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Dr K K Aggarwal

When it comes to losing weight, cut down on liquid calories rather than food.

Body is able to self-regulate its intake of solid food. If you eat too much solid food at lunch, you’ll tend to eat less at dinner. But the same self-regulation is not in place for what you drink. The body does not adjust to liquid calories, so over time, you gain more weight.

Cutting back on calories from sugary drinks – by only one serving per day – can account for nearly two-and-a-half pounds of lost weight over 18 months.

Beverages are categorized into eight categories

  1. Sugar-sweetened beverages (including soft drinks, fruit drinks, fruit punch, or high-calorie beverages sweetened with sugar)
  2. Diet drinks such as diet soda and other diet drinks that were artificially sweetened
  3. Milk (including whole milk, 2 percent milk, and 1 percent skim)
  4. 100 percent fruit and vegetable juice
  5. Coffee and tea with sugar
  6. Coffee and tea without sugar
  7. Alcoholic beverages
  8. Water with no calories

The best drinks are water, plain soda and tea/coffee with no sugar.

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As per WHO, one should not take more than 5gm of salt in a day. If salt intake is reduced, the incidence of heart attack, heart failure, will be reduced substantially.

Here are some ways to reduce salt intake:

  1. Substitute white salt with black salt wherever possible.
  2. Do not keep salt shaker on the table.
  3. Do not add salt in your food except in pulses and cooked vegetables.
  4. Do not add salt to salads.
  5. Avoid adding salt to foods at the table.
  6. Take stock of the sources of salt in your diet, such as restaurant meals, salt-based condiments and convenience foods. Some of these are really loaded with salt.
  7. Read the labels when shopping. Look for lower sodium in cereals, crackers, pasta sauces, canned vegetables, or any foods with low-salt options. Or, eat less processed and packaged foods.
  8. Ask about salt added to food, especially at restaurants. Most restaurant chefs will omit salt when requested.
  9. Remember the word ‘Na’, which is present in many drugs, soda etc.
  10. Nothing can be preserved without adding salt to it, therefore beware of processed and frozen fruits.
  11. Many sweet food items have significant hidden salt in them.
  12. To cook with reduced salt, add more lemon, garlic, amchur (mango powder) etc.
  13. It takes three months of salt-free diet to get adjusted to it and to ultimately start liking it.
  14. Never add salt to milk.
  15. Beware of salt in tooth pastes.
  16. Replace sodium with potassium salt.

Achar, papad, chutney traditionally used in Indian diet have very high salt content. Most sauces will also have very high salt content.

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Restricting salt in the diet can lower the risk of developing heart disease by 25 percent and the risk of dying from heart disease by 20 percent.

Dietary intake of sodium among Indians is excessively high. Among hypertensive individuals, lowering sodium is quite well established to lower blood pressure, but now it has been shown that reducing salt also has an effect on cardiovascular disease as shown in a Harvard Medical School study published in British Medical Journal.

When people with pre hypertension (blood pressure more than 120/80 and lower than 140/90), reduced their salt intake by about 25 to 35%, they were 25% less likely to develop cardiovascular disease 10 to 15 years after the trial ended. There was also a 20 percent lower death rate from cardiovascular disease among those who cut their salt consumption.

Salt restriction is best achieved by avoiding salted, salt cured and salt smoked foods such as lunch meat, hot dogs, ham, olives, pickles and regular salted canned foods, and other prepared foods, which often use more salt than homemade equivalents. Foods we would never think of as salty, such as breakfast cereals, cookies, and even some soft drinks, often contain copious additions of sodium.

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Cholesterol tips

By Dr K K Aggarwal
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Blood lipid levels may exhibit mild seasonal variation with a drop in the summer and total cholesterol level peaking in the winter. The variation can be up to 5 mg/dL Serum total and HDL-cholesterol can be measured in fasting or non-fasting individuals. There are only small clinically insignificant differences in these values when measured in the fasting or non-fasting state.

The total cholesterol can vary by 4 to 11 percent within an individual due to multiple factors including stress, minor illness and posture. Values may also vary between different laboratories, with data suggesting that a single measurement of serum cholesterol can vary as much as 14 percent. Therefore in an individual with “true” serum cholesterol concentration of 200 mg/dL the range of expected values is 172 to 228 mg/dL.

More than one measurement of total cholesterol should therefore be obtained when treatment considerations demand a precise determination. Measurement of serum HDL-C and triglycerides may demonstrate even greater variability.

A standard serum lipid profile consists of total cholesterol, triglycerides, and HDL-cholesterol. Lipid profile should be performed after 12 to 14 hours of fasting to minimize the influence of postprandial hyperlipidemia. One can use either plasma or serum specimen. The serum cholesterol is approximately 3 percent lower than the plasma value.

 


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While automobile vehicles need preventive servicing every three months, the human body needs it every two months. According to Ayurveda, the seasons change every two months, approximately in the middle of the month. Ayurveda describes these changes and precautions to be taken in great detail. The current makar rashi season, which starts today with sun changing its direction northwards resulting into lengthening of day and shortening of night time needs many lifestyle changes to balance health and prevent diseases. Vata gets aggravated, kapha gets accumulated and pitta gets depleted in this season. In allopathic language, pitta denotes metabolic functions, vata signifies movement functions and kapha stands for secretory functions of the body. Lohri, Makar Sankranti and Pongal are celebrated with khichdi, milk, gur, bhaat, sesame (Til) laddu, light hot food and beverages, etc. all indicating measures to reduce vata and kapha and to increase pitta in the body.

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Longer duration of chest pain means bigger MI risk

By Dr K K Aggarwal
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Patients with acute myocardial infarction have longer duration of chest pain than those without a myocardial infarction. Patients with chest pain of short duration, less than 5 minutes, are unlikely to have an acute infarction and have a good prognosis at 30 days. A single–center study showed that only 8.9% of the patients received a final diagnosis of acute MI, and these patients had a significantly longer duration of chest pain compared with the rest of the cohort (120 versus 40 minutes) according to Carlos Calle–Muller, MD, of Henry Ford Hospital in Detroit, and colleagues. Those who had chest pain lasting less than 5 minutes always had a good outcome, with no acute MIs or deaths within 30 days, as reported in the journal Critical Pathways in Cardiology. If the clinical assessment and ECG are benign, such patients might be able to be discharged directly from the emergency department without stress testing for outpatient follow-up. The median chest pain duration was 180 minutes among the 10 patients who died and only 40 minutes for the others. Among patients with acute MI, longer chest pain duration was not associated with higher 30–day mortality, but it was associated with a higher initial level of cardiac troponin-I.

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Cigarettes should be regulated

By Dr K K Aggarwal
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Electronic cigarettes are a new fad in the society. Not only adults, children too are getting hooked to them. They are easily available through Internet and can be ordered and purchased in Indian rupees. In its policy statement on e-cigarettes, published in the journal Circulation, the American Heart Association has asked the federal government to ban the sale of e-cigarettes to minors on the lines of the ban of cigarettes and smokeless tobacco products. The report has shown concern about the industries marketing and advertising e–cigarettes to children. In the US alone, there are 466 brands and 7764 unique flavors of e–cigarette products available. These flavors have been specifically designed to attract the youth. For the youth, an e-cigarette is high–tech, interesting and cool. In the US and in the west, an alarming number of middle and high school children are experimenting with e–cigarettes. It has also been seen that in experimental e–cigarette users, converting to regular smoking is very high. The efficacy of e–cigarettes as a primary smoking cessation therapy has not been established. A recent study published in the March 2017 of the journal JAMA Cardiology has shown an association of habitual e-cigarette use with increased cardiovascular risk.

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Why can the body be revived even after hours of death in hypothermia?

By Dr K K Aggarwal
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  • It is a well–known phenomenon that cardiopulmonary resuscitation (CPR) is not successful if the body temperature is less than 35°C.
  • In hypothermic deaths, a person can be revived even after hours of cardiac arrest. Only when the body temperature is brought back to normal, will CPR be effective. This would mean that consciousness gets frozen and does not leave the body when the temperature is below 35°C. This forms the basis for induced hypothermia after death to revive the brain.
  • Modern science is silent about this mechanism but ancient Indian literature talks about it in great detail. As per Chandogya Upanishad (6.15.1), the process of death takes time and is a sequential process.
  • First, the motor indriyas organs (Karma Indriyas) stop functioning then the sensory indriya organs (Gnanaindriyas) followed by cessation of prana or respiration.
  • Once this happens, the frozen sensory organs, motor organs, manas (mind, body, memory and ego) and prana have to get dissolved in Tej and then leave the body, which means presence of Tej is the most important factor for consciousness to leave the body.
  • In modern science, Tej would be governed by the body temperature. That means if the body temperature is low, the motor and sensory indriyas and manas product (Vritti) will find no heat or Tej to dissolve and come out of the body.
  • Therefore, till the body temperature (Tej) is brought back to normal, the indriyas will cease to function but still be revivable.
  • This process may take up to 48 minutes in presence of Tej and there is no time limit if Tej is absent.
  • A clinically dead person with cardiac arrest therefore will have absent functioning of Manas organs, Sensory organs, mind, intellect, memory and ego with no respiration but yet revivable back to life.
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