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THE CAUSE OF LOSS OF POPULARITY OF YOGA AND MEDITATION IN THE PAST

Yoga-meditation was and is the most scientific, complete, practical and effective way to maintain one's health in the best possible state and to keep away from disease. But why Yoga did not have so much popularity in the present era as was expected. The allopathy or modern medical science is still more popular today even in India, the land where Yoga was invented. Let's find out the cause of the setback that the Science of Yoga - Medication had in the last 2000 years.

The cause of this fall was repeated invasion of India from outside, imposition of foreign culture and lack of support from then existing Rolers. Starting from the Greek emperor Alexander's invasion (327BC) India had been over and again invaded by outsiders. It was Taimurlong, Lodis, Tughlaks, Babar and so on. By the time of about 500 AD Yoga got a major blow as the scriptures were burnt, gurukuls (where the students learnt Yoga from their teachers-called Gurus) were abolished and the support base was withdrawn. once the political front settled for 500 years (The Mughal Emperors became stable) there was a possibility that Yoga will become popular again but India was fragmented and so many smaller states started existing and were regularly fighting but India was fragmented and so many smaller states started existing and were regularly fighting with each other. The Yogis, Saints, Gurus thus could not promote the system as they lacked support - Government priorities being War and defense. The science could not have spread to outside countries because of it sea and the mountains - which did not allow it to travel beyond.

By the year 1500AD or so the British rulers came to India. Conversant with the modern medical science (Allopathy) the Britishers promoted drugs and surgery - which gradually became the order of the day. hospitals were opened, Medical colleges were established. The most important advantage to the Modern medical science was the organized way of spreading, more and more scientific research, growing manpower training and infrastructure. Yoga science remained dormant and was followed by only a few.

The Rise in the Popularity of Yoga-meditation again:

Though the medical science could understand and analyze the Body functions, organs, their pathology, the bacteria that cause the infection - they invented new drugs, used surgery after putting anesthetics in the brain and tremendous progress. They went deeper and deeper into the chemical structure, metabolism, hormones using the most modern gadgets - and achieved remarkable results. But they failed in one field very badly - that is to understand the brain mechanisms and production of stress. They could not even measure stress - even by using the most sophisticated equipments. Even, now the medical science does not know and understand 90% of the Brain's functioning.  

Since the Modern Medical Science did not have adequate information about brain - they could not give medical solutions to Stress and stress related diseases. They failed to give suggestions to keep the brain healthy. They failed miserably in solving the diseases which originate at the brain or are greatly influenced by it. All they tried was to nullify the effects of the stress hormones and manufactured drugs to maintain the body normal when stress created its effects. The Psychosomatic diseases grew by leaps and bounds cause remaining unchecked and undetected.

The main central station of the body - the mind/brain/cerebral cortex/emotional cortex, or whatever you call them - was out of their reach. All they could invent were some sleeping tablets, excitatory and depressive drugs. They tried to get Antacids to nullify acids in the stomach, anti blood pressure drugs to lower the blood pressure and so on. All these medicines had their side effects. The surgical means also failed. They could control the disease by giving temporary relief - by producing tons of chemicals (naturally the drug companies did very well).

The same people in the west - who once invented the Medical science, tablets and surgery have realized the complications and side effects of these drugs-chemicals intended to cure diseases and the surgeries being carried out and are looking for better alternatives. Many of them have adopted the ancient way of Yoga and Meditation as a non invasive way to deal with ill health in the last few decades. Now as the Modern Medical Science studies Yoga and Meditation in great depth more and more facts are emerging which support the beneficial effects of Yoga on the human body and mind. This has made yoga more acceptable and popular.

 Hope you liked this blog!

This article is written by Dr. Bimal Chhajer (Best Heart Doctor in Delhi NCR)

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ANGIOPLASTIES

Promises that have failed over the years! "Without taking care of the root cause of the illness, how can the problem be solved."

In the last 25 years or so every time a new angioplasty procedure came, the heart patients were given promises of a lifetime cure. Press conferences would be arranged to tell the press that the ultimate cure had come and there would be no heart patients left in the country! General population, an optimist, expecting that the new scientific inventions would probably wash away all their sorrows, believed the doctors. History has witnessed that every time these promises have failed! First came the ballooning or PTCA (Percutaneous  Transluminal Coronary Angioplasty) in the middle of eighties. The promises failed within a few years. The cardiologists in the heart hospitals reluctantly agreed that this procedure was not so good as promised. When the stent came, it was promised that only one percent of the cases would have problems. People soon forgot the last failure of the promise! Now the same cardiologists who performed millions of stent implantations with the above promise, again admit that the results are very bad. About 50% of the stents implanted failed within six months! Then came the drug elluting stent or drug coated stent. Instant publicity led to the belief that now there would be no problems left. The optimistic heart patients emptied their pockets in the hope that they would be now completely cured. The promises seem to be failing again! The FDA of USA has started issuing warnings. Guess... what may be the next step...?

One third of patients with coronary artery disease (CAD) will undergo coronary artery angioplasty (PTCA) and stenting.

The primary problem with PTCA is "restenosis" which is a closing of the coronary artery following balloon dilatation. Approximately 30% of all coronary arteries begin to close up after angioplasty. Stents were created to address this complications. But they are also failing.

In 1994 the first stent approved for use in the United States was called the Palmarz-Schatz. While the Palmarz-Schatz stent eliminated many of the complications of PTCA, restenosis still remained a problem, occurring around six months, post-PTCA, in about 25% of the cases.

Why was this happening despite the presence of a stent? The issue came down to the injury to the coronary artery wall caused by the PTCA procedure itself. In essence, the body's response to the balloon expansion of the blocked artery was to grow smooth muscle cells at the PTCA site in an attempt to repair what it saw as an injury. It became clear that a mechanical device alone was not going to solve the biological response of the body. In the 1990's researchers began looking to pharmacological coatings on the stents to interrupt the restenosis process. The first attempts were unsuccessful. However, by 2002 two new pharmacological agents were developed to improve the effectiveness of coated stents.

The first was a drug called sirolimus, which is found in the soil of Easter Island. It is used with the Cypher stent (manufactured by Johnson and Johnson). The second was a drug called paclitaxel. It is used with the Taxus stent (manufactured by Boston Scientific). Both of these stents, Cypher and Taxus, are called drug-eluting stents.

On April 23,2003 the FDA approved the Cypher stent for use in the United States.

However, by June 2003 the FDA issued a warning to physicians regarding possible clotting complications with the Cypher stent.

In October 29,2003 the FDA issued a second warning on the Cypher stent regarding possible "adverse events." Specifically, the FDA had received more than 290 reports of clotting between one to 30 days of using the Cypher stent.

In more than 60 of these reports, use of Cypher stent was associated with death of the patient.

What does this mean in terms of increased risk to patients undergoing PTCA? It appears that the Cypher stent is not going to solve the problem.

Without taking care of the root cause of the illness, how can the problem be solved? Just trying to provide a temporary relief to the symptoms by forcing open the clogged tubes is bound to result in restenosis.

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This article is written by Dr. Bimal Chhajer (Heart Caring Expert)

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BLOCKED ARTERIES: CLEAN THEM OUT NATURALLY

Fortunately, there are alternatives to bypass surgery, angioplasty, and medications. However, many patients and even physicians are not aware of these options. Preventive medicine experts have now proven that changing one's lifestyle can reverse blockages in heart blood vessels. Perhaps what is more important, when used properly, lifestyle agents such as stress control, smoking cessation, diet, and exercises have no harmful side effects. The only side effects are desirable ones contributing to better quality of life and decreased risk of diseases of many types in addition to heart disease. Those individuals with heart disease who become aware of the importance of lifestyle changes are confronted with a vital question: "Am I willing to make the common sense lifestyle changes are confronted with a vital question: "Am I willing to make the common sense lifestyle changes necessary to reverse my disease?" If the answer is "no" it is likely that either angioplasty or are negligible or absent. Most of these surgeries are not performed on the merit of the cases. These surgeries, cost a lot and are major sources of money providers in the hospitals. Usually after angiography, once the blockages are found, the angioplasty doctors/ surgeons ask the patient to undergo an angioplasty or bypass surgery. To emphasize their point, they start telling them "you are sitting on a time bomb, which can explode any time. "The patient, fearful that he has blockages, gives in to their demands and deposits money for it. If the doctors find the patient unwilling, they then catch hold of the relatives. The family members are as it is very scared and give in to their demands. Doctors tell them. "it is an emergency. Please deposit the money and then we will schedule the procedure". But, if the doctors realize that the patient or the relations will never be able to cough up so much amount of money, they advise medicines and tell them that, whenever the money would get deposited the surgery would be performed. Till such time they could continue on medicines and exercise. The punch line in this whole set up is that these procedures are performed for money only and is not a solution to the disease. A patient who ends up on the angiography table is so fearful that he falls prey to the demands of these hospitals/surgeons and ends up with these unnecessary surgeries/angioplasties.

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This article is written by Dr. Bimal Chhajer (Non-Invasive Heart Treatment Expert)      

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CORONARY ANGIOGRAPHY (NOT AN ORDINARY TEST)

Coronary Angiography (or Angiogram) is an X-ray examination of the blood vessels of the heart. A tube is inserted in your groin. The tube is now blindly passed into the body from outside. When positioned either in the heart or at the beginning of the arteries supplying the heart, a special fluid (called a contrast medium or dye) is injected. This fluid is visible by X-ray and the pictures that are obtained are called angiograms.

Coronary Angiography is not an ordinary test. It is an invasive procedure where a foreign body in the form of catheter is inserted inside the body through a cut. This carries a lot of amount of risk. Followings can occur during or after the procedure.

Death: Certain patient groups are at risk of death during the angiography. They can be elderly above 60 years, patients with angina class IV, those with blockages in the left main coronary artery. Also patients with previous heart attacks and low cardiac function, with valvular heart diseases or with non-cardiac diseases like kidney disease, diabetes (IDDM) etc. are at risk.

Heart Attack or Myocardial Infarction: The wire can cause an injury to the intima (inner covering of blood tubes) leading to formation of a blood clot and eventually a heart attack. Again patients with excessive blockages or blockages in left main with IDDM having angina at rest are more prone for heart attack.

Brain Injury : The blood clots as described above can move to the arteries of the brain which can lead to Brain Stroke (paralysis).

Delayed hemorrhage (bleeding) is also one of the complications. The collection of blood can compress nerves and other blood tubes. This can cause severe brain injury.

Injury or puncture of the blood tubes: The wire after inserting and moving towards the heart can puncture any blood tube through which it passes. It can also move into blood tubes of other organs like the kidney's, legs etc. and cause injury. This, in turn can result in internal hemorrhage and organ damage. In the same manner, the heart tubes can be punctured. The scratches in the blood tubes during the procedure caused by the wire always help in more deposition of cholesterol and triglycerides and hence development of new blockages.

Arrhythmias (Disturbances in the normal rhythm of the heart): The normal beating of the heart can be disturbed and may result in extra beats or reduced heart beats. Also, the pattern of the heart contraction may be damaged.

Cardiac Arrest or Cardiogenic shock: The vaso-vagal reaction can lead to cardiac arrest or shock.

Infection, fever: The wire introduced is a foreign body. It can lead to infection inside the blood tubes and create further complications. Reactions can also result by contaminating materials that may remain on incompletely cleaned wire surfaces.

Allergies and Anaphylaxis (severe reactions): The local anesthesia and the dye used can cause severe allergic reactions which can even cause death.

Hypotension: The reactions mentioned above can result in lowering of blood pressure. This can lead to damage to other organs. It can also cause kidney damage, bleeding lungs and respiratory insufficiency.

 RESULT OF ANGIOGRAPHY - Is it accurate?

If you notice, most of the blockages are reported as 70%, 80% or 90%. Why these round figures? Some write 75%, 85%, 95%. The results are only a visual estimation. The figures often change by 10-20%, if you take an independent opinion from cardiologists. The surgeons have a tendency to increase all the blocks and the Angioplasty doctors enhance one blockage but reduce the figures of others. The bias is to benefit themselves. If the results were accurate the figures would have been 71.7% or 92.5%.

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This article is written by Dr. Bimal Chhajer (Best Heart Doctor in New Delhi)                

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HOW TO IDENTIFY HEART ATTACK?

PAIN IN THE CHEST.... IS IT A HEART ATTACK?

Chest pain can have many causes. Some causes are related to the heart and blood vessels. Other have nothing to do with the cardiovascular system. The doctor considers the list of different possible causes. A careful description of the pain can often eliminate other possibilities. Sometimes a person has alarming chest pain and yet has no identifiable problem with the heart. Conditions that often turn out be present, although heart attack was suspected include stomach disorders such as heart burn, stomach ulcer, gall stones with gall bladder irritation, costochondritis (chest wall pain caused by soreness of the muscles between the ribs and the breast bone), cervical spondylitis and other skin infections.

Although acute heart attack may commence at any time of the day or night, circadian variations have been reported such that clusters are seen in the morning within few hours of awakening. The increased frequency early in the day may be due to a combination of an increase in sympathetic tone and an increased tendency to thrombosis between 6 am and 12 noon.

 Symptoms :

 Pain is the most common presenting complaint in patients with Heart attack. In some instances, it may be severe enough to be described as the worst pain the patient has ever felt. The pain is deep and visceral; adjectives commonly used to describe it are heaviness, sinking, squeezing and crushing, although occasionally it is described as stabbing or burning. It is similar in character to the discomfort of angina pectoris but usually is more severe and lasts longer. Typically the pain involves the central portion of the chest and/or the epigastrium (the upper part of central abdomen), and on occasion it radiates to the arms.

 Less common sites of radiation include the abdomen, back, lower jaw and neck. The frequent location of the pain beneath the xiphoid (lower most part of breast bone) and patients denial that they may be suffering a heart attack are chiefly responsible for the common mistaken impression of indigestion. The pain of Heart attack may radiate as high as the occipital area but not below the umbilicus.

 Accompanying Features

 There can be profuse sweating associated with the pain. The patient may complain of palpitation, restlessness, shortness of breath. Occasionally there can be dizziness, unconsciousness and sometime even blackouts associated with it.

 How to confirm?

 ECG is the easiest way to diagnose heart attack. During the initial stage of the acute phase total occlusion of the tube produces ST segment elevation. After sometime Q wave also starts appearing.

 Enzyme Changes

 Chest pains may not just get you a ride on a Treadmill or and ECG. Your doctor may also order blood tests to check for increased levels of certain enzymes that are normally found in the heart muscle. If you have experienced a heart attack, damage to your cells may allow these enzymes to leak into your blood over a period of hours. Creatine Phosphokinase (CPK) rising within 4-8 hours and return to normal within 48-72 hours. CPK (MB) is specific for heart attack. Cardiac specific Troponin T (cTnT) is also of considerable diagnostic usefulness.

 ECHO CARDIOGRAPHY

It shows abnormalities in the pumping power of the heart depending on the size of dead area due to heart attack. This is called Ejection Fraction which is normally 60%. It is substantially reduced in case of major heart attack, where the area of damage is more. It can also show the abnormalities of heart wall motion resulting out of heart attack.  

 Hope you liked this article.

 This blog is written by Dr. Bimal Chhajer (best heart doctor in Delhi)

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Physical Activity and Exercise

Most of us today are physically inactive. Throughout the day we do a lot of mental work but very little physical work. We get up from the bed, and sit and sit and sit. Starting from office work, travelling in a car or vehicle, eating breakfast-lunch-dinner, watching television, gossiping, having snacks, reading newspapers and magazines, writing - every other work is almost done in sitting posture. Only few of muscles work during sitting. Most of the work which need real physical activity - have either been mechanized or transferred to servant/employee. Examples of such work are - lifting weight, climbing stairs, walking to the market, washing our clothes, cleaning the floor, gardening, cleaning our house, dusting. All the physical activities in the kitchen have also been reduced by mixers, grinders and lately, dish washers.

Today, the only physical activity left is probably voluntary walk, (morning or evening), few kinds of sports as hobbies (like golf, swimming, tennis, badminton) but many of them are either reduced in duration or made grossly irregular by constraint of time and other commitments of modern busy life.

Muscles of the body, joints, heart, and lungs - which are in dire need of these exercises are the losers in this process. They gradually lose their health and fitness. They become sluggish and the day you suddenly need any strenuous physical activity - they refuse to strain and get exhausted and fatigued.

Regular exercise, not only keeps us fit but also prevents diseases like diabetes, heart disease, high blood pressure, arthritis, asthma, chronic fatigue syndrome and health conditions like obesity and early ageing. A minimum of 30 minutes of exercise - where the whole body is exerted to 70% of our maximum level - is very ideal for this purpose. Aerobic exercise, walking, cycling, swimming, table tennis. lawn tennis, badminton, jogging, skipping, stationary cycling - anyone can be a good choice.

But most of these are fitness exercises and should ideally be supplemented by some kind of flexibility exercises and relaxation of the body-mind combine. Nothing can compete yoga on this front. Yogic postures (asanas) and meditation are the most beneficial ways of achieving both these. In modern society everybody seems to be stressed beyond the optimum level and the spinal problems, joint diseases are common because of lack of flexibility exercises.

So, I would recommend for every individual a combination of 30 minutes of fitness exercise and 15-20 minutes of yoga-meditation per day - to keep one in the best of health.

So far as heart patient is concerned - they are different from a normal individual because of the insufficient blood supply to the heart muscles. Most of them have crossed 70% blockages in one or more of their heart arteries. They must know the safety of their fitness exercises - when they indulge into fitness them. They should learn the extent to which they can carry on.

Hope you liked this article!                                                                          

This article is written by Dr. Bimal Chhajer (Heart Caring Specialist)

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Silent  Heart Attack - Are You a Diabetic?

Srikant, 55 yrs, Executive, Diabetic experiences breathlessness on way to office. He consults his physician. ECG reveals Heart attack. He is rushed to the ICU.

Yes a Heart Attack, and no pain.

Ambulatory (Mobile) ECG reveals that a lot many no. of persons suffer from a silent attack, which is not associated with pain.

Patients with Diabetes are more likely to have a silent attack and this increases with age. About 90% of attacks in Diabetics are silent. This is due to the damage caused to the nerves carrying pain sensation due to uncontrolled Diabetes.

Diabetes is an independent risk factor for Coronary artery disease, and incidence is related to the duration of Diabetes. In Diabetes, not only are the attacks frequent but also tend to be more severe and associated with complications. Coronary Artery Disease is the most significant KILLER in Diabetes, because of accelerated deposition of fat in blood vessels, thus the threshold of Diagnosis should always be kept low.

It is treated like any other attack, keeping individual variations in mind.

Some Statistics on Coronary Heart Disease        

1. Prevalence of Coronary Artery Disease (CAD) has increased from 1.05% in 1960 to about 8-9.6% in 1990 in the urban population in India and 2.03% in 1974 to 3.5% in 1995 in the rural population.

2. The risk of Myocardial infarction (MI) has decreased between 1970 and 1993 by 23% in men and by 36% in women in the United States.

3. Trends in death rates have shown a 50% decline between the years 1970 and 1985 in the US and 10-15% decline in Scotland.

4. 2.5-3 times more frequent MI and 1.5 to 8.2 times mortality (studies from England, Wales, South Africa, Trinidad, Fiji, Singapore) in comparison to the local population.  

5. Average age at first myocardial infarction (MI) in Indians is 50.2 years compared to 55.5 years in white population.

6. Between ages 30-39 years age specific incidence of Heart Attack is 10:1 compared to whites, mortality from CAD in age group 30-39 years is 2.1:1 and 20-29 years, 3.1:1 compared to Western population groups.

7. 54% of Indians vs 21% whites have all three vessels diseased and arteries are very often diffusely diseased making them unsuitable for even bypass surgery.

8. 15-45% of Indians with coronary artery disease have hypertension as a risk factor.

9. Nicotine and carbon monoxide increase serum cholesterol by 3%, triglycerides by 9% and decrease HDL cholesterol by 6%.

10. One percent increase in serum cholesterol and 1.5% increase in serum LDL produce a 2-3% increase in Heart Attack incidence.

11. In North India there is a 3% incidence of diabetes but it is 7% in South India.

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This blog is written by Dr. Bimal Chhajer (India's Best Heart Doctor)

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HOW TO DETECT DIABETES MELLITUS? DIAGNOSIS AND MONITORING

Detection of Diabetes: The most common symptoms of Diabetes are Polyurea (frequent and excessive passage of urine), Polydypsia (increased intake of water or thirst) and Polyphagia (increased intake of food). These occur because of excessive urine formation as kidneys start throwing glucose out of blood. This loss of water leads to thirst. The loss of Glucose also leads to loss of calories. To make it up the body needs more calories or food. Delayed wound healing, proneness to skin or respiratory infections may often prompt doctors to instruct examination of blood glucose. Sudden loss of weight may be even a pointer towards Diabetes.

Many Diabetics do not have any major symptoms or complaints but are detected during routine examination of blood or executive checkups. It is advised that every individual should undertake a routine blood check-up for blood glucose (fasting and post prandial) and Lipid Profile (Cholesterol, Triglycerides, HDL Cholesterol) as soon as they reach the age of thirty years. This age can be lowered to 25 years if the parents have also Diabetes and should be repeated every year.

Confirmation : Confirmation of Diabetes can be made by Blood Glucose tests - which are very commonly available and less expensive. A patient should only be labeled Diabetic only when three consecutive blood tests show fasting blood glucose level above 120 mg/100 ml or Deciliter. A  postprandial (blood taken two hours after breakfast or meal. This is also called pp blood glucose) blood glucose level above 200 mg/dl or deciliter is also confirmatory of Diabetes.

A normal non Diabetic individual maintains a blood glucose level of 80-100 mg/dl when checked in fasting and after food (pp) blood level is usually below 140mg/dl.

Monitoring of Diabetes : Diabetes is a long and chronic disease. One must thus keep it under control throughout the life. Previously it was said "once a diabetes always a diabetic". But today the myth is proved wrong. With a better understanding of glucose metabolism and the lifestyle changes Diabetes can be cured, if detected in initial stages. But a regular check-up of blood sugar/Glucose is required to know the status of the patient. It is recommended to check blood once every month till all the reports for three months come under complete control. There after the tests can be done less frequently.

Those who find their blood glucose above the normal limits or way above normal - must check Blood Glucose much more frequently. For this Glucometers are available which are easy to test, handy and the reports are immediately available.

These days Glucometers cost hardly Rs. 3500 and each test costs about 15-20 Rupees. The aim of a Diabetic patient should always be to keep the blood glucose below 100mg/dl in fasting and 140mg/dl post prandial (pp).

Urine Examinations : Test for glucose in urine is another way of monitoring Diabetes. "Ready to use sticks " are available. But when the blood Glucose is above 180mg/dl. So if the urine becomes positive for glucose the control is definitely not good.    

Tests for complications of Diabetes: Diabetes with poor control of sugar must also check for blood urea, serum creatinine and urine for micro-albumin the involvement of kidneys.

Random Blood Glucose: It is not always possible to check blood sugar at fasting or pp because of practical problems. In such cases blood can be checked at any time when one is not fasting. This is called Random Blood Sugar. It should ideally be below 140mg/dl for well-controlled Diabetes. They should also check the eyes for changes and take care.

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This blog is written by Dr. Bimal Chhajer (Heart Care expert)            

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BEING INDIAN IS RISKY FOR THE HEART

When it comes to the health of the heart, the need to adopt a healthy lifestyle acquires added significance in the South Asian context. Several studies have shown that South Asians are not only more predisposed to coronary artery disease, but are also struck by it at a younger age and report a more aggressive presentation. While high fat-low fiber diets and a sedentary lifestyle are largely to blame, upping risk are also a combination of metabolic and genetic factors.

For instance, Indians are predisposed to the metabolic syndrome, which is a constellation of lipid and non-lipid related risk factors of metabolic origin. Apart from being associated with insulin resistance and glucose intolerance, this syndrome leads to increased body fat, particularly in abdominal area. Abdominal obesity, where the fat is concentrated on the waist and stomach, is a stronger risk factor for heart disease than total obesity, measured by body mass index (BMI, calculated by squaring the square of your height in meters divided by your weight in kilos. A healthy BMI should be between 18 and 24.9).

Indians are also prone to Dyslipidaemia, or unhealthy lipid profile, that ups their chances of having a heart attack. Coronary risk exists even if their overall total cholesterol and LDL (bad) cholesterol is normal because they tend to have lower levels of HDL (good) cholesterol and high levels of triglycerides.

Low-birth weight, where babies weigh lower than 2.5 kilos, is also a risk factor, say experts. "Babies who are underweight and have a short body length at birth are at higher risk of CAD (Coronary Artery Disease) and diabetes in adult life," says Dr. Philip Pool Wilson, of the Imperial College, UK. Lower levels of Vitamin B12 and Folate also raise levels of plasma Homocysteine, which is associated with higher risk of CAD (Coronary Artery Disease). "Prolonged cooking of vegetables is common in India and can destroy upto 90 percent of the folate content, so a modification in the dietary pattern can lower risk considerably," says the Brazil-based Mario Maranhao President of the World Heart Federation.

Several studies have also correlated infections to CAD (Coronary Artery Disease).

"Infections and inflammation are very common in the developing countries, and several studies indicate that the simultaneous presence of antibodies increases the risk of developing the disease," says Maranhao.

Since most of can do little about the genetic and environmental risk factors, making lifestyle changes seems the doable solution. "Exercise is the key, but sadly, few affluent Asians realize it," he says. So, pull out your trainers and save your life.

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This blog is written by Dr. Bimal Chhajer (Best Heart Doctor New Delhi)            

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TREATMENT OF OBESITY

A suitably planned course of dietetic treatment, in conjunction with suitable exercise and other measures for promoting elimination is the only scientific way of dealing with obesity. The chief consideration in this treatment should be the balanced selection of foods which provide the maximum essential nutrients with the least number of calories.

There should be a gradual weight reduction. The aim is to maintain ideal body weight and to correct faulty eating habits.

Let us understand the tips individually.

A. The total energy intake for the day should be adjusted to meet the individual weight reduction requirement. SAAOL's recommended dietary allowance for a person performing a minimum amount of (sedentary) work is 1600 calorie/day.

B. A total vegetarian diet should be followed as consumption of meat, fish, chicken, poultry, mutton etc will increase the cholesterol and triglyceride levels and ultimately the amount of fat in the body.

C. As carbohydrates (all cereals, vegetables, fruits, sugars, sweets etc) are the main source of energy in our diet one must select the right type of carbohydrates. Simple carbohydrates (sugar, sweets, all sweet fruits, jaggery, honey) when eaten get digested instantly, hence will led to rapid increase in weight while, complex carbohydrates (all cereals, vegetables, non-sweet fruits) get digested slowly and so gradually get utilized when needed.

The golden rule is to maintain a negative balance. Remember the human body is a wonderful machine. It will replenish the calories from the body stores, which is nothing but fat. In this manner a gradual reduction in weight can be achieved.

DIETARY TIPS

1. Follow total vegetarianism.

2. Take skimmed/ double tonned milk (200-250 ml/day)

3. No oil to be used for cooking.

4. Zero oil cooking methods

(i) Use non-stick, pressure cooking                  

(ii) Heating, boiling, baking, roasting

5. Salads before meals.

6. Prefer brown bread instead of white bread.

7. Avoid raw sugar.

8. Alternation of pulses.

9. mix wheat bran, soyaflour or besan to wheat flour.

Hope you liked this blog!

This blog is written by Dr. Bimal Chhajer (Indian Heart Specialist)

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CAUSE AND MECHANISM OF DIABETES

Literally "Diabetes Mellitus" means "sweet urine" or presence of sugar in urine. The Greek people (where the allopathic medical science initiated 500 years back) called it so, because they found the urine of people suffering from this disease is sweet in taste.

In this disease, the Islet cells of Pancreas (situated just below the Stomach in the abdomen) secrete less amount of Insulin- the hormone required to break down glucose inside the body cells. This in turn, increases the blood level of Glucose (which should normally be 80-100 mg/100ml of blood in fasting state and 10-140mg/100ml of blood two hours after food). When the blood level of glucose becomes above 180mg/100 ml of blood the kidneys start throwing glucose outside the body. This results in a huge loss of glucose from the body and also make the urine sweet. The raised level of glucose in the blood may not produce any major symptoms to the body in the short-term, but causes destruction of almost all the organs of the body in the long run.

Latest medical research findings in the last decade, point towards another cause of diabetes that is "reduced sensitivity of Insulin" apart from low secretion of Insulin from pancreatic Islet cells. In fact in the recent days this theory of low powered or ineffective. Insulin is gaining more ground in the causation of Diabetes.

Insulin is a protein molecule made up of 51 amino acids which is directly released into the body by the pancreas. This chemical or hormone, which travels in the blood stream to reach each and every cell of the body, is very vital. It facilitates the entry of glucose inside the cells which in turn, derive energy for survival by breaking down this glucose. Insulin has to bind with a protein present in  the cell membrane (called the insulin receptor) like a lock and key to facilitate this glucose entry. The pancreas secretes more Insulin as soon as the food is absorbed raising the blood glucose level. (Carbohydrate break down into small units called glucose during digestion of food in the intestine). Pancreas can sense the glucose level of the blood and acts by increasing or decreasing the Insulin release throughout the day.  

The exact cause of this reduction of insulin secretion or ineffective Insulin is not known but the followings may be implicated:

Genes: Almost 50% of the Diabetes patients have one of the parents or family members affected with diabetes. Till now the genes responsible have not been isolated but a strong correlation exists.

Lifestyle: High calorie food intake, lack of exercise and physical inactivity and obesity is very strongly connected to Diabetes. Diabetes is becoming more common as more and more amenities are developed reducing our physical activity. It is also related to affluence as rich people have more incidence of Diabetes. However, it is believed that increased consumption of sweets or sugar in normal people do not lead to Diabetes. Obese people develop definite "insulin Insensitivity" which becomes okay once they lose their weight leading to better diabetic control.  

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This blog is written by Dr. Bimal Chhajer (Heart Problems expert)        

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CAUSES OF OBESITY

When energy intake exceeds expenditure, the excess calories are stored in adipose tissue, and if this net positive balance is prolonged, obesity results i.e. there are two components to weight balance and an abnormality on either side (intake or expenditure) can lead to obesity.

INTAKE CONTROL

Appetite is controlled by discrete areas in brain called hypothalamus. Te feeding centers (areas in brain) send positive signals to brain cortex that stimulates eating. There is another area of brain called the satiety centre that modulates this process by sending inhibitory impulses to the feeding centre Thus destruction of satiety centre will lead to over eating and obesity. (Obesity may follow due to damage to hypothalamus after head injury because it is unable to regulate appetite or satiety). The satiety centre may get activated by plasma glucose and/or insulin that follows a meal.

The total adipose tissue mass may also influence the hypothalamic centre. Ultimately it is the brain cortex which controls eating behavior. Psychological, social and genetic factors also influence food intake. In many obese subjects these influences are overriding.

Eating behavior : Eating habits of certain people can lead to obesity like:

(i) Frequent consumption of high fatty food.

(ii) Nibbling between meals is common among housewives and is a potential cause for obesity.

(iii) Some may eat faster taking less time for chewing, therefore they tend to consume more food.

(iv). Obese  respond to external cues to eat rather than internal hunger signals. instead of having food when they are hungry, they eat when it is mealtime or are surrounded by tasty foods.

(v).Housewives who are fond of cooking variety of foods or persons who are working in the kitchens may become obese.

(vi). Business executives who frequently attend business lunches have more chance of becoming obese.

(vii). People who do not want left over foods to be thrown out many consume forcibly and put on weight.

Psychological Factors                                        

Some may eat more in situations such as anxiety, depression and frustration as a compensatory mechanism.

Socio Cultural Factors

(i). Prosperity and civilizations: Obesity is common in prosperous countries and people from higher socio economic status  of developing countries. They have the purchasing power and availability of surplus food. Civilization has brought plentiful supply of appetizing foods and variety of foods in the market.

(ii). Parties and socialization:   To maintain their social circle and also because of formality people often tend to eat a richer diet.

(iii). Job: It may also affect, like housewives, cooks, chefs etc may eat more while models and air hostesses tend to eat less in order to maintain their figures.

(iv). Before/after marriage: Usually before marriage in order to maintain an impressive personality and appearance people make efforts to maintain proper weight and figure. While after marriage they may not be very concerned about it.

Genetics

Genetic inheritance probably influence a person's chance of becoming fat. Within families the chances are 80% if both parents are obese, only 7% if either parent is obese.

Endocrinal (Hormonal) Factors

Obesity is found in hypothyroidism, hypogonadism and cushing's syndrome. Obesity is common at puberty, pregnancy and menopause.

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This article is written by Dr. Bimal Chhajer (India's best heart doctor)

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CHILDHOOD OBESITY

There are many factors that contribute tocausing child and adolescent obesity - some are modifiable and others are not. Obesity in children and adolescents is a serious issue with many health and social consequences that often continue into adulthood. Implementing prevention programs and getting a better understanding for treatment for youngsters is important to control the obesity epidemic.

Many parents are rightly concerned about their child's weight and how it affects them. They look for specific answers for prevention and treatment options. Unfortunately, the state of the science is a lot less precise than we would like. Are kids too concerned about their weight? What are the best strategies for prevention? What treatments work over a long time?

Researchers aretrying to answer those and many other questions. In many cases, common sense works well.

In situations where there is serious health, psychological or social problems, parents should seek out the best possible advice.

Prevention                                                    

Prevention should begin in early childhood. Obesity is harder to treat in adults than in children. Teaching healthy behaviors at a young age is important since change becomes more difficult with age.

Behaviors involving physical activity and nutrition are the cornerstone of preventing obesity in children and adolescents. Families and schools are the two most critical links in providing the foundation for those behaviors. Parents are the most important role models for children.

An important part of treating obesity among children and adolescents is for parents and healthcare professionals to be sensitive to the youngsters and focus on the positive. Small and achievable weight loss  goals should be set to avoid discouragement and to allow for the normal growth process.

Involvement of the entire family is also a motivating factor. Weight control programs that involve both parents and the child have shown improvement in long-term effectiveness compared to directing the program only to the child. Once the need for obesity treatment has been identified, your medical professional may suggest one or more options.

DIAGNOSIS

There are some signs that may help you determine if your child has or is at risk for childhood obesity, such as:

·         Family history of obesity-related health risks such as early cardiovascular disease, high cholesterol, high blood pressure levels, type 2 diabetes.

·         Family history of cigarette smoking and sedentary behaviors.

·         Signs in the child of obesity-related health risks from a pediatrician's evaluation including:

1.       Cardiac Risk Factors: Studies of children with obesity show higher than average blood pressure, heart rate and cardiac output when compared to children without obesity.

2.       Type 2 Diabetes Risk Factors: This involves glucose intolerance and insulin levels that are higher than average.

 ·         Orthopedic Problems: Some symptoms include weight stress in the joints of the lower limbs, tibial torsion and bowed legs, and slipped capital femoral epiphysis (especially in boys).

·         Skin disorders: Some are heat rash, intertrigo, monilial dermatitis and acanthosis nigricans.

·         Psychological / Psychiatric Issues: Poor self-esteem, negative self-image, depression, and withdrawal from peers have been associated with obesity.

·         Patterns of sedentary behavior (such as too much television viewing) and low physical activity levels.

·         Taller height: children with obesity are often above the 50th percentile in height.

 Modifiable causes

1. Physical activity - Lack of  regular exercise.

2. Sedentary behavior - High frequency of television viewing, computer usage, and similar behavior that takes up time that can be used for physical activity.

3. Socioeconomic status - High family incomes.

4. Eating habits - Over consumption of high-calories food. Some eating patterns that have been associated with this behavior are eating when not hungry, eating while watching TV or doing homework.

5. Environment - Some factors are over-exposure to advertisements of foods that promote high calories food and lack of recreational facilities.

Non - Modifiable causes

1. Genetics - Greater risk of obesity has been found in children of obese and overweight parents.

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This blog is written by Dr. Bimal Chhajer (Lifestyle Expert)  

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HOW IS OBESITY MEASURED?

Your bathroom scale may give you a measure of your weight and help you follow changes in your weight, but it is not the best way to determine if you are overweight or obese, or at risk for developing obesity and its related health conditions. Other measurements can help you find out more about your body composition.

Obesity is often expressed in terms of Body Mass Index (BMI). A BMI of 30 or more in males and 28.6 or more in females indicates obesity [Body mass index = Weight (kg) / height2 (m)]

1. Body Mass Index (BMI):

BMI is a number based on both your height and weight. It can help you determine the degree to which you may be overweight and gives a reasonable assessment of total body fat for the general population.

Knowing your BMI is important for you and your family. It correlates better with health conditions like heart disease and type 2 diabetes than does weight itself. BMI is not perfect. Some people, like athletes, may measure a high BMI but have more muscles than fat.

REGIONAL FAT DISTRIBUTION                

Fat mass distribution is different in men and women. The android or apple shaped obesity commonly observed in males is characterized by fat distribution predominantly in the upper part of the body above the waist, whereas the gynoid or pear shaped obesity seen in females, shows fat predominantly in the lower part of the body that is lower abdomen, buttocks, hips and thighs.

Fat cells from the upper part of the body seem to be functionally different from fat cells in the lower part. Abdominal or android fatness carries a greater risk for hypertension, cardiovascular disease, hyperinsulinemia, diabetes mellitus, gallbladder disease and stroke. It also carries a greater risk of overall mortality. It is primarily due to hypertrophy (increase in the size of fat cell) of existing cells, whereas lower body fat deposition is by hyperplasias (increase in the number of fat cells). Reducing the enlarged fat cell to normal size is easier rather than reducing the increased number of cell to normal.

METHODS TO ACCESS OBESITY

1. Body weight - If a man is more than 10% (15% for women) std weight he is obese.

2. Broca index - Ht (cm) minus 100. For example, if a person's height is 160 cm then ideal weight is 60kg.

3. Body Mass Index

BMI = Weight in kg/height₂ (m)

4. Measurement of body fat: skinfold callipers are used to measure total body subcutaneous tissue.

5. Waist to hip ratio: >0.35 (females) and 1.0 (males) is associated with obesity.

DIFFERENCES BETWEEN BMI AND HEIGHT/WEIGHT TABLES:

Height/Weight Tables identify an ideal weight range for each height, and BMI uses cutpoints (Table 1) for you to identify if you are at a healthy weight, overweight, obese or severely obese, based on your height.

·         Unlike the tables, BMI corresponds generally to measurements of body fat.

·         Height/Weight Tables are not designed to predict disease risk, but BMI can. The higher the BMI, the higher your risk of developing certain diseases associated with obesity.

·         Medical researchers often use BMI, not height/ Weight tables, when studying the effects of body weight on health.

·         There is one BMI chart used for adult men, women who are not pregnant and generally for all racial/ethnic groups. There are separate Height/Weight Tables for men and women.

BODY FAT ANALYSER

It is a machine which measures the total body fat at the same time it gives you your weight. Here is how it works:

After you have input your age, height and sex, a barely-detectable quantity of electricity passes through your legs by means of the sensor electrodes imbedded on the scale platform.

It measures the total volume of water and consequently, the quantity of your muscles and thin tissues (contrary to fat, muscles contain very little water). The difference between your weight and the quantity of thin tissues tells you the volume of body fat; when it's extrapolated to your entire body, it calculates your fat percentage. The level of the results is indicated by the curser on the screen, which gives you a comparison to the average expected. not recommended for people with implants or pacemakers.

WHAT IS A MONODIET?                                    

A Monodiet means consuming only one kind of food at a meal and that particular food is not repeated continuously. When a person eats only one food in a meal instead of having 2-3 varieties there is a version towards the food. A person feels unsatisfied after eating a meal, most of the time there is a feeling of hunger long after. Moreover the concept of having one food is not right in itself as a single kind of food will not meet the body's need for different nutrients. And it is not necessary that a particular food will be having all kinds of nutrients in right proportion. In no way it is possible for a single food to have all the nutrients. So, variety in diet is a must.

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This article is written by Dr. Bimal Chhajer (India's best Heart doctor)  

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EAT FIBROUS FOOD, BE HEALTHY FROM ROOT

IMPORTANCE OF DIETARY FIBER

Fiber forms the skeletal system of plants. Without it no plant or tree would be able to stand upright. Dietary fiber, the roughage of yesteryears, consists of those parts of the plant foods that cannot be digested by enzymes or other digestive secretions in the alimentary canal (digestive tract). Dietary fiber plays an important role                in the maintenance of health and prevention of diseases. Recent studies in this area indicate that sufficient intake of fiber rich diet may help prevent obesity, colon cancer, heart disease, gallstones, irritable bowel syndrome, diverticulosis and diabetic conditions.

PHYSIOLOGICAL EFFECTS

Fiber in the diet promotes more frequent bowel movements and softer stools having increased weight. The softness of stools is largely due to the presence of emulsified gas which is produced by the bacterial action on the fiber. A high fiber intake results in greater efficiency in the peristaltic movement of the colon. This helps in relieving the constipation which is the main cause of several acute and chronic diseases. Recent studies suggest that increasing the dietary fiber intake may be beneficial for patients with irritable bowel syndrome who have diarrhoea and rapid colonic transit, as well as to those who have constipation and slow transit. The high fiber diet like bran, thus regulates the condition inside the colon so as to avoid both extremes constipation and diarrhoea. Investigations have shown that several potential carcinogens (cancer causing elements) are produced in the faces. Their production is related to the acidity of the gut content. The greater the acidity in the bowel content, the less is the production of these carcinogens. The breaking down of the fiber by bacteria renders the faces more acidic. This reduces the amount of possible carcinogenic substances. Fiber also reduces the possibility of formation of harmful toxins in the large intestine by reducing the intestinal transit time of the food contents.

Dietary fiber increases the bacteria in the large intestines, which require nitrogen for their growth. This in turn reduces the chances of cancerous changes in cells by reducing the amount of ammonia in the large bowel. Fiber reduces the absorption of cholesterol in the diet. It also slows down the rate of absorption of sugars from the food in the digestive system. Certain types of fiber increase the viscosity of the food content. This increased viscosity indirectly reduces the need for insulin secreted by the pancreas. Thus a fiber rich diet can help in controlling diabetes mellitus.      

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This article is written by Dr. Bimal Chhajer (Heart Specialist)                        

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Heart disease is Multi-factorial

High Cholesterol

High cholesterol is one of the most important causes of coronary heart disease. With more and more research data coming in, it has become evident that the blockages are formed in the heart arteries by deposition of cholesterol. Cholesterol, besides being produced in our liver is additionally obtained in our food from animal sources like ghee, butter, milk, cheese, meat etc. The normal level of cholesterol is 130-200 mg/dl. Obviously higher cholesterol intake can only add to the blockages!

High Triglyceride

It is a fat derived from the plant sources. All cooking oils are triglycerides irrespective of being saturated or unsaturated. All of them lead to blockages. The normal level of triglyceride is 60mg/dl - 150mg/dl. We recommends less than 130mg/dl.

Low HDL

HDL cholesterol is the good cholesterol. Since it has a very high affinity to bind cholesterol . It removes cholesterol from the blockages. Saaol recommends a HDL cholesterol of above 40 mg/dl.

Smoking

People who smoke are four times more prone to develop heart disease as compared to the non smokers. Tobacco that is inhaled while smoking is the major cause of erosion of the inner lining of the coronary arteries. Nicotine, tar, alkaloids etc. causes this damage and make the layer more susceptible to cholesterol and fat deposition. It is like painting the inner lining with glue which would catch cholesterol and sticks it on the wall.

High BP

High Blood pressure puts an extra strain on the heart and the arteries supplying blood to the other organs of the body. Many diseases are caused by high blood pressure such as heart attack, heart failure, kidney failure, stroke (damage to the brain) etc. Higher the blood pressure greater are the chances of getting the above disease. Normal blood pressure is 120/80 mmHg.

Diabetic Mellitus

Normal level of fasting blood sugar is 80-120 mg/dl. If the fasting level is more than 110mg/dl and after meal is more than 160mg/dl, it is called diabetes or high blood sugar. Diabetes patients have a higher chance of developing coronary blockages. They are also prone to several other disease like kidney damages, as well as damages of nerves and eyes.  

Lack of physical activity

Lack of physical activity in our daily life has become the most important reason of heart disease in modern life. Regular exercise can break fats, decrease cholesterol, reduce blood sugar, control blood pressure, reduce overweight by consuming stored fat in the body and make the heart more healthy and stronger.

 New Risk factors

Lipoprotein (a)

The high rates of heart disease, despite lesser risk factors, suggests the possible role of a genetic risk factor, which is uninfluenced by even maximum modification of lifestyle.

Lp(a) is such a risk factor, since its levels are genetically determined and not influenced by diet or exercise. It is ten times as atherogenic as low-density lipoprotein (LDL) and has significant thrombogenic (clot forming) and antifibrinolytic (anti clot dissolving) properties due to its structural similarity with plasminogen.

PAI-1

There is increasing interest in thrombotic (clot forming) factors in the etiology of Coronary Artery Disease. Plasma plasminogen activator inhibitor 1 (PAI-1) levels are high in Indians. Indians have lower fibrinolytic (clot dissolving) activity with an increased likelihood of clot formation.

Obesity

Obesity is a risk factor for heart disease as it can lead to hypertension, diabetes and dyslipidemia. Overweight persons have 15 times greater chance to have a heart attack.

Low Fiber Intake

Fibers have a net like structure (like a dry leaf). fats in our food get stuck in this mesh work. Since fibers, don't get absorbed, these fats are excreted along with them. So low intake of fiber is another cause of heart disease. Vegetables, fruits and whole cereals are good sources.

Stress

Stress can lead to hypertension, diabetes and low HDL cholesterol. Stress increases the secretion of adrenaline in the body which raises the heart rate and work load of the heart. This in turn can lead to heart attack.

Genetics

Most of the hereditary effects in people come through excessive production of cholesterol and triglyceride in the body. These people even if they restrict their diet, may still have high cholesterol / triglyceride. Thus their chances of having a heart disease will multiply.

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This article is written by Dr. Bimal Chhajer (Heart Doctor in Delhi)  

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WHERE DO WE FIND FIBERS?

The most significant food sources of fiber are unprocessed wheat bran, whole cereals such as wheat, rice, barley, rye, millets, roots and tubers such as carrots, beet, turnip and sweet potato, fruits like mango and guava and leafy vegetables such as cabbage, lettuce and celery. The foods which are completely devoid of fiber are meat, fish, eggs, milk, cheese, fats and sugars. Bran, the outer covering of grains, is one of the richest sources of dietary fiber and it contains several types of fiber including cellulose, hemicellulose and pectin.

Wheat and corn bran are highly beneficial in relieving constipation. Experiments show that oat bran can reduce cholesterol levels substantially. Corn bran is considered more versatile. It relieves constipation and also lowers LDL cholesterol, which is one of the more harmful kinds. Besides being rich in fiber, bran has a real food value being rich in iron and vitamins and containing a considerable amount of protein. Legumes have high fiber content. Much of this fiber is water-soluble, which makes legumes likely agents for lowering cholesterol. Soyabeans, besides this, can also help control glucose levels. The types of fiber contained in vegetables and fruits contribute greatly towards good health. The vegetables with the biggest fiber ratings include sweet corn, carrots and peas. Among the high-ranking fruits are raspberries, pears, strawberries and guavas.

There are six classes of fiber. They are cellulose, hemicellulose, pectin, gums, mucilages and lignin. They differ in physical properties and chemical interactions in the gut, though all except lignin are poly-saccharides. The facts known so far about these forms of fiber are as follows:

Cellulose                                                                                      

It is fibrous and softens the stool. It is present in fruits, vegetables, bran, whole wheat bread and beans. It is also present in nuts and seeds. It increases the bulk of intestinal waste and eases it quickly through the colon. Cellulose may help level out glucose in the blood and curb weight gain.

Hemicellulose

It is usually present wherever cellulose is and shares some of its traits. Like cellulose, it helps relieve constipation, waters down carcinogens in the bowel and aids in weight reduction. Both cellulose and hemicellulose undergo some bacterial breakdown in the large intestine and this produces gas.

Pectin

This form of fiber is highly beneficial in reducing serum cholesterol levels. It however, does not have influence on the stool and does nothing to prevent constipation. Pectin can help eliminate bile acids through the intestinal tract thereby preventing gallstones and colon cancer. It is found in apples, grapes, berries , citrus fruits, guava, raw papaya and bran.

Gums and Mucilages

They are the sticky fibers found in dried beans, oat bran and oatmeal. They are useful in the dietary control of diabetes and cholesterol.

Lignin                                                                                            

The main function of lignin is to remove bile acid and cholesterol out of the intestines. It may prevent the formation of gallstones. It is contained in cereals, bran, whole wheat flour, raspberries, strawberries, cabbage, spinach, parsley and tomatoes.

Hope you liked this blog!

This article is written by Dr. Bimal Chhajer (Non Invasive Heart Specialist)