Way to weight loss

 Dr Shashank Shah, is a laparoscopic and bariatric surgeon of international repute working with Dr L H Hiranandani Hospital. He is a director of Laparo-Obeso Center, an organisation of medical consultants devoted for the field of obesity and metabolic syndrome and interventional treatment for T2DM. According to Dr Shah, obesity is on the rise in India especially in the metros. Genetic predisposition, medical illnesses and environmental factors, which discourage physical activity, promote unhealthy eating, have lead to this rise. Co-morbidities are illnesses associated with obesity i.e. decreasing weight decreases the co-morbidities. The more common co morbidities are diabetes type 2, hypertension and heart diseases at younger age, infertility due to polycystic ovarian disease, sleep apnoea, breathlessness, urinary stress incontinence, gall bladder diseases etc. A correct combination of diet, exercise and a permanent behaviour modification is required to weight loss. Drugs help moderately and temporarily. However only 5 per cent of people achieve long-term success. For the morbidly obese this is just impossible to achieve. Bariatric (obesity) surgery is recommended for those with BMI >33 kgs/m with co-morbidities. It consists of procedures which give satiety in spite of decreased intake. Some procedures have the additional advantage of the restricting the amount of calories absorbed from the food. Experts recommend considering surgical weight loss options for these patients as the risk of death from not having surgery is greater than the risks of surgery. Bariatric surgery is seen to cure and control the associated co morbidities (especially Diabetes type 2). A total of 55 per cent to 90 per cent of the Excess body weight is seen to disappear giving a boost to the self confidence and self esteem with resultant improvement the quality of life of the person and the family. For further details, contact: Dr Jayshree Gangwani : 9702803377 and Manish Joshi: 9819261222. OPD timing is on Wednesday and Saturday between 12 noon to 3.00 p.m. Add: Dr L H Hiranandani Hospital Laparo-Obeso Center, Hillside Avenue, Hiranandani Business Park, Powai. Mumbai – 400 078 Tel: 2576 3300, 2576 3333; Fax: 2576 3344, 2576 3311. E-mail: wecare@hiranadanihospital.org Website: www.hiranandanihospital.org 

Dr Shashank Shah

‘Eggs are safe for your heart’

Washington: If you are really fond of eggs, then you need not worry about relishing one too many. An egg a day's contribution to the risk of coronary heart disease (CHD) in healthy adults is just 1%, according to a new study funded by an industry body.
    Poor diet, smoking, obesity and physical inactivity contribute a whopping 30-40% to heart disease risk, depending on gender.
    The study, funded by the Egg Nutrition Centre and published online in Risk Analysis, substantiates decades of research challenging the myth that the cholesterol in eggs is linked to increased heart disease risk.
    Moreover, the study authors noted that their analysis did not adjust for the health promoting benefits of eggs which may, in fact, decrease heart disease risk.
    For example, research has found that overweight men who eat eggs while on a carbohydrate-restricted diet have
a significant increase in their HDL levels ("good" cholesterol) compared to men who do not eat eggs.
    In a recent study, experts found that eating two eggs for breakfast, as part of a reducedcalorie diet, helped overweight or obese adults lose 65% more weight and reduce their body mass index (BMIs) by 61% more than those eating a bagel breakfast of equal calories. IANS

Snorers 'burn more calories at rest'

LONDON: Believe it or not, snorers burn more calories than non-snorers, even at rest.

A new study has revealed that heavy snoring help burn calories and, in fact, the more severe one's snoring the more calories one regularly burns even while one's awake, reported the 'Archives of Otolaryngology-Head & Neck Surgery' journal.

According to researchers, the increased activity in a sufferer's nervous system caused by their snoring could be the reason behind the findings.

The researchers have based their findings on analysis of 212 patients, all of whom snored or had related conditions including sleep apnoea, a disorder in which sufferers actually make snoring noises and stop breathing momentarily during the sleep as their airways close over.

Those who suffered from the most serious snoring problems expended around 2,000 calories while resting every day, while those who tended to snore lightly and less often burned an average of 1,626 calories a day resting, they found.

And, according to the researchers, resting energy expenditure may be affected by increased reactions in nervous system caused by snoring and snoring-related disorders.

However, they have strictly warned that snoring could cause other problems, which could make sufferers gain weight, despite the fact that they are expending more calories while at rest.

Lead researcher Eric J Kezirian of the University of California was quoted by 'The Daily Telegraph' as saying: "First, sleep-disordered breathing often results in fatigue

and other (changes) in daytime functioning that can limit physical activity.

"Second this (study) does not specifically incorporate the emerging evidence that suggests sleep-disordered breathing may alter energy intake, whether through hormonal or other mechanisms."

BAD HYGIENE AT ROOT OF TEETHING TROUBLES

A fast-paced lifestyle and poor awareness has resulted in a marked deterioration in the city's dental health, finds a study

Sharad Vyas & Madhavi Rajadhyaksha | TNN

Mumbai: Mumbaikars have a poor level of oral hygiene, that could be blamed perhaps on their busy schedules and little dental awareness, finds a recent survey.
    A study by the BMC-run Nair Dental College released last week revealed that out of a lakh patients who visited the hospital in the last one year, a growing number suffered from cavities, gum diseases and oral cancers, with dental caries (tooth decay) and periodontitis (inflammation of gums) emerging as the most common problems.
    Dentists said most people not only lack awareness about oral hygiene, but don't even have the time in their fastpaced lives to brush their teeth before going to bed. "Some don't have time even to brush their teeth once in a day, and they are not aware of its consequences. This is the reason why the life expectancy of our teeth is going down,'' said Dr Suhasini J Nagda, dean of Nair, the oldest dental hospital in the city.
    Dean of the Government Dental College, Dr Mansingh Pawar, echoed her concerns: "We find that there is low awareness about dental health among most people, particularly because dental diseases don't affect daily routine till the problem is really severe,'' he said. He felt the changing food habits — increased consumption of sweets, chocolates, ice-creams and biscuits, is resulting in the higher incidence of oral caries.
    Dr Pawar observed another trend, pointing out there were more cases of caries among city-dwellers whereas rural folk turned up with more of gum diseases. "This is because wrong eating habits are more prevalent among city-dwellers, while the rural population have issues of hygiene,'' he said.
    The survey also revealed that an increased number of patients are opting for minor cosmetic surgery to improve their smile and looks. About 4,000 patients admitted at Nair alone underwent various treatments like bleaching, giving veneers, reducing gaps between teeth — all to change the character of their smiles. Most of them wanted a confident smile and model-like teeth, said doctors.
    In fact earlier this year, Nair Hospital had celebrated Oral Hygiene Day on August 1 to spread awareness. As part of an extensive drive, several students conducted street plays and skits propagating the importance of oral hygiene and discouraging dangerous habits such as smoking and tobacco chewing. "We work with a simple motto — Teeth for a lifetime,'' Nagda added.
    Moreover, the hospital's community dentistry programmes were regularly held at institutions, schools, prisons and public areas. A mobile dental van reached out to more than 3000 patients through as many as 133 visits.
    The hospital's community awareness drive also focused on the underprivileged sections of society, with some 4,544 street children and prostitutes treated at various camps. Among them, gingivitis and tooth decay were found to be the two most common diseases.
COMMON DISEASES
CARIES What is it? It is tooth decay due to multiple growth of microbes. Causes: Wrong eating habits particularly overdose of foods containing refined carbohydrates such as sweets, biscuits, chocolates, icecreams and sticky packaged foods Symptoms: Initial chalky white appearance on teeth which subsequently turns black if left unattended. It may further deteriorate to dental cavities and increased sensitivity
GROSSLY AFFECTED TEETH
What is it? Severe form of teeth decay in which enamel and dental tissues are destroyed, generally seen in the grinders (teeth at the back of the mouth) Causes: Wrong food habits Symptoms: Change in appearance of teeth.
GINGIVITIS What is it? External gum disease
Causes: Bad oral hygiene. People at risk include those who don't gargle after eating or don't brush their teeth properly.
Symptoms: Gums turn red and may show signs of swelling or bleeding. If it progresses it could result in the loss of teeth
PERIODONTITIS What is it? Internal gum disease, a severe form of Gingivitis.
Causes: Bad oral hygiene. Symptoms: Decay in the soft tissues around the teeth.
DENTAL INFECTIONS
The most common form is oral cancer which accounts for nearly 45 per cent of all cancers. Causes: Consumption of tobacco and tobacco products particularly chewing tobacco (gutka) Symptoms: Shows up as lesions in the mouth.
FOR PEARLY WHITES
Brush your teeth atleast twice a day.
Gargle after every meal or snack
Avoid eating excessive sweets, particularly chocolates, icecreams and food stuffs containing refined carbohydrates
Visit dentists for preventive checks, just as you would your family doctor.

Body BASICS

Watch out for winter

 Who doesn't like to bask in the winter sun? But the dip in mercury also signals the arrival of the common cold and flu, which often escalate to pneumonia. Try these tips to stay healthy as the mercury dips…
Do's
Keep yourself warm I This indirectly helps keep away bacterial and viral infections. Cold conditions decrease your immune response, increasing chances of colds, flu and pneumonia.
Drink plenty of water I You don't feel as thirsty as in summer, so the water intake tends to decrease. In winter, one tends to consume hot drinks like coffee and tea more often. But, caffeine draws out the water from the system, causing dehydration. Drink at least 6-8 glasses of water per day. Exercise regularly I With shorter daylight time, we tend to wake up later in winter and generally slow down. Our fitness routine is usually put on the back burner. Make a conscious effort to follow a daily exercise schedule. An extra 20 minutes of physical activity helps to improve circulation and keep those extra pounds at bay.
Massage your hands and feet I To prevent chilblain (small, itchy, blue swellings) in extreme cold temperatures, as are prevalent in North India, massage your palms, fingers, toes and heels with warm vegetable oil.
Get at least eight hours of sleep I Managing the recommended eight hours of sleep is crucial as a lack of it lowers one's immunity and energy levels during winter. Avoid alcohol and nicotine for a good sleep. Take care of hands and feet I This is a must for everyone. Foot care is important for diabetics to avoid infection that can lead to gangrene.
Keep a regular check on your blood sugar I As exercise tends to decrease in winter and infections are on the rise, this is a potential time for elderly diabetics to fall easy prey to obstinate infections that get exaggerated if one's blood sugar is uncontrolled. A regular check of blood sugar is recommended for diabetics.
Get checked for anaemia I Low haemoglobin can predispose you to infections and other winter ailments. Improving haemoglobin adequately keeps you better poised to avoid and confront infections.
Have plenty of vegetables and fruits I
Winter is the season especially in humid cities for good seasonal vegetables and fruits. Feel free to binge on them as they improve immunity and keep the body in supply of its requirements of anti-oxidants, vitamins and minerals.
Don'ts
Don't forget vitamin D
Those in very cold places are at risk of not getting enough vitamin D during winter, when the UV radiation from the sun's rays is weak. A vitamin D supplement of 200 IU is recommended.
Don't forget to moisturise
That winter wind is damaging to our skin, so the best beauty secret is to moisturise as frequently as possible. Everything from your hair to your skin starts to feel scaly so stock up on thick luxurious moisturisers and use the chapstick! Moisturised wipes will be useful if you have a cold.
Don't get into the "eating only high cal food" loop
When the environs are cold , many of us fall back on carb and fat heavy comfort food like pasta, thick creamy soups, mithai, ghee-soaked parathas. However, this will not only hinder your weight loss goals but also make you lethargic and sleepy.
Don't overlook sunscreen
Summer is not the only time to worry about using sunscreen. Surprisingly, skin damage is a great concern even in a snowsuit. Wearing at least an SPF 15 when outdoors in the winter is recommended. The glare from snow can be so harmful, so it's a good idea to wear goggles.
    (Inputs from Mumbai-based pathologist
    Dr Indumati Gopinathan)

Nuts help cut risk of heart disease

CHICAGO: Here's a health tip in a nutshell: Eating a handful of nuts a day for a year — along with a Mediterranean diet rich in fruit, vegetables and fish — may help undo a collection of risk factors for heart disease.

Spanish researchers found that adding nuts worked better than boosting the olive oil in a typical Mediterranean diet. Both regimens cut the heart risks known as metabolic syndrome in more people than a low-fat diet did.

"What's most surprising is they found substantial metabolic benefits in the absence of calorie reduction or weight loss," said JoAnn Manson, chief of preventive medicine at Harvard's Brigham and Women's Hospital.
In the study, the people who improved most were told to eat about three whole walnuts, seven or eight whole hazelnuts and seven or eight whole almonds. They didn't lose weight

, on average, but more of them succeeded in reducing belly fat and improving their cholesterol and blood pressure.

Manson, who wasn't involved in the study, cautioned that adding nuts to a western diet — one packed with too
many calories and junk food — could lead to weight gain and more health risks.

"But using nuts to replace a snack of chips or crackers is a very favorable change to make in your diet," Manson cautioned.

The American Heart Association says that over 50 million Americans have metabolic syndrome, a combination of health risks, such as high blood pressure and abdominal obesity.

Nuts help people feel full while also increasing the body's ability to burn fat, said lead author Jordi Salas-Salvado of the University of Rovira i Virgili in Reus, Spain.

"Nuts could have an effect on metabolic syndrome by multiple mechanisms," Salas-Salvado said. Nuts are rich in anti-inflammatory substances, such as fiber, and antioxidants, such as vitamin E

. They are high in unsaturated fat, a healthier fat known to lower blood triglycerides and increase good choleste

Eight hours to healthier cells

All you need to do is get some sleep

 Want healthier cells in just eight hours? Then get some solid shut-eye tonight.
    Your body does important things while you sleep — like healing your cells. But just one night of tossing and turning could trigger cell-damaging inflammation. So turn off the lights, slip on that sleep mask, and get your 40 winks.
Inflamed in the Membrane
    In a recent study, sleep-deprived people — especially women — showed a marked increase in their levels of a protein called NF-kB. That's bad news, because NF-kB plays an essential role in the body's inflammation response. The study may help explain why poor sleep is associated with several inflammation-related disorders, including cardiovascular disease, arthritis, diabetes, cancer, and obesity.
Mini Mind-Body Makeovers
    Need help adjusting to the end of daylight saving time? Or getting over jet lag? Or just sleeping through an average night? Doze your way to good health with these tips:
    Refresh yourself on the basics. Find out when to sleep, what temperature is best, and which foods to eat.
    You move, you snooze. You might associate stretching with waking up, but it can help you nod off, too. Stretch yourself to sleep.
    Develop good sleep habits. Fall asleep and stay asleep with a deepsleep plan.

SOUND SLEEP: Develop good sleep habits

How lizard spit aids diabetes

A drug that enables Type 2 diabetics to produce more insulin and lose weight opens a whole new chapter in diabetic management

A year ago, when 58-year-old retiree B S Wig, saw the scales tip at 149 kg, he was dismayed. He was diabetic and also increasingly obese. His blood sugar hit a dismal 350 mg/dl after meals. The normal should be under 140 mg/dl. ''I had become weak and refused to socialise. My life had gone haywire,'' says Wig. Till he was put on to a new drug, which not only reduced his weight to a healthy 118 kg, but his sugar levels to normal. ''I can now be dated,'' he says happily.
    Wig is lucky. Most diabetics have difficult lives, with an unending cycle of ill health, weakness and obesity as the pancreas produce little or no insulin, the hormone that converts glucose to energy. Plus, diabetic drugs usually make the patient obese, which adds to the risk of high BP, heart problems and strokes. So it's essential to have drugs which control sugar levels and reduce weight.
    And that's what a new injectable drug, Byetta, does, say experts. It's made from the saliva of the Gila monster, a venomous lizard found in Southwest America. It's the first in a new range of anti-diabetic medicines and is FDAapproved. However, it can be used only on Type 2 diabetics.
    It came to India exactly a year back and now, experts can quantify its success. By 2009, an upgraded version may be available.
    Unlike Type 1 diabetes where there's no insulin secretion, in Type 2, insulin production from the beta cells of the pancreas isn't sufficient. And for Byetta to work, viable beta cells are needed, says Dr Ambrish Mithal, senior endocrinologist, Apollo Hospital, Delhi.
    It works in three ways: It signals the pancreas to make the right amount of insulin after a meal; stops the liver from making too much glucose when the body does not need it, reduces appetite and the amount of food eaten and slows the rate at which glucose leaves the stomach.
    Type 2 diabetics form 90% of the estimated 40 million diabetic cases in India. Almost 80% of them are obese, says Mithal. Adds Dr Pradeep Talwalkar, professor, diabetology, Raheja Hospital, Mumbai. ''It suppresses rise in sugar levels by suppressing glucogon, a hormone which has the opposite effect of insulin.''
    ''Byetta'' says Mithal, ''can produce nausea and vomiting in some patients. It is a niche drug, not for all diabetics, but is a good choice for those who need to lose weight with high post-meal blood sugar rises that remain uncontrolled even on oral medicines.''
    ''Byetta also carries a lower risk than insulin of causing hypoglycaemia, a dangerous condition where the patient can lose consciousness and slip into coma as insulin drops to very low levels,'' says Talwalkar.
    Wig's case is an ideal example. ''I was not judicious about my medicines and kept oscillating between oral medicines and insulin. Meanwhile, my weight and sugar levels went for a toss till I started taking Byetta,'' he says.
    It's important for obese diabetics to lose weight, says Chennai-based Dr A Ramachandran, president, India Diabetics Research Foundation, as obesity makes them resistant to diabetic treatment. ''It is, in fact, an analog for hormones which produce insulin called incretin.'' A weight reduction of 5-6 kg a year is good, says Mithal. Byetta is normally given with oral medicines.
    But it's expensive — around Rs 7,500 monthly. Rimi Dasgupta, a 41-year-old diabetic, who lost 12 kg and with sugar levels which came down to 140 mg/dl from 390 mg/dl, says, ''It's easy to inject, but I don't know how long I can take it as it's expensive. I hope to continue it for a year.''
    Byetta comes in a prefilled injection pen which uses a small needle. This pen contains pre-measured doses, so the patient doesn't have to adjust the dose. It's injected twice daily before morning and evening meals.
    Generally, the patient is started off on a dose of 5 micrograms (mcg) twice a day for at least 30 days, but this could be increased to 10 mcg based on individual results. In clinical trials, it was found that on an average, patients lost five pounds in 30 weeks. However, Byetta cannot be used simply for weight reduction.
    Though there are other new medicines which stimulate the pancreas to make insulin without producing hypoglycaemia such as Januvia and Glavus, says Ramachandran, these don't make a patient lose weight.
    Byetta could just be that shot that makes a difference.

8 Steps for Aging Gracefully

The suggestions in this gallery are intended to help you become more aware of your spiritual self. Any activity that makes you feel more alive, more connected to others and to nature, less isolated, more comfortable with change, is beneficial. It will enhance your physical and mental health. It will help you accept the fact of your aging. It will help you to age gracefully. 1 PAY ATTENTION TO YOUR BREATH Many cultures identify breath with spirit, seeing the breath cycle as the movement of spirit in the physical body. Simply minding the breath is a way of expanding consciousness beyond the ego, of experiencing transcendence. 2 CONNECT WITH NATURE You can do this by walking or sitting in a natural setting; a city park will do just fine.Allow yourself to slow down, drop your usual routines, and just absorb the influence of the place. 3 SPEND TIME WITH YOUR LOVED ONES Make a list of people in your life in whose company you feel more alive, happy, and optimistic. Make an effort to spend more time with them. Our spiritual selves resonate with others, and that connection is healing. 4 REMEMBER THE LITTLE THINGS Bring flowers into your home and enjoy their beauty. 5 SOOTHE YOUR SOUL WITH SOUND Listen to music that you find inspirational and uplifting. 6 SEEK OUT BEAUTY Admire a work of art that raises your spirits: a painting, sculpture, or work of architecture. 7 MAKE AMENDS Reach out and try to resume connection with someone from whom you are estranged; practice forgiveness. 8 DO SERVICE WORK Give some of your time and energy to help others.The possibilities are endless, and there are so many ways to help in addition to writing a check to charity.

Amrita turns soyaholic

 Amrita Arora is an ultimate combination of a charming face and hot body. When we asked her how she manages to be so svelte, the actress said, "I am high on soya milk these days! I am so addicted to it that I keep having it at a regular interval throughout the day. It's an energy drink that I just can't part with as it's healthy sans calories and it keeps me full." Well, now if you ever see the actress with a bottle in hand you know what it is.

HEALTH FREAK: Amrita Arora