Skipping breakfast increases risk of diabetes

A review of existing studies looked at data from 96 000 people and concluded that skipping breakfast (even occasionally) is associated with a higher risk of developing diabetes.
Skipping breakfast once a week is associated with a 6 percent higher risk and skipping 4 or 5 times per week increased risk to 55 percent.

What happens?

• Increased blood sugar after lunch and dinner
• Impaired insulin response
• Tendency to overeat

What is the mechanism?

It is due to insulin resistance

. 

As a result, more insulin is secreted to keep the blood sugar in a normal range 

when it’s chronic, it is the onset of diabetes

Why people skip breakfast?

• No time (even to breath)
• Don't feel hungry in the morning
• There is no breakfast in our family

What you should eat?

Whole wheat bread
(The front label is misleading. See the list of ingredients. 
The first (not second or third) ingredient should read as whole wheat white bread or whole wheat brown bread

Potato

Banana or apple

Boiled egg (with yellow)
        
OR

Boiled Mung, or Chole or Rajma

A glass of milk

.This will help you kick-start your day, give you energy, satisfy your appetite, and set the stage for healthy eating all day long.”

We are obsessed with Cholesterol

         
            
We are still haunted by the' phantom' cholesterol.
That is why we eat only white of egg and throw away the yellow portion or give it to the made servant (good for her health)



Then we discovered a cooking oil 'zero' in cholesterol,and discarded our traditional cooking oils (mustard, coconut,groundnut oil) 

In fact, every cooking oil is 'zero' in cholesterol.

All plant foods are 'zero' in cholesterol.
All animal foods contain 'ready made' cholesterol

Liver in our body prepares cholesterol from saturated fats (butter, cheese ,cooking oil) and trans fats (fast foods) It means that saturated fats and trans fats increase blood cholesterol.  

But if we eat ready made cholesterol, there is no much rise in blood cholesterol. Thus the effect of egg yellow on blood cholesterol is minimal when compared with trans fats and saturated fats.

Look at the nutritious value of an egg:
.

Egg white:

Protein: 6 gm

The biological value of egg protein is superior to all animal and plant proteins

Egg yolk:

 very little saturated fat (1.5 grams)   

 Vitamin A (270 IU)

 Vitamin D (40 IU)

 Lutein (good for the eye)

 Choline (good for brain and nerves)

Cholesterol 186 mg

One egg has only 72 calories 

American heart association has stated that daily cholesterol intake up to 300 mg is safe.

One egg has only 186 mg


 Bottom line:

The relation between cholesterol and heart attack is controversial.

There are many risk factors for heart attack. We ignore them and are obsessed with only cholesterol.

Blood cholesterol increased due to

• saturated fats in cooking oils
• Trans fats (fast foods)

Egg yolk does not increase blood cholesterol

You can have one egg every day without feeling guilty
  

Garlic can reduce blood cholesterol

                          
Garlic is widely used around the world for its pungent flavor as a seasoning or condiment.It has a characteristic pungent, spicy flavor

,In folklore, garlic has been regarded as a force for both good and evil. In Europe, many cultures have used garlic for protection or white magic

National Institute of Nutrition,Hyderabad has done research on garlic and discovered the following effects on the health

Improves immunity

Anti cancer

Reduces blood Cholesterol

Prevents formation of thrombus in the blood vessels

Cloves of garlic

The recommended dose is 5 cloves per day.

Crush them and then swallow. 

(An intact clove could be excreted as such in the stool) 

P.S

Before starting a statin for high blood cholesterol you can 

try 5 cloves of garlic every day for 2 months and find out if

there is reduction in blood cholesterol.


If yes, then continue to take it.

Home blood pressure monitoring

  

Hand should be resting at elbow and cuff should be at the level of heart

American Heart Association (AHA) recommend that high blood pressure should be monitored at home. 
It can help you keep tabs on your blood pressure in a familiar setting, and confirm that your medication is working, 

.It is an important part of managing high blood pressure. 

• It Helps with early diagnosis of high B.P.
• It can discover 'white coat hypertension' This is when the B.P. is high in the clinic and normal at home. It does not need drug treatment (only a change in lifestyle)

• Multiple readings over a period is a good feedback to your doctor

• You get involved in your treatment

The arm should be resting on the pillow 
and cuff should be at the level of the heart.  

Blood pressure at your wrist or finger is not recommended 
It should be taken around the arm. Cuff size should be properly fitting. A smaller size cuff will give a higher reading.  

 Use the same arm. Rest your arm,on a table raised to the level of your heart. If needed, place a pillow under your arm to elevate it to the level of heart

• Measure twice daily, in the morning before breakfast and in the evening.Take two readings each time. Readings are little higher in the morning 

   Place the cuff on bare skin, not over clothing. 

Reading at the wrist is not recommended

• 
  

Drawback: 

Home BP monitors are not held to the same standards of accuracy as those devices in doctors' clinic. 

• 
  Products and Services

White coat hypertension

     
    

White coat refers to the white apron of doctor. When he is taking your blood pressure in the clinic you may become tense and as a result your B.P. may rise above normal. But if your B.P. is taken outside the clinic it may be normal.

This is white coat hypertension.

If your BP is high only in a clinic or hospital and normal at home. 

Everybody does not show this phenomenon. It is seen in highly anxious individuals

Should it be treated? 

No  
It is considered as a temporary rise in blood pressure

Should it be ignored?

Not really. 

To be on the safer side you should improve your lifestyle. 
Reduce your weight and abdominal circumference. This will also help to prevent diabetes.Reduce salt intake and do regular exercise

 Home blood pressure monitoring

Home tracking of blood pressure is very convenient and help you to understand the trend in your B.P.

     measure your B.P.:

1.  when you feel highly stressed and anxious 
2.  when you feel calm and cheerful

 

High blood pressure

       

When blood pressure is above 140/90, drug treatment is started. This is the modern trend.

Is there an urgency?
not really.

International guidelines have recommended modification of lifestyle before starting the drug treatment.

• Reduction of stress

      There may be some conflict at home or at the workplace.        .

• Reduce weight and abdominal circumference

      This would also help to prevent diabetes

• Healthy diet

       Foods rich in omega-3
       Cooking oil (mustard or soybean)
       Fish
       Rajma
       soybean
       Green leaf vegetables
       Fruits

•  salt reduction

        Half teaspoonful (2.5 g)per day. 
        avoiding fast and processed foods

• Exercise 

      climb the staircase
      yoga
      Suryanamaskar

Patient is given 6 months to improve the lifestyle and it will certainly normalise the BP. 



The spill over effect is the feeling of being in control of life situation.This will result in a healthy and positive attitude.


High BP should be considered as an opportunity.


P.S.

Nobody is interested. Nobody has the time 

Doctors start the treatment and patients happily accept it

Once the drug is started, patient does not want to stop it and the life goes on. 


Whose B.P. is it anyway?

Cooking oil, salt and sugar are the culprits

These are hunter gatherers. They are our ancestors
.(stone age)

They were nomads, moving from one place to the other, hunting for the meat,collecting root and tubers and wild honey on the way.

Every day was stressful. They had to fight with wild animals for the survival.



What was their food?

• Meat (when they could hunt the animal)
• Roots and tubers
• Wild honey (sweet dish)
• Mongango nuts

About 25 year ago, American nutritionist knew that the decedents of these hunter gatherers are still existing in a remote part of the Africa which is not shown on the map of the world.
They are still living the same nomadic lifestyle and same food habits.They are not aware of the modern world and modern lifestyle. (totally disconnected) 


American nutritionist reached the site, lived in the neighborhood, tried to talk with them in sign language, won their confidence and somehow convinced them to examine them and take out the blood samples.

What was found?

• No obesity
• No malnutrition
• No vitamin deficiencies
• B.P. decreased with age
• Normal blood sugar
• Blood cholesterol 120 mg% (Lowest in the world)

Modern lifestyle:



We discovered cooking oil, salt and sugar, which is the base of modern fast foods, processed and ultra processed foods,junk foods and ready to eat foods.




We cannot turn the clock backwards but at least think and select our food which is very less in oil,salt and sugar

Heart attack : Where do you live matters

   
This is an original research paper published in the prestigious medical journal 'New England Journal of Medicine'

This study involved 13000 participants, which were followed up for 9 years.

Those persons living in homes with a stressful environment had a higher risk of heart attack, and this risk is over and above the established risk factors for heart attack. 


This study examined the  various factors of neighborhood such as wealth,income, education and occupation 

Increased risk:

• Fear of crime
• Insecurity
• Noise
• Lack of open space
• Lack of Social support
• No medical help
• Lack of recreation facilities

Also, such environment may encourage smoking,irregular diet and lack of exercise. 


Decreased risk:

• Large public places
• Medical help
• Recreation facilities
• No noise
• No crime
• Social support
• Security

Such environment promotes a healthy lifestyle and preventive health behavior

P.S.


We already know that lack of education, poverty, low social status increase the risk of heart attack.This study adds an additional risk factor, which is the environment around

your residence.

The illness and the death are related to social inequalities.

Who suffer?

• 'Low' control over life
• 'Low' in social hierarchy 

Social gradient plays a role in life and in death