Uncategorized

The Causes Of Milk Indigestion and Their Solutions!

Many people cannot tolerate milk and milk products.

They develop varying degrees of abdominal discomfort, pain, bloating, gases, diarrhoea when they consume milk.

The commonest cause of this is lactose intolerance.

***

Lactose intolerance:

Lactose is the major sugar present in milk.

It is composed of two sugars namely glucose and galactose.

Our body needs an enzyme called lactase to digest lactose.

Lactase is an enzyme that is produced in the what is called as the brush border of the epithelial lining of the small intestines of humans and other mammals.

A large number of people lack adequate amounts of lactase and are unable to digest lactose fully and hence suffer from bloating, gases, diarrhoea and abdominal discomfort when they have milk.

Lactase is also available as a food supplement and is added to milk to produce ‘lactose free’ milk products.

People with lactose intolerance can take lactase supplements before consuming milk and milk products or add it to them before consuming them.

A few people may have difficulty digesting a protein in milk.

***

Milk proteins:

Milk majorly has two proteins, casein and whey proteins, the former contributing nearly eighty per cent while the latter makes up most of the balance twenty per cent of milk protein.

Casein has two major components, the A1 beta casein and and A2 beta casein proteins

Most buffalo and cow milk have both A1 and A2 variants of the beta casein proteins.

***

Milk protein intolerance:

It is this A1 beta casein that a few people have difficulty in digesting fully.

These people may have some abdominal discomfort when they have milk having both the A1 and A2 variants of the beta casein proteins.

But their number is much smaller than the people having lactose intolerance.

Sixty five to seventy per cent of the world population has varying degrees of lactose intolerance while much fewer people possibly suffer from milk protein intolerance.

Some milk variants of both buffalo and cow milk have only the A2 variant and not the A1 variant of the beta casein proteins.

The A2 milk is marketed at a special premium as a milk that is easier to digest and does not cause discomfort like gases and bloating which regular milk causes in some people.

Although there is not enough scientific evidence to support it, the findings are mixed, some people may experience less discomfort with the A2 milk, whether cow or buffalo, than the regular milk.

Other than that there is no special nutritional advantage of the A2 milk over the regular milk.

But if you like it, are more comfortable drinking it and don’t mind paying the premium for it, you can continue to use it.

The A1 variant of beta-casein can be found in cow’s milk from certain breeds like Holstein, while the A2 variant is found in milk from other breeds like Guernsey and Jersey cows.

***

The Gir cow:

Currently the Gir cow milk is touted as a highly superior milk and is sold at a considerable premium.

It is quite likely that buying the more expensive Gir cow milk is getting fashionable amongst our urban affluent, not unlike the use of olive oil!

Gir cow milk does have more A2 proteins than A1 proteins.

Some Gir cow milk may have only the A2 variant proteins but there is no guarantee that the milk you are buying has only the A2 variant and not the A1 variant of the beta casein proteins, unless you have it tested in a specialised laboratory.

***

What matters more is that the milk you get comes from buffaloes or cows those graze in open natural pastures, on grass that is free of harmful chemicals and pesticides and the animals are not injected with hormones and antibiotics.

But it is difficult in the current scenario to ensure this.

And buffalo milk is definitely superior to cow milk, you can look for A2 buffalo milk if you like it, tolerate it better or are very keen on buying A2 milk only.

Read more about the nutrition of milk on the link ‘Magical Health Benefits Of Milk’ on this website.

Fast Food Or Junk Food Are Harmful To Health!

Fast food or junk food are foods that are loaded with calories, sugars and salt, fats, cholesterol and trans fats and lack healthy nutrients like fibre, vitamins and minerals and antioxidants.

Most fast food may lack either complex carbohydrates or proteins or both.

Bakery products like cakes, pastries, biscuits, fried food like ‘wada’, ‘samosa’, ‘bhaji or pakoda’, french fries, fast foods like burgers, hotdogs, sandwiches, pizzas, snacks like chips, farsan, sweet delicacies like gulab jam, basundi, rabdi, jalebi, all kind of mithai including burfi, pedhas, chocolates and aerated sweetened soft drinks, sports energy drinks and alcohol are junk foods and drinks.

Sugar free mithai or sweets also are fast food, since they contain a lot of fat.

Also the sugar substitutes are also not harmless.

Processed and frozen meats like pork bacon, ham, salami, sausages and even chicken nuggets, salami, sausages also are examples of fast foods. They are high in sodium, cholesterol, saturated fats and trans fats.

They are often also treated with sodium nitrite to prevent growth of microorganisms in them and improve their shelf life. Nitrates and nitrites are thought to be carcinogenic.

The internationally famous fried chicken and the equally famous chicken or tuna sandwiches, claiming to be healthy because they have lettuce, tomato and cucumber but loaded with mayonnaise and other such sauces too, are loaded with fat, calories, cholesterol and trans fats.

Thus these foods, very popular amongst young people, too are junk foods.

When buying such foods, please check the labels for fat and sugars. Labels like ‘no added sugar’ can be misleading as it generally means no sucrose, there could be other sugars used.

Labels like zero trans fats too could also be misleading. Most bakery products in India carry the no trans fatty acid labels. But we don’t know if there are any periodic checks on such products to verify the claims of the manufacturer.

The so called health drinks and foods like fruit juices, energy bars, muesli bars too are junk foods as they still contain a lot of  sugar or fats or both.

Over consumption of fast food high in salt, sugars, fats, cholesterol, trans fats and calories leads to obesity, hypertension, type 2 diabetes, hypercholesterolemia , hypertriglyceridemia and heart disease, strokes, non-alcoholic fatty liver disease and certain cancers.

So keep the consumption of fast food low or minimal and exercise regularly to burn off any extra calories consumed through the fast food and prevent weight gain and all the above diseases.

If you are looking to lose weight, keep their consumption low, if you have hypertension, type 2 diabetes, hypercholesterolemia , hypertriglyceridemia and heart disease, avoid them as much as possible.

Also read the articles, ‘Dangers Of Eating Too Much Sugar’, ‘How Much Salt Do I Need’, and ‘The Good And The Bad Fats’ on this website.

Basic Information About Blood Pressure And Hypertension!

Today many people are aware that diabetes is a grave illness.

And they take the threat of the disease seriously.

But more people have hypertension than diabetes and few people are aware that hypertension is as grave a disease as diabetes.

A comprehensive survey reported an overall hypertension prevalence of 30.7%, with higher rates observed in men across various age groups in India, where as the prevalence of Type 2 diabetes in 2021 was estimated to be 11.4% and the prevalence of people with pre diabetes was estimated to be 15.3%.

Hypertension is directly responsible for approximately 57% of all stroke deaths and 24% of all coronary heart disease deaths in India. 

In 2015, hypertension led to an estimated 16,00,000 deaths in India while In 2019 the estimated deaths due to diabetes were 2,80,000.

This will give you an idea of how much higher the prevalence of hypertension is over Type 2 diabetes in India and how many more deaths occur in India due to hypertension than due to diabetes, even if prevalence of both diseases and the deaths they cause is still very high in India.

And a person with hypertension may not have any symptoms.

So many people may not even know that they have the disease.

So it is vital that you get a blood pressure check regularly, more so if you have family history of hypertension, heart disease and strokes.

And it is equally vital that you don’t ignore it, if you have it.

***

So What Is Hypertension?

Arterial blood pressure is measured as mm of Hg or mercury.

It has a higher level or the systolic blood pressure and a lower level or the diastolic blood pressure.

Systole is the phase of the heart beat in which the ventricles, the lower two chambers of the heart contract, the left ventricle sending blood out to the whole body and right ventricle to the lungs.

Diastole is that phase of the heart beat in which the ventricles relax after the contraction, receiving blood from the atria which are the two chambers above the ventricles.

The blood flowing through the arteries exerts certain pressure on the walls of the arteries when it flows through them, both when the ventricles contract, that is the systole and when they relax, the diastole.

The pressure when the ventricles contract is the systolic blood pressure and the pressure when they relax, is the diastolic blood pressure.

Hypertension or high blood pressure is a condition in which the blood pressures in the arteries are persistently higher than normal.

***

Normal levels of blood pressure and raised levels of blood pressure:

As per the American College Of Cardiology and the American Heart Association, the normal ranges and the raised levels of the blood pressure are as follows:

Normal blood pressure is 120 by 80 mm of Hg, or below.

Elevated blood pressure: Blood pressure ranging between systolic pressure 121 to 129 and diastolic pressure 80 or less mm of Hg, is elevated blood pressure.

Stage I hypertension: Systolic blood pressure between 131 to 139 and the diastolic between 80 to 89 mm of Hg.

Stage II hypertension: Systolic blood pressure between 140 or higher and the diastolic 90 or more, mm of Hg.

***

Types Of Hypertension:

Primary Or Essential Hypertension:

A complex combination of genes and environmental factors, excess salt consumption, Western kind of high fat – high calorie, high animal food diet deficient in complex carbohydrates, green vegetables and fruits, lack of exercise, abdominal obesity, stress, aging are some of the factors which can contribute to the development of hypertension.

In this type of hypertension, the major contributor to hypertension is the increased peripheral resistance to blood flow through arteries.

Secondary Hypertension:

Secondary hypertension is the hypertension which has an underlying disease as the cause of hypertension.

Kidney disease, renal artery stenosis (narrowing) are the most common causes underlying this kind of hypertension, endocrinal disorders like Cushing’s Syndrome, hyperthyroidism, hypothyroidism, certain pituitary disorders and a pituitary tumour called pheochromocytoma can also cause hypertension.

***

Signs And Symptoms Of Hypertension:

Hypertension usually causes few symptoms. That is why it is called a silent killer.

Some people may complain of headaches, especially at the back of the head, vertigo, tinnitus and fainting. But anxiety and stress can also cause these symptoms.

That is why hypertension is often detected in general medical check up or sometimes when people go for blood donation.

***

Effects Of Hypertension:

Prolonged hypertension causes inflammation in the endothelium, the inner lining, of the arterial walls damaging the arteries including those of various organs of the body.

This can lead to hardening and thickening of the arterial walls and narrowing of their lumen. This is called atherosclerosis.

Atherosclerosis causes loss of elasticity in the arterial walls causing an increase in the peripheral resistance to the blood flow and it also leads to heart attacks and strokes.

Raised blood pressure causes greater resistance to the flow of the blood through the arteries and forces the heart to pump harder to circulate blood through our body, causing hypertrophy (thickening) of the heart muscle. The thickened heart muscle struggles to pump blood efficiently and eventually fails to do so, causing heart failure.

It can also lead to weakening and bulging of the arteries. This is called aneurism and such aneurisms can rupture and cause heavy internal bleeding causing grave complications, including strokes.

Thickening and narrowing and aneurysms of the arteries in kidneys or eyes can damage these organs and can lead to renal failure and loss of vision.

Hypertension also contributes to development of the metabolic syndrome that leads to development of diabetes, heart attacks and strokes.

It can also cause circulatory problems and strokes in the brain.

It can a lead to impairment of memory and understanding and development of vascular dementia, a general name given to a condition that causes decline of cognitive abilities of thinking, remembering and reasoning in a person leading to inability to perform daily activities.

Hypertension is a major cause of premature death all over the world.

***

Prevention Of Hypertension:

Hypertension is best prevented than treated.

Maintain ideal body weight.

Keep your salt consumption low, eat less than one teaspoon or 5 gm table salt a day.

Keep your animal food consumption low, eat more of complex carbohydrates, vegetables, fruits and low fat milk.

Have at least five helpings of vegetables and fruits every day.

Have regular cardiovascular exercise like brisk walking, jogging, running, cycling, swimming, aerobics.

Keep stress low.

Limit alcohol consumption.

Stop smoking.

***

Treatment Of Hypertension:

Your doctor may advise lifestyle modification, healthy diet, low salt consumption, regular cardiovascular activity, weight loss, quitting alcohol and smoking and reduction in stress.

Doctors treat hypertension with a variety of anti hypertensive drugs including diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors (ACE inhibitors), angiotensin receptor blockers (ARBs) and beta blockers.

Previously beta blockers were thought to be effective as the first line treatment for hypertension, but the Cochrane Review, an independent, high quality review system of research in health care, has found that beta blockers were less effective in preventing heart disease than were the other anti hypertensive drugs.

According to a study published in 2003, 5 mm Hg drop in blood pressure reduces the risk of stroke by 34%, ischaemic heart disease by 21% and lowers the threat of dementia, heart failure and mortality due to heart disease.

Previous thinking about normal blood pressure levels was that older people, in their sixties and older could have higher normal levels blood pressure than the younger people, is no more considered acceptable.

Everyone should have blood pressures levels of 120 by 80 m.m. of Hg or lower, to be protected against heart disease and strokes and damage to the kidneys and eyes.

If your blood pressure levels are higher than 120 by 80 m.m., seek medical advice immediately, irrespective of your age.

And focus on getting your blood pressure down to the normal level, as early as possible!

Irrespective of your age!

Also read the articles ‘Preventing Hypertension’ and ‘Health Problems Of The Young: Hypertension’ on this website.

***

ब्लड प्रेशर आणि हायपरटेन्शन विषयी थोडेसे!

आज बहुतेक लोक डायबीटिस ह्या आजाराच्या धोक्यांबद्दल बऱ्यापैकी जागरूक होऊ लागले आहेत.

आणि चाळीशीच्या जवळ आलेले अनेक तरुण डायबीटिस होण्याच्या भीतीने वजन कमी करून त्यांच्या ब्लड शुगर्स कंट्रोल करून घेण्यासाठी माझ्याकडे येत आहेत.

पण डायबीटिस इतकाच धोकादायक आणि डायबीटिस पेक्षा खूप अधिक प्रचलित असलेल्या हाय ब्लड प्रेशर किंवा हायपरटेन्शन ह्या आजाराविषयी विषयी मात्र अजूनही पुरेशी जागरूकता आहे असे जाणवत नाही.

कारण केवळ हायपरटेन्शन असण्याच्या किंवा होण्याच्या भीतीने डायबीटिसच्या मानाने कमी तरुण माझ्याकडे वजन कमी करायला येत आहेत.

पण डायबीटिस पेक्षा खूप अधिक लोकांना हायपरटेन्शन किंवा हाय ब्लड प्रेशर आहे.

एका मोठ्या रिसर्च मध्ये भारतातील 30.7 % लोकांना हायपरटेन्शन असलेले आढळून आले आहे, आणि पुरुषांमध्ये हे प्रमाण ह्या ही पेक्षा अधिक असल्याचे दिसून आले आहे, तर 2021 मधील एका रिसर्च मध्ये भारतातील डायबीटिस चे प्रमाण  11.4 % तर प्री डायबीटिस चे प्रमाण 15.3 % असल्याचे दिसून आले आहे.

भारतात स्ट्रोक्स मुळे होणाऱ्या मृत्यूंपैकी 57 % तर हार्ट अटॅक  मुळे होणाऱ्या मृत्यूंपैकी 24 % मृत्यू हे हायपरटेन्शन मुळे होत आहेत.

आपल्या देशात 2015 मध्ये हायपरटेन्शन मुळे 16,00,000 तर 2019 मध्ये डायबीटिस मुळे 2,80,000 मृत्यू झाल्याचा अंदाज आहे.

ह्याचाच अर्थ आपल्या देशात हायपरटेन्शन मुळे मृत्यू पावणाऱ्या लोकांचे प्रमाण डायबीटिस मुळे होणाऱ्या मृत्यूंपेक्षा खूप अधिक आहेत.

तरी ही लोकांना हायपरटेन्शन च्या धोक्याची पुरेशी जाणीव नसावी असे वाटते.

आणि हायपरटेन्शन ही डायबीटिस इतकाच गंभीर आजार आहे.

पण हायपरटेन्शन असलेल्या बहुतेक लोकांना तो किती गंभीर आजार आहे ह्याची पूर्ण कल्पना आहे असे जाणवत तरी नाही.

आणि हायपरटेन्शन हे बऱ्याच वेळा एसिम्पटमॅटिक असते, म्हणजे त्याची फारशी काही लक्षणे ही नसतात.

त्यामुळे अनेकांना आपले ब्लड प्रेशर वाढलेले आहे हे कळतच नाही.

म्हणूनच हल्लीच्या तणावपूर्ण काळात प्रत्येकाने वर्षातून एकदा तरी आपले ब्लड प्रेशर डॉक्टरां कडून तपासून घ्यावे.

आणि जर हायपरटेन्शन, हृदयरोग, स्ट्रोक्स ह्यांची फॅमिली हिस्टरी असेल तर ब्लड प्रेशर दर सहा महिन्यांनी चेक करून घ्यावे.

आणि जर हायपरटेन्शन असेल तर त्याच्याकडे अजिबातच दुर्लक्ष करू नका.

***

तर काय आहे हे हायपरटेन्शन?

ब्लड प्रेशर हे mm of Hg ह्या युनिट मध्ये मोजले जाते.

ब्लड प्रेशर च्या दोन लेव्हल्स असतात, वरचे  सिस्टॉलिक ब्लड प्रेशर आणि खालचे डायस्टॉलिक ब्लड प्रेशर.

सिस्टली ही हार्ट बीट मधील हृदयाच्या व्हेन्ट्रिकल्स ह्या खालच्या चेंबर्स च्या कॉनट्रॅक्ट होण्याची तर डायास्टली ही व्हेन्ट्रिकल्स च्या रिलॅक्स होण्याची फेज असते.

सिस्टली मध्ये हृदयाची डावी व्हेन्ट्रिकल सर्व शरीरात ऑक्सिजनेटेड, शुद्ध रक्त पाठवते तर उजवी व्हेन्ट्रिकल फुप्फुसांकडे डीऑक्सिजनेटेड रक्त ऑक्सिजनेशन साठी पाठवते, तर डायास्टली मध्ये दोन्ही व्हेन्ट्रिकल्स ह्या ॲट्रिया ह्या हृदयाच्या वरच्या चेंबर्स कडून रक्त स्वीकारतात.

शरीराच्या आर्टरिज मधून वाहताना हे रक्त हार्ट बीट च्या सिस्टली आणि डायास्टली ह्या दोन्ही फेजेस मध्ये हृदयाच्या आर्टरिजच्या वॉल्स वर विशिष्ट प्रेशर टाकत असते.

तर हार्ट बीट च्या सिस्टलीच्या फेज मध्ये टाकले गेलेले ब्लड प्रेशर सिस्टॉलिक तर डायास्टली च्या फेज मध्ये टाकले गेलेले ब्लड प्रेशर हे डायस्टॉलिक ब्लड प्रेशर असते.

हायपरटेन्शन किंवा हाय ब्लड प्रेशर म्हणजे आर्टरिज मधील ही ब्लड प्रेशर्स सातत्याने नॉर्मल पेक्षा हाय असणे.

अमेरिकन कॉलेज ऑफ कार्डिऑलजी आणि अमेरिकन हार्ट असोसिएशन ह्यांच्या रेकमेंडेशन प्रमाणे 

नॉर्मल ब्लड प्रेशर लेव्हल्स: 120 बाय 80 mm of Hg.

वाढलेले (एलिव्हेटेड) ब्लड प्रेशर: सिस्टॉलिक ब्लड प्रेशर 120 ते 129 आणि डायस्टॉलिक ब्लड प्रेशर 80 किंवा कमी mm of Hg.

स्टेज I हायपरटेन्शन: सिस्टॉलिक ब्लड प्रेशर 131 ते 139 आणि डायस्टॉलिक ब्लड प्रेशर 80 ते 89 mm of Hg.

स्टेज II हायपरटेन्शन: सिस्टॉलिक ब्लड प्रेशर 140 किंवा अधिक आणि डायस्टॉलिक ब्लड प्रेशर 90 किंवा अधिक mm of Hg.

***

हायपरटेन्शन चे प्रकार: 

प्रायमेरी किंवा असेंशल हायपरटेन्शन:

जीन्स आणि एनव्हायरनमेंट ह्यांचे कॉम्प्लेक्स कॉम्बिनेशन, अन्नात मीठाचा अतिरेक, पाश्चिमात्य प्रकारचा हाय फॅट, हाय ॲनिमल फूड (मांसाहार), हाय कॅलरी, कॉम्प्लेक्स कार्बोहायड्रेट, फळे आणि भाज्या ह्यांचा अभाव असलेला आहार, व्यायामाचा अभाव, ॲब्डॉमिनल ओबेसिटी (पोटात अधिक चरबी असणे), स्ट्रेस (तणाव), वाढते वय ही प्रायमरी किंवा असेंशल हायपरटेन्शन निर्माण होण्याची कारणे आहेत.

प्रायमेरी हायपरटेन्शन मध्ये ब्लड प्रेशर वाढण्याचे प्रमुख कारण रक्त प्रवाहाला आर्टरीज मध्ये वाढलेला पेरिफेरल रेझिस्टन्स हे असते.

सेकन्डरी हायपरटेन्शनः

ह्या प्रकारच्या हायपरटेन्शन मध्ये इतर ऑरगन्स च्या आजारामुळे ब्लड प्रेशर वाढते.

किडनी चे आजार, रीनल आर्टरी स्टिनोसिस ही सर्वात कॉमन कारणे असतात. इतर कारणांमध्ये कुशिंग्स सिन्ड्रोम, हायपरथायरॉईडिझम, हायपोथायरॉईडिझम, काही पिच्युअटरी ग्लॅन्डचे आजार आणि फियोक्रोमोसायटोमा हा पिच्युअटरी ट्युमर ह्या आजारांमध्ये असे हायपरटेन्शन येऊ शकते.

***

हायपरटेन्शन ची लक्षणेः

वर सांगितल्या प्रमाणे हायपरटेन्शन बहुतेक वेळा एसिम्पटमॅटिक असते, म्हणजे त्याची फारशी लक्षणे जाणवतच नाहीत आणि त्यामुळे ते बऱ्याच वेळा वेळेत डायग्नोस होतंच नाही, म्हणूनच त्याला सायलेंट किलर म्हणतात.

काही लोकांना डोके दुखणे, विशेषतः डोक्याच्या मागील भागात, चक्कर येणे, फेंटीग अटॅक्स, कानात रिंगिंग आवाज येणे (टिनिटस) अशी लक्षणे जाणवू शकतात, पण ती डिप्रेशन मुळे ही असू शकतात.

म्हणूनच हायपरटेन्शन हे इतर काही कारणांसाठी मेडिकल चेकअप करताना किंवा ब्लड डोनेशन करायला गेल्यावर केल्या गेलेल्या ब्लड प्रेशर चेक मध्ये सापडते.

***

हायपरटेन्शनचे दुष्परिणाम:

प्रदीर्घ हायपरटेन्शन मुळे शरीराच्या आर्टरीज च्या एन्डोथेलियम म्हणजे अगदी आतल्या लायनिंग मध्ये इनफ्लमेशन (एक प्रकारचा दाह) निर्माण होऊन आर्टरीजच्या वॉल्स ची जाडी वाढते आणि त्यात कडकपणा येतो आणि आर्टरीज ची लवचिकता कमी होते. ह्यालाच अथेरोस्केरॉसिस म्हणतात.

ह्या मुळे रक्त प्रवाहा वरील पेरिफेरल प्रेशर वाढते आणि त्यामुळे ब्लड प्रेशर वाढते आणि त्या मुळे हृदयाला शरीरभर रक्त पुरवठा करण्यासाठी अधिक जोरात पंपिंग करावे लागते, त्या मुळे कार्डिॲक मसल ची हायपरट्रफी होते म्हणजे हृदयाच्या स्नायू ची जाडी वाढते. असे हृदय शरीरातून रक्त वाहते ठेवण्या साठी झगडू लागते आणि अखेर तसे करण्यात अपयशी होऊ लागते. ह्यालाच हार्ट फेलयर असे म्हटले जाते.

अशा अथेरोस्केरॉसिस मुळे एन्डोथेलियम डॅमेज झाल्याने आर्टरीज मध्ये ब्लड क्लॉट्स आणि प्लाक्स निर्माण होऊ शकतात आणि रक्त प्रवाहाला अडथळा निर्माण होतो आणि हार्ट अटॅक्स किंवा स्ट्रोक्स येऊ शकतात, तसेच इतर ऑर्गन्स ही डॅमेज होऊ शकतात.

ह्यात किडनी आणि डोळ्यांच्या आर्टरीज ही डॅमेज होतात.

कालांतराने ह्यातून रीनल फेलयर होऊ शकते आणि दृष्टी ही गमवावी लागू शकते.

हायपरटेन्शन मुळे मेंदू मधील आर्टरीज डॅमेज झाल्याने तर्कशुद्ध विचार करण्याची (रिझनिंग) आणि लक्षात ठेवण्याची क्षमता (मेमरी) नष्ट होऊ लागते. हळू हळू अशा व्यक्तीस दात घासणे, स्नान करणे, कपडे घालणे अशी दैनंदिन कार्य करणे सुध्दा जमत नाही. ह्या आजाराला व्हॅस्क्युलर डिमेन्शिया असे म्हटले जाते.

जगभर हायपरटेन्शन हे अकाली मृत्यू (प्रीमच्युअर डेथ) च्या प्रमुख कारणांपैकी एक कारण आहे.

***

हायपरटेन्शन प्रिव्हेन्शन:

ह्या आजारात सेकन्डरी हायपरटेन्शन पेक्षा प्रायमेरी हायपरटेन्शन चे प्रमाण खूपच अधिक आहे.

आणि प्रायमेरी हायपरटेन्शन निर्माण होण्या साठी जी कारणे जबाबदार आहेत त्यांची आपल्याला माहिती आहे. 

त्यातील बरीच कारणे पूर्णपणे टाळण्या सारखी आहेत.

म्हणूनच हायपरटेन्शन हा आजार होण्या आधी तो होणार नाही ह्याची काळजी घेतली, तर तो बऱ्याच अशी टाळता येण्या सारखा आजार आहे.

त्या साठी आपल्याला खालील गोष्टी करणे आवश्यक आहे.

तुमचे वजन सुयोग्य (आयडीअल) लेव्हल ला ठेवा. 

तुमच्या आहारात मिठाचे प्रमाण अगदी कमी राखा. आपण खात, पीत असलेल्या प्रत्येक पदार्थात छुपे मीठ असतेच.

तुमच्या आहारात मांसाहारी पदार्थ कमी ठेवा, धान्य – कडधान्य आणि भाज्या आणि फळे ह्या कॉम्प्लेक्स कार्बोहायड्रेट्स चे प्रमाण अधिक ठेवा.

भाज्या आणि फळे ह्यांचे निदान पाच सर्विंग्ज दिवसभरात आहारात ठेवा.

जलद चालणे, जॉगिंग, स्लो रनिंग, रनिंग, एरोबिक्स, स्विमिंग आणि ट्रेडमिल, इलिप्टिकल ट्रेनर सारख्या कार्डिओव्हॅस्क्युलर इक्विपमेंट वरील पुरेसे कार्डिओव्हॅस्क्युलर व्यायाम रोज करा.

स्ट्रेस लेव्हल कमी करा. त्या साठी मेडिटेशन, योगनिद्रा उपयुक्त ठरू शकतात.

अल्कोहोल सेवनाचे प्रमाण कमी करा.

धुम्रपान, तंबाखू पूर्णपणे बंद करा.

***

हायपरटेन्शन ची ट्रीटमेंट

तुमचे डॉक्टर तुम्हाला जीवनशैली आणि आहारातील वरील बदल, आणि अल्कोहोल आणि धुम्रपान, तंबाखू बद्दल सल्ला देतीलच.

ह्या शिवाय गरज असेल त्या प्रमाणे डायुरेटीक्स, कॅल्शियम चॅनेल ब्लॉकर्स, ACE इनहिबिटर्स, AR ब्लॉकर्स (ARBs), बीटा ब्लॉकर्स सारखी ॲन्टी हायपरटेन्सिव्ह औषधे प्रिस्क्राईब करतील.

दोन हजार तीन मध्ये पब्लिश झालेल्या एका रिसर्च मध्ये केवळ 5 mm ब्लड प्रेशर कमी झाल्याने स्ट्रोक्स होण्याचा धोका 34%, तर हृदयविकाराचा (इस्कीमीक हार्ट डिझीझ) धोका 21% कमी झालेला आढळला. ह्या शिवाय व्हॅस्क्युलर डिमेन्शिया, हार्ट फेल्यर आणि हृदयविकाराने मृत्यू येण्याचा धोका ही कमी झाल्याचे आढळले आहे.

त्या मुळे लवकरात लवकर तुमचे ब्लड प्रेशर नॉर्मल करण्या वर लक्ष केंद्रित करा!

Hypothyroidism Or Under Active Thyroid Gland

Thyroid is a butterfly shaped endocrine gland situated at the base of the neck, below the prominence of the Adam’s apple, resting on the trachea or the windpipe.

It produces three hormones, the two thyroid hormones called triiodothyronine or T3 and thyroxine or the T4 hormones and calcitonin.

The two thyroid hormones control the metabolic rate, synthesis of proteins and the growth and development of children.

Calcitonin is involved in calcium homeostasis that is, it takes up calcium from the blood and deposits it in bones.

The two thyroid hormones are regulated by thyroid stimulating hormone or TSH, which is secreted by the master endocrine gland, the pituitary and the production of TSH in turn is regulated by a hormone called the thyrotropin releasing hormone or the TRH, produced by the hypothalamus, a part of the brain.

It means the final control of the thyroid gland lies with the brain.

***

Hyperthyroidism and hypothyroidism:

When the thyroid gland produces excess thyroid hormones, it results in hyperthyroidism while when it produces low levels of the thyroid hormones, it results in hypothyroidism.

Hypothyroidism is more common in women and in people over 60.

The commonest cause of hypothyroidism all over the world is deficiency of iodine in food and most countries have tackled the problem by iodising the salt available to its population.

A condition called Hashimoto’s thyroiditis or Hashimoto’s disease, an autoimmune disease of the thyroid gland, is the common cause of hypothyroidism in areas where there is no iodine deficiency in the population. It gradually destroys the gland.

***

Hypothyroidism:

Hypothyroidism can cause a variety of symptoms including fatigue, intolerance of cold, slow pulse rate, anaemia, depression, constipation, dyspepsia, muscle weakness, shortness of breath, hoarseness of voice, hair loss, dry, rough skin, weight gain, heavy menstruation in ladies and weight gain.

Apart from depression, hypothyroidism is also known to accompany severe psychiatric disorders like bipolar disorder, mood disorders and schizophrenia.

It can occur also in pregnancy. Not treating hypothyroidism during pregnancy can lead to delayed growth and low intellectual development of the baby.

Mild or sub clinical hypothyroidism too can cause infertility and miscarriages and can also cause a grave pregnancy condition called pre-eclampsia, a condition in which there is rise in the blood pressure and loss of significant amounts of protein in urine. Gestational diabetes is also seen in hypothyroidism in pregnancy.

In mild or sub clinical hypothyroidism the TSH levels are raised but the thyroid hormone levels are normal.

***

The diagnosis and the treatment:

Many times, the patient of hypothyroidism is the last to complain about the condition. Often a family doctor may suspect the disease seeing sudden weight gain, deteriorated skin and changes in voice in a regular patient plus probably dulled comprehension reflected in speech and eyes, suspects hypothyroidism.

A doctor will usually suspect hypothyroidism when she or he sees that your skin and hair are dry and rough, there is coldness and swelling of extremities and your heart rate is slow (bradycardia). He may also see delayed relaxation of tendons on testing the tendon reflexes and a kind of non pitting oedema called myxoedema.

Thyroid function lab tests include checking the blood levels of the pituitary hormone TSH and levels of the thyroid hormones T3 and T4.

High blood levels of TSH and / or low levels of T3 and T4 are diagnostic of hypothyroidism.

Hypothyroidism is treated by your doctor with levothyroxine, a synthetic form of the thyroxine hormone or T4.

Levothyroxine is safe in pregnancy.

Your doctor will order regular lab checks of your blood levels of TSH, T3 and T4 (thyroid function test) and adjust the dose of your medication based on the severity of the symptoms and the levels of the hormones, from time to time.

That is the reason why you have to check your thyroid function and see your doctor at regular intervals as advised by your doctor.

***

The weight gain due to hypothyroidism is of mild to moderate degree. A huge weight gain is unlikely to be caused by hypothyroidism.

Many slimming programs tell people under their treatment that they haven’t lost weight because they have hormonal problems.

The commonest hormonal problems related to obesity are PCOD and hypothyroidism.

It doesn’t matter whether your weight gain is due to PCOD or hypothyroidism.

You still have to eat healthy and at least walk adequately to slim down perfectly and overcome PCOD and most likely help your doctor to reduce your levothyroxine dose considerably.

And people unfailingly do succeed, if they do.

The people on these slimming programs didn’t fail because they had hormonal problems, but because the treatments themselves were unscientific.

Also read the articles, ‘Basics Of Nutrition’, ‘The Science Of Exercise’ and the ‘Simple Steps To Slimming’ and ‘Health Problems Of The Young: PCOD‘ on this website.

***

हायपोथायरॉयडिझम! 

थायरॉईड ही एक फुलपाखराच्या आकाराची एन्डोक्रिन ग्लॅन्ड (ग्रंथी) आहे.

ही ग्लॅन्ड गळ्यातील ॲडम्स ॲपल ह्या उचंवट्या खाली ट्रकिया किंवा विंड पाइप वर बसलेली असते.

ती ट्रायआयोडोथायरोनाईन किंवा ‘टी 3’ आणि थायरॉक्झिन किंवा ‘टी 4’ ही दोन थायरॉईड हॉर्मोन्स आणि कॅल्सिटोनिन ही तीन हॉर्मोन्स निर्माण करते.

ह्या पैकी ही दोन थायरॉईड हॉर्मोन्स ही मेटबॉलिझम, प्रोटीन सिन्थेसिस आणि लहान मुलांची वाढ आणि डिव्हेलपमेंट नियंत्रित करते, तर कॅल्सिटोनिन हे रक्तातील कॅल्शियम हाडांमध्ये डिपॉझिट करते.

ही दोन थायरॉईड हॉर्मोन्स पिच्युअटरी ही मास्टर एन्डोक्रिनल ग्लॅन्ड ‘टी एस एच’ (TSH) ह्या हार्मोन ने कंट्रोल करते तर ‘टी एस एच’ हे हार्मोन, मेंदू च्या तळाशी असलेले हायपोथलॅमस, थायरोट्रोपिन रिलीझिंग हार्मोन किंवा ‘टी आर एच’ ने कंट्रोल करते.

म्हणजेच ह्या सर्व हॉर्मोन्स वर नियंत्रण अखेर मेंदू चे असते.

***

जेव्हा थायरॉईड ग्लॅन्ड गरजे पेक्षा अधिक थायरॉईड हॉर्मोन्स निर्माण करते, तेव्हा हायपरथायरॉयडिझम तर गरजे पेक्षा कमी थायरॉईड हॉर्मोन्स निर्माण करते तेव्हा हायपोथायरॉयडिझम हे आजार निर्माण होतात.

हायपोथायरॉयडिझम हे स्त्रिया आणि वयाच्या साठीच्या पुढच्या लोकांमध्ये अधिक प्रमाणात आढळते.

हायपोथायरॉयडिझम चे जगातील प्रथम कारण अन्नात आयोडीन ची कमी हे आहे.

आणि जगातल्या अनेक देशांनी मीठा मध्ये आयोडीन ॲड केल्याने जगातील हायपोथायरॉयडिझम चे प्रमाण खूप कमी झाले आहे.

जगातील मिठात आयोडीन ॲड केलेल्या भागात, हशिमोटो थायरॉयडायटीस किंवा हशिमोटो डिसीझ हा ऑटोइम्यून आजार हा हायपोथायरॉयडिझम प्रमुख कारण आहे. ह्या आजारात थायरॉईड ग्लॅन्ड हळू हळू नष्ट होते.

हायपोथायरॉयडिझम मध्ये थकवा, थंडी सहन न होणे, स्लो पल्स रेट, डिप्रेशन, कॉनस्टिपेशन, अपचन, स्नायूंचा वीकनेस, श्वास घ्यायला त्रास होणे, आवाजात होर्सनेस येणे, केस रफ होणे आणि गळणे, स्किन रफ होणे, वजन वाढणे, स्त्रियांमध्ये पाळी मध्ये खूप ब्लीडिंग होणे अशी लक्षणे दिसतात.

डिप्रेशन शिवाय ही बायपोलर डिसऑर्डर, मूड डिसऑर्डर्स, स्किट्झोफ्रेनिया ह्या सारखे गंभीर सायकियाट्रिक आजार ही हायपोथायरॉयडिझमशी संबंधित असू शकतात.

***

हायपोथायरॉयडिझम प्रेग्नन्सी मध्ये ही होऊ शकते.

काही लोकांना प्रेग्नन्सी मध्ये आलेल्या हायपोथायरॉयडिझम वर औषधे घेणे सुरक्षित आहे का ह्याची काळजी वाटते.

प्रत्यक्षात प्रेग्नन्सी मध्ये आलेल्या हायपोथायरॉयडिझम वर औषधे घेणे सुरक्षितच नव्हे तर अत्यावश्यक ही आहे.

प्रेग्नन्सी मध्ये आलेल्या हायपोथायरॉयडिझम वर योग्य उपचार न झाल्यास त्याचा परिणाम बाळाच्या वाढीवर आणि बौधिक विकासावर वर ही होऊ शकतो.

अनेक लोकांमध्ये हायपोथायरॉयडिझम सबक्लिनिकल सुध्दा असू शकते. ह्यात थायरॉईड हॉर्मोन्स च्या लेव्हल्स नॉर्मल असतात पण ‘टी एस एच’ ह्या पिच्युटरी हॉर्मोन च्या लेव्हल्स वाढलेल्या असतात.

अगदी माइल्ड किंवा सबक्लिनिकल हायपोथायरॉयडिझम मुळे सुध्दा वंध्यत्व किंवा प्रेगनन्सी मध्ये आल्यास गर्भपात होऊ शकतो. 

तसेच प्रीइक्लाम्पशिया हा अतिशय गंभीर आजार ही होऊ शकतो. ह्या आजारात ब्लड प्रेशर एकदम वाढते आणि लघवीतून मोठ्या प्रमाणात प्रोटीन्स शरीरा बाहेर पडतात. ह्या आजारातून पुढे आई ला कनव्हलशन्स ही येऊ शकतात, ह्या आजाराला इक्लाम्पशिया म्हणतात. हे आजार आई आणि बाळाच्या जीवाला घातक ठरू शकतात.

***

डायग्नोसिस आणि ट्रीटमेंट

हायपोथायरॉयडिझम ह्या आजारात सुरुवातीला तर पेशंट स्वत: काहीच तक्रार न करण्याची शक्यता असते, कारण तिला काही त्रास न जाणवण्याची शक्यता असते.

बऱ्याच वेळा नेहमीच्या पेशंट चे वजन अचानक थोडे फार वाढलेले दिसणे, आवाजात बदल (होर्सनेस, आवाज बसल्या सारखा, काहीसा घोगरा) झालेला जाणवणे, पेशंटच्या हालचाली आणि आकलन (कॉम्प्रिहेन्शन) मंदावलेले दिसणे, केस आणि स्किन ड्राय आणि रफ झालेले दिसणे असे बदल जाणवल्याने फॅमिली डॉक्टरांनाच हायपोथायरॉयडिझम चा संशय येऊ शकतो.

पण हल्ली फॅमिली डॉक्टर ही संस्थाच (इन्स्टीट्यूशन) फारशी शिल्लक नसल्याने, असे डायग्नोसिस होणे इतर काही कारणांसाठी कन्सल्टंट ने तपासल्या आणि ब्लड टेस्ट केल्यावरच होणे अधिक संभवते.

डॉक्टरांसाठी तपासणीत तुमचे केस आणि स्किन ड्राय आणि रफ असलेले आढळणे, हात पाय काहीसे थंड असणे आणि त्यांवर सूज सापडणे, आणि हार्ट रेट स्लो असल्याचे दिसणे, स्किन वर दाबून पाहिल्यास खड्डा न पडणारी सूज (नॉन पिटिंग इडीमा, ह्याला मिक्सिडीमा म्हणतात) दिसणे आणि स्लो रिलॅक्सेशन ऑफ टेंडन रीफ्लेक्स आढळणे ह्या हायपोथायरॉयडिझम च्या साईन्स असतात.

थायरॉईड फन्क्शन ह्या ब्लड टेस्ट्स मध्ये ‘टी एस एच’, ‘टी 3’ आणि ‘टी 4’ ह्या थायरॉईड हॉर्मोन्सच्या लेव्हल्स तपासल्या जातात.

हायपोथायरॉयडिझम मध्ये फक्त ‘टी एस एच’ च्या लेव्हल्स वाढलेल्या आढळतात किंवा टी 3 आणि टी 4 ह्यांच्या लेव्हल्स कमी झालेल्या ही आढळतात.

तुमचे डॉक्टर तुम्हाला लीव्होथायरॉक्झिन ह्या सिंथेटीक थायरॉक्झिन हॉर्मोन सप्लिमेंट देऊन तुमचे हायपोथायरॉइडिझम ट्रीट करतात.

लीव्होथायरॉक्झिन घेणे प्रेग्नन्सी मध्ये ही सुरक्षित असते. आणि तुमच्या डॉक्टरांनी ते प्रिस्क्राईब केले तर ते घेणे अत्यावश्यक ही आहे.

तुमचे डॉक्टर तुम्हाला ठराविक महिन्यांनी थायरॉईड फन्क्शन रिपोर्ट करून घेऊन चेकअप साठी बोलावतात आणि तुमची लक्षणे आणि रीपोर्ट वरून तुमचा लीव्होथायरॉक्झिन चा डोस अजस्ट करतात, म्हणजेच तो काही वेळा थोडा कमी जास्त ही होऊ शकतो.

त्यामुळे नियमित थायरॉईड फन्क्शन चेक करणे आणि तुमच्या डॉक्टरांना नियमित भेटणे आवश्यक आहे.

***

हायपोथायरॉयडिझम मुळे होणारे वेट गेन थोडे ते मध्यम स्वरूपाचे असते. तुमचे वजन खूप वाढलेले असेल, तर ते हायपोथायरॉयडिझम मुळे असण्याची शक्यता कमी असते.

जर तुमची वजनाची ट्रीटमेंट देणारे, तुमचे वजन हॉर्मोन्स मुळे कमी होत नाही, असे सांगत असतील, तर ते खोटे आहे.

त्यांच्या ट्रीटमेंट वर तुमचे वजन कमी होत नसेल, तर ते त्यांची ट्रीटमेंट अनसायंटिफिक असल्याने आहे, ते तुम्ही कमी पडल्याने किंवा तुमच्या हॉर्मोन्स मुळे नाही हे लक्षात ठेवा!

वजन वाढवू शकणारे दोन कॉमन एन्डोक्रिनल आजार म्हणजे पीसीओडी आणि हायपोथायरॉईडिझम.

तुम्ही जर योग्य, संतुलित आहार घेतला आणि पुरेसे चालला तर हायपोथायरॉयडिझम काय किंवा पीसीओडी काय, तुमचे वजन कमी होणे थांबवू शकत नाहीत!

आणि तुमचे वजन कमी झाले तर तुमचे डॉक्टर तुमचा लीव्होथायरॉक्झिनचा डोस कमी ही करू शकतात किंवा तुम्हाला पीसीओडी असेल तर तो रिव्हर्स ही होऊ शकतो.

त्या साठी उपासमार किंवा अतिरेकी व्यायाम ह्या दोन्हींची अजिबात गरज नाही! h

Raised Levels Of Blood Uric Acid, Gout And Kidney Stones!

Many people suffer from raised levels of uric acids in their blood.

Often this condition is found in routine renal function tests.

Most often this condition is ignored if the rise is borderline.

But left untreated, long term rise in uric acid could cause chronic illnesses like gout and renal stones and kidney and heart disease.

What exactly are these diseases?

***

Certain foods that we eat contain chemicals called purines.

Uric acid is formed when purines are broken down by our body.

Uric acid dissolves in blood and it is transported to the kidneys and they excrete it out of our body in urine, maintaining the blood uric acid levels normal (3.5 to 7.2 mg / dL).

If the blood uric acid levels rise above 7.2 mg / dL, the condition is called hyperuricemia.

If excess uric acid is accumulated in our body, it may get deposited in our joints in the form of uric acid crystals causing a very painful form of arthritis called gout.

They may also settle in the kidneys forming kidney stones.

If the condition is not treated it can cause permanent bone, joint, tissue and kidney damage and can also lead to heart disease.

Researchers have also found links between hyperuricemia and high blood pressure, type 2 diabetes and fatty liver.

***

Foods high in purines are:

Sea food like salmon and sardines and shell fish shrimps (prawns) and lobsters.

Red meat.

Organ meats like liver.

Sugar sweetened foods like sweetened cereals, bakery products, candies.

Alcohol, especially beers and distilled liquors and also non alcoholic beers.

Certain vegetables like spinach, asparagus.

***

Signs and symptoms of gout:

When the blood uric acid levels remain high for long time sharp needle like crystals of uric acid or urate crystals get deposited in some joints and tissues around the joints.

This causes the joints to become hot, red, swollen and tender. The pain is severe and comes on quickly and peaks in less than twelve to twenty four hours.

The joint at the base of the big toe is affected in half the cases, but the heal, knee, wrists, finger joints too can be affected.

Such attacks can recur frequently, unless treated.

Some people may also develop hard, painless deposits of uric acid crystals called tophi. These too can cause bone damage and arthritis.

Gout appears to affect elderly males more often. It is also associated with metabolic syndrome, presence of abdominal obesity, hypertension, insulin resistance and abnormal lipid profile including high triglyceride levels. So people with hypertension and diabetes are also at a greater risk of developing it.

Gout affects habitual beer drinkers and those who drink a lot of sweetened drinks. It also affects people who habitually consume purine rich foods like some fishes including shell fish like prawns and lobsters and red meats.

Some vegetables like cauliflower, asparagus, spinach, mushrooms, green peas and chickpeas (chana in Marathi) and fava beans (wal papadi in Marathi) and some dried beans too have high levels of purines.

But the plant purines have not been found to cause gout attacks as much as the animal purines.

And some individuals report different vegetables triggering gout attacks in them, including some vegetables not high in purines, e.g. tomatoes.

It probably means some factors other than purines may have a role to play in these attacks.

So such people might want to avoid foods those trigger gout attacks in them, irrespective of their purine content.

Dietary precautions may reduce the recurrence or the severity of gout attacks, but they cannot replace medication to control hyperuricemia and the attacks of gout or prevent further joint damage due to hyperuricemia.

In short, medications lowering blood uric acid levels are essential even if you watch your food and avoid foods those trigger gout attacks.

***

Diagnosis of gout:

Presence of hyperuricemia is not the same as gout.

Gout is diagnosed if uric acid crystals are found in the fluid drawn from the swollen joints or by special imaging diagnostic procedures like ultrasound, X Ray and CAT scan.

***

Treatment of hyperuricemia and gout:

Avoid red meat, organ meat and alcohol, especially beers.

Avoid the sugar sweetened foods viz. sweetened cereals, bakery products, candies

Sea food includes healthy proteins and healthy fats including the omega 3 fatty acids.

The health benefits of sea food on general and heart health outweighs the risk of hyperuricemia.

So you can have sea food in moderation.

Consuming vegetables like spinach and asparagus have not been seen to cause hyperuricemia. So they needn’t be excluded from your food.

Eat well balanced, wholesome food and exercise regularly to lose weight, if you are overweight.

Drink ample water to help the kidneys to excrete uric acid build up in the blood and the kidneys.

Taking Vitamin C may help.

Dietary exclusion of high purine foods will not be sufficient to lower blood uric acid levels or to prevent the gout attacks.

Your doctor will prescribe specific drugs to lower your blood uric acid levels.

Your doctor will also prescribe anti inflammatory medications (NSAIDs) to reduce the pain and duration of the attack.

Kidney stones may get get flushed out in urine.

They may require surgical intervention if they don’t get flushed out.

Also read ‘Basics Of Nutrition’ and ‘Simple Steps To Slimming’ on this website.

Kinds Of Fatty Liver Disease Or Hepatic Steatosis

Obese people have a greater risk of developing hypertension, diabetes and heart disease, than the slim people.

And most obese people know that they are at greater risk of developing these diseases.

And more obese people have fatty liver disease than heart disease, but most are totally unaware that they may have fatty liver disease and that is as dangerous a disease as hypertension or diabetes!

And few obese people know that they have this disease!

Most often fatty liver disease is diagnosed accidentally when an abdominal sonography is done for some other reason.

***

Fatty liver disease is also known as hepatic steatosis or fatty degeneration of liver.

It affects both alcoholics and nonalcoholics or those who drink very little.

Thus fatty liver disease is of two types, alcoholic fatty liver disease and nonalcoholic fatty liver disease or NAFLD.

Both diseases are characterised by build up of excess fat in the liver cells.

Nonalcoholic fatty liver disease or NAFLD is affecting increasingly greater number of people all over the world, more so in the Western world.

Some people suffering from Non Alcoholic Fatty Liver Disease or NAFLD develop nonalcoholic steatohepatitis or NASH.

Nonalcoholic steatohepatitis or NASH is a more aggressive form of fatty liver disease in which there is inflammation of the liver cells and it can progress to scarring of the liver tissue leading to liver cirrhosis and liver failure.

Thus the progression of nonalcoholic steatohepatitis or NASH could be similar to the severe alcoholic hepatitis seen amongst heavy alcoholics.

More than 90 per cent of heavy alcoholics develop fatty liver disease while 25 per cent develop the severe alcoholic hepatitis ending in liver cirrhosis and liver failure.

While children too suffer from non alcoholic fatty liver disease or NAFLD, older people, especially males, are affected much more often.

***

Causes:

Experts do not yet know why some people develop non alcoholic fatty liver disease or NAFLD and why some of them progress to nonalcoholic steatohepatitis or NASH and develop liver cirrhosis and liver failure.

But both are linked to

Over weight or obesity, especially abdominal obesity

Hyperinsulinemia and insulin resistance

Hyperglycaemia or high blood sugar levels, pre diabetes or diabetes

Hypertriglyceridemia or high levels triglycerides or circulating fats in blood

These conditions could be helping build up of excess fat in the liver, causing NAFLD and in some this fat could be acting as a toxin to the liver cells and causing inflammation and scarring in them, causing NASH.

***

Signs and symptoms:

Non Alcoholic Fatty Liver Disease or NAFDL may have no symptoms but some times there can be fatigue and pain or discomfort in upper right hand area of the abdomen where the liver lies within the body.

Signs and symptoms of people with nonalcoholic steatohepatitis or NASH are the same as those of advance scarring and cirrhosis of liver seen in cirrhosis in severe alcoholic hepatitis:

Swelling of abdomen due to ascites or accumulation of fluid in abdominal cavity.

Enlarged blood vessels under the skin.

Yellowing of skin and eyes due to jaundice.

Red palms.

Enlarged spleen.

***

Other risk factors associated with development of NAFLD and NASH:

Alcohol

Hypercholesterolemia or high levels of cholesterol

Metabolic syndrome: Abdominal obesity, hypertension, high levels of blood sugar and triglycerides and low levels of HDL cholesterol

PCOD

Type II diabetes

Sleep apnea

Under active thyroid gland

Under active pituitary gland

***

Complications or progression

The fatty liver disease can end up in development of inflammation and scarring resulting in liver cirrhosis.

Ascites or abdominal swelling due to fluid build up.

Swelling of veins in oesophagus or oesophageal varices, which can rupture causing bleeding

Liver cancer

Confusion, drowsiness, slurred speech, delirium due to hepatic encephalitis

Complete liver failure meaning liver stops functioning altogether

***

Treatment and prevention:

Eating healthy, well balanced food

Exercising regularly

Losing and maintaining weight at a healthy level.

Also read the articles ‘Basics Of Nutrition’, ‘Designing A Healthy Weight Loss Food Plan’, and ‘Simple Steps To Slimming’ on this website.

The Root Cause Of Diseases Like Diabetes, Heart Disease And Cancers!

Everyone knows hypertension, diabetes, heart disease, strokes, arthritis and cancers.

Few know that the root cause of these dangerous disease is inflammation!

What is inflammation?

We have all experienced injuries from our childhood when we fell and scratched our skin of legs and hands etc. We develop redness, swelling, pain and the area also becomes hot, and possibly bleeding if there is a wound, more than a mere scratch.

The redness, swelling, pain and heat are due to acute inflammation of the tissues of the area.

This is inflammation.

It is natural part of the process of healing of our bodies.

This is part of the body’s defence mechanism.

Inflammation can be acute and chronic.

Acute inflammation:

Whenever our body suffers from an injury or encounters an infection or a toxic substance, its immune system, which is the body’s defence mechanism, swings into action and unleashes its inflammatory cells and substances called cytokines at the site of injury.

Cytokines further stimulate more inflammatory cells to be unleashed in the area. The inflammatory cells trap and eliminate the invading bacteria or viruses or the toxin to initiate the healing process of the body.

This process causes pain, heat, redness and swelling. There may be some loss of function as the painful hand or leg becomes stiff as movement causes pain.

This is the process of acute inflammation which helps protect and heal the body after the injury. This process is healthy.

Chronic inflammation:

But sometimes the process of acute inflammation continues too long, even after the threat of the injury is over and the body continues to produce inflammatory cells which begin to attack healthy body tissues.

Untreated acute inflammation from infections, injury or toxins, chronic exposure to pollution or industrial toxins and autoimmune disorders lead to chronic inflammation.

Unchecked, this continuous state of inflammation becomes chronic inflammation and leads to diseases like diabetes, atherosclerosis, hypertension, heart disease, rheumatoid arthritis, asthma, Alzheimer’s disease and cancers.

In fact the root cause of almost all chronic diseases is chronic inflammation.

Chronic stress, bad food, complete lack of exercise or long term high intensity over exercise, obesity, smoking, regular alcohol consumption can also cause chronic inflammation.

The foods causing chronic inflammation:

Fried foods, fast foods.

Frozen meats cured with nitrites to preserve them and prevent growth of pathogenic bacteria.

Refined oils and trans fats.

Foods like pastries, white bread, bakery products prepared with sugar, refined carbohydrates like rava, maida, refined corn flour.

Life style factors leading to chronic inflammation:

Obesity.

Complete lack of exercise or exercising to the maximum limit too frequently.

Smoking, drinking alcohol.

Continuous stress.

Long term exposure to smoke and other air pollutants.

Treating inflammation:

Acute inflammation is easier to treat with rest, ice and good wound care.

Chronic inflammation is treated by nutritional supplements like Vitamins A, C and D and zinc and omega 3 or fish oil supplements and inclusion of fresh fruits, green leafy vegetables, tomatoes, low fat dairy, sea food and anti inflammatory spices like turmeric, garlic and ginger in food.

Preventing chronic inflammation:

Eating healthy.

Exercising moderately and regularly three to five times, daily better.

Maintaining healthy weight.

Keeping stress away by using techniques like meditation, yoganidra and pranayam.

Stopping smoking and avoiding drinking alcohol or keeping its consumption to the minimum.

Avoiding exposure to smoke and pollution.

Preventing chronic inflammation is preventing most chronic diseases!

So the pathway to healthy living is to eat healthy, exercising regularly, staying slim and stress free, avoiding smoking, alcohol and exposure to pollution.

Also read articles ‘Preventing Hypertension’, ‘Preventing Diabetes’ and ‘Heart Heathy Diet And Lifestyle!’ on this website.

How To Choose A Healthy Cooking Oil!

This is a delicate and controversial issue, involving complex scientific research which is still underway and emotions and geographical preferences and commercial interests of oil seed producers and the oil industry.

We have already seen in the ‘Heart Health Poster Boy Olive Oil Vs Groundnut Oil’ article on this website that the best oils nutritionally are groundnut oil for Indian style cooking and olive oil for Western type low temperature cooking or cold dressing oil.

Both oils are heart healthy and anti inflammatory oils.

***

All oils are principally made up of three kinds of fatty acids, viz. monounsaturated, saturated, and polyunsaturated fatty acids.

***

Monounsaturated fatty acids:

Monounsaturated fatty acids are healthy fats found in various nuts like groundnuts, almonds, cashews and hazelnuts and avocados and in olive and groundnut oils. They are liquid at room temperature but may start to solidify when chilled.

They can help reduce bad cholesterol (LDL) levels, lowering the risk of heart disease and stroke.

Some studies suggest they improve insulin sensitivity and help in managing blood sugar levels and that they may also help reduce inflammation, which is linked to chronic diseases like heart disease and diabetes.

Replacing saturated and trans fats in your food with monounsaturated fats can help prevent diabetes, heart disease and can promote better overall health.

***

Saturated fatty acids:

Oils rich in saturated fats are coconut, palm and palm kernel oils.

Saturated fats raise LDL cholesterol, which is harmful to heart health and their consumption leads to heart disease and strokes.

The saturated fatty acids in coconut oil have been portrayed by some to be a medium chain triglycerides (MCT) rich oil which is supposed to be absorbed directly in the portal vein and transported straight to the liver which uses it up immediately for energy and that it is not stored as fat, and hence it is said to be healthy.

This is true for a special formulation coconut oil composed of hundred per cent medium chain triglycerides, used as a special nutritional supplement for pre term, low birth weight babies and critically ill ICU patients, not for regular coconut oil. Regular, commercially available coconut oil is rich in lauric acid and other saturated fatty acids, which function as long chain triglycerides and are absorbed slowly and raise the LDL cholesterol levels leading to heart disease and strokes.

***

Polyunsaturated fatty acids:

Polyunsaturated fatty acids include the omega 6 and the omega 3 fatty acids.

Omega 6 (Linoleic) fatty acids trigger inflammatory processes in the body causing damage to tissues and vital organs while omega 3 (Linolenic) fatty acids reduce the inflammatory processes and protect the tissues and vital organs from inflammatory damage.

Thus oils rich in the omega 6 oils lead to diabetes, hypertension, heart disease and strokes while fats rich in omega 3 protect us from these diseases.

***

Monounsaturated fatty acids to polyunsaturated fatty acids ratio:

A high monounsaturated fatty acids to polyunsaturated fatty acids ratio oils help lower total cholesterol and the bad cholesterol, the LDL cholesterol and increase the good cholesterol, the HDL cholesterol and also reduce the inflammatory processes in the body, thus protecting us from, diabetes, hypertension, heart disease and strokes.

***

Comparisons of various oils:

Safflower seed oil:

Safflower seed oil is low in monounsaturated (oleic) fatty acids, 15 per cent, very high in omega 6 (Linoleic) fatty acids, 77 per cent and has zero omega 3 (Linolenic) fatty acids.

Thus it has a very bad monounsaturated fatty acids to polyunsaturated fatty acids ratio and completely lacs omega 3 (Linolenic) fatty acids.

Sunflower seed oil:

Sunflower seed oil is low in monounsaturated (oleic) fatty acids, 25 per cent, very high in omega 6 (Linoleic) fatty acids, 64 per cent and is very low in omega 3 (Linolenic) fatty acids, 0 to 3 per cent.

Thus it too has a bad monounsaturated fatty acids to polyunsaturated fatty acids ratio and completely or nearly completely lacs omega 3 (Linolenic) fatty acids.

Soy oil:

Soy oil is rich in omega 6 (Linoleic) fatty acids, 54 per cent and lower in monounsaturated (oleic) fatty acids, 23 per cent plus it has 10 per cent saturated fatty acids too.

Thus it has a bad monounsaturated fatty acids to polyunsaturated fatty acids ratio and also has substantial saturated fats.

Rice bran oil:

Rice bran oil has 41.4 per cent monounsaturated (oleic) fatty acids, about 35 per cent omega 6 (Linoleic) fatty acids and about 20 per cent saturated fatty acids.

Thus it doesn’t have a high monounsaturated fatty acids to polyunsaturated fatty acids ratio and is also high in saturated fatty acids.

Cotton seed oil:

Cotton seed oil is rich in omega 6 (Linoleic) fatty acids, 55 per cent, low in monounsaturated (oleic) fatty acids, 17 per cent and high in saturated fatty acids, 22 to 29 per cent.

Thus it has a bad monounsaturated fatty acids to polyunsaturated fatty acids ratio and is also high in saturated fatty acids.

Sesame oil:

Sesame oil has 43 per cent each monounsaturated and polyunsaturated fatty acids and 13 per cent saturated fatty acids.

Thus it too lacks a high monounsaturated to polyunsaturated fatty acids ratio.

Canola oil:

Canola oil has a very favourable fatty acid composition, about 57 to 65 per cent monounsaturated fatty acids, 17 to 21 omega 6 fatty acid, about 12 per cent omega 3 fatty acids and about 6 per cent saturated fatty acids.

But it comes from a genetically modified plant and is an industry manufactured oil.

Mustard oil:

Mustard oil in fact has a very good balance of the monounsaturated fatty acids to the polyunsaturated fatty acids (60 gm to 21 gm per 100 gm of oil) as well as the omega 6 to the plant source omega 3 or ALA (15 gm to 6 gm per 100 gm of oil ratio).

But it also has the erucic acid, an omega 6 fatty acid that has been connected to heart disease.

Also its pungent odour and taste are unacceptable to most people in our region.

Flaxseed oil:

Flaxseed oil has 9 gm saturated fatty acids, 18 gm monounsaturated fatty acids and almost 75 gm polyunsaturated fatty acids, of which 18 gm is omega 6 fatty acids and 55 to 58 gm plant source omega 3 or ALA fatty acids.

Thus it has a very poor monounsaturated to polyunsaturated fatty acids ratio, not very conducive to heart health.

Also the oil is easily oxidised when exposed to light, air and heat. Its smoking point is low, hence it is unsuitable to Indian style high temperature cooking and it has to stored in a refrigerator to prevent its oxidation.

It can at best be used as cold dressing oil as a small supplement to the main cooking oil.

***

Industry Manufactured Oils versus Cold Pressed Oils:

Industry manufactured oils like soya oil, rice bran oil, corn oil, sunflower oil, safflower seed oil (kardai), Canola oil, cottonseed oil are considered bad fats by many nutritionists.

The use of heat and chemicals in extracting and refining these oils alters their fatty acid structures and trans fats and other toxic substances are developed in them, turning them unhealthy.

Cold pressed oils in contrast retain the original fatty acids composition of their oil seeds.

Today many researchers are asking us to shun all industrially produced oils and recommend cold pressed oils.

***

Groundnut Oil and Olive Oil:

That leaves us with the choice of cold pressed groundnut oil and olive oil!

Both oils have similar ability to control inflammation.

Olive oil has a better monounsaturated to omega 6 polyunsaturated fatty acids than groundnut oil.

But olive oil which has a comparatively lower smoking point than groundnut oil cannot be considered as a premium cooking and frying oil for Indian style of cooking which involves deep frying.

Groundnut oil reportedly has greater oxidative stability and higher smoking point as compared to olive oil and has been considered as a premium cooking and frying oil as compared to olive oil. Gomez et. al., 2003 have shown that the phenolic compounds in extra virgin olive oil get damaged very quickly by heat along with a loss of Vitamin E.

The preliminary analysis of blood samples from people who have been consuming groundnut and olive oil since one year do not show any significant differences in the biochemical parameters assessed.

Only it is important to consume groundnut oil in moderation, to keep our omega 6 fatty acids consumption low.

But this is true of any other oil as excess oil consumption will also lead to obesity.

Studies have also shown that resveratrol, a phenolic antioxidant present in groundnuts reduces the risk of vascular disease caused by angiotensin a hormone that causes the arteries to contract and leads to raised blood pressure which damages the endothelial lining of the arteries leading to heart disease and strokes, amongst damage to other organs. Resveratrol also protects the arteries by increasing the vasodilator hormone, nitric oxide.

Groundnuts also are high in the powerful antioxidant, Vitamin E, which protects the cells of the mucosa and skin from the damage caused by oxygen free radicals.

Thus we can conclude that groundnut oil could be the better choice of oils for Indians, than olive oil, both nutritionally as well as economically.

***

In short, if you live in India and your oil consumption is moderate, you can safely use groundnut oil.

If you live in India and cook your food at low temperature and don’t mind spending extra money on your oil, or if you use oil only as salad dressing oil or  cook your food at low temperature and live in the US or Europe, you can use olive oil.

***

Achieving a healthy balance of fatty acids:

Groundnut or olive oil do not provide us with sea source omega 3 fatty acids.

Sea source omega 3 fatty acids (DHA and EPA) are essential for the maintenance of heart, brain and eye health and in preventing inflammation associated with chronic disease like arthritis, asthma and some autoimmune disorders. They are also essential for the proper development of the foetal brain and eyes.

That is why it is important that we maintain a proper balance of healthy of fats in our food.

We can do so by consuming sea fish or omega 3 supplements twice or thrice a week to supplement the monounsaturated fatty acids provided by groundnut or olive oils.

Also read the articles ‘Heart Health Poster Boy Olive Oil Vs Groundnut Oil’, The Good And The Bad Fats’ and the ‘Basics Of Nutrition’ on this website.

Choosing Between Olive Oil And Groundnut Oil!

Hit the internet to search for foods to fight inflammation and the chronic diseases like rheumatoid arthritis, diabetes and heart disease resulting from it and it invariably comes up with one particular food, the heart health poster boy, the extra virgin olive oil.

Researchers have for sometime now been advising us to use cold pressed monounsaturated dominant oils and olive oil suits the bill perfectly. But so does groundnut oil, also called peanut oil.

But olive oil, especially the extra virgin olive oil has been heavily promoted by the Western World as the poster boy of heart health!

The imported and expensive extra virgin olive oil, while out of reach of the average Indian homes, has found its way into the kitchens of the homes of the affluent Indians, probably in a big way!

Let us see how the homegrown, unglamorous, unadvertised and much cheaper cold pressed groundnut oil compares with extra virgin olive oil, as anti inflammatory and heart healthy oil.

***

Both oils are cold pressed monounsaturated fatty acids dominant oils which have lower amounts of saturated and polyunsaturated fatty acids.

Researchers have known for some time now, that exactly this kind of oils are heart healthy, as they raise the levels of HDL cholesterol and lower levels of LDL cholesterol and they also have anti inflammatory properties.

Recent studies also show, that for a healthy lipid profile a high monounsaturated fatty acid to polyunsaturated fatty acid ratio is desirable and also high levels of monounsaturated fatty acids are beneficial in regulating blood sugar levels.

In this respect, olive oil is superior to groundnut oil as it has higher levels of polyunsaturated fatty acids than olive oil.

***

A team of researchers at The Department Of Biochemistry, Shree Venkateswara College, University Of Delhi, has conducted a year long study of the effects of both oils on various health parameters of people consuming the two oils, including lipid profile, blood glucose, liver function efficiency, antioxidant status (lipid peroxides and antioxidant enzymes) and inflammatory properties (nitric oxide) in blood samples collected from populations who have been consuming olive oil  or groundnut oil as a staple oil for at least one year.

The study did not include diabetic patients, but it showed that the blood sugars levels of people in the study were normal at the end of the year.

The study showed that both olive and groundnut oils matched each other in their performance of keeping the HDL cholesterol levels high and total cholesterol and LDL cholesterol levels low at the end of one year. If any, groundnut oil people showed up slightly lower levels of triglycerides.

Both groups showed normal liver function meaning both groups had normal metabolism and no metabolic syndrome.

One of the marketing strategies of olive oil is that it contains increased amount of polyphenols / antioxidants which help reduce oxidative stress and promote overall health in consumers. So both oils were investigating for these activities and it was found that groundnut oil consumers also showed the same lipid peroxide levels as the olive oil consumers, adequate activity of antioxidant enzymes and comparable levels of nitric oxide, indicating that ground nut oil was as effective as olive oil on providing protection against oxidative damage and stress.

Also olive oil which has a comparatively lower smoking point than groundnut oil cannot be considered as a premium cooking and frying oil for Indian style of cooking which involves deep frying.

Groundnut oil reportedly has greater oxidative stability and higher smoking point as compared to olive oil and has been considered as a premium cooking and frying oil as compared to olive oil. Gomez et. al., 2003 have shown that the phenolic compounds in extra virgin olive oil gets damaged very quickly by heat along with a loss of Vitamin E.

The preliminary analysis of blood samples from people who have been consuming groundnut and olive oil since one year do not show any significant differences in the biochemical parameters assessed.

Although more research is needed, the contention of the researchers is that groundnut oil could be the better choice of oils for Indians, than olive oil, both nutritionally as well as economically.

***

Studies have also shown that resveratrol, a phenolic antioxidant present in groundnuts reduces the risk of vascular disease caused by angiotensin a hormone that causes the arteries to contract and leads to raised blood pressure which damages the endothelial lining of the arteries leading to heart disease and strokes, amongst damage to other organs. Resveratrol also protects the arteries by increasing the vasodilator hormone, nitric oxide.

Groundnuts also are high in the powerful antioxidant, Vitamin E, which protects the cells of the mucosa and skin from the damage caused by oxygen free radicals.

***

In short, if you live in India and your oil consumption is moderate, you can safely use groundnut oil.

If you cook your food at low temperature and don’t mind spending extra money on your oil, or if you cook your food at low temperature and live in the US or Europe, you can use olive oil.

Also read the articles ’Basics Of Nutrition’ and the ‘The Good And The Bad Fats’ on this website.

Health Benefits Of Omega 3 Fatty Acids!

Carbohydrates, proteins and fats are the three macronutrients of our nutrition.

Fats are composed of fatty acids.

Fatty acids are of four types, the monounsaturated fatty acids, the polyunsaturated fatty acids, the saturated fatty acids and the trans fatty acids.

Of these, the body can synthesise most of the fatty acids from other fatty acids, except the polyunsaturated fatty acids. Hence they must to be acquired from food. So they are also called the essential fatty acids.

Polyunsaturated fatty acids include Omega 3 and omega 6 fatty acids.

The omega 3 fatty acids are majorly of three types, namely the Eicosapentaenoic acid  or EPA, docosahexaenoic acid or DHA and Alpha-linolenic acid or ALA.

Of these the DHA and EPA are the sea source or marine omega 3 and ALA is the plant source omega 3.

Marine algae are rich in the DHA and EPA.

Marine fish get the DHA and EPA from these algae.

We get DHA and the EPA fatty acids from these marine fish and ALA from plant sources, like walnuts, some oils like mustard oil and soy oil, flax seeds and flaxseed oil and leafy vegetables.

Seaweed, nori, spirulina, chlorella are some of the sea algae which contain DHA and EPA omega 3 fatty acids, but vegetarian people knowing about them or the chances of their being available and being consumed in India are slim.

Omega 3 are an important constituent of the cell membrane of all tissues of the body, they also have a role to play in the functioning of the receptors on the cell membrane and their genetic functions and in the formation of hormones essential for blood clotting, contraction and relaxation of the arterial walls and in the prevention of inflammation in the walls of the arteries.

Inflammation of the arterial walls leads to the development of arteriosclerosis or hardening and thickening of the arteries which lose their elasticity and this causes the blood pressure to go up.

This inflammation also causes atherosclerosis or development of plaques in and on the arterial walls.

This leads to narrowing of the arteries leading to heart disease, strokes and kidney disease depending upon which arteries are affected.

By preventing or reducing this inflammation, omega 3 help protect us against coronary artery (heart) disease and strokes.

They also help relieve the symptoms of metabolic syndrome.

They help lower blood pressure, regulate and lower the heart rate and improve the functioning of the arteries. They prevent irregular heart rhythm and arrhythmias, which accounts for majority of the cardiac deaths in the US and also kill lacs of people all over the world, every year.

DHA is also essential for the proper development of the brain and other parts of the nervous system of a baby from the first trimester of the mother’s pregnancy to the time the baby is two years old.

Marine omega 3 also help prevent ADHD and reduce the severity of asthma in children.

One large study (GISSI Prevention Trial) has found that heart attack survivors put on daily 1 gm supplement of omega 3 for three years were less likely to have another heart attack or stroke or die suddenly than those who took placebo.

In a recent Japan EPA Lipid Intervention Study (JELIS), it was found that those who took an EPA supplement along with statin (cholesterol lowering group of drugs) were less likely to suffer from a sudden cardiac event than those who took only statin.

So along with the evidence that they prevent heart disease and strokes, omega-3 fats have been shown to help control lupus, eczema, and rheumatoid arthritis, and may play protective roles in some cancer and other conditions.

Omega 3 are also beneficial for the health of the skin and the eyes.

By reducing inflammation, they help reduce acne lesions, improve hydration of the skin and help reduce redness, dryness and itching of skin in different conditions like dermatitis and psoriasis, helps relieve symptoms of sun burns due to ultraviolet A and B rays. They also help wound healing.

They are an important constituent of the structure of the retina and are essential for the health of the eye and vision. They are also linked to a reduced risk of macular degeneration which is one of the major reasons of blindness in the world.

They are also linked to lowered risk of depression and anxiety and relieve symptoms like sadness, lethargy and lack of interest in life and fear, panic and restlessness.

***

Are there any alternative sources of marine omega 3, DHA and EPA?

Unfortunately most of the health benefits of omega 3 are due to the marine omega 3, DHA and EPA.

The plant source omega 3 or ALA doesn’t have the same benefits.

A small amount of ALA is converted by our bodies into marine omega 3 at a slow pace, but this is not enough, so non fish eaters lose out on the benefits of marine omega 3, which are obtained only by eating marine fish.

Contrary to the claims made by some poultry industries, eggs of chicken fed on flax seeds do not have much marine omega 3.

So the only source of marine omega 3 remains marine fish or fish oil.

But the fact remains that purely vegetarian people too can live long and healthy life.

So don’t try to eat fish if you have never eaten it!

***

How much sea fish is enough to get adequate omega 3 fatty acids DHA and EPA?

Adults should eat about 170 gm sea fish twice a week and children between the ages of 2 to 8 years between 40 to 85 gm and children over 9 years between 115 to 140 gm twice a week to get enough of the two omega 3 fatty acids.

***

How to cook fish to preserve more of the omega 3 available in the fish?

Boiling, steaming or cooking fish in a gravy, or baking it at 200 degrees for 20 minutes or smoking fish (not a common practice in India) can preserve much of the omega 3 in fish.

Cooking fish in a microwave at 200 degrees or lower temperature can also help retain most of the omega 3 intact.

The key to keeping the healthy omega 3 in your sea fish intact on cooking appears to be cooking it at a lower temperature than about 200 degrees and cooking it quickly in about 20 minutes, may even be at a lower temperature if for a little longer time frame.

Higher temperatures and longer cooking time completely alters the chemical structure of the fatty acids in the fish so it doesn’t resemble the original chemical structure of the fish lipids. High heat also helps develop the very harmful trans fatty acids and some other toxic substances in fish.

Deep frying or pan frying fish or cooking it in a tandoor are all done at high temperature which destroys most of the omega 3 in fish

Canning fish also destroys much or most of the omega 3 in fish.

Also read the articles ‘Basics Of Nutrition’, ‘The Good And The Bad Fats’ and the ‘Effect Of Cooking On Omega 3 In Fish’ on this website.