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The Threat Of Pre Diabetes!

Even when I started my pioneering obesity clinic in Pune four decades ago, it was clear that we were fast becoming the world capital of diabetes and heart disease!

But the threat of a condition called pre diabetes was not as commonly recognised then as it is today.

Currently the commonest fear with which young people are approaching me to help them get over their weight and health issues is the threat of going from pre diabetes to full blown diabetes!

What exactly is pre diabetes?

Pre diabetes is a condition in which the blood sugar levels are raised above normal but are still lower than the diagnostic levels of diabetes.

The HbA1c or the glycated haemoglobin levels lie between 5.7 and 6.4 per cent, just below the diagnostic levels of diabetes, 6.5 per cent and above.

Pre diabetes is a condition that is part of the metabolic syndrome, characterised by obesity, especially abdominal obesity, hypertension, raised levels of triglycerides and LDL, the bad cholesterol and lowered levels of HDL, the good cholesterol.

LDL cholesterol causes blocks in the coronary arteries which leads to heart disease and myocardial infarctions or heart attacks and HDL cholesterol cleanses the coronary arteries off these blocks and protects us from heart disease.

Pre diabetes is considered the stepping stone towards developing diabetes and some of the complications of diabetes can affect the pre diabetics too.

Pre diabetes is diagnosed by checking the the blood sugar fasting and post prandial levels, the glucose tolerance test, the HbA1c, the blood insulin levels and the lipid profile. Abdominal obesity and hypertension confirm the presence of pre diabetes.

Pre diabetes may not have any recognisable signs and symptoms, that makes it even more difficult to diagnose.

But some people may have the same symptoms as those of diabetes, like excessive thirst, increased urination and fatigue and they could indicate that you aught to rule out pre diabetes and diabetes.

If you are suffering from obesity, especially abdominal obesity, have family history of diabetes, have a sedentary lifestyle, you should check your blood pressure, blood sugars, blood insulin, HbA1c and lipid profile, to screen for pre diabetes.

The causes of developing pre diabetes could be family history of diabetes, sedentary lifestyle, stress, older age, ladies who have had history of gestational diabetes and have had high birth weight (more than 9 pound) babies.

When carbohydrates are digested, they are absorbed in blood as sugar and the blood sugar levels increase.

In response to this the pancreas releases insulin in blood and insulin helps transport the sugar to various tissues of the body and under its influence, the cells of the tissues take up sugar from the blood and utilise it for the energy that they require for their functions.

Under the influence of insulin the liver also stores more sugar for providing energy to the body later.

This lowers the blood sugar and the blood insulin levels.

But when you eat too much sweets or sugary food regularly, the pancreas is forced to produce more insulin to bring down the blood sugar to normal.

After a while the cells of the various tissues stop responding adequately to the insulin and do not absorb sugar efficiently.

This means the cells of the tissues develop insulin resistance.

This causes both, the blood sugar and the blood insulin levels to stay high.

This raised blood level of insulin is called hyperinsulinemia.

When the capacity of the liver and the muscle cells to store sugar is over, the excess blood sugar is stored in the fat cells of various fat depots in the body and our weight increases, gradually leading to obesity.

Diagnostic levels of pre diabetes:

Fasting Blood Sugar Levels: Between 110 to 125 (WHO) or 100 to 125 (American Diabetes Association)

Sugar Tolerance Test: Between 140 and 199 mg/dL two hours after taking standardised 75 gm glucose solution.

Glycated Haemoglobin or HbA1c levels between 5.7 to 6.4 per cent.

Levels above these are diagnostic of diabetes.

Reversing Pre Diabetes:

The earlier that the condition of pre diabetes is diagnosed, the greater are the chances that it can be reversed.

How to reverse Pre Diabetes:

Healthy Eating: Focus on a balanced diet rich in whole grains, fruits, vegetables, lean proteins, and healthy fats. Limiting processed foods and sugary beverages is crucial.

Regular Physical Activity: Engage in at least 150 minutes of moderate-intensity exercise per week, such as brisk walking, cycling, or swimming.

Weight Management: Losing even a small percentage of body weight can significantly reduce the risk of developing diabetes.

Regular Monitoring: Keep track of blood sugar levels and have regular check ups with your physician or endocrinologist.

Keeping your consumption of sweets low, so it helps keep your blood insulin from rising unnecessarily high.

If you have uncontrollable craving for sweets, eat ample fruits through the day. It will take away the abnormal craving for eating sweets and also add valuable nutrition to your food.

Staying away from sweets with determination for a fortnight, to allow the taste buds on your tongue to get adjusted to not eating them. Once they are retrained, you won’t be able to eat as much sweets anyway.

So, to reverse your pre diabetes, you need to develop healthy food habits, eat nutritionally balanced food, exercise regularly, reduce your weight, keep stress low and sleep well.

And don’t wait to start all these things till you catch diabetes!

If you start now, you could most likely prevent the development of insulin resistance and pre diabetes!

Also read ‘Sweets, Obesity And Diabetes’, ‘Insulin Resistance And Diabetes’, ‘Dangers Of Eating Too Much Sweets’ and ‘Preventing Diabetes’ on this website.

प्री डायबीटिस!

Eating Too Much Sweets, Obesity And Diabetes!

It was amply clear even when I started my then unique ‘Obesity Clinic’ in Pune, nearly 40 years ago, that our county was poised to be the world capital of diabetes and heart disease!

The three primary reasons for it were that we are genetically more prone to develop both diseases than people in the West and the increasing affluence of the Indian middle class meant that we are eating more calorie rich food and our lifestyles are getting more and more sedentary.

With the modern culture bringing in greater amount of sweets in our food with increasing temptations like rich deserts becoming available with mithai and cake shops and ice cream parlours springing up everywhere and the five star hotel culture introducing us to a rich dessert culture and the television and You Tube master chefs making the average house wives culinary experts, we are eating more and more sweets.

Sugar of course is nearly hundred per cent simple carbohydrate.

When we eat carbohydrates, they are digested and absorbed into the blood as sugar. When the blood sugar rises, the pancreas release the hormone insulin into the blood, to bring down the blood sugar to the normal levels and thus regulate the blood sugar.

The cells of every tissue in the body take up the sugar from the blood under the influence of insulin and use it for the energy that they need for their functions.

The liver also stores more sugar under the influence of insulin, for later use, when the body needs energy.

This brings down the blood sugar and in response, the pancreas cuts down on the insulin production.

This process is smooth and works seamlessly when we are healthy.

But when we eat too much of sweets or carbohydrates, a lot of sugar enters the blood.

This forces the pancreas to produce more insulin than normal, to influence the cells of various tissues to take up more sugar to control the blood sugar levels.

And if we continue to eat a lot of sweets regularly, after some time the various cells of the body respond less efficiently to the available insulin and do not absorb the sugar from the blood adequately.

This means that they become insulin resistant.

With the result, the blood sugar levels increase and so does the level of blood insulin.

This raised blood level of insulin is called hyperinsulinemia.

Under the influence of these raised levels of insulin, the liver and muscles store more sugar and when their capacity of storing sugar is full, this excess sugar is converted into fat and stored in various fat depots.

This leads to development of obesity.

This means our blood insulin, blood sugar and weight, all go up.

Over a period of time eating too much sugar and sweets leads to obesity and diabetes!

Also read the articles ‘Abdominal Obesity, Diabetes And Heart Disease‘, ‘Preventing Diabetes’ and the ‘Dangers Of Eating Too Much Sugar’ and ‘Insulin Resistance And Diabetes’ on this website.

The Process Of Developing Insulin Resistance And Diabetes!

Any one can become diabetic.

It is not a must to have a family history of diabetes to develop the disease.

Yes, you have a greater chance of developing the disease if you have a family history of diabetes.

But you will see that many develop the disease irrespective of a family history of diabetes these days.

That is why it is vital that we understand that the process of becoming diabetic starts much before the actual onset of the full fledged disease.

***

Carbohydrates, Insulin And Blood Sugar

Normally insulin, the hormone produced by pancreas, regulates our blood sugar levels precisely.

The carbohydrates that we consume in our food, enter our blood in the form of sugar and as soon as it enters our blood, the pancreas releases insulin in our blood to regulate the blood sugar.

The cells of every tissue in the body take up the sugar from the blood under the influence of insulin and use it for the energy that they need for their functions.

The liver also stores more sugar under the influence of insulin, for later use, when the body needs energy in between two meals.

This brings down the blood sugar to normal and in response, the pancreas cuts down on the insulin production.

A few hours, typically around four to five hours, the blood sugar levels dip before the next meal.

At this time the liver releases the stored blood sugar in the blood to provide the energy that the body needs and the stored sugar in the liver goes back to normal.

This process is smooth and works seamlessly when we are healthy.

***

Insulin Resistance And Pre Diabetes

But when we eat too much of sweets or carbohydrates, a lot of sugar enters the blood.

This forces the pancreas to produce more insulin than normal, to influence the cells of various tissues to take up more sugar to control the blood sugar levels.

But if we continue to eat a lot of sweets regularly, after some time the various cells of the body respond less efficiently to the available insulin and do not absorb the sugar from the blood adequately.

This means that they become insulin resistant.

With the result, the blood sugar levels increase and so does the level of blood insulin.

This raised blood level of insulin is called hyperinsulinemia.

Under the influence of these raised levels of insulin, the liver and muscles store more sugar and when their capacity of storing sugar is full, this excess sugar is converted into fat and stored in various fat depots.

This leads to weight gain.

This means our blood insulin, blood sugar and weight, all go up.

At this stage, not only our blood sugar and insulin, but also our blood triglycerides and the LDL (harmful to the heart) cholesterol levels are likely to go up and our HDL (beneficial to the heart) cholesterol levels are likely to drop below normal.

These are all signs insulin resistance.

This is the pre diabetic stage which eventually can lead to diabetes, heart disease and strokes.

***

We yet do not know the exact reasons of insulin resistance, but family history of type 2 diabetes, sedentary lifestyle, total lack of exercise and obesity can all be the contributing reasons.

Stress and lack of adequate sleep too could worsen the situation.

***

How to reverse insulin resistance

Getting physically more active and exercising regularly, walking adequately is the safest exercise, improves the insulin sensitivity of the cells of different tissues of our body.

That is the reason why exercise is the key to not only diabetes management, but also to our overall health and well being!

Keep your consumption of sweets low, so it helps keep your blood insulin from rising unnecessarily high.

If you have uncontrollable craving for sweets, eat ample fruits through the day. It will take away the abnormal craving for eating sweets and also add valuable nutrition to your food.

Stay away from sweets with determination for a fortnight, to allow the taste buds on your tongue to get adjusted to not eating them. Once they are retrained, you won’t be able to eat as much sweets anyway.

So, to reverse your insulin resistance, you need to develop healthy food habits, eat nutritionally balanced food, exercise regularly, reduce your weight, keep stress low and sleep well.

And don’t wait to do all these things till you catch diabetes!

Start now, so you don’t develop insulin resistance in the first place!

Also read the articles ‘Preventing Diabetes’, and ‘Dangers Of Eating Too Much Sugar’ on this website.

इन्सुलिन रेझिस्टन्स आणि डायबीटिस!

Wheat Is As Healthy As Any Other Cereal!

Wheat is the second largest cultivated cereal crop of the world, next only to maize.

Wheat is the largest staple food of the world population, next only to rice.

The wheat crop cultivation covers more land than any other cereal in the world.

Its turnover in the world market is larger than that of all other cereals put together.

The wheat grain, like all other cereals, has three parts, the bran, the germ and the endosperm.

The bran is the protective outer cover of the grain, the germ develops into a new plant when the seed germinates and the endosperm is the store house of the food of the seed, that the grain uses for energy when the new plant is being developed.

The wheat grain has 71 % carbohydrates, 13 % proteins, fibre, some B vitamins, folate, Vitamins E, some minerals, phytochemicals, antioxidants and some good fatty acids.

Wheat provides us with 327 calories per hundred gm.

Of these, most of the fibre, vitamins, minerals, phytochemicals, antioxidants and fatty acids and 25% of the proteins in the wheat grain are housed in the bran and the germ while the most of the carbohydrates and 75% of the proteins are housed in the endosperm.

The carbohydrates in the whole wheat grain are starch, fibre and some sugars.

Of these, the starch and the fibre are the complex carbohydrates while the sugars are the simple carbohydrates.

Thus wheat is a very important source of calories, carbohydrates, proteins, small amounts of healthy fats, vitamins and minerals of a large proportion of the population of the world.

Wheat, like all other cereals, is deficient in the essential amino acid lysine and hence, by itself it is not a good source of complete proteins.

On the other hand, pulses have lysine but they are deficient in the essential amino acids methionine, tryptophan and cysteine.

And wheat has methionine, tryptophan, and cysteine.

So wheat and pulses together supply us all the essential amino acids and together they become a good source of better quality proteins in a vegetarian diet.

That is why we have chapatis, rice, bhakri together with ‘varan’ / ‘amti’ / ‘dal’ / ‘sambar’ / ‘curry’ or ‘usal’ in both lunch and dinner in our regular meals.

Chapatis, rice, bhakri are all cereals and ‘varan’ / ‘amti’ / ‘dal’ / ‘sambar’ / ‘curry’ or ‘usal’ are all pulses.

Together they provide most of the better quality proteins in a vegetarian diet.

Wheat chapatis or roti are the main ingredient of regular meals for most Indians.

The wheat protein is majorly composed of gluten, constituting 75 to 80 per cent of the wheat protein.

A few people in the world have gluten intolerance and they can’t digest gluten properly and develop abdominal pain, gases, constipation or diarrhoea when they eat wheat.

About 0.5 to 1 per cent people in the world suffer from Celiac disease, a severe autoimmune, chronic disease and can’t eat wheat at all.

Their number is slowly rising probably because of the newer crops developed to increase the yield and disease fighting abilities of the crop and body’s inability to adapt quickly to it. It also may appear to increase because of increased awareness about the illness and also improved diagnosis of the disease.

It is definite that such people shouldn’t eat wheat but that still cannot not be the reason for most of the world population to stop eating wheat which is their staple food.

It is also not right to equate rava and maida with whole wheat, just because they are made from wheat.

Whole wheat is robbed of most of its good nutrition by grinding and separating the germ and the bran from endosperm which is further ground and refined to make rava and maida.

So when we eat rava or maida, we consume only the less nutritious endosperm of the wheat.

Glycemic index of whole wheat is 41, that is low, and that of rava is 66, that is medium and that of maida is over 70, that is high.

That is why rava and maida are bad nutrition

On the other hand, when we eat chapatis made from whole wheat flour, we consume the bran, germ and endosperm together in the whole ground wheat flour.

Currently it has become fashionable to label wheat as unhealthy food.

It is like blaming carbohydrates for weight gain.

Both are passing fads.

But all cereals have more or less similar nutrition.

Various researchers give us slightly variable figures of calories but generally we can say that nachani (325), wheat (329), rice (341 ते 346), jwari (349) and bajri (361) give us more or less similar calories per 100 gm.

Also their glycemic indices and loads are similar.

The whole grain wheat is as nutritious every other cereal.

So you can eat wheat chapatis or bhakri made from nachani, jowar or bajri.

Also read the article ‘Effects Of Rava And Maida On Health’ on this website.

Studying The Effects Of Intermittent Fasting On Health

Intermittent fasting is as ancient as civilisation and has been practiced in all religions for centuries.

An ‘enthusiastic’ paper published by a British doctor over a hundred years ago and lapped up merrily by lay press and very energetically canvassed from time to time by some enthusiastic doctors, all over the world, since the sixties has made sure that it a well known and popular diet.

Some body builders in the West have used intermittent fasting for a long time.

Intermittent fasting includes various kind of diets in which the dieter fasts for different periods of time, with or, more often, without  planned calorie restrictions.

Intermittent fasting are diets in which one goes through regular periods of eating and fasting.

It includes a wide variety of patterns.

Some of the well known varieties are:

Time restricted fasting: It involves fasting for 12 hours or longer and eating two or more meals in the rest of the time window.

The 16:8 or 14:10 kind of diets are of this type. On these diets you eat ad libitum during the 8 hour or 10 hour window and fast for 16 or 14 hours respectively.

The 5:2 diet: It involves eating ad libitum for five days and then eating around 500 or 600 calories for two days, sometimes one day at a time twice a week, or on two consecutive days.

Eat stop eat diet: It involves a full 24 hour fast once or twice a week and eating ad libitum for  the rest of the week. This is an extreme version of the 5:2 diet.

Alternate day diet: It involves eating ad libitum and going on complete fast on alternate days.

***

Ad libitum means ‘at one’s pleasure’, meaning eating as much as you please, of whatever you please.

***

Available scientific information about intermittent fasting:

Intermittent fasting has generated a fair amount of scientific interest in the last few decades.

Most of the scientific research on the subject has involved animal studies and whatever human studies have been done are of shorter duration and many of them have not taken into account such factors as calorie intake, balance of nutrition and physical activity.

Most of the research on human beings has centred around athletic performance of athletes observing Ramadan. The results are varied, most showing decline in performance of athletes, in both mid and high intensity sports, and none reporting any improvement in performance.

And the results are conflicting, based on the outcome investigated and the methodology used.

Some studies have found worsening of lipids in people gorging on high fat, high sugar, high calorie food in one or two meals than those who nibbled on frequent smaller meals.

This is a very likely outcome, if people will eat two or three high fat, high calorie meals in a window of 10 or even 8 hours and fasted for 14 or 16 hours or even one or two meals in a smaller time window than 8 hours and fasted longer than 16 hours.

Early epidemiological studies have shown increased cardiovascular disease risk on reduced meal frequency and lower total and LDL cholesterol levels in people who reported four or more meals a day as compared to those who reported having one or two meals only.

According to another large cohort study, the Malmo Diet And Cancer Study, the people who ate six or more meals a day had reduced risk of obesity than those who ate three or less meals and the frequent eaters also had lower waist circumference.

On the other hand, animal studies have shown improvement in weight and metabolic markers like blood sugar and blood pressure LDL cholesterol.

According to a 2018 review, different studies show 2.5 to 9.5 per cent of weight and fat loss, but there is little evidence that it is superior to other diets or eating patterns in promoting weight loss.

Calorie restriction is known to improve insulin resistance. After a period of fasting, insulin sensitivity increases and insulin levels drop. These changes result in improved blood sugar levels both during fasting and shortly after eating.

The benefits of fasting also appear to be linked to the Circadian rhythm, which is sometimes also called the ‘body clock’. It is natural for humans to eat during the day and mice to feed during the night.

So the benefits of intermittent fasting are seen when we eat during the day time and fast during the night and exactly the reverse is seen in case of mice.

Abnormal Circadian rhythms may be linked to obesity, diabetes, depression, bipolar disorder, seasonal affective disorder and sleep disorders such as insomnia.

Intermittent fasting may also cause dizziness, nausea, insomnia, syncope (sudden fainting attacks with loss of consciousness), falls, migraine, weakness, excessive hunger, dehydration and hypotension, in some people.

Diabetics are more likely to suffer from these ill effects. Certain drugs prescribed for the treatment of diabetes also increase the risk of developing these illnesses.

Besides these, many people complain of developing severe hyper acidity on these diets.

***

Inference:

There appear to be some benefits of intermittent fasting. Diets based on it could help lower some weight and improve metabolic markers like blood sugar and blood pressure and LDL cholesterol.

These benefits are available only if you don’t gorge on high fat, high sugar, high calorie food in one or two meals during the window of eating. That means you can’t really eat ad libitum.

Eating ad libitum, anything you fancy, as much as you please will not bring you the desired health benefits, even if you follow the rules of intermittent fasting strictly.

It means you still have to eat healthy, you still have to observe the rules of balanced nutrition to get the full benefits of intermittent fasting.

And also the health benefits of intermittent fasting are available only if you follow the Circadian rhythm, that is to eat during the day and fast during the night.

Intermittent fasting is not the only way to improve your blood insulin levels, insulin resistance and blood sugar, much less of losing weight and lowering your blood pressure, total and LDL cholesterol and triglycerides levels and increasing your  HDL cholesterol levels.

If intermittent fasting helps people lose between 2.5 to 9.5 per cent of their excess weight, a 5 foot 70 kg lady can lose approximately between under 2 to 7 kg weight and a 5 foot 6 inch 80 kg man can lose approximately between 2 to 8 kg weight.

On the other hand, balanced food in three or more meals a day and exercising regularly can help both lose full 20 kg weight and get completely slim and have much better metabolic markers, especially the abdominal circumference.

***

Intermittent fasting versus balanced nutrition and normal meals:

Intermittent fasting can give you some weight loss and improved metabolic markers.

Most times, intermittent fasting programs are run on mass scale as a diabetes control campaign and not as an individual treatment, individual nutrition is not planned, people are left to choose to their own food, eating ad libitum could be dangerous and exercise may not be a part of the regimen.

Individually planned balanced nutrition in regular meal pattern with three or more meals and regular exercise can give you complete weight loss and much improved metabolic markers.

Those people who habitually eat only two meals a day, viz. lunch and dinner and are not used to having a breakfast, could find intermittent fasting suitable.

Those people who have fixed time slots available for lunch and an early dinner, could find intermittent fasting suitable.

If your work schedule doesn’t allow regular meal hours, intermittent fasting may not suit you.

Many people on intermittent fasting could soon complain of hyper acidity, hunger pangs, possibly headaches and fainting spells.

Such people might not find intermittent fasting suitable.

Some people find it difficult to continue with the intermittent fasting regimen a year or two after starting it successfully initially, for one reason or another and give it up.

There are no long term studies to show how many people stay on, on intermittent fasting long term.

Most people are used to eating at least three meals, including breakfast, lunch and dinner, spread over the day.

So they are more likely to be more comfortable eating in the same pattern all their lives, than switch to eating  two meals during a smaller time window.

So it is for you to take a call on which of the two regimens suits you better.

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

***

इंटरमिटन्ट फास्टींग आणि त्या वरील संशोधना विषयी थोडेसे!

हल्ली वजन कमी करण्यासाठी आणि डायबीटिस कंट्रोल करण्यासाठी अनेक लोक एका विशिष्ट पद्धतीचा किंवा प्रणाली चा इंटरमिटन्ट फास्टींग चा डायट करत आहेत.

फास्टींग म्हणजे उपवास करणे.

उपवास करणे ही विविध संस्कृती आणि धर्मांमध्ये अगदी त्यांच्या उत्पत्ती पासून प्रचलित असलेली प्रथा आहे.

इंटरमिटन्ट फास्टींग म्हणजेच विशिष्ठ कारणांसाठी, विविध पद्धतीने केलेले उपवास!

अशा प्रकारचे इंटरमिटन्ट फास्टींग हे काही आजारांवरचे उपचार म्हणून फार पूर्वी पासून वापरले गेले आहेत. 

युरोप अमेरिकेत काही बॉडी बिल्डर्स बॉडी बिल्डिंग करण्यासाठी ही अशा प्रकारचे इंटरमिटन्ट फास्टींग एक शतकभराहून अधिक काळ वापरत आहेत.

विविध धार्मिक उपवास ही अशाच पद्धतीचे असतात, फक्त आपण त्याला इंटरमिटन्ट फास्टींग म्हणत नाही इतकेच!

एकोणिसाव्या शतकाच्या सुरुवातीला इंटरमिटन्ट फास्टींग विषयी एका ब्रिटिश डॉक्टर ने प्रकाशित केलेल्या एका ‘एन्थूझिॲस्टीक’ (उत्साही) पेपर ने आणि जगातील विविध नामांकित पब्लिकेशन्स नी तो त्यावेळेस उचलून धरल्याने इंटरमिटन्ट फास्टींग अचानक प्रकाश झोतात आले.

त्या नंतर जगातील विविध डॉक्टर्स नी वेळोवेळी त्याचा उत्साहाने प्रसार केल्याने इंटरमिटन्ट फास्टींग हे सतत प्रकाश झोतात राहिले आहे.

इंटरमिटन्ट फास्टींग मध्ये लोक काही तास उपवास करतात, आणि बहुतेक वेळा उरलेल्या वेळात ‘ॲड लिबिटम’ म्हणजे  ‘पाहिजे ते आणि पाहिजे तितके’ खातात. काही वेळा अशा फास्टींग मध्ये कॅलरी रिस्ट्रिक्शन (कॅलरीज कमी करणे) ही प्लॅन केले जाते, पण बहुतेक अशा डायट्स मध्ये फक्त खाण्याची वेळांची बंधने असतात, पण काय आणि किती खायचं ह्याची बंधने नसतात.

इंटरमिटन्ट फास्टींग प्रकारातील काही कॉमन डायट्स असे आहेत:

टाइम रिस्ट्रिक्टेड फास्टींग: ह्या प्रकारा मध्ये बारा तासा पेक्षा अधिक काळ उपवास करणे आणि उरलेल्या वेळात दोन किंवा अधिक वेळा खाणे.

ह्या प्रकारातील फास्टींग मध्ये 16:8 आणि 14:10 हे प्रचलित डायट्स ही येतात. ह्या प्रकारच्या डायट मध्ये लोक 16 किंवा 14 तास उपवास करतात आणि उरलेल्या 8 किंवा 10 तासांच्या ‘विन्डो’ मध्ये ‘ॲड लिबिटम’ म्हणजे ‘पाहिजे ते आणि पाहिजे तितके’, दोन किंवा अधिक वेळा खातात.

सध्या आपल्या कडे प्रचलित असलेल्या इंटरमिटन्ट फास्टींग डायट मध्ये खाण्याच्या विन्डो मध्ये दोन जेवणात काय आणि किती खावे ह्या पेक्षा जे काही खाल ते विशिष्ट वेळात संपवण्याचे बंधन असावे.

ईट स्टॉप ईट डायट: ह्या प्रकारच्या डायट मध्ये लोक अठवड्याभरात एक किंवा दोन दिवस पूर्ण उपवास करतात आणि 5 किंवा 6 दिवस ‘पाहिजे ते आणि पाहिजे तितके’ खातात.

इंटरमिटन्ट फास्टींग प्रकारातील 5:2 हा डायट ही ह्याच प्रकारात मोडतो. ह्या डायट मध्ये लोक आठवड्याभरात 5 दिवस ‘पाहिजे ते आणि पाहिजे तितके’ खातात आणि दोन दिवस उपवास करतात. काही लोक एक आठवड्यात एक एक दिवस दोन वेळा किंवा काही लोक सलग दोन दिवस उपवास करतात.

ऑल्टरनेट डे डायट: ह्या प्रकारच्या डायट मध्ये लोक एक दिवसा आड एक दिवस पूर्ण चोवीस तास उपवास करतात एक दिवस ‘पाहिजे ते आणि पाहिजे तितके’ खातात.

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सायंटिफिक रिसर्च:

गेल्या काही दशकात इंटरमिटन्ट फास्टींग बद्दल बराच सायंटिफिक इंटरेस्ट निर्माण झाला आहे.

त्या मुळे इंटरमिटन्ट फास्टींग वर रिसर्च ही झाला आहे.

पण हा रिसर्च प्राण्यांवर अधिक आणि ह्यूमन (मानवा वरील) रिसर्च त्या मानाने कमी प्रमाणात आणि काहीसा शॉर्ट टर्म झालेला आहे. आणि त्यात ही बहुतेक वेळा ह्या रिसर्च मध्ये आहार आणि व्यायाम हे फॅक्टर्स विचारात घेतलेले नाही आहेत.

ह्यातील बराचसा ह्यूमन रिसर्च हा रामदान हे उपवास करणाऱ्या ॲथलिट्स च्या परफॉर्मन्स वर झाले आहेत आणि ह्या पैकी बहुतेक रिसर्च मध्ये ॲथलिट्स चे परफॉर्मन्स खालावलेले दिसले आहेत पण परफॉर्मन्स उंचावलेले मात्र एका ही रिसर्च मध्ये दिसलेला नाही.

ह्यूमन रिसर्च मध्ये रिझल्ट्स कॉनफ्लिक्टींग (परस्पर विरोधी) दिसून आलेले आहेत.

काही रिसर्च मध्ये इंटरमिटन्ट फास्टींग मध्ये लोकांची वजने कमी झाल्याचे आढळले आहे पण ते इतर कॅलरी रिस्ट्रिक्टेड डायट पेक्षा अधिक असल्याचे दिसून आलेले नाही.

काही रिसर्च मध्ये इंटरमिटन्ट फास्टींग मध्ये लोकांनी हाय फॅट – हाय शुगर – हाय कॅलरी दोन किंवा तीन मील्स (जेवणे) घेतले असतां त्यांचे लिपिड प्रोफाईल्स अधिक खराब झालेले दिसून आले आहेत.

सुरुवातीच्या इपीडीमिलॉजिकल स्टडीज् मध्ये कमी मील्स (कमी वेळा खाणे) घेणाऱ्या लोकांमध्ये हृदयविकाराचा धोका वाढलेला दिसला तर अधिक मील्स घेणाऱ्या लोकांमध्ये टोटल कोलेस्टेरॉल आणि एल डी एल कोलेस्टेरॉल चे प्रमाण कमी आढळले आहे.

मॅल्मो डायट आणि कॅन्सर स्टडी ह्या मोठ्या स्टडी मध्ये तीन किंवा कमी मील्स घेणाऱ्या लोकांची वजने तीन पेक्षा अधिक मील्स घेणाऱ्या लोकांपेक्षा अधिक असल्याचे आढळले आहे.

ह्या उलट प्राण्यांमधील (उंदीर) स्टडीज् मध्ये इंटरमिटन्ट फास्टींग वर वजन, ब्लड प्रेशर, ब्लड शुगर आणि मेटबॉलिक मार्कर्स (पोटाचा घेर, ब्लड शुगर, ब्लड प्रेशर, ट्रायग्लिसराइड्स, एच डी एल कोलेस्टेरॉल) मध्ये सुधारणा झालेली आढळली आहे.

चार वर्षांपूर्वीच्या, 2018 मधील, एका रिव्ह्यू मध्ये इंटरमिटन्ट फास्टींग वर लोकांची वजने 2.5 ते 9.5 पर सेंट कमी झालेली आढळली पण हे रिझल्ट्स इतर कुठल्या डायट वर असलेल्या लोकांपेक्षा अधिक नव्हते.

म्हणजे पाच फूट उंची असलेल्या 80 किलो वजनाच्या बाईचे वजन 2 ते 7.6 किलो उतरू शकण्या सारखे आहे, जेव्हा तिला 30 वजन कमी करायची गरज आहे.

काही वेळ फास्टींग केल्याने इन्सुलिन रेझिस्टन्स कमी होऊन इन्सुलिन सेन्सिटिव्हिटी सुधारते आणि इन्सुलिन लेव्हल्स आणि ब्लड शुगर्स फास्टींग पिरियड मध्ये आणि थोडा वेळ त्या नंतर कमी राहतात असे दिसून आले आहे.

फास्टींग चे हे फायदे ‘सिरकॅडियन ह्रिधम’ (बॉडी क्लॉक) शी ही कनेक्टेड असलेले ही आढळून आलेले आहे. मानवांच्या बॉडी क्लॉक प्रमाणे दिवसा खाणे नॉर्मल आहे, तर रात्री खाणे ॲबनॉर्मल आहे, म्हणजेच नॉर्मल नाही.

त्यामुळे इंटरमिटन्ट फास्टींग चे पूर्ण फायदे मिळवायचे असले तर आपल्याला दिवसा खाणे आणि रात्री फास्टींग करणे आवष्यक आहे. ह्या उलट करण्याने इंटरमिटन्ट फास्टींग चे पूर्ण फायदे होत नसावेत.

इंटरमिटन्ट फास्टींग वर काही लोकांना थकवा, खूप भूक भूक होणे, गरगरणे, मळमळणे, अचानक शुद्ध हरपणे (सिनकोप), पडणे, मायग्रेन (एक प्रकारची असंह्य डोकेदुखी), शरीरातून पाणी कमी होणे (डीहायड्रेशन), ब्लड प्रेशर कमी होणे असे त्रास होऊ शकतात.

डायबीटिस असलेल्या लोकांना तसेच डायबीटिस साठी घ्यावी लागणारी काही औषधे घेण्याने ही अशा प्रकारचे दुष्परिणाम होण्याचा धोका अधिक असतो.

अर्थातच हे साईड इफेक्ट्स काही काळात कमी होतील असे ह्या लोकांना सांगितले जात असावे.

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ह्या शिवाय प्रत्यक्ष प्रॅक्टिस मध्ये अनेक लोक इंटरमिटन्ट फास्टींग वर हायपर ॲसिडिटी चा खूप त्रास सुरू झाल्याने ते सोडून दिल्याचे सांगतात. ह्यातील काही लोक पूर्वी कधीच हायपर ॲसिडिटी नसल्याची तक्रार करतात.

आणि काही लोकांना एखाद दोन वर्ष इंटरमिटन्ट फास्टींग केल्या नंतर ही ह्या ना त्या कारणावरून जेवणाच्या त्या वेळा पाळणे जमणे अवघड झाल्याने हा डायट सोडणे भाग पडते असे ते सांगतात.

अर्थातच काही लोक इंटरमिटन्ट फास्टींग यशस्वीपणे करत असतीलच पण ते माझ्याकडे येत नसल्याने त्यांचे म्हणणे माझ्या पर्यंत पोचत नाही.

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इनफरन्स:

इंटरमिटन्ट फास्टींग प्रकारच्या डायट्स मध्ये 2.5 ते 9.5 पर सेंट पर्यंत वजन आणि ब्लड प्रेशर, ब्लड शुगर, टोटल आणि एल डी एल कोलेस्टेरॉल कमी होऊ शकतात.

पण ह्या डायट्स मध्ये ही तुम्ही ‘ॲड लिबिटम’ म्हणजे ‘पाहिजे ते आणि पाहिजे तितके’ खाऊ शकत नाही.

जर तुम्ही 8 किंवा 10 तासांच्या खाण्याच्या काळामध्ये (विंडो मध्ये) ही एक किंवा दोन जेवणात, अगदी तुम्हाला दिलेल्या विशिष्ट वेळात ही जेवलात तरी ही, हाय फॅट – हाय शुगर – हाय कॅलरी अन्न खाल्लेत तरी ही तुमचे वजन, पोटाचा घेर, ब्लड प्रेशर, ब्लड शुगर, टोटल आणि एल डी एल कोलेस्टेरॉल कमी होण्या ऐवजी वाढू शकतात आणि चांगले म्हणजे एच डी एल कोलेस्टेरॉल वाढण्या एवजी कमी होऊ शकते.

ह्याचाच अर्थ, तुम्ही इंटरमिटन्ट फास्टींग केलेत तरी ही तुम्ही हेल्दी न्युट्रिशन चे नियम पाळले नाहीत, तर तुमचे वजन, पोटाचा घेर  आणि ब्लड प्रेशर, ब्लड शुगर, टोटल आणि एल डी एल कोलेस्टेरॉल, ट्रायग्लिसराइड्स कमी होण्या ऐवजी वाढू शकतात आणि एच डी एल कोलेस्टेरॉल वाढण्या ऐवजी कमी होऊ शकते.

तसेच तुम्हाला दिवसा खाणे आणि रात्री उपवास करणे ही आवष्यक आहे.

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जर तुम्हाला इंटरमिटन्ट फास्टींगच्या कॉन्सेप्ट्स आवडल्या असतील, पटल्या असतील, दोन जेवणाच्या फिक्स वेळा तुम्हाला पाळता येणार असतील, हे डायट्स तुम्हाला सूट होत असतील, अशा आहारावर असताना तुम्हाला अगदी फ्रेश आणि एनर्जेटिक वाटत असेल, त्या वर तुमचे वजन आणि ब्लड शुगर खाली आलेल्या असतील आणि ते आयुष्यभर फॉलो करता येणार असतील, तर तुम्ही तो जरूर फॉलो करा.

पण जर ते तुम्हाला सूट होत नसतील, त्या आहार पद्धतीचा तुम्हाला त्रास होत असेल, तर लक्षात घ्या, वजन कमी करण्याची किंवा डायबीटिस कंट्रोल करण्याची आणि हार्ट हेल्दी होण्याची इंटरमिटन्ट फास्टींग ही जगातील एकमेव ट्रीटमेंट नाही.

दिवसाभरात निदान ब्रेकफास्ट, लंच आणि डिनर ह्या तीन मील्स मध्ये न्युट्रिशनली बॅलन्स्ड किंवा संतुलित आहार आणि ह्या मील्स च्या मधल्या काळात भरपूर दूध आणि फळे खाऊन आणि पुरेसे चालून तुम्ही 2.5 ते 9.5 पर सेंट फॅट कमी करणेच नव्हे, तर पूर्ण स्लिम होऊ शकता आणि तुमचे ब्लड शुगर सकट सर्व मेटबॉलिक मार्कर्स सुधारून अधिक तुम्ही अधिक हार्ट हेल्दी होऊ शकता.

आणि वजन कमी करण्यासाठी किंवा डायबीटिस कंट्रोल करण्यासाठी आणि हार्ट हेल्दी होण्यासाठी कुठल्याही प्रकारचे डायटींग किंवा उपासमार करण्याची आवश्यकता नसते, हे माझ्याकडे ट्रीटमेंट घेणारे कोणी ही तुम्हाला सांगू शकेल!

Effect Of Post Meal Exercise On Weight, Blood Sugar And Insulin

Exercise any time is extremely beneficial to our health and its effects on your our health are well documented in international research.

Exercise boosts the levels of endorphins, the feel-good neurotransmitters,
Reduces stress,

Lifts gloom and depression,

Improves self-esteem,

Improves cardiovascular fitness,

Improves lung function,

Lowers blood pressure, blood sugar, total cholesterol, and LDL Cholesterol and triglycerides,

Improves HDL, the good Cholesterol,

Protects us from hypertension, diabetes, heart disease and strokes,
And boosts immunity.

Exercise also improves our metabolic health.

People with better metabolic health generate more energy and and use it more efficiently, burn fat better and maintain a healthy weight easier. They also have more energy and better memories.

Effect of insulin and exercise after a meal on blood sugar:

Carbohydrates in our food raise our blood glucose levels, when they are digested and absorbed in our small intestines.

Our body releases insulin in response to the raised blood sugar levels. Insulin influences muscle, liver and fat cells, amongst others, to absorb this extra sugar from the blood, so the blood sugar levels are brought down to normal.

Research has shown that exercising after a meal has similar effect on blood sugar and much better effect on overall health.

How exactly does post meal exercise lower our blood sugar?

Exercising after a meal triggers three mechanisms to occur simultaneously.
It causes the heart to pump more glucose rich blood to our muscles, triggers complex changes in certain enzymes further boosting glucose transport to muscles and the muscle membranes to become more efficient at absorbing glucose.

Exercise increases glucose uptake by muscles fifty times more than in a sedentary person.

With the result, our muscle cells get the extra glucose they need during a workout and our blood glucose levels drop, without the body needing to deploy extra insulin.

This is the reason why exercise after a meal lowers both the blood sugar levels as well as blood insulin levels.

Sustained high levels of insulin are harmful to the body as they eventually lead to insulin resistance and diabetes.

Maintaining low insulin levels is very beneficial to health.

When is the best time to exercise after a meal, to lower our blood sugar?

New research suggests that post meal exercise has special benefits if done after thirty minutes of a meal, up to maximum of six hours after the meal. As per one study, the best time is between thirty minutes to two hours.

But if you consume a liquid meal like a milkshake or a smoothie, the best time is to exercise immediately after the meal, as the blood sugar spikes immediately as liquid meals are absorbed much faster than a solid meal.

Which kind of exercise is most beneficial to lower blood sugar and insulin levels best?

Researchers have found that medium intensity exercise like walking lowers blood sugar and insulin best.

How much time should one walk after meals to lower blood sugar and insulin levels?

Thirty minutes would be ideal, but even ten minutes would be fine compared to being sedentary post meals.

Keeping moving around a little every half hour too would be more beneficial than being sedentary.

To summarise:

Exercising after a meal helps improve our metabolic health, lowers our blood sugar and blood insulin levels and helps us maintain a healthy weight and boosts our energy levels and memory.

That is the reason why exercising after a meal is very beneficial to our long term health!

It could be life saving if you are a diabetic!

Also read the articles ‘Science Of Exercise’ and ‘Walking To be Slim And Healthy’, on this website.

Learning What GI And GL Are And How They Affect Blood Sugar

Most people have heard about the Glycemic Index (GI) And Glycemic Load (GL).

Let’s learn what they exactly are.

Glycemic Index is a numerical value assigned to a food as per how quickly or slowly it raises your blood sugar when compared with 100 gm pure glucose. The speed of 100 gm glucose is considered 100 and all other foods are given a numerical value of between 0 and 100, as per the speed at which they raise the blood sugar.

The thumb rule is, the more processed a food is, the higher its GI, and the more fiber or fat in a food, the lower it’s GI.

The lower the Glycemic Index of a food, the slower it raises your blood sugar and the higher the Glycemic Index of a food, the faster it raises your blood sugar.

So obviously, we should be looking to avoid high Glycemic Index foods if we are watching our blood sugar or watching our weight and health in general.

But does Glycemic Index tell us the whole story?

No, it doesn’t.

Glycemic Index of water melon is pretty high, between 75 to 80, but the amount of glucose in a serving of it is very low, so its Glycemic Load is very low, at 5. This means diabetic people can eat watermelon in spite of its high Glycemic Index, without worrying about their sugar climbing up much.

This is the reason why we need another kind of measurement system of a food’s impact on our blood sugar.

Glycemic Load fulfils that requirement.

Glycemic Load is the number that tells us how much a food is going to raise our blood sugar, not just how quickly, when we consume it. The amount of rise in our blood sugar is considered as one unit, when we consume 1 gm glucose.

So obviously the Glycemic Index and the Glycemic Load are two different measures of the effect of a food on our blood sugar.

Glycemic Load is calculated by multiplying the grams of available carbohydrate in the food by the food’s glycemic index, and then dividing by 100.

Thus the Glycemic Load not only takes into account both how quickly a food raises our blood sugar, but also how much glucose it delivers into our blood, per serving.

Glycemic Load can be calculated for any size serving of a food, an entire meal, or an entire day’s meals.

The verdict:

There are experts who advocate using one or both of the above numbers in choosing your food if you are a diabetic. Others believe that using these numbers is too complex.

The American Diabetes Association, on the other hand, says that the total amount of carbohydrate in a food, rather than its glycemic index or load, is a stronger predictor of what will happen to blood sugar.

But reaching and staying at a healthy weight is more important for our blood sugar and our overall health.

So instead of worrying too much about Glycemic Index and Glycemic Load, learn to eat healthy, balanced food in moderation, focusing on food that includes whole grain cereals and pulses in moderation and vegetables and fruits and avoiding simple and processed carbohydrates and excess fat and lose weight by walking or taking up any more vigorous cardiovascular exercise if you are fitter.

The slimmer and fitter that you are, the better will be your sugar control.

Read the articles ‘Basics Of Nutrition’, ‘Preventing Diabetes’ and ‘The Good And The Bad Carbohydrates’ on this website.

Learning What Makes Our Nutrition Balanced!

Our body needs to get calories, carbohydrates, proteins, fats, fibre, various vitamins and minerals and antioxidants and water from our daily food.

Our food is majorly composed of cereals, pulses, vegetables, fruits, oil, milk and milk products like curds, buttermilk, butter, ghee, paneer, cheese and in mix diet people, eggs, flesh and fish.

In a vegetarian diet, cereals and pulses provide us with most of the calories we need throughout the day, carbohydrates, proteins, some fats, fibre, various vitamins, minerals and antioxidants.

Fresh vegetables and fruits provide us with fibre, various vitamins, minerals and antioxidants.

Milk and milk products, eggs, flesh and fish provide us with excellent quality proteins, fats, various vitamins and minerals.

Oil, cream, butter, ghee, hydrogenated oils provide us with fats.

***

Cereals have more carbohydrates than pulses and pulses have more proteins and fibre than carbohydrates.

Cereals and pulses are not only the major source of energy and carbohydrates but also the major source of of proteins in a vegetarian diet.

Even mix food eaters eat non vegetarian food on a few days in a week or two, so on most days, cereals and pulses are the major source of proteins in their diets too.

Proteins are made up of amino acids, meaning amino acids are the building blocks of proteins.

Some of these amino acids can be synthesised by our body from other amino acids, while it cannot synthesise some other amino acids from other amino acids.

While both kinds of amino acids are equally essential for our body, the type that cannot be synthesised by our body are called essential amino acids. We have to get them from our food.

Milk and milk products and eggs, flesh and fish individually contain the complete range of essential amino acids, so they provide us with excellent quality, complete proteins.

In a vegetarian diet, cereals and pulses provide us with most proteins we need.

But cereals and pulses individually contain incomplete range of essential amino acids, so the proteins in them are incomplete.

Cereals lack the essential amino acid lysine and pulses lack tryptophan and cysteine.

But pulses have lysine and cereals have tryptophan and cysteine.

So when consumed together, they provide us with complete proteins.

That is the reason why we must consume cereals and pulses together in breakfast, lunch and dinner.

***

We get adequate amount of good quality proteins if we take cereals and pulses together in major meals and include adequate amount of milk in our daily food.

That is why vegetarians don’t need to to eating non vegetarian food to simply to get adequate good quality proteins.

Today many pure vegetarians are forced to consume multiple eggs through the day on various ill conceived, so called high protein slimming diets.

There is absolutely no need to punish oneself with eggs on such bad diets.

***

So in a vegetarian diet, we need cereals, pulses, vegetables and moderate amount of oil to cook them, in every major meal to get balanced nutrition.

But such meals still don’t provide us with Vitamin B12.

Only milk, eggs, flesh and fish have Vitamin B12.

So vegetarians need to include milk in their diet to get Vitamin B12.

We also get excellent quality proteins and ample calcium and B vitamins and other minerals in milk.

It is very likely that you have heard that milk causes weight gain and diabetes.

This is absolutely untrue.

Like vegetables, fruits too provide us with ample fibre, vitamins, minerals and antioxidants.

They also provide us with energy.

That is why adding fruits and milk to the above described balanced meals makes your nutrition complete.

The only nutrient missing in the above diet is the heart and nervous system friendly sea source omega 3 fatty acid.

For us, it is available only in sea fish.

If you can add sea fish to your food, though few people eat fish, it becomes a wonderfully balanced diet.

It helps keep you heart healthy.

But omega 3 is not the only factor that keeps your heart healthy and purely vegetarian people too live to be a hundred, so no great harm done, if you don’t eat fish!

***

We have already seen that to get well balanced nutrition, we need to get carbohydrates, proteins, fats, fibre, various vitamins and minerals and antioxidants in balanced proportions.

In such balanced nutrition we need to have:

Cereals in the form of chapatis, bhakri, rice singly or in any combination,

Pulses in the form of varan, amti, dal, usal, pithla.

Vegetables,

And moderate amount of healthy oil needed to cook them, in our lunch and dinner.

The mix food eaters, who also have non vegetarian food, should look to have sea fish twice a week to get adequate omega 3 and meats like turkey or chicken or goat (not lamb) meat once a week and one whole egg thrice a week on the no non vegetarian food days, to keep the cholesterol consumption under control.

Such a plan will provide balanced nutrition.

***

For four decades now, we have successfully helped innumerable people get slim and healthy not only in our Obesity Clinic in Pune, but all over the world, on our ‘Distance Program’. Absolutely balanced nutrition and exercise even as simple as walking have always been at the core of  our Weight Loss Treatment in Pune and all over the world.

***

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

Weight Loss Tips To Get Slim and Healthy!

Diets never work!

At least not long term.

All diets are low calorie and most border on starvation.

And they are not like your normal, daily food at all!

Doesn’t matter which category diet you try.

You never feel good on a diet.

On any kind of diet, you soon start feeling the the ill effects.

You lose glycogen and the water molecules associated with it and you get dehydrated.

Glycogen is a carbohydrate that is stored majorly in our liver and muscles and is used as a ready source of energy that the body can draw upon whenever needed.

Every gram of glycogen is associated with three gm of water.

It means that on a very low calorie diet you are going to not only lose glycogen but also three times its weight in water!

So people on low calorie diets experience a quick initial drop of weight more because of dehydration and glycogen loss than fat loss!

You keep feeling hungry and irritable, you feel run down instead of feeling fresh and energetic, you soon start feeling fatigued and tired all day.

You get constipated and there could be discomforting gases, you could end up developing fissures and piles.

You start suffering from hyper acidity which you may never have experienced before then.

In general you feel miserable.

If there is weight loss, you may initially see your blood pressure and blood sugar dipping a little and this may lure you into continuing with these diets.

You will soon start suffering from various nutritional deficiencies.

Your haemoglobin starts going down and you start looking pale and anaemic.

You begin to lose proteins from the collagen connective tissue holding your skin firm and it begins to wrinkle and sag and you start looking older. You also lose muscle mass and proteins from other tissues and organs.

Your bones start losing calcium and you develop bone pains and later osteopenia and osteoporosis, if you persist with these diets.

Some people still manage to hang on to these for months and even lose 10 or 20 kg braving such diets.

But it is impossible to continue with these diets for ever and the weight bounces back and the blood pressure and sugar climb back with vengeance as soon as they start eating their regular food.

***

But then how should we eat to lose weight healthily?

If we really want to be slim and healthy for a lifetime, we must lose weight on our own normal, every day food, viz. chapati, rice, bhakri, dal / varan / amti, usal and vegetables.

Or idli, dosa, sambar, rice, if you are a South Indian.

And we must have at least breakfast, lunch and dinner as the major meals and ample low fat dairy (low fat milk, curds, buttermilk) and fruits in between the major meals.

This gives you the best balanced food even if you are a vegetarian.

It not only provides balanced nutrition and keeps you feeling satiated all day and night, it also prevents development of hyper acidity.

Non vegetarians can also have eggs, fish and flesh in appropriate kind and amounts.

But if you are a vegetarian, you needn’t add eggs or chicken or protein powders to your food just to lose weight.

You can definitely lose weight on a vegetarian diet.

A lacto-vegan diet (vegetarian diet plus milk) is very much a well balanced diet.

This is the only kind of food plan that we can follow all our lives.

Simply because this is how we have eaten all our lives, for generations.

And no other kind of diet can make you slim and healthy for a lifetime because we cannot live on any other kind of diet for a lifetime.

All we need is to learn to eat our own normal, daily food, only nutritionally fine tuned with a little bit of discipline and at least walk regularly, to get slim and healthy for a lifetime!

And this discipline is enjoyable for most people and not in any way bothersome!

***

Remember:

Diets are temporary and so are their results,

Eating healthy is permanent and so are its results!

***

And all you need is to eat healthy and walk regularly to get slim and healthily for a lifetime.

And if you are younger and fitter, you can jog, run, dance, take up aerobics, pedal a stationary exercise bike or a street bicycle, swim if you are an expert swimmer, or workout on treadmill or an elliptical trainer, or play a fast sport like tennis. In short take up any cardiovascular activity that you enjoy to become slim, fit and heart healthy, for a lifetime.

Yoga, floor exercises or lifting weights (strength training) won’t burn comparable calories and will not help you lose weight as well, or get as heart healthy, as the cardiovascular exercises will.

***

This quote of a great American philosopher, thinker, author and philanthropist, perfectly sums up the philosophy of our process of the treatment of getting slim and healthy perfectly:

‘When we begin to work on ourselves, sometimes things get worse before they get better. It’s ok if that happens. It’s the beginning of the process. It’s untangling of old threads. We need to just flow with it. It takes time and effort to learn what we need to learn. We might not see changes instantly.

Impatience is the only resistance to learning. It means we want the goal without going through the process. We need to let ourselves learn, step by step. It will get easier as we go along.’

Louise L Hay

***

And remember, Rome wasn’t built in a day!

Lose weight at your own comfortable pace, focus only on the process and keep following it and your body will take care of the rest.

As you begin to follow the process, you will begin to feel fresh and energetic, your fitness will improve, you will start looking slimmer, healthier and younger, your skin and complexion will begin to glow with your newfound health and your hair health will improve significantly.

Soon your blood pressure, blood sugar, cholesterol, triglycerides and insulin levels will start improving and you will be protected against hypertension, diabetes, heart disease and strokes and PCOD, infertility and miscarriages and many other chronic diseases including some cancers.

***

For four decades now, we have successfully helped innumerable people get slim and healthy not only in our Obesity Clinic in Pune, but all over the world, on our ‘Distance Program’. Absolutely balanced nutrition and exercise even as simple as walking have always been at the core of  our Weight Loss Treatment in Pune and all over the world.

***

Also read the article ‘Simple Steps To Slimming’ on this website.

Effect Of Dietary Cholesterol, Saturated Fats And Simple Carbohydrates On Blood Cholesterol

Until 2013 it was generally accepted that dietary consumption of cholesterol should not exceed 300 mg daily for people who are not at a risk of developing coronary heart disease and 200 mg daily for people who are at a risk of developing coronary heart disease.

But research across the world could not establish a direct link between dietary cholesterol and raised blood cholesterol and LDL cholesterol and cardiovascular disease risk and hence the contemporary guidelines for coronary heart disease risk reduction from the American Heart Association (AHA) and American College of Cardiology (ACC) and the 2015–2020 Dietary Guidelines for Americans (DGA) have not issued explicit guidance for dietary cholesterol.

Researchers have found that it is not dietary cholesterol, but presence of excess saturated fatty acids in diet that lead to raised blood cholesterol and LDL cholesterol and cardiovascular disease risk.

But most of the high cholesterol foods, viz. full cream milk and animal flesh are also high in saturated fats.

So eating high cholesterol foods also adds excess saturated fats to your diet.

One notable exception of a high cholesterol food that is not high in saturated fat is egg.

Having said this, the two diets highly recommended for prevention of heart disease, the Mediterranean Diet and the DASH Diet are both low cholesterol diets.

And although the American Heart Association and the American College Of Cardiology and the 2015–2020 Dietary Guidelines for Americans (DGA) have not issued explicit guidelines for dietary cholesterol for lowering the blood cholesterol levels, they still recommend healthy eating patterns involving relatively low levels of dietary cholesterol and advice against excessive consumption of cholesterol.

These healthy food patterns and the Mediterranean Diet and the DASH Diet both lay emphasis on fruits, vegetables, whole grains, low-fat or fat-free dairy products, lean protein sources, nuts, seeds, and liquid vegetable oils.

So even if there is insufficient evidence that dietary cholesterol raises blood cholesterol significantly, it is prudent to keep your dietary cholesterol consumption low.

Luckily the dietary habits of most Indians are based more on vegetarian food than non vegetarian food.

So we any way consume little dietary cholesterol.

But we must guard against eating excess saturated fatty acid rich foods, namely milk fats and solid at room temperature vegetable oils.

We must also guard against excessive consumption of milk based sweets which are commonly made from full cream milk and also have ample sugar.

Full cream milk is rich in cholesterol as well as saturated fats.

Eating too much sugar also leads to raised levels of triglycerides which in turn lead to raised levels of LDL, the bad cholesterol.

Eating too much simple carbohydrates viz. refined flours like rava, maida, refined cornflour and bakery products principally made from maida, also causes raised levels of triglycerides and LDL cholesterol.

So being vegetarian and not consuming full cream milk is no guarantee against high blood cholesterol levels.

Thus eating too much sugar, sweets made from full cream milk and eating too much simple carbohydrates also raises the blood cholesterol levels.

They can all lead to coronary artery disease and strokes.

Also read the articles ‘Basics Of Nutrition’ and ‘What You Must Know About Cholesterol’ on this website.