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Dr K K Aggarwal

What type of a vegetarian are you?

By Dr K K Aggarwal
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There are 4 main types of vegetarian diets:

  • Lacto–ovo–vegetarian consumes dairy products and eggs but no meat, poultry, or seafood
  • Lacto–vegetarian eats dairy products but no eggs, meat, poultry, or seafood
  • Ovo–vegetarian eats eggs but no dairy products, meat, poultry, or seafood
  • Vegan does not eat any animal products, including meat, fish, poultry, eggs, and dairy products; many vegans will also avoid honey.

Vegetarian and plant-based diets are associated with a reduced risk of obesity, diabetes, heart disease, and some types of cancer as well as increased longevity. Vegetarian diets are typically lower in fat, particularly saturated fat, and higher in dietary fiber. They are also likely to include more whole grains, legumes, nuts, and soy protein, and together with the absence of red meat, this type of eating plan may provide many benefits for the prevention and treatment of obesity and chronic health problems, including diabetes and cardiovascular disease.

What type of a vegetarian are you?

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , | | Comments Off on What type of a vegetarian are you?

There are 4 main types of vegetarian diets:

  • Lacto–ovo–vegetarian consumes dairy products and eggs but no meat, poultry, or seafood
  • Lacto–vegetarian eats dairy products but not eggs, meat, poultry, or seafood
  • Ovo–vegetarian eats eggs but no dairy products, meat, poultry, or seafood
  • Vegan does not eat any animal products, including meat, fish, poultry, eggs, and dairy products; many vegans will also avoid honey.

Vegetarian and plant–based diets are associated with a reduced risk of obesity, diabetes, heart disease, and some types of cancer as well as increased longevity. Vegetarian diets are typically lower in fat, particularly saturated fat, and higher in dietary fiber. They are also likely to include more whole grains, legumes, nuts, and soy protein, and together with the absence of red meat, this type of eating plan may provide many benefits for the prevention and treatment of obesity and chronic health problems, including diabetes and cardiovascular disease.

Artificial sweeteners in sweets may be harmful

By Dr K K Aggarwal
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In a joint statement, the American Heart Association and the American Diabetes Association have given a cautious recommendation to the use of nonnutritive sweeteners to help people maintain a healthy body weight and for diabetics to aid glucose control. These products should be considered like a nicotine patch. They are appreciably better than the real product (sugar), but not part of an optimal diet. The statement, published in both Circulation and Diabetes Care on July 9, 2012, warns that sweeteners are helpful only as long as people don’t eat additional calories later as compensation. The term nonnutritive sweeteners cover six sweeteners including aspartame, acesulfame K, neotame, saccharin, sucralose, and plant–derived stevia. These nonnutritive substances have zero calories. Two things may happen in terms of compensation

  1. Physiological, where the body might be expecting more calories and so the individual may be hungrier and therefore may eat more
  2. Psychological, where the individual thinks they are allowed to eat more sugar-rich food because they had a diet soda instead of a full–sugar soda.

When people use sweeteners there is compensation. The key is how much? Partial compensation is ok but people often completely compensate or even overcompensate, so these sweeteners have to be used smartly to be successful. Compensation seems less of a problem when these sweeteners are consumed in beverages as opposed to food. People don’t really notice the lack of calories in a diet soda and so don’t tend to eat more, whereas if they consume a low–calorie foodstuff, they do tend to eat more as compensation.

Its better when sweeteners are used in beverages and not sweets or other foods. One is not completely sure about the safety of these products, because their long–term use in humans has not been studied fully. However, the artificial sweeteners on the market are almost certainly safer than consuming large amounts of sugar, which has definite harm when consumed in large amounts. This harm, particularly when consumed in beverage form such as soda, includes increases in risks of obesity, diabetes, cardiovascular disease, and gout. A concern, though, is that just replacing sugar with artificial sweeteners leaves a person, especially children, conditioned to high levels of sweetness, which is likely to influence their food choices adversely.

Air pollution can raise blood pressure

By Dr K K Aggarwal
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Breathing polluted air for even 2 hours can increase blood pressure, potentially raising the risk of cardiovascular disease in those exposed to smog.

In susceptible patients this small increase may actually be able to trigger a heart attack or stroke. In a study, which appeared in the journal Hypertension, researchers tested 83 people as they breathed levels of air pollution similar to those in an urban city near a roadway. The air pollution caused diastolic pressure (lower number in a blood pressure reading) to rise within 2 hours. Blood vessels were impaired for as long as 24 hours. Tests showed that microscopic particles in the air, rather than ozone gases, caused the rise in blood pressure and impaired blood vessel function. If air pollution levels are forecasted to be high, those with heart disease, diabetes or lung disease should avoid unnecessary outdoor activity.

Blood vessels were impaired for as long as 24 hours. Tests showed that microscopic particles in the air, rather than ozone gases, caused the rise in blood pressure and impaired blood vessel function. If air pollution levels are forecasted to be high, those with heart disease, diabetes or lung disease should avoid unnecessary outdoor activity.

Artificial Sweeteners in Sweets May Be Harmful

By Dr K K Aggarwal
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The American Heart Association and the American Diabetes Association have given a cautious recommendation to the use of nonnutritive sweeteners to help people maintain a healthy body weight and for diabetics to aid glucose control. These products should be considered like a nicotine patch. They are appreciably better than the real product sugar but not part of an optimal diet. The joint statement published in both Circulation and Diabetes Care on July 9 2012 warns that sweeteners are helpful only as long as people don t eat additional calories later as compensation. The term nonnutritive sweeteners cover six sweeteners including aspartame acesulfame K neotame saccharin sucralose and plant derived stevia. These nonnutritive substances have zero calories. Two things may happen in terms of compensation 1. Physiological where the body might be expecting more calories and so the individual may be hungrier and therefore may eat more 2. Psychological where the individual thinks they are allowed to eat more sugar rich food because they had a diet soda instead of a full sugar soda. When people use sweeteners there is compensation. The key is how much Partial compensation is ok but people often completely compensate or even overcompensate so these sweeteners have to be used smartly to be successful. Compensation seems less of a problem when these sweeteners are consumed in beverages as opposed to food. People don t really notice the lack of calories in a diet soda and so don t tend to eat more whereas if they consume a low calorie foodstuff they do tend to eat more as compensation. Its better when sweeteners are used in beverages and not sweets or other foods. One is not completely sure about the safety of these products because their long term use in humans has not been studied fully. However the artificial sweeteners on the market are almost certainly safer than consuming large amounts of sugar which has definite harm when consumed in large amounts. This harm particularly when consumed in beverage form such as soda includes increases in risks of obesity diabetes cardiovascular disease and gout. A concern though is that just replacing sugar with artificial sweeteners leaves a person especially children conditioned to high levels of sweetness which is likely to influence their food choices adversely.

Weekend Social Jetlag can be heart unfriendly

By Dr K K Aggarwal
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Switching to late nights and late mornings on the weekend is associated with cardiometabolic risk. Termed social jetlag it is associated with poorer lipid profiles worse glycemic control and increased adiposity in healthy adults as per a report published in Journal of Clinical Endocrinology Metabolism. These metabolic changes can contribute to the development of obesity diabetes and cardiovascular disease. A total of 111 study participants had a social jetlag of more than 60 minutes. Compared to the other study participants these individuals had Higher mean triglycerides 107 mg dL versus 91 mg dL P 0.009 Lower mean HDL cholesterol 54 mg dL versus 57 mg dL P 0.014 Higher mean fasting insulin levels 13.5 U mL versus 12 U mL P 0.03 More insulin resistance as measured by homeostatic model assessment 4.0 versus 3.7 p 0.028 Greater mean waist circumference 94 cm versus 89 cm P 0.001 Higher mean BMI 28 versus 26 P 0.004 It has been shown that regulating sleep times can help treat insomnia and this emerging evidence along with others suggest that perhaps doing so will have benefits in treatment and prevention of other diseases.

Seven Behaviors Cut Heart Deaths

By Dr K K Aggarwal
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Seven heart–healthy behaviors can reduce the risk of death from cardiovascular disease. In a prospective study, by Enrique Artero, PhD, of the University of South Carolina, and colleagues and published in the journal Mayo Clinic Proceedings, those who met 3–4 of the American Heart Association’s ‘Simple Seven’ heart–health criteria had a 55% lower risk of cardiovascular mortality than those who met no more than two of those practices over 11 years. Four core behaviors 1. No smoking 2. Normal body mass index 3. Engaging in physical activity 4. Eating healthfully Three parameters 1. Cholesterol lower than 200 mg/dL 2. Blood pressure lower than 120/80 mm Hg 3. Not having diabetes

Restricting salt in diet can lower heart disease risk

By Dr K K Aggarwal
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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.

Stress may increase smoking habits

By Dr K K Aggarwal
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Stress increases the risk of heart attack by pushing people toward bad habits. A British study published in the Journal of the American College of Cardiology suggests that people with psychological stress had a 50% increased risk of a cardiovascular disease event over the follow–up period.

The reasons were higher smoking rates and low exercise levels of individuals who were stressed.

In the study over a 7-year follow–up period, incidence of cardiovascular events (heart attacks, stroke, bypass surgery)was 50% higher among the people with a high level of depression and anxiety when compared to happier people. Smoking and lack of physical activity explained about 63% of the increase, with smoking alone responsible for 41%.

Alcohol intake explained less than 2% of the increase, with high blood pressure assigned 13% of the blame. All such patients should be treated with combined physiological approaches with intensive lifestyle changes to reduce modifiable risk.

Women Beware Of Heart Disease

By Dr K K Aggarwal
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Cardiovascular disease is very common in women. The warning signals of heart attack include:

• Uncomfortable pressure, squeezing, fullness or pain in the center of the chest. It lasts more than a few minutes, or goes away and comes back.

• Pain or discomfort in one or both arms, the back, neck, jaw or stomach.

• Shortness of breath with or without chest discomfort.

• Breaking out in a cold sweat, nausea or lightheadedness. However, women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:

• Neck, jaw, shoulder, upper back or abdominal discomfort.

• Shortness of breath.

• Pain in one or both arms.

• Nausea or vomiting.

• Sweating.

• Lightheadedness or dizziness.

• Unusual fatigue.

In presence of any of the above one should not wait for more than five minutes and get to a hospital right away.

More than 80% of cardiac events in women can be prevented by modifying diet, exercise and abstinence from smoking.

Aspirin for the primary prevention of cardiovascular disease and cancer

By Dr K K Aggarwal
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People above the age of 50 without excess bleeding risk should take low-dose daily aspirin (75 to 100 mg) as per the current recommendations. 

Patients who are more concerned about the bleeding risks than the potential benefits (prevention of cardiovascular events and cancer) may reasonably choose to not take aspirin for primary prevention. 

Meta –analyses of randomized trials have shown aspirin to reduce the risk of non-fatal myocardial infarction (Arch Intern Med 2012; 172:209) and long–term aspirin use reduces overall cancer risk (Lancet 2012;379:1602). 

A meta–analysis addressing this combined outcome suggests that aspirin use in 1000 average risk patients at age 60 years would be expected to result, over a 10–year period, in six fewer deaths, 19 fewer non-fatal myocardial infarctions, 14 fewer cancers, and 16 more major bleeding events.

What type of a vegetarian are you?

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , | | Comments Off on What type of a vegetarian are you?

There are 4 main types of vegetarian diets:

  • Lacto–ovo–vegetarian consumes dairy products and eggs but no meat, poultry, or seafood
  • Lacto–vegetarian eats dairy products but not eggs, meat, poultry, or seafood
  • Ovo–vegetarian eats eggs but no dairy products, meat, poultry, or seafood
  • Vegan does not eat any animal products, including meat, fish, poultry, eggs, and dairy products; many vegans will also avoid honey.

Vegetarian and plant–based diets are associated with a reduced risk of obesity, diabetes, heart disease, and some types of cancer as well as increased longevity. Vegetarian diets are typically lower in fat, particularly saturated fat, and higher in dietary fiber. They are also likely to include more whole grains, legumes, nuts, and soy protein, and together with the absence of red meat, this type of eating plan may provide many benefits for the prevention and treatment of obesity and chronic health problems, including diabetes and cardiovascular disease.

Aspirin for the primary prevention of cardiovascular disease and cancer

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , | | Comments Off on Aspirin for the primary prevention of cardiovascular disease and cancer

People above the age of 50 without excess bleeding risk should take low-dose daily aspirin (75 to 100 mg) as per the current recommendations.

Patients who are more concerned about the bleeding risks than the potential benefits (prevention of cardiovascular events and cancer) may reasonably choose to not take aspirin for primary prevention.

Meta –analyses of randomized trials have shown aspirin to reduce the risk of non-fatal myocardial infarction (Arch Intern Med 2012; 172:209) and long–term aspirin use reduces overall cancer risk (Lancet 2012; 379:1602).

A meta–analysis addressing this combined outcome suggests that aspirin use in 1000 average risk patients at age 60 years would be expected to result, over a 10–year period, in six fewer deaths, 19 fewer non-fatal myocardial infarctions, 14 fewer cancers, and 16 more major bleeding events.

Restricting salt in diet can lower heart disease risk

By
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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. Quoting a Harvard Medical School study published in British Medical Journal, Dr Aggarwal said that 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.

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.

WHO recommends limiting the salt intake to less than 5 grams per day.

Indian government is envisaging compulsory treatment of some sex offenders with antiandrogenic drugs, commonly referred to as chemical castration.

Laws in several American states allow compulsory medical treatment of offenders who have committed serious sex offences. Chemical, as well as physical, castration of sex offenders takes place in psychiatric hospitals in theCzechRepublicunder the legal framework of “protective treatment.” Meanwhile, inEnglandthe Department of Health is supporting an initiative to facilitate the prescription of drugs on a voluntary basis for sex offenders in the criminal justice system.

Demand for the prescription of antiandrogens or physical castration for sex offenders is a common reaction by lawmakers and politicians when a high profile sexual crime is committed.

Whether medical or surgical, the procedure requires the participation of doctors. It also shifts the doctor’s focus from the best interests of the patient to one of public safety.

Antiandrogenic drugs and physical castration undoubtedly reduce sexual interest (libido) and sexual performance, and they reduce sexual reoffending.

Physical castration of sex offenders was carried out in several European countries in the first part of the 20th century.

Nowadays drugs are usually used alongside psychological treatment).

The main drugs used are cyproterone acetate (in the United Kingdom, Europe, and Canada); medroxyprogesterone (in the United States); and increasingly the more expensive but possibly more potent gonadotrophin releasing hormone agonists such as leuprolide, goserelin, and tryptorelin.

Although these drugs act in different ways, they all reduce serum testosterone concentrations in men to prepubertal values.

Castration, however—whether chemical or physical—is associated with serious side effects, including osteoporosis, cardiovascular disease, metabolic abnormalities, and gynaecomastia. Physical castration is mutilating and irreversible, and it carries the potential for serious psychological disturbance, although some offenders request it nonetheless.

Is there a clear medical rather than social reason for prescribing powerful drugs.

When the intensity or ability to control sexual arousal is the presenting feature—whether it manifests as frequent rumination and fantasy or strong and recurrent urges—then treatment directed towards the biological drive makes sense.

Treatment protocols can then be based on the medical indication (remembering that drugs other than the antiandrogens, such as selective serotonin reuptake inhibitors, can also be effective, particularly when sexual rumination is the presenting problem) rather than on risk.

When drugs work the clinical effect is often dramatic, with offenders reporting great benefit from no longer being preoccupied by sexual thoughts or dominated by sexual drive. These drugs can also allow offenders to participate in psychological treatment programmes where previously they may have been too distracted to take part. Given the transparency of benefits and risks, there is no obvious reason why an offender should not be able to make an informed choice about drugs. [Source BMJ, 2010]