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Dr K K Aggarwal

Eating Out Tips

By Dr K K Aggarwal
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• Curb portions: Always order for one if you are two people and if you are alone set aside some of what is on your plate to bring home.

• Resist refined carbohydrates.

• Load your plate with colorful choices at the salad bar with vegetables, fruits, and small amounts of lean protein. Skip the creamy dressings.

• Choose dishes that are grilled, roasted, steamed, or sautéed.

• Don’t be afraid to request a salad, vegetables, or fruit instead of starchy side dishes.

• In non–vegetarian food, order only fish or seafood.

• If you decide to have dessert, share it with your dining companion(s).

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Treatment of acute leg cramps

By Dr K K Aggarwal
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Patients with an acute leg cramp should forcefully stretch the affected muscle, as an example by active dorsiflexion of the foot with the knee extended, when the cramp is in the calf.

Some patients may also find relief from passive stretching by getting out of bed and standing with the foot flat on the floor then pressing downward firmly, although active dorsiflexion of the foot may be more effective.

Other measures that may offer relief from the acute cramp include:

• Walking or leg jiggling followed by leg elevation

• A hot shower with the stream directed at the cramp area of the body, usually for five minutes, or a warm tub bath

• Ice massage

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Alcohol: Benefits Vs Risk

By Dr K K Aggarwal
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• There is consensus that nondrinkers should not start and the ones who drink can continue provided they do so in moderation and in absence of contraindications. People tend to consume more alcohol in winter and near the New Year.

• Persons who have been lifelong abstainers cannot be easily compared with moderate or even rare drinkers. Recommending alcohol intake to them even if they would agree to drink is not justified.

• The diseases that moderate alcohol use prevents (such as coronary heart disease, ischemic stroke, and diabetes) are most prevalent in the elderly, men, and people with coronary heart disease risk factors. For these groups, moderate alcohol use is associated with a substantial mortality benefit relative to abstention or rare drinking.

• For young to middle–aged adults, especially women, moderate alcohol use increases the risk of the most common causes of death (such as trauma and breast cancer).

• Women who drink alcohol should take supplemental folate to help decrease the risk of breast cancer.

• Men under the age of 45 may also experience more harm than benefit from alcohol consumption. In this age group, moderate alcohol use is unlikely to provide any mortality benefit, but consumption of less than one drink daily appears to be safe if temporally removed from operation of dangerous equipment. For individuals with established contraindications to alcohol use, even this level of alcohol use is dangerous.

• Men can tolerate more alcohol than women. The ideal therapeutic dose of alcohol is around 6 grams per day. Medically safe limits are 10 grams in one hour, 20 grams in a day and 70 grams in a week. (50% for the women).

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An over–the–counter antacid is often used to relieve mild cases of heartburn or acid reflux. Though they are available without a doctor’s prescription they should be taken only under a doctor’s advice.

As per American Academy of Family Physicians

• Different types of antacids work in different ways.

• To manage an ulcer, an antacid may need to be taken in conjunction with an antibiotic.

• If one needs more calcium to help strengthen bones, prefer an antacid that contains calcium carbonate.

• Antacids may have minor side effects in some such as nausea, headache, diarrhea or constipation.

• Read the label carefully to make sure that you are not allergic to any of the ingredients.

• People with kidney disease may not be able to take all types of antacids.

• An antacid may interact with other medications.

So, talk to the doctor before taking an antacid.

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Don’t ignore women’s health

By Dr K K Aggarwal
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Women are not diagnosed or treated as aggressively as men. Even though more women than men die of heart disease each year, women receive only 33% of all angioplasties, stents and bypass surgeries; 28% of implantable defibrillators and 36% of open–heart surgeries, according to the National Coalition for Women with Heart Disease.

Although the traditional risk factors for coronary artery disease — such as high cholesterol, high blood pressure and obesity — have a detrimental impact in men and women, certain factors play a bigger role in the development of heart disease in women.

• Metabolic syndrome — a combination of increased blood pressure, elevated blood glucose and triglycerides — has a greater impact on women than men. • Mental stress and depression affect women’s hearts more than they do men’s.

• Smoking is much worse for women than men.

• A low level of estrogen before menopause is a significant risk factor for developing microvascular disease.

• Though women will often have some chest pain or discomfort, it may not be the most prominent symptom. Diffuse plaques build–up and diseased smaller arteries are two reasons why symptoms can be different in women.

• In addition to chest pain, pressure or discomfort, signs and symptoms of heart attack in women include: Neck, shoulder, upper back or abdominal discomfort, shortness of breath, nausea or vomiting, sweating, light–headedness or dizziness and unusual fatigue.

• Endothelial dysfunction is more common in women. In this the lining of the artery does not expand (dilate) properly to boost blood flow during activity, which increases the risk of coronary artery spasm and sudden death.

• Results of the WISE study suggest that the commonly used treatments for coronary artery disease — angioplasty and stenting — are not the best options for women with more diffuse plaques.

• Typical tests for coronary artery disease — angiogram, treadmill testing and others — are not reliable in women.

• The WISE study showed that in some women, plaques accumulate as an evenly spread layer along artery walls, which is not visible using traditional testing methods.

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Tips for healthy ageing

By Dr K K Aggarwal
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• Quit smoking: This is the first and foremost critical step that you can take in order to improve your health and combat age related health complications. Smoking kills by causing deadly diseases like cancer, strokes and heart failure. If you were a smoker in your younger years and still are, it is not too late to quit this fatal habit.

• Stay active: Make it a daily routine to undertake something that keep you fit and active. Let it be something that promotes strength, balance and flexibility and most importantly, something that you enjoy. Physical activity is critical for maintaining a healthy weight, controlling illness, promoting bone strength and reducing stress.

• Prevent accidental falls: Elderly people are especially vulnerable to accidental falls. They can be prevented by making small changes around your house like removing loose rugs and carpets, keeping walking paths free of cords and clutters and using night lights for hallways. Wearing good friction supporting shoes has been observed to significantly prevent falls.

• Stay updated with immunizations and screenings: Women over 50 should maintain regular mammography screening for breast cancer and Pap smear test for cervical cancer. Similarly, men should get screened for prostate cancer. Some preventive vaccinations against infections that can occur during old age are also available. Cholesterol, lipid profile and thyroid screenings are equally important. Consult your healthcare provider for these options.

• Maintain a heart healthy lifestyle: The chances of heart disease increase significantly as you grow older. To combat this deadly disease, maintain a healthy body mass index (BMI), keep your blood pressure in check and eat a healthy diet with less salt/sugar and cholesterol.

• Eat well: A well-balanced healthy diet when combined with moderate physical activity can be the key to healthy aging. Many illnesses like heart disease, hypertension, diabetes, obesity and osteoporosis are strongly linked to what you eat. Calcium and vitamin D supplements can help women.

• Stay mentally active: Maintain a good amount of mental activity in old age to counter dementia and cognitive impairment that come with aging. Any issues of mental lapse and memory problems should be addressed promptly.

• Sleep well: Many elderly people face problems with maintaining a healthy sleep cycle. Insomnia and daytime sleepiness in excess are common complaints, talk to your healthcare provider about such issues.

• Manage stress: Old age can be stressful, especially due to emotional trauma associated with loss of loved ones, major life transitions and loneliness. Try exercise and relaxation techniques like yoga or meditation. Old age can be a great time to renew your social circle. Practice the art of positive thinking, it may seem small but it can take your health a long way. Keep you sense of humor, those laughing exercises may look silly but are really helpful.

• Get regular checkups for dental, vision and hearing health: Your teeth, gums, vision and hearing have the potential to last a lifetime, if cared for properly. Get regular checkups with your healthcare provider to understand how old age affects these aspects and what changes you can incorporate to keep them healthy.

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Follow these to beat arthritis

By Dr K K Aggarwal
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• Exercise routinely to maintain the flexibility of the bones

• Don’t smoke as it can lead to rheumatic arthritis

• Eat a low-fat diet; increase the consumption of whole grains, fruits and vegetables. People who eat such foods are on a low risk of developing arthritis

• Consume more of vitamin C if you are an arthritis patient. The best sources of vitamin C are strawberries, kiwi, pineapple, kidney beans, cabbage and cauliflower.

• People who consume Omega 3 have fewer chances of developing swelling and stiffness in the joints. The best sources for the daily dose of Omega 3 are salmon, trout, sardines, mackerel and anchovies. And if you are a vegetarian, then walnuts, fish oil supplements and flaxseed are some of the options

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Diabetes mainly linked to obesity

By Dr K K Aggarwal
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Type 2 diabetes mellitus is strongly associated with obesity. More than 80 percent of cases of type 2 diabetes can be attributed to obesity.

• There is a curvilinear relationship between BMI and the risk of type 2 diabetes.

• Lowest risk is associated with a BMI below 22 kg/m2

• At a BMI greater than 35 kg/m2, the relative risk for diabetes adjusted for age increases to 61. The risk may further increase by a sedentary lifestyle or decrease by exercise.

• Weight gain after age 18 years in women and after age 20 years in men increases the risk of type 2 diabetes.

• The Nurses’ Health Study compared women with stable weight (those who gained or lost <5 kg) after the age of 18 years to women who gained weight. Those who had gained 5.0 to 7.9 kg had a relative risk of diabetes of 1.9; this risk increased to 2.7 for women who gained 8.0 to 10.9 kg.

• Similar findings were noted in men in the Health Professionals Study. The excess risk for diabetes with even modest weight gain is substantial.

• Weight gain precedes the onset of diabetes. Among Pima Indians (a group with a particularly high incidence of type 2 diabetes), body weight gradually increased 30 kg (from 60 kg to 90 kg) in the years preceding the diagnosis of diabetes. Conversely, weight loss is associated with a decreased risk of type 2 diabetes.

• Insulin resistance with high insulin levels is characteristic of obesity and is present before the onset of high blood sugar levels.

• Obesity leads to impairment in glucose removal and increased insulin resistance, which result in hyperinsulinemia. Hyperinsulinemia contributes to high lipid levels and high blood pressure.

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