Staying Cool by the Pool

Summer Fruits are one of the best ways to beat the heat. So, let’s have a look at some fruits to keep you cool this season.

Some fruits are extremely useful during summer because they refresh, rehydrate and rejuvenate us during the hot days. When the environment is hot and humid, our body has to work harder to maintain a normal temperature. This is automatically achieved by our body’s internal mechanism by altering the blood circulation and losing water through skin and sweat glands. Heat waves are extremely dangerous in cities due to pollutants that are trapped in the atmosphere. During a heat wave, it is recommended to reduce strenuous activities or reschedule them to a cooler time of the day. Moreover, you should avoid too much of sun exposure in the daytime. It is also recommended to drink a lot of fluids in the summer even if you don’t feel thirsty.

Extreme temperatures are not only demanding on the body’s metabolic mechanism, they can also be a threat to the normal functioning of the heart. It is because of this reason that we recommend individuals with heart ailments to take extra precaution in the summer and winter seasons.

While water is very important at such high temperatures, you can also resort to fruits in order to keep your body hydrated and healthy. Eating summer fruits is a healthy way to keep you cool and get all the goodness of nature. These are the fruits to cool you down:

  1. Watermelons
  2. Lemons
  3. Pineapples
  4. Muskmelons
  5. Sweet Limes


  • Watermelons are made of 92% water and electrolytes, and it has the highest water content out of all summer fruits. One cup (100g) of watermelon has only about 46 calories.
  • Melons are low in saturated fat and sodium and they are a good source of potassium, magnesium, vitamin A, C, B1 and B6.
  • It can have a positive effect on people suffering from asthma, arteriosclerosis, diabetes, colon cancer and arthritis. Melons have antioxidants that help neutralize free radicals to keep us youthful and energetic.


  • Lemons generally have 89% water and it is one of the most refreshing drinks in summer. One lemon fruit contains 17 – 24 calories, depending on the size.
  • They are a good source of vitamin B6, potassium, iron and an excellent source of dietary fibre and vitamin C.
  • Lemon water is very good for common summer weather problems like nausea, heartburn and dehydration.


  • Pineapples are a delicious summer fruit. It has approximately 86% of water content. A hundred grams of pineapple contains about 48 calories, mostly from sugars.
  • Pineapples are rich in vitamin C and bromelain, which help fight microbial infections and boosts immunity. It is rich in antioxidant which helps to reduce cholesterol level and prevent heart diseases.
  • Pineapple will help get rid of respiratory tract problems like frequent colds. This fruit contains high amounts of manganese that helps in strengthening bones and connective tissues.


  • Muskmelon is a popular summer seasonal fruit; it is another high water content fruit with 90% water. 100 grams of muskmelon contains about 34 calories.
  • It is rich in potassium, an important electrolyte that is helpful to regulate blood pressure. Other vital nutrients found in muskmelon are vitamins A, C and K, protein, fibre, folate, calcium and iron.
  • Regular intake of muskmelon reduces the risk of obesity, diabetes and heart disease while promoting healthy skin and hair. It also provides protection from common cold and some cancers.

Sweet Limes

  • Sweet lime or Mosambi is a versatile fruit with a sweet and sour taste. It has 80% water content and a medium- sized fruit provides 43 calories.
  • It is rich in vitamin C, copper, iron, fibre and calcium. The acids in sweet lime help to flush out toxins from the bowel and to prevent constipation.
  • This fruit is rich in antioxidants and flavonoids that have detoxifying and antibiotic properties and is also effective in healing peptic ulcers.
  • It will keep you hydrated and provide essential minerals and vitamins at the same time. Sweet lime juice is helpful in treating sunstroke.

Including summer fruits in your daily diet can be very beneficial for your overall health this season. The good thing about these summer fruits is that they not just keep you cool, but are loaded with vitamins, minerals, and a lot of other health benefits too.

Enjoy these healthy refreshing fruits in summer and beat the heat!!!

Psychosocial counseling can reverse heart disease

Psychosocial counseling simply means getting individual or group sessions with a healthcare professional experienced in ‘mind matters’. You might be taking your medicines regularly, getting your parameters checked and visiting your doctor periodically, but these measures will only help you monitor your health. It takes a little more effort to reverse heart disease!

You need to strike at the root cause of the problem if you would like to see the end of it. As psychosocial issues like chronic stress, depression and anxiety play a major role in causing coronary artery blocks and are often hidden or unnoticed, it takes an expert to address these issues of the mind. We have already seen in an earlier post that poorly managed stress can repeatedly attack the coronaries and ruin your heart as well as your overall health.

It is for this reason that a psychosocial counselor has become an integral part of the cardiac rehab team. A comprehensive cardiac rehab program like the one we provide at Cardiac Wellness Institute includes supervised exercise, dietary modification and psychosocial counseling in addition to health education and targeted behavior change. The counselor helps individuals understand the concepts of feelings, emotions and habits and paves the way for unraveling the stress triggers. Stress management techniques, non-pharmacologic treatment of depression, anger reduction methods, coping skills after a cardiac procedure,  ways to overcome anxiety, sleep problems and addiction are just a few things that a counselor can help you with. The image you see here is from one of the group counseling sessions at our centre where our counselor made participants do role-play (something like a mini-drama) to help them understand everyday stress triggers and coping strategies.

As counseling is defined as listening to someone and providing advice to overcome his/her problems, the counselor should not be the sole person providing counseling. Members of our team, for instance, take time to listen to what our patients have to say and work together with them in finding an effective solution to their physical and mental health problems. We are all counselors in our own little ways! But we know our limitations and acknowledge and appreciate the role of the psychosocial counselor in solving the deeply ingrained emotional problems faced by our patients.

With strong scientific evidence becoming available on the complete regression of coronary blocks with intensive lifestyle modification, there is no reason to ignore or neglect the psychological distress you are going through. It is not something to be ashamed or embarrassed about, we all have feelings and there are experts to help us feel better.

If you or your loved ones are going through a rough patch or if you would like to know how an experienced counselor can help you, please get in touch with us and we will guide you in the right direction.






Exercise and Ageing – Made for each other

In an earlier thread, we have discussed how older adults can maintain good nutrition. In this blog post, we will look at how exercise can enrich the lives of senior citizens. Ageing, as believed by many, should not stop you from doing activities; on the contrary, it should allow you to do all your favourite activities and lead a healthy life. Engaging in regular exercise is the best way to achieve this.

Most people think that walking is the only exercise suitable for elders. While walking is definitely suitable for all ages and health conditions, there are many types of exercises that you can do as you age. Exercise is an important part of everyone’s health and this is very true for elders too. “If you don’t move, you won’t move” is an old saying. That is quite right because as we age our physical and mental abilities change causing both deterioration in coordinated function and an increasing dependence on others. Hence, as a physiotherapist, my advice for all of you out there is: “start to move now and prevent ill health forever”.

You are all aware that high blood pressure, diabetes, arthritis, heart disease and stroke are common in the elderly. What you might not know is that all of these conditions can be controlled and reversed with exercise. In fact, frequent falls or fear of fall due to impaired balance and coordination is the worst enemy to a happy and enjoyable seniors’ life; even this can be solved by regular exercise. Additionally, muscle strengthening exercises help to improve your level of performance in daily activities. While these are all compelling arguments to start your exercise regimen right away, remember to get proper medical advice prior to starting any new exercise.

There are various types of exercises that you can do to improve muscle strength, balance and coordination

  • Aerobic and flexibility training– 5 days/week
  • Strength training – 2 days/week
  • Balance and coordination training – every day

The benefits of regular exercise are:

  • Improves your strength and helps you stay independent
  • Improves your balance and prevents falls
  • Gives you more energy
  • Prevents and reverses diseases, such as heart disease, diabetes, arthritis and osteoporosis
  • Improves your mood and fights off depression

Stop exercising and contact your doctor if you experience any of the following symptoms:

  • Muscle or joint pain
  • Chest pain or pressure
  • Excessive shortness of breath
  • Light-headedness, dizziness

Exercise tips

  • Always start your exercise session with warm-up and end with cool-down exercises
  • Drink more fluids to stay hydrated
  • Start slowly and set reachable goals
  • Exercise in a small group to stay motivated
  • Listen to your body and respond to its needs
  • Don’t overdo any exercise
  • Avoid doing exercise when you are sick

The definite way to attain all the health benefits of exercise in your old age is to start doing exercise in your younger years. It is never too early to start exercising, and it can never be too late whatever your age! The team at Cardiac Wellness Institute provides various programs to improve the health status of all individuals including senior citizens. If you are interested and eager to know more about the seniors’ program please feel free to contact us, we will help you improve your health and your quality of life in an enjoyable manner.


The sweet danger of sugar

Would you like to understand ‘sugar’ better? While you might know that sugar is really sweet and enhances taste did you know that it can be dangerous too? Let me take you through some basic facts about sugar before seeing the health hazards of this sweet ingredient…

Sugars are broadly grouped into simple and complex sugars, and natural and added sugars.

Simple Sugars

Simple sugars are carbohydrates that are quickly absorbed by the body to produce energy. These sugars are present in both natural and processed foods. Natural foods that contain simple sugars include fruits, vegetables and milk products. Processed foods often have simple or refined sugars added to improve flavour. Examples of refined-sugar foods include candy, cakes, syrups, fruit juices and carbonated beverages.

Complex Sugars

Complex sugars are complex carbohydrates that take a longer time to digest as they are packed with fibre, vitamins and minerals. Examples are cereals, legumes, whole wheat pasta and vegetables.

Natural sugar

Natural sugar is naturally occurring, which makes them healthy. There are two types of natural sugars.

  1. Fructose – it is found in fruits
  2. Lactose – it is found in dairy products. These nutrients help to stabilize your blood sugar levels, which prevents you from feeling hungry soon after eating.

Added sugar

Added sugars are sugar carbohydrates added to foods and beverages during their processing. This does not include naturally occurring sugars such as those in milk and fruits. It provides empty calories that are of no benefit  to your body. Examples are candy, cake, soft drinks, ice cream and other desserts. Consuming too much added sugar is a health hazard!

Sugar, honey and jaggery are the commonly used sweetening agents added to beverages and foods to increase palatability. The crystallised sugar we all keep in our kitchen shelves is made up of glucose and fructose. It’s a source of energy providing 4 kilocalories per gram. Jaggery is made from sugar cane juice after processing it and is a fair source of iron. Honey is the golden coloured syrup made by bees from the nectar of flowers. It also consists of glucose and fructose.

How much sugar can be consumed on a daily basis?

While theoretically, a normal healthy adult can consume 24 grams (or) 6 teaspoons per day, research reveals that minimal or zero added sugar is best for our health. Diabetic patients, however, have a reduced ability to metabolise sugar and should strictly avoid all forms of added sugar.

How many calories does one teaspoon of sugar contain?

Amount         –  1tsp (4.2g)

Calories          – 16 kcals

Carbohydrate  – 4.2 g

Health risks of eating too much sugar

Sugar, an instant source of energy, can lead to multiple health problems if consumed in large quantities: weight gain, fatty liver disease, diabetes, hypertension, heart attack, stroke and kidney failure are some of the common ailments caused by this sweet substance.

Artificial sweeteners

Artificial sweeteners, also referred to as sugar substitutes, are used to replace sugar in foods and beverages. Sucralose, aspartame and saccharin are the mostly purchased artificial sweeteners, especially by diabetic individuals. We will look at these agents in depth in a future blog post, but it is apt to say that their use should be minimised keeping in mind their harmful side effects.

So, here are some tips to cut down on sugar in your daily diet:

  • Instead of adding sugar to cereal or oatmeal, add fresh fruits (try bananas, pomegranate or berries) or dried fruit (raisins, cranberries or apricots).
  • If you consume tea, coffee or milk with added sugar, try alternatives like green tea, black coffee and unsweetened milk.
  • Instead of adding sugar in recipes, use extracts such as almond, vanilla, orange or lemon.
  • Enhance the taste of foods with spices instead of sugar; try ginger, allspice, cinnamon or nutmeg.
  • Compare the sugar content of different foods and choose the lower sugar and calorie option.

“ Eat less SUGAR;

You’re SWEET enough already”



Understanding the difference between heart attack and cardiac arrest

If you are under the impression that a heart attack and a cardiac arrest are the same, you are mistaken. Both these terms refer to different conditions of the heart; let us see how.

Heart attack: sequence of events

When someone has reduced or lack of blood flow in the blood vessels supplying the heart muscle, or in other words, one or more critical block(s) in the coronary arteries leading to deficient oxygen supply to the myocardium, the individual is said to have a heart attack.

This usually manifests as chest pain, chest tightness, lower jaw, neck or upper back discomfort or heartburn. Breathlessness, giddiness, excessive sweating, nausea and vomiting can accompany the pain or be lone symptoms. Silent attacks can occur too.

A heart attack (or myocardial infarction) can lead to a cardiac arrest.

So what is a cardiac arrest?

A cardiac arrest is when the heart suddenly stops pumping blood, mostly due to abnormal electrical signals or arrhythmias within the heart. There is a sudden lack of blood supply to all the body parts including the brain leading to a loss of consciousness and collapse.

Cardiac arrest is a deadly condition, which can lead to death within a few seconds to minutes. By providing immediate cardiopulmonary resuscitation (CPR) and defibrillation, a cardiac arrest can be reversed. An automated external defibrillator or AED is available in many public facilities these days for this purpose. However, only people trained in CPR and emergency healthcare should volunteer to resuscitate someone, as incorrect maneuvers can be dangerous.

There are several reasons for a cardiac arrest; the commonest is a heart attack.

Some other causes of cardiac arrest are cardiomyopathy (due to diabetes, hypertension or other causes), heart failure, valve abnormalities, abnormally formed coronary arteries, recreational drug use, certain medications, certain electrical abnormalities of the heart like Wolff-Parkinson-White Syndrome and inherited genetic abnormalities like Long QT Syndrome.

Important points to note:

  • Heart attack leads to death of heart muscle tissue which if untreated can lead to death of the individual; however, a massive heart attack can cause instant death. Whether sudden or not, the usual mechanism of death following a heart attack is cardiac arrest.
  • Cardiac arrest is a deadly condition that can cause death in a matter of seconds to minutes; immediate CPR can reverse the arrest.
  • Treatment for someone who has had a heart attack often includes lifestyle modification, medicines, angioplasty or bypass surgery and cardiac rehabilitation.
  • A cardiac arrest survivor is managed with lifestyle advice, medicines, cardiac device like pacemaker or implantable cardioverter defibrillator (ICD), surgical denervation if necessary and cardiac rehabilitation.
  • Sudden cardiac arrest or death in a healthy individual below 40 years of age may be due to a genetic cause; thorough evaluation by a cardio-genetic team often helps prevent future arrest/death.
  • Both heart attack and cardiac arrest are preventable by healthy lifestyle, regular health checks and adherence to medication.

The healthcare team at Cardiac Wellness Institute provides comprehensive services for individuals and families with heart attack and cardiac arrest; you may contact us for any further questions or clarifications.

Exercise is a must after heart surgery

As a Physiotherapist providing personalised cardiac rehabilitation programs for individuals of different ages and walks of life, it is part of my work to address their questions and concerns related to exercise. In this blog post, I hope to clarify some of the doubts pertaining to exercise in the minds of patients who have undergone or are planning to go through a cardiac surgery.

  1. Is it safe to exercise after a bypass surgery?                                                             Yes. It is not only safe to exercise after a bypass surgery but it is also a part of the treatment plan after someone is diagnosed with coronary blocks and undergoes stent procedure or bypass surgery. In fact, regular exercise has been proven to improve the outcomes after all types of cardiac procedures including valve replacement, device implantation and even heart transplantation. Be sure to talk to your doctor before you start your exercise routine as a comprehensive Cardiac Rehabilitation program that offers supervised exercise sessions along with nutritional advice and psychosocial counselling is ideal.

2. How will I benefit from exercise?                                                                    Regular exercise after a heart surgery has the following benefits:

  • Helps you get back to work early
  • Reduces the risk of future cardiac events
  • Restore your physical function to normal
  • Improves stamina and confidence
  • Reduces stress
  • Lowers the chance of depression
  • Helps reverse the coronary blocks

3. What kind of exercise can I do and when can I start?                                     You can do aerobic exercises like walking and cycling in the initial period after surgery but after some time strength and flexibility exercises and even high-intensity exercises can be done. However, the exercise training should only begin after the surgical wound heals completely and is best done under the medical supervision of a cardiac rehab team.

4. Is the exercise program common for all patients?
No, it will be a personalised program specifically designed for you by a medical practitioner following international guidelines.

5. How hard can I exercise?
The exercise should be started at low intensity and it can progress gradually according to your body’s response. We generally recommend a walking program for patients, to begin with.

6. Can you guide me on how to go about a walking program?
Start your program with shorter sessions, for example, 10-15 minutes of slow walking, and gradually progress to 30-40 minutes of brisk walking with 10 minutes of warm up and 10 minutes of cool down periods. Please consult your healthcare provider prior to starting any exercise plan.

7. Can I get back to playing sports and swimming after my heart surgery?   If you have been playing some sports and swimming prior to your heart surgery, you can safely resume these activities after your cardiac rehab program. During the rehab program, you will gradually increase your work-out intensity in a safe environment where your clinic parameters will be monitored. The rehab team will prepare you for playing the sport of your choice with due consideration to your heart function, risk factors and medications. Swimming is a great exercise but it can be an extra burden on the diseased heart; so please take medical advice before hitting the pool.                                                          

8. What are the warning signals to be noted during exercise?
If you experience any pain or discomfort in the chest, shortness of breath, dizziness, unusual sweating or palpitation (abnormal heartbeat), you should stop the exercise, take rest and report to your doctor at the earliest. Any upper body tightness, pain or discomfort can be a warning signal for cardiac problem.

9. How can I include more physical activity in my everyday life?
You can take the steps instead of the elevator if your home or office is on the first few floors of a high rise building. While going for shopping, park your vehicle as far away as you can to walk those extra steps. But be cautious not to carry heavy bags on your way back as lifting heavy objects can be harmful to the heart. If you are engaged in a desk job, get up from your seat every half an hour and do some stretches.

10. What happens after I complete the cardiac rehabilitation program?
After completion of the exercise program in cardiac rehabilitation, you will know the safe and effective method of exercise, the cardinal warning signs to be noted while you exercise and the various types of exercises (strength, flexibility, etc..) and how to mix and match them

Here are some general exercise tips:

  • Start slowly, progress gradually
  • Exercise in small groups to stay motivated
  • Exercising regularly is more beneficial than exercising in bouts
  • Don’t overdo any exercise; go by the response of your body
  • Stay hydrated; do not exercise in extremely cold or very hot weather conditions


Which type of milk is best for me?

Milk is a rich source of essential nutrients that are required for our body, especially optimal heart functions. It is rich in high-quality protein and is an excellent source of vitamins and minerals such as calcium, vitamin B12 and riboflavin.

Benefits of drinking milk:

  • Milk is one of the best sources of calcium for the body
  • Milk is rich in Vitamin D that helps the body absorb calcium
  • Proper calcium intake contributes to strong and healthy bones
  • Drinking milk provides other benefits such as healthy teeth and nerves

Now that you know milk brings a lot of goodness with it, let’s look at the types of milk  generally consumed.

Cow’s milk

Pros of cow’s milk:

  • Cow’s milk comes in various types and brands (Table 1)
  • Whole milk can provide essential proteins, extra calories from fats, as well as vitamins and minerals for infants and older adults
  • It is high in calcium, which is the key for healthy bones
  • It is less expensive and widely available in grocery stores and convenience stores

  Cons of cow’s milk:                   

  • Whole milk is high in saturated fat as well as cholesterol as it’s animal based
  • Milk is a common cause of food allergy (allergy to milk protein)
  • Many people lack the enzyme to digest lactose (milk sugar). This is called lactose intolerance, which causes bloating, gas, and diarrhoea.

Table 1. Locally available cow’s milk brands 

Brand Type of milk Colour of packet Fat ( %)
Aavin Toned

Double toned


Full cream












Double toned

Full cream


Golden Cow


Family toned




Blue (dark)



Blue (light)








Mother dairy Toned


Full cream










Double toned


Full cream

Blue (dark)

Blue (light)







Cavin’s Toned


Full cream







Arokya Toned

Double toned


Full cream















Double toned


Full cream









Goat’s milk  

Pros of goat’s milk:

  • This milk is easily digestible by humans
  • It is rich in calcium and tryptophan level which is an essential amino acid
  • Goat’s milk contains selenium, an essential trace mineral that supports the immune system

Cons of goat’s milk:     

  • Goat milk is deficient in folic acid and vitamin B6 and B12 which are all essential for growth and well-being
  • Hence exclusive goat milk diet in infants and young children can be dangerous
  • It is expensive compared to cow’s milk

Almond milk

Pros of almond milk:

  • It is low in calories and contains no saturated fat
  • It is a good source of vitamin A and can be fortified to be a good source of calcium and vitamin D
  • It is vegan and naturally lactose-free

Cons of almond milk:

  • It is not a good source of protein
  • It may contain carrageenan, which may cause digestive issues in some people
  • It affects thyroid hormone levels

Soy milk

Pros of soy milk:

  • It is a good source of protein, vitamin A, vitamin B12, potassium, and isoflavones, plus it can be fortified with calcium and vitamin D
  • The fat content in soy milk is good for the healthy heart
  • It contains very little saturated fat

Cons of soy milk:

  • Soy is a common allergen for both adults and children
  • Too much soy may be a problem for people with thyroid conditions
  • Too much soy of any kind in the male diet can cause infertility problems

Rice milk

Pros of rice milk:

  • It is the least allergenic of milk alternatives
  • It can be fortified to be a good source of calcium, vitamin A, and vitamin D.
  • Rice milk is naturally sweeter than other milk alternatives        

Cons of rice milk:

  • It is high in carbohydrates, so it’s the least desirable choice for people with diabetes
  • It is not a good source of protein
  • Eating too much of a rice product may pose a health risk for infants and children due to inorganic arsenic levels

Coconut milk

Pros of coconut milk:

  • It is highly nutritious and rich in fibre, vitamins C, E, B1, B3, B5 and B6 and minerals including iron, selenium, sodium, calcium, magnesium and phosphorous
  • It rarely causes allergies
  • Coconut milk is lactose-free so can be used as a milk substitute by those with lactose intolerance

  Cons of coconut milk:

  • High amounts of saturated fat in coconut may contribute to weight gain
  • It is not a good source of protein
  • Excessive intake of coconut milk can lead to cardiovascular diseases


While milk comes in various types and strengths, there is no one size fits all when it comes to ideal milk. The table below gives the nutritive value of some commonly used milk types.

Toned (also known as skimmed or low fat) milk is suitable for children and adults; it has many important health benefits including its ability to build strong bones and teeth, boost the immune system, protect the heart, prevent diabetes, eliminate inflammation, aid in weight loss and help stimulate growth. Pasteurised milk is superior to raw milk as it is microbe-free and ready to drink.

The recommended daily allowance of calcium varies by age and gender. From ages 19 to 70, men should get 1,000 milligrams of calcium, and 1,200 milligrams if they are 71 and older. Women between the ages of 19 and 50 should get 1,000 milligrams of calcium a day, and 1,200 if they are 51 and older.

Make milk a part of your every day diet and enjoy good health!

Is it okay to feel the way I feel?

If you are feeling anxiety, fear, guilt, confusion, anger, depression or just drained of energy after you have been diagnosed with a heart problem – you’re not alone. It is extremely common for individuals to experience emotional disturbances when their routine life gets shaken up by a cardiac problem.

Questions often arise in our minds when a sudden health calamity strikes. While some of them have straightforward answers, some questions can only be answered with passage of time and especially after tiding over the acute phase.

Worries are to be expected. It is only natural that you are worried about your health and the thought about what is in store for you.

Your needs will vary depending on your health condition, your age, your social support and other factors, but everyone has needs that must be addressed by the healthcare team.

Let us see what emotions two of our patients felt.

As seen in the picture above, Mr. Arun (name changed) was rushed to the emergency department directly from his office within 30 minutes of the start of acute chest pain. He was 44 years old, married and had 2 young children. He was working in a multinational IT company as a project lead. He had never had a health check before this episode and was paranoid about what the doctors are going to say. He was diagnosed with a heart attack due to a severe block in an important coronary artery and advised angioplasty immediately.

Why me? Is this the end of my career? Will I live to see my daughters grow up? Can my block be reversed? …. These are just a few questions running through his mind prior to angioplasty.

Another individual, Mrs. Neela (name changed) was in her 70s and taking treatment for diabetes and hypertension when one day she suddenly collapsed to the ground while climbing stairs at home. Her maid who was at home at that time did not know what to do, panicked and called the family doctor’s phone. He promptly alerted the ambulance and instructed the patient to be admitted to the emergency department. The first aid crew in the ambulance provided CPR and successfully revived the lady. She was diagnosed with severe heart failure (Ejection Fraction 22%) and was initiated on multiple medications. Mrs. Neela was better within a week but she had several questions, concerns and unaddressed needs.

How do I prevent a future collapse? What should my caretakers do if I collapse? How can I improve the function of my heart? How often should I see the doctor? Can I carry out my daily duties?

This is where a cardiac rehab team comes into the picture. By providing answers to health-related questions, alleviating worries and offering evidence-based guidance and advice, our team of healthcare professionals work side by side with the doctors and nurses in the hospital, to establish a rapport with the patients and their family members. They provide ongoing emotional support during the hospital stay, the recovery period and most importantly during the intensive rehabilitation period of 3-6 months after the disease sets in.


Postural changes to relieve breathlessness

Did you know breathlessness or difficulty in breathing may be an important indicator of various health issues? Any unusual breathlessness while climbing stairs or walking can be caused by anaemia, heart ailments and lung problems. So don’t neglect the signal your body is giving, consult your doctor at the earliest!

Once the doctor has checked you, you will be explained about the underlying medical condition and prescribed some medications. It is very important that you follow the doctor’s instructions. You should report back to the doctor if the breathlessness does not improve or if it worsens.

In this blog post, we are going to see some easy postural techniques to relieve breathlessness (dyspnoea).Breathlessness is an unpleasant sensation and its severity increases as the disease progresses, leading to significant disability and a negative effect on quality of life.


These positions will improve the use of breathing muscles with the assistance of gravity. It helps in the normal pattern of breathing and decreases your anxiety during breathlessness.


  • Lie on your side with 3-4 pillows
  • Keep your head & shoulder supported
  • Relax yourself
  • Breathe in & breathe out

STANDING (fig 1)

  • Stand near the chair/table
  • Bend forward
  • Rest your hands on the chair/table
  • Relax yourself
  • Breathe in & breathe out


  • Sit in chair with foot on the floor
  • Bend forward
  • Rest your elbows on your knees
  • Relax yourself
  • Breathe in & breathe out


  • Sit in chair with foot on the floor
  • Bend forward
  • Rest your head & forearm on the pillow
  • Relax yourself
  • Breathe in & breathe out


Easy steps to be followed in all the above positions to reduce and manage breathlessness

  1. Sit in relaxed position
  2. Breathe in slowly through your nose
  3. Breathe out even more slowly through your mouth
  4. Repeat the above steps 5-10 times

A to Z of a heart-healthy lifestyle


We introduce the English alphabets to our kids at a very young age hoping that their language skills and intellect will start developing as they master their A to Z. Likewise, let us try to understand the building blocks of a healthy heart through this set of lifestyle guidelines.

A Avoid tobacco products and alcoholic beverages
B Balance your diet by including fruits, veggies and whole grains
C Cheer up and be grateful for what you have
D Discover your hidden talents and use them
E Engage in some form of exercise everyday
F Fruits – everyday; fast foods & fried foods – very rarely
G Goal setting is a useful tool to improve health
H Help others as much as you can
I Invest time in building friendships and relationships
J Juices should ideally be fresh, homemade and sugar free
K Kill the sitting habit; get up and walk as much as possible
L Love unconditionally – Learn a new skill – Leave the past behind
M Make meditation a part of your life
N Nature is all around for us to enjoy, protect it and pass it on
O Open up your feelings to your loved ones
P Play games that bring back memories of childhood
Q Quitting smoking is the best gift you can give yourself
R Refresh your body and soul with active hobbies
S Smile as much as you can; sleep at least 6-7 hours per day
T Television/gadget time should be kept to a minimum
U Use your time wisely – don’t use lack of time as an excuse
V Visit your physician regularly to keep your health in check
W Water – drink a lot; Walking – brisk walk is the most effective
X Xpect less out of others and give more from yourself
Y Young at heart is a feeling, it is a state of mind that can beat aging
Z Zealously follow your dreams but don’t lose track of your health

If we can lead this lifestyle and set an example for our youngsters to follow, there is going to be a sea of change in how they care for themselves as they grow up.

When the going gets tough, the tough get going – Old Saying

Tough are those who are resilient to unhealthy habits – New Saying


How to optimise nutrition as we age

Health refers to physical, mental and social well being, as defined by the World Health Organization. Nutrition plays an important role in preserving health in all age groups, and more so in the elderly. If you are in your 60s, 70s and beyond or caring for someone who is 60 plus, you should read this post to understand the age-related barriers to healthful nutrition and the ways to overcome them.

Older people are at higher risk of insufficient diet and lack of nutrition. Planning and preparing nutritious meals becomes more difficult with advancing age. Even though it is of high priority to consume more calcium, iron, fibre, protein and other nutrients, it can be hard to meet the dietary requirements due to physical, mental, economic, and social and lifestyle changes.

Medical factors:                                                                                                                 

With increasing age, we often come across health issues like breathing difficulties, joint pains, stroke, mood problems and poor memory. These conditions may affect one’s appetite, mobility or ability to swallow, all leading to altered food intake and suboptimal nutritional status. Medications can add to this due to the side effects of loss of appetite, nausea, diarrhoea, vomiting, dry mouth, imperfect absorption of food and alterations in taste and smell. A heart-healthy diet is recommended for people of all ages, but it is especially important after midlife when the risk of heart disease is highest.

The ability to taste and smell food is an important part of feeling hungry and eating well. Foods may seem to lose their flavour as you age. Your favourite dishes might taste different. Older adults can experience diminished ability to taste and smell because of certain medications and conditions. Reduced ability to taste may also result from a decreased number of taste buds or receptors involved in the sensation of taste. The sense of smell also diminishes, particularly after age 70, perhaps due to loss of nerve endings in the nose. Loss of smell makes food less tasty and enjoyable.

Difficulty swallowing can result from a stroke or other conditions and lead to dietary deficiency if an appropriate alternative is not provided. The health of your teeth is an essential factor in your nutrition. Dental problems, poorly fitting artificial teeth or missing teeth make it difficult to chew. Improper chewing can lead to poor nutrition, reduced quality of life and diminished health in general.

Nutritional factors:                                                                                                         

Many people don’t feel like eating and eat less as they age; making it difficult to get all the nutrients they need for good health. Changes in your body’s regulatory mechanism, hormonal balance and nervous stimuli can affect how much you eat. Your desire for food can also be affected by medications and other factors. Older adults may not absorb nutrients well because of age-related changes in metabolism (a collection of chemical reactions that takes place in the body’s cells). Vitamin B12 deficiency is particularly common because the digestive tract of an older adult doesn’t absorb this vitamin well, leading to depression and memory disorders.

Socio-economical factors:                                                                                     

Seniors living on fixed incomes may not be able to afford the amount of nutritious food needed to maintain good health. Money budgeted for groceries may take a back seat to the costs of utilities, housing, medication and health care. Eating alone can have a negative effect on your nutrition, especially if you are depressed or have a poor appetite. Older adults who live by themselves may also be vulnerable to social isolation, particularly if many of their life-long friends are no more.

Physical factors:                                                                                                                         

The ability to buy the ingredients and cook healthy meals are important factors in an elderly person’s nutrition. Homebound or disabled people are unable to go out grocery shopping or prepare meals thereby leading to poor health.

Psychological factors:                                                                                                      

Very often, we fail to identify the emotional and psychological problems that can derail nutrition as we age. Depression is a common cause of weight loss and lack of proper nutrition in senior citizens. Stress and fearfulness can also cause you to eat less than you need. Alzheimer’s disease is the main cause of memory loss as we age. The onset of Alzheimer’s disease is insidious, and disease progression includes memory loss and loss of physical function and independence. Memory loss and confusion can affect an elderly person’s desire to eat and their ability to feed themselves.

If there is a problem there is a solution

Ways to approach the challenges of sub-optimal nutrition status:

Recognition of poor nutritional status is a key to reversing any effect. Prevention, early identification and treatment of weight loss are crucial to good health in the elderly.

The first step should always be to maximise an individual’s nutritional intake from regular food and drinks, often termed “Food First”. The Food First approach includes increasing the frequency of eating, maximising the nutrient and energy density of food and drinks and fortifying food with the much-needed nutritional elements.

Eating methods that ensure good nutrition:

  • Encourage “little and often” – that is, three small meals with regular in-between snacks of energy-rich, high protein foods. Encourage people to eat every two to three hours
  • Serve meals and snacks that are appealing in size and appearance – avoid large meals, use small plates and maximise the “eye appeal” of the food
  • Drinks can reduce hunger – keep drinks for after meals rather than before and during a meal
  • Choose nourishing fluids – milk-based drinks, soups or fresh fruit juice can replace soda or coffee
  • Consider meal settings – make mealtimes enjoyable and avoid interruptions or rushing during meals
  • Find ways to stimulate hunger – a short walk before meals can be helpful
  • Add flavour to your meals with herbs and spices
  • Encourage adequate dental and oral care
  • Modify the consistency and texture of foods as needed instead of leaving them out; try soft foods that require little chewing eg. tender cuts of meat cooked in gravies are often more easily managed
  • Consuming a variety of foods from the four food groups that include grains, grams, fruits and vegetables will ensure that energy, macronutrient and micronutrient requirements are met
  • Food is the best way to get the nutrients you need; dietary supplements like vitamin and mineral pills may be prescribed if you have deficiencies due to improper absorption of certain nutrients but not otherwise

Healthy ageing recommendations:                                                                                    If you follow a few tips on healthy eating as you age, your risk of disease can be largely minimized:

  • maintain a healthy weight and body composition
  • increase vegetable and fruit consumption
  • reduce total, saturated and trans fat consumption
  • increase dietary fibre
  • reduce dietary sodium (salt) and increase dietary potassium
  • obtain your vitamins and minerals from foods rather than supplements
  • maintain normal blood cholesterol, blood glucose and blood pressure
  • limit alcohol intake; stay away from tobacco in any form
  • increase physical activity
  • A heart-healthy diet that limits saturated fat and salt, while incorporating whole grains, plenty of fruits and veggies and walnuts, almonds, avocados, olive or canola oil and potassium-rich foods, such as bananas and low-fat milk is best suitable for senior citizens. Calories from fats should be limited to between 20 and 35 percent of an older adult’s diet and most of the fats should be unsaturated (namely nuts, vegetable oils and oily fish are rich in unsaturated fats).

Don’t hesitate to ask for support:

  • Use convenience foods: ready to make cereals like bread, cornflakes, oats, adai using organic millets etc
  • Enlist family and carer support; consider a service that delivers prepared meals to your home. It minimises your efforts and is usually affordable
  • Prepare snacks and meals to eat later if you’re unable to prepare each meal
  • Add extra nutrients to meals and snacks to boost energy intake, for example, add soya paneer to gravies and powdered peanuts to vegetable dishes
  • Ensure shopping and food preparation assistance is available
  • Consider assessment by a physiotherapist or occupational therapist

Make eating a social event:                                                                                         

Meals are more enjoyable when you eat with others. Find a meal program for seniors by contacting your local senior centre, attend an adult day-care centre or invite friends, family and neighbours to share meals with you. There are many ways to make mealtimes pleasing.

Nutrition education programs to improve mental health:                           

Nutrition education programs for the caregivers of people with poor mental health are the best way to prevent weight loss and improve their nutrition status. The most recent collective evidence suggests that the optimal approach for Alzheimer’s disease would seem to combine early nutritional approaches (multi-vitamin supplements), along with lifestyle modifications such as social activity and mental and physical exercise, with an addition of medicines if necessary.

Our Upcoming Program for Seniors:                                                                             

As part of our heart-health awareness campaign, Cardiac Wellness Institute is launching a program for senior citizens (men and women 60 years of age and older) to enlighten and equip them with skills for ageing healthily. The Healthy Aging program will commence with a free introductory session from 10.30 am -12.30 pm on Wednesday, 22nd November 2017. Thereafter, interested seniors can enrol for weekly sessions. The components included in the program are Doctor Consultation, Exercise Sessions, Nutrition Advice, Group Education and Counseling.

Registration is mandatory and free of cost.                                                          Please call +9144 43192828 or +91 9940408828 or send an email to for registration.

Active ageing benefits the individual, improves health, increases independence and assures a good quality of life.

Breathe, Believe & Receive

All of us breathe unconsciously each second of our lives but can you just imagine what it would be like if our breathing itself is a problem. So in this post we are going to see how to proceed if disease affects our lungs (the medical term for lung is pulmo).

Rehabilitation or rehab means the act of restoring something to its original state. I would like to introduce the importance & effects of pulmonary rehabilitation, which simply means restoring the lungs to their original state.

Lung is the source of oxygen to our body; it is the key to our life. So, if disease affects our lungs what will happen to our body? The overall quality of life & function of our body reduces.

Any abnormality in the lungs that prevents it from working properly can lead to lung disease. And when the disease is present for more than 6 weeks, it is called chronic lung disease. Examples are chronic bronchitis, asthma, bronchiectasis and interstitial lung disorders.The main symptom of chronic lung disease is difficulty in breathing or breathlessness; the others are cough, excessive sputum production, tiredness and pain in the chest. Chronic lung disease is a major cause of morbidity and mortality across the world. By the year 2020, it is estimated that chronic lung disease will be the 5th most burdensome disease and 3rd leading cause of death worldwide. According to a World Health Organization report, the prevalence of this disease ranges between 4% and 20% among Indian adults. However, lack of awareness tends to underestimate prevalence and progression of chronic respiratory conditions.

Pulmonary Rehabilitation

Pulmonary rehabilitation is an essential component in the management of individuals with chronic lung disease.It is an important modality and adjunct to other therapies such as medication and oxygen supplementation in men and women diagnosed with these conditions.

Members of the team

It is a multi-disciplinary approach and involves a physician, physical therapist, occupational therapist, respiratory therapist, social worker, psychologist and dietician.

Goals of rehabilitation:

  1. Preserving optimal lung function
  2. Improving functions of daily living
  3. Improving health-related quality of life
  4. Reducing symptoms
  5. Preventing recurrent exacerbations

People who undergo pulmonary rehab report the following benefits:

    • Able to do more of daily activities
    • Have less puffing and panting
    • Feel an improvement in muscle strength
    • Able to do more exercises with ease
    • Feel less anxiety and depression
    • Get an overall positive feeling about life

Components of pulmonary rehabilitation

1. Assessment

2. Exercise

3. Education /Training

4. Nutritional supplements

5. Psychological intervention

6. Vocational Training


A 10-12 week rehab program with 2-3 sessions per week with the rehab team will usually start producing obvious health benefits. The program will be tailored to the specific needs of the individual. For long term effects patients can continue with a maintenance program.

The education and counseling during the rehab program will help individuals in the following ways:

  • Reduce and control breathing difficulties
  • Understand the medical condition affecting their lungs, it’s treatment options, and coping strategies
  • Reduce dependence on healthcare professionals and costly medical interventions
  • Maintain healthy behaviours such as smoking cessation, good nutrition, stress management, and adequate exercise    


It’s not the end to rest, it’s a NEW BEGINNING with pulmonary rehab

Watch your Micro-Nutrient intake

Micronutrients play a crucial role in human nutrition, particularly in the prevention and treatment of various diseases. Though they are needed only in small amounts, these substances are essential to produce enzymes and hormones and regulate all body functions. Micronutrient deficiencies if left untreated can lead to symptoms and ailments of many organs including the heart and blood vessels. In other words, sufficient micronutrient intake in our daily diet helps to maintain cardiac function and to prevent many common health problems faced by people today.
Now let us take a detailed look at of some of the micronutrients known to impact heart health and also learn how to include them in our everyday cooking.

Magnesium is essential for the proper functioning of heart, muscles, kidneys, and other organs in the body. Magnesium deficiency is associated with higher blood pressure and cardiovascular disease. You should include varieties of nuts and legumes in your diet to avoid magnesium deficiency. The Recommended Dietary Allowance (RDA) of Magnesium is 340 mg/day for men and 310 mg/day for women.

Vitamin D is a fat-soluble vitamin that is naturally present in few foods. It is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Low levels of Vitamin D increases the risk of hypertension and diabetes, both known to cause cardiovascular disease. Intake of vitamin D-rich foods will help lower your risk of coronary heart disease. The RDA of Vitamin D is 400 IU/day.

Calcium is the key micronutrient for healthy bone and teeth. It also helps our heart, muscles, and nerves to work well. Calcium deficiency is associated with abnormal heart rhythm, also known as arrhythmia. Higher intake of calcium from food sources is known to lower the risk of atherosclerosis and maintain normal beating and pumping actions of the heart. RDA of Calcium is 600 mg/day.

Potassium helps the heart muscle to pump blood effectively throughout the body. Taking a good amount of potassium-rich foods will improve your blood pressure, lower your cholesterol and regulate your heartbeat. Low levels of potassium could cause heart rhythm disturbances and muscle weakness. RDA of potassium is 3750 mg/day for men and 3225 mg/day for women.

B vitamins like vitamin B9, B6, B12 have been linked to a healthy heart rhythm and lack of these can cause palpitation. Sources of folate (B9) include vegetables, fruits, whole or enriched grains, beans, and legumes. Pyridoxine (B6) sources include fish, vegetables, liver, meats and whole grain. RDA of Folic acid-vitamin Bis 200 mg/day, Cobalamin-vitamin B12 is 1 mg/day and Pyridoxine-vitamin B6 is 2 mg/day.

Vitamin C is a powerful antioxidant; it has the ability to block the damage caused by free radicals. Free radicals may accelerate ageing and contribute to the development of atherosclerosis. It’s through this antioxidant effect that vitamin C has an influence on heart health. RDA of Vitamin C is 40 mg/day.

This table gives the Recommended Dietary Allowance (RDA) for 100 grams of edible portion of these food substances. 

Note: We recommend adequate intake of natural foods containing the above micronutrients. We do not advise the use of commercially available supplements. If you have any health concerns, please follow the dietary advise of your healthcare provider or contact us for assistance.


Mindfulness for better health outcomes

Some of you might have come across the word ‘mindfulness’ while it might be new for others. In this post, I would like to throw some light on what mindfulness means and how it can positively impact our health.

What is mindfulness?

Mindfulness simply refers to being aware or mindful of our everyday moments. It is the opposite of dwelling in the past and planning for the future. It is living in the present. We often hear things like “be mindful of what you say”, “time is precious, be mindful of what you do with it” and “pay attention to your thoughts for negative thoughts can harm you”. It just means being more aware of our words, our actions and our thoughts, so that we harness their positive power and avoid their negative impact

How to practice mindfulness?

Now that you know what mindfulness is, can you think of some ways you can apply it to improve your overall health? Let me walk you through 5 proven ways.

  • Mindful eating
  • Mindful breathing
  • Mindful exercising
  • Mindful thinking
  • Mindful interacting

Mindful eating

‘We are what we eat’ is a famous quote. That is exactly why we should be fully aware of what we eat and how much we eat. Eating slowly, that is chewing food properly and relishing what we eat, is an integral aspect of good health. And most importantly, are we enjoying what we eat? Or is it just another mundane routine that gets done every day? By the way, there are no mundane routines in the world of mindfulness. When we pay a little more attention to whatever we do and apply our minds to make it enjoyable, it ceases to be a mundane routine and starts to excite us!

Mindful breathing

Our previous blog post on proper breathing techniques for individuals with heart and lung ailments is proven to work wonders for just about anybody and everybody. It is a slow and deep breathing process that all of us can easily follow. It reinforces the fact that even breathing, which we hardly ever pay attention to, if done mindfully is a powerful tool against illness.

Mindful exercising

Exercise – some of us do it for the sake of ticking it off on our daily agenda while some of us enjoy the process of working out. Guess you know by now which of the two groups is likely to reap the full benefits of exercise. A simple activity like walking to the neighbourhood grocery store can become a mini work-out if done mindfully. Yes, even a 10-minute walk done at a brisk pace with good arm swing and synchronised breathing can rejuvenate the mind and body, as compared to a lethargic purposeless walk with a ‘why do I have to do this’ attitude which can drain us of our energy.

Mindful thinking

Thoughts arising from our mind may be positive or negative. The first step to mindful thinking is simply realising which of our thoughts are positive and have a positive influence on our well-being, and which are negative with a negative influence on our health and well-being. The second step is being grateful for and reinforcing the positive thoughts while trying to find a solution or working our way out of the negative situations that give rise to those negative thoughts. Meditation is a strong and effective technique proven to help people find the mind-body alignment needed for mindfulness and holistic well-being. We will dwell on this in a future blog.

Mindful interacting

When it comes to interacting with strangers or not-so-close people, we seem to have mastered the technique of a mindful approach. Moreover, if it is someone we need to impress, we are on our best behaviour giving all the attention to that person. On the contrary, we are slipping up on the everyday opportunities to interact deeply and renew our relationships with our near and dear ones. We could blame it on technological advancements, fast paced life, a highly demanding society and so on and so forth, but the solution is simple, take time for your loved ones and don’t take them for granted.

At Cardiac Wellness Institute, we work closely with men and women of all walks of life, inculcating this habit of mindfulness to improve cardiac function and overall well-being.



Breathing right is the secret to a long life

Breathing or Respiration is not just the single most important bodily function but it is the essence of life. The lungs are the main organs of respiration. They are equipped with gas exchange mechanisms that effectively allow oxygen from the inhaled air to enter the blood and carbon dioxide from the blood to diffuse into the air we breathe out. The heart works closely with the lungs to circulate the oxygenated or pure blood throughout the body and to pump the impure blood back to the lungs

Do you know what ‘lung capacity’ is? It is the total amount of air that your lungs can hold at a given point in time. Our lung capacity and lung function typically decrease as our age increases. Some heart and lung conditions can significantly speed up these reductions in lung capacity and functioning leading to difficulty in breathing and shortness of breathDuring exercise, the heart and the lungs work much harder to provide the extra oxygen we need. Breathing exercises are designed to retrain the muscle of respiration and improve gas exchange and oxygenationThis type of exercise also improves the overall endurance and ability to do activities of daily living.

Breathing consists of two parts:

  • Inhalation (breathing in)
  • Exhalation (breathing out)

Proper breathing should be deep, slow, rhythmic and done through the nose. Breathe in slowly and imagine your lungs filling up with air, your chest slightly widens, your diaphragm pulls your chest cavity down and your belly button pulls away from your spine as you breathe in. When your lungs are full, breath out slowly and pull your belly button back in towards your spine to push out all of the air from the lungs.

Who can do?

All individuals with heart and lung ailments; and healthy individuals.


  • Improves ventilation
  • Improves strength, endurance and coordination of respiratory muscles
  • Improves chest and thoracic spine mobility
  • Corrects inefficient and abnormal breathing patterns
  • Improves overall functional capacity
  • Promotes relaxation


  • Quiet area
  • Remove restrictive clothing
  • Comfortable and relax position sitting, standing or lying
  • Never do forced exhalation(breathing out slowly just enough to empty your lungs)



Diaphragmatic breathing                                                                                          

  • Relax your shoulders and sit back or lie down
  • Place one hand on your belly and one on your chest
  • Breathe in through your nose, feeling the air move into your abdomen and feeling your stomach move out, your stomach should move more than your chest does
  • Breathe out through your mouth while pressing on your abdomen
  • Repeat


Pursed-lips breathing                                                                                                                                                                                         

  • Inhale slowly through your nostrils
  • Purse your lips, as if pouting or about to blow on something
  • Breathe out as slowly as possible through pursed lips, this should take at least twice as long as it did to breathe in
  • Repeat.


Take a deep breath and just enjoy your life

A guide to healthy eating for older adults

Eating the right type of food, staying fit and having a healthy lifestyle are important no matter what your age. As you get older your body has different needs, so certain nutrients become especially important for good health. This blog post will help you to understand some basic facts about the foods we eat which in turn will help you to select the right kinds of foods in the right amounts to stay healthy and fit. So if you are above 50 years or nearing the half century mark, take note of these dietary tips!
Old age is neither a disease nor a disorder; it is a biological process that everyone goes through. A little care is all you need to enjoy the aging process. Age-related health problems like obesity, hypertension, diabetes, heart attack, stroke, joint pains, dementia and cancers can be controlled and even prevented by modifying your diet.

Special Nutrient Needs for Older Adults

Calcium and Vitamin D
Older adults need about 600mg of calcium and 400IUof Vitamin D on a daily basis to help support bone health. It is advisable to increase the intake of calcium-rich foods like milk, milk products like paneer and curd, green leafy vegetables and sesame seeds. Low-fat milk and milk products made from low-fat milk should be used. Exposure to sunlight should be part of your daily agenda; if you are unable to go outdoors regularly, you might want to discuss vitamin D supplementation with your doctor.

Iron and Vitamin B12
It is common that seniors do not get enough iron and vitamin B12 because of poor nutrient absorption in the body. Anaemia or reduced haemoglobin is a nutritional problem in old age caused by low iron and/or vitamin B12 levels leading to weakness, tiredness and breathlessness. You should include green leafy vegetables, fresh fruits, jaggery, rice flakes, millets, fortified cereals, milk products, lean meat and seafood in your daily diet to prevent deficiency.

Regular intake of 40gms of fibre-rich foods will help to lower your risk of heart disease, obesity and diabetes. Eating whole-grain bread and cereals, and more beans and peas along with fruits and vegetables is a great way to ensure fibre intake.
Tip: the skin is often the most fibre-rich portion so avoid peeling if possible. If you’re worried about dirt and chemicals, soak the whole vegetable/fruit in warm salt water for 30 minutes before eating, chopping or cooking.

Sodium and Potassium
Reducing sodium (salt) intake to 2500mg/day reduces your risk of high blood pressure. Fruits, vegetables and low-fat or fat-free milk and yoghurt are good sources of potassium, which you may consume liberally. Also, preparing food with minimal salt, avoiding the salt shaker during meals and refraining from buying packet foods are great ways to keep away the excess salt.

Foods that are low in saturated fats and trans fat will help in reducing your risk of heart disease. Most of the fats you choose should be polyunsaturated and monounsaturated fats which you get from vegetable oils like sunflower oil, rice bran oil, olive oil etc. Oil intake per day should not exceed 25gms (4-5teaspoons).

Many degenerative age-related diseases and disorders cause dehydration in older persons. Older adults should keep in mind that they need about 30 ml/kg (1800 to 2000 ml) of fluids per day. Fluids refer to all liquids consumed such as milk, juices, soft drinks, soup, tea and coffee. However, tea and coffee should be taken in moderate amounts only.

5 Things to remember about a routine health check

A routine medical examination is something we all need to have every year after the age of 40. This is the only way to catch cardiovascular risk factors early and take preventive measures before heart disease strikes. But there are so many different health check packages available that most people are confused as to which tests to go for. If you’d like to get some clarity on this, do take a few minutes to read this post.

  1. Health-related behavior

It is imperative to know if you’re eating a balanced diet, exercising adequately, sleeping well, keeping away from tobacco products and excessive alcohol and are free from psychosocial problems like chronic stress, anxiety and depression. Since assessment of these behavioral aspects has to be done objectively and without bias, it is best left to your healthcare professional.

  1. Simple but vital numbers

Some things are very easy to keep track of: your weight, your body mass index, your waist and hip circumferences, your breath rate, heart rate and your blood pressure. It will take you less than 5 minutes to measure and note down all these simple but salient markers of heart health. Blood pressure measurement can be done at home if you own a digital blood pressure monitor.

  1. Blood tests

Blood sugar and cholesterol levels should be measured empty stomach after an overnight fast. Hemoglobin level in the blood needs to be checked regularly as anemia (low blood hemoglobin) is a frequently missed but easily treatable cause of illness.

  1. Electrocardiogram

An electrocardiogram (ECG or EKG) is a non-invasive test whereby the electrical activity of the heart is studied while you lie down comfortably. Abnormal waveforms in the ECG are quite often the first clue to serious heart conditions. Your physician will be able to assess your health with all these parameters and will also request for some symptom-guided tests if necessary.


5. Symptom-guided tests

Let us say you have noted some difficulties in performing your daily activities or are experiencing joint pains or have frequent heartburns; then one or more special tests such as stress test (also called treadmill test, TMT) and echocardiogram may be needed to better understand your health status. An annual dental and eye examination is a must for all, even if there are no complaints.

Remember these 5 things when you’re due for your next health check. They go hand in hand to throw light on your heart health as well as your overall wellness. In addition to this, regular screening tests such as Pap smear and mammogram in women and PSA level (prostate specific antigen) in men is a must.

There are hormonal assays, vitamin D levels and bone scans, ultrasound scans, renal and liver function tests and several other panels of investigations, which are to be called for only when you have specific complaints. Getting them done on a routine basis is unwarranted.

At Cardiac Wellness Institute, prevention of cardiovascular disease is our primary goal. If you have any queries or concerns pertaining to your routine health check up, you may talk to us or email us (for contact details see

Your first step to a healthy heart

Exercise is the best tool to live healthy; that too aerobic exercise plays a major role in strengthening the heart without stressing your body much. Aerobic exercise is the key for a long and healthy life. Aerobic activities improve the pumping capacity of the heart and make all your organs to work in a more efficient way.

What is Aerobic Exercise?

Aerobic exercise is defined as continuous movement of the body with moderate exertion for a long duration of time. These types of exercises, when practiced regularly prevent and control cardiovascular diseases such as hypertension, stroke and heart attack, as well other chronic ailments. The unique characteristics of aerobic exercises are:

  • Large muscle groups are used in our body
  • It delivers oxygen faster to the working muscles
  • It is a rhythmic sustained type of exercise less prone to injuries

Benefits of Aerobic Exercise

  • Lowers blood pressure
  • Improves blood circulation
  • Lowers resting heart rate
  • Improves functional capacity
  • Reduces shortness of breath
  • Improves cardio respiratory endurance
  • Improves heart and lung function
  • Reduces obesity
  • Improves quality of life
  • Reduces joint pains
  • Increases bone density and strength
  • Improves mental health
  • Prevents many cancers
  • Enables healthy aging

 Examples of Aerobic exercise

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Types of Aerobic Exercises

  • Continuous: Exercise should be done continuously for particular duration
  • Interval: Exercise should be done with proper rest periods for particular duration
  • Circuit: Series of exercises are repeated for particular duration
  • Circuit interval: Series of exercises repeated for particular duration with proper rest periods

How to start Aerobic Exercises?

Begin slowly and progress gradually.

Start with 5-10 min of aerobic exercise for 3-5 days/ week and progress to 5-7 days/week.

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Individuals with the following conditions should seek the advice of their doctor before beginning any exercise plan:

  • Uncontrolled hypertension
  • Myocardial infarction (heart attack, bypass surgery, stent procedure)
  • Chest pain or unexplained breathlessness
  • Fainting or giddiness
  • Cardiomyopathy (heart muscle disease)
  • Heart failure
  • Heart valve problems
  • Any cardiac surgery or procedure

If you would like to know more about what type of exercise is best suited for your health condition, please feel free to reach out to us by email or by phone +9144 43192828, +91 9940408828.

Don’t find time to exercise?

Make time for exercise!


Fats are healthy too!

What are fats?
Dietary fats are the major source of energy for a day’s activities and they also support cell growth. They help protect organs and maintain body warmth. Fats are essential for our body to absorb some nutrients and to produce important hormones. Dietary fats may be saturated (solid at room temperature) or unsaturated (liquid at room temperature).
Fat does not directly make you “fat” – only the excess calories will make you “fat”. It’s about getting the right balance.

What are the types of fats in food?



Why do we need fats?
• Source of energy – Our body uses the fat we eat and converts it into energy

• Essential fatty acids (EFA) – Fats that are essential for growth, development and cell functions that cannot be synthesised by our body but have to be consumed in our diet

• Proper functioning of nerves and brain – Fats are part of myelin, a fatty material which surrounds our nerve cells and enables transmission of electrical impulse

• Maintaining healthy skin and other tissues – All our body cells need some fats as essential parts of cell membranes

• Transporter of fat-soluble vitamins – Vitamins A, D, E and K are transported through the bloodstream with the help of fats

• Component of hormones –  Steroids and other important hormones are made up of fats

How much fat do we need?

The total fat in the diet should provide between 20-30% of our daily calorie intake. Adults with normal daily physical activity can consume upto 25 g (5 tsp /day) of fat, while an individual with high physical activity requires 30 – 40 g of visible fat. However, too much fat is not conducive to good health.

For individuals with coronary heart disease, the daily fat intake should be limited as per their health condition.

So, what is cholesterol, do we need it?

Yes, we need cholesterol. Cholesterol is present only in animal products such as milk, meat, egg and ghee, but not in plant foods. Vegetable oils and nuts do not contain Cholesterol. Cholesterol is found in all cells of our body and plays an important role in the formation of brain and nervous tissue. Apart from cholesterol in the food we eat, our liver also synthesizes cholesterol. Of the various forms of cholesterol, the high density lipoproteins (HDL) are the good cholesterol and have cardio protective effect. HDL is purely synthesized by our liver. So, to answer the question “do we need to take in cholesterol in our food”, the answer is no. Endogenous cholesterol or cholesterol produced by our liver is sufficient.

How to ensure healthy fat intake?
Fats can be taken in the form of oil in our daily diet. Always choose oil labelled us MUFA or PUFA and preferably vegetable oil. While it is recommended to consume small amounts of different oils on a daily basis, do not mix the different types of oils; instead keep them in separate containers and use for different purposes. Never cook with reheated oils as it converts healthy fats into unhealthy trans fats. Trans fats lead to accelerated aging, obesity, cancer, diabetes, Alzheimer’s disease, heart attack and stroke.

How to select and store Cooking Oils?

1. While selecting oil for cooking, always choose oils rich in monounsaturated fats ( Groundnut oil, Ricebran oil) instead of saturated fats (Ghee , Butter) and polyunsaturated fats(Sunflower, Red palm oil) because the former is rich in cholesterol and the latter is not stable at high temperatures.

2. Try to avoid frying, particularly at high temperatures. Frying the food in oil at high temperature causes oxidation of fats which is very unhealthy.

3. Purchase small quantities of oils at a time, that way we will most likely use them before they turn rancid.
4. Heat, oxygen and light cause oxidative damage of cooking oils. Therefore to protect oils from oxidation, it is important to keep them in an air tight container and place them in a cool, dry and dark place.

Beware: Stress can kill

What is stress?

The word stress has become synonymous with mental stress, which is nothing but a psychological imbalance triggered by environmental factors. We’ve all experienced one or more stressful situations during our lifetime – work deadlines, competitive exams, lack of support, financial crisis, separation of a loved one, family pressure – and so on and so forth. The question at hand is “can these be life-threatening?” And the answer is “yes”.

Let me explain myself. Stress can be acute or chronic; positive or negative; obvious or hidden and, most importantly, well-managed or poorly-managed. In other words, stress can be benign when short-lived, constructive, identified, acknowledged and appropriately managed. And malignant when not.

Stress and the heart

There are 9 modifiable risk factors for heart attack of which stress (grouped under psychosocial factors) is the most sinister; it is not only the most difficult to diagnose but also the only factor that can potentially cause all of the other factors (all 8 of them shown in the image below; you can enlarge the image by clicking on it).

Stress can kill

And there are 2 other important mechanisms of stress induced heart disease namely coronary vasospasm and stress cardiomyopathy. We will discuss these entities in a separate blog post.

A real-life example

We recently provided cardiac rehab for a 44-year-old gentleman who had suffered a critical heart attack and had undergone angioplasty with stenting. He came to us 2 weeks after discharge and was very worried about his health. Both he and his wife were confused, anxious and upset. They were concerned about the future of their family, which included 2 young children and elderly parents. We began by explaining to them the cause for his heart attack; his lifestyle risk factors were lack of exercise and unhealthy eating habits, his metabolic risk factors were obesity, dyslipidemia and diabetes and his newly-diagnosed risk factor was uncontrolled severe stress related to the financial woes of his construction business. The point that these were all modifiable risk factors and that he could lead a very healthy and normal life moving forward was their only consolation. And he was determined to do all he could to ensure a strong heart and a good health, for his own sake and that of his family. And so began his journey to a successful cardiac rehab program, enriched with behaviour modification and stress management sessions, psychological counselling and diet education, supervised exercise and risk factor management training.

At the end of the rehab program, he was confident about his health and was motivated to adhere to a healthy lifestyle for a lifetime. He enrolled in a maintenance plan for continued healthcare support. His wife was convinced that this was a life-changing program for her husband and that her family’s health was now guaranteed due to all the knowledge and awareness she had gained from us.

Stress mantras

So, remember these simple stress mantras for a healthy life.

  • Stress does not come from outside; it is your own response to the outside world
  • Do not be afraid of stress; do not ignore stress
  • Be aware of your stress triggers
  • Try to avoid or overcome the recurring triggers
  • Manage your stress appropriately
  • Get professional help if necessary
  • There is no one size fits all solution to manage stress, each individual is different