Fast track to healthy living
Your Health
DR GITA MATHAI
Anna Hazare during his fast in New Delhi
Fasting is common in India. Hindus fast on certain days of the week, Jains after six in the evening, Muslims during the month of Ramadan and Christians during Lent. Politicians and activists have traditionally used it as a means to an end.
Some fasts involve total avoidance of all food and water. In some others, food is avoided at specific times of the day. Yet others restrict the type of food. Fasting is different from involuntary starvation due to famine or illness. Voluntary fasting isn’t advisable for people under 15, over 70, pregnant women, people involved in outdoor or heavy labour, and those suffering from illnesses. Some medicines dangerously accelerate the biochemical effects of fasting.
Any food that we eat is digested and broken down into its components — glucose, fatty acids and amino acids. Glucose is the body’s main source of energy and is required by all tissues. When the body is deprived of food, any excess glucose stored in the body is accessed and utilised to get energy. Once these stores are depleted, the body starts to break down fat and use it. This is around 7 per cent of the body weight of males and 10 per cent in females. When is used up, there is an intense craving for food. If this is still not enough, the muscles in the body start to get metabolised. The person develops a wasted and emaciated appearance.
Deprived of food and water, a healthy adult can survive about 10-12 days. With water, survival can extend to 50-60 days. Children and the elderly succumb more rapidly. Women and obese individuals (both sexes) are able to withstand starvation better as they have more body fat reserves. Extremes of temperature (heat or cold) accelerate the ill effects of starvation.
Stopping food and water abruptly causes changes of “acute starvation” in the body within 24 hours. Thirst and hunger pains set in. The mouth gets parched, the saliva thickens and the urine is high coloured and scanty. After 48 hours, the voice becomes feeble, the pulse weakens, the temperature drops and dehydration sets in. As the days pass by, the blood pressure and temperature drop, the hair and nails become brittle, the eyes sink and the pupils dilate. Constipation is usual, but diarrhoea may occur. The intellect can remain clear and unclouded, but delirium and convulsions may precede death.
The medical complications associated with prolonged fasting are electrolyte imbalances, cardiac arrhythmia and kidney failure. Death can occur if fasting is pursued to the point of complete starvation.
Some medical tests have to be done upon “fasting” or on an “empty stomach”. There is often ambiguity and confusion between these two terms. Medically, fasting usually means an overnight fast of eight to 12 hours. That’s because metabolic adjustments occur in the body during fasting. The normal values of the results of some tests like lipid profile and sugar tests are standardised for fasting conditions. “On an empty stomach” typically means three to five hours after a meal, when the meal has left the stomach and digestion is complete.
Extended, intermittent, regular fasting has been recommended from the ancient times to preserve health. Today we know fasting improves the blood lipid profile and reduces total cholesterol. Research done on human volunteers at the US National Institute on Aging suggests that fasting every alternate day offers major health benefits. The cumulative calorific restriction reduces the risk of cancer, cardiovascular diseases, diabetes, insulin resistance and immune disorders. It also actually slows the aging process, and seems to have the potential to increase the life span. People do tend to lose weight with alternate day fasting, but on the negative side they tend to be irritable on the fasting day. Also, repeated fasts can result in the body going into a “conserve mode” and the metabolism slowing down to conserve energy. There will be no weight loss despite repeated intermittent fasting.
It is possible to “starve in the midst of plenty”. This occurs in diabetics who are unable to utilise the food they eat. In some others, the food may be unhealthy (just fat and sugar) and lacking essential proteins, vitamins and minerals.
Teenagers may resort to excessive fasting to prevent obesity. This can result in mental changes and anorexia nervosa.
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
Tuesday, April 19, 2011
Tuesday, April 12, 2011
PS its PMS
It’s PMS, stupid
Your Health
DR GITA MATHAI
Women are often maligned and labelled as “unreasonable, unrealistic, illogical and hysterical”, even when their statements are reasonable and logical. “Blame it on the hormones” is the usual explanation from a male-dominated society. Physicians (mostly male) in the 19th century, unaware of hormone levels, concluded that somehow all this behaviour was connected to the presence of a uterus (from the Greek word hystera which means womb). They sometimes recommended hysterectomy to remove the root cause of these problems and render these women “normal”.
Unfortunately, some surgeons today, too, subscribe to this view. Women in the reproductive age are advised a hysterectomy to remove the uterus, once it has finished its reproductive function, to relieve them of all their physical and psychological symptoms.
Yet 15 per cent of women suffer from unreasonable anger, excessive sensitivity, paranoid thoughts, anxiety, depression, uncontrollable crying spells, and bizarre food cravings during the pre-menstrual period. In 0.4 per cent, the symptoms may be severe enough to be labelled psychotic. These symptoms are called pre-menstrual syndrome (PMS). They are not because of the presence of the uterus, but are attributed to the body’s response to normal changes in the hormonal (oestrogen and progesterone) ratios during the course of a menstrual cycle.
In PMS sufferers, there’s a lack of perfect synchronisation in the hormone levels, both at the pituitary-hypothalamic level in the brain and at the level of the ovaries (not uterus). Surges and dips cause changes in the biochemical neurotransmitters (serotonin) and precipitate the depressed “low feeling”. Attempts to alleviate the depression and push up neurotransmitter levels lead to food cravings and binge eating.
The mental changes can be disruptive to the family and in the workplace. By the time the distraught family persuades the woman to seek medical help, the onset of menstruation has restored the woman’s Jekyll-and-Hyde personality to normal. Unfortunately, the menstrual cycle and mood swings repeat themselves month after month.
PMS is commoner between the ages of 30 and 45. This led to the erroneous belief that it was in some way connected with approaching menopause. This isn’t true. However, this is the time when women experience the maximum stress in both their family life and career. They often fail to cope with the combination of stress and hormonal imbalances.
Some physical changes can be produced as a result of the hormones. Fluid retention can result in a measurable weight gain (1-2kg). This can make clothes tighter. There may be backache, joint pain, breast tenderness and palpitations.
Treatment becomes imperative when the mood swings make women depressed and suicidal, or psychotic and murderous. (Most murderesses committed their crime during their pre-menstrual phase). Also, job efficiency and interpersonal relationships may be affected because of tiredness, fatigue, sensitivity and ill temper.
It is difficult to convince women with PMS that they need help, especially since they are normal for around 20 days in a month. Also, the sensitivity varies from woman to woman. Some with mild forms may be acutely conscious of their problem, while others with severe degrees of PMS may rationalise their behaviour. To avoid PMS,
Try to maintain a body mass index (weight divided by height in metre squared) as close to 23 as possible
Instead of three large meals, eat six small meals at regular three-hour intervals. Add at least six helpings of fresh fruits and vegetables, one with each meal. These are high in fibre and beneficial antioxidants. Fibres delay digestion and absorption, helping to maintain a steady blood glucose level with no depression-inducing dips
Reduce the salt intake in cooked food to one teaspoon a day
Avoid fried, salted snacks and chocolate
Reduce the use of caffeine by cutting down on carbonated colas, tea and coffee
Do regular aerobic exercise such as an hour of walking, jogging, cycling, climbing stairs or swimming to reduce stress. Exercise improves blood circulation and reduces bloating and fatigue. It produces a sense of well being. It boosts the body’s natural production of endorphins, which acts as a mood elevator
Daily supplements of vitamins and minerals may be administered to relieve some PMS symptoms. A multivitamin capsule with B6 (100 mcg), B complex, vitamin E (400 IU) and vitamin C (100mg) and calcium (1,000mg) supplementation is beneficial
Capsules of evening primrose oil, oral contraceptive pills, low dose diuretic therapy, mild antidepressants and tranquilisers have been tried and have anecdotally helped some sufferers.
PMS tends to run in families. This may be because the hormone ratios are inherited, leading to similar behaviour. This becomes more likely because of a comparable lifestyle, with improper diet and inadequate physical activity.
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
Women are often maligned and labelled as “unreasonable, unrealistic, illogical and hysterical”, even when their statements are reasonable and logical. “Blame it on the hormones” is the usual explanation from a male-dominated society. Physicians (mostly male) in the 19th century, unaware of hormone levels, concluded that somehow all this behaviour was connected to the presence of a uterus (from the Greek word hystera which means womb). They sometimes recommended hysterectomy to remove the root cause of these problems and render these women “normal”.
Unfortunately, some surgeons today, too, subscribe to this view. Women in the reproductive age are advised a hysterectomy to remove the uterus, once it has finished its reproductive function, to relieve them of all their physical and psychological symptoms.
Yet 15 per cent of women suffer from unreasonable anger, excessive sensitivity, paranoid thoughts, anxiety, depression, uncontrollable crying spells, and bizarre food cravings during the pre-menstrual period. In 0.4 per cent, the symptoms may be severe enough to be labelled psychotic. These symptoms are called pre-menstrual syndrome (PMS). They are not because of the presence of the uterus, but are attributed to the body’s response to normal changes in the hormonal (oestrogen and progesterone) ratios during the course of a menstrual cycle.
In PMS sufferers, there’s a lack of perfect synchronisation in the hormone levels, both at the pituitary-hypothalamic level in the brain and at the level of the ovaries (not uterus). Surges and dips cause changes in the biochemical neurotransmitters (serotonin) and precipitate the depressed “low feeling”. Attempts to alleviate the depression and push up neurotransmitter levels lead to food cravings and binge eating.
The mental changes can be disruptive to the family and in the workplace. By the time the distraught family persuades the woman to seek medical help, the onset of menstruation has restored the woman’s Jekyll-and-Hyde personality to normal. Unfortunately, the menstrual cycle and mood swings repeat themselves month after month.
PMS is commoner between the ages of 30 and 45. This led to the erroneous belief that it was in some way connected with approaching menopause. This isn’t true. However, this is the time when women experience the maximum stress in both their family life and career. They often fail to cope with the combination of stress and hormonal imbalances.
Some physical changes can be produced as a result of the hormones. Fluid retention can result in a measurable weight gain (1-2kg). This can make clothes tighter. There may be backache, joint pain, breast tenderness and palpitations.
Treatment becomes imperative when the mood swings make women depressed and suicidal, or psychotic and murderous. (Most murderesses committed their crime during their pre-menstrual phase). Also, job efficiency and interpersonal relationships may be affected because of tiredness, fatigue, sensitivity and ill temper.
It is difficult to convince women with PMS that they need help, especially since they are normal for around 20 days in a month. Also, the sensitivity varies from woman to woman. Some with mild forms may be acutely conscious of their problem, while others with severe degrees of PMS may rationalise their behaviour. To avoid PMS,
Try to maintain a body mass index (weight divided by height in metre squared) as close to 23 as possible
Instead of three large meals, eat six small meals at regular three-hour intervals. Add at least six helpings of fresh fruits and vegetables, one with each meal. These are high in fibre and beneficial antioxidants. Fibres delay digestion and absorption, helping to maintain a steady blood glucose level with no depression-inducing dips
Reduce the salt intake in cooked food to one teaspoon a day
Avoid fried, salted snacks and chocolate
Reduce the use of caffeine by cutting down on carbonated colas, tea and coffee
Do regular aerobic exercise such as an hour of walking, jogging, cycling, climbing stairs or swimming to reduce stress. Exercise improves blood circulation and reduces bloating and fatigue. It produces a sense of well being. It boosts the body’s natural production of endorphins, which acts as a mood elevator
Daily supplements of vitamins and minerals may be administered to relieve some PMS symptoms. A multivitamin capsule with B6 (100 mcg), B complex, vitamin E (400 IU) and vitamin C (100mg) and calcium (1,000mg) supplementation is beneficial
Capsules of evening primrose oil, oral contraceptive pills, low dose diuretic therapy, mild antidepressants and tranquilisers have been tried and have anecdotally helped some sufferers.
PMS tends to run in families. This may be because the hormone ratios are inherited, leading to similar behaviour. This becomes more likely because of a comparable lifestyle, with improper diet and inadequate physical activity.
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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