heart attacks

How do you fix your diet to take adequate fibre?

/ Subash Rau / Leave a comment

Fibre or roughage refers to anything that that can be taken by mouth and is not digested, bulks up the contents of the intestine and helps smooth evacuation of stools.

Having a diet that has plenty of fibre is good for health. Apart from preventing constipation, dietary fibre has a beneficial effect in lowering the risk for heart attacks and strokes, reducing the risk of diabetes, improving diabetic control in those already with diabetes and in preventing obesity. Modern dietary habits, based on the consumption of large amounts of refined cereals (grains) has very little fibre and therefore increases the risk of developing common lifestyle diseases such as obesity, dyslipidaemia, hypertension, diabetes and their complications.

What are the types of dietary fibre?

Dietary fibre comes predominantly in three forms namely, soluble fibre, insoluble, fibre and fermentable fibre.

Soluble fibre, dissolves in in water and puffs up, fills the tummy, promotes satiety (a feeling of being full, and therefore reduces hunger). It therefore helpful in those with diabetes and dyslipidaemia.

Insoluble fibre doesn’t swell up in water but tends to bulk up the intestinal contents, reduce intestinal transit times and helps quicker elimination from the body. Insoluble fibre is very important in maintaining intestinal health and preventing constipation.

Fermentable fibre can come from both the above groups and maintain a population of good bacteria in the gut. These are often referred to as pre-biotics (food for the good bacteria). Their digestion by intestinal bacteria (flora) results in short chain fatty acids (which can be used by the human host as an energy source) and is also converted to gas (methane, ammonia, hydrogen and carbondioxide.

So how much fibre do we need in our diets daily?

Most dietary institutes recommend 30 g of fibre for adults and reduced amount of fibre in children based on their ages.

While there is no upper limit to the amount of Phiber that can be consumed every day, it is recommended that any increase in dietary fibre is done gradually in order to prevent gas, bloating, constipation, diarrhoea and abdominal pain.

How do you fix your meals in order to have enough fibre daily?

This can be simply done by incorporating more green vegetables, taking more of whole fruit with skin, whole grains (instead of polished grains), plenty of lentils, and legumes(beans), a generous helping of nuts and also drinking plenty of water (upto 3 to 4 L per day).

By knowing how much fibre different foods and vegetables have, you can design your healthy meals with adequate fibre. Make sure that every meal has a fibre containing food in it just as you have proteins in every meal.

So what then is constipation?

Constipation refers to defecation that is unsatisfactory because of passing stools infrequently, needing to strain stools or with a feeling of incomplete bowel evacuation. Constipation could refer to for example, passing motions to 3 times a week only (not daily) or passing hard stools that are difficult to expel.

Why are people constipated?

People may be constipated because their diet does not contain adequate fibre or because of not taking enough fluids by mouth or because they dont exercise daily (and more so if they are elderly, bedridden or sick). Constipation can also occur due to the presence of medical conditions such as diabetes, hypothyroidism, kidney failure, high calcium levels, intestinal tumours especially cancers of the large bowel (causing partial or total obstruction), diverticular disease, neurological conditions such as Parkinson’s disease/Multiple Sclerosis etc. A variety of medications such as painkillers, antidepressants, iron tablets, antihistamines, certain antihypertensives, psychiatric medications and anti-seizure medications commonly cause constipation.

So how is constipation treated?

Before medication is tried, it is important to correct dietary deficiencies of fibre, inadequate water intake and being physically inactive. Medical conditions often stop patients from being able to do the above (patients with heart or kidney failure who can’t drink much water, patients with intestinal obstruction or inflammatory bowel diseases who cannot take fibre or those who can’t walk or exercise) may need laxatives to help them pass motions every day. Laxatives work by loosening the stools or relaxing the intestines thereby helping defecation.

So the most important thing to do would be to prevent constipation by fixing your diet by taking adequate fibre.

Coffee in the news!

/ Subash Rau / Leave a comment

Coffee is a stimulant with caffeine as the active ingredient. It acts by activating the central nervous system. It can counteract tiredness and improve concentration and focus. Caffeine has very many effects on the body apart from increasing mental alertness. It can also cause an increase in the heartrate, BP and can make you feel warm on a cold day Caffeinated drinks, especially coffee, teas (regular as well as green tea) energy drinks and colas are popular throughout the world and are drunk by people of nearly all age groups. Below are excerpts from a few articles about coffee that I have recently read online, which may be of interest to you. If so …….read on.

Daily coffee intake may benefit the heart

There used to be a time when coffee was believed to be harmful to the heart and was discouraged. But recently even people who have suffered a heart attack are not denied their daily cuppa. Even in those without heart disease, drinking coffee can increase the heart rate and some people worry that this could trigger off a heart attack or an arrhythmia (palpitations). Recently there was a publication by the American College of cardiology reporting that coffee intake specially 2-3 cups a day may actually be good for the heart. In the UK they has followed patients for a 10 year period They divided patients into groups according to the number of cups of coffee that they consumed. The groups were <1, 1 to 2 cups,2-3 cups, 4 to 5 cups and lastly 5 or more cups a day and they found that, those who had 2-3 cups of coffee a day had a 10 to 15% lower risk of developing heart disease (coronary heart disease), heart failure, heart rhythm problems and from dying from any cause. In another study done on people already having some kind of cardiovascular disease at baseline, 3 cups a day was associated with a lower risk of dying. So the take home message was that having 2-3 cups of coffee a day may actualy do you good in the long run.

Drinking 2 or more cups of coffee by patients with severe hypertension ups the mortality!
This article was published in the Journal of the American heart association reported from Japan found that when hypertensive people (defined as those with BP >160/100) who take 2 or more cups of coffee had a higher death rate. This is not seen in people who take less in 1 cup of coffee or people who had well controlled or NO severe hypertension.

High caffeine levels may lower body mass index, fat index and type 2 diabetes risks!
A study done from Sweden had shown that 2 gene variations results in genetically predicted lifelong higher caffeine concentration in the blood and this was associated with a lower body mass index, lower body fat mass and a lower risk for diabetes mellitus. 50% of the benefits in preventing diabetes comes from reduction of the body mass index or a body weight. Coffee has been known to be thermogenic. I.e. it increases the fat burn. The authors cautions that further studies need to be done before linking caffeine consumption with prevention of diabetes, i.e. it does not prove cause and effect relation between caffeine and and diabetes prevention.

Although there may seem to be many contradictions regarding the benefits of coffee in health , this may be due to different study populations, different methodologies and dfferent interpretations. It may be safe to conclude that coffee consumption is indeed safe. Despite coffee’s various effects on the body it may have some benfits to those driniking it. However, based on currently available evidence in medical literature, it probably cannot be recommended to non drinkers (of coffee) to improve their health at this point in time.

Anger and why you must control it!

/ Subash Rau / Leave a comment

Anger is a sudden maladaptive response to a variety of stimuli characterised by an aggression which could be verbal, physical or both. It is provoked more often in people with a certain personality types especially when subjected to stressful triggers or situations in specific contexts. It may even be provoked by minor stimuli in anyone depending on the circumstance. While it has been essential for the survival of our species, modern life (in overcrowded urban jungles) provides too many stressors that provoke unnecessary anger which then has long term health implications. This article attempts to throw some light as to the causes, effects and changes during and after an episode of Anger.

Civilisation and urbanisation forces people of all different personality types, of different interests and priorities to live together. In the hustle and bustle of daily living we are forced to deal with different situations and people who could make our lives difficult, with intention or otherwise. We are provoked into losing our tempers, get angry, explode (or implode) and suffer the consequences. Our personality type, our current mental state, our previous experiences, the people we have to deal with, all have a role in determining how we respond to a situation and how angry we get. Often we get irritated with what is happening and if this isn’t resolved, results in anger. I call Anger a maladaptive response because we get angry only with people we can get away with showing it and it rarely solves the issue that provoked it.

The Anger reaction begins in the Amygdala in the brain, it spread to the Hypothalamus and the Pituitary which releases ACTH hormone that stimulates Cortisol secretion from the Adrenal glands. Cortisol suppresses the immune system, increase sugar production and the conversion of Fatty acids to energy. The adrenals also produce Adrenaline which increase the Heart rate BP and the Cardiac output. Adrenaline also increases the release fo glucose from the Liver and increases the tension in the skeletal muscle and also increasing the rate and force of contraction of the skeletal muscles. The respiratory rate increases and visual fields constrict and pupils dilate allowing the angry person to focus on the person triggering the reaction. In short the body prepares for “fight or flight” when angry.

All these hormones increase the blood pressure, Heart rate and respiratory rates. Blood is shunted away from “nonessential” organs such as the intestine and kidneys in favour of the heart lung brain and skeletal muscles. It is quite common to feel like you want to empty your bladder or even vomit when very stressed.

Chronic and recurrent Anger depletes the body’s ability to fight inflammation that is triggered by the free radicals. This eventually causes disease.

Anger is known to cause frequent headaches, digestive problems and abdominal pain/gastritis, Insomnia, increased anxiety and depression, skin problems and eczema and even Heart attacks and Strokes.

Your Anger has not only implications for you, your mental and physical well being and productivity but also for that of your family, friends, work colleagues and everyone in your immediate surroundings. Your anger will have a domino effect on others. It is therefore very important to control or release your anger, not just for your own selfish reasons but also for the greater good of society.

The first step in Anger management would be to realise that Anger is harmful to you more than to anyone else. While there may be many ways to keep your anger in control, I personally believe that if you have an understanding nature, have empathy for others and make excuses (to yourself) for their inability to see or do things your way – you could control your anger. Being placid or timid or avoiding people or situations may not necessarily be the right way to deal with anger or a situation that could make you angry. Learning to meditate, attempting to resolve conflict by understanding the other person and seeking counselling (professional) could help you deal with your anger. Yoga, exercise, regular breaks from your work, having a supportive network of friends and family could also help you release your anger. Keeping a diary could help you understand your anger and could help you device strategies to cope with stressful situations when they happen the next time.

My very best wishes to you for staying cool always.