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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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Energy drinks may raise blood pressure and prolong QT interval increasing the risk of sudden cardiac death. In a meta-analysis by Sachin A. Shah at University of the Pacific in Stockton, Calif, with a pooled analysis of 93 people who consumed energy drinks, the QT interval on an ECG was significantly prolonged by 10 ms. The threshold level of regulatory concern is around 5 ms. In another pooled analysis of 132 people by the same group, researchers found a significant increase in systolic blood pressure by 3.5 mmHg that was associated with the consumption of energy drinks. Doctors are generally concerned if patients experience an additional 30 ms in their QT interval from baseline. QT prolongation is associated with life-threatening arrhythmias. Most energy drinks have caffeine. Drinks such as Monster, Red Bull, Rockstar, Full Throttle and AMP have three times the amount of caffeine as colas. A 16-oz. can of Monster Energy, for example, contains 160 mg of caffeine, which is almost as much as 5 cans of soda.
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• Replace your contact lens case regularly. • Do not sleep or nap while wearing contact lenses. • Don’t swim or shower while wearing contact lenses. (Source: CDC)

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Consuming tobacco can increase the cardiovascular age of a person, which can be much higher than the biological age. Cardiovascular aging in chronic smokers can be 10 years more than the biological age. This can be calculated by measuring the wall thickness of the carotid neck artery supplying blood to the brain. Apart from that, one can also measure the endothelial functions of the brachial artery supplying blood to the hand. Cardiac age of a person is calculated by measuring the relaxation functions of the heart. With advancing age the heart fails to relax properly. This relaxation abnormality usually comes after the age of 60. If the same is seen at the age of 40, one knows what the biological age and cardiac age is. The good news is that cardiovascular age of a person can be regressed by quitting smoking and tobacco along with adoption of a healthy lifestyle including diet and exercise. Graying of the hair may not be sufficient to know the age of a person. Today, it is the cardiovascular age which is important.

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Lose weight: For every extra pound you carry, you put about three pounds of additional pressure on your knees and multiply the pressure on your hips by six. If you have arthritis, losing just 15 pounds can cut your knee pain in half. If you do eventually need a joint replaced, losing weight beforehand can reduce your risk of having complications from surgery. Swimming, walking, or riding a stationary bike are the way to go. • Take care when using your joints: By standing up straight instead of slouching you can protect the joints in your neck, hips, and knees. Also use the proper technique when lifting or carrying anything heavy. If any activity hurts, stop doing it right away. • Try nonsurgical approaches before turning to surgery: Treatment with steroid injections is one approach. Benefits can last anywhere from 4 to 6 months. However, it doesn’t work for everyone. Viscosupplementation involves injecting a lubricating fluid into damaged knee joints to treat osteoarthritis. • Get pain relief: Use NSAIDs. There is also some evidence that the dietary supplement glucosamine chondroitin can lead to subtle improvements in arthritis pain. “It doesn’t rebuild joints, but it does seem to help with the pain. • If you can’t escape from joint pain even while at rest, your pain is only relieved by narcotic medications, or your function is severely compromised, it’s time to consider a joint replacement.

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If you have heart failure, call your doctor if you notice any of these signs: • Sudden weight gain (2–3 pounds in one day or 5 or more pounds in one week) • Extra swelling in the feet or ankles • Swelling or pain in the abdomen • Shortness of breath not related to exercise • Discomfort or trouble breathing when lying flat • Waking up feeling short of breath • Coughing or wheezing • Increased fatigue • Mental confusion • Loss of appetite

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Premature heart disease is when heart disease occurs before 55 years in men and 65 years in women. In premature heart disease, the prevalence of dyslipidemia (high cholesterol levels without symptoms) is 75-85%. Fifty-four percent of all patients with premature heart disease and 70% of those with a lipid abnormality have a familial disorder. Hence, a screening test for lipids is recommended for first-degree relatives of patients with myocardial infarction, particularly if premature. Screening should begin with a standard lipid profile and if normal, further testing should be done for Lp(a) and apolipoproteins B and A-I. About 25% patients with premature heart disease and a normal standard lipid profile will have an abnormality in Lp(a) or apo B. Elevated apo A-1 and HDL are likewise associated with reduced CHD risk. First-degree relatives are brothers, sisters, father, mother; second-degree relatives refer to aunts, uncles, grandparents, nieces, or nephews and third-degree relatives refer to first cousins, siblings, or siblings of grandparents. Familial hypercholesterolemia (FH) is a genetic disorder, characterized by high cholesterol, specifically very high LDL (“bad cholesterol”) levels and premature heart disease. Patients may develop premature cardiovascular disease at the age of 30 to 40. Heterozygous FH is a common genetic disorder, occurring in 1:500 people in most countries. Homozygous FH is much rarer, occurring in 1 in a million births. Heterozygous FH is normally treated with drugs. Homozygous FH often does not respond to medical therapy and may require apheresis or liver transplant. To detect familial high cholesterol levels, a universal screening must be done at age 16. The cholesterol levels in heterozygous patients are between 350 to 500 mg/dL, and in homozygous, the levels are between 700 to 1,200 mg/dL.

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Smoking is still the leading preventable cause of death. Not only does tobacco smoke cause lung cancer, it is also implicated in heart disease, other cancers and respiratory diseases. As per WHO, an estimated 3 million people in industrialized countries will have died as a result of tobacco use by 2030, and an additional 7 million people in developing countries face the same fate. Women who quit smoking have a 21 percent lower risk of dying from coronary heart disease within five years of quitting their last cigarette. The risks of dying from other conditions also decline after quitting, although the time frame varies depending on the disease. For chronic obstructive pulmonary disease, it may take up to 20 years. It’s never too early to stop, and it’s never too late to stop. Women who are current smokers have almost triple their risk of overall death compared with non smoker women. Current smokers also have a 63 percent increased risk for colon cancer compared with never-smokers, while former smokers have a 23 percent increased risk. There was no significant association between smoking and ovarian cancer. Women who started smoking earlier in life are at a higher risk for overall mortality, of dying from respiratory disease and from any smoking–related disease. However, a smoker’s overall risk of dying returns to the level of a never–smoker 20 years after quitting. The overall risk decline by 13 percent within the first five years of abstaining. Most of the excess risk of dying from coronary heart disease vanishes within five years of quitting. For chronic obstructive pulmonary disease, the return to normal takes 20 years, although there is an 18 percent reduction in the risk of death seen within five to 10 years after quitting. And the risk for lung cancer does not return to normal for 30 years after quitting, although there is a 21 percent reduction in risk within the first five years.

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