Can Vitamin D deficiency lead to obesity?

 Source: https://indianexpress.com/article/health-wellness

Not everyone with obesity will experience vitamin D deficiency, though the risk is higher.

Vitamin D is a crucial nutrient that plays a role in many bodily functions, including bone health, immune support and mood regulation. However, there is a lot of confusion surrounding its relationship with obesity. Let’s take a closer look at some common myths and facts about vitamin D deficiency and obesity.

Myth: Vitamin D deficiency causes obesity.

Fact: While vitamin D deficiency is linked to obesity, it is not the cause of it. Obesity is primarily influenced by factors such as genetics, lifestyle choices (like diet and physical activity) and hormonal imbalances. Vitamin D deficiency, on the other hand, may be more of a consequence of obesity rather than a cause.

Excess fat in the body can store vitamin D in fat cells, preventing it from circulating freely in the bloodstream where it is needed. This reduced availability of vitamin D can make it difficult for individuals with obesity to maintain optimal vitamin D levels. However, this does not mean that vitamin D deficiency directly leads to obesity.

Myth: People with obesity cannot absorb vitamin D.

Fact: It’s not that people with obesity cannot absorb vitamin D, but rather that excess fat can sequester the vitamin, making it less available in the bloodstream. Vitamin D is a fat-soluble vitamin, which means it is stored in fat cells. When an individual has a higher body fat percentage, vitamin D is more likely to be trapped in these fat cells, reducing its availability for other bodily functions. Therefore, people with obesity often need higher doses of vitamin D to achieve adequate levels in the blood.

Myth: Obese individuals don’t need to worry about vitamin D deficiency.

Fact: Obese individuals are at a higher risk of vitamin D deficiency. Due to the way vitamin D is stored in fat tissue, people with higher body fat are more likely to have lower blood levels of the nutrient.

Myth: Taking vitamin D supplements will automatically help with weight loss.

Fact: While vitamin D supplements can help address a deficiency, they are not a weight-loss solution. A combination of healthy eating, regular exercise, and weight management strategies is necessary.

Myth: Obesity has no impact on vitamin D metabolism.

Fact: Obesity does affect vitamin D metabolism. In individuals with excess body fat, the liver, and muscle tissue can also impact vitamin D processing. Fatty liver, which is common in people with obesity, can reduce the liver’s ability to convert vitamin D into its active form, calcitriol. Additionally, excess muscle mass can bind to vitamin D, decreasing its bioavailability.

Myth: Obesity will always lead to vitamin D deficiency.

Fact: Not everyone with obesity will experience vitamin D deficiency, though the risk is higher. Several factors, including dietary habits, sun exposure and overall health can influence vitamin D levels.

 

Is overusing painkillers harming your stomach and kidney?

 Source: https://indianexpress.com/article/health-wellness

Here’s all you need to know about the hidden dangers of popping pills

Painkillers can be broadly classified into two main categories: non-steroidal anti-inflammatory drugs (NSAIDs) and opioids.

Painkillers are among the most commonly used medications worldwide. From over-the-counter options to prescription drugs, they offer quick relief from a variety of ailments, such as headaches, muscle aches and chronic pain conditions. However, while they can be effective in alleviating discomfort, their excessive or improper use can lead to significant health issues, particularly those of the stomach and kidneys.

Understanding Painkillers

Painkillers can be broadly classified into two main categories: non-steroidal anti-inflammatory drugs (NSAIDs) and opioids. NSAIDs work by reducing inflammation and blocking pain signals in the body. Opioids, on the other hand, interact with the nervous system to relieve severe pain but come with a higher risk of dependency and adverse effects.

Impact on Stomach Health

Prolonged use of NSAIDs results in gastrointestinal (GI) complications.

• Gastritis: Inflammation of the stomach lining can cause pain, nausea and vomiting.
• Peptic Ulcers: Open sores that develop on the stomach lining or the upper part of the small intestine, leading to burning stomach pain, bloating and indigestion.
• Gastrointestinal Bleeding: Chronic use of painkillers can result in bleeding in the stomach, which may be life-threatening. Signs include dark or bloody stools, vomitting blood or feeling faint.

The risk of these conditions increases with higher doses, prolonged use and the use of multiple medications. Additionally, individuals with a history of GI issues, older adults and those who consume alcohol may be more susceptible to these side effects.

The Toll on Kidney Health

The kidneys play a crucial role in filtering waste from the blood and maintaining fluid balance. Chronic painkiller use, particularly NSAIDs and certain prescription medications, can strain the kidneys, leading to various health complications:

• Acute Kidney Injury (AKI): Overuse of painkillers can result in sudden damage to the kidneys, causing them to lose their filtering ability. This can lead to a buildup of waste products in the blood, which can be dangerous.
• Chronic Kidney Disease (CKD): Long-term use of painkillers may contribute to the gradual loss of kidney function, potentially leading to kidney failure. This is especially concerning for individuals with existing kidney conditions or those who are diabetic or hypertensive.
• Fluid Retention: Some painkillers can cause the body to retain fluids, leading to increased blood pressure and additional strain on the kidneys.

Signs to watch out for

Consult a doctor when you develop symptoms such as persistent abdominal pain, changes in bowel habits, swelling in the legs or ankles, fatigue and decreased urine output after you have had painkillers.

Best Practices for Safe Painkiller Use

To mitigate the risks associated with painkiller use, consider the following recommendations:

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1. Follow Dosage Instructions: Always adhere to the prescribed or recommended dosage. Avoid self-medicating and consult with a healthcare professional if you have ongoing pain issues.
2. Limit Duration of Use: Use painkillers for the shortest time necessary. If pain persists, seek medical advice rather than relying on painkillers for prolonged periods.
3. Explore Alternatives: Depending on the type of pain, non-pharmacological interventions like physical therapy, acupuncture, or mindfulness practices, can provide effective relief without the associated risks.
4. Regular Check-Ups: If you are a regular user of painkillers, consider routine medical check-ups to monitor stomach and kidney health.
5. Avoid Alcohol: Combining painkillers with alcohol can exacerbate the risks of stomach irritation and kidney damage.

 

Drinking 3 litres of water but still feeling exhausted? Here’s how to have water at the right time

 Source: https://indianexpress.com/article/health-wellness

As we all know, water prevents dehydration, helps regulate your body temperature and blood pressure, lubricates your joints, keeps your spine in fine fettle and rids the body of waste and toxins. (Representational)

We are often told to consume about three litres of water every day. However, spacing out this amount throughout the day is more important for your body to function optimally. As we all know, water prevents dehydration, helps regulate your body temperature and blood pressure, lubricates your joints, keeps your spine in fine fettle and rids the body of waste and toxins.

WHAT ARE YOUR DAILY WATER REQUIREMENTS?

Men: Approximately 3.7 litres (or about 13 cups) per day.

Women: Approximately 2.7 litres (or about 9 cups) per day.

This includes all fluids consumed, not just water.

WHAT ARE FACTORS INFLUENCING NEEDS?

Activity Level: Increased physical activity raises water needs.

Climate: Hot or humid weather can lead to increased perspiration.

Health Status: Conditions like fever or diarrhoea require additional fluid intake.

HOW TO SPACE OUT WATER CONSUMPTION?

To maximise hydration benefits, consider the following strategies for spacing your water intake throughout the day:

Morning Hydration: Start your day with a glass of water upon waking. This helps to rehydrate your body after several hours of sleep and wash out toxins.

Regular Intervals: Aim to drink water at regular intervals rather than consuming large amounts at once. A good practice is to drink a glass of water every hour.

Use reminders: Set app alerts to prompt you to drink water throughout the day.

Pre-Meal Consumption: Drink a glass of water about 30 minutes before meals. This not only aids digestion but can also help control hunger, preventing you from overeating and helping in weight management.

During Meals: Sipping water during meals can aid digestion but avoid excessive consumption as it may dilute digestive enzymes. Drink water an hour after the meal to allow the body to absorb the nutrients.

Before a bath: Drink one glass of water before taking a bath to help lower your blood pressure.

Post-Exercise Hydration: After physical activity, replenish lost fluids by drinking water or electrolyte-rich beverages.

Evening Routine: Limit water intake in the evening to avoid disruptions in sleep due to nighttime bathroom visits but ensure you are adequately hydrated throughout the day.

Before sleep: Drink one glass of water an hour before bedtime to replenish any fluid loss that can occur during the night.

HOW DO I KNOW I AM DEHYDRATED?

Monitoring your hydration status is crucial. Common signs of dehydration include thirst, dark yellow urine, fatigue, dizziness and dry mouth. If you experience these symptoms, increase your fluid intake promptly.

HYDRATION TIPS FOR SPECIAL NEEDS

During Exercise: Drink water before, during, and after exercise. For prolonged activities (over an hour), consider electrolyte drinks.

In Hot Weather: Increase fluid intake in hot conditions or when engaging in outdoor activities to compensate for increased sweat loss.

Pregnancy and Breastfeeding: Women who are pregnant or breastfeeding should increase their fluid intake to support their own health and that of their baby.

Here is a fun fact: Almost three-fourths of your brain contains fluid, so if you are dehydrated, blood vessels in this organ shrink. That’s why you feel listless, have a lack of focus and stamina.

 

Are dark chocolate, cinnamon, coffee and green tea enough to reduce blood sugar?

 Source: https://indianexpress.com/article/health-wellness

These days the internet is full of theories about how bitter polyphenols — the kind you find in dark chocolate, cinnamon, cloves, basil, coffee and green tea as well as in some fruits, vegetables, legumes, wholegrains, nuts and seeds — can lower the risk of diabetes. The logic goes that they reactivate taste receptors not only in the mouth but the gut. These in turn trigger secretion of hormones that may help lower a person’s risk of developing type 2 diabetes and obesity.

At first glance, the association between bitter polyphenols and improved metabolic health might seem compelling. After all, these compounds have been shown to have various beneficial effects in other contexts. However, attributing a straightforward, guaranteed diabetes prevention capability to them oversimplifies a complex issue.

Polyphenols or plant micro-nutrients have antioxidant, anti-inflammatory and potential metabolic effects. Bitter polyphenols, like those found in bitter melon, have been studied for their effects on blood glucose regulation. Some research indicates that these compounds may influence glucose metabolism by enhancing insulin sensitivity or modulating carbohydrate digestion. For instance, bitter melon contains compounds like charantin and polypeptides that may mimic insulin action or affect glucose uptake. However, these effects have been observed in controlled laboratory settings and animal models, with mixed results in human studies.

Clinical trials investigating the impact of bitter polyphenols on diabetes risk are limited and often yield inconclusive results. While some studies have demonstrated potential benefits, the evidence is not robust enough to conclusively state that bitter polyphenols alone can significantly reduce diabetes risk.

The impact of any single nutrient or food component on diabetes risk cannot be isolated from an individual’s overall dietary pattern and lifestyle. A diet rich in various polyphenol-containing foods is associated with better metabolic health. But that’s because these foods are also nutrient-dense and antioxidant-rich.

Besides, genetic and environmental factors contribute to individual responses to dietary interventions. What works for one person might not work for another, and the effectiveness of polyphenols in diabetes prevention can vary based on genetic predispositions and lifestyle factors.

Of the polyphenols that work for diabetes and obesity are curcumin, found in turmeric, resveratrol, which is found in grapes, peanuts and berries, quercetin, which is found in onions, catechin, which is found in cocoa and green tea.

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While incorporating bitter polyphenol-rich foods into a balanced diet can be part of a healthy lifestyle, relying solely on these foods as a preventive measure against diabetes is not advisable. A comprehensive approach to diabetes prevention includes maintaining a healthy weight, engaging in regular physical activity, and consuming a diverse range of nutrients from various food sources.

 

How blood sugar myths are harming you: What you need to know about diagnosis truths

 Written by Dr. Ambrish Mithal

Source: https://indianexpress.com/article/health-wellness

Over the past few months, social media has been flooded by new information about the diagnosis of diabetes that runs contrary to science. Many people believe in these fake unscientific forwards on their phone and end up damaging their health.

What’s floating online?

Most of these so-called experts claim the following:

1. The criteria for diagnosis of diabetes has been altered frequently in recent years.

2. These alterations have reduced the threshold level of blood sugar used to diagnose diabetes.

3. Reduction in diagnostic levels leads to millions of additional people being labelled as diabetics.

4. These changes are decided upon by a few ‘wise’ men seated on a table according to their whims, based on random parameters.

5. More people being diagnosed with diabetes means more will require medication.

6. All experts who are involved in this decision making are hand-in-glove with drug manufacturers. So ultimately the process is driven by the pharmaceutical industry so that they can make billions of dollars.

Are these allegations true?

In 1979, the WHO formally defined diagnostic criteria for diabetes mellitus based primarily on plasma glucose levels — fasting plasma glucose more than or equal to 140 mg/dl, and a two-hour post-glucose value more than 200 mg/dl.

In 1997, the threshold for fasting plasma glucose was lowered to 126 mg/dl by the American Diabetes Association (ADA). The post-glucose cut-off of 200 mg/dl was retained. The 1997 changes in the diagnostic criteria for diabetes were influenced by studies which provided evidence that levels between 126 and 140 mg/dl were also associated with an increased risk of diabetes-related complications, supporting the need for lower diagnostic thresholds for diabetes.

The diagnostic criteria for diabetes have not changed since 1997.

What about prediabetes?

The 1979 WHO criteria recognised impaired glucose tolerance as a post-glucose value between 140 and 199 mg/dl. This is the same as we use today. The major change in 1997 was the inclusion of a category called impaired fasting glucose — fasting glucose values between 110 and 125 mg/dl. In 2003, the ADA further lowered the fasting glucose criterion to 100 mg/dl. Some studies showed that individuals with fasting glucose levels between 100 and 109 mg/dL were also at a higher risk of progressing to Type 2 diabetes. Additional research indicated that fasting glucose levels in the range of 100 to 109 mg/dL were associated with an increased risk of cardiovascular diseases. However, the WHO continued to use a fasting level of 110 mg/dl as a cut-off.

 Glucose Testing and Interpretation

Since then the cut-offs for fasting plasma glucose and oral glucose tolerance tests have remained the same with the only change being HbA1c (average blood sugar counts of three months) included in 2009. An HbA1c level of 6.5 per cent or more is diagnostic of diabetes mellitus. Levels between 5.7 to 6.4 per cent indicate prediabetes.

The importance of prediabetes lies in the risk of its conversion to diabetes or possible remission. In India 60 per cent of those with prediabetes convert to diabetes in five years. Initiatives like the Indian Diabetes Prevention Programme (IDPP) have demonstrated that lifestyle interventions can reduce the risk of progression to diabetes by about 28-35 per cent. Medications are used for a minuscule number of people with prediabetes. The last change in diagnostic criteria in 2003 added a large number of people to the pool of prediabetes so that people could recognise their risk and initiate lifestyle changes.

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The increase in diabetes prevalence is real and not because of changed criteria. Consult a qualified practitioner.

Heart attack among techies in 30s: How overwork, 70-hour week and stress can damage your heart

 Source: https://indianexpress.com/article/health-wellness

Cardiologist explains risk factors among Bengaluru’s techies between 20 and 35.

Over time that damages the heart, and even accelerates levels of blood sugar, cholesterol and triglycerides.

Just the other day, a 33-year-old executive, came to the emergency in the evening as he suffered a heart attack. I had to do an emergency stenting in all three of his arteries which were blocked well over 90 per cent. He worked from home but rarely detached himself from his laptop, logging in at 7 am and logging out at 8 pm. Then he took a 10-minute break and living alone, ordered food almost every day. He would have his dinner by 9.30 pm, would enjoy a smoke or drink occasionally, take work or personal calls and sleep by 11 pm.

I recount this story to highlight how punishing 12-hour work days (assuming there is one weekly off) to meet the 70-hour work week rule being advocated by the likes of Infosys founder Narayana Murthy and now OLA CEO Bhavish Aggarwal can cost the body. The young executive’s life is a perfect example of how a decade of long sedentary work hours, with the stress of delivery deadlines that left little time for him to unwind, amplified moderate risks or underlying conditions faster. Remember the young man slept the requisite hours but being on a wire during the most productive decade of his life, had poor sleep quality.

I admitted another young patient with a blood pressure of 200/115 mmHg, without him feeling it (young people generally do not feel symptoms of elevated blood pressure). He did sports with a friend on weekends but that wasn’t enough to offset his high-stress 14-hour five day week.

HOW DO LONG WORKING HOURS AFFECT THE HEART?

Most of my patients are from the tech park in Bengaluru’s Whitefield, between 20 and 35. All of them have a similar work profile — no less than 12-hour workdays or long night shifts, emergency duties, two hours of commute time through congested roads and crunching sleep, family time and recreation in about an eight to ten-hour window, often interrupted by work calls. Zero physical activity.

The body is clearly in a prolonged adrenaline rush because of too much stress and demands made on it. Excess adrenaline constricts the arteries that supply the heart with blood, reducing blood flow, hastening plaque buildup and inflammation. Stress hormones like adrenaline and cortisol cause the heart to beat faster, elevating blood pressure in the process. Over time that damages the heart, and even accelerates levels of blood sugar, cholesterol and triglycerides. No exercise means weight gain.

Chronic stress results in irregular heart rhythms, which can cause blood to pool in the left atrial chamber of the heart, contributing to clot formation. The clot can then travel from the heart to the brain and result in a stroke.

For those with underlying conditions like diabetes, cholesterol or with a family history, even short-term stress can dislodge plaques from the arteries it narrows down, resulting in a blood clot that, in its attempt to repair the torn wall of the arteries, could grow large enough to block blood flow completely and cause a heart attack. During angioplasty procedures among the young, I have often found that the plaque may not have been big enough but the stress-induced thickness of the blood has led to quicker clot formation.

LIFESTYLE CORRECTION MUST

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A Lancet study has shown that individuals who worked more than 55 hours per week had a 13 per cent increased risk of developing heart disease compared to those who worked standard hours.Smoking and alcohol are other stressors and can accelerate triggers even with limited use. So lifestyle correction — diet, sleep and exercise — are a must. If prescribed medication, strictly go by your doctor’s advisory.

 

Heart attack among techies in 30s: How overwork, 70-hour week and stress can damage your heart

 Source: https://indianexpress.com/article/health-wellness

Over time that damages the heart, and even accelerates levels of blood sugar, cholesterol and triglycerides.

Just the other day, a 33-year-old executive, came to the emergency in the evening as he suffered a heart attack. I had to do an emergency stenting in all three of his arteries which were blocked well over 90 per cent. He worked from home but rarely detached himself from his laptop, logging in at 7 am and logging out at 8 pm. Then he took a 10-minute break and living alone, ordered food almost every day. He would have his dinner by 9.30 pm, would enjoy a smoke or drink occasionally, take work or personal calls and sleep by 11 pm.

I recount this story to highlight how punishing 12-hour work days (assuming there is one weekly off) to meet the 70-hour work week rule being advocated by the likes of Infosys founder Narayana Murthy and now OLA CEO Bhavish Aggarwal can cost the body. The young executive’s life is a perfect example of how a decade of long sedentary work hours, with the stress of delivery deadlines that left little time for him to unwind, amplified moderate risks or underlying conditions faster. Remember the young man slept the requisite hours but being on a wire during the most productive decade of his life, had poor sleep quality.

I admitted another young patient with a blood pressure of 200/115 mmHg, without him feeling it (young people generally do not feel symptoms of elevated blood pressure). He did sports with a friend on weekends but that wasn’t enough to offset his high-stress 14-hour five day week.

HOW DO LONG WORKING HOURS AFFECT THE HEART?

Most of my patients are from the tech park in Bengaluru’s Whitefield, between 20 and 35. All of them have a similar work profile — no less than 12-hour workdays or long night shifts, emergency duties, two hours of commute time through congested roads and crunching sleep, family time and recreation in about an eight to ten-hour window, often interrupted by work calls. Zero physical activity.

The body is clearly in a prolonged adrenaline rush because of too much stress and demands made on it. Excess adrenaline constricts the arteries that supply the heart with blood, reducing blood flow, hastening plaque buildup and inflammation. Stress hormones like adrenaline and cortisol cause the heart to beat faster, elevating blood pressure in the process. Over time that damages the heart, and even accelerates levels of blood sugar, cholesterol and triglycerides. No exercise means weight gain.

Chronic stress results in irregular heart rhythms, which can cause blood to pool in the left atrial chamber of the heart, contributing to clot formation. The clot can then travel from the heart to the brain and result in a stroke.

For those with underlying conditions like diabetes, cholesterol or with a family history, even short-term stress can dislodge plaques from the arteries it narrows down, resulting in a blood clot that, in its attempt to repair the torn wall of the arteries, could grow large enough to block blood flow completely and cause a heart attack. During angioplasty procedures among the young, I have often found that the plaque may not have been big enough but the stress-induced thickness of the blood has led to quicker clot formation.

LIFESTYLE CORRECTION MUST

Top of Form

Bottom of Form

A Lancet study has shown that individuals who worked more than 55 hours per week had a 13 per cent increased risk of developing heart disease compared to those who worked standard hours.Smoking and alcohol are other stressors and can accelerate triggers even with limited use. So lifestyle correction — diet, sleep and exercise — are a must. If prescribed medication, strictly go by your doctor’s advisory.