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 tharani@cardiacwellnessinstitute.com.

Strength training and its impact on heart and lung health

Hello everyone! Hope you are safe and healthy in the midst of the ongoing pandemic. In continuation with our previous blog post that focused on performing aerobic exercises at home (click here to read about fitness at home) we will enlighten you about what is strength training, why it is important and how to go about becoming physically stronger.

You may be familiar with the names Karnam Malleswari and Gurdeep Singh, weightlifting champions in the female and male categories respectively, who have made India proud in the global arena! While competitive bodybuilding and weightlifting are not for everyone, toned up muscles and a sleek core are some things we should all work for.

What is strength training?

Strength training or resistance training is a form of physical activity designed to work our muscles against resistance in order to improve muscle strength, power and endurance. There are multiple ways of doing strength training, such as:

  • Use of free weights such as dumbbells and barbells
  • Use of machines/equipments that consist of adjustable weights
  • Use of resistance bands
  • Use of body weight

Benefits of strength training

  • Improves strength, power and tone of the muscle
  • Improves flexibility and functioning of joints
  • Aids weight loss by increasing calorie expenditure
  • Helps in increasing bone mass and density thereby reducing the risk of osteoporosis (weak bones)
  • Also improves posture, mobility and balance

Impact on heart and lung health

Regular strength training exercises help prevent and control diabetes, hypertension, abnormal cholesterol and obesity, thereby reducing the risk of heart attack, stroke, kidney failure, and liver damage. There is also a direct connection between better muscle strength and improved heart function. That is why cardiac patients are now advised to engage in resistance exercises on a regular basis, so that not only their arms and legs but also their heart muscle will work more effectively and more efficiently.

As medical literature has proven that individuals with chronic lung diseases benefit from a combination of breathing retraining, aerobic exercises and strength training exercises, we teach these exercises to our patients with asthma, bronchitis, and even those who have had heart and lung transplant to improve their breathing efficiency and reverse their muscle wasting.

Body weight exercises

Half Squats
Stand tall with feet apart;
out stretch your hands and slowly squat down halfway. Keep your knees in line with your toes and your back straight.
The Lunge | OrthoVirginia
Lunges
Stand tall with feet apart and extend the left leg forward; slowly go down until your right knee nearly touches the floor and come back up; repeat the same on the other leg in an alternate manner.
4 Effective Leg Toning Exercises | WW USA
Calf Raises
Stand tall with feet minimally apart, raise your heel and balance on your toes for 2 to 3 seconds and slowly come down.
Modified Push Ups
From a face-down position with your hands shoulder width apart and from a half kneeling position, lift your toes up and slowly go down until your chest is 5 cm above the ground and come back.

Tips for body weight training

  • Start at a lower level of 8-12 repetitions (1 set) and try to do 1-2 sets
  • Focus on the quality of the movement throughout the regime
  • Avoid holding your breath while performing these exercises
  • Take breaks of 30-60 seconds in between each set and 2-3 minutes between each exercise

What is core strength?

Additionally, adequate amount of time should also be devoted towards strengthening your core, that is, your abdominal and lower back muscles. Core strength will improve your fitness level, enhance your aerobic performance and prevent low back pain and flabby tummy or potbelly.

Core strength exercises

7 best body weight exercises to train your core at home - YP ...
Abdomen curl ups
Lie flat on the ground with your knee bent as shown; keep your hands by the sides of your head to maintain your neck in neutral position. Slowly come up as you breathe out and go back down as your breathe in, feeling the tightness in your abdomen.
Alternate/Both Leg Raises
Lie supine and keep your hands to the side; now slowly lift your legs high up without bending your knees as you breath out and slowly lower your legs down as you breathe in.
Free Workout: Transform-Wk1W1: Power · WorkoutLabs Fit
Modified Plank
Lie prone on the ground and position your upper limb with elbow support and lower limb on your knees with toes lifted up and maintain this position for a few seconds.
Modified Side Plank
Lie on a side and semi flex your knees and with the elbow support lift your upper body and maintain in that position for a few seconds.

The abdominal exercises can be done for 10-12 repetitions per set for a minimum of 2 sets and the plank hold for 10-15 seconds per round and minimum of 2 rounds.

Tips for core exercises

  • For abdominal exercises, remember to breathe out as you come up and breath in as your go down and avoid breath holding
  • In planks, see to it the position is well maintained and focus on breathing throughout the duration
  • Focus on the quality of the movement and do it at an appropriate pace for a better rhythm

Some of the prerequisites one should have in mind prior to performing strength training are:

  • Perform on a non slippery, safe surface to avoid injuries
  • Adequate warm-up and cool-down should be done for better performance
  • Allow adequate rest of 24-36 hours before performing the next session
  • Beginners may experience muscle soreness; application of ice packs on the localised area will help in relieving pain and discomfort

Performing these exercises at home will not only make you fit and healthy but also provide you with the confidence that exercise is simple and fun and can be done without any fancy equipment!

Exercise your way out of the COVID-19 crisis

Today, all of humanity is doing one of these three things: trying not to contract the infection, fighting the infection actively or coping with the post-infective period having survived the infection. Exercising regularly, eating a healthy diet and keeping up the positive attitude are 3 things that will help all of us irrespective of which phase we are in. Let us support one another and get through this crisis together!

Stay Fit at Home without any Equipment

Exercise is nothing but physical activity done in a structured, planned and repetitive manner. The importance of regular exercise in maintaining health and preventing disease is well known. But many of you might be of the impression that walking is the only exercise that can be done without equipment. While brisk walking is a great way to stay fit and can be done almost universally, there are infinite numbers of other exercises that do not require any equipment and can be performed at home.

In this current situation of being confined to your homes due to the COVID-19 outbreak and the work-from-home demands for many of you, keeping yourself active and exercising regularly should be your main goal. This habit of exercising will not only help avoid a sedentary lifestyle but will also help you be more productive in your work. Go ahead, read on and find out how to perform exercises at home without any equipment.

A robust exercise routine should include a warm-up phase (5-10 minutes), an active aerobic exercise phase (30-45 minutes) and a cool-down phase (5-10 minutes), adding up to a total of at least 40 minutes of exercise. This regime should be followed on at least 5 days weekly.

Warm-up is a pre-exercise phase which involves active movements of all joints right from your head to your toes. A good warm-up prepares you adequately for the exercise phase and also helps avoid injuries to muscles, joints and ligaments. Here are 6 warm-up exercises everyone should do. Each warm-up exercise should be done 10 times.

Aerobic exercises that you might have been doing are walking, running, cycling, swimming etc. Some alternatives that can be done inside your house are:

On spot jogging/marches (10 – 20 minutes)
On spot pogo jumps
Jumping jacks
High knees
Butt kicks
Step up & down

On spot marching or jogging can be done for 10-20 minutes. Each of the other 5 exercises can be done for 15 – 30 times (repetitions) per set for 2-3 sets. For step up & down, you can use your stairs as a platform to climb up an down. Repetition is the number of times you perform a particular exercise and Set is the number of cycles of repetitions one completes. A rest period of 30-60 seconds is advised in between each set.

Cool-down is a post-exercise phase which involves active stretching of the major joints to avoid muscle cramps or soreness after exercising. Each stretch position should be held for about 20-30 seconds and repeated 2-3 times. Remember to be gentle while releasing from the stretched position to avoid muscle catch.

Those who are acquainted with exercising in fitness centres and groups can perform these home exercises easily. However, beginners should take note of the following precautions to avoid injuries and other complications while exercising at home:

  • Start with 5-10 repetitions and take adequate rest in between each set
  • Total exercise time may be 15-20 minutes to begin with and gradually go up to 30-40 minutes within a months’ time
  • Keep a log of your exercise duration and the occurrence of pain, swelling, discomfort etc.
  • If you experience giddiness, chest pain, breathlessness or abnormal heartbeat, please stop the exercise immediately

In conclusion, you do not need modern equipment or machines to exercise but you definitely need the knowledge on how to perform the exercise, need to allot time for exercise and need dedication and determination to stay healthy without an external push.

Cardiac Wellness Institute has initiated the HeartHealth@Home program where we are open for online consultation and also provide home-based heart health programs and fitness and diet guidance for individuals. Please feel free to contact us for further information.

In fact, once you master these basic exercises, you can start incorporating strength training exercises and core strengthening exercises at home. I will guide you on these exercises in my subsequent blog post. Until then, STAY HOME, STAY FIT!

Metabolic Syndrome is a threat to heart health

At our centre, we regularly come across individuals with multiple health problems, particularly those related to heart disease. Very often, they need robust prevention and rehabilitation programs to help improve their physical, physiological and psychosocial wellbeing.

One such condition which we encounter commonly these days is “Metabolic Syndrome”. As the name suggests it is a combination of multiple risk factors of heart disease such as abdominal obesity, high blood pressure, increased blood sugar level and abnormal cholesterol level. This condition is growing in number day by day in India and expected to grow exponentially across the globe. The fact that several risk factors are present in the same individuals puts them at a very high risk of heart attack and stroke.

Based on multiple research findings, the rise in the incidence of obesity and diabetes was found to be the main reason behind the increase in metabolic syndrome. Also, the younger population, that is individuals between 25 and 35 years of age, are most affected suggesting that it is high time the youngsters take note of it!

The criteria for diagnosing Metabolic Syndrome as per the International Diabetes Federation guidelines in 2006 are:

  • Higher waist circumference – more than 102cm for men; more than 88 cm for women & higher BMI
  • Increased blood sugar level – more than 100 mg/dL
  • Abnormal cholesterol levels – increased triglycerides and decreased High-Density Lipoprotein
  • Increased blood pressure – more than 130/85 mmHg
Obesity
Diabetes
Unhealthy Diet

The unhealthy lifestyle choices of our people such as

  • Physical inactivity
  • Unhealthy diet
  • Chronic stress
  • Disturbed sleep pattern
  • Increase in tobacco and alcohol consumption

are the culprits causing this sudden surge in metabolic syndrome.

One important fact to be highlighted here is that all the above risk factors are interrelated which means that the occurrence of any one of the risk factors could pave way for the others as well.

If an individual has been diagnosed with metabolic syndrome, the following management should be initiated at the earliest:

1. Intensive lifestyle modification

An intensive lifestyle modification program is the first and only step in fighting metabolic syndrome, especially in individuals who are young, whose blood pressure, blood sugar and cholesterol levels are borderline elevated and who are free of organ damage. The program typically consists of health education about the condition and its effect on the body, tailor-made exercise training which focuses on controlling blood pressure, lowering blood sugar and cholesterol levels and education about the importance of exercise, along with personalized dietary guidance. Psychosocial counselling to help individuals cope better with their mental stress and emotional problems is also included in the program.

Importance of Exercise Training in Metabolic Syndrome

Exercise training is the cornerstone in the lifestyle program because of its multiple benefits:

Aerobic Training

  • Helps to improve endurance and stamina
  • Results in fat and carbs being used up as calories
  • Lowers blood sugar, normalises cholesterol level and also controls blood pressure
  • Aids in weight loss

If you are wondering how much aerobic exercise is adequate, here is my recommendation:

Frequency Intensity Duration Type
5-7 days/week Mild to moderate Intensity 30-60 minutes/day walking, jogging, cycling, swimming, hiking, treadmill,
EFX

Strength Training

  • Helps to improve muscle strength and power
  • Aids in calorie expenditure and weight loss
  • Increases muscle mass and reduces fat mass
  • Can be done with the help of equipment or use of bodyweight too

Guidelines for strength training:

Frequency Intensity Duration   Type
2-3 days/week Mild to moderate Intensity 20-30 minutes/day Bodyweight (push-ups, pull-ups, squats), dumbbells, barbells,
machine-based

Other types of exercise training such as flexibility training, interval training and circuit training can be incorporated in the exercise program as per the individuals’ needs and health goals.

2. Medications

In individuals with advanced metabolic syndrome, that is high levels of blood sugar, abnormal cholesterol and uncontrolled blood pressure, medications such as anti-diabetic drugs, anti-hypertensive drugs and cholesterol-lowering drugs should be initiated along with the lifestyle intervention.

3. Surgery

Fat-reduction surgery or bariatric surgery is sometimes needed to address severe obesity especially if it does not respond to lifestyle changes and medications.

As metabolic syndrome is on the rise and so is the incidence of heart attack and stroke, we need to adopt a healthy lifestyle that includes regular exercise, balanced diet, well-managed stress and adequate sleep, along with regular medical checks. It is never too early and never too late to make a change that will improve your health and your overall wellbeing.

The truth behind Ketogenic diet

Obesity is a major health issue worldwide and increases the risk of several chronic conditions, including cardiovascular disease, hypertension, diabetes, and cancer. In recent times two types of diets have been for weight loss – Ketogenic diet and Paleo diet. Ketogenic (or keto) diets are characterized by a marked reduction in carbohydrates (usually to <50 g/day) and a relative increase in the proportions of protein and fat. The Ketogenic diet comprises of 70-80% fat, 5-10% carbohydrate and 10-20% protein, while the Paleo diet has 30% protein, 40% fat (from mostly monounsaturated and polyunsaturated fats) and 30% carbohydrates. This varies from a normal diet that comprises of 20-35% fat, 45-65% carbohydrate and 10-35% protein.

How the body handles a ketogenic diet

In our body glucose is the main source of energy for all cells and is obtained by consuming carbohydrates rich foods. The hormone Insulin is responsible for the proper use of glucose as a source of energy by the body. When carbohydrate consumption is low initially glucose in the muscles gets utilized and later stored glucose from the liver is used up for energy. If this scenario continues for 3 to 4 days and once stored glucose is fully depleted, blood levels of insulin hormone decreases and the body begins to use fat as its primary fuel. The liver produces ketone bodies from fat, which are used in the absence of glucose. When ketone bodies accumulate in the blood, this is called ketosis. Healthy individuals naturally experience mild ketosis during fasting and very hard exercise.

What to eat and what to avoid in a Ketogenic diet?

Healthy vegetables and fruits that are rich in natural sugars and carbohydrates are limited in this diet.

Foods included in the keto diet are:

  • Chicken, turkey, beef, pork, lamb,
  • Fish and seafood, especially fatty fish like salmon, sardines, tuna and mackerel
  • Eggs and whole milk
  • Nuts and oil seeds
  • Whole milk cheese, butter, paneer, yogurt
  • Avocados

Foods to be avoided in a keto diet are:

  • Cereals and Grains (e.g. rice, oatmeal)
  • Starchy vegetables, including corn, potatoes, and peas
  • Low-fat dairy products
  • Most fruits, except for lemons, tomatoes and berries
  • Pulses and legumes (Beans, peas, lentils)
  • Sugary (Juice and soda) and alcoholic beverages (wine, beer, and sweetened cocktails)
  • Snack foods, such as potato chips, pretzels, and crackers

Benefits versus Harms

Some immediate benefits of a Ketogenic diet are weight loss, reduced blood glucose level and increase in muscle mass. However, an increase in LDL or bad cholesterol, blocks in the coronary arteries due to excessive fat consumption, renal failure and liver dysfunction due to fat accumulation in the liver have been identified as the harmful effects of this diet.

Prolonged Ketogenic diet causes the following side effects in the body

  1. Constipation
  2. Dehydration and loss of electrolytes
  3. Kidney stones
  4. Hypoglycemia
  5. Bad breath
  6. Nutritional deficiencies
  7. High Cholesterol and an Increased Risk for Heart Disease
  8. Several vitamin and mineral deficiencies, decreased bone mineral density, and gastrointestinal distress
  9. People with kidney disease or a history of disordered eating should avoid the diet, and people with type 1 diabetes may want to avoid it

Ketogenic diet may be associated with some improvements in obesity, type 2 diabetes and HDL cholesterol levels, but these effects are usually short lived. Insulin resistance is also a potential negative effect.

If you’re at risk for heart disease, one overarching factor to consider is that the keto diet is restrictive, and it’s tough to stick to a restrictive diet. People go on keto and in the short term lose a lot of weight, but it’s not sustainable. So when they go off from keto, they regain the weight back. This yo-yoing or up and down effect of body weight is also not healthy in the long run.

In summary, the ketogenic diet is not free of side effects. Eating a well-balanced diet which includes all the food groups, that is moderate carbohydrate with high fiber foods such as fruits, vegetables and whole grains, healthy fats and proteins along with adequate water intake helps to achieve health goals without any complications. One should always talk to their doctor before beginning any new diet and also consult a dietitian to ensure they are getting enough nutrients through diet to keep them healthy and free from disease.

Fiber intake for better heart health

If you are wondering what the connection is between fiber intake and heart health, read on! In this blog post, I hope to convince you that including sufficient amounts of fiber in your diet is not only important for a healthy gut but also for a healthy heart.

When someone has difficulty in passing stools, the common advice given is “eat bananas”. The reason is that banana contains soluble fiber which helps to regulate bowel movements and thereby addresses the problem of constipation.

So what is dietary fiber? It is a non-digestible form of carbohydrates present in plant based foods like fruits, whole grains and vegetables. It can neither be digested nor broken down like other foods.

There are two kinds of dietary fiber namely soluble and insoluble fiber.

  • Soluble fibers are easily dissolved in water and change into a gummy gel like substance that is partially digested in the large intestine. Some examples of soluble fibers are legumes, lentils, brown rice, oats, barley, whole or cut fruits (with skin and pulp and not in juice form), potato, and dried beans. Apart from helping in blood pressure reduction, the low glycaemic index of high fiber foods helps to control blood sugar level.
  • Insoluble fiber absorbs water, which adds bulk to the digestive tract and helps to regulate bowel movements. Whole grain products, cabbage, green beans, green leafy vegetables, nuts and whole bran are some foods rich in insoluble fibre. Fiber can have various beneficial effects on our body when taken in good quantities every day.

Evidence from medical research

Greater dietary fiber intake is associated with a lower risk of many cardiovascular diseases including coronary heart disease. Dietary fiber intake specifically from grains is inversely associated with total mortality rates, particularly cardiovascular, infectious, and respiratory deaths in both men and women (a National Institute of Health Survey done in USA has shown that dietary fiber intake actually lowered risk of death from cardiovascular, infectious, and respiratory diseases by 24%–56% in men and 34%–59% in women).

In fact, constipation can be a serious threat to heart health as it increases the strain on the heart and can lead to sudden death in individuals with heart ailments. So consuming adequate fiber in your diet not only prevents heart problems but also helps avoid some dreaded complications in heart patients.

What other benefits does fiber provide?

* Fiber can soak up water in the stomach slowing the absorption and increasing the feeling of fullness

* It can cause weight loss by reducing your intake of high calorie foods

* Fiber can promote the growth of good bacteria in your gut, thereby establishing a healthy gut microbiome

* Consuming adequate amounts of fibre prevents gastrointestinal disease, piles and haemorrhoids

 * Fiber is known to protect against colon cancer

How much fiber should I eat?

The Indian Dietetic Association recommends that adult men and women should consume about 25-35 grams of fiber per day, with 10-15 grams from soluble fiber. This can be accomplished by choosing 6 servings of grains (of which 3 are from whole grains), 3 servings of vegetables, and 2 servings of fruits.

Choose high fiber varieties of grain-based foods like whole-wheat chappathis, multigrain bread, millet dishes and unpolished rice like brown rice instead of refined grains like maida products, white rice and white bread. Include a variety of wholegrain, such as brown rice, oats, millets and barley and 2-3 servings of fruits and 3-4 servings of vegetables every day.

Can too much fiber be harmful?

High-fiber foods are good for your health. But too much fiber can produce excessive intestinal gas and abdominal bloating. My suggestion is that you increase fiber in your diet gradually over a period of time. This allows the natural bacteria in your digestive system to adjust to the change. Drinking adequate water will help you to avoid the gas, bloating, cramping and constipation that can occur when you increase your consumption of fruits, vegetables, legumes and whole grains suddenly. If you are advised to be on fluid restriction due to heart problems, you should consult your dietician to find out more about how much fiber is good for you.

I hope I have convinced you to incorporate fiber-rich foods into your daily life! It is really that simple. When you think of all the health benefits plus the added bonus that you may lose excess body weight and become fit, why shouldn’t you start focusing on fiber for a healthy you?

The most precious gift ever

We all love to receive gifts, be it simple or expensive, or practical or exotic. We value the gifts and hold them very dear to our hearts for a long time. They bring back fond memories whenever we see them. Many of us give our time, money or material possessions for a charitable cause. We might not know the name or the identity of the people benefitting from the good deed but we nevertheless donate when the cause appeals to us. Have you ever wondered what the most precious gift or donation is? 

I believe it is donating an organ to a person in need! It is nothing but literally gifting the opportunity to live a disease-free healthy life to someone who has been deprived of that. I recently registered myself as an organ donor at the Tamil Nadu Organ Sharing Registry portal https://tnos.org and am very happy to have done so. I will not be alive to see the person(s) whose lives and whose health improves after receiving my organs, but I will rest in peace knowing that a part of me will continue to live on meaningfully. 

While blood and eye donation are things many of us have heard of, solid organs like heart, lungs, kidneys, liver and pancreas are successfully being transplanted from a deceased individual to a diseased individual with good outcomes these days. Medical advances are so commendable that within a couple of hours of (brain) death of an individual, multiple organs are harvested and transplanted into different needy individuals if the individual was and/or the family members are willing to donate. There is a government registry that connects the transplant team in hospitals with the family of the deceased individual and the families of sick people in need of organs. As there is always a greater demand than there is availability of organs, priority is given to patients based on certain criteria like date of registration, severity of illness, age and other associated illnesses. 

A heart transplant is advised to individuals with severe heart failure resulting from various underlying heart problems and not responding to medical, surgical or device treatment. Chennai has become one of the leading heart transplant hubs in India today. Individuals from various parts of the country are being referred to hospitals in Chennai for the procedure, as the experience and expertise of the transplant doctors here are superior. 

The cardiopulmonary rehabilitation team at Cardiac Wellness Institute provides pre and post transplantation rehab for heart and lung transplant patients. It is not only important to take care of the new organs and the new lives by adopting a healthy lifestyle but also equally important to prevent diabetes, hypertension, dyslipidemia and coronary heart disease which are much more common in people who have been transplanted with a new heart and other solid organs.   

While the transplantation team continues to be the core team involved in the care of transplant patients, especially their medication schedule and monitoring for organ rejection, infections etc., the rehab team supports the lifestyle needs of the patient such as nutritional requirements, exercise needs, mental wellbeing and psychosocial aspects. A strong relationship is established between the patient, family and the professionals in the rehab team during the weeks to months of the rehab program and this helps in addressing any anxiety or worries the the patients and their family members may have. In fact, the disease burden as well as the surgical procedure and the post-surgical recovery have such huge impacts on the psyche of the affected individual and the immediate family members that the comprehensive support of a wellness physician, a psychosocial counselor, a physical therapist, a yoga instructor and a nutritionist become very valuable.

The new lease of life that individuals get is something they are thankful for the rest of their days. So if you’re convinced that the most precious gift is donating your organ(s), why not register yourself as an organ donor?

Exercise & Fittness for Women

Women’s day is around the corner and what can be more helpful than reliable and specific information on women’s fitness. Physical exercise, as you may know, is a planned repetition of bodily movements, done on a regular basis. Now let us look at some exercise principles for women.

The FITT principle is often used to describe an exercise session:

F – Frequency of exercise

I – Intensity of exercise

T – Time or duration of exercise

T – Type of exercise

Frequency refers to the number of times per day or week an exercise is done (eg. 2 times/day, 5 times/week). Intensity refers to the amount of effort that is required to perform the particular activity, which is expressed as a percentage of maximal oxygen consumption or maximal heart rate or in easy terms how breathless we become. Time/duration refers to the total time allotted for the exercise regime. Type of exercise refers to the different components of exercise namely – aerobic, resistance or strength, flexibility, balance etc.

Exercise guidelines for women do not differ much from the recommendations for the general population. Thus, the current global exercise recommendations are as follows:

As per the American Heart Association guidelines, every individual should exercise at least 5 days a week that is a minimum of 150 mins of moderate intensity aerobic exercise per week, or 75 mins of vigorous aerobic exercise per week. In addition to this, they should do strength training exercises twice a week.

 

For women new to exercising 

  • Ideal start to exercise regime would be basic aerobic exercise like brisk walking, cycling, hiking or use of equipment’s such as stationery cycle or cross trainer for 30-45  mins on 3-5 days/week.
  • Adequate warm up of 10-15 mins prior to exercise and cool down of 5-10 mins post exercise is a must.
  • Strength training can be started after 4 weeks of regular aerobic exercise.

For women already exercising (following an exercise regime for more than 3-6 months)

  • Increase the exercise intensity and also try other training such as high intensity interval training, recreational sport activities and regular participation in sports events like marathon, hiking, cycling tour etc.
  • Adequate combination of strength and aerobic training can enhance your overall fitness.

 

 

 

    

Here are some exercise recommendations for some special populations of women:

Diabetes

  • Individuals on anti-diabetic treatment can do aerobic exercise of moderate intensity for 30-60 mins for 5-7 days/week and always keep some healthy snack like a fruit or water with electrolytes for use in case of low sugar levels (hypoglycemia).
  • Resistance training helps you to shed more calories and when combined with aerobic exercise is the best way to lose weight and normalize blood sugar.

Hypertension

  • For hypertensive individuals, aerobic exercise such as swimming, cycling and brisk walking is ideal. Resistance training can be added for better results at a later stage.
  • If your resting BP is above 200/100 mm-Hg do not exercise; consult your physician.
  • Avoid breath holding while exercising.
  • If you have nausea, giddiness or palpitations, stop the exercise session and consult your doctor; a low salt diet high fibre diet can help control BP.

Obesity & Overweight

  • Here the focus should be on exercise and proper diet. Calorie expenditure should be more than calorie intake (refer to calorie blog post).
  • The exercise session should be at-least 60 mins, 5-7 days a week with aerobic and strength training combined.
  • Increase the hours of physical activity per day to avoid weight regain.
  • Keep a positive health goal such as improved fitness or a better balanced diet rather than a negative goal like losing weight.

Dyslipidemia (Abnormal cholesterol level)

  • A combination of aerobic exercise, resistance training and flexibility training along with relaxation techniques like meditation will help improve your cholesterol.
  • A high fiber diet rich in fruits, veggies and whole grains is equally important.
  • Long term use of lipid lowering medications can cause muscle weakness and soreness. Kindly consult physician if so

Osteoporosis (Weak bones)

  • Here the main aim is work on weight bearing activities that enhance bone density and also help in strengthening your bones and muscles.
  • Exercising 5 days/week, 30-60 min per session on weight bearing aerobic activities such as walking, cycling, cross trainer and strength training helps to improve bone density and muscle mass
  • While working on strength training, avoid lifting heavy weights and handle the equipment’s with precautions

Post-menopausal women are at a higher risk of obesity, osteoporosis, heart attack, stroke and some cancers. It is important that they indulge in regular aerobic and strengthening exercises to keep these diseases at bay.

Breast cancer is a common malignancy affecting women of all ages these days. If you have a family history of breast cancer, periodic screening tests like mammogram can help to identify the disease early. Maintaining a healthy lifestyle with regular exercise, balanced diet and a relaxed mindset is the key to preventing many cancers including breast and uterine cancers.

Hope the exercise and lifestyle recommendations are helpful for you and your loved ones in keeping good health!

Calories – Inside Out

We all know that there is a close link between body weight and heart health. In fact, obesity or excessive body weight in relation to height, is an independent risk factor for cardiovascular disease.

Regular exercise along with a healthy diet can help maintain physical, physiological and mental health. Many of us want to reduce weight; some of us wish to gain weight. An important thing to understand before making any weight management plan is the concept of calorie intake and calorie expenditure.

Calorie intake per day refers to the amount of calories that is being taken in the form of foods or supplements by an individual in a 24-hour period. Calorie expenditure refers to the amount of calories that is being burned out by an individual in the same time period. The overall working of our body relies on these two things, in short, on our body metabolism.

Now let us see what Positive calorie intake and Negative calorie intake are. Positive calorie intake refers to calorie intake being higher than calorie expenditure and negative refers to intake being lesser than expenditure.

Positive calorie intake = calorie intake > calorie expenditure = Weight Gain

Negative calorie intake = calorie intake < calorie expenditure = Weight Loss

In India, an average working individual consumes around 2100 – 2500 kcal in a normal day (weekday) and goes upto 3000 kcal during the weekends (outside food consumption). Our body at a resting state expends around 1200 – 1400 kcal for carrying out our basic functioning. Overall an individual has around 600 to 700 calories being left unused post consumption. This results in calorie overload, leading to weight gain.

Incorporation of physical activity and exercises can help in depleting the additional calories. Moreover, a minimal modification in the calorie intake with the help of a dietitian can help you shift from a positive calorie intake to a negative calorie intake resulting in weight loss.

Use of indoor equipments like treadmill, cycle ergometer, and cross trainer with adequate speed, inclination and resistance, burns around 300 – 400 kcal/hr. Outdoor activities such as jogging, swimming, brisk walking, hiking and cycling burns up-to 400 – 500 kcal/hr. Individuals involved in sports such as badminton, tennis, cricket, basketball, volleyball, football etc expend about 450 – 600 kcal/hr. Other activities like Zumba, Pilates, Yoga and Gymnasium can also help you loose your extra calories and attain an ideal body weight. If you are underweight and are planning to gain weight, it should be a healthy weight gain resulting from the intake of a healthy balanced diet and engaging in appropriate exercises rather than taking nutritional supplements, eating junk food and performing excessive exercises and succumbing to injuries.

Some important points to keep in mind with calories…

  1. 3,500 kcal = 0.45 kg of fat
  2. Adequate calorie expenditure = 200 – 400 kcal/day (or) 1000 – 1500 kcal/week
  3. Exercise 3-5 days/week for aerobic training, 2-3 days/week for resistance training and daily 15-20 minutes/day for abs and core training for more calorie expenditure
  4. Healthy weight loss = 1-2 kg/month
  5. Adequate calorie intake for weight loss =1600 – 1800 kcal/day
  6. Spend more time in outdoor activities and sports that you enjoy; it will help relieve your stress and expend those extra calories
  7. Incorporate a combination of workouts (rather than the same routine everyday) for better calorie expenditure
  8. High intensity interval training and resistance training burns calories even after the workout session.

Regular exercise and a good diet are sure to help you reach your health goals. Additionally, having an idea of your calorie intake and expenditure is important to maintain fitness and body weight. This is especially true for those of us who are diabetic, hypertensive, obese and diagnosed with heart problems. Better weight management is a sure-shot strategy to improved health metrics. Eat right, stay fit and always believe that you can!

Active Hobbies for Heart Health

One of the questions I often ask the audience in my education sessions is “Is the heart dependent on the brain for it’s pumping action?”

Well, what do you think?

Mind Heart Connection

The heart has its own automaticity and therefore does not depend on signals from the brain to do its work. However, we are all aware that there is a close relationship between our minds and our hearts. We often feel our hearts racing fast and thumping aloud especially in a stressful or fearful situation. And we also feel a calm spread across our chest and our heart beat in sync with our mood when we are happy and grateful.

These feelings are nothing but the result of the innumerable nervous and hormonal connections between the brain and the heart. In fact, this branch of medicine is called Behavioral Cardiology and is very much studied and researched in the present time.

Happy Chemicals

We now know that there are the happiness hormones such as dopamine, endorphin and serotonin and that these hormones are responsible for a lot of the feel-good phenomena associated with exercise and outdoor activities. If you have ever noticed, a session of brisk exercise like fast walking, jogging or running makes blood gush into your head, makes you feel confident and energetic, gives you clarity of thought and even helps you solve a crisis situation with a fresh outlook!

Active Hobbies

Think of which of these active hobbies resonate well with you…in other words, which of these do you think you would enjoy doing in your free time.

  • Cycling
  • Swimming
  • Skating
  • Rowing, Kayaking
  • Hiking
  • Gardening
  • Running
  • Dancing
  • Pilates
  • Surfing
  • Walking
  • Team Sports like football, basketball, hockey etc.
  • Individual sports like badminton, tennis, squash etc.

This is clearly not an exhaustive list but should definitely give you an idea of what an active hobby is: it is an activity that you love engaging in and something that lets you loose track of time.

Make time

You might think that a hobby is meant to keep you occupied in your free time but the aim of this blog post is to impress upon you that an active hobby needs to be pursued frequently to have a positive impact on your heart as well as overall health. Yes, it simply means you have to make time for your active hobbies. You have to learn to carve some time out of your daily routine to engage in one or more of these energy-boosting activities. And this time is known fondly as “ME TIME”.

Here are some tips to start taking time out for a healthy activity:

  1. Plan ahead & delegate – if you already have your plate full and are just about able to complete your daily tasks before hitting the bed, see if you can delegate some of your work and plan in advance for the time requirement of your active hobby.
  2. Prioritise – if there is one thing you should do for yourself everyday, it is 30 minutes of brisk exercise. So, try to swap your TV time, social media time or general chitchat time for a quick outdoor activity.
  3. Follow your passion – even if it’s your best friend, don’t feel bad to let him/her know that your interests are different from theirs; because if and only if you are passionate about the hobby will you pursue it relentlessly.
  4. Reward yourself – don’t be too hard on yourself; instead, reward yourself for your efforts and attempts at changing your lifestyle. Simple things like talking about your achievement to your friends or taking a much needed break as a reward might work wonders in keeping your motivation up.
  5. Activity groups – in the long run, knowing that someone you care about is equally interested in the activity you enjoy will help you stay focused and involved. But remember, it is not a competition or a power game, but a simple energy-expending, mind-refreshing and health-boosting activity that needs your continuous time and effort.

Let me sign off here but I sincerely hope that you are already thinking about YOUR active hobbies and ways to pursue them on a REGULAR basis!

10 Golden rules to incorporate exercise while at work

Nowadays, we are so busy with work that exercise is completely missing from our daily routine. Especially, the younger generation is glued to the chair for long hours, working on computers, watching television and studying for exams. This causes many unwanted reactions in the body, often leading to chronic health issues. Lack of exercise is a major reason for the growing rate of obesity, diabetes, high blood pressure and heart disease. In this blog post, let me guide you through 10 golden rules that can be incorporated in your busy work day to change your lifestyle from sedentary to active.

      

  1. Avoid taking the lift; instead, you can use the stairs for climbing up and down. This is a great way to improve your cardiac and lung function and tone up your legs.
  2. Park your vehicle at a distance from your office and walk a while; or use the public transport system so that you compulsorily move those lower limbs.
  3. Go for a walk to the pantry and have your (healthy) snack or beverage instead of having it in your cabin.
  4. Drink water at regular intervals so that you will get up more often to walk to the loo.
  5. Walking meetings can be organised instead of sitting in a cold conference room. It not only adds up to your day’s exercise but also improves your brain function and your work performance.
  6. Avoid using the intercom facility and move around the office to communicate with your colleagues.
  7. Use your lunch break for a short walk.
  8. Do at least 5 minutes of stretching exercises at the end of every hour of desk job.
  9. If you travel frequently on work, use the opportunity to walk in the train station or airport before boarding.
  10. Form interest-based groups amongst your colleagues so that you can plan group activities during after-work hours and on your off days.

Hope you enjoy implementing these simple but effective measures to pep up your activity levels and preserve your heart health.

Magical millets for holistic health

What are millets?

Millet is tiny in size and round in shape and can be white, gray, yellow or red. The most widely available form of millet found in stores is the hulled variety, although traditional couscous made from cracked millet can also be found. The majority of the world’s commercial millet crop is produced by India, China and Nigeria.

It is a delicious grain whose consistency varies depending upon cooking method; it can be creamy like mashed potatoes or fluffy like rice. Additionally, since millet does not contain gluten, it is a wonderful grain alternative for people who are gluten-sensitive.

Millets

Pearl millet known as Kambu in Tamil has 8 times more iron than rice does. It is a great body coolant.

Finger millet popularly known as Ragi is also called as wonder grain as it is a powerhouse of essential amino acids and calcium.

Foxtail millet is thinai in Tamil. This is high in carbohydrate but also rich in fiber.It helps us to keep our body strong & immune. It helps to control blood sugar & cholesterol levels.

Kodo millet is known as varagu in Tamil. It is rich in phytochemicals, that plays an important role in preventing cancer.  Barnyard millet known as kuthiravali has 6 times more fiber in comparison to wheat.

Little millet known as saamai is a wonderful millet which is suitable for people of all ages and can be incorporated in different dishes.

 

How to Select and Store

Millet is generally available in its hulled and whole-grain form. It is available pre-packed as well as in bulk containers. Just as with any other food that you may purchase in the bulk section, make sure that the bins containing the millet are covered and that the store has a good product turnover so as to ensure its maximal freshness. Whether purchasing millet in bulk or in a packaged container, make sure that there is no evidence of moisture.

Store millet in an airtight container in a cool, dry and dark place, where it will keep for several months.

Tips for Preparing and Cooking

The Healthiest Way of Cooking Millet

Like all grains, before cooking millet rinse it thoroughly under running water and then remove any dirt or debris that you may find. After rinsing, add one part millet to two and a half parts boiling water or broth. After the liquid has returned to a boil, turn down the heat, cover and simmer for about 25 minutes or it can also be pressure cooked. The texture of millet cooked this way will be fluffy like rice. If you want the millet to have a more creamy consistency, stir it frequently adding a little water every now and then.

To impart a nuttier flavour to the cooked millet, you could roast the grains before boiling them. To do this, place the grains in a dry skillet over medium heat and stir them frequently. When they have achieved a golden colour, add them to the boiling cooking liquid.

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Health benefits

  • Millet acts as a prebiotic feeding microflora in the inner ecosystem.
  • The serotonin derived from millet is calming to moods and brings good sleep.
  • Millet is a small carbohydrate food with lots of fiber and low simple sugars. Because of this it has a relatively low glycemic index and has been shown to produce lower blood sugar levels than wheat or rice.
  • Niacin (vitamin B3) in millet can help lower cholesterol.
  • Millet is gluten-free and non-allergenic; a great grain for individuals with celiac disease and gluten sensitivity.
  • Millet’s high protein content (15 percent) makes it a substantial addition to a vegetarian
  • Millets are generally rich in Protein, Fibre, Calcium, Iron and Minerals especially Magnesium, Copper and Phosphorous.
  • It helps to lower the risk of Type 2 Diabetes.
  • It is high insoluble fiber content protects against Gallstones.
  • Phytonutrients in millets, particularly lignan, helps reduce the risk of breast and colon cancer.

Regularly adding millets to our diet is a great way to prevent heart and blood vessel disorders.