed to the advice of Madhav Nagarkar, a meditation teacher based in Pune. “All we have to do is assign the mind a mantra and ask it to focus on the breath to enjoy the benefits of meditation. Just as a naughty child will jump from seat to seat in a classroom till you assign him a seat and ask him to sit in it, similarly the mind needs the mantra and the breath to focus on. Only once quiet can the mind start its journey towards experiencing pure consciousness.”

Chant a simple “Om” with each inhalation and each exhalation of breath, and choose a fixed space and time of meditation that is free of mental distraction, he says. “Noise is a major impediment to a meditation practice, even music is disruptive.”

“Awareness constitutes the foundation of all and its cultivation supports all. As meditation increases awareness, meditation is the greatest single tool we can use to improve our lives and the lives of others,” says Kevin Selig, a practising Tibetan Buddhist monk based in Bali, on email.

I’m working on making it a daily practice.

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 sunshine paradox

By |March 9th, 2016|General|

Vitamin D plays a definitive role in the normal growth and upkeep of our body and the quality of our bones. Though classified as a vitamin, it is actually a steroid hormone that is produced by the skin when exposed to sunlight. A vitamin is an organic compound that is essential for the body but is required in very tiny amounts. In that sense vitamin D is a vitamin. However, vitamins are usually not synthesized by the body and for that reason vitamin D is not a vitamin.

Here comes the sun: Vitamin D is a steroid hormone produced by the skin when exposed to sunlight.
Once produced in the skin, vitamin D is still biologically inert, or incapable of biological action till it is sequentially metabolized first in the liver and then the kidneys. After it has been altered by the liver and the kidneys, it binds its receptor, the Vitamin D receptor (VDR), which is found inside cells, and proceeds to make a variety of physiological decisions.

Vitamin D is known best for its role in maintaining the calcium balance in our bones. But over the last four decades, scientists have identified many new biological actions for vitamin D apart from bone growth and upkeep, says Anthony Norman, Distinguished professor of biochemistry and biomedical sciences, Emeritus, University of California, Riverside, US. Anthony Norman discovered the existence of vitamin D in 1967 and VDR in 1969.

In a mini review by Norman and Roger Bouillon titled �Vitamin D Nutritional Policy Needs a Vision for the Future� published in Experimental Biology and Medicine, September 2010, the authors say that VDR has been found in at least 38 different tissues in the body. This means vitamin D has a role to play in those many tissues. The review also says that research has shown that Vitamin D plays a role in muscle function and improving muscle strength. It also stimulates the synthesis of anti-bacterial agents in blood cells, and strengthens our immune cells so that they can fight infection more efficiently. It makes our pancreas secrete insulin, and maintains heart muscle function. It also prevents excessive cell proliferation. In other words it may deter various cancers, including prostate, colon and breast cancer, from gaining a foothold. 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.

Fast for health

By |March 9th, 2016|General|

Those interested in rejuvenating their bodies and minds post Diwali, listen up. The secret to extending your youth while keeping disease at bay seems to lie in, ever so often, not eating at all. Fasting, or not eating for 12 hours or more, triggers a protective response in our bodies at a cellular level. Our bodies seem to become stronger and more able to fight diseases, both chronic and acute, as a result of this short stint of starvation.

And while the thought of starving once in a while may seem unpleasant, this is how pre-historic man lived. Eating three meals a day, with snacking thrown in for good measure, is not normal from an evolutionary perspective. And recent research suggests that fasting or eating like our hunter-gatherer ancestors has the potential of helping us live longer, disease-free lives.

Isaac Mathai, chairman and managing director of Soukya, a holistic healing centre in Bengaluru , says naturopathic medicine has always recommended fasting for a host of medical conditions, from constipation to arthritis. “It is considered beneficial for healthy adults as an anti-ageing and detoxifying regimen too,” he says. Dr Mathai suggests a water-only or juice-only fast for 24-48 hours every month for healthy adults. “A fast longer than 48 hours or in someone who is taking medicines is best done under medical supervision,” he says.

Fasts are highly beneficial in reducing the risk of chronic diseases, particularly in people who are obese and sedentary, according to a review of the research on fasting published in February 2014 in the journal Cell Metabolism. Authors M.P. Mattson and V.D. Longo said that in animal studies, fasting improved important health indicators like blood pressure, body fat, insulin, brain performance and inflammation. Fasting has also been found to reduce the risk of heart attacks, diabetes, stroke and, sometimes, even prevent cancer. The reason that fasting works this way, they argue, is because at a molecular level it enhances anti-oxidative pathways, protecting cells from DNA damage and suppressing unrestricted cell growth while simultaneously destroying damaged cells.

In humans too, studies on fasting are promising. According to a review published in the journal Proceedings Of The National Academy Of Sciences in November 2014, multiple studies have shown that fasting can reduce the symptoms in patients with rheumatoid arthritis and asthma.

Dominic Benjamin, a consultant geriatrician at the Bangalore Baptist Hospital in Bengaluru, recommends shorter fasts as a weight-loss measure to patients—to accrue the benefits of fasting and manage weight. “I suggest to my non-diabetic obese patients that they aim for a 14- to 16-hour fast over the weekend. They can eat an early dinner on Friday and Saturday and eat a late breakfast or an early lunch at noon the following day. This kind of a fast isn’t too demanding for my patients,” says Dr Benjamin.

Fasting works in many ways. For one, it suppresses inflam-mation, which is a pivotal participant in arthritis, asthma, heart disease and cancer formation. Another way that fasting works is by increasing the “autophagy” or “eating” of defective proteins and membranes within a cell by the cell. In other words, fasting makes the cell “cleanse” itself of damaged biomolecules.

If you want to give fasting a try, there are many ways to do it, writes Dr Mattson, chief of the laboratory of neurosciences at the US’ National Institute on Ageing, in an email interview. He writes that while we don’t know yet which way is the most beneficial fasting method, and some methods may be more beneficial than others, there is no doubt that fasting is a healthful practice. “Fasting one or two days/week or fasting for two consecutive days every week or every other week are all worth trying. I would suggest starting by eating only one moderate-size meal one day each week for one month and then do this for two days each week for the next month,” he says.

You could also try the intermittent fasting diet called the 5:2 diet popularized by Michael Mosley and Mimi Spencer in their book The Fast Diet: The Secret Of Intermittent Fasting—Lose Weight, Stay Healthy, Live Longer. In this, you would eat 500 calories (600, if you are male) two days a week and eat whatever you want (within reason) the remaining five days of the week. Dr Longo, director of the US’ USC Longevity Institute, cautions that the 5:2 diet has several limitations. “It requires that someone eat a low-calorie diet every third day, which is difficult for most people to maintain, and it can also confuse the body the same way that sleeping erratically would; the body’s circadian clock doesn’t like frequent changes. However, it is still better than not fasting at all,” he writes.

It’s important to add, however, that the research done thus far is limited in its scope and till there is more evidence, it’s best to check with your doctor before incorporating regular fasts into your lifestyle. I fast once a week, living on 500 calories of juices and fruit, and find myself more energetic and alert on fast days.

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

The joy in giving

By |March 9th, 2016|General|

People routinely give their time and money to others, often at a cost to themselves. Blood donation is one example of giving. Substantial research in psychology shows that adults worldwide feel happier spending money on others rather than on themselves. And the act of giving money to charity actually activates regions of your brain that would normally be activated when you have received something.

Children too are not immune to the feeling of joy that giving brings. A recent study with toddlers found that even very young children enjoy giving. This suggests that the act of giving may be hardwired in our brain, like eating or sleeping. It isn’t something that we have to be taught to do, we instinctively know how to do it.

The experiment on toddlers, published in June in the Public Library of Science journal, PLOS ONE, in an article titled �Giving Leads to Happiness in Young Children�, was done at the University of British Columbia, Vancouver, Canada, by Elizabeth Dunn and her colleagues. The study involved 23 toddlers, a monkey puppet, and goldfish crackers.

Each toddler was taken into a testing room and made to sit at a table facing the monkey puppet and the monkey puppet holding experimenter. The toddler and the monkey puppet had a bowl in front of them. The children were introduced to the monkey puppet and told that the puppet liked goldfish crackers. The fact that the toddlers believed the experimenter did not come as a surprise to parents of young children. And medical research has shown that toddlers think that non-humans like puppets have hopes and desires too, like loving goldfish crackers. When the children were brought into the room, the bowls were empty. The experimenter then �found� eight crackers and put them in a toddler�s bowl. She then �found� another cracker and gave that to the puppet, and then �found� another and asked the child to give it to the puppet. She finally asked the child to give a cracker from her bowl to the puppet. 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.

Why vegetarians should worry about vitamin B12 intake

By |March 9th, 2016|General|

Have you had your vitamin B12 levels checked recently? A 37-year-old homemaker in Delhi had been suffering from mood swings for over six months before her family and general physician suggested she consult a psychiatrist. The psychiatrist ordered a battery of blood tests for hormonal imbalances and nutritional deficiencies. The woman’s blood report was normal apart from vitamin B12 levels—they were very low, at 70 pg/ml (below 250 pg/ml is defined as deficient). The psychiatrist recommended 10 vitamin B12 injections over 20 days combined with daily vitamin B12 tablets.

The why of vitamin B12

Vitamin B12 is profoundly important for health. Adequate stores of the vitamin help our nerve and blood cells to function properly; this vitamin is also needed for the manufacture of DNA strands in the body. If left untreated, vitamin B12 deficiency can lead to permanent nerve damage. Sanjay Chugh, a psychiatrist who practises in New Delhi, says: “Vitamin B12 deficiency is rampant in India (among men and women). The deficiency is so common that it’s the first thing I recommend for patients regardless of their psychiatric symptoms. And often when vitamin B12 deficiency is found, simple supplementation of vitamin B12 is enough to clear the symptoms such as mood swings and crying bouts.” Vitamin B12 injections are recommended when the deficiency diagnosed is severe and vitamin B12 levels have to be brought back to normal quickly. Once the levels have normalized, then vitamin B12 can be taken orally like any other vitamin supplement.

One reason why vitamin B12 deficiency is particularly common in India is that a large number of people here are vegetarians.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.

Cellphone alert

By |March 9th, 2016|General|

Cellphone technology is over 40 years old. The first call over a cellular network was by American engineer Martin Cooper in 1973, and it took another 10 years for the technology to be commercialized. In 1983, when Motorola came out with the Motorola DynaTAC 8000X, the cellphone essentially looked like a plastic brick with an antenna attached.

Things have changed a lot since then. Now we have cellphone devices that are not only far more attractive but often double up as computers. Devices that allow you both connectivity and information in an instant. This revolution in communication has extraordinary benefits, but is there a health trade-off?

The fact that the use of cellphones while driving leads to an increase in accidents, whether the phone is in the hands-free mode or is hand-held, is well established. And the risk of accident when using a cellphone is comparable to driving with a blood alcohol level of 0.05%, which is over the legal limit for driving under the influence of alcohol in India.

Researchers are studying the cancer-causing potential of the low-powered radio frequency (RF) generated by cellphones. In a 2010 report, the World Health Organization stated that “to date, no adverse health effects have been established for mobile phone use”. The International Agency for Research on Cancer, however, has classified RF electromagnetic fields as possibly carcinogenic to humans. The reason for this kind of classification is that data on cellphone usage doesn’t go back more than 15 years. An adult will typically be using her cellphone for her entire adult life, which is at least 50 years if she got her first phone at 20. And effects of cancer-causing agents can take decades to manifest.

Bobby Paul, assistant professor, department of preventive and social medicine, at the All India Institute of Hygiene and Public Health in Kolkata, published a commentary on the subject of cellphone usage and its health effects in January in the Indian Journal Of Public Health, making an India-specific cautionary statement. She writes: “Indian experts are of the opinion that hot tropical Indian climate, low body mass index, low fat content of an average Indian, in combination with a high environmental concentration of RF radiation, may place Indians at higher risk of RF radiation adverse effects than the Europeans.”

Studies have investigated the effect of RF on blood pressure, sleep, heart rate, even the blood-brain barrier, a semi-permeable barrier that separates the blood from the brain tissue. The studies done so far have focused on adults, and are inconclusive. There’s also not enough data on how children’s health is affected—though children are increasingly using cellphones earlier, and often.

Pettarusp Wadia, consultant neurologist, Jaslok Hospital, Mumbai, says that given that the jury is still out on the subject, “it is prudent to avoid indiscriminate use of the cellphone”.

Paul agrees. In an email interview, she says exposure to RF falls as you increase the distance from the handset. So keep the handset 30-40cm away from the body while it is in speaker mode or while using a Bluetooth headset. This will lead to much lower exposure than holding the device close to the head while speaking. Since time also plays a role in determining a person’s exposure, she recommends limiting the time spent using the phone—by reducing the number of calls and the time spent on each call.

Remember that in the case of children, the RF exposure is double that of adults because a child’s skull is thinner than an adult’s. The difference in skull thickness means that a child’s brain is closer to a cellphone when she holds it close to her ear. So as a precaution children must use the cellphone on speaker mode or with a headset.

The good news is that 3G phones are believed to have two times lower RF emissions than 2G phones and the digital enhanced cordless telecommunications phones, or digital portable phones, have even lower emissions.

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

Battling the blues

By |March 9th, 2016|General|

Battle ready

By |March 9th, 2016|General|

When my two-year-old coughed a little recently, I thought it was time to start on the cough syrup and bring out the ear thermometer. Since there was no fever as the day progressed, I was optimistic that this was a mild viral infection that would clear in a couple of days. Late that evening I was jolted out of complacence. Our son had started shivering and gasping for air; he was running a fever of 103 degrees Fahrenheit. He was also coughing in a peculiar way, best described like a dog�s bark.

My husband and I rushed him to hospital, and the doctor who examined him heard the barking cough and diagnosed it as croup, inflammation of the upper airways that include the voice box and the windpipe.

Our son was prescribed a dose of steroid medication to reduce the inflammation that was responsible for his breathing difficulty and the funny cough.

As parents of young children inevitably know, children between six months and three years are susceptible to a host of upper and lower respiratory illnesses in this season. �You should expect at least six-eight episodes of such infections per year,� says Meena Malkani, consultant paediatrician, Jaslok Hospital and Research Centre, Mumbai. The upper respiratory infections include rhinitis, sinusitis, laryngitis, epiglottitis, otitis media and croup. Often but not always, infection in the nasal passages (rhinitis) can lead to an infection in the throat (laryngitis) and then the ear (otitis media). Epiglottitis is infection of the tissue that covers the trachea (windpipe). These infections can also progress lower down the respiratory system and cause diseases like bronchiolitis and pneumonia. 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.

You’ve got to move it

By |March 9th, 2016|General|

There are people who appear to remain slim almost magically, no matter what they eat and whether they formally exercise or not. Janaki Bahri, the 29-year-old mother of a boy who just celebrated his first birthday, is one of those people. She has always been slim and petite and returned to her pre-pregnancy size within six months of the baby’s birth.

Bahri is an active person but is not someone who works out regularly. She says that she has not worked out in over a year and a half and didn’t have to exercise to lose her pregnancy weight. If you ask her how she remains slim, her instinctive reply is: �It’s genetic; my father is exactly the same way.�

Meanwhile, urban India is putting on more weight now than ever before because we are putting more energy into our bodies than we are using up, consistently. Lancet published a paper in November 2010 that looked at the growing health concern of obesity in developing nations like India, Brazil and China. The study was led by Daniel Chisholm and his colleagues at the health division of the Organisation for Economic Co-operation and Development (OECD) and found that dietary habits and a sedentary way of life were causing an energy surplus in our bodies and fuelling the obesity epidemic. 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.

The truth about supplements

By |March 9th, 2016|General|

India is a paradox when it comes to the intake of vitamins and health supplements. We have seemingly healthy people walking around with vitamin deficiencies and then we have a few who are consuming way too many supplements than they require, causing more harm than good,” says Shashank Joshi, consultant endocrinologist, Lilavati Hospital and Research Centre, Mumbai.

He says people should stay away from multi-vitamin pills and only take the supplement for which they have a deficiency. Gayathri Karthik, consultant obstetrician-gynaecologist, Mother and Child Clinic, Bengaluru, agrees. It is better to “eat a well balanced diet”, she adds.

According to an article published in the journal Nutrients in February last year, 70% of the Indian adult population is deficient in vitamin D.

Apart from vitamin D deficiency, studies show that a big percentage of Indian women have iron deficiency, leading to anaemia—and this holds true across social classes.

Similarly, studies find that adult Indian men and women are increasingly deficient in vitamin B12. Micronutrients like iron, zinc and B12 are available in limited quantities in plant-based foods, so vegetarians tend to suffer from deficiencies of these.

Some people may need to take vitamin supplements, but it is best to do so under medical supervision.

The big issue with taking vitamin and health supplements unsupervised is that since the industry isn’t regulated, the consumer doesn’t actually know what is inside the pill or powder.

New Delhi-based psychiatrist Sanjay Chugh says there was a time when he would see about “10 patients every couple of months with symptoms of delusions and paranoia, because they were taking supplements their trainers had recommended in various gyms. Some of these contain amphetamines, a potent nervous system stimulant used to treat attention deficit disorder.” He too suggests taking vitamins and minerals only on a doctor’s advice.

Vitamin supplements, when taken in high doses, can have side effects. Pettarusp Wadia, consultant neurologist, Jaslok Hospital, Mumbai, says: “I have seen at least two cases—one patient was a general physician himself—where both patients were rendered unconscious because they were taking mega doses of vitamin D.”

An article published in March in the journal Critical Reviews In Food Science And Nutrition, by researchers from the Council of Scientific and Industrial Research’s Central Food Technological Research Institute, Mysuru, said that while micronutrients are indeed found in limited quantities in vegetarian food, age-old cooking practices and certain food combinations together improve the bioavailability of micronutrients. Household processing like sprouting and fermentation increases the bioavailability of iron and carotene from plant foods. Amchur (dry mango powder) and lime enhance the bioavailability of iron, zinc and beta-carotene (a carotenoid vital for vision, immunity), as do onion, garlic, red and black pepper, as well as ginger. Fruits such as mango, when consumed with milk, provide significantly higher amounts of bioavailable beta-carotene than when consumed alone.

If your aim is to get the most vitamins and minerals from food, then perhaps it’s time to go back to our age-old Indian practices of cooking and eating foods in specific combinations.

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

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