Simple dietary hacks to beat the summer heat

With the temperature rising to unbearable levels this summer, it is important to know how to protect ourselves from the heat and to take preventive measures to avoid the adverse effects of the heat waves and intense humidity. Keeping our body cool from the inside by drinking plenty of water and consuming summer-friendly, nutritious foods are the best ways to beat the heat.

Adequate hydration is the most important thing our body needs to fight the soaring mercury level. When the outside temperature is very high, our body sweats a lot in an effort to keep the body surface cool. However, the body also loses some essential minerals like sodium and chloride along with the sweat. As a dietitian providing nutritional guidance to individuals with cardiovascular ailments and metabolic conditions like diabetes and obesity, I am glad to share the following dietary hacks that will help us all beat the summer heat.

Dietary hacks for the summer

  • Water: Drink at least 2-3 litres of water daily to stay well hydrated; remember to carry fresh drinking water with you to work, to your workouts, and just about anywhere you go.
  • Tender coconut water: Packed with essential electrolytes, minerals and vitamins, it helps to restore the body’s fluid balance. Remember to drink some of this naturally available energy drink before or after an activity where you sweat a lot.
  • Buttermilk or Lassi: This is an effective cooling agent and a refreshing beverage; it also provides essential probiotics, vitamins, and minerals that get depleted due to the intense summer heat. A glass of chilled buttermilk seasoned with a pinch of asafoetida, salt, and jeera powder is also the perfect welcome drink for summer social gatherings. A salt lassi or a mango lassi are some summer favourites too!
  • Watermelon: A versatile fruit with 90% water content, it hydrates the body during the summer season and helps in replacing the lost vitamins and minerals due to sweating. Use it in a fruit salad, as a glass of chilled juice, or watermelon ice cubes made from fresh juice. 
  • Musk melon: This summer fruit is a nature’s gift as it can be consumed in various forms.If you didn’t know, the dried and roasted musk melon seeds are rich in the healthy fatty acids, essential proteins, vitamins and minerals. Musk melon seeds can be dried, roasted and added to literally any dish.
  • Cucumber: Another water-rich vegetable, the cucumber can be incorporated in multiple ways in our daily diets during summer. It is good for hydration and detoxification and is best had as a raita, a juice or a salad.

Foods to avoid in the summer months

  • Spicy foods and deep fried foods are best avoided during the summer months.
  • Caffeine, soda and other carbonated drinks are to be consumed minimally as they can increase the risk of dehydration.
  • Red meat is rich in fat, takes more time to digest, and also increases the body temperature; instead, grilled and sautéed chicken and fish are better options.

When to get a doctor / dietician’s advise

  • In case you have been advised to limit your fluid intake by your doctor, you should get a dietician’s advice or a personalised diet plan suitable for the intense heat.
  • If you have a medical diagnosis and are taking medications, it is best to consult a dietician prior to making any dietary changes.
  • Individuals with dietary restrictions and allergies should be guided appropriately by a dietician in their healthy diet journey.
  • Individuals with heart diseases should remember to avoid exposure to extremes of temperature without adequate preparation as it can worsen their cardiac function.

In conclusion, consuming nature’s gift of summer-friendly fruits and vegetables that contain more vitamins and minerals is the best way to maintain the body’s hydration. Good hydration helps us work efficiently and keeps our brain more active. Remember to include at least 5 servings of fruits and vegetables everyday to stay healthy and hydrated this summer! Think wisely and choose foods and drinks that help to keep your body healthy despite the heat and remember to take the help of an experienced nutritionist for better personalised advise.


The Secret to exercising right

As a Physiotherapist managing cardio-metabolic conditions and catering to individuals with various exercise needs I am often faced with questions like “How much of exercise do I need?” and “Can over-exercising be bad for me?”. If you have had similar questions, read on to find out the answer.

The short answer is: similar to medication, exercise requires the right dosage to be both secure and efficient. And just like how medicines are prescribed based on your clinical condition, medical history, weight and height, exercise prescription is also tailored to each individual’s health status and fitness level. So, how does one get the right dose of exercise?

The secret of exercising right lies in the FITT Principle – Frequency, Intensity, Time and Type of exercise.

Let me walk you through the FITT Principle, which is the basic framework that we as exercise professionals follow to determine the right dose of exercise for our clients.

  • Frequency – This is simply HOW OFTEN you exercise or the number of days per week dedicated to an exercise routine; eg. 1 or 2 days per week, at least 3 days per week, 5 or more days per week etc.

Intensity – this is nothing but HOW HARD you exercise. It can vary between light, moderate and vigorous intensity. You would usually assess the intensity of your exercise by simple measures such as how breathless you are, you much you sweat and how fast your heart is beating. Some of you may use mobile apps or wearable devices that tells you your heart rate, respiratory rate etc. A useful method to assess the intensity of your exercise is the talk test; you can easily sing a song during light exercise, you can talk sentences but not sing during moderate exercise, and you will not be able to say more than a few words without pausing for a breath during a vigorous exercise.

Here are some examples of exercises in each intensity category:

  • Light – normal walking, gentle yoga
  • Moderate – brisk walking, cycling, dancing
  • Vigorous – running, swimming, competitive sports
  • Time – this is simply HOW LONG you exercise each time. It could be as short as 5 minutes or as long as 2 hours! Having an idea of the time you usually spend on exercise on a regular day and on a busy day is a must.
  • Type – this refers to the TYPE of exercise such as cardio or aerobic exercise, resistance training or anaerobic exercise, balance exercise and flexibility exercise. Each and every exercise you normally engage in can be categorised into 1 or more of the above types. Having a varied exercise routine incorporating all the types of exercise is key to overall fitness.

Benefits of using a correct dosage (FITT principle) for exercise:

  • It provides a framework which you can follow for developing an effective exercise program
  • It allows you to design a routine that ensures that you will attain a high level of physical fitness
  • It can be customised to meet your specific fitness goals 

A sample Exercise Framework for individuals with Cardio-metabolic conditions like obesity, hypertension, diabetes, and cardiac issues, using the FITT principle is as below:

FREQUENCY 5 to 6 days / week

In summary, the acronym FITT represents Frequency, Intensity, Time and Type. These are key factors in designing an exercise program which fits your fitness level and goal. Consulting your physician, getting your baseline parameters checked and seeking professional help for designing an exercise routine that is suitable for you is important for everyone, and more so if you have had a medical diagnosis and are under any medications.


Added sugar and its impact on our health

As a nutritionist managing the diet and lifestyle of individuals with heart ailments and comorbidites like diabetes, hypertension, obesity and chronic renal failure, I am hugely concerned about the alarming surge in people’s sugar intake! If you are wondering about what sugar is and what the difference is between natural and added sugar, I recommend you go through our earlier article

Now that you understand some basics about sugar, let us see how added sugar is detrimental to our overall health and our heart health in particular. The below image outlines all the detrimental effects of excess sugar in our diet. It is important to realise that making simple lifestyle changes like cutting down on sugar intake can reduce the risk of all of these and even other ailments like cancer and multi-organ damage.

The link between excessive sugar consumption and heart disease is worth elaborating upon. High levels of sugar in the blood can damage the inner walls of the blood vessels leading to coronary artery disease, heart attack and heart failure. This is one of the key reasons for heart problems and sudden death in youngsters today.

The vicious cycle

Habitual intake of sugary foods leads to several nutritional deficiencies which in turn are notorious triggers of sugar cravings. This vicious cycle has to be broken.

There are three steps in the fight against excess sugar consumption. When we explain to our clients these tips and tricks, they are often empowered to start taking the initial steps to overcoming the sugar addiction.

  1. Know the villains

Excessive sugar in the diet is the number 1 villain. And the main reason we consume so much added sugar is the addiction for sugar! Just like tobacco and alcohol, sweet dishes and treats are addictive. It is a ‘just a habit’ or ‘a harmless act’ as many would call it. But reaching out for chocolates, biscuits, candies and cookies after a meal or indulging in sweet snacks more than occasionally are truly harmful habits. Quite often, it is these small habits that add up to a critical health hazard.

You should be aware by now that added sugars are the secret ingredient in many packaged foods. Some common aliases for this villain are:

  • High-fructose corn syrup
  • Cane sugar or sucrose
  • Brown sugar
  • Honey
  • Agave syrup
  • Maple syrup
  • Fruit juice concentrate
  • Molasses

Huge amounts of sugar are added to soft juices, energy drinks, alcoholic drinks, soda, fruit drinks, pasta sauce, iced coffee and teas, bakery products like brownies, cookies and doughnuts, ice cream, salad dressing and even packaged yogurt. Reading food labels is one easy way to identify the level of added sugars in packaged foods, but be aware that most bakery items do not come with food labels and are nevertheless loaded with sugars!

2. Replace the villains with heroes

You want to cut down on added sugars but are there any foods to make up for that? Yes, there are some sugar-rich natural foods, the real heroes that are full of natural sugars like fructose, maltose and lactose, as detailed below.

  • Fruits (all fruits contain fructose which is a healthy form of sugar)
  • Vegetables (root vegetables like carrot and beetroot have more natural sugars than other vegetables)
  • Dairy products (lactose is the natural sugar present in dairy products)
  • Whole grains (the natural sugar maltose is present in several grains like wheat, barley and corn)

So go ahead and include at least 4-5 portions of fruits and vegetables, 2-3 portions of whole grain dishes and adequate dairy products in your daily diet and notice the difference! Your body will stop craving for sweet dishes simply because you are fuelling it with sufficient healthy and natural sugars! We should also be clear that sugar is an essential dietary component as long as it is consumed as natural foods and not in the form of added sugar.

3. Use hidden heroes to break the addiction

The hidden heroes are nothing but non-dietary measures that will help you to stay active physically and mentally and beat that boredom or depression, both of which are prime reasons for giving in to that sweet temptation.

Some hidden heroes that our clients have found useful in breaking their sugar addictions are:

  • Regular exercise
  • Adequate sleep
  • Sufficient hydration
  • Emotional balance / psychological support
  • Peer groups / Social circles with similar interests
  • Pursuing hobbies
  • Volunteering / social work
  • Creative arts / music / dance

In summary, sugar is not always a foe. It is definitely a friend and a key component of a healthy balanced diet provided we know how to stay away from those added sugars that are actually nothing but sweet-looking (and tasting) devils!


Cardiac rehab for heart failure

Heart failure, as you may know, is a condition where the heart fails to pump blood efficiently leading to shortness of breath, fatigue, weakness, swelling in the limbs, rapid or irregular heartbeat, persistent cough, loss of appetite and nausea. You may read our earlier article to better understand the causes and types of heart failure:

We now know that cardiac rehabilitation or cardiac rehab is the best therapy for heart failure, especially when combined with the right medications and surgical or interventional procedures as needed.

What is Cardiac Rehabilitation?

Cardiac rehabilitation is a program designed to help people with heart problems recover, improve their overall health and reduce the risk of future heart problems. It is a team effort involving healthcare professionals such as cardiologists/ physicians, nurses, physiotherapists, dietitians and psychologists. 

What are the phases of Cardiac Rehabilitation?

Phase 1: Inpatient Phase (in the hospital)

Patients with heart ailments such as heart failure might be referred to cardiac rehabilitation right from their hospital stay. The rehab team will assess and evaluate your physical as well as psychosocial abilities and initiate education, early mobilisation, medications and lifestyle modifications.

Phase 2: Outpatient Phase (post discharge)

Once the patient is discharged from the hospital, the rehabilitation will continue at an outpatient care facility. It involves supervised exercise training, education on risk factor management, nutritional guidance, psychological counselling and lifestyle changes.

Phase 3: Training Phase

It focuses on long term cardiovascular health maintenance and involves transition from supervised to a less supervised exercise training.

Phase 4: Maintenance Phase

This phase continues throughout your entire life once you complete the previous 3 phases. Patients are encouraged to make regular exercise a part of their daily routine and adopt healthy lifestyle choices.

How is Cardiac Rehabilitation beneficial in heart failure patients?

  • Makes the cardiovascular system stronger
  • Improves exercise capacity
  • Enhances quality of life
  • Reduces hospital readmissions
  • Improves long term adherence to healthy behaviours
  • Helps control the risk factors which lead to heart failure (e.g., diabetes, hypertension, etc.)
  • Elevates mood and positive attitude towards life

What are the safety measures to be followed during exercise?

  • Consult with your physician before starting or modifying an exercise routine
  • Start gradually and progress slowly
  • Prior to exercise, perform a warm-up routine and end the session with a cool-down period
  • Keep track of your heart rate and symptoms such as chest pain, palpitations, shortness of breath, dizziness, leg cramps and excessive fatigue
  • Stay hydrated, consuming fluids as advised by your physician
  • Take prescribed medicines as directed
  • Exercise in a safe and controlled environment

Hence, enrolling in a cardiac rehab program is a positive step towards taking control of your heart health and enjoying a better quality of life. Remember that you are not alone in this journey, and there is a dedicated team ready to support you in every possible way.


Obesity and Heart Health

Obesity or overweight, a state of excess accumulation of fat in the body, may lead to various diseases. When an individual is obese, their excess body fat can have detrimental effects on overall health as well as on heart health.

The heart has to work harder to pump blood in obese individuals, and this extra strain on the heart can lead to hypertension, heart muscle disease, heart rhythm abnormalities, enlarged heart and heart failure. It has recently come to limelight that a condition called “Obesity cardiomyopathy” accounts for a significant proportion of heart failure and can only be managed by experienced cardiologists.

A recent study by the Indian Council of Medical Research has shown that our country now has 101 million diabetics, with a further 136 million pre-diabetic individuals in need of prevention as shown in the statistics in the Metabolic non-communicable disease health report of India, ICMR.

The study also looked at the number of people with hypertension, central obesity and generalized obesity.

The vicious cycle

There is strong scientific evidence to show that obesity plays a key role in the causation of diabetes, hypertension and cholesterol abnormalities and together they contribute to the condition called Metabolic Syndrome. The vicious cycle of obesity worsening your blood sugar, blood pressure and cholesterol levels which in turn leads to deterioration in lifestyle and pushes one into further obesity, has to be halted right in the beginning. In fact, these are the most sinister precursors of killer diseases like heart attack and stroke. If you are wondering how being obese predisposes an individual to deadly ailments, the excess fat that builds up inside the arteries supplying the heart and brain – a condition known as atherosclerosis – is the culprit.

Timely detection and an early intervention are very important in addressing the obesity burden that the world is facing today. While maintaining an ideal body weight should be high priority right from the age of adolescence, the warning signs that warrant immediate medical attention in obese people are:

  • Fatigue or excessive tiredness
  • Shortness of breath
  • Inability to do their routine activities
  • Excessive snoring and daytime sleepiness
  • Swelling of feet, frequent coughs and colds
  • Chest pain
  • Palpitations

People with obesity not only face many physical challenges but significant emotional challenges too. Obese individuals may develop depression, anxiety, mood swings and eating disorders; hence it is vital to keep your loved ones on a routine medical follow-up and provide them adequate emotional support.

The causes for obesity are many

Lack of exercise, unhealthy food choices, chronic mental stress, long work hours, lack of sleep are some of the modifiable causes of obesity and the Metabolic Syndrome. It is important to identify and treat any underlying medical conditions like thyroid hormonal insufficiency and polycystic ovarian syndrome while correcting the lifestyle factors.

But the solution is simple

Overcoming obesity can be simple with the right knowledge, awareness, help and guidance.

Changes in lifestyle such as making healthier food choices, exercising regularly for at least 30 minutes daily, practicing good sleep hygiene, adopting stress management strategies and keeping a track of the silent killers namely BP, blood sugar and blood cholesterol are the cornerstones of beating obesity.

A simple measure of your waist and knowing your body mass index can reveal a lot about your heart health, talk to your healthcare provider about it. Please refer to our earlier article on this topic:

Below are a few tips that are rather simple to follow and easy on the pocket too:

  • Restrict use of processed and packaged foods
  • Stock your refrigerator / pantry with fresh fruits and veggies
  • Reach out to a variety of nuts and seeds like almonds, walnuts, sunflower seeds etc. as a snack instead of cookies and biscuits
  • Eat whole grains and pulses, limit use of refined grains and flours like maida, polished rice, sugars, and artificial sweeteners.
  • Learn to manage food portions well; use a smaller plate during meal times
  • Our humble buttermilk and lime juice are far better and healthier alternatives to soft drinks and packaged juices
  • Practice a good sleep routine; avoid the use of gadgets and bright screens prior to sleep
  • Ensure adequate water intake
  • Incorporate physical activity in your daily routine – use steps instead of elevators, park your vehicle a bit far away and walk to your office or the supermarket, try a walking break for 5-10 minutes every 1-2 hours while at work and learn; incorporate regular brisk aerobic exercise along with muscle strengthening exercises on a regular basis

In summary, obesity is a universal problem that significantly increases the risk of heart disease and several other chronic ailments. Taking proactive measures to address obesity through lifestyle changes is vital in promoting heart health and avoiding other comorbid conditions.


Awareness about a second heart attack is crucial

If you or your loved one has survived a heart attack, the only thing you don’t want is another one. Yet, research shows that 1 in 5 people have a second heart attack (technically called a recurrent myocardial infarction) within five years. And 1 in 10 people suffer a second heart attack within a year.

A recent publication in the Journal of the American Heart Association has thrown light on this important aspect of care for the heart patient. It has shown that patients admitted with a first heart attack are at the highest risk of a second attack within the first two days to two weeks after discharge from the hospital. The study also revealed that patients who suffer an early second attack have poor outcomes.

The three defenses that can protect you from that sinister second attack are:

  • Taking your heart medications
  • Attending the doctor visits
  • Joining a cardiac rehab program
A second heart can best be prevented by following the 3 steps

Please refer to our earlier posts on medications for the heart and cardiac rehab for a better understanding of these defenses:

The questions our patients usually ask when they join the cardiac rehab program are:

  • Am I at risk for another heart attack?
  • Is it possible to reverse my heart disease?
  • When can I get back to my work routine?
  • Do I really need to take so many pills?
  • When should I rush to the hospital’s emergency room?

While there is no one-size-fits-all answer to these questions, the evidence-based response is that a comprehensive cardiac rehab program provided by an experienced team of healthcare professionals is your best bet to lower your risk of a second heart attack, reverse your coronary blocks, reduce your medications, get you back to your work and life routine and finally stave off that much-dreaded emergency room visit.

The decision of how you will attend the rehab sessions, whether home-based / centre-based / hybrid, will be made jointly by you and the rehab team. The good thing is whichever format you attend, you will reap all the benefits of the cardiac rehab program such as higher energy levels, more ability to do the things you enjoy, a healthy weight, better control of blood sugar, blood pressure and lipids, heightened emotional wellbeing and an overall increase in quality of life and general wellbeing.

Upon completion of your intensive cardiac rehab program, it is important to stay on a regular follow-up with the rehab team to ensure that the benefits are sustained and that the long-term outcomes are good. There is strong scientific evidence to show that individuals who remain on a regular maintenance rehab phase stay healthier and have better cardiac outcomes than those who do not.


Role of Exercise in Hypertension

This World Hypertension Day, Cardiac Wellness Institute aims to improve awareness about hypertension and it’s causes and provide some practical tips to keep blood pressure under control.

World Hypertension Day: 17 May

The term blood pressure or BP refers to the force of blood flow in our arteries, produced by the pumping action of the heart, and should be lower than 120 / 80 mmHg in healthy adults. As a fitness expert, the most important parameter that I rely on to assess a person’s heart health is their BP.

High BP or hypertension is a silent killer as most people do not know their BP is high and may end up with a heart attack, heart failure, stroke, or renal failure without any warning. The only way to diagnose hypertension in an individual is by checking the BP using a BP monitor (at a doctor’s office or at home).

The factors known to cause hypertension are lack of physical activity, unhealthy diet along with excess salt intake, being overweight or obese, psychological stress, tobacco use, alcohol consumption, and a family history of hypertension.

There are 4 stages of hypertension as shown below.

Prehypertension:  120-139 / 80-89: At this stage we can control the BP by lifestyle modifications such as eating healthy fibre-rich foods, exercising regularly, reducing weight, and managing stress adequately.

Hypertension Stage I (140-159 / 90-99) and Stage II (160/100 and above): The plan here is to bring the BP under control at the earliest with medications and lifestyle modifications.

Hypertensive crisis (above 180/110): This is a medical emergency and will need urgent intervention to avoid multi organ damage and sudden death.

How regular exercise affects BP:

Regular exercise makes the heart healthier. A strong heart can pump more blood with less effort. As a result, the force on the arteries decreases, lowering the BP.

Regular exercise also helps to maintain a healthy weight which is another important way to control BP. Even losing small amounts of weight can lower the BP. In fact, adequate BP control in heart patients paves the way for reducing medications and reversal of the heart disease.

To keep the BP under control, one has to exercise regularly. It takes about one to three months for regular exercise to have an impact on the BP. It is important to note that the benefits last only as long as you continue to exercise. A combination of aerobic and strength training exercises has been shown to provide the most heart health benefits.

As you see in the American Heart Association’s guidelines below, we have to engage in at least 30 minutes of aerobic activity such as brisk walking, cycling, swimming etc. on 5 days of the week and also do muscle strengthening exercises on 2-3 days per week. Examples of resistance exercises that will improve our muscle strength are exercises using our own body weight like pushups, planks, squats etc. or using equipment like weight cuffs, resistance bands, dumbbells etc.

American Heart Association Recommendations for Physical Activity -  Infographic

Practical tips to keep BP under control:

  • Taking medications as advised
  • Being physically active regularly
  • Reducing salt intake (to less than 5 grams daily)
  • Eating more fruit and vegetables
  • Limiting the intake of foods rich in unhealthy fats and trans fats (eg. fried / baked / packaged foods)
  • Staying hydrated
  • Getting at least 6-8 hours of sleep per day
  • Avoiding the use of tobacco in any form
  • Reducing alcohol consumption
  • Splitting your exercise session into short bouts of 10-15 minutes 2 or 3 times a day if you are hard pressed for time

Patient stories:

Let me share a couple of real-life examples of how a lifestyle approach has helped in controlling BP in our clients.

A 54-year-old Civil Engineer, treated for hypertension and cholesterol issues for about 20 years, suffered a heart attack and underwent a bypass surgery. He enrolled in a 3-month cardiac rehabilitation program with us during which time we focused on supervised exercise training along with dietary modification and stress management counselling. He showed a lot of dedication and commitment to improve his health and we were glad to see his BP, cholesterol and other parameters coming under control beautifully.

A middle-aged working mother enrolled in our lifestyle program with a desire to reverse her hypertension and come off her BP medications which she had been taking for about 8 years. She had a young child and a demanding job, both of which had slowed down her self care attempts. We guided her on strategies to reduce her BP through exercise (effective walking and strengthening exercises for the limbs and core), following a balanced healthy diet rich in fibre and whole grains and focusing on breathing exercises to manage her stress better. Her overall wellbeing and lifestyle choices have improving significantly within a few weeks of joining our program and she is well on her way to achieving her health goal.

To summarise, hypertension is a silent killer but we can prevent, control and reverse high BP by being aware and acting in a timely manner. The mantra to follow is know your BP, consult your doctor, modify your health behaviour and keep your heart healthy.


Anemia in the general population and in heart patients

What is anemia?

Anemia is a condition in which your body does not have enough healthy red blood cells to carry adequate oxygen to your body’s tissues. Having anemia, also referred to as low hemoglobin, can make you feel tired and weak and is often associated with pale skin and nails, and hair fall.

Anemia widely affects people of all age groups and genders. In India, the prevalence of anemia is as high as 38% in women, 22% in men and 40% in pregnant women.

Anemia is diagnosed by a blood test called complete blood count that looks at the hemoglobin level along with cell counts in the blood. The normal value of hemoglobin for women is 12-15.5 g/dl and for men it is 13-17.5 g/dl. Anything below this hemoglobin level is considered to be anemia.

What are the types of anemia?

Nutritional anemia is the commonest type of anemia and is divided into iron deficiency anemia, vitamin B12 deficiency anemia and folic acid deficiency anemia. The lack of the desired amount of vitamins and minerals, also known as micronutrients, in our diet is the main reason why nutritional anemia develops.

The other less common types of anemia may be due to genetic factors, abnormal red blood cells, chronic illnesses and disease of the bone marrow.

Who is at risk of developing anemia?

The following groups of people are at a high risk of developing anemia:

1. Lack of a balanced healthy diet leads to nutritional anemia. People may not be consuming a healthy diet due to lack of knowledge about healthy food choices, lack of financial means to procure healthy food, or due to poorly informed dietary practices such as avoidance diets, crash diets etc.

2. Chronic blood loss such as women in the reproductive age group with heavy menstrual bleeding, individuals with undiagnosed occult blood loss from the gut, and medication-induced bleeding in those who take pain medication for prolonged periods of time.

3. Acute blood loss such as during surgical procedures and road traffic accidents.

4.  Elderly individuals are at a higher risk of developing anemia due to a combination of factors such as poor appetite, dentition related issues, reduced absorption of nutrients from the gut, associated co-morbidities and lack of access to fresh and nutritionally wholesome foods.

5. Pregnant women are susceptible to anemia because of the increased demand posed by the developing fetus.

6. Adolescent girls are prone to anemia due to the alterations in their body physiology and the hormonal changes associated with menstruation.

7. Individuals with any chronic conditions such as chronic kidney disease, liver disease, heart failure and malabsorption syndromes are at high risk for developing anemia.

Why should heart patients be extra vigilant about anemia?

From the above discussion, it is clear that anemia may occur in heart patients who have undergone cardiac surgeries such as bypass surgery or valve surgery, in individuals with heart failure and in almost any cardiac patient with poor nutritional habits. As the heart is the pumping organ responsible for circulating blood to all parts of the body, whenever there is anemia your heart has to work much harder than normal to ensure that the rest of the body gets sufficient oxygen and energy. This means that the wear and tear on the heart muscle is higher when you are anemic and therefore the possibility of the heart becoming weak or failing is also much higher than in normal individuals. In fact, anemia, heart failure and renal failure are a deadly combination as they form a vicious cycle where one worsens the other and leads to rapid deterioration of overall health. Hence, it is very important to diagnose anemia in a timely manner and to treat it at the earliest to avoid further complications. 

What should you do if you have symptoms of anemia or are at risk?

If you are experiencing symptoms such as undue tiredness or fatigue, breathlessness while doing routine activities, or have had a history of surgery or excessive and prolonged bleeding, visiting your physician should be the first step. After running a battery of tests, your doctor will be able to come to a conclusion about what type of anemia you have and advise you on the appropriate interventions to overcome the problem. While dietary modifications and supplemental iron pills are the most commonly employed solutions, intravenous iron infusion and blood transfusion may be necessary in severe deficiency.

What are the nutritional strategies to overcome anemia?

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As a cardiopulmonary dietician, I often guide individuals with anemia on how to improve their hemoglobin level through dietary modifications. Let me walk you through some tips about consuming a diet rich in iron and ensuring that the dietary iron is efficiently absorbed into your bloodstream

There are two types of iron in your food: heme iron that is present in animal sources and non-heme iron that is present in plant sources.

Animal sources of iron – lean meat, chicken breast, meat liver, sardine, oyster, crab, tuna, mackerel, salmon

Plant sources of iron

Nuts and seeds – Nuts, seeds and dried fruits such as figs, dates, pistachios, hemp seeds, pumpkin seeds

Green leafy vegetables – Dark green leaves such as drumstick leaves, spinach, kale

Beans – Chickpeas, kidney beans, soy beans, black beans

Whole grains and millets – such as oats, whole wheat, ragi

Fortified foods – There are a variety of foods that are fortified with iron such as fortified pasta, fortified white rice, fortified orange juice, fortified cereals etc.

Vitamin C helps the absorption of iron in the body and is also essential for cell growth, development and repair of all body tissues, proper functioning of the immune system, and wound healing. Dietary sources of Vitamin C are gooseberry, orange, lemon,  guava, strawberries, papaya, capsicum and broccoli.

Vitamin B12 and folic acid are also important in order for our body to produce healthy red blood cells. Sources of Vitamin B12 for vegetarians are bananas, melons, sprouts, soy milk and tofu.

Folic acid is present in green leafy vegetables, dried beans and peas, nuts, enriched bread, cereals and other grains.

Poultry, fish, dairy products and eggs also contain both these micronutrients.

In summary, anemia is a common medical condition that should be diagnosed and managed early. Regular routine health checks are very useful in picking up the condition in otherwise well individuals. Eating a balanced diet with a focus on locally available iron-rich foods along with vitamin C, vitamin B12 and folic acid containing foods is the ideal way to prevent and manage nutritional anemias.


10 Tips to Stay Fit this Festive Season

The much-awaited festive season is here! Sure you are making plans to celebrate Christmas, New Year, and Pongal with friends and family. This is indeed a great time to enjoy and to have fun, especially after the gruelling months of the pandemic. But many of you may have already realised that it is a challenge to stay fit in the midst of all the fun, celebration, and togetherness. In fact, you may be wondering how some people manage to maintain their fitness levels despite the temptations all around.

In this post, we would like to share some easy tips to help you stay fit this festive season.

1. Stay energetic

Allotting time for workouts during the festive season is not easy but you definitely can plan get-togethers that involve a walk along the beach, some games in the park, or a neighbourhood stroll. Walking to the nearby stores or to your hang-out spot instead of taking your two / four-wheeler is a healthier alternative.

2. Play with your kids/grandkids/friends 

A nice picnic in the park, outdoor games like Frisbee, Kho Kho, 7 tiles, Cricket, Badminton, and Cycling are some great bonding activities for multi-generation families and for friends. Kids can come up with their own creative games too but the only rule is it should be an active one.

3. Move more sit less

There may be many interesting programs on the TV but remember that long hours of sitting can bring a lot of trouble. Take short walks between serials, spread your household chores in such a way that you get up and move every 30 minutes and just do some simple stretches and on-spot exercises to get the muscles working and the blood circulating.

4. Aim for a colourful meal every day

Most of the foods that we eat during the festive season are fried, oily, baked and loaded with lots of calories. Including more fruits and vegetables in various dishes is a great way to compensate for the festive indulgence. Naturally available foods are rich in fibres, minerals, and nutrients and are fat-free; in short, they are the best way to ensure a glowing skin, a healthy gut, and complete wellbeing.

5. Be mindful of what you eat

Mindful eating simply means enjoying whatever you eat by chewing properly and relishing the food, taking time to eat and not rushing, watching the portion size, and stopping when you feel satisfied (or even before that) so that you feel good at the end of the meal and not stuffed or bursting. Avoid the unhealthy cycle of binge eating and then fasting.

6. Keep oil to a minimum and do not reuse oil

While keeping oil consumption low is a great idea, you may be tempted to reuse the leftover oil for some other dish but beware (!) – repeated heating of any oil leads to the formation of trans-fats which are the worst type of fats and are extremely harmful to the heart, the blood vessels and all the organs.

7. Drink more water

Drinking a few glasses of water before a big party will make you feel fuller, eat lesser and get your digestive system going at the same time. Limit the consumption of alcoholic and non-alcoholic beverages and choose fresh juices (no added sugar) instead.

8. Stick to a bedtime routine

Late night parties are best avoided or wrapped up early as unhealthy meals with lack of sleep is a deadly combo. Schedule early dinners if possible and try to have at least an hour or two between dinner and bedtime. Getting a good night’s sleep of 7-8 hours is the best thing you can do for yourself.

9. Plan ahead

A little bit of proactive thinking and planning will come in handy this festive season. If you are hosting parties, ensure you provide adequate options for those guests who may be calorie conscious or on a restricted diet due to some health condition. Likewise, let your hosts know beforehand your dietary preferences if you are invited to a get-together.

10. Cheer up, say thank you

Remember, this season is all about loving, caring, being thankful, and spreading good cheer. Being emotionally well is a major part of being physically fit. So, unleash your creative talents and come up with the most innovative ways to say “Thank You” to all those who have made your year a memorable one.

Team Cardiac Wellness Institute takes this opportunity to wish each and every one of you a wonderful festive season – a Merry Christmas, a Happy New Year, and a Happy Pongal! Stay safe, follow COVID safety protocols, and have a fit start to the New Year!


Healthy salads for a healthy heart

Adding some raw foods to our everyday diet has many benefits. Raw foods have more nutrient content, density, flavour, texture and are rich in fibre that helps you feel fresh and energetic. The best way to eat raw food is to make them into salads of different types. Our daily dietary requirement is at least 3 cups of vegetables and 2 cups of fruits (with one cup measuring approximately 80 grams of foodstuff) and a nutritious salad can help us meet this requirement easily. If you are a busy person and would like to prepare a healthy, nutritious and colourful salad bowl at home, for you and your family or friends, within a few minutes, then this post is just for you!

There are different types of salads such as greens salad, fruit salad, rice and pasta salad, vegan salad, vegetarian salad, seafood salad, lean meat salad and many more. In fact, “raitas”, the desi way of consuming raw vegetables are an excellent option too and a great side dish for our Indian delicacies. Moreover, salad recipes can be made tastier by adding healthy ingredients like whole grains, dried fruits, fresh herbs, seeds and nuts. These will not only improve the flavour of your salad but will also add value to the nutritional content.

A salad can be a filling wholesome meal by itself or a between-meal hunger quencher. As they are easy to prepare, do not require much cooking experience and are often the best opportunity to showcase your creative talents in the kitchen, we invite you to begin your journey with salads today!

Some of the health benefits of salads are:

  • Rich in vitamins and minerals, thereby boosts your immunity and prevents infections and helps to manage hypertension and cholesterol abnormalities
  • Contains the healthy type of fat, hence good for your heart and blood vessels
  • Has a desirable effect on sugar metabolism, hence recommended for diabetes prevention and control
  • Rich in fibre, therefore the ideal way to stay away from constipation
  • Low in calories, hence your best choice at any time of the day without having to worry about weight gain

Let me share some simple and nutritious vegetable salad recipes for the benefit of our readers.

1. Sweet and Spicy Tofu Salad with carrot

Tofu is a good source of protein and contains all nine essential amino acids. It is a plant source of iron, calcium, manganese and phosphorous. It also contains magnesium, copper, zinc and vitamin B1. It helps to lower LDL cholesterol, reduces the risk of breast cancer and osteoporosis, and keeps the liver healthy.


  1. Tofu – 1 cup
  2. carrot, steamed – 1
  3. Onion, finely chopped – 1
  4. Tomatoes, finely chopped – 2
  5. Coriander Leaves, roughly chopped
  6. Green Chilli, finely chopped – 1
  7. Dates syrup, or honey – 1 tablespoon (may be replaced by soy sauce)
  8. Salt as required
  9. Pepper as required


  • Chop the carrots into equal size and place it in a steamer
  • Steam the carrot in a steamer until cooked well
  • Once the carrots are steamed, set them to cool completely
  • In a bowl add the onion, tomatoes, the steamed carrots and green chilli
  • Now add tofu diced in the bowl
  • Add honey/dates syrup/soy sauce to the bowl
  • Add salt and pepper to taste
  • Add the coriander leaves
  • Gently mix it, your salad is ready to serve

2. Sprouts with roasted mushroom salad

Mushrooms are rich in fibre, protein, antioxidants, B vitamins like riboflavin and niacin, selenium and are low calorie as well. Sprouted legumes are a rich source of proteins and are ideal for all age groups.


  1. Mango (raw), peeled – 1/2
  2. Mushrooms – 10
  3. Green moong sprouts – 1 cup
  4. Puffed rice – ½ cup
  5. Onion – 1
  6. Tomato – 1
  7. Salt, pepper, chat masala, chilli flakes, as required
  8. Oil (sesame oil / sunflower oil) 1 table spoon
  9. Lemon juice, from half a lemon
  10.  Coriander leaves, roughly chopped


  • Wash the mushrooms and cut into small pieces
  • Roast the mushrooms in oil for 10 –15 minutes
  • Once the mushrooms are roasted, set them to cool completely
  • Peel the raw mango & cut it into equal size
  • In a bowl add the onion, tomatoes, the roasted mushrooms along with puffed rice and raw mango
  • Add red chilli flakes, salt, pepper or chat masala to taste
  • For more taste, add a few drops of lemon juice
  • Add the coriander leaves and gently mix with it, now the salad is ready to serve

3. Spicy chickpeas salad (zero oil sundal)

Chickpeas are a good source of protein and fiber. They are also rich in iron, zinc, phosphorus and B vitamins. Chickpeas help to control blood sugar, improve digestion and to lower cholesterol.


  1. Chickpeas – 1 cup
  2. Onion – ½
  3. Tomato – 1
  4. Green chillies – 1-2
  5. Raw mango chopped – 1/3 cup
  6. Juice of half a lemon
  7. Coriander leaves, roughly chopped
  8. Salt and pepper as required
  9. Red chilli powder as required


  • Soak the chickpeas overnight
  • Boil the chickpeas for 30 – 35 minutes till they get soft
  • Add the boiled chickpeas in a bowl, and add chopped onion, tomatoes, green chilli, tomato, puffed rice, raw mango,
  • Add salt and pepper and red chilli powder to taste
  • For more taste squeeze the lemon juice
  • Add the coriander leaves and gently mix it, now the salad is ready to serve

4. Spicy vegetable salad with curd

A diet rich in vegetables helps to lower blood pressure, reduces the risk of heart disease and stroke and prevents cancer digestive problems. Vegetables are a good source of many nutrients, including potassium, magnesium, iron dietary fiber, folate, vitamin A and C.

Curd is a great source of probiotic and the bacteria present in curd helps to improve the digestive health and gut activity. It boosts immunity and builds strong bones and teeth. Curd is rich in calcium, vitamin B-2, vitamin B-12, potassium, and magnesium


  1. Carrot – 1
  2. Cucumber – 1
  3. Onion -1
  4. Tomato – 1
  5. Curd / yogurt – 1 cup
  6. Capsicum-1
  7. Salt, red chilli powder – to taste
  8. Coriander leaves, roughly chopped


  • Rinse the vegetables in water; chop the carrot, tomatoes, capsicum, cucumber, onion in equal sized pieces
  • Add the chopped vegetables to a mixing bowl
  • Whisk the yogurt/ curd till smooth
  • Add the chilli powder and salt in the curd and mix well
  • Now add the chopped vegetables and coriander leaves and mix it gently, now the salad is ready to serve.

Happy salad prep to our readers! Please do let us know your feedback after trying out these salad recipes. You may email us at for any questions or clarifications.


Pain and its implications in a heart patient

As a cardiac rehab expert working with and helping individuals in their recovery from heart ailments, the commonest complaint that is brought to my attention is ‘pain’.

Cardiac rehab, the only proven path to complete recovery from cardiac conditions, is comprehensive in nature, medically supervised, and addresses all your lifestyle choices, risk factors and symptoms including pain. The most common sites where pain may be felt while recovering from cardiac surgery or procedure are the chest, upper back, upper abdomen, access sites like wrist or groin and vein removal sites like legs. Let me walk you through some real-life scenarios where we worked closely with our cardiac rehab participants to understand and address pain.

Scenario 1

A 70-year old Businessman who was under treatment for hypertension for over 40 years was diagnosed with severe coronary artery blocks and underwent open-heart bypass surgery.

Being a very active and fit person, he enrolled in our cardiac rehab program within a few weeks of the bypass surgery with an aim to recover completely and to get back to his gym-based exercises and swimming at the earliest. We were glad to see his enthusiasm to walk long distances and engage in strengthening exercises taught by us but we had to advise him to hold back and not perform over-zealously as he was just recovering from a major surgery.

While on the cardiac rehab program, he started to experience upper back pain that was aggravated in the lying position due to which he was unable to sleep well and felt tired in the daytime. After a thorough assessment, we explained to him that the pain is due to a combination of abnormal body posture which is quite common after an open chest surgery and over-exertion due to long brisk walks while the body is still recovering. We guided him with some postural correction techniques, advised him to do short bouts of brisk exercise instead of long sessions and suggested a few tips to relieve the muscular spasm. He felt a lot better within a couple of weeks and was able to sleep well and do a variety of exercises within 6 weeks of surgery.

Scenario 2

A 51-year old Architect had suffered a heart attack in the year 2019 for which he underwent a coronary stent procedure and had another attack and stenting in 2020 and presented to us for cardiac rehab during the pandemic. He complained of angina (chest pain) while exercising.

After going through his medical records and interrogating him, we understood that his angina was not new but persisted for quite some time. We first reassured him that his coronary blocks had been treated appropriately with stents. We then provided him closely supervised exercise training sessions with adequate guidance on what to do to relieve the pain. As he had lost his job during the early days of the pandemic, we ensured to counsel him on the psychosocial aspects as well along with nutritional guidance to modify his dietary behaviour. These measures along with some minor modifications to his prescription helped relieve him of his angina and he went on to complete the cardiac rehab program successfully. He also got placed in another firm and was looking forward to a fresh start when he completed the program with us.

Scenario 3

A 47-year old Marine Engineer, who underwent a combination of stent procedure plus minimally invasive bypass surgery, complained of shoulder pain that affected his daily activities and hindered his sleep. The cardiac diagnosis had come as a complete shock to him and his wife as he had just come back home after a long voyage and had a heart attack the very next day.

We noticed that he had discomfort in the keyhole access site on the left side of his chest due to which he was avoiding using the left arm and was overusing his right arm instead. We offered him simple solutions like hot pack applications and gentle shoulder exercises, which helped him to adhere to the rehab program better.

He has been on the rehab program for over 8 weeks now and has been following our guidance strictly. He is glad that he is able to perform all his routine activities comfortably and that he is able to build his fitness levels with professional help. He used to smoke in the past and has been counselled on the importance of complete avoidance of all tobacco products.

Scenario 4

A 62-year old retired Airforce personnel with diabetes complained of pain at the surgical site 6 weeks after undergoing open-heart bypass surgery.

Being a fit person with regular exercise habits he was disappointed and emotionally shaken after being diagnosed with a cardiac condition. Residing far away from our rehab centre, he made use of the home-based rehab program option and showed a lot of dedication and willpower to improve his health.

We guided him on strategies to resume exercises without aggravating his pain and worked closely with him to alleviate his anxiety and sleep issues. While his overall wellbeing, his blood sugar control and his lifestyle choices improved significantly within a few weeks, we redirected him back to his surgical team to examine him and search for any local cause for lingering pain in the surgical site.

We hope that our readers have gained some valuable insights into how we work together with our patients to understand the root cause of pain and address them appropriately. It is a gratifying experience every time we see a smile on their face, be it with more awareness, improved symptoms, or the sheer joy of gaining a clear idea about their condition and the ways to manage their health better.


Eat right to regain health after your bypass surgery

Good nutrition is important for us to be healthy, prevent many diseases and feel good, and is especially important for our hearts as heart disease is the number one killer disease today. Quite often we manage our ailments through lifestyle changes, medications or non-surgical procedures, but there are some medical conditions that need to be surgically managed and cardiac conditions are no exception to this.

A surgical procedure that is performed to resolve a problem in the heart is called a cardiac surgery or a heart operation. The most commonly performed type of cardiac surgery is Coronary Artery Bypass Graft also known as bypass surgery. A bypass surgery may be done via an open heart procedure where the rib cage is cut open to access the heart or a minimally invasive procedure where the heart is accessed through key holes without opening the rib cage. Bypass surgery has been used for the treatment of heart attack or coronary artery disease for more than 50 years, and has been performed for millions of people worldwide. The recovery process after a cardiac surgery can differ depending on varying procedures performed as part of the patient’s operative treatment. Caring for wounds and keeping up good health is mandatory after the surgery.

Dietary management after cardiac surgery

In the immediate post-operative period, nutrition is provided through an intravenous line in order to rest your gut and to allow your anaesthesia to wean off completely. This is known as parenteral nutrition and is planned by your surgical team and the hospital’s in-house dietician. Once your surgical team certifies you fit for oral food intake, you will be initiated on a healthy liquid-based diet that is easy to digest like soups, stews, protein-based drinks followed by semi-solid foods like porridge, smoothies etc. and then slowly progressed to a solid diet. You may notice that your appetite is poor and that the food has lost its flavour in the early post operative period. Your sense of smell may change and you may also experience a strange metallic taste in your mouth. This can be caused by the operation or your medications and can take some time to fully recover. Eating small amounts of food at frequent intervals is a good way to gradually build your digestive abilities.

Common dietary questions of individuals undergoing bypass surgery

There are some common questions that I face as a dietician from individuals who have undergone bypass surgery recently and would like to share them here for the benefit of the readers.

  1. What is the best diet after bypass surgery?

Our bodies get stressed when we are ill or have surgeries and it is very important to have good nutrition before your surgery (if it is a planned surgery) to help you heal faster after your surgery. Many studies have shown that a diet rich in fruits, vegetables, whole grains, nuts and seeds can reduce your risk of heart disease and help you heal better post surgery. A healthy balanced diet (2 serves of fruit, 5 serves of vegetables and 4 or more serves of whole grains per day, lean proteins and legumes, nuts and oil seeds, low fat dairy products) will help the body to heal, reduce the risk of complications and enable speedy recovery. Maintaining a well-balanced diet plays an integral part in reducing surgical complications and promoting heart disease reversal

2. How much protein should I consume on a daily basis?

You need a good proportion of protein and enough calories to heal after a cardiac surgery. The normal protein intake for a healthy individual is 1 gram per kilogram body weight whereas 1.2-1.5 grams per kilogram body weight are required per day if you have undergone a bypass surgery. It can be hard to meet your daily requirements because you may be on medications that affect your appetite. Taking small frequent protein-rich foods like lean meats soups, sprouts or ‘sundal’, low fat milk products, ‘dhals’ or legumes, mixed unsalted nuts and seeds can help you meet the protein requirements

3. What are the recommended levels of sugar and salt intake?

Sugar – sugary foods are often consumed instead of healthy foods and can contribute to poor blood sugar control and weight gain. Keep your blood sugars under control; high blood sugar also makes it hard for your body to heal. Added sugar in any form like white sugar, brown sugar, jaggery or honey is harmful and is best avoided or kept to a minimum.

Salt – reducing your salt intake or limiting your sodium intake to less than 1,500 mg per day helps by reducing fluid accumulation and preventing excessive stress on the heart. Cardiac patients are regularly advised to consume less than 5 g of salt per day (less than 1 tablespoon per day) which means that you need to follow low-salt cooking and avoid packaged foods, pickles, ‘papads’, crisps and other snacks which are high in hidden salt.

4. What foods should I avoid after my bypass surgery?

Foods with a high saturated fat content like liver and organ meats, egg yolk, whole milk, ghee, butter, cream and whole-milk cheese should be limited to once or twice a week. Fried foods, packaged and processed foods and pastries should be avoided completely as they are high in trans fat that is extremely unhealthy for the recovering body tissues.

5. How can I eat better to improve my good cholesterol or HDL (High Density Lipoproteins)?

High-density lipoprotein (HDL) is the good kind of cholesterol that will keep your arteries healthy. Mixed nuts and seeds, lean meat, fish and beans are the dietary sources to increase HDL level. Several medical and environmental factors such as sedentary lifestyle, uncontrolled blood sugar, inflammation, smoking and obesity are also responsible for low HDL cholesterol and should be aggressively modified.

6. How much of dietary fiber do I need?

Fiber is an important component of a healthy balanced meal. It acts as a natural laxative by increasing stool bulk, which allows stools to pass more readily through the colon. Most of the fiber is found in the husk and skin of fruits, vegetables, greens and whole grains. The normal requirement of fiber for an individual is 25-30 grams per day. Constipation is the biggest enemy for heart health and should be completely avoided in heart patients. Post surgery, you may have constipation due to improper food intake, less fruits, vegetables and whole grains in your diet, less fluid intake, medications and physical inactivity. Consuming adequate fiber will help to prevent constipation and keep your heart as well as gut healthy.

These are the most frequent and common questions asked by cardiac patients and their caregivers. Eating right is an art. Eating right after a surgery is extremely important to the healing process. Therefore, it is vital that you stick to the diet chart prescribed by your dietitian. Do not hesitate to ask questions or raise your concerns to your doctor or dietitian. Be sure to get the physical activity and exercise your physiotherapist recommends, stay away from smoking, keep your blood sugar and blood pressure under control, and do things that make you happy and help you relax.


How cardiac care has evolved during the pandemic

Cardiac care can be broadly divided into acute management of cardiac emergencies and longer-term prevention and rehabilitation strategies for the heart patient. In this post, we would like to share our experience on how cardiac rehab has evolved with the ongoing pandemic.

During the pre-COVID era, our focus was predominantly on conventional centre-based cardiac rehab where patients and their caregivers would visit our rehab centre on a periodic basis for sessions with the doctor, physiotherapist, dietician, counselling psychologist and yoga therapist. Home-based cardiac rehab offered through tele / online modality occupied a minor portion of our work prior to the pandemic and was reserved for those living outside Chennai or abroad. However, it was gratifying to note that both formats were well appreciated by the participants and the program outcomes were excellent irrespective of whether they were attending in-person or home-based sessions and we have shared our thoughts on this topic in June of 2019 (click the link for the earlier post).

The biggest advantages of in-person care are the personal touch and the ability to examine the patient. Looking back, these are the things we have missed the most in the past year since the start of the lockdown as our entire team of healthcare professionals switched to the work-from-home mode to maintain continuity of care and uninterrupted services for patients.

We initiated HeartHealth@Home, an online consultation service to cater to patients’ queries and concerns related to cardiac care while at home during the lockdown. Some common issues for which people approached us were:

  • Symptoms like gastritis, heartburn and chest pain for which detailed history was elicited and appropriate guidance given
  • Doubts about cardiac medications and their dosages as they were not able to contact their primary physician
  • Questions about COVID-19 related safety measures in individuals with diabetes, hypertension and heart ailments
  • Queries pertaining to when to approach the hospital and whether it was safe to do so during the pandemic

We realised that our home-based cardiac prevention and rehab program soon became a much sought after service as patients were able to make use of the online services seamlessly and cardiologists and heart surgeons were happy to refer their patients. The initial evaluation, the program planning and the execution of the rehab sessions were all done online and smooth communication was maintained with the enrolling participant, their family members and the referring doctors. Without the technological advances of video calls through smartphones, audiovisual presentations for groups of people using various platforms and online questionnaires and forms to evaluate and track patient progress, the home-based programs would not have been possible.

As we embrace the new normal and gradually resume in-person consultations and regular centre-based programs this month, we are making sure we closely adhere to the COVID prevention protocols and maintain high standards of safety and hygiene for our patients. We encourage all our patients to get vaccinated against the novel coronavirus at the earliest possible time and to continue following personal precautions for the timebeing. Moving forward, patients will have the option to choose centre-based or home-based programs or a hybrid model with a combination of both formats. We are confident that after having pioneered the concept of preventive cardiology in South India and having sailed through the pandemic situation with minimum impact on patient care, we are better poised to continue in our exciting journey of best-in-quality cardiac care for our people.


Let your new year resolution be Healthy Eating

Consumption of a healthy diet has been scientifically proven to reduce the risk of several diseases and to keep our body and mind healthy. This new year, we urge you to take a resolution to start eating a balanced healthy diet and sustain it for life. As a dietician focusing on improving peoples’ cardiovascular health, I would like to share some of the food-related behaviour patterns I come across frequently and some simple solutions to help you acquire a heart-healthy eating habit.

Pattern 1 – Lacks awareness and is resistant to change

These individuals do not include adequate amounts of fruits and vegetables on a daily basis mainly because they are ignorant about the importance of a balanced diet. Moreover, they are likely to consume packaged foods and eat out very often, which makes things worse when it comes to behaviour modification.

Mr. SC, an entrepreneur in his 50s was recently operated for a heart attack and is currently undergoing cardiac rehabilitation with us. Apart from his smoking habit, which he quit after the heart attack and his high BP that has come under control now, his unhealthy dietary behaviour has been and continues to be the main risk factor for his cardiac condition. He has been habitually consuming unhealthy foods like wafers, sweets, savouries and carbonated drinks on a regular basis, and does not include vegetables and fruits in his daily diet.

Solution – Fruits and vegetables are low in calories and are nutrient dense; in other words, they are packed with vitamins, minerals, antioxidants and fibre. Plain salads and plain steamed veggies can quickly become boring; there are plenty of ways to add taste to your vegetable dishes. Some healthy cooking methods such as boiling, steaming, grilling, roasting, or pan frying enhances the taste of the vegetables. Naturally sweet vegetables such as carrots, beets, sweet potatoes and peppers add sweetness to your meals and reduce food cravings. Bringing in variety to your menu in the form of mixed vegetable soups or a stew, veggie gravy or a raita, vegetables cooked with dhal and garnished with shredded coconuts and peanut crumbs etc. would enhance the palatability of your dishes. Similarly, getting creative with your salads, experimenting with different combinations of fruits and going local when it comes to farm produce are ideal ways to spruce up your fibre intake.

Mr. SC has understood that his diet has been unhealthy all along but it has been very challenging for him to incorporate the recommended 4-5 portions of veggies and fruits daily. We have succeeded in bringing down his intake of empty calories (carbonated drinks) and packaged snacks but he has troublesome cravings as he as been addicted to unhealthy foods. In fact, he did not find quitting smoking as difficult as adopting a heart-healthy diet but is making slow and steady progress and is sure to achieve all dietary goals during his rehab program.

Pattern 2 – Focused on fitness but consumes an improper diet

Some of us are health conscious and know that we need to exercise regularly to stay fit and healthy. In fact, we believe we are improving our health by over-exercising and cutting down some dietary components like healthy fats to a dangerously low level or consuming too much protein-rich foods which in turn throws the dietary balance away and affects our health negatively.

Mr. R aged 51 years has been an avid exerciser for over 20 years focusing on power lifting (lifting heavy weights), and has been consuming a calorie-dense diet and multiple protein supplements. He recently suffered a heart attack, underwent an angioplasty procedure and is currently receiving cardiac rehabilitation. His main concerns were whether he could return to power lifting and whether his cardiac condition will have long-term effects on his overall fitness.

Solution – Over consumption of any particular nutrient can cause adverse effects. The daily requirement of different nutrients varies according to age, gender, body composition and level of physical activity. The ideal way to improve your diet is by focusing on the nutrients in your diet and not on the calories, that is, count the nutrients and not the calories.  In many instances, the vitamins and minerals found in food sources are better utilised by our body than those in commercially available capsules and powders. Eating healthily gives far greater benefits than opting for supplements and eating poorly. A healthy balanced diet with sufficient fruits and vegetables, whole grains, healthy fats and lean meats along with some naturally available seeds and nuts helps to prevent nutritional deficiencies and fulfils our dietary requirements.

Pattern 3 – Follows multiple fad diets and loses health

A fad diet is a diet that is popular for a time without being a standard dietary recommendation, and often promising unreasonably fast weight loss or nonsensical health improvements. Some of us tend to follow multiple fad diets with the hope of getting magical results in a short period of time and unfortunately end up losing our health in the process.

Mrs. DD, a home maker aged 44 years, had tried the paleo diet (high protein low carbohydrate diet), keto diet (high fat diet) and a few other diets in the past but ended up gaining rather than losing weight and becoming hypertensive. The pattern we noticed was she would follow a particular diet for 2-3 months and move onto another diet plan when results were not as expected, without incorporating a regular exercise regimen and making healthy lifestyle changes.

Solution – Some disease conditions may alter our nutrient requirements, but otherwise we all need a balance of proteins, fats, carbohydrates, fibre, vitamins, and minerals in our diet to sustain a healthy body. Instead of eliminating certain food groups from your diet, selecting the healthiest options from each category is the better thing to do. A combination of a balanced healthy diet with proper intake of recommended nutrients, sufficient exercise, good sleep and adequate stress management helps to maintain a normal weight in the long term whereas crash diets may reduce the body weight temporarily mainly by loss of muscle mass rather than loss of stored body fat and is therefore extremely unhealthy.

Making the switch to a healthy diet

Switching to a healthy diet doesn’t have to be complicated. You need not completely eliminate foods you enjoy, and you don’t have to change everything overnight. A better approach is to make few small changes at a time. Keeping your goals simple will help achieve more in the long term without feeling overwhelmed by a major diet. Think of planning a healthy diet as a number of small, manageable steps like adding a salad to your diet once a day, reducing your intake of hidden salt present in packaged foods and cutting down added sugar, one change per week. Once these small changes become a habit, you can continue to add more healthy choices. When cutting back on unhealthy foods in your diet, it’s important to replace them with healthy alternatives.

A healthy eating plan should include

  • A variety of vegetables from all of the subgroups like dark green, red and orange, legumes (beans and peas), starchy, and other leafy vegetables
  • Fruits, especially whole fruits which are are superior to fruit juices
  • Choose whole grains instead of refined ones (e.g. whole grain bread instead of  white bread)
  • Fat-free or low-fat dairy, including low-fat milk, yogurt, cheese, and/or fortified soy beverages
  • A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), nuts, seeds, and soy products
  • Steam or shallow fry instead of deep fry

Some tips to ensure a balanced wholesome diet

  • Try at least one new healthy recipe per week
  • Try to eat a family meal everyday to help you focus on eating healthy meals
  • Pack a healthy lunch with some healthy in-between fillers like nuts and fruits for work. This lets you have more control over what you eat.
  • Eat breakfast, and eat smaller meals throughout the day. A healthy breakfast can jumpstart your metabolism, while eating small, healthy meals keeps your energy up all day.
  • Avoid eating late at night. Try to eat dinner earlier and fast for 14-16 hours until breakfast the next morning. Studies suggest that eating only when you’re most active and giving your digestive system a long break each day may help to regulate weight.

Shortcuts might help you achieve temporary results, but focusing on sustainable healthy changes will help you maintain good health for decades. Feel free to take professional help if you’re not sure where to start or how to help a loved one with nutritional challenges. After all, we are what we eat and eating healthy is an art that once learnt will go a long way in keeping you healthy and happy!


Post COVID Syndrome and ways to Overcome it

While you may be aware of the symptoms of COVID-19 by now, it is equally important to know that around 20% of those who recover from the acute phase of the infection may continue to have health issues in the weeks and months that follow, this is known as post-COVID syndrome. With a high rate of recovery in India, several individuals are struggling to cope with the aftermath of the infection. There is strong scientific evidence to show that a medically supervised rehabilitation program helps in the complete recovery from this post-COVID syndrome.

Individuals affected with COVID-19 may be left with physical and mental impairments such as:

  • Impaired lung functions
  • Severe muscle weakness
  • Joint stiffness
  • Fatigue
  • Limited mobility and ability to do daily tasks
  • Delirium and other cognitive impairments
  • Difficulty in swallowing and communicating
  • Mental health disorders and psychosocial support needs

It has been found that not only does the presence of diabetes pose a threat when it comes to recovery from COVID-19, but non-diabetic persons may also develop diabetes as a complication of the COVID-19 infection. Both the direct effect of the virus on sugar metabolism as well as the indirect effect of steroid medications on blood sugar levels have been implicated in this. The impact of the coronavirus on the heart has also been recognised. Acute inflammation of the cardiac cells known as myocarditis, blocks in the coronary arteries leading to heart attack and abnormal heart beat known as arrhythmias are some established cardiac complications of the COVID-19 illness.

Post COVID rehabilitation is the need of the hour to improve the overall wellbeing of individuals by  improving their lung function, functional capacity and exercise tolerance, by enabling early return to work and daily routine and by enhancing psychosocial wellbeing.

The main focus areas in post COVID rehab as outlined by the World Health Organization, European Respiratory Society and American Respiratory Society are:

  1. Improve lung functions
  2. Decrease fatigue at rest
  3. Improve mobility and joint functions
  4. Prevent further muscle weakness
  5. Provide customised exercise training
  6. Provide appropriate dietary advice
  7. Provide adequate psychological counselling
Benefits of Post COVID rehabilitation

Individuals recovering from COVID-19 are advised to focus on some self management techniques as follows:

  • Improving lung functions and breathlessness

Breathing exercises such as diaphragmatic breathing exercise and thoracic expansion exercise will help to improve lung expansion and avoid further deterioration. Forced expiratory technique such as coughing and huffing will improve the bronchial hygiene and also assist in expectorating the mucus. Breathing exercises are proven to decrease the severity of breathlessness and paves the way for being more active.

  • Improving fatigue and exercise intolerance

Fatigue and exercise intolerance are the most common symptoms of post-COVID syndrome and can be managed by appropriate exercise training. Exercise capacity testing is a must to identify the level of functioning and to administer appropriate exercise training. A combination of aerobic exercises, resistance exercises that improves muscle strength and endurance and breathing and flexibility exercises is a must for rapid recovery. Activity pacing and energy conservation techniques should be advised such that it avoids the onset of fatigue and also aids exercise performance.

  • Improving psychological health and mental wellbeing

Survivors of COVID-19 face several psychosocial challenges such as stigma in the living community, at work, at social gatherings and public places. This in turn can result in insomnia, isolation, anxiety, depression and other psychological disorders. It is important that the rehab program provides counselling, reassurance, coping skills, and emotional support to overcome this stressful period.

  • Improving dietary intake

A healthy balanced diet is key to full recovery from any illness. Consumption of fruits & vegetables, protein rich foods and whole grain products with appropriate vitamins and minerals and staying away from unhealthy foods like fast food, packaged food, fatty food and artificially sweetened dishes will aid in the speedy recovery from the coronavirus.

We at Cardiac Wellness Institute are providing Post COVID Rehabilitation through a completely online service. You may contact us at +919902155772 for further information.


Bypass Surgery versus Angioplasty

If you have been faced with the question “bypass or angioplasty”, either for a loved one or for yourself, you are not alone. This is the commonest dilemma people encounter when diagnosed with a myocardial infarction or heart attack. Both are revascularisation techniques, that is, methods to allow blood flow to the heart muscle when there are one or more critical blocks in the blood vessels supplying the heart. However, there are significant differences between the two treatment modalities.

Important facts

While the healthcare team caring for you at the time of the heart attack usually decides on the best management modality based on your medical parameters, it is important for you as the receiver of the treatment to have a clear understanding of what a bypass means, what an angioplasty means, and what to expect in the long term.

To begin with, coronary artery bypass graft or CABG is an open-heart surgery wherein the blocked coronary blood vessels are circumvented or bypassed using healthy vessels from other parts of your body such as your legs or chest area. This alternate route or bypass then supplies the much-needed blood to the heart muscle. Minimally invasive cardiac surgery or MICS is a newer treatment modality in which instead of opening up the chest to access the heart the surgeon performs the bypass surgery through small key-holes in the chest wall using thoracoscopy device. The recovery time is lesser for MICS approach than the conventional approach but only certain patients are eligible for this type of surgery.

Angioplasty, on the other hand, is a non-surgical procedure in which the coronaries are accessed via the peripheral arteries, that is, arteries in our hands and legs. The access points are either the groin or the wrist. A stent is a thin device that is inserted into the artery in our groin or wrist that goes all the way to the heart and to the blocked part of the coronary artery and stays there to allow blood to flow through it. This is an interventional procedure and not a surgery, therefore there are very few complications and the recovery is faster but again it is not suitable for all patients.

Of late, hybrid coronary revascularization is also being performed where minimally invasive coronary bypass surgery and angioplasty with stenting are performed in the same patient when multiple blocks are present.

The major criteria taken into consideration when choosing the revascularisation procedure are:

  • Number of blocks
  • Severity of blocks
  • Location of blocks
  • Known diabetic or not
  • Other comorbidities like kidney failure, chronic lung disease etc.

Better outcomes

The team of doctors treating you will make the decision about what is the best management for you after considering all the relevant factors. Coronary revascularization is a life-saving procedure and whether bypass or angioplasty is chosen, it is important to adhere to the medications prescribed and to follow a cardiac rehabilitation program for better outcomes. Modifying the risk factors, attending the follow-ups regularly and leading a heart-healthy lifestyle are the best ways to prevent occurrence of complications and repeated hospitalizations.

Pandemic restrictions

Due to the ongoing pandemic, there is a doubt in people’s mind about whether it is safe to see the doctor and to get investigated or if should be postponed.


Tele-consultation is a safe alternative for non-emergency medical conditions but if you suspect a heart attack, stroke or other medical and surgical emergencies, you should report to the casualty at the earliest, taking all COVID-19 precautions.


Eat right to keep that stroke away

Worldwide, 15 million people suffer a stroke each year of which one‐third die and one‐third are left permanently disabled. As a dietician focusing on the prevention and rehabilitation of lifestyle diseases, let me break down some important facts about stroke and it’s prevention.

What is stroke?
Stroke is a medical emergency that occurs due to obstruction of blood flow to the brain. Without proper blood flow, the brain cells fail to work and may even die and this causes serious symptoms such as inability to talk, walk and see and often death. Symptoms of stroke include the following sudden changes – numbness or weakness of the face, arm, or leg, usually on one side of the body, confusion, difficulty speaking or understanding, visual disturbances, dizziness and/or loss of balance.

What are the types of stroke?
There are two main types of stroke namely ischemic stroke and hemorrhagic stroke. An ischemic stroke occurs when a blood clot interrupts the blood flow to the brain. The blood clot is often due to atherosclerosis – a buildup of fatty deposits on the inner lining of a blood vessel. An ischemic stroke can be embolic, meaning the blood clot travels from another part of your body to your brain. A hemorrhagic stroke results as a blood vessel in your brain ruptures or breaks, spilling blood into the surrounding tissues.
It is important to note that stroke is a risk factor for heart disease and people who have had a heart attack have twice the risk of occurrence of stroke.

What are the risk factors for stroke?
Stroke and heart attack are the two major non-communicable (non-infectious) diseases or cardiovascular diseases threatening the world today and have many commonalities. Both are vascular events that involve the blood vessels and the arteries in particular. Both conditions can lead to death in a matter of seconds to minutes. And both diseases are caused by the same lifestyle and metabolic risk factors listed below:

• High blood pressure
• Abnormal cholesterol
• Diabetes
• Unhealthy diet
• Sedentary lifestyle
• Obesity
• Smoking
• Excessive alcohol intake
• Severe mental stress
• Family history
• Atrial fibrillation (abnormal heart rhythm)

How to eat healthy to prevent stroke? A recent study conducted in nine European countries with a total of 4,18,329 participants has concluded that adequate daily consumption of fruits, vegetables, dietary fibre and dairy products reduces the risk of stroke and that too much red or processed meat consumption increases the risk of stroke. This study also shows that too much sodium (salt) in diet is associated with a higher risk of stroke, while improving potassium intake through fruits and vegetables is protective against stroke.

We also have solid scientific evidence to show that healthy eating habits and a balanced diet reduce the risk of hypertension, diabetes, obesity, and heart diseases.

There are some major food items that need to be considered while planning a healthy diet:

Red meat – meat is a major source of saturated fat, which could contribute to atherosclerosis and thus higher risk of stroke

Whole grains – whole grain products such as cereals and millets are rich in dietary fibre, and help in  reducing the chances of stroke and it’s severity

Fruits and vegetables – fruits and vegetables are rich in anti-oxidants, which reduces free radicals in our body. They provide various micronutrients including potassium and folate. Potassium helps to reduce blood pressure while higher folate intakes may lower plasma homocysteine concentrations, and thereby reduce stroke risk. Fruits and vegetables are also a major source of dietary nitrates which have blood pressure lowering and blood vessel protective properties. Eating at least 5 cups of fruits and vegetables every day is the best thing we can do to keep stroke at bay

Dairy products – Dairy based foods, particularly low fat milk and low fat milk products like cheese, yogurt and paneer are rich sources of calcium, along with potassium, which can help to control blood pressure while keeping cholesterol within normal limits

There is a link between blood cholesterol levels and stroke. Saturated fat (unhealthy fat) found predominantly in animal organs (brain, liver, kidneys) and red meat (beef, veal, pork) are unhealthy and should be avoided while the healthy unsaturated fat found in fish, chicken and turkey breast can be included in our diet. Egg has a combination of proteins, fats and minerals and can be consumed in moderation. 

Minimize the use of highly processed, preserved or packaged and frozen products as they are high in calorie and contain a lot of unhealthy saturated fat

It is important to read the labels of the products and to choose the ones that contain 0% transfat, low fat and no added sugar

What else should we do to prevent stroke?
1. High blood pressure is one of the biggest contributors to the risk of stroke in both men and women. Monitoring and maintaining optimal blood pressure (120/80 mmHg) helps to reduce the incidence of stroke. Also reducing salt intake to 1-2 grams (about a teaspoon) a day is a proven way to keep blood pressure under control and prevent heart attack and stroke.
2. Obesity as well as it’s complications are linked to stroke. Try to maintain a healthy normal weight to prevent occurrence of stroke
3. Regular exercise is extremely important to keep all the risk factors mentioned above under control. In fact, exercising everyday for about 30 minutes has the maximum benefits on all our organs and systems.
4. Elevated blood sugar levels damage the blood vessels over time that might result in clots, more likely to form inside them. Keeping your blood sugar under control through a healthy lifestyle and medications (if necessary) will help prevent stroke, heart disease, kidney failure and several other ailments.
5. Quit smoking and alcohol consumption that are direct risk factors of stroke and heart diseases
6. Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart. Those clots can then travel to the brain by dislodging, resulting in an embolic stroke. If you have atrial fibrillation, get appropriate treatment at the earliest.

Too many people ignore the signs of stroke because they are unaware or unable to relate the symptoms to a serious underlying medical emergency. Now that you are aware what stroke is and how it can be prevented, you should become an ambassador of stroke prevention in your community.

If you choose a well-balanced healthy diet, placing emphasis on natural, whole, and unprocessed foods, and if you exercise regularly and keep all your risk factors under control, you can protect yourself from stroke, heart attack and other chronic ailments like dementia, cancer and lung disease.


Exercise can break the Work From Home monotony

Work From Home has become the new norm since the start of the COVID-19 pandemic. There are several pros and cons to this way of working but the most noticeable negative aspect is the blurring of boundaries between our professional life and personal life and the associated lack of adequate time for ourselves.

We tend to sit for long hours in front of our gadgets taking calls and attending meetings. We fail to pay attention to our physical activity requirements on a day-to-day basis. We neglect the warning signs like aches and sores until they become a real issue. We even ignore the fact that we are gaining weight and getting out of shape. We need to take remedial action now to ensure that Work From Home doesn’t pose a threat to our heart health and to our overall well-being. This post will focus on some exercises that can easily be done while working from home!

  • Perform active movements or stretching of both upper and lower limbs at least for 5 to 10 minutes every hour
  • Avoid prolonged sitting for more than 2-3 hours at a stretch by getting up from that place, taking a brisk walk or climbing 2 to 3 flights of stairs for 10 minutes

The illustrated exercises are a combination of active movements and stretches focusing on the major joints. They are:

  • The Chin tucks and Head movements will help prevent neck pain which is often a result of prolonged sitting with the head in a particular position – 10 to 15 repetitions each
  • The stretches focus on relieving tension in the major joints of the upper limbs, chest and back and to avoid muscle cramps and stiffness – hold each stretch for 20 to 30 seconds
  • The lower limb exercises namely alternate leg lifts and ankle movements will help avoid stiffness, improve blood circulation, and especially to keep the calf muscles active as they are the peripheral heart in our body – 10 to 15 repetitions each

Pay attention to your work posture

Maintain correct posture while working on your devices to avoid back pain and other musculoskeletal injuries. Keeping a straight back and neck with your device at a proper height is important. As this may be a challenge at home as you may be working on your dining tables or sofas, try to sit straight and prop a pillow on your lap if you need to.

Performing the above exercises helps in:

  • Preventing joint pains and muscle soreness
  • Improving your mood
  • Increasing your working ability
  • Preventing chronic health issues

The current lifestyle change of working from home has given us an opportunity to get work done in spite of the ongoing pandemic. But we have to realize that it’s a double-edged sword that needs to be handled tactfully. A healthy home-cooked balanced diet, adequate exercise in between work commitments and sufficient sleep and relaxation are easier to achieve now than they were ever before but it’s completely in our hands whether we make use of them or ignore them until our health deteriorates. Let us take a pledge to keep ourselves healthy and spread positivity to others too!!


Strategies to checkmate COVID19

Globally, more than 1 crore (10 million) people have been diagnosed with COVID-19 disease caused by the novel coronavirus over the past 6 months and over 5 lakh (0.5 million) people have been reported dead, as of 1 July 2020.

The good news is that the recovery rate from COVID19 is higher in India than in many other countries. However, the overcrowding and lack of discipline amongst the people is leading to a fast spread of the virus in big cities like Mumbai, Chennai and Delhi and in smaller towns as well.

While each and every one of us is susceptible to get infected and should take adequate precautions, individuals with a previous diagnosis of heart disease and other chronic ailments like diabetes, hypertension, kidney disease and cancer should be extra alert and safe as they could become very sick if they contract the virus. In fact, we now know that not only the lungs are attacked by the virus, but the heart, liver and almost all our organs are susceptible to damage, leading to multi-organ failure and death in critically ill patients.

With some antiviral therapies emerging and vaccine discovery underway, the only way to ensure freedom from COVID19 is preventing the infection. Imagine a game of chess in which you have moved your pieces so well that your opponent is in CHECKMATE! In the fight against this pandemic, our opponent is the coronavirus and if we make the right moves we can CHECKMATE this deadly bug. If we all follow the steps for CHECK and those with chronic ailments also follow the steps in MATE as shown below, there is a good chance we can checkmate and eliminate COVID19 in the near future.

If you or your loved ones are worried or anxious about your health condition and would like to get specific advice, you should contact your healthcare provider at once. It is safer to be extra cautious than to regret being careless during these testing times.

Stay home, stay safe, stay healthy! And to mark National Doctor’s Day today, what can be more rewarding for a physician than spreading awareness and educating people about their health!


How to eat healthy during lockdown

With the ongoing pandemic and the enforced lockdown, many of us are increasingly concerned about maintaining healthy eating habits. And those of us under treatment for diabetes, hypertension, heart disease, kidney problems and other chronic conditions are likely to be more anxious about staying safe and healthy during these uncertain times. As a dietician, I can reassure you that eating a healthy diet is the most important thing to keep all our parameters under control while staying home. Taking care of our heart health begins with getting the concept of healthy nutrition right!

Ideal nutrition not only has an effect on our physical health but it also affects our mental health. We need to figure out how to eat in order to keep our immunity intact, how to manage healthy meals with limited ingredients on hand, how to cook when some of us may not be very experienced cooks and also how to be disciplined about our diet and health goals.

Purchasing and storing fresh fruits and vegetables can be challenging during lockdown. But whenever available, it is important to include adequate fruits and vegetables in your daily diet.

Tips to eat healthy during lockdown

  • We can store dried goods like beans, pulses and grains such as lentils, peas and legumes for longer periods of time. They are nutritious as well as affordable. Include dhal, sprouts or sundal in your everyday cooking
  • Include dried fruits, nuts, rice flakes and puffed rice instead of biscuits, chips and fried foods
  • Limit the intake of highly processed drinks, snacks and ready-to-eat meals
  • Try to avoid high fat, high salt foods like pastries, pre-cooked and packaged foods
  • B vitamins are present in green leafy vegetables, beans, eggs, poultry and fish
  • Eat a good source of protein every day (e.g. fish, meat, eggs, nuts, beans, tofu)
  • Consume 2 servings of dairy every day (e.g. milk, cheese, yoghurt or dairy alternatives such as soya milk)
  • Eat at least five portions of fruits and veggies every day
  • Boredom may lead to mindless snacking on unhealthy foods; so make a daily plan to keep yourself busy and follow it
  • Limit the intake of added sugar in the form of sweet beverages and desserts
  • Include anti bacterial and anti microbial foods to improve immunity level, eg: turmeric, lemon, ginger, garlic, green tea
  • Try to minimize consumption of coffee and tea, especially during this lockdown, as this can help you sleep and focus better
  • As we are spending more time inside than ever before, and many of us do not have access to an outdoor space, vitamin D deficiency is common; sunlight is the best source of vitamin D and the morning and late afternoon hours are ideal for some sun exposure in your garden, terrace etc.; a daily supplement of Vitamin D or fortified foods can be consumed if sun exposure is not possible

Eat a balanced diet

Eating a well balanced diet with plenty of fruits and vegetables, wholegrains, plant (pulses and legumes) and animal proteins (lean meat, fish,poultry, eggs) and healthy fats (nuts and oil seeds) is the best option to getall the essential nutrients for good health and optimal immune function.

Eat plenty of fruits and vegetables

Fruits and vegetables are the most important foods for supplying our dailyrequirement of vitamins, minerals and fiber. We should aim to eat 5 portionsof fruits and vegetables every day. Different colored fruits and vegetables provide phytochemicals and antioxidants, which are essential forgood health.

Stay hydrated

Keeping hydrated is essential for overall health. We can add watery fruitsand vegetables (bottle guard, pumpkin, cucumber, muskmelon, watermelonetc.) to maintain fluid level in the body. Try to consume as whole fruits insteadof fruit juices.

Get enough sleep

Adequate sleep is as important as a healthy diet. Make sure you get the recommended 6-8 hours of good quality sleep every night.

Keep healthy snacks around

Keeping healthy and nutritious snacks nearby will ensure you don’t head straight to the fried, baked and preserved foods.

e.g. Nuts and dried fruits, sprouts or sundal, fruits, vegetable salads, soups, smoothies, butter milk, tender coconut water, seasonal fruits

Practice personal and food hygiene

Good hygiene is important when handling food to prevent the spread of virus. Wash your hands thoroughly with soap and water before preparing food. Wash unpacked products of fruits and vegetables thoroughly under running water.

In conclusion, eating a healthy diet should be a priority at this time. Make sure you shop smartly for the essential ingredients; take adequate preventive measures before stepping out, during shopping and after returning home with the products. Following personal hygiene measures and maintaining social distance remain the best means of avoiding infection. There are lots of different nutrients that are involved with the normal functioning of the immune system. So, we would encourage maintaining a healthy balanced diet in order to support the body’s immune function. In addition to exercising regularly and quitting smoking and drinking, maintaining a healthy diet plays a crucial role in preserving our physical health and emotional wellness.

A positive attitude, adequate nutrition and regular exercise are a great way to offset the anxiety, worries and uncertainties during this quarantine period. If you or your loved ones have any special dietary requirements or disease condition and would like professional advice on how to eat healthy during this pandemic, please feel free to email me on