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Hypertension!

Basic Information About Blood Pressure And Hypertension!

Today many people are aware that diabetes is a grave illness.

And they take the threat of the disease seriously.

But more people have hypertension than diabetes and few people are aware that hypertension is as grave a disease as diabetes.

And a person with hypertension may not have any symptoms.

So many people may not even know that they have the disease.

So it is vital that you get a blood pressure check regularly, more so if you have family history of hypertension, heart disease and strokes.

And it is equally vital that you don’t ignore it, if you have it.

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So What Is Hypertension?

Arterial blood pressure is measured as mm of Hg or mercury.

It has a higher level or the systolic blood pressure and a lower level or the diastolic blood pressure.

Systole is the phase of the heart beat in which the ventricles, the lower two chambers of the heart contract, the left ventricle sending blood out to the whole body and right ventricle to the lungs.

Diastole is that phase of the heart beat in which the ventricles relax after the contraction, receiving blood from the atria which are the two chambers above the ventricles.

The blood flowing through the arteries exerts certain pressure on the walls of the arteries when it flows through them, both when the ventricles contract, that is the systole and when they relax, the diastole.

The pressure when the ventricles contract is the systolic blood pressure and the pressure when they relax, is the diastolic blood pressure.

Hypertension or high blood pressure is a condition in which the blood pressures in the arteries are persistently higher than normal.

As per the American College Of Cardiology and the American Heart Association, the normal ranges and the raised levels of the blood pressure are as follows:

Normal blood pressure is 120 by 80 mm of Hg, or below.

Elevated blood pressure: Blood pressure ranging between systolic pressure 121 to 129 and diastolic pressure 80 or less mm of Hg, is elevated blood pressure.

Stage I hypertension: Systolic blood pressure between 131 to 139 and the diastolic between 80 to 89 mm of Hg.

Stage II hypertension: Systolic blood pressure between 140 or higher and the diastolic 90 or more, mm of Hg.

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Types Of Hypertension:

Primary Or Essential Hypertension:

A complex combination of genes and environmental factors, excess salt consumption, Western kind of high fat – high calorie, high animal food diet deficient in complex carbohydrates, green vegetables and fruits, lack of exercise, abdominal obesity, stress, aging are some of the factors which can contribute to the development of hypertension.

In this type of hypertension, the major contributor to hypertension is the increased peripheral resistance to blood flow through arteries.

Secondary Hypertension:

Secondary hypertension is the hypertension which has an underlying disease as the cause of hypertension.

Kidney disease, renal artery stenosis (narrowing) are the most common causes underlying this kind of hypertension, endocrinal disorders like Cushing’s Syndrome, hyperthyroidism, hypothyroidism, certain pituitary disorders and a pituitary tumour called pheochromocytoma can also cause hypertension.

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Signs And Symptoms Of Hypertension:

Hypertension usually causes few symptoms. That is why it is called a silent killer.

Some people may complain of headaches, especially at the back of the head, vertigo, tinnitus and fainting. But anxiety and stress can also cause these symptoms.

That is why hypertension is often detected in general medical check up or sometimes when people go for blood donation.

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Effects Of Hypertension:

Prolonged hypertension causes inflammation in the endothelium, the inner lining, of the arterial walls damaging the arteries including those of various organs of the body.

This can lead to hardening and thickening of the arterial walls and narrowing of their lumen. This is called atherosclerosis.

Atherosclerosis causes loss of elasticity in the arterial walls causing an increase in the peripheral resistance to the blood flow and it also leads to heart attacks and strokes.

Raised blood pressure causes greater resistance to the flow of the blood through the arteries and forces the heart to pump harder to circulate blood through our body, causing hypertrophy (thickening) of the heart muscle. The thickened heart muscle struggles to pump blood efficiently and eventually fails to do so, causing heart failure.

It can also lead to weakening and bulging of the arteries. This is called aneurism and such aneurisms can rupture and cause heavy internal bleeding causing grave complications, including strokes.

Thickening and narrowing and aneurysms of the arteries in kidneys or eyes can damage these organs and can lead to renal failure and loss of vision.

Hypertension also contributes to development of the metabolic syndrome that leads to development of diabetes, heart attacks and strokes.

It can also cause circulatory problems and strokes in the brain.

It can a lead to impairment of memory and understanding and development of vascular dementia, a general name given to a condition that causes decline of cognitive abilities of thinking, remembering and reasoning in a person leading to inability to perform daily activities.

Hypertension is a major cause of premature death all over the world.

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Prevention Of Hypertension:

Hypertension is best prevented than treated.

Maintain ideal body weight.

Keep your salt consumption low, eat less than 6 gm table salt.

Keep your animal food consumption low, eat more of complex carbohydrates, vegetables, fruits and low fat milk.

Have at least five helpings of vegetables and fruits every day.

Have regular cardiovascular exercise like brisk walking, jogging, running, cycling, swimming, aerobics.

Keep stress low.

Limit alcohol consumption.

Stop smoking.

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Treatment Of Hypertension:

Your doctor may advise lifestyle modification, healthy diet, low salt consumption, regular cardiovascular activity, weight loss, quitting alcohol and smoking and reduction in stress.

Doctors treat hypertension with a variety of anti hypertensive drugs including diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors (ACE inhibitors), angiotensin receptor blockers (ARBs) and beta blockers.

Previously beta blockers were thought to be effective as the first line treatment for hypertension, but the Cochrane Review, an independent, high quality review system of research in health care, has found that beta blockers were less effective in preventing heart disease than were the other anti hypertensive drugs.

According to a study published in 2003, 5 mm Hg drop in blood pressure reduces the risk of stroke by 34%, ischaemic heart disease by 21% and lowers the threat of dementia, heart failure and mortality due to heart disease.

So focus on getting your blood pressure down to the normal level, as early as possible!

Also read the articles ‘Preventing Hypertension’ and ‘Health Problems Of The Young: Hypertension’ on this website.

Hypothyroidism

Hypothyroidism Or Under Active Thyroid Gland

Thyroid is a butterfly shaped endocrine gland situated at the base of the neck, below the prominence of the Adam’s apple, resting on the trachea or the windpipe.

It produces three hormones, the two thyroid hormones called triiodothyronine or T3 and thyroxine or the T4 hormones and calcitonin.

The two thyroid hormones control the metabolic rate, synthesis of proteins and the growth and development of children.

Calcitonin is involved in calcium homeostasis that is, it takes up calcium from the blood and deposits it in bones.

The two thyroid hormones are regulated by thyroid stimulating hormone or TSH, which is secreted by the master endocrine gland, the pituitary and the production of TSH in turn is regulated by a hormone called the thyrotropin releasing hormone or the TRH, produced by the hypothalamus, a part of the brain.

It means the final control of the thyroid gland lies with the brain.

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Hyperthyroidism and hypothyroidism:

When the thyroid gland produces excess thyroid hormones, it results in hyperthyroidism while when it produces low levels of the thyroid hormones, it results in hypothyroidism.

Hypothyroidism is more common in women and in people over 60.

The commonest cause of hypothyroidism all over the world is deficiency of iodine in food and most countries have tackled the problem by iodising the salt available to its population.

A condition called Hashimoto’s thyroiditis or Hashimoto’s disease, an autoimmune disease of the thyroid gland, is the common cause of hypothyroidism in areas where there is no iodine deficiency in the population. It gradually destroys the gland.

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Hypothyroidism:

Hypothyroidism can cause a variety of symptoms including fatigue, intolerance of cold, slow pulse rate, anaemia, depression, constipation, dyspepsia, muscle weakness, shortness of breath, hoarseness of voice, hair loss, dry, rough skin, weight gain, heavy menstruation in ladies and weight gain.

Apart from depression, hypothyroidism is also known to accompany severe psychiatric disorders like bipolar disorder, mood disorders and schizophrenia.

It can occur also in pregnancy. Not treating hypothyroidism during pregnancy can lead to delayed growth and low intellectual development of the baby.

Mild or sub clinical hypothyroidism too can cause infertility and miscarriages and can also cause a grave pregnancy condition called pre-eclampsia, a condition in which there is rise in the blood pressure and loss of significant amounts of protein in urine. Gestational diabetes is also seen in hypothyroidism in pregnancy.

In mild or sub clinical hypothyroidism the TSH levels are raised but the thyroid hormone levels are normal.

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The diagnosis and the treatment:

Many times, the patient of hypothyroidism is the last to complain about the condition. Often a family doctor may suspect the disease seeing sudden weight gain, deteriorated skin and changes in voice in a regular patient plus probably dulled comprehension reflected in speech and eyes, suspects hypothyroidism.

A doctor will usually suspect hypothyroidism when she or he sees that your skin and hair are dry and rough, there is coldness and swelling of extremities and your heart rate is slow (bradycardia). He may also see delayed relaxation of tendons on testing the tendon reflexes and a kind of non pitting oedema called myxoedema.

Thyroid function lab tests include checking the blood levels of the pituitary hormone TSH and levels of the thyroid hormones T3 and T4.

High blood levels of TSH and / or low levels of T3 and T4 are diagnostic of hypothyroidism.

Hypothyroidism is treated by your doctor with levothyroxine, a synthetic form of the thyroxine hormone or T4.

Levothyroxine is safe in pregnancy.

Your doctor will order regular lab checks of your blood levels of TSH, T3 and T4 (thyroid function test) and adjust the dose of your medication based on the severity of the symptoms and the levels of the hormones, from time to time.

That is the reason why you have to check your thyroid function and see your doctor at regular intervals as advised by your doctor.

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The weight gain due to hypothyroidism is of mild to moderate degree. A huge weight gain is unlikely to be caused by hypothyroidism.

Many slimming programs tell people under their treatment that they haven’t lost weight because they have hormonal problems.

The commonest hormonal problems related to obesity are PCOD and hypothyroidism.

It doesn’t matter whether your weight gain is due to PCOD or hypothyroidism.

You still have to eat healthy and at least walk adequately to slim down perfectly and overcome PCOD and most likely help your doctor to reduce your levothyroxine dose considerably.

And people unfailingly do succeed, if they do.

The people on these slimming programs didn’t fail because they had hormonal problems, but because the treatments themselves were unscientific.

Also read the articles, ‘Basics Of Nutrition’, ‘The Science Of Exercise’ and the ‘Simple Steps To Slimming’ and ‘Health Problems Of The Young: PCOD‘ on this website.

Uric Acid, Gout And Kidney Stones!

Raised Levels Of Blood Uric Acid, Gout And Kidney Stones!

Many people suffer from raised levels of uric acids in their blood.

Often this condition is found in routine renal function tests.

Most often this condition is ignored if the rise is borderline.

But left untreated, long term rise in uric acid could cause chronic illnesses like gout and renal stones and kidney and heart disease.

What exactly are these diseases?

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Certain foods that we eat contain chemicals called purines.

Uric acid is formed when purines are broken down by our body.

Uric acid dissolves in blood and it is transported to the kidneys and they excrete it out of our body in urine, maintaining the blood uric acid levels normal (3.5 to 7.2 mg / dL).

If the blood uric acid levels rise above 7.2 mg / dL, the condition is called hyperuricemia.

If excess uric acid is accumulated in our body, it may get deposited in our joints in the form of uric acid crystals causing a very painful form of arthritis called gout.

They may also settle in the kidneys forming kidney stones.

If the condition is not treated it can cause permanent bone, joint, tissue and kidney damage and can also lead to heart disease.

Researchers have also found links between hyperuricemia and high blood pressure, type 2 diabetes and fatty liver.

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Foods high in purines are:

Sea food like salmon and sardines and shell fish shrimps (prawns) and lobsters.

Red meat.

Organ meats like liver.

Sugar sweetened foods like sweetened cereals, bakery products, candies.

Alcohol, especially beers and distilled liquors and also non alcoholic beers.

Certain vegetables like spinach, asparagus.

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Signs and symptoms of gout:

When the blood uric acid levels remain high for long time sharp needle like crystals of uric acid or urate crystals get deposited in some joints and tissues around the joints.

This causes the joints to become hot, red, swollen and tender. The pain is severe and comes on quickly and peaks in less than twelve to twenty four hours.

The joint at the base of the big toe is affected in half the cases, but the heal, knee, wrists, finger joints too can be affected.

Such attacks can recur frequently, unless treated.

Some people may also develop hard, painless deposits of uric acid crystals called tophi. These too can cause bone damage and arthritis.

Gout appears to affect elderly males more often. It is also associated with metabolic syndrome, presence of abdominal obesity, hypertension, insulin resistance and abnormal lipid profile including high triglyceride levels. So people with hypertension and diabetes are also at a greater risk of developing it.

Gout affects habitual beer drinkers and those who drink a lot of sweetened drinks. It also affects people who habitually consume purine rich foods like some fishes including shell fish like prawns and lobsters and red meats.

Some vegetables like cauliflower, asparagus, spinach, mushrooms, green peas and chickpeas (chana in Marathi) and fava beans (wal papadi in Marathi) and some dried beans too have high levels of purines.

But the plant purines have not been found to cause gout attacks as much as the animal purines.

And some individuals report different vegetables triggering gout attacks in them, including some vegetables not high in purines, e.g. tomatoes.

It probably means some factors other than purines may have a role to play in these attacks.

So such people might want to avoid foods those trigger gout attacks in them, irrespective of their purine content.

Dietary precautions may reduce the recurrence or the severity of gout attacks, but they cannot replace medication to control hyperuricemia and the attacks of gout or prevent further joint damage due to hyperuricemia.

In short, medications lowering blood uric acid levels are essential even if you watch your food and avoid foods those trigger gout attacks.

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Diagnosis of gout:

Presence of hyperuricemia is not the same as gout.

Gout is diagnosed if uric acid crystals are found in the fluid drawn from the swollen joints or by special imaging diagnostic procedures like ultrasound, X Ray and CAT scan.

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Treatment of hyperuricemia and gout:

Avoid red meat, organ meat and alcohol, especially beers.

Avoid the sugar sweetened foods viz. sweetened cereals, bakery products, candies

Sea food includes healthy proteins and healthy fats including the omega 3 fatty acids.

The health benefits of sea food on general and heart health outweighs the risk of hyperuricemia.

So you can have sea food in moderation.

Consuming vegetables like spinach and asparagus have not been seen to cause hyperuricemia. So they needn’t be excluded from your food.

Eat well balanced, wholesome food and exercise regularly to lose weight, if you are overweight.

Drink ample water to help the kidneys to excrete uric acid build up in the blood and the kidneys.

Taking Vitamin C may help.

Dietary exclusion of high purine foods will not be sufficient to lower blood uric acid levels or to prevent the gout attacks.

Your doctor will prescribe specific drugs to lower your blood uric acid levels.

Your doctor will also prescribe anti inflammatory medications (NSAIDs) to reduce the pain and duration of the attack.

Kidney stones may get get flushed out in urine.

They may require surgical intervention if they don’t get flushed out.

Also read ‘Basics Of Nutrition’ and ‘Simple Steps To Slimming’ on this website.

Fatty Liver Disease Or Hepatic Steatosis

Kinds Of Fatty Liver Disease Or Hepatic Steatosis

Obese people have a greater risk of developing hypertension, diabetes and heart disease, than the slim people.

And most obese people know that they are at greater risk of developing these diseases.

And more obese people have fatty liver disease than heart disease, but most are totally unaware that they may have fatty liver disease and that is as dangerous a disease as hypertension or diabetes!

And few obese people know that they have this disease!

Most often fatty liver disease is diagnosed accidentally when an abdominal sonography is done for some other reason.

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Fatty liver disease is also known as hepatic steatosis or fatty degeneration of liver.

It affects both alcoholics and nonalcoholics or those who drink very little.

Thus fatty liver disease is of two types, alcoholic fatty liver disease and nonalcoholic fatty liver disease or NAFLD.

Both diseases are characterised by build up of excess fat in the liver cells.

Nonalcoholic fatty liver disease or NAFLD is affecting increasingly greater number of people all over the world, more so in the Western world.

Some people suffering from Non Alcoholic Fatty Liver Disease or NAFLD develop nonalcoholic steatohepatitis or NASH.

Nonalcoholic steatohepatitis or NASH is a more aggressive form of fatty liver disease in which there is inflammation of the liver cells and it can progress to scarring of the liver tissue leading to liver cirrhosis and liver failure.

Thus the progression of nonalcoholic steatohepatitis or NASH could be similar to the severe alcoholic hepatitis seen amongst heavy alcoholics.

More than 90 per cent of heavy alcoholics develop fatty liver disease while 25 per cent develop the severe alcoholic hepatitis ending in liver cirrhosis and liver failure.

While children too suffer from non alcoholic fatty liver disease or NAFLD, older people, especially males, are affected much more often.

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Causes:

Experts do not yet know why some people develop non alcoholic fatty liver disease or NAFLD and why some of them progress to nonalcoholic steatohepatitis or NASH and develop liver cirrhosis and liver failure.

But both are linked to

Over weight or obesity, especially abdominal obesity

Hyperinsulinemia and insulin resistance

Hyperglycaemia or high blood sugar levels, pre diabetes or diabetes

Hypertriglyceridemia or high levels triglycerides or circulating fats in blood

These conditions could be helping build up of excess fat in the liver, causing NAFLD and in some this fat could be acting as a toxin to the liver cells and causing inflammation and scarring in them, causing NASH.

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Signs and symptoms:

Non Alcoholic Fatty Liver Disease or NAFDL may have no symptoms but some times there can be fatigue and pain or discomfort in upper right hand area of the abdomen where the liver lies within the body.

Signs and symptoms of people with nonalcoholic steatohepatitis or NASH are the same as those of advance scarring and cirrhosis of liver seen in cirrhosis in severe alcoholic hepatitis:

Swelling of abdomen due to ascites or accumulation of fluid in abdominal cavity.

Enlarged blood vessels under the skin.

Yellowing of skin and eyes due to jaundice.

Red palms.

Enlarged spleen.

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Other risk factors associated with development of NAFLD and NASH:

Alcohol

Hypercholesterolemia or high levels of cholesterol

Metabolic syndrome: Abdominal obesity, hypertension, high levels of blood sugar and triglycerides and low levels of HDL cholesterol

PCOD

Type II diabetes

Sleep apnea

Under active thyroid gland

Under active pituitary gland

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Complications or progression

The fatty liver disease can end up in development of inflammation and scarring resulting in liver cirrhosis.

Ascites or abdominal swelling due to fluid build up.

Swelling of veins in oesophagus or oesophageal varices, which can rupture causing bleeding

Liver cancer

Confusion, drowsiness, slurred speech, delirium due to hepatic encephalitis

Complete liver failure meaning liver stops functioning altogether

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Treatment and prevention:

Eating healthy, well balanced food

Exercising regularly

Losing and maintaining weight at a healthy level.

Also read the articles ‘Basics Of Nutrition’, ‘Designing A Healthy Weight Loss Food Plan’, and ‘Simple Steps To Slimming’ on this website.

Acute And Chronic Inflammation!

The Root Cause Of Diseases Like Diabetes, Heart Disease And Cancers!

Everyone knows hypertension, diabetes, heart disease, strokes, arthritis and cancers.

Few know that the root cause of these dangerous disease is inflammation!

What is inflammation?

We have all experienced injuries from our childhood when we fell and scratched our skin of legs and hands etc. We develop redness, swelling, pain and the area also becomes hot, and possibly bleeding if there is a wound, more than a mere scratch.

The redness, swelling, pain and heat are due to acute inflammation of the tissues of the area.

This is inflammation.

It is natural part of the process of healing of our bodies.

This is part of the body’s defence mechanism.

Inflammation can be acute and chronic.

Acute inflammation:

Whenever our body suffers from an injury or encounters an infection or a toxic substance, its immune system, which is the body’s defence mechanism, swings into action and unleashes its inflammatory cells and substances called cytokines at the site of injury.

Cytokines further stimulate more inflammatory cells to be unleashed in the area. The inflammatory cells trap and eliminate the invading bacteria or viruses or the toxin to initiate the healing process of the body.

This process causes pain, heat, redness and swelling. There may be some loss of function as the painful hand or leg becomes stiff as movement causes pain.

This is the process of acute inflammation which helps protect and heal the body after the injury. This process is healthy.

Chronic inflammation:

But sometimes the process of acute inflammation continues too long, even after the threat of the injury is over and the body continues to produce inflammatory cells which begin to attack healthy body tissues.

Untreated acute inflammation from infections, injury or toxins, chronic exposure to pollution or industrial toxins and autoimmune disorders lead to chronic inflammation.

Unchecked, this continuous state of inflammation becomes chronic inflammation and leads to diseases like diabetes, atherosclerosis, hypertension, heart disease, rheumatoid arthritis, asthma, Alzheimer’s disease and cancers.

In fact the root cause of almost all chronic diseases is chronic inflammation.

Chronic stress, bad food, complete lack of exercise or long term high intensity over exercise, obesity, smoking, regular alcohol consumption can also cause chronic inflammation.

The foods causing chronic inflammation:

Fried foods, fast foods.

Frozen meats cured with nitrites to preserve them and prevent growth of pathogenic bacteria.

Refined oils and trans fats.

Foods like pastries, white bread, bakery products prepared with sugar, refined carbohydrates like rava, maida, refined corn flour.

Life style factors leading to chronic inflammation:

Obesity.

Complete lack of exercise or exercising to the maximum limit too frequently.

Smoking, drinking alcohol.

Continuous stress.

Long term exposure to smoke and other air pollutants.

Treating inflammation:

Acute inflammation is easier to treat with rest, ice and good wound care.

Chronic inflammation is treated by nutritional supplements like Vitamins A, C and D and zinc and omega 3 or fish oil supplements and inclusion of fresh fruits, green leafy vegetables, tomatoes, low fat dairy, sea food and anti inflammatory spices like turmeric, garlic and ginger in food.

Preventing chronic inflammation:

Eating healthy.

Exercising moderately and regularly three to five times, daily better.

Maintaining healthy weight.

Keeping stress away by using techniques like meditation, yoganidra and pranayam.

Stopping smoking and avoiding drinking alcohol or keeping its consumption to the minimum.

Avoiding exposure to smoke and pollution.

Preventing chronic inflammation is preventing most chronic diseases!

So the pathway to healthy living is to eat healthy, exercising regularly, staying slim and stress free, avoiding smoking, alcohol and exposure to pollution.

Also read articles ‘Preventing Hypertension’, ‘Preventing Diabetes’ and ‘Heart Heathy Diet And Lifestyle!’ on this website.

Choosing A Healthy Cooking Oil!

How To Choose A Healthy Cooking Oil!

This is a delicate and controversial issue, involving complex scientific research which is still underway and emotions and geographical preferences and commercial interests of oil seed producers and the oil industry.

We have already seen in the ‘Heart Health Poster Boy Olive Oil Vs Groundnut Oil’ article on this website that the best oils nutritionally are groundnut oil for Indian style cooking and olive oil for Western type low temperature cooking or cold dressing oil.

Both oils are heart healthy and anti inflammatory oils.

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All oils are principally made up of three kinds of fatty acids, viz. saturated, monounsaturated and polyunsaturated fatty acids.

Oils rich in saturated fats are coconut, palm and palm kernel oils.

Saturated fats raise LDL cholesterol, which is harmful to heart health and their consumption leads to heart disease and strokes.

The saturated fatty acids in coconut oil have been portrayed by some to be a medium chain triglycerides (MCT) rich oil which is supposed to be absorbed directly in the portal vein and transported straight to the liver which uses it up immediately for energy and that it is not stored as fat, and hence it is said to be healthy.

This is true for a special formulation coconut oil composed of hundred per cent medium chain triglycerides, used as a special nutritional supplement for pre term, low birth weight babies and critically ill ICU patients, not for regular coconut oil. Regular, commercially available coconut oil is rich in lauric acid and other saturated fatty acids, which function as long chain triglycerides and are absorbed slowly and raise the LDL cholesterol levels leading to heart disease and strokes.

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Polyunsaturated fatty acids include the omega 6 and the omega 3 fatty acids.

Omega 6 (Linoleic) fatty acids trigger inflammatory processes in the body causing damage to tissues and vital organs while omega 3 (Linolenic) fatty acids reduce the inflammatory processes and protect the tissues and vital organs from inflammatory damage.

Thus oils rich in the omega 6 oils lead to diabetes, hypertension, heart disease and strokes while fats rich in omega 3 protect us from these diseases.

A high monounsaturated fatty acids to polyunsaturated fatty acids ratio oils help lower total cholesterol and the bad cholesterol, the LDL cholesterol and increase the good cholesterol, the HDL cholesterol and also reduce the inflammatory processes in the body, thus protecting us from, diabetes, hypertension, heart disease and strokes.

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Safflower seed oil is low in monounsaturated (oleic) fatty acids, 15 per cent, very high in omega 6 (Linoleic) fatty acids, 77 per cent and has zero omega 3 (Linolenic) fatty acids.

Thus it has a very bad monounsaturated fatty acids to polyunsaturated fatty acids ratio and completely lacs omega 3 (Linolenic) fatty acids.

Sunflower seed oil is low in monounsaturated (oleic) fatty acids, 25 per cent, very high in omega 6 (Linoleic) fatty acids, 64 per cent and is very low in omega 3 (Linolenic) fatty acids, 0 to 3 per cent.

Thus it too has a bad monounsaturated fatty acids to polyunsaturated fatty acids ratio and completely or nearly completely lacs omega 3 (Linolenic) fatty acids.

Soy oil is rich in omega 6 (Linoleic) fatty acids, 54 per cent and lower in monounsaturated (oleic) fatty acids, 23 per cent plus it has 10 per cent saturated fatty acids too.

Thus it has a bad monounsaturated fatty acids to polyunsaturated fatty acids ratio and also has substantial saturated fats.

Rice bran oil has 41.4 per cent monounsaturated (oleic) fatty acids, about 35 per cent omega 6 (Linoleic) fatty acids and about 20 per cent saturated fatty acids.

Thus it doesn’t have a high monounsaturated fatty acids to polyunsaturated fatty acids ratio and is also high in saturated fatty acids.

Cotton seed oil is rich in omega 6 (Linoleic) fatty acids, 55 per cent, low in monounsaturated (oleic) fatty acids, 17 per cent and high in saturated fatty acids, 22 to 29 per cent.

Thus it has a bad monounsaturated fatty acids to polyunsaturated fatty acids ratio and is also high in saturated fatty acids.

Sesame oil 43 per cent each monounsaturated and polyunsaturated fatty acids and 13 per cent saturated fatty acids.

Thus it too lacks a high monounsaturated to polyunsaturated fatty acids ratio.

Canola oil has a very favourable fatty acid composition, about 57 to 65 per cent monounsaturated fatty acids, 17 to 21 omega 6 fatty acid, about 12 per cent omega 3 fatty acids and about 6 per cent saturated fatty acids.

But it comes from a genetically modified plant and is an industry manufactured oil.

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Industry manufactured oils like soya oil, rice bran oil, corn oil, sunflower oil, safflower seed oil (kardai), Canola oil, cottonseed oil are considered bad fats by many nutritionists.

The use of heat and chemicals in extracting and refining these oils alters their fatty acid structures and trans fats and other toxic substances are developed in them, turning them unhealthy.

Today many researchers are asking us to shun all industrially produced oils.

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That leaves us with the choice of groundnut oil and olive oil!

Both oils have similar ability to control inflammation.

Olive oil has a better monounsaturated to omega 6 polyunsaturated fatty acids than groundnut oil.

Also olive oil which has a comparatively lower smoking point than groundnut oil cannot be considered as a premium cooking and frying oil for Indian style of cooking which involves deep frying.

Groundnut oil reportedly has greater oxidative stability and higher smoking point as compared to olive oil and has been considered as a premium cooking and frying oil as compared to olive oil. Gomez et. al., 2003 have shown that the phenolic compounds in extra virgin olive oil gets damaged very quickly by heat along with a loss of Vitamin E.

The preliminary analysis of blood samples from people who have been consuming groundnut and olive oil since one year do not show any significant differences in the biochemical parameters assessed.

Although more research is needed, the contention of the researchers is that groundnut oil could be the better choice of oils for Indians, than olive oil, both nutritionally as well as economically.

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Studies have also shown that resveratrol, a phenolic antioxidant present in groundnuts reduces the risk of vascular disease caused by angiotensin a hormone that causes the arteries to contract and leads to raised blood pressure which damages the endothelial lining of the arteries leading to heart disease and strokes, amongst damage to other organs. Resveratrol also protects the arteries by increasing the vasodilator hormone, nitric oxide.

Groundnuts also are high in the powerful antioxidant, Vitamin E, which protects the cells of the mucosa and skin from the damage caused by oxygen free radicals.

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In short, if you live in India and your oil consumption is moderate, you can safely use groundnut oil.

If you live in India and cook your food at low temperature and don’t mind spending extra money on your oil, or if you use oil only as salad dressing oil or  cook your food at low temperature and live in the US or Europe, you can use olive oil.

Also read the articles ‘Heart Health Poster Boy Olive Oil Vs Groundnut Oil’, The Good And The Bad Fats’ and the ‘Basics Of Nutrition’ on this website.

Heart Health Poster Boy Olive Oil Vs Groundnut Oil!

Choosing Between Olive Oil And Groundnut Oil!

Hit the internet to search for foods to fight inflammation and the chronic diseases like rheumatoid arthritis, diabetes and heart disease resulting from it and it invariably comes up with one particular food, the heart health poster boy, the extra virgin olive oil.

Researchers have for sometime now been advising us to use cold pressed monounsaturated dominant oils and olive oil suits the bill perfectly. But so does groundnut oil, also called peanut oil.

But olive oil, especially the extra virgin olive oil has been heavily promoted by the Western World as the poster boy of heart health!

The imported and expensive extra virgin olive oil, while out of reach of the average Indian homes, has found its way into the kitchens of the homes of the affluent Indians, probably in a big way!

Let us see how the homegrown, unglamorous, unadvertised and much cheaper cold pressed groundnut oil compares with extra virgin olive oil, as anti inflammatory and heart healthy oil.

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Both oils are cold pressed monounsaturated fatty acids dominant oils which have lower amounts of saturated and polyunsaturated fatty acids.

Researchers have known for some time now, that exactly this kind of oils are heart healthy, as they raise the levels of HDL cholesterol and lower levels of LDL cholesterol and they also have anti inflammatory properties.

Recent studies also show, that for a healthy lipid profile a high monounsaturated fatty acid to polyunsaturated fatty acid ratio is desirable and also high levels of monounsaturated fatty acids are beneficial in regulating blood sugar levels.

In this respect, olive oil is superior to groundnut oil as it has higher levels of polyunsaturated fatty acids than olive oil.

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A team of researchers at The Department Of Biochemistry, Shree Venkateswara College, University Of Delhi, has conducted a year long study of the effects of both oils on various health parameters of people consuming the two oils, including lipid profile, blood glucose, liver function efficiency, antioxidant status (lipid peroxides and antioxidant enzymes) and inflammatory properties (nitric oxide) in blood samples collected from populations who have been consuming olive oil  or groundnut oil as a staple oil for at least one year.

The study did not include diabetic patients, but it showed that the blood sugars levels of people in the study were normal at the end of the year.

The study showed that both olive and groundnut oils matched each other in their performance of keeping the HDL cholesterol levels high and total cholesterol and LDL cholesterol levels low at the end of one year. If any, groundnut oil people showed up slightly lower levels of triglycerides.

Both groups showed normal liver function meaning both groups had normal metabolism and no metabolic syndrome.

One of the marketing strategies of olive oil is that it contains increased amount of polyphenols / antioxidants which help reduce oxidative stress and promote overall health in consumers. So both oils were investigating for these activities and it was found that groundnut oil consumers also showed the same lipid peroxide levels as the olive oil consumers, adequate activity of antioxidant enzymes and comparable levels of nitric oxide, indicating that ground nut oil was as effective as olive oil on providing protection against oxidative damage and stress.

Also olive oil which has a comparatively lower smoking point than groundnut oil cannot be considered as a premium cooking and frying oil for Indian style of cooking which involves deep frying.

Groundnut oil reportedly has greater oxidative stability and higher smoking point as compared to olive oil and has been considered as a premium cooking and frying oil as compared to olive oil. Gomez et. al., 2003 have shown that the phenolic compounds in extra virgin olive oil gets damaged very quickly by heat along with a loss of Vitamin E.

The preliminary analysis of blood samples from people who have been consuming groundnut and olive oil since one year do not show any significant differences in the biochemical parameters assessed.

Although more research is needed, the contention of the researchers is that groundnut oil could be the better choice of oils for Indians, than olive oil, both nutritionally as well as economically.

***

Studies have also shown that resveratrol, a phenolic antioxidant present in groundnuts reduces the risk of vascular disease caused by angiotensin a hormone that causes the arteries to contract and leads to raised blood pressure which damages the endothelial lining of the arteries leading to heart disease and strokes, amongst damage to other organs. Resveratrol also protects the arteries by increasing the vasodilator hormone, nitric oxide.

Groundnuts also are high in the powerful antioxidant, Vitamin E, which protects the cells of the mucosa and skin from the damage caused by oxygen free radicals.

***

In short, if you live in India and your oil consumption is moderate, you can safely use groundnut oil.

If you cook your food at low temperature and don’t mind spending extra money on your oil, or if you cook your food at low temperature and live in the US or Europe, you can use olive oil.

Also read the articles ’Basics Of Nutrition’ and the ‘The Good And The Bad Fats’ on this website.

Omega 3 Fatty Acids!

Health Benefits Of Omega 3 Fatty Acids!

Carbohydrates, proteins and fats are the three macronutrients of our nutrition.

Fats are composed of fatty acids.

Fatty acids are of four types, the monounsaturated fatty acids, the polyunsaturated fatty acids, the saturated fatty acids and the trans fatty acids.

Of these, the body can synthesise most of the fatty acids from other fatty acids, except the polyunsaturated fatty acids. Hence they must to be acquired from food. So they are also called the essential fatty acids.

Polyunsaturated fatty acids include Omega 3 and omega 6 fatty acids.

The omega 3 fatty acids are majorly of three types, namely the Eicosapentaenoic acid  or EPA, docosahexaenoic acid or DHA and Alpha-linolenic acid or ALA.

Of these the DHA and EPA are the sea source or marine omega 3 and ALA is the plant source omega 3.

Marine algae are rich in the DHA and EPA.

Marine fish get the DHA and EPA from these algae.

We get DHA and the EPA fatty acids from these marine fish and ALA from plant sources, like walnuts, some oils like mustard oil and soy oil, flax seeds and flaxseed oil and leafy vegetables.

Seaweed, nori, spirulina, chlorella are some of the sea algae which contain DHA and EPA omega 3 fatty acids, but vegetarian people knowing about them or the chances of their being available and being consumed in India are slim.

Omega 3 are an important constituent of the cell membrane of all tissues of the body, they also have a role to play in the functioning of the receptors on the cell membrane and their genetic functions and in the formation of hormones essential for blood clotting, contraction and relaxation of the arterial walls and in the prevention of inflammation in the walls of the arteries.

Inflammation of the arterial walls leads to the development of arteriosclerosis or hardening and thickening of the arteries which lose their elasticity and this causes the blood pressure to go up.

This inflammation also causes atherosclerosis or development of plaques in and on the arterial walls.

This leads to narrowing of the arteries leading to heart disease, strokes and kidney disease depending upon which arteries are affected.

By preventing or reducing this inflammation, omega 3 help protect us against coronary artery (heart) disease and strokes.

They also help relieve the symptoms of metabolic syndrome.

They help lower blood pressure, regulate and lower the heart rate and improve the functioning of the arteries. They prevent irregular heart rhythm and arrhythmias, which accounts for majority of the cardiac deaths in the US and also kill lacs of people all over the world, every year.

DHA is also essential for the proper development of the brain and other parts of the nervous system of a baby from the first trimester of the mother’s pregnancy to the time the baby is two years old.

Marine omega 3 also help prevent ADHD and reduce the severity of asthma in children.

One large study (GISSI Prevention Trial) has found that heart attack survivors put on daily 1 gm supplement of omega 3 for three years were less likely to have another heart attack or stroke or die suddenly than those who took placebo.

In a recent Japan EPA Lipid Intervention Study (JELIS), it was found that those who took an EPA supplement along with statin (cholesterol lowering group of drugs) were less likely to suffer from a sudden cardiac event than those who took only statin.

So along with the evidence that they prevent heart disease and strokes, omega-3 fats have been shown to help control lupus, eczema, and rheumatoid arthritis, and may play protective roles in some cancer and other conditions.

Omega 3 are also beneficial for the health of the skin and the eyes.

By reducing inflammation, they help reduce acne lesions, improve hydration of the skin and help reduce redness, dryness and itching of skin in different conditions like dermatitis and psoriasis, helps relieve symptoms of sun burns due to ultraviolet A and B rays. They also help wound healing.

They are an important constituent of the structure of the retina and are essential for the health of the eye and vision. They are also linked to a reduced risk of macular degeneration which is one of the major reasons of blindness in the world.

They are also linked to lowered risk of depression and anxiety and relieve symptoms like sadness, lethargy and lack of interest in life and fear, panic and restlessness.

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Are there any alternative sources of marine omega 3, DHA and EPA?

Unfortunately most of the health benefits of omega 3 are due to the marine omega 3, DHA and EPA.

The plant source omega 3 or ALA doesn’t have the same benefits.

A small amount of ALA is converted by our bodies into marine omega 3 at a slow pace, but this is not enough, so non fish eaters lose out on the benefits of marine omega 3, which are obtained only by eating marine fish.

Contrary to the claims made by some poultry industries, eggs of chicken fed on flax seeds do not have much marine omega 3.

So the only source of marine omega 3 remains marine fish or fish oil.

But the fact remains that purely vegetarian people too can live long and healthy life.

So don’t try to eat fish if you have never eaten it!

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How much sea fish is enough to get adequate omega 3 fatty acids DHA and EPA?

Adults should eat about 170 gm sea fish twice a week and children between the ages of 2 to 8 years between 40 to 85 gm and children over 9 years between 115 to 140 gm twice a week to get enough of the two omega 3 fatty acids.

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How to cook fish to preserve more of the omega 3 available in the fish?

Boiling, steaming or cooking fish in a gravy, or baking it at 200 degrees for 20 minutes or smoking fish (not a common practice in India) can preserve much of the omega 3 in fish.

Cooking fish in a microwave at 200 degrees or lower temperature can also help retain most of the omega 3 intact.

The key to keeping the healthy omega 3 in your sea fish intact on cooking appears to be cooking it at a lower temperature than about 200 degrees and cooking it quickly in about 20 minutes, may even be at a lower temperature if for a little longer time frame.

Higher temperatures and longer cooking time completely alters the chemical structure of the fatty acids in the fish so it doesn’t resemble the original chemical structure of the fish lipids. High heat also helps develop the very harmful trans fatty acids and some other toxic substances in fish.

Deep frying or pan frying fish or cooking it in a tandoor are all done at high temperature which destroys most of the omega 3 in fish

Canning fish also destroys much or most of the omega 3 in fish.

Also read the articles ‘Basics Of Nutrition’, ‘The Good And The Bad Fats’ and the ‘Effect Of Cooking On Omega 3 In Fish’ on this website.

Understanding Pre Diabetes!

The Threat Of Pre Diabetes!

Even when I started my pioneering obesity clinic in Pune four decades ago, it was clear that we were fast becoming the world capital of diabetes and heart disease!

But the threat of a condition called pre diabetes was not as commonly recognised then as it is today.

Currently the commonest fear with which young people are approaching me to help them get over their weight and health issues is the threat of going from pre diabetes to full blown diabetes!

What exactly is pre diabetes?

Pre diabetes is a condition in which the blood sugar levels are raised above normal but are still lower than the diagnostic levels of diabetes.

The HbA1c or the glycated haemoglobin levels lie between 5.7 and 6.4 per cent, just below the diagnostic levels of diabetes, 6.5 per cent and above.

Pre diabetes is a condition that is part of the metabolic syndrome, characterised by obesity, especially abdominal obesity, hypertension, raised levels of triglycerides and LDL, the bad cholesterol and lowered levels of HDL, the good cholesterol.

LDL cholesterol causes blocks in the coronary arteries which leads to heart disease and myocardial infarctions or heart attacks and HDL cholesterol cleanses the coronary arteries off these blocks and protects us from heart disease.

Pre diabetes is considered the stepping stone towards developing diabetes and some of the complications of diabetes can affect the pre diabetics too.

Pre diabetes is diagnosed by checking the the blood sugar fasting and post prandial levels, the glucose tolerance test, the HbA1c, the blood insulin levels and the lipid profile. Abdominal obesity and hypertension confirm the presence of pre diabetes.

Pre diabetes may not have any recognisable signs and symptoms, that makes it even more difficult to diagnose.

But some people may have the same symptoms as those of diabetes, like excessive thirst, increased urination and fatigue and they could indicate that you aught to rule out pre diabetes and diabetes.

If you are suffering from obesity, especially abdominal obesity, have family history of diabetes, have a sedentary lifestyle, you should check your blood pressure, blood sugars, blood insulin, HbA1c and lipid profile, to screen for pre diabetes.

The causes of developing pre diabetes could be family history of diabetes, sedentary lifestyle, stress, older age, ladies who have had history of gestational diabetes and have had high birth weight (more than 9 pound) babies.

When carbohydrates are digested, they are absorbed in blood as sugar and the blood sugar levels increase.

In response to this the pancreas releases insulin in blood and insulin helps transport the sugar to various tissues of the body and under its influence, the cells of the tissues take up sugar from the blood and utilities it for the energy that they require for their functions.

 

Under the influence of insulin the liver also stores more sugar for providing energy to the body later.

This lowers the blood sugar and the blood insulin levels.

But when you eat too much sweets or sugary food regularly, the pancreas is forced to produce more insulin to bring down the blood sugar to normal.

After a while the cells of the various tissues stop responding adequately to the insulin and do not absorb sugar efficiently.

This means the cells of the tissues develop insulin resistance.

This causes both, the blood sugar and the blood insulin levels to stay high.

This raised blood level of insulin is called hyperinsulinemia.

When the capacity of the liver and the muscle cells to store sugar is over, the excess blood sugar is stored in the fat cells of various fat depots in the body and our weight increases, gradually leading to obesity.

Diagnostic levels of pre diabetes:

Fasting Blood Sugar Levels: Between 110 to 125 (WHO) or 100 to 125 (American Diabetes Association)

Sugar Tolerance Test: Between 140 and 199 mg/dL two hours after taking standardised 75 gm glucose solution.

Glycated Haemoglobin or HbA1c levels between 5.7 to 6.4 per cent.

Levels above these are diagnostic of diabetes.

Reversing Pre Diabetes:

The earlier that the condition of pre diabetes is diagnosed, the greater are the chances that it can be reversed.

How to reverse Pre Diabetes:

Getting physically more active and exercising regularly, walking adequately is the safest exercise, improves the insulin sensitivity of the cells of different tissues of our body.

That is the reason why exercise is the key to not only diabetes management, but also to our overall health and well being!

Keeping your consumption of sweets low, so it helps keep your blood insulin from rising unnecessarily high.

If you have uncontrollable craving for sweets, eat ample fruits through the day. It will take away the abnormal craving for eating sweets and also add valuable nutrition to your food.

Staying away from sweets with determination for a fortnight, to allow the taste buds on your tongue to get adjusted to not eating them. Once they are retrained, you won’t be able to eat as much sweets anyway.

So, to reverse your pre diabetes, you need to develop healthy food habits, eat nutritionally balanced food, exercise regularly, reduce your weight, keep stress low and sleep well.

And don’t wait to start all these things till you catch diabetes!

If you start now, you could most likely prevent the development of insulin resistance and pre diabetes!

Also read ‘Sweets, Obesity And Diabetes’, ‘Insulin Resistance And Diabetes’, ‘Dangers Of Eating Too Much Sweets’ and ‘Preventing Diabetes’ on this website.

Sweets, Obesity and Diabetes!

Eating Too Much Sweets, Obesity And Diabetes!

It was amply clear even when I started my then unique ‘Obesity Clinic’ in Pune, nearly 40 years ago, that our county was poised to be the world capital of diabetes and heart disease!

The three primary reasons for it were that we are genetically more prone to develop both diseases than people in the West and the increasing affluence of the Indian middle class meant that we are eating more calorie rich food and our lifestyles are getting more and more sedentary.

With the modern culture bringing in greater amount of sweets in our food with increasing temptations like rich deserts becoming available with mithai and cake shops and ice cream parlours springing up everywhere and the five star hotel culture introducing us to a rich dessert culture and the television and You Tube master chefs making the average house wives culinary experts, we are eating more and more sweets.

Sugar of course is nearly hundred per cent simple carbohydrate.

When we eat carbohydrates, they are digested and absorbed into the blood as sugar. When the blood sugar rises, the pancreas release the hormone insulin into the blood, to bring down the blood sugar to the normal levels and thus regulate the blood sugar.

The cells of every tissue in the body take up the sugar from the blood under the influence of insulin and use it for the energy that they need for their functions.

The liver also stores more sugar under the influence of insulin, for later use, when the body needs energy.

This brings down the blood sugar and in response, the pancreas cuts down on the insulin production.

This process is smooth and works seamlessly when we are healthy.

But when we eat too much of sweets or carbohydrates, a lot of sugar enters the blood.

This forces the pancreas to produce more insulin than normal, to influence the cells of various tissues to take up more sugar to control the blood sugar levels.

And if we continue to eat a lot of sweets regularly, after some time the various cells of the body respond less efficiently to the available insulin and do not absorb the sugar from the blood adequately.

This means that they become insulin resistant.

With the result, the blood sugar levels increase and so does the level of blood insulin.

This raised blood level of insulin is called hyperinsulinemia.

Under the influence of these raised levels of insulin, the liver and muscles store more sugar and when their capacity of storing sugar is full, this excess sugar is converted into fat and stored in various fat depots.

This leads to development of obesity.

This means our blood insulin, blood sugar and weight, all go up.

Over a period of time eating too much sugar and sweets leads to obesity and diabetes!

Also read the articles ‘Abdominal Obesity, Diabetes And Heart Disease‘, ‘Preventing Diabetes’ and the ‘Dangers Of Eating Too Much Sugar’ and ‘Insulin Resistance And Diabetes’ on this website.