Cancer for sale
Your Health
DR GITA MATHAI
Many Indians like to chew paan — meetha or khatta — after a good meal. It aids digestion, freshens the breath and acts as a mild stimulant. The soporific effects of the heavy meal are counterbalanced. Best of all, it is also believed to have aphrodisiac properties when mixed with the right spices in the right proportion. This may be the reason why it is often offered after a traditional wedding feast to the newlyweds and departing guests.
Paan may be prepared at home or bought from the ubiquitous paan shop. Making a good paan involves smearing mineral slaked lime (calcium hydroxide) on betel leaves, and then adding spices, flavouring substances and pieces of supari or areca nut. After that, the leaf is folded around these ingredients and held together by a clove. Tobacco may also be added. Some habitual paan consumers push the prepared leaf into the cleft between the cheeks and the gums and leave it there. Chewing paan is dangerous, but when the stuff is mixed with tobacco, it is lethal.
Sometimes tobacco may be flavoured and chewed alone without a betel leaf. Such stuff is known by various names such as paan masala and gutka. Pieces of supari may also be sweetened and eaten separately.
Supari, paan and chewing tobacco are often considered harmless and non-addictive. Nothing could be further from the truth. Such stuff suppresses appetite and produces a “high”. What’s more, the nitosamines (cancer causing chemicals found in tobacco, betel leaves and supari) released can precipitate type 2 diabetes.
The lime in paan acts to keep the active ingredients (polyphenols, alkaloids and tannins) in the betel nut in its freebase form. The tobacco contains nicotine and polycyclic aromatic hydrocarbons. Paan may also contain sugar. One of the chemicals in the nut — called arecoline — promotes salivation. This facilitates rapid absorption of this chemical cocktail from under the tongue.
Paan turns the saliva orange red which stains the lips and teeth. Also, the sugar and various other chemicals destroy the enamel of the teeth. They eventually turn black and get ground down to the gums.
The chemicals released while chewing paan irritate the lips and cheeks. They cause changes in the cells, leading them to become precancerous. The lining of the inner cheek turns white (leukoplakia). It may start to bleed or form an ulcer that eats away into the flesh and opens out into the cheek. A tumour may form and protrude into the mouth. As the carcinogen-laden saliva proceeds towards the stomach through the esophagus (tube leading to the stomach), its lining becomes affected and cancer can occur there as well.
Chewing paan is an ancient tradition. The habit leads to cancers of the mouth or esophagus, which set in when the consumer is between 50 and 60 years. Generally, such people also follow an unhealthy lifestyle, a diet with little or no fresh fruits and vegetables, and inadequate exercise. Such cancer is the most commonly diagnosed cancer in males in Assam. For Indian women in general, it is the second biggest reason for cancer. Mouth and esophageal cancer is relatively rare in other parts of the world.
Esophageal cancer is difficult to diagnose in the early stages as the symptoms are often vague and non-specific. Tiredness and fatigue may make the person lethargic. There may be chest pain or unexplained loss of weight which may make the person appear ill. Later, as the tumour grows, it blocks the lumen of the esophagus causing difficulty in swallowing solids.
Treatment of mouth and esophageal cancer involves surgery, radiation and chemotherapy. Stents may have to be placed to prevent blockage. In the case of esophageal cancer, a part of the intestine may be used to replace the esophagus. Sometimes a feeding tube may have to inserted through the stomach to bypass the esophagus. Treatment is expensive and long-drawn. Results are fairly good if the ailment is diagnosed early. Unfortunately, this is often not the case.
An expert committee formed by the government in September 1997 recommended a blanket ban on the manufacture, distribution and sale of all forms of chewing tobacco like paan masala, gutka and zarda. Unfortunately, supari was left out of the committee’s purview. However, despite legislation these products are openly sold. What’s worse is that teenagers too are becoming addicts.
The government has been dragging its feet over enforcing legislation to regulate use of these carcinogenic and addictive products. This is partly because the paan, supari and zarda industries collectively employ over 50 million people in its raw material procurement, manufacture and distribution networks. These people constitute a large vote bank which successive governments are reluctant to lose.
The choice is therefore yours — a healthy and happy life or harmful substances that may lead to cancer.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Wednesday, January 27, 2010
Sunday, January 17, 2010
2010 in 2010
2,010 in 2010
Your Health
DR GITA MATHAI
IN GOOD COMPANY: Join a group if exercising alone seems uninspiring
Somehow the spirit of the New Year affects everyone, including cynics. It is time for all those resolutions that will change your life and make you a better person. After all, before you “heal the world (and) make it a better place,” you have to change “the man in the mirror”.
The changes must be effected on a war footing. India is already known as the world’s diabetic and ischaemic heart disease capital. The statistics are alarming. Unless we get going right now, many of us will not live to see our grandchildren. And even those who survive may be too sickly to enjoy them.
Recommendations for fitness have increased over the last five years from walking half an hour three or four times a week to one hour every day. However, a one-hour stroll in bathroom slippers will not do the trick — walking or jogging should be at a steady pace where conversation is not possible. At least four to five kilometres have to be covered in 60 minutes. If you feel you can walk for an hour in the evening as well, your health may improve further.
At times, taking walks outdoors may be dangerous, especially for women. There are no nearby walkers’ parks. Don’t lose heart — it’s possible to get almost similar benefits by spot jogging. This means standing in one spot and running vigorously, moving the arms as well. You must wear jogging shoes. The right foot has to hit the ground 45 times in one minute. Gradually, try to work up to 45 minutes a day. It is less effective than a using a treadmill or running on the road as there is no forward propulsion, but it definitely has health benefits and is better than doing nothing.
Jogging or walking helps reduce weight, trim the waistline and tone the body, controls blood pressure, boosts the immune system, and decreases the risk of heart disease, diabetes, cancer, stroke, fracture and mental disease. Depression and insomnia are far less. Walkers have also been shown to live to a healthy, mentally active old age in greater numbers than their inactive counterparts.
People are always asking for a magic pill for health, a single ingredient to prevent disease and treat all illnesses. Regular speed walking or jogging is an activity that provides an answer to all these.
Diabetes, hypertension and ischaemic heart disease develop in susceptible genetically predisposed individuals when the environment is right. Even if the disease appears inevitable, the onset of these diseases can be delayed 10 years or more by maintaining a body mass index (BMI) of 23. This can be calculated by dividing the weight in kilograms by the height in metre squared. The only variable in this formula is the weight, as adult height does not change.
Walking or running alone will not help maintain your BMI. Diet has to be factored in by eating 20 calories per kilogram of expected weight. This, combined with jogging or walking, will help maintain your BMI. Calories are hidden everywhere — a cube of chocolate means 60 calories, a ladoo 280 calories and a plate of bhel puri 400 calories! Each teaspoon of sugar in juice adds 20 calories, 100gm of peanuts 550 calories and a teaspoon of oil around 50 calories.
A good way to chart progress is to maintain a diary and record the kilometres covered daily along with the approximate number of calories consumed. The weight should be recorded once a week.
It takes a negative balance of 3,500 calories to lose half a kg of body weight. This cannot be achieved by dieting alone. Walking or jogging builds up the calf muscles. It also increases the BMR (basal metabolic rate) so that more calories are utilised even at rest.
If exercising alone is a bother, get yourself good company. I am a member of groups such as Runners for Life, Chennai Runners and Chain Reaxion. I participated in the Chennai Half Marathon and two 47-km cycling events. To my pleasant surprise, I found a group of enthusiastic young people determined to propagate a healthy lifestyle. I also discovered that contrary to common belief, age is not a bar. Nor does running cause your knees to develop osteoarthritis!
Take the example of 97-year-old Fauja Singh who goes around the world running marathons. He is the Adidas poster boy for their slogan “nothing is impossible”.
So as we move into 2010, let us make the figure our walking milestone and cover 2,010 km in 365 days.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
DR GITA MATHAI
IN GOOD COMPANY: Join a group if exercising alone seems uninspiring
Somehow the spirit of the New Year affects everyone, including cynics. It is time for all those resolutions that will change your life and make you a better person. After all, before you “heal the world (and) make it a better place,” you have to change “the man in the mirror”.
The changes must be effected on a war footing. India is already known as the world’s diabetic and ischaemic heart disease capital. The statistics are alarming. Unless we get going right now, many of us will not live to see our grandchildren. And even those who survive may be too sickly to enjoy them.
Recommendations for fitness have increased over the last five years from walking half an hour three or four times a week to one hour every day. However, a one-hour stroll in bathroom slippers will not do the trick — walking or jogging should be at a steady pace where conversation is not possible. At least four to five kilometres have to be covered in 60 minutes. If you feel you can walk for an hour in the evening as well, your health may improve further.
At times, taking walks outdoors may be dangerous, especially for women. There are no nearby walkers’ parks. Don’t lose heart — it’s possible to get almost similar benefits by spot jogging. This means standing in one spot and running vigorously, moving the arms as well. You must wear jogging shoes. The right foot has to hit the ground 45 times in one minute. Gradually, try to work up to 45 minutes a day. It is less effective than a using a treadmill or running on the road as there is no forward propulsion, but it definitely has health benefits and is better than doing nothing.
Jogging or walking helps reduce weight, trim the waistline and tone the body, controls blood pressure, boosts the immune system, and decreases the risk of heart disease, diabetes, cancer, stroke, fracture and mental disease. Depression and insomnia are far less. Walkers have also been shown to live to a healthy, mentally active old age in greater numbers than their inactive counterparts.
People are always asking for a magic pill for health, a single ingredient to prevent disease and treat all illnesses. Regular speed walking or jogging is an activity that provides an answer to all these.
Diabetes, hypertension and ischaemic heart disease develop in susceptible genetically predisposed individuals when the environment is right. Even if the disease appears inevitable, the onset of these diseases can be delayed 10 years or more by maintaining a body mass index (BMI) of 23. This can be calculated by dividing the weight in kilograms by the height in metre squared. The only variable in this formula is the weight, as adult height does not change.
Walking or running alone will not help maintain your BMI. Diet has to be factored in by eating 20 calories per kilogram of expected weight. This, combined with jogging or walking, will help maintain your BMI. Calories are hidden everywhere — a cube of chocolate means 60 calories, a ladoo 280 calories and a plate of bhel puri 400 calories! Each teaspoon of sugar in juice adds 20 calories, 100gm of peanuts 550 calories and a teaspoon of oil around 50 calories.
A good way to chart progress is to maintain a diary and record the kilometres covered daily along with the approximate number of calories consumed. The weight should be recorded once a week.
It takes a negative balance of 3,500 calories to lose half a kg of body weight. This cannot be achieved by dieting alone. Walking or jogging builds up the calf muscles. It also increases the BMR (basal metabolic rate) so that more calories are utilised even at rest.
If exercising alone is a bother, get yourself good company. I am a member of groups such as Runners for Life, Chennai Runners and Chain Reaxion. I participated in the Chennai Half Marathon and two 47-km cycling events. To my pleasant surprise, I found a group of enthusiastic young people determined to propagate a healthy lifestyle. I also discovered that contrary to common belief, age is not a bar. Nor does running cause your knees to develop osteoarthritis!
Take the example of 97-year-old Fauja Singh who goes around the world running marathons. He is the Adidas poster boy for their slogan “nothing is impossible”.
So as we move into 2010, let us make the figure our walking milestone and cover 2,010 km in 365 days.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
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