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Dr K K Aggarwal

Guidelines about Eating

By Dr K K Aggarwal
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Malnutrition and wrong dietary habits have been identified as major risk factors for ill health, including heart attacks. Most people below the poverty line suffer from malnutrition due to lack of calories, proteins and vitamins in their food. In the affluent society, overeating or eating wrong food results in overnutrition, a form of malnutrition leading to heart blockages. Some guidelines about eating include:

  • Eat only when you are hungry.
  • Do not eat for pleasure, social obligations or emotional satisfaction.
  • Eat at a slow pace.
  • Eat less; dinner less than lunch.
  • Take small mouthfuls each time, chew each morsel well, swallow it and only then take the next morsel.
  • Do not eat while watching television, driving a car or watching sports events. The mind is absorbed in these activities and one does not know what and how much one has eaten.
  • Do not talk while eating and never enter into heated arguments. The stomach has ears and can listen to your conversation. It will accordingly send signals to the mind and heart.
  • Plan and decide in advance what and how much food you will be eating.
  • Use low fat or skimmed mild dairy products. For cooking, use oils which are liquid at room temperature.
  • Do not take red meat and if you are a non–vegetarian, you may take poultry meat or fish.

Even the elderly should exercise

By Dr K K Aggarwal
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Research has found that older runners live longer and suffer fewer disabilities than healthy non runners. This observation applies to a variety of aerobic exercises including walking. A study by authors from Stanford University School of Medicine published in the Archives of Internal Medicine has shown that being active reduces disability and increases survival. There are benefits of vigorous activity late in life. Earlier many experts believed that vigorous exercise would actually harm older individuals. And running in particular would result in an epidemic of joint and bone injuries. But this new study proves otherwise. Two hundred and eighty four runners and 156 healthy controls or non runners in California completed annual questionnaires over a 21 year period. The participants were 50 years old or over at the beginning of the study and ran an average of about four hours a week. By the end of the study period the participants were in their 70s or 80s or older and ran about 76 minutes a week. At 19 years just 15 percent of the runners had died compared with 34 percent of the non runners. In the study running delayed the onset of disability by an average of 16 years. It s so important to be physically active your whole life not just in your 20s or 40s but forever. Exercise is like the most potent drug. Exercise is by far the best thing you can do. One should take lessons from Yudhishthir in Mahabharata who walked till his death. However a word of caution if an elderly is walking or entering into an exercise program he or she should have a cardiac evaluation done to rule out underlying heart blockages.

Heart disease starts in youth

By Dr K K Aggarwal
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Autopsy studies of young people who died in accidents have shown that by the late teens, the heart blockages, the kind of lesions that cause heart attacks and strokes are in the process of developing The best opportunity to prevent heart disease is to look at children and adolescents and start the preventive process early. More than a third of children and adolescents are overweight or obese. The first signs that men are at higher risk of heart disease than women appear during the adolescent years despite the fact that boys lose fat and gain muscle in adolescence, while girls add body fat. Between the ages of 11 and 19, levels of triglycerides, a type of blood fat associated with cardiovascular disease, increase in the boys and drop in the girls. Levels of HDL cholesterol, the “good” kind that helps keep arteries clear, go down in boys but rise in girls. Blood pressure increases in both, but significantly more in boys. Insulin resistance, a marker of cardiovascular risk, which is lower in boys at age 11, rises until the age of 19 years. Any protection that the young women have for cardiovascular protection can be wiped out by obesity and hence obesity in girls at any cost should be handled on priority.

Even the elderly should exercise

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , | | Comments Off on Even the elderly should exercise

Research has found that older runners live longer and suffer fewer disabilities than healthy non–runners. This observation applies to a variety of aerobic exercises, including walking.

A study by authors, from Stanford University School of Medicine, published in the Archives of Internal Medicine has shown that being active reduces disability and increases survival.

There are benefits of vigorous activity late in life. Earlier many experts believed that vigorous exercise would actually harm older individuals. And running, in particular, would result in an epidemic of joint and bone injuries. But this new study proves otherwise.

Two hundred and eighty–four runners and 156 healthy “controls,” or non–runners, in California completed annual questionnaires over a 21–year period. The participants were 50 years old or over at the beginning of the study and ran an average of about four hours a week. By the end of the study period, the participants were in their 70s or 80s or older and ran about 76 minutes a week. At 19 years, just 15 percent of the runners had died, compared with 34 percent of the non–runners.

In the study, running delayed the onset of disability by an average of 16 years. It’s so important to be physically active your whole life, not just in your 20s or 40s, but forever.

Exercise is like the most potent drug. Exercise is by far the best thing you can do.

One should take lessons from Yudhishthir in Mahabharata who walked till his death. However a word of caution, if an elderly person is walking or entering into an exercise program, he or she should have a cardiac evaluation done to rule out underlying heart blockages.

Non obstructive heart blockages not benign

By Dr K K Aggarwal
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In a retrospective study of patients undergoing elective coronary angiography, non-obstructive coronary artery disease (heart blockages), compared with no apparent coronary artery disease (no blockages), was associated with a significantly greater 1-year risk of heart attack and all-cause mortality.

After risk adjustment, there was no significant association between 1- or 2-vessel non-obstructive coronary artery disease (blockages in one or two arteries) and mortality, but there were significant associations with mortality for 3-vessel non-obstructive coronary artery disease (blockages in all three arteries).

Veterans with evidence of non-obstructive CAD on elective coronary angiography had a 2- to 4.5-fold greater risk for heart attack compared with those with no evidence of blockages and 1-year heart attack risk was found to increase progressively by the extent of blockages, rather than increasing abruptly when blockages became obstructive. The results of this study are published in Nov. 5 issue of JAMA.

Never tell your patients “that your coronaries are fine and they have nothing to worry about.” Instead, one should say “There is evidence of atherosclerosis and while there is no need to panic, we need to address it.”

Remember there is nothing like “mild coronary artery disease.” Up to 1 in 4 angiograms show minimal plaque or blockages.

Non-obstructive blockages mean presence of atherosclerotic plaque revealed during coronary angioplasty or angiography that does not appear to obstruct blood flow or result in angina symptoms.

These non-obstructive lesions occur in about 10-25% of patients undergoing elective angiography, and their presence has historically been characterized as “insignificant” or “no significant blockages in the medical literature even though multiple studies have shown plaque ruptures leading to heart attack commonly come from non-obstructive plaques.

Even the Older Should Exercise

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Research spanning two decades has found that older runners live longer and suffer fewer disabilities than healthy non-runners. This observation applies to a variety of aerobic exercises, including walking.

A study by authors, from Stanford University School of Medicine, published in Archives of Internal Medicine has shown that being active reduces disability and increases survival.

Late in life, there are benefits of vigorous activity.  Earlier many experts believed that vigorous exercise would actually harm older individuals. And running, in particular, would result in an epidemic of joint and bone injuries. But this new study proves otherwise.

Two hundred and eighty-four runners and 156 healthy “controls,” or non-runners, in California completed annual questionnaires over a 21-year period. The participants were 50 years old or over at the beginning of the study and ran an average of about four hours a week. By the end of the study period, the participants were in their 70s or 80s or older and ran about 76 minutes a week. At 19 years, just 15 percent of the runners had died, compared with 34 percent of the non-runners.

In the study running delayed the onset of disability by an average of 16 years. It’s so important to be physically active your whole life, not just in your 20s or 40s, but forever. Exercise is like the most potent drug. Exercise is by far the best thing you can do.

One should take lessons from Yudhishter in Mahbharata who walked till his death.

However a word of caution if an elderly is walking or entering into an exercise program, he or she should have a cardiac evaluation to rule out underlying heart blockages.