In the last few days, I have received a number of calls about whether or not the COVID-19 vaccine should be taken.
I am not surprised by this, as this is naturally a concern to many that have been approached by the governing bodies about taking the vaccine.
I thought I would address some of the common questions that are being asked about the vaccine.
Please note that some of the information below may be relevant to the state of Karnataka (where I hail from), so do check with your local governing body about rules and regulations they may have.
What Are The Vaccines Available In India?
I think you probably know the answer to this question, but nonetheless, here goes.
There are currently 2 vaccines available in India:
Covishield is manufactured by AstraZeneca, while Covaxin is manufactured by Bharat Biotech. The government is currently administering both these vaccines at select centers across Karnataka and the rest of the country.
Which Vaccine Should I Take?
Currently, there is no choice given to the public about which vaccine they should take. Each center has stocked the vaccines given to them by the government, so if you are allotted a center then you will have to take the vaccine they are offering there.
Please note that the decision to take the vaccine is entirely VOLUNTARY. You may opt not to have the vaccine if you do not wish to.
How Do I Register For The Vaccine?
Right now, it appears the only way to get the vaccine is to register on the COWIN website or by downloading the app.
The website is https://www.cowin.gov.in/home
Once you land on the website, you will need to register yourself or a family member using a telephone number and an OTP. Up to 4 family members can be registered using a single telephone number.
You may also register using the Aarogya Setu app, where they have included a section for COWIN registration.
I would advise you to read this article on NDTV for step-by-step instructions.
How Is The Vaccine Administered?
Having had both doses, I can tell you that the vaccine will be administered in your left arm (Or right arm if you are left-handed).
If the thickness of muscle in your left arm is very little, they may administer it in the buttocks. I am not aware of any of my colleagues having had such an injection though.
The left shoulder muscle will be cleaned with cotton and some spirit and the injection will be administered.
Honestly, it is no different from any other injections you might have had in your lifetime.
Does It Hurt?
Well, it’s an injection!! It is going to hurt a tiny bit, but it will not bother you!
Afterward, a small number of people may develop shoulder pain which may last a couple of days. I had a little shoulder pain for 2 days after the first shot, but no pain when I had the second shot.
What Are The Side Effects?
Rarely, one may develop side effects from the injection. Common ones are –
I Am On ‘Blood Thinners’ – Can I Take The Vaccine?
I guess this is the most commonly asked question. There are 2 types of blood thinners that are prescribed to patients.
- Antiplatelet agents – Aspirin, Clopidogrel, Ticagrelor and Prasugrel
- Anticoagulants – Warfarin, Nicoumadin, Dabigatran, Apixaban, Rivaroxaban
Those who are taking antiplatelet agents can take the vaccine.
Those taking anticoagulants should probably avoid the vaccine due to the risk of blood clot formation within the muscle.
For example, if you are taking tablet Ecosprin or Clopilet, or if you have had a stent or bypass surgery and are on these agents, then you can go ahead and take the vaccine.
If you have a metallic prosthetic heart valve or if you have an irregular heart rhythm and are taking Acitrom, then there is a risk of bleeding or clot formation after the injection.
However, it is not very clear.
Here is what I suggest. Speak to your doctor about whether your anticoagulation must be stopped for a few days, and whether it is safe to do so. You may not be eligible for the vaccine if you should never miss the anticoagulation medicine.
I Have Had COVID Infection Already – Should I have The Vaccine?
Yes, please do!! You are at risk, later on, so better to have the vaccine to protect yourself.
I Have Diabetes. Can I Take The Vaccine?
If your diabetes is well controlled, with your fasting sugars within 130 and postprandial sugars within 180, then go ahead. This is not guideline-based but is just my opinion.
If your diabetes is poorly controlled, then time to get it right! Once controlled and your doctor gives you the all-clear, go ahead and get vaccinated.
Who Should Not Take The Vaccine?
If you are on anticoagulants, then probably avoid it. Check with your doctor as well.
If you have a history of allergic reactions to vaccines in the past, then best avoid the COVID vaccine. However, an allergic reaction to a painkiller or antibiotic in the past is not relevant and should not stop you from taking the vaccine.
If you have had a high fever in the last 5 days, or are currently on treatment for fever, then the vaccine should not be taken. However, if you have a simple runny nose or the common cold, or a very low-grade fever around 99 deg F, then you should be fine to take the vaccine.
Pregnant women should avoid vaccination.
Those with low immunity (cancer therapy, HIV, etc) may not have the same response that those with a normal immune system will have after the vaccine. The vaccine is still being given to them. If you have such issues, please contact your doctor.
Those with a low platelet count should avoid the vaccine as well. If you have any blood disorders like leukemia or lymphoma, speak to your hematologist about whether you can take the vaccine.
How Long Will The Vaccine Protect Me?
This is not clear. We estimate it might be around 8 months to a year. Time will tell whether we need a booster dose next year.
I Have Had My First Shot – Can I Travel Now?
Nice try. I am sure you are itching to go on that holiday you planned ages ago, but don’t plan it yet.
After the first dose, you are not adequately protected. You can still contract the infection. Make sure you follow COVID-specific precautions as advised previously to the public.
I Have Lung Disease. Can I Take It?
If you have a stable lung condition, then it should be fine to take the injection. If you are on treatment for active infection in the lungs or worsening of asthma, then wait till your pulmonologist or physician gives you the all-clear.
I Have Had A Cardiac Bypass. Can I Have The Vaccine?
Of course. If you are stable from a cardiac perspective, then go right ahead. There is no reason to avoid it.
Is Sulfa Allergy A Contraindication?
If you are allergic to sulfa or penicillin, you can still have the vaccine.
Do I Need The Second Dose? Can I Avoid It?
The first shot is called the primer shot. It just kickstarts the immunity-building process. You need your second injection – it is a booster that powers up your immune system.
Your booster dose will be given to you within 4 to 6 weeks. You will be fully protected if you take both the jabs.
How Much Does It Cost?
The vaccine costs Rs 250 to the public. My understanding is that most private hospitals are charging the same as government institutes.
Watch This Space – As and when more information pops up, I will share it with you.
Kiwifruit is not really that popular in India, though I personally feel it should be. A native of China, the kiwifruit is a dynamic fruit loaded with nutrients.
In India, it has gained some exposure as a fruit that can help manage patients with dengue fever. But that’s just the tip of the iceberg.
Today, I will discuss the various reasons why you should never ignore the kiwifruit when you are out shopping.
The kiwifruit is the fruit of the woody, deciduous vine belonging to the genus Actinidia. It was previously called the Chinese Gooseberry or mihoutau, being native to China for centuries.
Over the years, it has been grown in New Zealand, Chile, France, Japan and the United States, and is exported globally to various countries, including India. This explains its high cost in our country (an average single kiwifruit in India costs around Rs 25).
The fruit is not always green in color. There are different variants, some of which are golden or yellow. The one we get in India is Actinidia deliciosa, a green fruit with tiny, crunchy black seeds and a hairy outer coat.
Health Benefits Of Kiwifruit
As an ancient Chinese medicine, kiwifruit was used to cure digestive problems, hemorrhoids (piles), acidity and rheumatism (joint pains).
Nutritional Composition of Kiwifruit (table)
Source Of Vitamin C, E and Folate
When you bite into the fruit, you will be hit by a sweet, tangy note instantly. You might even grimace in pleasure.
Thats because the kiwifruit is rich in vitamin C. It contains around 80 mg to 120 mg of vitamin C per 100 grams of fresh fruit.
Vitamin C is an essential vitamin that the body gets only through diet. It is essential in the synthesis of collagen, which is responsible for keeping our skin and cartilage healthy.
Our recommended daily allowance (RDA) for vitamin C is around 70 – 90 mg per day, with an upper limit of 2000 mg daily. However, consumption of over 1 gram per day does not provide much benefit, as less than 50% will end up being absorbed.
It is also important in the synthesis of numerous hormones and in DNA synthesis.
Of course, with the recent COVID-19 infection affecting humans globally, vitamin C has been in the spotlight as a powerful immune booster, which it is.
The vitamin C also helps in better absorption of iron from the diet. So if you are low in iron or have anemia, then including kiwifruit with your iron rich diet can be very helpful.
An interesting study was published looking at kiwifruit and how it could improve vitamin C levels. In this study, the subjects were asked to consume half a kiwifruit daily for 4 weeks, then 2 kiwifruits daily for 6 weeks, and then 3 per day for another 4 weeks.
At the end of the study, they found that while half the fruit helped elevate levels of vitamin C in the blood, a whole fruit would be required to get the required levels. With 2 fruits, vitamin C levels reached ‘saturation’ level, and 3 fruits per day had no additional benefit.
In short, if you wish to boost your vitamin C intake and blood level, have a kiwifruit every day.
In addition to vitamin C, it is also a good source of vitamin E and folate. Along with vitamin C, vitamin E is a powerful antioxidant and fights free radicals and subsequent damage to vital organs, skin and hair.
Folate is required for normal blood production and in protein synthesis. It is an essential nutrient in pregnancy as it is responsible for the fetal spinal column development.
Useful In Hypertension
In a study comparing the effect of consumption of 3 kiwifruits per day versus foods rich in antioxidants, researchers found that the former group had a 11% reduction in their angiotensin converting enzyme activity level. This enzyme is responsible for hypertension, and is often targeted in medical therapy. Overall reductions were around 10 mmHg in systolic and 9 mmHg in diastolic blood pressure.
Normal levels of potassium in the blood are essential to keep the heart pumping efficiently.
Kiwifruit is a good source of potassium, coming a close second to banana among the fruits. It is naturally low in sodium, containing only 3 grams per 100 gram of fruit.
This makes it a good fruit to eat if you have high blood pressure. It may have some benefit in lowering your blood pressure, and this has been seen in some smokers.
That being said, most studies have only shown a ‘trend’, and not a significant change in blood pressure. Don’t rely on it to bring your blood pressure down naturally to normal values.
However, I recommend avoiding it if you have kidney disease, as potassium can accumulate in the blood if consumed in high quantities.
Improves Your Digestive System Health
Constipation and irritable bowel syndrome (IBS) are common problems in India. Treating IBS can be quite difficult.
In a study looking at regular kiwifruit intake over 4 weeks by healthy elderly individuals, researchers found that those with constipation had a better stool frequency, better stool volume and softer stools. This makes the fruit useful in managing constipation.
Similarly, in individuals with IBS, a study evaluating intake of 2 kiwifruits per day for 4 weeks improved bowel function significantly.
This improvement in gut function may be related to the high quantity of soluble and insoluble fiber it contains. It contains one third soluble and two-thirds insoluble fiber. It also has the ability to hold onto water and swell up in the gut, helping bulk up the stools and in easy evacuation.
There are many other explanations on how kiwifruit improves digestive health, and I will not delve on it any more as it would just complicate this article.
If you have problems with your digestion, or have a history of constipation, try eating a kiwifruit every day. You should see an improvement in a few weeks.
Kiwifruit Is Safe In Diabetes
Green kiwi fruit which is available in India has a GI index of 39, which is low. Only 12% of the fruit is carbohydrate.
In other words, eating it if you have diabetes is not really a problem. It will not increase your sugar levels much.
Studies have found that the primary sugar in kiwifruit is fructose. This, in addition to the high fiber content in the fruit, helps keep blood glucose levels in check.
Kiwifruit does not contain any cholesterol. Interestingly, when it comes to metabolic parameters, kiwifruit can help lower your cholesterol.
In one particular study , regular consumption of 2 kiwifruits a day over 4 weeks improved HDL values (good cholesterol) and lowered triglyceride levels (bad cholesterol).
However, it did not have an effect on LDL levels.
Another study found that even consumption of one fruit a week had the same effect.
It is possible that the elevation in HDL cholesterol levels may be related to the polyphenols and vitamin C present in kiwifruit. The green variety increases the levels of apolipoprotein A1, a protein attached to HDL cholesterol.
Protects The Heart
I have already mentioned how HDL cholesterol levels increase with regular kiwifruit intake. This can protect the heart against heart attacks.
By lowering blood pressure, it keeps the heart under a lower deal of stress.
The vitamin C and polyphenols also benefit heart function in various ways.
However, these are not the only ways.
Another property of this fruit is its ability to lower the ‘stickiness’ level of cells called platelets. One study showed that it reduced this by around 15%. Some have gone so far as to say it is as good as an aspirin tablet.
By lowering this, it can reduce the chances of clots forming within heart arteries, a phenomenon that is responsible for heart attacks.
There is a school of thought that kiwi fruit can increase platelet count in dengue. This is not clinically proven. That being said, there is no harm in eating it if you have dengue fever, as the vitamin C may be beneficial.
Among the many foods that can naturally lower cancer risk, kiwifruit may have some benefit too.
However, the studies are limited.
Most studies conducted to see if it has a property of lowering cancer are lab based studies looking at DNA injury and subsequent repair through the vitamin C component of the fruit.
Also, the high fiber content and digestive tract protective effects may benefit against colon cancer.
There may be some role for kiwifruit in healing of acute burns. This is because it has antibacterial properties, along with the property to stimulate new blood vessel formation.
This information stems mostly from rat studies.
Risk Of Allergy
One disadvantage of kiwifruit is that it can cause allergic reactions in some people when they consume it. However, the reaction is not that severe.
Some adults may experience an itchy throat and a bloated stomach. Itching skin (urticaria) and even a more serious reaction may occur, albeit rarely.
The kiwifruit is a nutritional czar, if there ever was one. If you ever get a chance, try and chow down on one now and again to reap the multiple health benefits.
Our versatile Indian cuisine incorporates curry leaves in most dishes, especially in the South of India. While it adds flavor and an aroma to the food, it in fact has numerous health benefits that are often overlooked.
Curry leaves, also called Kadi Patta, have amazing health benefits. Let’s take a look at them here.
What Are Curry Leaves?
Curry leaves, also called Murraya koenigii in the world of biology, is a herb that is widely used in cooking. It originates from the curry tree.
Curry leaves contain numerous nutrients, including proteins, fiber, carbohydrates, minerals and numerous vitamins. It also contains alkaloids like murrayastine, murrayaline, pyrayafoline carbazole alkaloids.
Traditionally, curry leaves have been used as a medicine to improve digestion and appetite. It was also used as a treatment for diabetes. Besides this, it has been used in treating loose motion, blood disorders, worms, piles and open wounds.
The health benefits of curry leaves are numerous. Let’s take a look at what it can do for your health.
Curry Leaves Can Lower Cholesterol
There is a fair bit of data that suggests that curry leaves can lower your cholesterol levels.
In one study conducted in diabetic rats, curry leaf extract administered over 1 month lowered both total cholesterol and triglyceride levels by 31% and 37% respectively.
Human studies have also confirmed the same. In a study looking at post-menopausal women between 45 – 65 years with high cholesterol, an addition of 5 grams of curry leaf powder to their lunch over 45 days –
- Lowered LDL (bad cholesterol)
- Increased HDL (good cholesterol)
- Lowered triglycerides (bad cholesterol)
It appears that curry leaves can lower cholesterol naturally. Munch on them when you get a chance!
Protection In Diabetes
The role of curry leaves in managing diabetes is rather complicated.
In diabetes, you will know that there is initially an excess of insulin secretion to try to control elevated blood sugar levels. Over time, the pancreas beta cells, which are responsible for this excess insulin production, become tired and exhausted. This leads to lower insulin levels.
Over a period of time, diabetes begins to affect multiple organs, including the heart, kidney, brain, eyes and nervous system.
Studies have found that curry leaf extracts can protect the beta cells of the pancreas, and normalise insulin levels. It also works on the way muscles utilise the glucose in the blood, increasing it’s uptake, improving muscle health and lowering glucose levels.
In a study conducted in diabetic male rats, regular oral administration of curry leaf extract reduced levels of urea and creatinine in the bloodstream. This means that it can protect the kidneys in diabetes.
Similar studies have found that these extracts can protect the nerve fibers as well, making it useful in preventing diabetic neuropathy.
It is believed that the presence of certain trace elements such as zinc, chromium, copper, iron, nickel etc. may be responsible for better blood glucose control.
There are many foods that have natural anticancer effects.
The extracts of the bark of the curry leaf tree contain carbazole alkaloids called girimbine and acarbazone, which studies have shown to kill cancer cells in liver cancer.
It may also have some benefit in preventing colon and bowel cancer.
An Indonesian trial found that extract of curry leaves could kill HeLa cells, which are the cancer cells seen in cervical cancer.
Similarly, it may have a protective effect against prostate cancer.
Numerous anticancer mechanisms have been proposed, but most studies are animal studies or lab based studies and not human trials.
You will know that high alcohol intake on a regular basis can destroy the liver. The carbazole alkaloids in curry leaves have been shown to have a protective effect on the liver cells.
In a study where rat livers were damaged by high doses of paracetamol, curry leaf extract fed to these rats improved liver function and appearance of the tissue under the microscope. This effect is brought about by it’s powerful antioxidant properties and ability to lower inflammation.
Similarly, a improvement in liver enzymes is also seen in rat studies.
Antibacterial And Antifungal Properties
Fighting bacterial and fungal infection with medications all the time may not always be possible.
Extracts of curry leaves have been found to possess antibacterial properties. They can fight against common bacteria such as E.coli, staphylococcus, streptococcus and proteus.
Essential oils derived from the leaf has been shown to be effective against powerful bacteria such as Pseudomonas.
The alkaloids and flavonoids that are present in curry leaf can prevent fungal infections as well. It appears to have a negative effect on a wide variety of different fungi.
Curry Leaves Protect Your Brain
Alzheimer’s disease and Parkinson’s disease are worrying clinical conditions that affect the brain and rob you of your dignity.
Studies have found that curry leaves can improve memory and learning.
Besides what I have listed above, curry leaves have numerous other benefits.
For example, the oils derived from the leaves can be incorporated in creams and used to cure skin diseases such as acne, boils, itching and athlete’s foot.
Curry leaves are rich in vitamin A and calcium, so eating these can strengthen your bones as well.
Of course, don’t forget how awesome your food tastes when you add these leaves to it!
Where To Buy
Curry leaves are available with your local vegetable vendor or supermarket.
There is no doubt that there are numerous health benefits of curry leaves. Make sure that you include them as a part of your regular diet.
Anticancer foods – does such a thing even exist?
A diagnosis of cancer can be devastating, even if you know there is a cure. While treatments are many, prevention remains better than possible cures.
There are many ways one can reduce their risk of developing cancer. Avoiding smoking, lowering alcohol intake and regular exercise – all can help reduce your chances of developing cancer.
Probably the most important way to lower your cancer risk is consuming the right foods. I thought I would touch upon ‘anticancer’ foods, and hopefully by the time you reach the end of the article, you will realize that what you eat matters when it comes to cancer.
I will be touching upon foods that you can eat rather than spices like turmeric that have anticancer properties.
How Your Diet Can Increase Your Risk Of Cancer
First, I thought I would talk about how what you eat and how much you eat can increase your risk of cancer.
Low Fiber Diet
Fiber is an essential part of a nutritious diet. The more you eat, the more you protect your body against heart disease, digestive problems, and yes, cancer.
A diet low in fiber is generally seen in those who mostly eat non-vegetarian food. Meat and fish, while high in protein, lack any fiber.
Those who eat white bread or foods made from refined flour (biscuits, bakery items etc) also get no fiber in their diet.
If you recall, in an article elsewhere, I have spoken of soluble and insoluble fiber. Soluble fiber mixes with water in the gut, forming a gel that coats the inner lining of the bowel. This coating prevents harmful cholesterol and excessive sugar from being absorbed by the gut.
This has a protective effect on the body.
Insoluble fiber helps maintain a healthy digestive tract. It prevents you from becoming constipated.
Studies have found that consuming low fiber can increase your risk of bowel cancer.
Diet High In Red Meat
There are many of us who enjoy eating red meat regularly. The bad news is that there exists a strong link between red meat intake and colon cancer.
Remember that red meat, while high in protein, lacks fiber. When cooking red meat, compounds called heterocyclic amines are generated, which are carcinogenic (cancer forming).
Studies have found that these heterocyclic amines can increase the risk of breast cancer.
Overeating Is A Problem
We are a nation of over-eaters. Many of us can’t just stop a meal at a main course alone. Some want a starter and a dessert with every meal!
Ordering food in has become the norm, though it has come down a little during the current COVID crisis. Prior to this, people would order food almost every evening, mostly because their jobs were keeping them busy.
Not just that; eating more is being made more attractive through advertising. Portion sizes are expected to be large for the money that is spent on food.
The basic problem with how we eat in our country is that we consume too many calories. Some of our diets have over 3000 to 4000 calories sometimes, and we rarely realise it.
Even if you eat your veggies every day, having a high amount of calories in your diet on a regular basis can make you overweight.
Obesity has been estimated to cause 14% of all cancer deaths in men and around 20% in women.
In a study conducted in India, women who had a higher body mass index were more likely to develop breast cancer compared to those who had a normal weight.
Just by cutting down your calories and increasing your veggie intake, the risk of cancer can come down many fold.
High calorie foods include rice and rice based foods, fried items, snacks, bakery items and foods with added sugar in them.
Refined Flour Based Foods
Foods that are made from refined flour (maida) may be tasty, but they can harm your health. Refined wheat flour contents 78% less fiber, 74% less vitamins and 69% less minerals, according to the USDA Food Database.
In addition to this, refined flour based foods have a high glycemic index. This means that they increase the blood sugar values rapidly once they are eaten.
Of course, it is not just refined flour that can shoot up your sugars. Even simple cane sugar, honey and normal sugar we eat can have the same effect.
In other words, sugary foods that can increase your blood sugar levels rapidly can cause cancer.
So now that you have an idea of what foods can increase your risk of cancer, let’s take a look at some anticancer foods you could include in your diet.
Best Anticancer Foods You Can Eat
Here are some of my favorites –
Flax seeds are becoming a popular health supplement, mostly due to its high fiber content and presence of omega-3 fatty acids.
Flax seeds contain lignan – a compound that has anticancer effects. Mouse studies that have been conducted over years have found that a diet rich in flax seeds could lower the risk of breast cancer and it spreading as well.
There also appears to be a benefit of flax seed intake against prostate cancer in men. However, this effect is not seen with flax seed oil, but rather with whole flax seed.
Following a vegetarian diet can lower your chances of developing cancer. This has been proven time and again in clinical studies.
Numerous anticancer elements in veggies and fruits include vitamin C and E, folic acid, lycopene, dietary fiber, selenium and isoflavones.
In fact, the American Institute of Cancer Research states that multiple types of cancers can be prevented by just following a vegetarian diet.
In recent years, there has been a move towards ‘veganism’. This is a diet made of just vegetarian food, but with no dairy products (milk, curds, cheese etc). Generally, the risk of cancer is not lower than what a vegetarian diet confers, though it seems to have more benefit in prostate cancer.
Let’s take cruciferous vegetables – broccoli, cauliflower and cabbage. These are probably the best anticancer foods, as they are rich in sulforophane, which has anticancer properties. Of these, broccoli is the most powerful.
Regular consumption of cruciferous veggies can lower your risk of breast cancer, Non-Hodgkin’s Lymphoma, lung cancer and even prostate cancer.
Tomatoes contain lycopene, a compound that has protective effects against prostate cancer, and reduces the risk by up to 40%. Cooked tomatoes have more lycopene compared to raw ones, so better to choose the latter.
I often advise patients to eat different colors of vegetables. This is because different colored veggies have alpha and beta carotenoids, which have powerful cancer fighting properties. Carrots, carrot juice and pumpkins are amazing sources. Capsicum (traffic light – red, green and yellow) also contain carotenoids.
There remains a dictum of eating 5 portions of fruit and vegetables every day. I am not sure where this number really came from, but I guess keeping this in mind makes it easier to ensure you get what your body needs. The more you eat, the better it is for you.
A single portion is a cupful of vegetables or a single fruit.
Foods Rich In Vitamin C
Citrus fruits, especially amla (gooseberry), are excellent sources of vitamin C. Vitamin C has powerful antioxidant and anticancer effects, and is sometimes used as an intravenous medicine in cancer therapy.
Doses given in cancer treatments are significantly greater than what is prescribed as a daily supplement of vitamin C.
How Much Fruits And Vegetables Should You Eat For Anticancer Effects?
It is advised by some experts to have 10 servings of vegetables and 4 or more servings of fruits a day to protect yourself from cancer.
Honestly speaking, it might be quite hard to keep track of that.
If you really want to reap the anticancer effects of foods, then you need to include them in good quantities in your daily diet.
What Is The Best Anticancer Diet Then?
In a nutshell you should include all the following that I have listed in the table below:
You could lower your risk of developing cancer with these anticancer foods. Choose well and stick to not just a good diet, but also an exercise routine.
The COVID-19 crisis is giving many sleepless nights. Many are looking for ways to build up their immunity in order to lower their chances of getting infected. Reports suggest a relationship between vitamin D and COVID infection – one where vitamin D protects you against it.
I thought I would explore the existing literature today.
The COVID-19 Crisis
You will be aware that the COVID-19 infection, also called SARS CoV-2, is a viral infection that is sweeping our planet and affecting many. It acts through numerous mechanisms, leading to fever, cough, loss of taste and smell, body pain, and in some cases diarrhoea and vomiting.
Even those taking precautions are getting affected, mostly because some people around them are not.
The only way to prevent this infection effectively is to practice social distancing, wash your hands regularly with soap and water at home, use a sanitizer with at least 70% alcohol when you are out of the house, and of course, to wear a tight-fitting mask.
Staying healthy is also essential to build up immunity against the coronavirus infection. Regular exercise, a healthy balanced diet with plenty of fruits and veggies, and a good night’s sleep is of paramount importance.
A good intake of vitamins and minerals is needed to keep our immune system at full guard. Vitamin D has a role to play in this.
The Role Of Vitamin D In Immunity
Vitamin D has been primarily recognised as a vitamin essential for bone health. Vitamin D and calcium work as a pair in strengthening our bones, keeping them healthy and preventing fractures.
Interestingly, vitamin D also helps boost your immunity. This is in fact old news, with vitamin D supplements (in cod liver oil) being previously used to treat lung tuberculosis .
Our immune system consists of various types of cells. These include monocytes, dendritic cells, B cells, T cells, and macrophages. Each of these have a role to play when fighting viral infections, including COVID-19.
On the surface of these cells are tiny receptors called Vitamin D receptors, or VDR. When the immune cells move to sites within the body where there is inflammation, the vitamin D binds to the VDR, forming a complex.
This complex moves into the nucleus of the immune cell, where it modifies the genes and produces antimicrobial compounds like defensin and cathelicidin.
This phenomenon leads to lower production of harmful products called cytokines. Cytokines are generally released in large quantities in COVID-19 infection, overwhelming the body and leading to rapid deterioration of patients.
This burst of cytokine release is called cytokine storm. Vitamin D can lower this significantly.
There are many other mechanisms through which vitamin D can boost immunity. I will not be discussing them here as it is out of the scope of this article.
Vitamin D versus Common Cold
The common cold is probably the most ‘common’ infection us humans suffer from. Visits to the doctors are mostly due to runny nose and chest congestion, especially in the rainy and cold winter months.
Studies have found that a dose of 400 IU per day of vitamin D can build up immunity against chest infections. Doses up to 2000 IU per day have also been advised.
The benefits have been seen in both adults and children.
In children, a combination of regular vaccinations and vitamin D supplementation has been found to boost immunity against respiratory tract infections. It also reduces the chances of needing antibiotics.
However, the benefit may not be seen in all.
For example, in a study looking at adults with mild to moderate asthma who were taking steroid inhalers, addition of vitamin D supplements did not help reduce cold or severity of it.
The maximum benefit of vitamin D supplementation to boost immunity against chest infections was seen in those who were deficient.
In general, combining vitamin D with vitamin C supplements can lower the duration and severity of the common cold.
Vitamin D and COVID-19
The levels of vitamin D that we have in our body reduces as we get older. Unfortunately, our chances of catching the COVID-19 infection increases as we get older too.
So is there a connection between vitamin D levels and COVID-19 infection?
There is a plethora of evidence that describes vitamin D supplementation as an effective way to prevent chest infections.
In a rather interesting study, it was found that people who lived in countries below 35 degrees northern latitude had a lesser chance of dying from COVID-19. This was because those that are above the 35 degree latitude had lesser exposure to sunlight, and hence more likely to be vitamin D deficient.
In another study looking at COVID-19 patients admitted to an ICU, researchers found that lower vitamin D levels amplified the symptoms of COVID-19.
In a very recent study, low vitamin D levels were found to worsen conditions (high blood pressure, heart disease etc) that would indirectly lead to lowered immunity and an ability to fight COVID infection.
In other words, if you have low vitamin D levels, topping it up with supplements could not only lower your chances of contracting COVID-19; it could lower the severity of the infection if you did. There appears to be a benefit of vitamin D supplements for children as well.
As is the case always, there are proponents of the opposite. The National Institute of Clinical Excellence (NICE) in the UK has extensively reviewed the available evidence , and categorically states that there is no strong evidence supporting a role of vitamin D supplementation in COVID-19.
What Dose Of Vitamin D Is Needed To Boost Immunity?
If you have ever checked your vitamin D level in a clinical laboratory, you will find that levels below 30 ng/ml are described as deficient.
Studies suggest that keeping your vitamin D level around 50 ng/ml is ideal to protect you against viral infections.
The recommended daily dose for vitamin D is around 600 IU to 800 IU a day. However, those that are deficient will require between 2000 IU to 4000 IU daily.
I generally recommend 2000 IU daily to keep levels at an appropriate value. Higher doses can cause abdominal pain, constipation, increased thirst, vomiting and high calcium levels.
Are Vitamin D Supplements Safe?
Generally yes. But you must bear in mind that vitamin D is a ‘fat soluble’ vitamin. This means that any excess ingested can accumulate in the body.
This can be harmful.
As such, 2000 IU a day is a safe dose to take. If you are deficient, you may need a higher dose. Talk to your doctor about what is right for you.
Should I Take Vitamin D Supplements To Prevent COVID Infection?
As vitamin D is only obtained through sunlight exposure, it is likely that you will need a supplement right now.
We are all locked up in our houses, and even sitting out on your terrace every morning may not give you the dose you need.
There are plenty of over-the-counter supplements of vitamin D available in the market. If you are confused about what to take, speak to your doctor.
Bottom Line and Closing Remarks
There appears to be a connection between vitamin D and COVID infection. There also appears to be a role in vitamin D supplements lowering your chance of developing COVID infection as well.
However, there is still data needed.
I personally feel that more randomized trials that look particularly at the relationship between vitamin D levels and COVID infection are needed. This will obviously take time.
When you get a chance, check your vitamin D levels in a lab and ask your doctor if you need supplements. In addition to possibly offering protection against the COVID-19 infection, it will most certainly keep your bones and muscles healthy.
If you have low calcium levels, then you may want to consider a change in your diet. When doing so, remember ragi.
Ragi, or finger millet, is a commonly consumed food in south India. A staple food in some parts, ragi is eaten either in a cooked ball form (mudde), as a porridge or even as a roti.
What Is Ragi?
Ragi is a millet called Eleusine coracana, a crop with powerful nutraceutical properties. It is recognized globally as a super-cereal, with nutritional values of certain elements off the charts.
Not only is ragi high in protein, it is also packed with minerals and vitamins that are essential for the normal functioning of the human body.
Minerals include calcium, magnesium, manganese, phosphorus, zinc, sodium and potassium, among many others. It is rich in B complex vitamins and vitamin E as well.
Today, I will briefly discuss how ragi can be an excellent calcium source in your diet.
The Harms of Low Calcium
Calcium is the 5th most abundant mineral in the body. It makes up for 1.9% of our total body weight.
Low calcium levels in the blood, also called hypocalcemia, can lead to muscle cramps in various parts of the body. Thinning of the bones, also called osteoporosis, is also due to low calcium and vitamin D in the body. Osteoporosis makes the bones easily susceptible to fractures.
Those who have insufficient calcium in the diet can feel quite tired all the time. Sleep patterns might be disturbed, and insomnia can set in. Low energy levels become a problem.
Low calcium levels can affect your skin, making it dry and itchy. Your nails may become thin and brittle, leading the tips to break off time and again.
Calcium is an important part of our teeth. Low calcium in the diet or in the bloodstream can lead to brittle teeth and tooth decay.
Clearly, calcium has a role to play in keeping our body healthy. Making sure you get the right amount in your diet can help prevent numerous health problems.
Ragi As A Source Of Calcium
There are many food sources of calcium.
Many of us rely on regular cows milk and milk products (cheese, cream etc) to give us the calcium we need in our diet. Nuts such as almonds are also a good source.
You might be surprised to hear that while cow’s milk has around 112 mg calcium / 100 grams of milk, ragi contains a whopping 350 mg in every 100 grams.
That’s over 3 times the calcium content of milk.
When compared to brown rice and wheat, ragi has 10 times more calcium in comparison.
But how well is it absorbed in the digestive tract?
Studies have found that <30% of the calcium we consume in our diet is absorbed. This is because a large part of the calcium we consume is bound to phytates and oxalates, becoming insoluble and therefore useless to the body.
In comparison to rice and maize, the calcium in ragi is much better absorbed. This is despite it having a higher phytate and oxalate content.
Many of us rely on supplements to maintain our calcium levels and to keep our bones strong. However, one study found that the absorption of calcium from ragi is significantly better than supplements available commercially.
In other words, if you want to get more calcium, eat ragi.
Children need good sources of calcium to help build strong teeth and bones. Food companies will advertise products such as cheese and other such snacks as a good source of calcium. While these might be palatable, in the long run they can be harmful to your child’s health, due to the salt and fats in them.
Instead, opt to give your child ragi. One study found that a single serving of ragi based foods can give your child 25% of the recommended daily need of calcium. Furthermore, children retain this calcium a lot better, mostly because their digestive tracts are much better.
Ragi In Diabetes
I just thought I would mention a sentence or two about ragi as a food for people with diabetes.
Ragi generally has a high glycemic index (104), but is packed with other nutritive elements that make it a good choice if you have diabetes.
In south India, ragi eaters tend to mix it with rice and consume it. This can increase the blood sugar levels in those with diabetes. It is advised to just have ragi (mudde, roti) alone, instead of mixing it with rice.
Ragi contains polyphenols, which are believed to have some role in keeping blood sugar levels under control.
In one study looking at patients with type 2 diabetes, consumption of ragi lowered plasma glucose levels, as compared to a glucose rich meal.
But I must make one comment based on my experience here. Ragi has a glycemic index of 104, while white rice is 75. I have time and again found that patients who consume ragi based foods also have uncontrolled blood sugar levels. This is probably because they have made it their staple, and consume it 2 or 3 times a day. Stopping ragi and rice has drastically lowered their blood glucose levels.
As a general rule, if a diabetic patient is undernourished, then I recommend ragi in their diet. If a diabetic patient is overweight, I advise them against it.
When it comes to topping up your calcium levels, make sure you choose ragi as one of your foods. If it is not something you enjoy eating, then replace it with other calcium rich foods. Alternatively, you could speak to your doctor about calcium supplementation.
Baldness in women is a common problem in practice. Losing hair at a young age can not only change one’s appearance; it can also affect the individual psychologically.
For a long time, it was just men who were concerned about becoming bald. Over the last few years though, it is being recognised and being treated more actively in women.
Female pattern hair loss, or female androgenetic alopecia as it is known in the medical world, can majorly impact the quality of life of a woman.
Today, I will be discussing why women can lose their hair, and how it can be prevented and treated.
What Is Alopecia And Female Pattern Baldness?
Alopecia is basically a condition where there is loss of hair. There are different patterns of alopecia noted in literature.
The word ‘alopecia’ is derived from the Greek word ‘alopex’ meaning ‘fox’.
Yes, I was surprised too to read this.
Apparently the fox sheds a lot of hair. Hence the derivative.
Usually, baldness presents itself in the reproductive years of women. It starts and progresses very slowly throughout the younger years, though those seeking treatment usually lie within the ages of 25 to 40 years. Women between the ages of 50 and 60 years are also among those seeking treatment.
While there is a plethora of epidemiological data on the prevalence of baldness in women in the western world and the orient, Indian data is lacking.
What Causes Baldness In Women?
It all boils down to hormonal imbalances. Excess levels of testosterone in the bloodstream predisposes women to hair loss, while also increasing facial hair.
Get ready…… I am going all scientific now.
The hair grows in different stages. The anagen phase is the growth phase, catagen is the transitional phase, while the telogen phase is the dying or rest phase.
Normally, the anagen phase lasts for several years (2 to 8 years), catagen for 2 to 3 weeks, and the telogen for around 3 months (though it can be variable).
A balance is maintained so that hair growth and hair loss are almost the same.
At any given time, around 10 – 15% of all hairs on your body are in the telogen phase, ready to be shed. On the scalp alone, around 80 to 90% of all hair are in the anagen phase, 10 to 20% in the telogen phase and around 1 to 2 % in the catagen phase.
In female pattern baldness, the anagen phase (healthy phase) is shortened to a few weeks or months, while most of the hair remains in the telogen phase. Around 20% or more hair are in the telogen phase, which explains the shedding when combing or washing.
Normally, the telogen phase is quickly followed by the anagen phase, so that your head is full of hair. However, in female pattern baldness, this time interval is a lot longer.
Within the hair follicle roots and the outer papillae of the skin of the scalp are receptors called androgen receptors, in addition to three different types of enzymes. Excessive androgen levels can stimulate androgen receptors and alter the enzyme levels, leading to patterned hair loss.
There is some belief that estrogens can also affect hair growth and shedding, though there is underlying controversy regarding this. I will not discuss this further here.
Of course, a family history of baldness can also increase the risk of hair loss in women. Women under the age of 40 years report a family history in around 40 to 54% of cases.
Hormonal problems such as hypothyroidism and excessive prolactin can also increase the risk of hair loss.
Certain BP medicines, epilepsy medicines, and prolonged use of antibiotics can all lead to hair loss. Alcoholism, antacids (ranitidine), kidney disease and digestive disorders can lead to baldness in women as well.
There are some essential nutrients that are required for healthy hair growth. I have listed them in the picture below.
Patterns Of Baldness In Women
There are numerous methods of classification of hair loss in women – Ludwig’s classification, Sinclair’s classification and Olsen’s classification.
It is a little too complicated for this article. However, in a nutshell, there are 3 stages to hair loss. Stage III is usually seen after menopause.
It describes hair loss that starts just above the forehead, then extending towards the middle aspect of the head, finally spreading out. Hair is generally preserved over the temple area. After menopause though, hair loss can extend to the rest of the scalp.
Recently, I have had a few young women visit with hair loss starting in their adolescence. The pattern of hair loss is the same.
Diagnosis Of Hair Loss In Women
If you are a woman who is experiencing hair loss, then make sure you visit a dermatologist or your physician.
A simple examination of the hair with a dermoscope can reveal the characteristics of the hair in great detail.
A ‘pull test’ can also be helpful. Here, slight traction is exerted on the scalp hair, and the number of hair that comes off is determined. Traction is exerted using the thumb, index and middle finger. An estimated 50 to 60 hairs are grasped and pulled. If more than 10% of the hair is pulled away (around 6 hairs or more), then the test is positive. Less than 6 is normal.
A trichogram is a test where around 50 to 100 hairs are examined with a light microscope. The test helps determine what phase the hairs are in. This may be performed by the dermatologist.
Blood tests have some role in determining the cause of baldness in women. Vitamin D levels, thyroid hormone levels, iron studies, testosterone, estrogen, prolactin and sex-hormone binding globulin levels can provide some clues, but not always.
The most common association of female pattern baldness is polycystic ovarian disease. An ultrasound scan of the ovaries can confirm that.
Treatment For Hair Loss In Women
Any associated conditions will be treated first. For example, if you have thyroid disease, then you will have tablets for that.
A popular medicine for hair fall is minoxidil. It is available in the form of a solution and is prescribed by a dermatologist. Other medical treatments such as melatonin, platelet rich plasma and micro-needling exist, and a discussion on this is out of the scope of this article.
Natural Ways To Increase Hair Growth
Are there any natural ways to increase hair growth? There are plenty.
When I talk natural, I mean food. Spinach, eggs, berries, fish, avocados and many other foods can help your hair grow. I have included a short list in the table below.
Probably one of the best foods to help with hair growth is eggs.
Studies have shown that the protein in eggs contains biotin (vitamin H), which is an essential element to promote hair growth. Biotin is also naturally produced in the body by the bacteria in the intestine.
However, make sure you have your eggs cooked, as raw eggs have avidin, which can bind to biotin and lower its concentration in the body.
Foods that are rich in iron can help to some extent. Green leafy vegetables (especially spinach), beetroot, lentils, cashew nuts and potato are all good sources of iron.
Zinc rich foods include non-vegetarian sources (chicken, fish, beef) mostly, though mushrooms, lentils and oats also contain a good quantity of it. Milk and cheese are also good sources. Whole grains contain phytates that bind to zinc, lowering its absorption from the gut.
Antioxidants such as vitamin C can prevent hair follicle damage from free radicals, and consuming foods that are rich in this vitamin can help prevent excessive hair fall. Berries (especially amla) are a rich source of vitamin C. Vitamin C is also essential to produce collagen, which helps keep hair strong (remember the shampoo ads?!!).
Do Natural Ways Really Work?
It’s a little hit and miss.
There are those who gorge on fresh fruits and vegetables, and still lose hair. It is a little deflating to hear I know, but not everyone will regain their hair with natural methods. Medication and hair loss supplements will be needed some time.
Always make sure you take any supplements or hair loss products after approval by your doctor. Excessive intake can lead to side effects and toxicity.
Baldness in women is a worrying problem to the affected individual. It can lower self esteem and affect quality of life. There are many reasons why it might happen, and while treatments work, natural ones have a limited role.
There are many patients with high blood pressure that often ask me how they can lower blood pressure naturally. I thought I would talk about one way it could be done – by choosing the right foods.
Let me start by saying that I will not be discussing lowering salt in your diet as a way to lower your blood pressure. It is something I am sure you will be very well aware of.
But now that I have mentioned it already, I might as well reiterate that keeping your salt intake low, avoiding junk foods and salty snacks, keeping your pickle intake at bay and making sure you check the label on the ready foods you purchase for salt content can all help keep your blood pressure controlled.
Today, I am going to discuss specific foods, fruits and veggies that can help you bring your blood pressure down in a natural way.
The Problem With High Blood Pressure
High blood pressure is a common problem in India and across the world. It is estimated that 1 in 5 individuals in our country have this problem.
The Indian Society of Hypertension has issued specific guidelines on how elevated blood pressure should be managed, and we physicians follow the recommendations laid out.
It is essential to keep blood pressure under control, mostly because of the damage it can cause should it remain unchecked. Heart attacks, strokes, kidney disease, eye disease and a multitude of other problems are closely linked to high blood pressure.
The treatment of high blood pressure revolves around lifestyle modification, diet, exercise and medication.
The Dietary Approaches To Stop Hypertension, or DASH diet, has gained notoriety for being effective in lowering blood pressure. It requires the individual to increase their fruit and vegetable intake, lower their salt intake and lower their meat intake to keep their blood pressure under control.
What I have covered here is specific foods that have evidence supporting their blood pressure lowering effect. I have limited my discussion to vegetarian sources.
Foods That Lower Blood Pressure Naturally
So, let’s begin……
You either love or hate beetroot. I, for one, love it. Beetroot has multiple health benefits, and one such benefit is lowering your blood pressure.
It does so due to its high content on inorganic nitrates (NO3-). It is one of the highest among all vegetables, with over 250 mg of nitrates per 100 gram of beetroot.
Inorganic nitrates have the property of relaxing the blood vessels in the body, hence reducing the pressure within them. They also improve the health of the tiny cells that line the inner surface of the blood vessels (called endothelial cells) of the heart and the rest of the body, making beetroots a heart-health veggie.
In one study that evaluated 43 trials looking at beetroot juice supplementation and blood pressure, they found that regular consumption lowered systolic blood pressure by around 9 mmHg. In fact, this was equal to taking a single tablet, which would usually lower the blood pressure by 10 mmHg. Studies suggest that even a 5 mmHg reduction in your blood pressure can lower your risk of stroke.
However, do note that it has to be regular consumption, not just once in a while. The data looked at supplementation for > 14 days.
It also appears that the effect of blood pressure lowering with beetroot juice was greater in those who were affected by chronic diseases (non-healthy people) and those who were overweight, compared to healthy individuals.
Of course, even if you are healthy, you will still reap the benefits of blood pressure control.
Another study looking at beetroot juice supplementation in 20 elderly people with heart disease (but normal heart function) found that one week daily intake lowered blood pressure. Incidentally, it also enhanced their exercise endurance.
So if you are in the older age group and are looking to lower your blood pressure naturally, then have a glass of beetroot juice every day. It is safe even if you have diabetes, provided you do not add sugar to it!!!
You could also make beetroot bread if you wish to. Apparently that can also lower your blood pressure.
Garlic (Allium sativum) has been around for generations, being used as a spice in cooking and medicine as well.
There is robust scientific data published that has demonstrated that garlic can lower your blood pressure. The effect is believed to be due to the active compound present in garlic called Allicin and S-allylcysteine.
The blood pressure lowering effect of garlic is mediated through the release of nitric oxide and hydrogen sulfide, both of which can relax the blood vessels. It also reduces oxidative stress of the cells within the blood vessels, keeping them healthy and fighting fit.
In a study that evaluated 20 different clinical trials involving garlic supplements, it was found that blood pressure in those with high blood pressure was lowered by around 8 – 9 mmHg systolic and 6 – 7 mmHg diastolic. The effect was not that prominent in those who did not have high blood pressure.
One study found that the blood pressure reduction seen with garlic supplements consumed regularly over 24 weeks was equivalent to taking tablet Atenolol everyday.
Another trial looking at supplementation every day of 480 mg of aged garlic extract over a 12 week period lowered systolic blood pressure by 11.8 mmHg.
Similarly, regular supplementation with garlic powder lowered diastolic blood pressure from 102 mmHg to 89 mmHg in 12 weeks.
It is not clear how much garlic should be consumed regularly to lower blood pressure. Studies seem to look more at garlic supplements (oils, powders, pills etc) rather than fresh garlic itself.
The allicin in fresh garlic can irritate the stomach and lower red blood cells count if taken in large quantities. Also, if you are taking blood thinners, it may be wise to consult with your doctor about garlic and garlic based supplements, as they can thin the blood a little.
A summer fruit favourite, watermelon is often consumed to quench thirst and feel refreshed on a hot summer day in India. Unbeknownst to many, watermelon too has a number of health benefits, and one of them is lowering your blood pressure.
In a study that looked at 20 subjects supplemented with watermelon extract everyday for 6 weeks, a significant reduction in blood pressure was noted. The group included those with mildly elevated blood pressure (prehypertension, a term now abandoned) and high blood pressure.
In another study that looked at 11 women and 3 men who were middle-aged and obese, watermelon supplementation over a period of 6 weeks lowered blood pressure significantly.
Similar effects have been seen in post-menopausal women with high blood pressure.
The effect of watermelon on lowering your blood pressure is believed to be due to a compound called L-citrulline, which is converted to L-arginine in the body. This aids the release of a compound called nitric oxide.
Nitric oxide is a potent molecule that relaxes blood vessels and reduces blood pressure.
Best way to eat watermelon
I love watermelon juice. It’s great when blended with fresh green grapes. Even cold watermelon pieces by itself are delightful! Alternatively, you could have a fresh watermelon salad as well.
Spinach is probably the most popular green leafy vegetable consumed in India. Not only is it packed with iron and other minerals, it contains nitrates which have been proven to lower blood pressure.
Researchers in Australia have found that consumption of a single nitrate-rich spinach meal increased levels of nitric oxide in the blood, thus lowering blood pressure. Overall, it showed that this would improve the health of your heart.
In another study, participants who ate spinach daily for 7 days versus those who ate asparagus daily had a greater reduction in their blood pressure. This is because spinach has a greater nitrate content, while asparagus has a lower nitrate content.
Grab a bowl of spinach if you can every day. You can enjoy it as a soup or just in salads. It will help lower your blood pressure naturally.
Millets are emerging as a popular food in India now. They are being used more by people with diabetes, mostly because they have a low glycemic index and do not increase blood sugar levels much.
Interestingly, millets can lower your blood pressure as well.
In a study that looked at 45 patients with mild, untreated hypertension, regular consumption of 50 grams of foxtail millets over a period of 12 weeks lowered both systolic and diastolic blood pressure. It also lowered body weight and fat percentage.
There are not too many studies really evaluating millets and blood pressure reduction. But given it’s additional health effects and safety in diabetes, it is worthwhile making it a part of your regular diet.
Green tea is catching on as a go to drink in our country, but we are nowhere close to what people in the orient consume.
Green tea is packed with catechins such as epigallocatechin gallate (EGCG), epicatechin gallate, epigallocatechin, and epicatechin, all of which have beneficial effects on health.
In a robust meta-analysis study of 24 clinical trials, investigators found that regular green tea consumption lowered both systolic and diastolic blood pressure.
Longer trials in Japanese populations have found that consuming 2 or more cups of green tea every day for over 10 years lowers the risk of heart disease and stroke.
The available evidence suggests that blood pressure lowering is more prominent in those with elevated blood pressure already.
The reap the most health benefits from green tea, drink around 3 to 4 cups a day. Don’t add sugar!!
I have discussed the health benefits of oats in great detail in another post on this blog.
Clinical studies have found that regular oat consumption can lower your blood pressure significantly.
Try to make oats a part of your daily diet. It should be in your list of foods that lower blood pressure naturally.
Don’t fall off your seat. I’m talking about a veggie, not a space rocket.
Rocket is not a widely available leafy veggie in India, though some higher end supermarkets stock these. It is renowned for its peppery taste, and is delicious in salads.
Rockets also have a high nitrate content, and therefore have a beneficial effect on blood pressure.
Chinese cabbage, celery, parsley, lettuce and fennel are other veggies that have high nitrate content and can lower your blood pressure.
Fish intake is closely linked to lower blood pressure, especially when combined with weight loss.
As you can see, there are many foods that lower blood pressure naturally. I have only listed some of the common ones. Mix and match your fruits and vegetables to get the most benefit out of them.
There is a reason why people say ‘an apple a day keeps the doctor away’.
The intake of fruits and vegetables has been shown time and again to help lower the risk of developing heart attacks and strokes. For example, in one study that looked at 84000 women and 42000 men followed up for 14 years and 8 years respectively, those that consumed the highest amount of fruits and vegetables had a 20% lower risk of developing heart attacks.
In particular, apples contain flavonoids, and studies have found that regular flavonoid intake lowers your mortality rate from chronic diseases.
Apples are the second most consumed fruit in the world, with bananas at the top of the list. It’s not just the variety, crunch and the taste of apples that make it a world-wide favorite; it has a number of health benefits too.
If you have been wondering if apples are good for your health, I have today 8 reasons why you should munch on these beauties when you get a chance.
Nutritional Value Of Apples
Your average Joe apple contains fructose as the main sugar, and is low in fat. It is also rich in vitamin C and E, potassium, magnesium and fiber (both soluble and insoluble), along with polyphenols.
Most apples contain around 2 – 3% fiber in them. Pectin is the main soluble fiber that has many health benefits. The insoluble fiber includes cellulose and hemicellulose.
The pectin escapes digestion in the stomach, and heads over to the intestine, where it forms a gel that coats the inner aspect of the bowel. Here, it is fermented with the micro-organisms in the gut, leading to the formation of short chain fatty acids (SCFAs). These SCFAs have multiple positive health effects.
The apple peel forms about 6 – 8% of the fruit, but has the highest concentration of phenolics. The phenolics are powerful antioxidants. Make sure you do not peel your apple before eating it. Juicing can remove the healthy polyphenols. Cloudy juice may be better than clear juice.
Are Apples Good For You?
I would love to stand on a rooftop and shout ‘YES!’. Apples are an amazing fruit to eat every day.
The benefits of eating apples stems from the presence of compounds called phenolics. These have numerous antioxidant and anticancer properties. Apples are particularly high in ‘free phenolics’, meaning these compounds are available in greater proportions compared to other fruits.
If you look at antioxidant activity alone, apples rank second, coming close to cranberries that rank first. This is primarily due to the high concentration of vitamin C that is available in this fruit.
Apples Lower Your Risk Of Cancer
Apple intake can lower your chances of developing cancer, research has shown.
In a study that looked at 77000 women and 47000 men, fruit and vegetable intake on a regular basis lowered the risk of lung cancer by 21% in women, but not in men (!!). Apples seem to have a great benefit particularly. Just one serving a day (1 apple) appeared to do the job.
However, another study found that consumption of apples and onions lowered lung cancer risk in both men and women (phew!).
Similarly, researchers have found regular consumption of at least one apple a day lowered the risk of cancer of the bowel (colorectal cancer).
Besides this, there are research groups that have found that apple intake (one or more) everyday lowered the risk of cancer of the oral cavity, esophagus (food pipe), breast, ovary and prostate.
Some of this has been demonstrated well in lab based studies, where it was found that extracts from the peel of an apple (they used Gala apples) reduced the growth rate of cancer cells in prostate and breast cancer tissues. This is because the extract increased the level of a protein called maspin, which slowed down the cancer cell growth.
Pectin, another component found in apples, is a soluble fiber that can lower the spread of cancer, as demonstrated in animal studies. It does so by inducing a phenomenon called apoptosis, which is the medical term for programmed cell death.
The research on whether apples can lower your risk of cancer is solid. It appears an apple a day (around 166 gm) is sufficient enough.
They Can Protect Your Heart
As I have mentioned earlier, apples are rich in compounds called flavonoids. In the Women’s Health Study, a trial that followed up 40000 women over a period of almost 7 years, ingestion of a high quantity of flavonoids lowered the risk of heart disease by 35%.
A similar study looking at apple and wine intake found a lower death rate in women from coronary disease. This was due to compounds called catechins and epicatechins.
High cholesterol is a risk factor in the development of heart disease and stroke. The high polyphenol and fiber content of apples has been shown in studies to lower levels of LDL i.e. bad cholesterol.
Apples have a better cholesterol lowering effect compared to pears and peaches. It appears apples prevent excess cholesterol from being absorbed in the intestine, as evidenced by a higher fat content in the stools.
This would lower your risk of heart attacks.
There are studies looking at apple intake and risk of stroke, and a similar association has been seen. If you eat an apple a day, you could lower your risk of stroke.
Apples Are Great In Diabetes
Are apples safe in diabetics?
If you suffer from diabetes, then apples are a great fruit to eat. Apples have a low glycemic index, which means they do not increase your blood sugar much if you eat them.
Quercetin, a powerful antioxidant in apple peel, has been shown to lower the chance of developing type 2 diabetes by slowing down how fast the body breaks down the food you eat. It also protects the heart and prevents cancer at the same time.
Similarly, chlorogenic acid and phlorizin, also antioxidants, can help your body utilize the sugar in your foods more efficiently. They also help lower blood sugar at the same time.
At the core of diabetes is a phenomenon called insulin resistance. Here, your body does not respond to the natural insulin being secreted by the pancreas. In other words, the insulin does not work, and hence the glucose levels increase.
Mouse studies have found apple polyphenol extracts to improve sensitivity to insulin (in other words, it lowers insulin resistance). This in turns would improve blood sugar levels as well.
These polyphenols have also been shown to lower postprandial glucose spikes, making it a great snack if you wish to fill up your stomach without worrying about your blood sugar rising.
When it comes to preventing diabetes, apples take the cake. Regular intake of one apple everyday of the week can lower your risk of developing type 2 diabetes by 28%, research has found.
If you like fruit juice, then choosing a 100% juice option is better. Don’t purchase ones with added sugar. It appears that consuming 100% fruit juice may not have too much of an impact on your blood sugar control.
Improves Asthma And Lung Health
I must admit – this was an eye-opener for me. I had no idea that apples could help people with asthma and lung problems.
Lung problems are common in India. The pollution levels are sky-high, and exposure to cancer-forming particles is increasing the incidence of asthma and chronic lung disease (wheezing).
But there is great news. If you eat an apple a day, you can power up your lung health.
In fact, evidence suggests that regular apple consumption could improve the function of your lungs, and build local immunity. There appears to be greater benefit in those who consume 5 or more apples a week. Even consuming just 15% or more of a large apple can lower the incidence of asthma by 10%!
The benefit of apples for lung health is due to the flavonoids (quercetin, hesperetin and naringenin).
Boosts Your Memory
As we get older, memory loss is to be expected. But some encounter it at a younger age, and it can be quite frustrating.
In a mouse model of an Alzheimer’s disease study, it was found that mice that were fed apple juice regularly demonstrated an improvement in cognitive function and memory.
In humans, it is believed that apples may lower the rate of decline of a chemical in the brain called acetylcholine. It also suppresses the expression of a protein called presenilin-1, which is closely linked to Alzhiemer’s disease.
By doing so, it improves memory and lowers the chance of developing Alzheimer’s disease.
Apples May Help You Lose Weight
If you are looking to lose weight with a health diet, then make sure you include apples in it.
The high fiber content in apples makes it a great snack. It’s not just packed with nutrition, but the fiber in it can keep your stomach full for longer. This will prevent you from snacking on junk food.
The weight loss you experience with apple intake is probably just modest.
In one study that compared women who consumed 3 apples, 3 pears and oat cookies everyday, the weight loss was seen most in those who consumed apples.
May Strengthen Your Bones
Osteoporosis, or brittle bone syndrome, is a common problem seen as we get older. It is particularly common in post-menopausal women.
Apple intake on a daily basis may help enhance bone density by lowering the loss of calcium from the body and improving its uptake to form new bone.
However, when compared head to head to dried prunes, dried apples did not have much benefit in protecting the bones.
Among all the fruits, it appears prunes have the best bone protective effect. I will be talking about this in another post.
Apples May Protect Your Stomach Lining
Painkillers are notorious at causing acidity related symptoms. It appears that apples can protect the lining of the stomach, which in turn can reduce your chance of developing ulcers in the stomach.
Acidity in the stomach is sometimes linked to a bacteria called Helicobacter pylori. This bacteria, if left untreated, can lead to bad gastritis and even stomach cancer. The polyphenols in apple peel can help fight this bacteria.
Some Trivia For You
The aphorism ‘an apple a day keeps the doctor away’ originates from Wales.
A slightly different format of this aphorism was published in 1866 as a form of a rhyme ‘eat an apple on going to bed and you’ll keep the doctor from earning his bread’. It was rephrased in 1913.
By the way, there has been a study looking at whether eating an apple everyday lessens your chance of visiting the doctor.
Well, it does not.
However, those who do eat it everyday are less likely to have more medicines prescribed over their lifetime.
Storing Your Apples
The best way to store your apples is to refrigerate them. They can last for 1 to 2 months this way, and remain crisp. Make sure you keep them away from other fruits that might require ripening. This is because an apple that is ripening emits ethylene, which can ripen nearby produce.
Kept at room temperature, apples will likely over-ripen within 2 weeks.
I hope this answers your question – ‘are apples good for you?’. There are so many health benefits, it would be a shame if you did not munch on one everyday.
Obesity is gripping the world. People are moving from one diet to another with desperate hope that one of them will work.
Enter intermittent fasting.
Yet another way to lose weight. Some have knocked it before they tried it; some have given it a half-hearted go.
But many have found trying intermittent fasting for weight loss to be a success.
So I thought I would give you a brief overview of this type of diet, and hopefully clarify your doubts on how it should be done and what to expect.
Terms To Know
Here are some terms I will be using in this article. Feel free to refer back to them as and when you read the article.
Intermittent Fasting (IMF)
What is intermittent fasting?
It is a form of intermittent energy restriction. It includes a >60% restriction in total energy consumed on 2 to 3 days a week.
An example is having a normal diet 4 days a week, and restricting the quantity of food and total calorie intake the remaining 3 days of the week.
Time-Restricted Feeding (TRF)
This is a variant of intermittent fasting. The period of food intake is limited to 8 hours a day, following which the calories are restricted.
An example is eating breakfast at 7 am and lunch at 3 pm, and nothing after that till the day after.
There are 3 patterns that people follow – 16/8, 18/6 and 20/4. 20/4 indicates a 20 hour fast along with 4 hours when food is consumed.
Some consider intermittent fasting and time restricted feeding to be the same thing. For the purposes of this article, we shall do so too.
Continuous Energy Restriction (CER)
This is where the total calories consumed are reduced by 500 to 750 kcal per day or a 30% reduction of what the individual needs at the baseline.
It is a hard diet to adhere to, and many falter and give up within 4 months of starting CER, making them gain back all the weight they lost!
Alternate Day Fasting (ADF)
In this variant, the person eats 75% of their normal intake on one day, and to their heart’s content on the next day, thus alternating between the two.
Does Intermittent Fasting Work As A Diet?
Given how people have been trying continuous energy restriction for years on end, it is natural that most clinical studies would look at whether intermittent fasting is better or comparable to this.
Human studies are hard to conduct as people tend to give up during the study period. On an average, burn out ranges between 0 to 60%. Hence, most of the information comes from animal studies and a few human trials.
Intermittent Fasting For Weight Loss
I start with this subsection, as most people who take up fasting of any sorts are doing it for one reason – to lose body weight.
When I talk about body weight, what I am primarily referring to in this article is body fat content. It is the excessive body fat that is responsible for heart disease and diabetes, so reducing that becomes of prime importance.
Generally, when you lose body fat, you lose body weight as well.
When we eat our food, it is broken down by digestive enzymes into glucose and other components that are needed for normal cells and vital organ functioning.
Glucose is absorbed into the bloodstream and thereon goes to provide energy to all vital structures of the body. The excess glucose generated is stored in the liver in the form of glycogen.
Anything over and above what the body needs is stored as body fat.
In other words, if you eat too much, a large part of what you eat will get converted to body fat, thus raising your body weight.
When you perform intermittent fasting, you make drastic changes to your body’s metabolism.
Let us take an example where you might be following the 8/16 protocol. When you consume food during the 8 hour period, your body glucose level remains high during that time and for a few hours after that. For about 16 hours or so after, during the fasting period, the glucose levels begin to drop.
Adaptive mechanisms kick in to keep the vital organs going, and glycogen from the liver begins to get utilised. Once this is emptied out, the body begins a process called gluconeogenesis, or ‘new glucose’ release. This is generated from the breakdown of fat cells.
As more and more of these fat cells breakdown to provide energy, the total body fat content begins to reduce. This leads to weight loss due to body fat loss.
Mouse studies have shown that the weight loss experienced could range between 13 to 18% on an alternate day fasting regime.
Human studies are limited, and while they too have shown modest weight loss in subjects performing time restricted feeding, there does not seem to be much difference to continuous energy restriction. However, the time restricted feeding group had more overall body fat loss.
In other words, available studies state there is no difference between the weight loss you would experience by performing intermittent fasting compared to just reducing the calories you consume every day.
But if you were never dieting and have now taken up intermittent fasting, then you would expect to lose around 6.5 – 7% of your body weight over an 8 to 12 week period, according to some studies.
This is actually pretty good!
So, if you are planning to take up intermittent fasting for weight loss, then you can be assured to lower your body fat, provided you stick with the regime for a few months at least.
I thought I would touch upon some other important aspects of intermittent fasting as well here.
Intermittent Fasting And Blood Pressure
Intermittent fasting has a positive effect on blood pressure control, and this too has been proven in clinical and animal studies.
A study conducted at the Buchinger Wilhelmi clinic in Germany looked at 1422 individuals subjected to fasting periods over 4 to 21 days. They were restricted to 250 calories per meal as well.
Over a period of one year, these individuals had a lower systolic and diastolic blood pressure control. The lowering of blood pressure is understood to be due to hormonal changes and neurological control mechanism alterations that are brought about by fasting.
However, once the fasting was stopped, the blood pressure returned to normal. This makes it important, once again, to stick to the diet.
Multiple human studies have also confirmed the same.
Interestingly, the heart rate of patients included in the study also reduced. This is beneficial as high resting heart rates have a detrimental effect on heart health.
In short, intermittent fasting has long term benefits on lowering blood pressure and heart rate, provided it is observed for a prolonged period of time.
Intermittent Fasting And Cholesterol
I mentioned earlier about how intermittent fasting can alter the way glucose is handled by the body.
During the fasting phase, all the glucose in the body is exhausted to provide the vital organs with energy. In the process of doing so, new energy has to be generated.
A process called ‘lipolysis’, or fat breakdown begins. The fat cells begin to release fatty acids, which are then transported to the liver. In the liver, these fatty acids undergo a process of oxidation, making them ‘energy-giving’ compounds.
In some time, this leads to changes in the levels of lipids in the body. Blood cholesterol levels are reduced, and animal models have found that the levels of ‘bad’ cholesterol, or LDL, reduce.
Multiple human studies conducted since have shown the same thing, with some even showing elevated levels of good (HDL) cholesterol.
Intermittent Fasting And Diabetes
This is an important one to note, as we currently have nearly 100 million people in our country with diabetes.
Obesity and leading a sedentary lifestyle are closely related to the development of diabetes. So it stands to reason that lowering body weight, along with regular exercise would prevent diabetes.
In patients with type 2 diabetes, intermittent fasting has been found to have numerous benefits, as per a clinical study called the DiRECT trial. In this clinical trial, individuals with type 2 diabetes were given an 850 kcal diet to eat every day for 12 weeks. Each participant lost a significant amount of weight, and this was accompanied with lower fasting blood sugars, lower HbA1c values and improved sensitivity to insulin.
Basically, intermittent fasting makes all the cells of the body respond better to insulin naturally secreted by the pancreas. This means the glucose generated from digestion of food is taken up more effectively by all cells and vital organs.
Intermittent Fasting And Inflammation
I thought I would make a brief mention on the role of intermittent fasting on inflammation.
The reason I wish to is because inflammation is the root cause for heart attacks and strokes. It is the reason fat deposits in the arteries of the heart, leading to atherosclerosis and subsequent heart attacks.
Intermittent fasting has been found to increase the levels of a protein called adiponectin. High levels of adiponectin have a protective effect against the development of heart disease.
In people who are obese, those with diabetes and cardiac disease, the levels of adiponectin are significantly lowered, which increases the risk of atherosclerosis and heart artery ‘blockages’.
Similarly, intermittent fasting lowers the levels of leptin, resistin and similar compounds, all of which are pro-inflammatory and promote atherosclerosis.
In essence, intermittent fasting can lower your risk of heart disease by lowering inflammation within the body.
In A Nutshell
So it is clear that intermittent fasting has many advantages. It can lower weight, lower LDL cholesterol, lower blood pressure and lower the risk of heart attacks and strokes.
Are There Any Disadvantages of Intermittent Fasting?
Well, with everything good, there is always a little bad.
Firstly, intermittent fasting may not be for everyone. Those with diabetes who attempt this must do it under the supervision of a doctor, as medications normally taken can precipitate low blood sugars.
Some studies have reported mood changes, anger, frustration and argumentative behaviors in those who are starting out.
The results for intermittent fasting that have been published with respect to weight loss are all short term studies. There are no long term studies that have evaluated how effective it is over years. While we know there are multiple advantages, we are still limited in our understanding of how it can help lower health problems over years.
Women who undertake intermittent fasting may find that their monthly menstrual cycles become irregular.
Pregnant women must avoid intermittent fasting as it could affect the health of the growing fetus. The same holds for athletes as it could negatively affect their performance.
On a lighter note, eating out in the evening with friends and family comes down, sadly. But your bank balance may improve over time!!!
Intermittent fasting is an effective way to lose weight and stay healthy. However, it may not be better than just reducing your overall calorie intake everyday.
Unfortunately, long term data regarding its true efficacy is limited, but that should not stop you from taking it up. Do remember that for the most effective weight loss, combine your diet with exercise.