Blueberries are rich in fiber, antioxidants, and phytonutrients. According to a study carried out at Harvard Medical School, older adults who eat plenty of blueberries (and strawberries) are less likely to suffer from cognitive decline.
2. Apples
Apples are an excellent source of antioxidants, which combat free radicals. Researchers at Florida State found that older women who started a regime of eating apples daily experienced a 23 percent drop in levels of bad cholesterol (LDL) and a 4 percent increase in good cholesterol (HDL) after just 6 months.
3. Dark leafy vegetables
Studies have shown that a high intake of dark-leafy vegetables, such as spinach or cabbage, may significantly lower a person’s risk of developing Type 2 diabetes. Spinach, for example, is very rich in antioxidants, especially when uncooked, steamed, or very lightly boiled.
4. Sweet potatoes
Sweet potatoes are rich in dietary fiber, beta-carotene (vitamin A), potassium, vitamin C, and vitamin B-6. The Center for Science in the Public Interest compared the nutritional value of sweet potatoes to other vegetables. The sweet potato ranked number one, when vitamins A and C, iron, calcium, protein, and complex carbohydrates were considered.
obesity
It’s Reasons and Prevention
Obesity is a disorder which results in an excessive accumulation of the body fat. To keep a check on obesity is not only important for cosmetic reasons, but it causes serious health issues like heart diseases and high blood pressure. If you are obese it is most likely that you may encounter various health problems.
Obesity
Obesity is a multifaceted health disorder that affects both adults and children. Being obese not only affects the overall persona of an individual but also increases the risk for many health concerns. An obese person is at a higher risk of developing health conditions like diabetes, heart disease, stroke, arthritis, breathing problems, and some cancers.
Statistics have revealed that obesity is a major factor contributing factor for metabolic syndrome and type 2 diabetes mellitus (T2DM) among Asian Indians. Various factors contribute towards making an individual obese. Some major factors which contribute towards obesity are environment, family history and genetics, metabolism or the way your body converts food and oxygen into energy, and individual’s lifestyle. Besides these factors certain medical conditions also leads to obesity. Scientists are also trying to understand that some chemicals in the environment may be playing in the growing obesity problem.
Recent guidelines have revealed that 10-15% of Indian population would fall under the obese category and would need appropriate management. Purpose of these guidelines on countrywide basis projects an alarming situation of T2DM and cardiovascular disease.
Some startling facts about obesity:
According to a recent survey conducted worldwide: India has second highest obese children in world.
Followed by China India ranks second in childhood obesity with the incidence of China with 15.3 million and India with 14.4 million.
According to National Family Health Survey in 2018 –In past one decade the number of obese people has doubled.
According to a latest publication in a medical journal-“The Lancet” –Currently there are 30 million obese Indians and by 2025, this number is expected to pass 70 million.
Did you know lack of sleep increases the chances of obesity- If you do not sleep enough you produce Ghrelin, a hormone that increases your appetite and hence adds extra pounds to your body.
India the third most obese country in the world – According to a study published in a medical Journal Lancet- India is just behind US and China in this global hazard list of top 10 countries with highest number of obese people.
Latest Survey reveals that technology addiction too is adding to obesity amongst young adults and children in India. Television, computers and video games at the cost of sports and physical activity, causing sedentary life style are prime causes of obesity among young ones.
Surprisingly but true-Globally, Obesity causes more deaths than malnutrition -Worldwide, obesity is one of the top five leading causes of death. It results in greater than 2.8 million deaths every year.
What is the need for new guidelines for obesity among Asian Indians?
New guidelines have been proposed in view of alarming situation of obesity among Indians. These guidelines have been prepared by 100 medical experts all across the country hailing from the backgrounds of internal medicine, diabetes, metabolism, endocrinology, nutrition, cardiology, exercise physiology, sports medicine, bariatric surgery and representing reputed medical institutions, hospitals, government funded research institutions. The very need for these guidelines has been enumerated below:
In view of increasing trend in frequency of obesity and related metabolic diseases, there is dire need of effective interventions in obesity
As Asian Indians manifest a higher risk of cardiovascular risk factors and T2DM at lower levels of obesity, the appropriate obesity diagnosis should be based on lower level of weight for height than in non-Asian Indian populations.
Current obesity international guidelines are not appropriate for Asian Indians. Moreover, WHO has authorized local governments and scientists to decide on the localized guidelines for the Asian Indians.
If appropriate diet, exercise, drug and surgery are employed at lower levels of obesity, nearly 15% of the adult population of India (nearly 5-7 crore people) will show improvement in obesity coupled with reduced risk of diabetes and cardiovascular disease.
How obesity is diagnosed among Indians?
Three parameters which are used to measure obesity are body mass index BMI, waist circumference WC and waist-to-hip circumference ratio (WHR). The most accepted method to define thinness and fatness is BMI, a ratio of weight in kilograms divided by height in meters squared (kg/m2).
What are the cut offs for BMI and WC in defining obesity among Asian Indians?
After a major consensus among scientists below table has been prepared to depict the obesity among Asian Indians:
Classification
BMI(kg/m2)
Principal cut-off points
Cut-off pointsfor Asians
Normal range
18.5 – 24.9
18.5 – 22.9
23.0 – 24.9
Pre-obese
25.0 – 29.9
25.0 – 27.4
27.5 – 29.9
Obese (Class I)
30.0 – 34.9
30.0 – 32.4
32.5 – 34.9
Obese (Class II)
35.0 – 39.9
35.0 – 37.4
37.5 – 39.9
Obese (class III)
≥40.0
≥40.0
Source: Adapted from WHO 2004 and recent guidlines
What does recent guidelines say about WC and WHR cut offs in defining obesity?
Research has revealed that abdominal obesity is associated with higher risk of diabetes and cardiovascular disease when compared with generalized obesity. Cardiovascular disease is associated with increased amounts of excess abdominal adipose tissue, both intra-abdominal adipose tissue (IAT) and subcutaneous adipose tissue (SCAT). In view of this a joint discussion and consensus among scientists concluded the WC cut off among Asian Indians as defined below:
Action level 1: Men: 78 cm, women: 72 cm. Any person with WC more than these levels should refrain from gaining weight and adopt healthy lifestyle to prevent the risk of any of the cardiovascular risk factor.
Action level 2: Men: 90 cm, women: 80 cm. Individuals with WC above this should seek medical help so that obesity-related risk factors could be diagnosed and handled.
What are the causes of obesity?
Obesity could be genetic, behavioral and can also result due to the hormonal changes in the body. Obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat. Some medical conditions also result in obesity such as Prader-Willi syndrome, Cushing’s syndrome, and other diseases and conditions. The main reasons for obesity are either sedentary lifestyle or eating unhealthy such as junk foods at wrong intervals.
What are the risk factors that can contribute to obesity?
Obesity usually results from a combination factors, including:
Genetics. Genetics may also play a role in how efficiently your body converts food into energy and how your body burns calories during exercises.
Family lifestyle. Family members share common eating habits. Obesity runs mostly in families as common eating habits of eating fatty foods contribute to obesity.
Inactivity. If you are inactive throughout the day, you are more prone towards obesity. Certain diseases like arthritis also result in decreased mobility and hence inactivity
Diet. A diet rich in fats and less minerals and vitamins can result in obesity
Medical problems. In some people, obesity can be traced to a medical conditions like Prader-Willi syndrome, Cushing’s syndrome and other conditions. Medical problems, such as arthritis, also can lead to decreased activity, which may result in weight gain.
Medications. Some medicines such as antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers also make the person obese
Social and economic issues. Research has shown that weight gain can be linked to social and economic factors.
Age. As we grow in age a decreased physical activity and lower metabolic rate can result in obesity.
Sleep deprivation. Not getting enough sleep or getting too much sleep can cause changes in hormones which may lead to an increase in appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.
What are the complications associated with obesity?
A number of health problems arise if you are obese. Some of the diseases which you may encounter include:
High triglycerides and low high-density lipoprotein (HDL) cholesterol
Type 2 diabetes
High blood pressure
Heart disease
Stroke
Cancer
Breathing disorders, including sleep apnea, a potentially serious sleep disorder in which breathing repeatedly stops and starts
Gallbladder disease
Gynecological issues such as infertility and irregular periods
Erectile dysfunction and sexual health issues
Quality of life-If you are obese you are most likely to suffer from other issues, which can severely affect the quality of life. Some common problems which arise due to obesity include depression, disability, sexual problems, shame and guilt, social isolation, and poor performance at workplace
How can you prevent obesity?
You can take some below-mentioned steps to prevent obesity:
Exercise regularly. Exercises such a fast walking and swimming for 150 to 300 minutes in a week can prevent obesity
Eat healthily. Eat low-calorie, nutrient-dense foods, such as fruits, vegetables, and whole grains. Refrain from foods which are high in fat content.
Monitor your weight regularly. Keep an eye on your weight at regular intervals as it can help you to assess your weight regularly
What are the recent guidelines on physical activity?
According to joint decision among scientist below is the list of guidelines about physical activity in combating obesity and associated health concerns:
Physical inactivity should be refrained as much as possible
Pro active medical consultation is recommended for those with chronic conditions or those who are symptomatic
Inactive people must switch on to physical activity
Brisk walking (walking at an intensity wherein an individual finds speaking difficult but not impossible) should be encouraged
On an average a total of 60 minutes of physical activity like aerobic activity, work-related activity and muscle strengthening activity should be included daily
For additional and greater health benefits, adults can increase their aerobic physical activity to 300 minutes (5 hours) a week of moderate-intensity, or 150 minutes a week of vigorous-intensity aerobic physical activity
Yoga should be included; however, more research is needed to fully explore its benefits
Children should undertake at least 60 min of outdoor physical activity. Screen time (television/computers) should be less than 2 hrs a day.
What is the treatment of obesity?
The treatment of obesity includes a combination treatment from a dietitian, behavior counselor or an obesity specialist. Recent guidelines suggest identifying and treating the underlying cause of obesity, lifestyle modification, pharmacological treatment like ant-obesity drugs along with lifestyle modification, and if needed surgical treatment is advisable in treating obesity.
Scientists have concluded that anti-obesity drugs should be prescribed in combination with dietary and lifestyle changes as a part of comprehensive weight loss program. Also, drug treatment should be monitored on an ongoing basis for efficacy as well as safety. In general, anti-obesity drugs should be administered for BMI above 27 kg/m2 or a BMI above 25 kg/m2
Anti-obesity drugs which are recommended to treat obesity are sibutramine, orlistat should be used as a second line therapy. At times metformin and exenatide can be used under special clinical conditions.
What is the surgical treatment for obesity?
Over the past few years bariatric surgery has come out as an option for obesity reduction. Bariatric surgery involves an alteration in the digestive system by reducing the gastric volume or by changing the path of food bolus which can lead to malabsorption. According to current international guidelines below are the guidelines for bariatric surgery:
Current International Guidelines: BMI above 35 kg/m2, or BMI above 40 kg/m2.
For Asian Indians: BMI above 32.5 kg/m2
Various surgical options are available under the umbrella of surgery which includes:
Restrictive Procedures like Adjustable gastric banding (LAGB) & sleeve gastrectomy
Combined Procedures like Roux-en-Y Gastric or Bypass (RYGBP)
Malabsorptive Procedures like Bilio-pancreatic diversions (BPD)
Experimental Procedures like ileal interposition
Duodeno-jejunal bypass and other implantable pulse generators.
Pros and Cons are associated with above mentioned procedures; however, it is upon the physician to decide that which surgical treatment is best suited for the particular patient.
Having a positive attitude towards weight loss and employing various changes in lifestyle such as exercising and eating a well-balanced diet can help you to lose weight. Nevertheless, obesity remains a rampant problem even in developing nation like India. Appropriate interventions are required in a timely manner to combat this problem to prevent other major health concerns.
Obesity Support Groups
These inspiring stories of those who have overcome Diabetes will keep you motivated
Are you tired of hearing don’t do this? Don’t eat this? Restricting yourself from all the joys of life you previously enjoyed before you were diagnosed with diabetes? Relax! And read on to a few handy tips which can really help you and your partner cope up with diabetes.
Eating Out
Invited for lunch/dinner or party- don’t stop yourself go ahead! But remember not to starve yourself. Starving leads to overeating according to Centre for Disease Control and Prevention, USA. Instead it is advisable to eat a small meal to avoid hunger pangs while eating at a party. You may choose from various diet plans and methods by various dieticians worldwide, but the Plate method suggested by American Diabetes Association is quiet easy to follow. Fill half of your plate with non-starchy fibres vegetables like grilled or barbequed mushrooms, bell peppers, broccoli, beans, cauliflower, capsicum, lettuce, carrots, tomatoes, turnips and onions. 1/4th of your plate with lean protein like grilled fish/cottage cheese/shrimps or chicken. And the rest 1/4th with Low carbs and whole grain breads. Ideally desserts should be replaced by fresh fruits, but you may have a tiny portion. You may also consult your doctor and take medications.
Travel
Have you avoided travelling with family and friends lately? With little preparation, Diabetes induced complications like frequent urination, burning foot syndrome, anxiety, rapid heartbeat, headache, numbness in fingers or simple change in diet can be controlled. Discuss with your physician, your doctor may suggest some medicines or ways to overcome these complications in the best possible way. If you are insulin dependent, you no longer need to compulsorily refrigerate the insulin. There are new and convenient ways of carrying insulin pens and cartridges. For complications like frequent urination adult diapers are readily available for men & women in the medical stores incase of unavailability of proper washrooms.
Exercise Routine
People tend to get irritated or angry when they are not able to achieve their goals. Relax! You can always start again. According to American Diabetes Management programme along with diet you need to run a successful 150 minutes physical activity program per week. We know this is not easy and many people tend to give up. We at Famhealth urge you to initiate a physical activity routine as small as 30 minutes per day. Once the benchmark is set then we can increase it from 30 minutes to 60 minutes per day. You may opt from a wide range of physical activities not restricting yourself only to gyming. You may want to choose Power yoga, Aerobics, Martial Arts like (Kick boxing Tai chi), Cycling, Swimming, Badminton, Pilates, and Jogging, walking to your friends place, climbing stairs and breaking the monotony of gyming.
Medicine Management
This is the most important aspect of diabetes management. Medicines cannot be missed or delayed unnecessarily due to work pressure, mood fluctuations or other engagements. Medicine compliance along with blood sugar monitoring is an ideal way to manage diabetes. Blood sugar levels vary time to time and not remain same even throughout the day. It is very important to monitor your blood glucose levels, as sometimes your blood glucose level may drop causing hypoglycaemia or increase causing Hyperglycaemia. You may discuss with your diabetologist incase you are having more than 4-5 medicines as to which can be taken before meals or after meals based on priority to manage diabetes effectively. You may set an alarm or take the help of your spouse or caregiver in reminding you to take medicines on time.
Stress Management
According to Mariella Meachen Psychotherapist from International diabetes federation, people living with Diabetes may undergo emotional turmoil’s like anxiety, fears, depression, guilt, denial which causes stress. Studies suggest stress hormones like epinephrine and cortisol raises the blood glucose level in the body resulting in poor diabetes management. Research suggests Psychological support from spouse and family help coping up with diabetes. American Diabetes Association suggests changing coping styles like accepting a problem, Saying OK, and learning to relax help you cope with stress. You may also choose to join a sports team, Diabetic community, take dance lessons or learn a new craft. There is no harm in talking to a diabetic educator or seeking a medical counsellor.
Grooming
According to Cleveland Clinic; People with diabetes are more likely to have problems in their mouths—like gum disease, fungus and dry mouth. That’s why mouth care is so important. They should brush with a soft-bristled brush after every meal and floss at least once a day.
As per Joslin Diabetes Center; Ingrown toenails can lead to infection and other problems. Caregivers or family members can help check toe nails once a week for swelling or signs of infection. Toe nails should be trimmed with a nail clipper straight across and then smoothed with an emery board. Don’t round off nail corners.
Bathing
Mild soap and warm (not hot) baths or showers are best to prevent dry skin. Skip foot soaking, which can dry skin. Dry between toes. She should use a doctor-approved moisturizer—including on her feet, except between toes.
A small thing like a callus or cut on the foot can lead to serious problems for anyone with diabetes. And if she has nerve damage from diabetes, she may not even feel a cut or sore. After a bath, she should do a daily skin check, especially of her feet. Give her a hand-held mirror, or look in the places she can’t see. Look for red spots, blisters, and sores.
Erratic Glucose levels
Sometimes erratic glucose levels may happen, you and your caregiver may be very worried and frustrated.
Discuss that with your physician and your physician might recommend some changes in your medication, diet and lifestyle.
There might be a remote possibility of you becoming insulin resistant. Your physician may change your dosage or add another medication.
You may also consider other factors like stress, weather, your physical activity levels, hormonal changes, sleeping patterns for your erratic glucose levels
You may consider talking to diabetelogist to know how to control your glucose levels. Make changes in your existing diet to achieve your goal.
Living with Diabetes
Right approach and positive attitude is very important in managing diabetes. While you may find it challenging to control your cravings, which may effect your blood sugar levels.
Instead find a way to motivate yourself and your partner to stay healthy and achieve your targets.
Join a community or surround yourself with encouraging and positive people.
You may consider talking to a diabetic educator typically a physician or a dietician who will help you in keeping fit and achieve your targets.
Instead of feeling low and lamenting about having diabetes, find out about the ways of managing this disease perhaps you don’t like gyming.
You may consider opting for a physical activity ranging from Yoga, Gym, Marshal Arts or Cycling.
You need to carefully choose what you are eating that does not mean you cannot eat delicious food. There are many Diabetic friendly recipes available which satisfy your taste buds and also maintain your blood glucose levels.
You can go for parties, you can dress well and feel absolutely elated and keep at par with all your day to day activities.
You may sometimes also enjoy your alcohol provided, do not exceed and have your medication on time and regular basis.
Medicine adherence is one of the most important aspects of diabetes management.
Not everybody is similar certain blood glucose lowering medication may cause low blood glucose levels hypoglycemia.
To read more on Diabetes, click on the link below.
4 cups mixed green leaves (cabbage/lettuce/spinach)
½ large cucumber
1 cup chopped tomato
½ thinly sliced red onion
½ cup crumbled cheese
1 tablespoon balsamic vinegar
1 tablespoon olive oil
1 clove garlic minced garlic
¼ teaspoon black pepper
4 light tomato-flavour oval multigrain wraps
2/3 cup hummus
Directions
In a large bowl combine all the greens, cucumber, tomato, and red onion and cheese. In a small bowl whisk together vinegar, olive oil, garlic and black pepper. Pour dressing mixture over greens mixture. Toss to combine
Spread each wrap about 2 & ½ tablespoon of Hummus. Top each with 1/4th of dressed greens mixture roll up and serve immediately.
Nutrition Facts
Make 4 servings (Amount per serving)
Calories (Kcal)
269
Protein (g)
16
Carbohydrates (g)
35
Total Sugars (g)
3
Cholesterol(mg)
3
Total fat (g)
12
Sodium (mg)
574
Note
Remember to manage your portion sizes. Recommended portion size should not exceed 2 servings/helpings. Consuming diabetes friendly recipes in inappropriate portion sizes may lead to spiking of your blood glucose levels.
5 Dried long red chillies, deseeded, soaked and drained
Pinch of salt
3 tbsp Lemongrass, chopped
5cm/2” piece fresh root ginger’ chopped
1 tsp Turmeric
4 Shallots, chopped
6 Garlic cloves, peeled and chopped
For the curry: 1 Organic, free-range chicken, about 1.6 kg/3½ lbs
2 Garlic cloves, peeled
2 cm/1” piece Fresh ginger root, peeled
2 tbsp Coconut oil
12 Shallots, peeled
2 tbsp Cashew nuts
2 tbsp Fish sauce
Water or chicken stock to cover
Steps:
First, dry the coriander seeds, star anise, cumin seeds, whole cloves and cardamom pods in a small dry pan until fragrant. When cooled, remove the cardamom seeds and discard the pods. Grind the spices in pestle and mortar. Combine these with the other curry paste ingredients and mix to a paste either in a mortar or in a food processor.
Wash the chicken, joint into 8 pieces and remove the skin. Mash the garlic cloves and ginger to make a paste. In a large pan, heat the coconut oil and fry the garlic and ginger paste until golden. Add the curry paste and chicken and simmer for several minutes, turning frequently. Add the whole shallots and cashew nuts. Season with fish sauce. Cover with stock or water and simmer for at least 30 minutes, or until the chicken is tender.
Note: The combination of chicken and nuts gives this dish a very high magnesium content (125g per serving). Magnesium is key mineral for diabetics: and it has been shown that people with low magnesium are at higher risk of type 2 diabetes.
