Monday, July 30, 2012

To attain Peace of Mind.......

       It's been a 'tearing your hair' out kind of day. After a tough day at the office, you've come home to find your kids still haven't started their homework, then there's dinner to be made from scratch all the while knowing that you've then got to be on a conference call till late in the night. If this has become the norm rather than the exception, it's time to step back and ask yourself a few questions....

     There are many external sources of stress - career, financials, kids' education, family expectations, etc but these translate into a very real physical response from the body. When the body is under perceived threat, Cortisol, a steroid hormone is released by our adrenal glands. It's job is to redistribute stored glucose to parts of the body that may need to deal with the 'threat' - the brain and major muscles. 

     Persistently higher cortisol levels (seen in chronic stress) results in slowing down of the metabolism (rate at which your body burns calories) and weight gain. Cortisol is such a powerful hormone, if you're under chronic stress - you could even develop Diabetes, heart attack, stroke, high blood pressure, high cholesterol levels, hypothyroidism, delayed wound healing, decreased bone density, impaired memory and other cognitive brain functions. 

     Wait, one other result of this hormone is suppressed immune function, meaning you tend to fall sick more if you let stress take over your life. What a wide array of health impacts of long standing stress. But these disorders are so common, does that mean that in addition to eating healthy and regular exercise, one also needs to focus on being happy and peaceful in trying circumstances to avoid chronic illness? YES!!!

     This is one more aspect of WELLNESS - Emotional Well-Being. It's important to work hard on your relationships, especially with people you love most. Having flourishing relationships that bring us joy and peace serves as a sheet-anchor through the ups and downs of life. 

     Dealing with loss of loved ones is also a necessary capability unfortunately developed only through experience. The death of someone close is such a source of stress that every health risk assessment questionnaire has this standard question - have you lost someone dear to you in the last 6 months? This experience can literally reduce your life expectancy so do whatever you need to do to cope powerfully. Therapy or counseling can make a huge difference in these cases. Depression too needs to be addressed similarly. 

     Great, now how do I reduce my stress levels? The first step to dealing with stress is ADMITTING YOU ARE STRESSED. Stress is always something that happens to someone else - that delusion ends now. There are many professional tools and methods out there to support you but here are some you can get started with on a daily basis: 

My top five:

1] Music - preferably not fast paced (like heavy metal or acid rock with a lot of screeching). Calm music that evokes memories of good times, Indian or Western classical music (for those with an ear for it). Enjoy it in between your busy day - even 3 - 5 minutes does you good.

2] When you feel yourself getting worked up over something, take a quick mental break - a few deep breaths and practice LETTING GO. Notice when you're trying to be a perfectionist and BE FLEXIBLE.

3] Develop a hobby or practice around something you're passionate about - it could be bottle top collecting or even volunteering at your neighbourhood old age home. In fact, giving your time or money to a worthy cause extends your lifespan!

4] When tense, notice your body contracting - jaws clenched, forehead furrowing, contracted eyebrows, biting your tongue, fist clenched, leaning forward in your seat are some signs of up-tightness. As you notice these, start to relax your body parts, one by one till you've hit them all and breathe deeply the whole time. Distracting yourself like this gives you a different perspective and you'll end this exercise with a smile on your face with a little practice.

5] Make a list of things you are intensely grateful for (at least 5 items), keep it in your wallet or diary and read it frequently.

     Last but NOT the least (I am a nutritionist after all), take care of your health - eat nutritious meals and snacks, exercise regularly, get enough sleep and include one of the following journeys inside - meditation, pranayama, yoga. 

This article was published in 'Life in Adyar', Chennai -  June 16th, 2012.

Sunday, July 22, 2012

A bend in the road is not the end of the road... unless you fail to make the turn.

       I started noticing a graceful senior citizen while exercising in the neighbourhood park a few months ago. She would come every day, a gentleman (I presumed he was her physiotherapist) holding her hand, talking to her gently and her husband walking slowly behind. She wore a brace on her right knee and I could see the massive effort it took just to put one foot in front of the other.

     Their progress was slow and I would keep passing them walking or jogging. I said hello and smiled a few times but one day noticed that she had covered a quarter of the circuit in a much shorter time than she used to. I couldn’t hold back my congratulations, we got to talking and she invited me home.

     Dr Sacchubai Palaniappan, a retired professor with the Dept. Of Polymer Science, Madras University had osteo-arthritis which flared up last year with both knees requiring surgery. From the time of her return last year in a wheelchair from a visit to the UK, to her now being able to walk a short distance without support is a journey whose hallmarks are grit and perseverance.

     Surgery, while restoring ability in her left knee, left her right one functional, but in pain. She had almost no will to face what was in store for her but the presence of her loving children and grandchildren were just what she needed to begin to hope for renewed good health. Physiotherapy started soon after, with walking every evening in the local park.

     It was at this stage I first saw her. Her devoted husband who is always at her side, shared that those initial days were very difficult since she had an intense fear of falling and hesitated to even stand up. She had to be reassured and motivated constantly. 

     The Physiotherapist who was by her side even before the surgery, played a critical role here – he encouraged, counselled and pushed her (figuratively) to keep doing her exercises and walking. He was there without fail, several days a week. His perseverance with Sacchubai was the origin of her own. She put her faith in God and overcame her fears, step by step – to the extent that when I asked her ‘does that fear remain?’ she promptly stood up without support, grinning! 

     Some points I took away from this moving encounter:

-          ANYBODY  can work to restore their health – you’ve just got to hang in there and go the distance. It could be recovering from cancer or even lowering your cholesterol levels for prevention.

-          We never truly realise the value of our health until we lose it. Get an annual medical check up. Don’t let seemingly small symptoms fester – get them diagnosed and dealt with professionally (Apart from Nutrition Therapy - Homoeopathy and Ayurveda are wonderful alternatives to Western Medicine / Allopathy). Take care of yourself – a healthy balanced diet and exercise are critical for long term health.

-          Family support, understanding and love is critical – Patients do not always have the sweetest disposition. When one is ill, ill temper and even depression tend to follow. It takes those who know you best to just love you and give you everything to live for. Her husband, Mr Palaniappan took over the care of the household as well as of her.

-          Healthcare is more than just hospitals and surgery – it’s about the people who support you and nurse you back to health. In this case, the Physiotherapist who was at Dr Sacchubai’s side regularly showed remarkable dedication and a sound, professional work ethic.

     Though she still has some more distance to cover on the road to health, Dr Sacchubai now has belief in herself and a healthy future. Feeling strongly about various social issues, she has a new future ahead and, having restored her health, will continue to make a difference to society.

This article was published in 'Life in Adyar', Chennai -  June 16th, 2012.

Nurture Your Child's Digestive Health

     Does your child suffer from gastro-intestinal trouble on a regular basis? Constipation, flatulence, stomach pain or even acid reflux (common in infants)? We adults have a stronger digestive system, by and large capable of dealing with whatever we ingest but kids’ guts are still developing, growing stronger, getting used to the variety of foods we feed them.

     The First and MOST IMPORTANT thing you can do for your child’s gut is to breastfeed exclusively for the first 6 months of life. If that’s not possible because of insufficient or non – existent mother’s milk supply, consider a formulation which is 100% organic and natural. A nutritionist will help you formulate this and give guidelines on it’s preparation. Home-made is always best.

     Breast milk sets up your child’s immune system both by enabling it to produce antibodies and immunoglobulins and it’s bacterial content (lactobacillus bifidus) which protects against harmful pathogens. Also, the mere act of breastfeeding safely introduces bacteria from the environment into the infant’s colon, helping build the intestinal flora which produce Vitamin K and other nutrient components later.

     Soy, shellfish, fish, peanuts, tree nuts, and eggs are allergens and ideally should not be introduced to a child under 12 months. This is the age by which they have developed a basal digestive capacity and immunity level.

     Going one step further, it is wise not to feed them any junk food till they are at least 2 years old, and even then – don’t make it a habit. So many parents complain that their child wants junk food all the time – well, who introduced them to it? Who buys it for them? Who gives into their tantrums? Who eats these along with the child?

     By the way, biscuits, instant noodles, burgers, pizzas and fries aren’t great for their gut health but there are so many more INDIAN JUNK FOODS! Avoid feeding too many refined cereals like white rice and rava as well – these have almost zero nutrients and are at best easy sources of energy. Go Whole Grain!

     Milk and Wheat are best introduced at around 6-7 months, however, if not digesting well, leave them aside till the child completes 1 year. It is possible that diluted curd may be tolerated where milk isn’t so use this to ensure your child’s Vitamin B 12 supply. B 12 is not found in plant sources so small amounts of either milk or curd is a necessary part of the diet.

     Parents often think an allergy manifests as rashes or wheezing or similar symptoms but the truth is the lining of the digestive system is the first to come in contact with the allergen, therefore the most vulnerable. In fact, major symptoms may be nothing other than diarrhoea, vomiting, gas build up and abdominal pain.

     Common problems faced by toddlers till they reach the age of 7 years (after which their gut is more powerful) are colic, diarrhea, vomiting, constipation and even acid reflux (if not eating enough).

     When to go to the doctor: when your child is vomiting and not keeping food down, showing signs of dehydration / has severe abdominal pain / has fever along with digestive issues.

Tips for the little ones (0 – 2 years):

·     While feeding keep the child’s body at an angle of at least 40ยบ to prevent food/breast milk from flowing back into the oesophagus once it reaches the stomach. Burp them during and after the feed.

·      If your child spits up regularly and also makes a fuss to feed, is not gaining weight and is irritable – this could be gastro - oesophageal reflux disorder or GERD. You should meet your paediatrician in this event.

·     While breastfeeding, stay off spicy, high fat, gas causing foods – these might cause disturbances in your infant’s digestion. Drink lots of water - minimum 3 L per day.

·      Don’t give children sugar or salt in the first 2 years of life – trust me, they’ll get their carbohydrates and sodium from other natural foods. You might think ‘It’s so bland’ but the chances of your child becoming addicted to junk food later in life is minimized. In fact, your child may just relish his/her fruits, veggies and other natural foods all the more. Use herbs and spices to make foods interesting.

·      Use malted whole grains* after 6 months of age as these are richer in nutrients and easier to digest.

·         Feed children small amounts of food, more frequently.

·         Avoid tight diapers and waistbands

For older children (2-7 years):

-      Help him / her stick to a healthy toilet routine – for some kids it can be bowel movements thrice a day, for others, once in 2 days. Ensure frequent urination.

-      Serve foods slightly warmer than room temperature. Avoid extremely hot and very cold foods.

-      Ensure sufficient fibre intake by including whole grains, pulses (legumes), fruits, green leaves and other vegetables. Even sprouts can be made attractive with a little imagination.

-      Expose your child to different food textures crunchy salad veggies, nuts, pappads (roasted) are some examples. They are capable of eating these and these foods provide valuable nutrients. You can even start chapathis and whole grain bread at the age of 1 ½ to 2 years – just make sure they’re chewing everything properly and ensure no food is stuck between gums or on the palate.

-      Fluids – 1.5 L of water per day is ideal but ensure whole fruits and veggies (up to 90% moisture), buttermilk, tender coconut water, rasam, soups, etc is also present. Be watchful of your child’s fluid intake as mild dehydration can occur very easily. Habituate him/her to asking for and drinking water regularly.

-      Exercise – this scientifically proven link between physical activity and digestion is not present just in kids but also in adults. Keep them active by playing vigorously with them.

     Every human being’s system is unique – it responds differently to various stimuli so don’t beat yourself up if things aren’t going right. It’s about trial and error and learning. At the same time, your child’s gut health IS in your hands. You ARE the parent. You HAVE THE say in what they eat. It may mean new healthy habits for the whole family. We invite you to be open to the process and share your results.


* Malted grains are Amylase Rich Foods which are the easiest to digest by your 6 month old. This is the ideal food for when you’re weaning an infant off the breast. Cereal grains and grams (legumes) both are used together to provide complete protein.


RECIPE FOR MALTED BABY FOOD (BEST USED TO WEAN)
Ingredients:

Ragi  - 1 kg
Whole Green Gram (Moong) – ½ kg
Fenugreek (Methi) seeds – 100g
Cardamom seeds – 1 tbsp (15 g)

Method:
1] The first step is to sprout the grains. Soak the ragi, moong and methi separately for 3-5 hours. If you soak for longer it will take longer to roast later on. Drain the water and hang separately in light cotton or muslin cloths.
2] Each type germinates at different rates –  the sprouts don’t need to be too long. It can take anywhere from 5 to 8 hours to sprout so the best thing is to leave the cloth containing grain slightly wet overnight.
3] Dry the sprouted grains in the sun till completely dry – cover the tray with a light layer of cloth to protect from dust.
4] Roast each type of grain separately (they roast at different rates) till they turn slightly brown / red and the aroma reaches you.
5] Mix the roasted grains, add the cardamom and powder finely – you can do this at a mill (make sure they’ve just cleaned their machine) or even with your grinder at home.
6] To make kanji, mix 1 tsp of the flour with 150 – 200 ml of water and bring to a boil on a low flame.
Wheat can also be used with ragi in this recipe – the ratio becomes 1 : 1 : 1 : 0.2  of ragi : wheat : moong : methi.

Credit for this recipe goes to Dr Khader, our Homoeopathic Doctor and green revolutionary  - it's used by a lot of families in our circle.



An edited version of this article was published in Parent Circle, July 2012

Since when did GLUTEN become the enemy?

     Cases of Coeliac [see-li-yac] Disease have been recorded as early as the 2nd Century AD but only in WWII did a Dutch pediatrician tracking children with the condition notice that they seemed to be doing better during that time when wheat, barley and rye were restricted in war rations. He noted they took a turn for the worse after the war when supplies of these grains resumed. He proved the relationship between the protein present in these 3 grains – GLUTEN and the disease. This clinician, Willem Dicke, was the first to propound and frame guidelines for the gluten-free diet.

     While there have been numerous cases in the West, the incidence of a milder form of the condition, Gluten Intolerance as well as the full blown disorder in India have become a household discussion topic with many people now thinking that going gluten-free is the healthiest option.

     As a nutritionist facing questions about this topic from the people I counsel, I observe these trends with alarm – how is this information overload landing on the general public? The question in fact is - are the people reading these materials now educated about the condition? Are people recognizing their previously inexplicable symptoms and getting themselves and family members screened for the condition?

     I hope, at least, the latter is being accomplished because this is a serious disorder with serious health consequences if it remains undiagnosed. Research is now examining coeliac disease as a possible cause for osteoporosis, liver problems apart from anaemia and other nutrient deficiencies and their impacts.

      It is evident that, like Diabetes and Heart Disease initially in India, cases of coeliac disease and gluten intolerance largely go undiagnosed because of lack of awareness and unavailability of inexpensive large scale screening processes. Coeliac disease and Gluten intolerance cannot occur without genetic predisposition. We must develop simple, cost effective DNA tests to determine this tendency.

     Having said this, delving into research on the subject is dissatisfying for someone who’s interested in prevention. Not enough research is being done to answer several basic questions:

  • -          If a person is genetically predisposed, are there aggravating dietary factors which result in onset of symptoms? A possible avenue for deeper research could be the dependence on refined wheat (maida) – eating maida based junk food and maybe an unhealthy diet, especially low in whole grains, fruits and vegetables in general.
  • -          Continuing with this train of thought, is it a coincidence that the rise in prevalence of this condition through the ages is proportional to the extent which refined wheat flour based foods and unhealthy eating habits have become predominant globally?
  • -          If there are such aggravating factors, in the same genetically predisposed person - what are the effects of a multiple whole grain, healthy, balanced diet implemented as early as possible?
  • -          If a newborn is diagnosed with genetic predisposition, can it be symptom - free if breast fed exclusively for 6 months and introduced to wheat only after a year of life? Also, could life-long adherence to a multiple whole grain, largely natural, unprocessed, high fiber, balanced diet where wheat is an occasional inclusion be the answer to prevent symptoms from ever occurring?
     Ask people who follow a multiple whole grain diet (including wheat, whole rice, oats and millets) ingesting plenty of vegetables, fruits, legumes and whole pulses, nuts and dry fruits, etc with minimal junk food intake (such people do exist – including yours truly and extended family) whether they suffer from any digestive disruptions and the answer would be a resounding NO.

     For those of you who are pregnant or have young children, you need to know that research has proved that exclusive breast feeding for the first 6 months of life and continuing to breast feed in the weaning period while introducing wheat among other whole grain cereals not only decreases risk of gluten related disorders in later life, it also provides protection against other auto-immune conditions such as Down’s Syndrome, Insulin Dependent Diabetes, Systemic Lupus and Multiple Sclerosis. This is one of the reasons why in India, where extended breastfeeding is the norm, symptoms of sufferers start later in life and are generally much less severe than any Western nation.

     For a disease condition which only has a simple dietary solution (exclusion of gluten and gliadin containing foods - wheat, rye, barley and a few others), an entire industry has been built around it. From healthcare to publishing, from food manufacturing to media – millions, if not billions of dollars are made annually worldwide. So it is profitable to many to keep Coeliac Disease and Gluten Intolerance fresh in the minds and conversations of the public. If people, who have no business going gluten-free, want to do so, this industry welcomes them with open arms and tries to fan that flame as well with books and endorsements made by people who profit financially from doing so.

     Let’s be clear – going gluten-free or eliminating wheat completely from the diet has absolutely no benefits for a family or an individual having normal digestive health. Go ahead and include chapathis, whole wheat bread, daliya, etc in your diet. Just make sure you include the other whole grains mentioned above as well (you can also eliminate white rice and switch to red or brown). While you’re at it, limit consumption of maida and it’s products to an absolute minimum. Cereal grains are important in the Indian diet but aren’t the only components – eat a well balanced diet.

     One of the reasons that people (with average digestion) who go gluten-free report dramatic improvements is because they probably evaluate and healthily modify their eating habits, cut out maida products (which translates into most junk food) and include more varieties of whole grain cereals apart from other healthy practices. Anyone would show results if he/she did this.

     Switch off those alarm bells that have been ringing for some time – ignore this hype completely! Everyone just take a deep breath and relax. Don’t allow this topic to create any more stress or doubt for you than it already has. However, this is a great time to start to educate yourself with hard facts about what you can do to improve your family’s nutrition, health and fitness.