Diabetics should check their vitamin B12 levels

Most diabetic patients are above 60 and also taking metformin, both of which are associated with vitamin B12 deficiency.



This affects the nerves of hands and legs and there is numbness, tingling,burning sensations in hands and legs (peripheral neuropathy)




This is treated by taking the injections of vitamin B12 and folic acid

Inj. VITCOFOL 10 ml vial

2ml per injection.given once a week

Total 5 injections

These injections should be given in the buttock

Vitamin D in diabetes

Most diabetics have a deficiency of vitamin D 

This leads to 

• High Hb A1c levels (uncontrolled diabetes)

• Albumin in urine (nephropathy)

Every diabetic should have a normal level of vitamin D( 30 ng /mL)

• There is no vitamin D in foods. Only a limited amount in some foods

• If you expose to sunlight for 90 minutes per day then you get vitamin D, just enough for the day. 

• Only reliable way of getting it through the supplements which are available as sachet or tablets

Diabetics suffer from depression

Depression is both a cause and effect of diabetes

A study of 272 diabetic patients showed that 60% had depression


Following features were seen

• Physical inactivity
• smoking 
• Alcohol intake
• Albumin in urine

• Poor control of diabetes
• poor quality of life
• Neglect of proper diet

P.S.

• Depression remains unrecognized and hence untreated
• Diabetics will not take professional help
• They are not proactive  
• They do not complain 
• They just accept the problem and do nothing about it.

Diabetics should monitor their blood pressure

100 diabetics who had normal blood pressure were studied.
These patients had fluctuations in the blood pressure which are as follows

• Early morning rise
• Night time surge (Nocturnal hypertension)
• Fluctuations during the 24 hr period

Such variations were associated with

• Albumin in urine
• High HbA1C (Average blood sugar during the last 3 months

Do they need medicines to lower the blood pressure?
No. 
These patients are not hypertensives.


But they should monitor their blood pressure at home 


Ambulatory blood pressure monitoring:

Use the same arm. Place the cuff on bare skin, not over clothing. 

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

P.S.

These variations in B.P. will stop when we control our diabetes.

• Reduce weight and abdominal circumference
• Reduce calories
• Stop eating out

• 
  

Pear shaped woman & Apple shaped woman

A woman who has abdominal circumference more than 80 cm has central (abdominal) obesity.  Her body weight may be in normal range.

Pear shaped woman:

• Fat is deposited in buttocks and hips
• No deposition of fat around abdomen
• Abdominal circumference at the level of navel is 80 cm or less
• No risk of diabetes or heart disease

Apple shaped woman:

• Larger waist and carry a lot of weight around the abdomen
• Abdominal circumference is much more than 80 cm (it is between 95 to 100 cms)
• More risk of diabetes and heart disease

Pear-shaped women are healthier than Apple-shaped women 

Waist -to-hip ratio:

Measure around the widest part of your hip and the narrowest part of your waist (just above the navel)

Divide your waist measurement by your hip measurement

Waist -to- hip ratio should be less than 0.85 

The ratio greater than 0.85 is a risk factor for diabetes and hear disease.
Apple shaped women have higher waist to hip ratio

More and more women are becoming Apple shaped with a high waist- to- hip ratio and are suffering from diabetes or heart attack

 .P.S.

Women are not aware of abdominal obesity.

Even if they are told about it they may not take it seriously

It needs great efforts and a very disciplined lifestyle.

Average woman will just accept it and do nothing about it

Can we prevent dementia in old age?

Dementia is a condition characterized by a decline in memory, language, problem-solving and other thinking skills 

It affects a person's ability to perform everyday activities. Memory loss is an example. Alzheimer's is the most common cause of dementia. 

Dementia is seen in old age but the process is going on in the brain for the past 15 to 20 years.

 common early symptoms::

•  memory problems,(for the recent events) 
•  increasing confusion.
•  reduced concentration.

It is possible to prevent this irreversible problem, 
It is difficult but not impossible.

How is your cardiovascular health when you become 50 years old.?
If you rectify these risk factors you can minimize the risk of dementia.

what is the action plan?

• Stop smoking from today,(if you are a smoker)
• Improve you diet:.

      fruits and vegetables  
      whole wheat bread or roti
      Basmati rice (refer to the blog on basmati rice)
      Chole, rajma ,Mung 
      Restrict the cooking oil to half liter per month 

• Regular physical exercise 
• optimal body weight
• Normal blood sugar (without anti diabetic drugs)
• Normal blood cholesterol (without statins)
• Blood pressure within normal range 

   Stop eating out (birthdays,marriages,get together etc)  

P.S.

• How simple is it and how difficult it is?

• If there were medicines to rectify these risk factors, you would not mind taking them.

• Unfortunately you have to make efforts and lead a disciplined lifestyle for many many years.

• Is it possible? 

Do it as much as you can.

Something is better than nothing

Brown rice & white rice

 

 The outermost layer of rice, called the hull, is removed to make brown rice. 

All white rice starts out as brown rice. A milling process removes the rice’s husk, bran, and germ. This process increases white rice’s shelf life but removes much of its nutrition, including fiber, vitamins, and minerals.

Brown rice is a whole grain. It contains more overall nutrition than the white rice and reduces the risk of heart disease and diabetes. It reduces the level of HbA1c and bad cholesterol

Brown rice is generally higher in fiber than white rice.which has many health benefits

• feel fuller faster, which can aid in weight management
• lowers cholesterol 
• control blood sugar 
• reduced risk of heart disease
• nourish gut bacteria

White rice has high GI (72)
Brown rice has low GI (50)

Risks:

• Rice crop is known to be contaminated with arsenic, whether white, brown, organic, or conventional. 

FDATrusted Source issued a statement discouraging pregnant women from using rice or rice cereals as the primary grain staple due to arsenic contamination. 

Bottom line:

• White rice has very less arsenic, since the bran layer has been totally removed.

• Brown rice is more nutritious but contains arsenic. 

• If the intake is limited then brown rice is preferred.

• One should limit the intake of rice and eat a variety of cereals

• Basmati rice has the least amount of arsenic and all the vitamins and the minerals

Basmati rice is not only for status

Basmati rice comes from the foothills of the Himalayas in northern India and Pakistan. This is a long grain variety of rice commonly used in Indian,cooking.

It is available in both white and brown varieties






It has so many attributes:

• Basmati has a light and fluffy texture. it's  long, slender grains offer the palate a totally different experience in terms of mouth-feel and a distinctive taste. 

• It is gluten-free and low in fat. 

• It contains all eight essential amino acids,and folic acid,

      The other types of rice are deficient in one of the eight              essential amino acid called lysine. which is supplied   
       when the rice is eaten with the pulses (which contain lysine)

GI of Basmati is low
Gi of other varieties of white rice is high

The brown version of Basmati rice is more nutritious because
of more dietary fiber and essential fatty acids, and the germ contains a number of nutrients,

Basmati brown

The brown version of basmati rice (and all rice) is generally considered healthier than the white version



. .

Basmati rice have about one third of the arsenic compared to brown rice from other regions. 
so it is safe to eat.

Arsenic in rice crop

Arsenic is a natural element in soil and water,  

While growing, rice plants tend to absorb arsenic more readily than other food crops, 

All the varieties of rice are contaminated with arsenic, whether white, brown, organic, or conventional.

Arsenic accumulates in outer layers(hull and bran)
which are removed to make white riceWhite rice has much less arsenic than brown rice

rusted Source

Source,Trusted SourceTrusted Source

How to reduce the arsenic content of your rice?:

• Rinsing raw rice thoroughly before cooking,
• Mix 6 cups water to 1 cup rice, and drain the excess water This is a traditional method of cooking rice in Asia
• Use plenty of water while cooking

• urce

• Trusted Source

Which Rice Has The Least Arsenic?

Basmati rice from California, India, or Pakistan is the best choice, These types of rice have about one third of the  arsenic compared to brown rice from other regions.

Bottom line:

• White or brown rice provide many health benefits that outweigh the potential risks associated with arsenic.

• Brown rice is more nutritional than white rice,but has more arsenic content  If the intake is moderate then brown rice to be preferred

• Limit the intake of rice and eat a variety of cereals

• Organically grown rice has the same arsenic content as the conventional rice. 

• 
  

.

Trusted Source, Source,

Do you know Iron fortified salt?

                


Iron is needed at all the stages of life.
Iron deficiency anemia is widespread in India.
poor diet is responsible. 
Even if diet is adequate, the absorption of iron is limited and variable

very small amount of iron is absorbed (1- 3 mg/day). 
This is because there is a limited capacity to absorb iron. 

 2 - 5% iron is absorbed from cereals, pulses and nuts,

                    But

 10 -20 % iron is absorbed from meat,fruits and vegetables


Hence our diet should contain 10 times the amount of iron that is absorbed.

Dietary sources of iron

Red meat, fish
Jowar, bajra, rice flakes (pohe)

Chole,,Rajmah, soybean
Almond, cashew nut raisins, dates(dried)

Leafy vegetables:
green color vegetables contain more iron than less green vegetables 

Seethaphal, water melon

In India the fortification of common salt with iron has been successfully developed, and its regular use will help to prevent iron deficiency anemia
We should use this iron fortified salt and not the ordinary salt       

Prevention of iron deficiency:

• Use iron fortified salt 
• 50 gm of green leaf vegetable
• Seethaphal or water melon

Sarson -ka -saag

However iron capsules or syrup is needed to treat iron deficiency anemia

Atkin's diet

                  
The Atkins Diet is a popular low-carbohydrate eating plan developed in the 1960s by cardiologist Robert C. Atkins. This diet restricts carbs (carbohydrates) while emphasizing protein and fats. It is usually recommended for weight loss.

You can lose weight while eating as much protein and fat as you want, and avoid foods high in carbs.

Low-carb diets without restriction of calories are effective for weight loss 

Plan for Atkin's diet:

• Phase 1:

     Eating 20 grams of low carb leafy green vegetables
     for 2 weeks,  Eat high fat and high protein. This kick-starts
      weight loss.

• Phase 2:

      Add more nuts, low-carb vegetables and fruits in small
      amounts         .

• Phase 3:

      Add more carbs until weight loss slows down.

• Phase 4:      

      Eat as many healthy carbs as your body can tolerate 

      without weight gain 

A variation:

some prefer to just stay in the phase 1 indefinitely. This is known as a very low carb ketogenic diet (keto).

How it works?

• Insulin levels in the blood are directly proportional to the glucose levels and too many carbs lead to weight gain  .
• In the absence of adequate glucose, the body starts metabolizing fats thus facilitating weight loss.

• Appetite is reduced due to low carbs and increased protein intake. you eat less calories. 

what about vegetarians?

• More high-fiber vegetables, are included for vegetarians 

     

    You can choose from:

• soy-based foods (for protein)
• Nuts and seeds.
• Olive oil and coconut oil (plant-based fat) 
• Baingan (Brinjal or aubergine)
• nutritious low carb vegetables
• paneer 
• Sarso Ka Saag.
• Avial                              
• Palak Paneer.

sarso ka saag

Exercise

Atkin's Diet does not emphasize on exercise because it is not vital for weight loss. It can help maintain your weight, and offer other health benefits.

What are the risks?

Drastically cutting carbs in the early phase can result in some side effects, 

• Headache
• Dizziness
• Weakness
• Fatigue
• Constipation
• Nausea

•  Ketosis occurs when you don't have enough glucose for energy, Body breaks down stored fat, causing ketones to build up in your body.and it causes nausea,fatigue and bas breath 

• Risk of heart attack due to eating animal fats and proteins . . 

Bottom line:

 you will need to stay moderately low-carb for life, even if you reach your weight loss goals.

If you start eating the same old foods again in the same amounts as before, you will gain back the weight.

 This is true of any weight loss diet.