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Dr K K Aggarwal

Vitamin D intake associated with reduced risk for Crohn’s disease

By Dr K K Aggarwal
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Increased intake of vitamin D may significantly reduce the risk for Crohn’s disease (CD) in women, according to an article published online December 12 and in the March issue of the journal Gastroenterology.

  • This study involved 72,719 women who returned the 1986 questionnaire. They had data on both vitamin D intake and physical activity and did not have a history of CD or UC.
  • Diagnosis of CD was based on a typical history of 4 weeks or longer and was confirmed by radiologic, endoscopic, or surgical evaluation.
  • The diagnosis of ulcerative colitis (UC) was based on typical clinical presentation of 4 weeks or more and endoscopic, radiologic, or surgical evaluation.
  • Mean age of the participants at baseline was 53 years, mean body mass index (BMI) was 25.4 kg/m2, mean physical activity was 13.2 metabolic hours per week, 94.5% were white and 36.6% never smoked.
  • A documented 122 cases of CD and 123 cases of UC were recorded during 1,492,811 person–years of follow–up. The median predicted 25(OH)D level was 27.6 ng/mL.
  • Women in the lowest quartile of predicted 25(OH)D level compared with those in the highest quartile had a higher body mass index, were less active, tended to reside in the Northern or Midwestern regions of the United States, and had lower intake levels of dietary or supplemental vitamin D. The median age of diagnosis of CD was 64.0 years; for UC, it was 63.5 years.
  • The median interval between assessment of plasma 25(OH) D levels and disease diagnosis was 12 years for UC and 10 years for CD.
  • For every 1 ng/mL increase in predicted 25(OH)D level, the risk for CD was reduced by 6%.
  • For UC, there was also a reduction in risk, but it was non–significant at 4%.
  • Women in the highest two quartiles of 25(OH)D levels had multivariate HRs of 0.50 and 0.55, respectively, for CD
  • Each 100 IU/day increase in total intake resulted in a 10% reduction in UC risk and a 7% reduction in CD risk.
  • For vitamin D intake from diet and supplements based on quartile distribution, there was a significant linear inverse trend for vitamin D intake and UC risk, but this trend was weaker for CD.
  • Intakes of 800 IU/day or higher resulted in greater reductions in the risks for UC and CD
  • Vitamin D intake was inversely associated with the risks for CD and UC, vitamin D insufficiency or deficiency was an important mediator in the pathogenesis of UC and CD, and assessment of vitamin D status should be a part of the assessment of inflammatory bowel diseases.

Vitamin D Facts

By Dr K K Aggarwal
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  • Calcium has an indispensable assistant in building bones: vitamin D.
  • Vitamin D helps the body absorb calcium.
  • Increasing vitamin D can help prevent osteoporosis.
  • A small amount of sun exposure can help the body manufacture its own vitamin D.
  • Five to 30 minutes of sunlight between 10 a.m. and 3 p.m. twice a week to your face, arms, legs, or back without sunscreen will enable you to make enough of the vitamin
  • People with fair skin that burns easily should protect themselves from skin cancer by limiting sun exposure to 10 minutes or less.
  • Food and sun exposure should suffice, but if not, get 2,000 IU of vitamin D daily from a supplement

Sexuality In Ancient Mythology

By Dr K K Aggarwal
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1. Both sexuality and spirituality have been mentioned in mythology to prevent HIV and sexually transmitted diseases. An educational art was created at Khajuraho which talks about “multiple positions with one are better than one position with many.”

2. Asexual reproduction – Lord Ganesha’s birth from the skin of Goddess Parvati represents a form of asexual reproduction using pluripotent cells.

3. The birth of Kartikay from Shiva can be linked to success story of in vitro fertilization. Shiva throws away white sparks (semen) in the air (centrifugation), they fell down in river (petri dish) become five petal flower (5 cell zygote) adopted by local Kartikayan girls (in vitro fertilization) and Kartikay was born.

4. Artificial insemination of semen was well described in mythology. The birth of Dashrath’s children, Hanuman all were probably examples of the same.

5. Sexuality and spirituality are opposite to each other. No Tirath Sthan is ever used as honeymoon place.

6. Bull or Nandi represents sexual desires and is always placed outside Shiva Mandir. You cannot enter a spiritual place without sexual desires on.

7. Polygamy was the need of the day at that time as is evident by three wives of Dashrath and five husbands of Draupadi.

8. Santoshi Mata Ka Vrat was created to prevent iron deficiency anemia in child bearing age ladies. They were made to eat Gur (iron) and Chana (protein) every week to prevent recurrent abortions and death by anemia.

9. Ashrams were created in mythology as part of discipline. Brahmcharya was the period for education and Grihastha for active sexual reproductive life.

10. Dharma Artha Kama Moksha were the four purposes of life which meant earning money righteously to fulfill all our desires which leads to inner happiness.

11. Sex education at that time was through sculptures.

12. The Science of Kamasutra was the classical textbook which promoted sexual hygiene.

13. True love was symbolized by Meera–Krishna and Radha–Krishna.

14. Marriages were not solemnized in Chaturmaas as during this period the mind is always in a negative state with more chances of divorce.

15. The marriage months have been the month of Maagh, Vaishakh and Kartik. These are spontaneous months with increased fertility.

16. To enhance fertility Shahi snans were advocated which involve exposure to sun so that vitamin D deficiency can be avoided.

17. Marriage seasons used to start with Tulsi Vivah which meant that Shyama Tulsi seeds are good for fertility and make the semen thick.

Do I Need Multivitamin Tablets?

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1. Multivitamin tablets are not needed unless there is a scarcity of a particular vitamin.

2. If you include all seven colors and six tastes in your food, there is no need for vitamin supplementation.

3. Wheat grass and barley grass juice contain folic acid and vitamin B12.

4. Anything which is green contains vitamin B.

5. Anything which is red contains lycopene.

6. Citrus foods contain vitamin C.

7. All dry fruits contain vitamin E.

8. Sunlight is an excellent source of vitamin D.

9. Carrots contain vitamin A.

10. Folic acid is lost if the food is boiled and the water is discarded.

11. Vitamin D is not absorbed if exposed to sunlight is through glass.

12. Vitamin D is not absorbed through clothes if you are fully-clothed in sunlight.

Science behind Kalpvas

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The month of Magh is observed as Kaplvas where for one month people from all over  gather, do sun worship (Vitamin D) , eat sesame (high in calcium) and do tulsi or basil pooja (high fertility and high in calcium). The significance behind is to gather one year’s vitamin D quota. For getting vitamin D we need to expose 40 % of the body for atleast 40 minutes at a stretch for forty days in a year (formula of forty).

Dr K K Aggarwal is Padma Shri and Dr B C Roy National Awardee, President Heart Care Foundation of India and National Vice President Elect IMA

Magh is Fertility Month

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1. Starting from lohri starts the fertility and the marriage month.

2. Other fertility months are Vaishak and Kartik

3. All fertility months involve sun bath (vitamin D) near Ganges or rivers (mental bath with detoxification of the mind), eating high calcium food ( sesame), eating high iron foods (jaggery) and consuming fertility friendly foods (black tulsi seeds and leaves, amla etc); positive thinking (most festivals are in Uttarayana or after Chaturmas in Dakshinayana); high intake of iron (jaggery), calcium (sesame), vitamin D (sunlight), physical, mental and soul detoxification ( vratas).

4. Tulsi is worshiped throughout the magh mela and in kalpvas.

5. Seeds of tulsi are effective in premature ejaculation .It also increases quantity of semen.

6. Tulsi contains small amount of Vitamin C and Folate.

7.  Tulsi can also take care of insulin resistance. One can take a paste made from 21 leaves each of neem, bail, tulsi at breakfast time to reduce insulin resistance. One can also soak 1 tsp fenugreek seeds at bedtime in a cup of water and take this water first thing in the morning.

8. A weight decrease of only 5 percent of total body weight is associated with decreased insulin levels, increased fertility, reduced hirsutism and acne, and lower androgen levels.

About the author: Dr K K Aggarwal is Padma Shri and Dr B C Roy National Awardee, President Heart Care Foundation of India and National Vice President Elect IMA


Revisiting 2012

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  • A large randomized trial (14k men) of multivitamins has shown a small, statistically-significant reduction in total cancer risk (JAMA 2012;308(18):1871-1880).
  • Vitamin D does not prevent cold (JAMA 2012;308(13):1333-1339).
  • A large randomized trial in patients at increased risk for heart disease because of dysglycemia found no effect of fish oil supplements in reducing the rate of cardiovascular events (N Engl J Med 2012;367:309-318). 
  • A systematic review and meta-analysis of 9 randomized trials evaluating supplementation with beta-carotene, vitamin C, and vitamin E for one year found no evidence that vitamin supplementation reduced the risk of cataract or of cataract extraction (Cochrane Database Syst Rev 2012;6:CD004567).
  • Portable monitoring is a reasonable alternative to in-laboratory sleep study in patients with a high pre-test probability of moderate to severe obstructive sleep apnea.
  • Systemic high BP is more common among individuals who have untreated obstructive sleep apnea (snoring) than among those who do not.
  • Antiretroviral therapy is now recommended in all HIV-infected patients, regardless of CD4 cell counts.
  • Prolongation of the QT interval and torsades de pointes in ECG is associated with antibiotics, such as erythromycin and clarithromycin.
  • After a heart attack, beta-blockers may not be required for more than 4 years unless specifically indicated.
  • Anti-depression drugs SSRIs may lead to one additional brain hemorrhage for every 10,000 patients treated for one year.
  • All pregnant women should receive tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine in each pregnancy
  • Tdap should be administered after 20 weeks and optimally between 27 and 36 weeks of pregnancy.
  • Previously, Tdap was recommended only for women who had never received the acellular pertussis vaccine.
  • Tenofovir-emtricitabine is now used for pre-exposure prophylaxis among confirmed HIV-negative individuals at high risk for sexually-acquired HIV infection
  • In areas of high HIV prevalence, the daily use of tenofovir-emtricitabine reduced risk of HIV by 48 to 75%.


Importance of Vitamin D in Mythology

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Today it is a known fact that 80% of the India society is Vitamin D deficient. It was probably known to our Rishi Munis and they created rituals so that everybody gets enough Vitamin D from sunlight. Shahi snan in sunlight are mentioned in our Vedic literature.

1. The month of Magha, Vaishakha and Kartik are considered as months for Shahi Snans where one is supposed to worship sun early in the morning and eat calcium rich food whether it is Urad Ki Daal or sesame seeds.

2.      The Chhat pooja which takes place immediately after Diwali is also linked to sun worship.

3.      The Marghshirsha month immediately after the month of Kartik also involves worshipping sun.

4.      Karkit purnima and Vaishakh purnima are especially known for sun worshiping.

Vitamin D deficiency is linked with metabolic syndrome, heart diseases and also with fertility. All these months when sun is worshipped are also the months of increased fertility. After  chaturmaas is over, Tulsi vivah starts the marriage season during which one worships both Tulsi and Amla. Both of them are known to increase the quantity of semen and increased ovulation.

Probably, the age old treatment of infertility was to acquire vitamin D, taking calcium rich food and consume both tulsi and amla on regular basis.

 The current vitamin D mantra is that 40 days in a year for atleast 40 minutes, one should expose 40% of the body to the sunlight either after sunrise or just before sunset.

1. Chhath puja is mainly observed in Bihar and Nepal. Bihar has a number of Sun temples, flanked by a surajkund or sacred pool of the Sun.

2. It is a ritual bathing festival that follows a period of abstinence and ritual segregation of the worshiper (parvaitin) from the main household for four days. The parvaitin observes ritual purity, and sleeps on the floor on a single blanket.

3. This is the only festival which has no involvement of any priest.

4. The devotees offer their prayers to the setting sun, and then the rising sun.

5. It is the most glorious form of Sun worship.

6. The main worshipers (parvaitin) are women.

7. The parvaitin pray for the well-being of their family, for prosperity and for offspring.

8. The prasad offerings include sweets (Thekua) and fruit offered in small bamboo winnows.

9. The food is strictly vegetarian and it is cooked without salt, onions or garlic.

10. Day 1: Nahay khay (bathe and eat): The parvaitin take a dip in river. The house is cleaned. Only one meal is eaten and contains “kaddu-bhat” or channa dal, and arwa chawal (rice).

11. Day 2: Kharna (the day before Chhath): On Panchami, the parvaitins observe a fast till evening a little after sunset. Just after the worship of earth, the offerings of Rasiao-kheer (rice delicacy), puris (puffs of wheat flour) and bananas, are distributed. From time onwards, for the next 36 hours, the parvaitin goes on a fast without water.

12. Day 3: Chhath: Sanjhiya Arghya (evening offerings): The day is spent preparing the Prasad (offerings) at home. Offerings (Argh) are made in the evening to the setting sun. In the night a colorful event of Kosi is held. Here, lighted earthen lamps are kept under a canopy of five sugarcane sticks. The five sticks signify the human body made of five elements.

13. Day 4: Parna (day after Chhath): Bihaniya Aragh (next morning offerings): On this final day the parvaitin with family go to the riverbank before sunrise and offer (Aragh) to the rising sun. The festival ends with the breaking of the fast.

Science behind the pooja

1.Sun worship in Kartik month is related to absorption of vitamin D

2. Vitamin comes from UVB rays

3. These rays are predominant at sun set and sun rise

4. Vitamin D deficiency today is running like an epidemic in the society

5. Vitamin D is sued for absorbing calcium from the food.

6. All the food items used in this pooja are high in calcium.

7. Kartik is also high fertility months. Vitamin D deficiency is linked to infertility.

8. In fasting state natural calcium is better absorbed.

9. Patients with compromised kidneys should not do this fast.

10. Fast is never broken with feast. This fast is usually broken with ginger and jaggery.