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Dr K K Aggarwal

Cycling can cause erectile dysfunction

By Dr K K Aggarwal
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Age, diabetes, hypertension, obesity, high lipids, smoking, drugs, heart disease, upright cycling for more than 3 hours a week can cause erectile dysfunction in males. For those who ride bicycles for more than 3 hours a week should do so in a reclining position and not upright position.

A man is considered to have erectile dysfunction when he cannot acquire or sustain an erection of sufficient rigidity for sexual intercourse. Any man may, at one time or another during his life, experience periodic or isolated sexual failures.

The term “impotent” is reserved for those men who experience erectile failure during attempted intercourse more than 75 percent of the time. Heart disease increases the risk for later erectile dysfunction. Erectile dysfunction may be an early warning sign of future heart disease. Men with erectile dysfunction without an obvious cause (e.g., pelvic trauma), and who have no symptoms of heart disease, should be screened for heart disease prior to treatment since there are potential cardiac risks associated with sexual activity in patients with heart disease.

Eight of the 12 most commonly prescribed medications list impotence as a side effect and it is estimated that 25 percent of cases of erectile dysfunction are due to drugs.

Depression, stress, or the drugs used to treat depression can result in erectile dysfunction.

Neurologic causes of erectile dysfunction include stroke, spinal cord or back injury, multiple sclerosis, or dementia. In addition, pelvic trauma, prostate. Surgery or priapism may cause erectile dysfunction.

Bicycling, less obvious, but of increasing importance, has been the possible association of erectile dysfunction with bicycling. Anything that places prolonged pressure on the pudendal and cavernosal nerves or compromises blood flow to the penile artery can result in penile numbness and impotence.

Cycling-induced impotence is primarily a problem of serious cyclists and has been reported to occur in Norwegian men competing in a 540 km bicycle race.

The penile numbness is attributed to the pressure on the perineal nerves whereas the erectile dysfunction is thought to be due to a decrease in oxygen pressure in the pudendal arteries.

Recreational cyclists, those who cycle for less than 3 hours per week and men who cycle in a reclining position avoid the sustained intense pressure on the penile nerve and artery and are less likely to experience sexual side effects. Continued cycling in a seated upright position can reduce the penile oxygen levels lasting 10 minutes.

HCFI tips for fasting

By Dr K K Aggarwal
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  1. Plan your diet especially if you have medical conditions such as diabetes and hypertension. Do not skip your medication schedule. Keep a healthy snack handy for those cravings.
  2. Keep yourself hydrated by drinking water, coconut water, green tea, buttermilk, and lime juice. Avoid aerated drinks.
  3. Avoid gorging on salty ‘vrat snacks’. Eat something that is boiled or roasted instead.
  4. Use rock salt in your food instead of usual salt as it helps in better mineral absorption. It is also beneficial for those who have high or low blood pressure.
  5. Eat lighter meals as these can aid digestion.
  6. For dessert, you can try eating dates or fruit yogurt. Also, add honey instead of sugar.
  7. Eat lots of fresh fruits and vegetables.

Harvards Medical schools 4 exercising tips for people with diabetes

By Dr K K Aggarwal
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Get a “preflight” check

  1. Talk with your doctor before you start or change a fitness routine.
  2. Especially if you are overweight or have a history of heart disease, peripheral vascular disease, or diabetic neuropathy.
  3. Go for a complete physical exam and an exercise stress test for people if you are 35 or older and who have had diabetes for more than 10 years. The results can help determine the safest way for you to increase physical activity.

Spread your activity throughout the week

  1. Adults should aim for a weekly total of at least 160 minutes of moderate aerobic activity, or 80 minutes of vigorous activity, or an equivalent mix of the two.
  2. Be active at least 3 to 5 days a week.

Time your exercise wisely

  1. The best time to exercise is 1 to 3 hours after eating, when your blood sugar level is likely to be higher.
  2. If you use insulin, it’s important to test your blood sugar before exercising. If it is below 100 mg/dL, eat a piece of fruit or have a small snack to boost it and help you avoid hypoglycemia. Test again 30 minutes later to see if your blood sugar level is stable.
  3. Check your blood sugar after any particularly grueling workout or activity.
  4. If you use insulin, your risk of developing hypoglycemia may be highest 6 to 12 hours after exercising.
  5. Do not exercise if your blood sugar is too high (over 250).

Be prepared

  1. Should you experience a medical problem while exercising (or at any time) it is important that the people who care for you know that you have diabetes.
  2. Keep card handy or glucose tablets with you while exercising in case your blood sugar takes a sudden nosedive.

What type of a vegetarian are you?

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

  1. Lacto–ovo–vegetarian consumes dairy products and eggs but no meat, poultry, or seafood

  2. Lacto–vegetarian eats dairy products but not eggs, meat, poultry, or seafood

  3. Ovo–vegetarian eats eggs but no dairy products, meat, poultry, or seafood

  4. 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.

Diabetics should take pneumonia vaccine

By Dr K K Aggarwal
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Diabetes is associated with a 25–75% increase in the relative risk of hospitalization due to pneumonia. Hence, patients with diabetes, especially those who have had diabetes for a longer duration should be given flu and pneumococcal vaccine. It is equally important to control diabetes adequately to prevent pneumonia-related hospitalization among diabetic patients.

In the study Dr. Jette B. Kornum from Aarhus University Hospital, Aalborg and colleagues identified 34,239 individuals with a pneumonia–related hospital admission and 342,390 individuals from the general population who served as a control group. The study showed that individuals with diabetes had a 26% higher risk of pneumonia–related hospitalization compared with those without diabetes. The risk of pneumonia–related hospitalization was increased by 4.4–fold in subjects with type 1 diabetes and by 1.2–fold in those with type 2 diabetes.

The maximum risk was related to longer duration of diabetes (more than 9 years) with poor glycemic control (A1c > 9%). The risk was 37% higher in diabetics of over 9 years duration and 60% higher when the A1c was over 9% as compared to 22% higher risk when the A1c was lower than 7%.

A1c is the measure of average blood sugar of the last three months and should be kept lower than 7%.

A mix of exercise protocol is better

By Dr K K Aggarwal
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A combination of weight training and aerobic exercise is the best prescription for overweight patients at risk for diabetes and heart disease.

Only aerobic exercise is also good as it reduces weight and inches off the waistlines. Jut weight lifting alone has very little benefit.

According to a study published in the American Journal of Cardiology, people in the weight-training group gained about 1.5 pounds and those in the aerobic group lost an average of 3 pounds and half an inch from their waists. Those who did both weight and aerobic training dropped about 4 pounds and 1 waistline inch.  This group also had lower diastolic lower blood pressure as well as a decline in metabolic syndrome score. Both the aerobic-only group and the combined-exercise group also lowered their levels of bad triglycerides.

Kidney patients more at risk for future heart attacks

By Dr K K Aggarwal
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Chronic kidney disease patients with kidney function less than 60% are included in the list of criteria for defining people at highest risk for future heart attacks. In a large cohort Canadian study published in The Lancet led by Dr Marcello Tonelli at University of Alberta, patients with only chronic kidney disease had a significantly higher rate of heart attacks than those who only had diabetes. Those who had already had a heart attack had the highest overall rate of heart attacks.

Chronic kidney disease should be regarded as a coronary heart disease risk equivalent, similar to diabetes, as patients with the condition have high rates of cardiovascular events, particularly when they also have proteinuria. When chronic kidney disease was defined more stringently with kidney function less than 45% and increased proteinuria, the rate of first heart attack was higher in those with both chronic kidney disease and diabetes than in those with either disorder alone.

Cycling can cause erectile dysfunction

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , , , , , , | | Comments Off on Cycling can cause erectile dysfunction

Age, diabetes, hypertension, obesity, high lipids, smoking, drugs, heart disease, upright cycling for more than 3 hours a week can cause erectile dysfunction (ED) in males. Those who ride bicycles for more than 3 hours a week should do so in a reclining position and not upright position. A man is considered to have ED when he cannot acquire or sustain an erection of sufficient rigidity for sexual intercourse. Any man may, at one time or another during his life, experience periodic or isolated sexual failures. The term “impotent” is reserved for those men who experience erectile failure during attempted intercourse more than 75% of the time. Heart disease increases the risk for later ED; ED also may be an early warning sign of future heart disease. Men with erectile dysfunction without an obvious cause (e.g., pelvic trauma), and who have no symptoms of heart disease, should be screened for heart disease prior to treatment since there are potential cardiac risks associated with sexual activity in patients with heart disease. Eight of the 12 most commonly prescribed medications list impotence as a side effect and it is estimated that 25% of cases of ED are due to drugs. Depression, stress, or the drugs used to treat depression can result in ED. Neurologic causes include stroke, spinal cord or back injury, multiple sclerosis, or dementia. In addition, pelvic trauma, prostate. Surgery or priapism may cause ED. A less obvious, but of increasing importance, has been the possible association of ED with bicycling. Anything that places prolonged pressure on the pudendal and cavernosal nerves or compromises blood flow to the penile artery can result in penile numbness and impotence. Cycling-induced impotence, is primarily a problem of serious cyclists and has been reported to occur in Norwegian men competing in a 540 km bicycle race. The penile numbness is attributed to the pressure on the perineal nerves whereas the erectile dysfunction is thought to be due to a decrease in oxygen pressure in the pudendal arteries. Recreational cyclists, those who cycle for less than 3 hours per week and men who cycle in a reclining position avoid the sustained intense pressure on the penile nerve and artery and are less likely to experience sexual side effects. Continued cycling in a seated upright position can reduce the penile oxygen levels lasting 10 minutes.

A mix of exercise protocol is better

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , , , | | Comments Off on A mix of exercise protocol is better

A combination of weight training and aerobic exercise is the best prescription for overweight patients at risk for diabetes and heart disease. Only aerobic exercise is also as good as it reduces weight and takes inches off the waistlines. Just weight lifting alone has very little benefit.

According to a study published in the American Journal of Cardiology, people in the weight–training group gained about 1.5 pounds and those in the aerobic group lost an average of 3 pounds and half an inch from their waists. Those who did both weight and aerobic training dropped about 4 pounds and 1 inch from the waistline. This group also saw a decrease in diastolic lower blood pressure and in a metabolic syndrome score. Both the aerobic–only group and the combined-exercise group also lowered their levels of bad triglycerides.

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.

Reduce your risk of stroke

By Dr K K Aggarwal
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Stroke is preventable. About 90 of strokes are associated with 10 risks factors that are modifiable. 1. Control high blood pressure 2. Do moderate exercise 5 times a week 3. Eat a healthy balanced diet high in fruit vegetables low in sodium 4. Reduce your cholesterol 5. Maintain a healthy BMI or waist to hip ratio 6. Stop smoking and avoid second hand exposure 7. Reduce alcohol intake men 2 day women 1 day 8. Identify and treat atrial fibrillation 9. Reduce your risk from diabetes talk to your doctor 10. Get educated about stroke

A slight move is all that matters

By Dr K K Aggarwal
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Middle-aged women who move around more in their daily life have lower levels of intra-abdominal fat, a risk factor for heart disease.
A minor modification in daily routine: Reducing the time watching TV or increasing the walk time to work can make a difference in the long-term health.
Visceral fat is a hot topic because of metabolic syndrome, which predisposes people to diseases.
Intra-abdominal fat, or the fat that wraps around the organs in the abdomen and chest, tends to accumulate at midlife and can contribute to developing diabetes, hypertension and heart disease. The fat around the organs is known to be more related to heart disease and diabetes. A woman does not need to appear outwardly heavy to have a potentially troublesome extra “tire” around her organs.
Exercise for long has been known to reduce the amount of intra-abdominal fat.

Eating foods in their natural form is always better

By Dr K K Aggarwal
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An elephant is obese, eats sugarcane (ganna) and yet does not develop diabetes. I am sure if he is given 10% sugar drinks everyday or made to eat 30% sugar containing sweets, he too would end up with diabetes. The natural form of sugarcane is eating ganna, the second form is sugarcane juice, third is gur (jaggery), fourth is shakkar and fifth is white sugar. The more you eat foods in their natural form, more the health benefits you will get from that food. Food is Brahmin and contains the same consciousness as you have. Food, which is more refined will loses its consciousness and is not beneficial to the health. Similarly, wheat flour with bran is better than flour without bran, which is better than suji, which is better than maida. Maida is the final product and if taken every day, it can cause heart disease, diabetes and high blood pressure.

A diet that is healthy for a person may be junk food for another

By Dr K K Aggarwal
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We have all wondered why some people do not seem to gain weight, while others do. A study has found that even if we all ate the same meal, we would all burn it differently and have different blood sugar levels later. These findings draw attention to personalized nutrition. High blood sugar levels are associated with several diseases including obesity, diabetes, heart disease, cancer and strokes. Blood sugar levels of 800 individuals of varying weights continuously were monitored with a glucose monitor for over a week as they ate nearly 47,000 meals. Some had prediabetes. The study subjects used a smartphone app to log when they slept, exercised, and ate. Stool samples were also taken to analyze gut microbiome. The study revealed a vast variability in the responses to even identical meals. Some people who ate bread did not show any variation in blood sugar levels, while others had high blood sugar with the same meal. Eran Segal, PhD, another researcher who worked on the study noted that one prediabetic obese woman had a blood sugar spike when she ate a tomato, which is a healthy food. The researchers next examined if personalizing the diet improved blood sugar levels for 26 people. The personalized diets reduced the blood sugar levels after meals and altered their gut bacteria. (Medscape)