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.

 

Is your heartbeat racing during walking? Know what it means for your heart health

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

Dr. T S Kler warns that rapid heartbeats, chest pain, nausea, and shortness of breath while walking may indicate heart issues.

Many may not know this but if your heartbeats race or you experience some discomfort while walking, it could be a fairly good indication of the status of your heart health.

What one has to watch out for is if the rapid heartbeats linger long enough, happen frequently and are accompanied by chest pain, nausea, shortness of breath, sweating and anxiety.

What are signs to watch out for during walking?

If you get chest pain, particularly behind the sternum, left or right side of the chest, left arm or right arm, jaw, a nagging discomfort between the scapula (shoulder blade) and the back, fluttering heartbeat or a tightness while walking – all of which vanish when you stop moving – then you possibly have a blockage in your coronary artery.

If you’re able to do brisk walking, which is classified as a moderate-intensity physical activity, without chest pain, palpitations or tightness or difficulty breathing, this means that your heart is normally supplying your body with the oxygenated blood it needs.

What to make of palpitations?

Sometimes you may develop palpitation, have a rapid heartbeat and an increased heart rate while doing even mild activities like walking. That could mean either of two things. First, it could be that you have been leading a sedentary life and your body has not yet acclimatised itself to exercise. So your heart has to work more to produce the same result. But sometimes palpitations can happen in an active person too when there is narrowing of the aortic valve. You could have rapid fluttering heartbeats, difficulty walking short distances and maybe unable to do activities you once did. This could mean that some damage has already happened.

What about breathlessness during walking and talking?

This is a dual activity and hence more energy is required. Talking interferes with your respiratory processes when you are walking simultaneously. This doesn’t always indicate heart disease.

What is palpitation at rest?

The normal resting heart rate for adults is between 60 and 100 beats per minute. Lower is even better because it indicates your heart muscle is in good condition and doesn’t have to work as hard to pump blood. Usually, athletes with a disciplined physical activity routine have a low resting heart rate. But if the resting heart rate is higher, you would feel exhausted before completing regular activities. This could be a sign of heart disease such as heart failure or leaking heart valves.

What should you do when the above signs show up?

I would advise consulting a cardiologist immediately and not wait for the symptoms to go away or dismiss them as nothing. Also, do the tests as advised. These could include an electrocardiogram, Holter monitoring, echocardiogram or a CT scan. Once the heart problem is identified, then the cardiologist will suggest the best intervention. After that the patient can get back to exercising according to customised protocols for cardiac rehabilitation.

 

How much fibre should you ideally have in a day?

 Source: https://indianexpress.com/

Consuming an excessive amount of fibre can trigger a series of uncomfortable reactions within your body

Fiber is a dietary hero, but can too much cause discomfort?

Fibre is a dietary superstar, lauded for its role in digestive health, blood sugar control, and even cancer prevention. However, as with most things in life, moderation is key.

G Sushma, Clinical Dietician at CARE Hospitals, Banjara Hills, Hyderabad, explained what happens when you overdo your fibre intake.

The discomfort zone

“Consuming excessive fibre can trigger a series of uncomfortable reactions within your body,” said Sushma. When you overload your system with fibre, it struggles to keep up with processing all that bulk. This can lead to a trio of unpleasant digestive issues: bloating, gas, and diarrhoea. Essentially, you’re giving your digestive system more work than it can handle, leading to disruptions in your normal bowel movements.

 “While fibre is undoubtedly beneficial for health, consuming excessive amounts can have negative consequences,” cautions Sushma. Overdoing it can lead to bloating, gas, and diarrhoea. These issues arise because fibre bulks up stool, and when there’s too much, it can strain your digestive system.

 Overdoing it can lead to bloating, gas, and diarrhoea. (Source: Getty Images/Thinkstock)

How much fibre should you eat?

The ideal amount of fibre varies depending on factors like age, gender, and calorie intake. However, Sushma recommended a general guideline of 25-30 grams of fibre per day for adults. This amount provides health benefits without overwhelming your digestive system. Remember, exceeding this recommendation can lead to unwanted side effects.

While excessive fibre can cause discomfort, getting it right offers a wealth of health benefits. Here are some key reasons to include fibre in your diet:

Digestive Champion: Fibre is essential for a healthy digestive system. It regulates bowel movements, preventing constipation and promoting regularity.

Blood Sugar Guardian: Fibre helps manage blood sugar levels by slowing down the absorption of sugar into the bloodstream, preventing those unwanted spikes and crashes.

Cholesterol Fighter: A high-fibre diet can lower LDL (“bad”) cholesterol levels, reducing the risk of heart disease.

Cancer Risk Reduction: Studies suggest a link between a high-fibre diet and a decreased risk of certain cancers, particularly colorectal cancer.

Feeling Full, Staying Satisfied: Fibre contributes to a feeling of fullness and satiety, helping you curb unhealthy calorie intake and manage weight.

Sushma emphasised the importance of hydration alongside a high-fibre diet. “Insufficient fluid intake can exacerbate these symptoms and potentially lead to bowel obstruction in severe cases.” To support optimal digestion and well-being, ensure you drink plenty of fluids when increasing your fibre intake.

By understanding the benefits and potential downsides of fibre, you can find your personal sweet spot and reap the rewards of a balanced, fibre-rich diet.

 

9 morning habits that can bring down cholesterol levels within a month

 Source: https://timesofindia.indiatimes.com/life-style/health-fitness/health-news

Beginning your day with healthy behaviours can pave the way for improved health and well-being. If you want to naturally lower your cholesterol, including certain morning routines in your daily routine will help. Following are 9 scientifically proven morning practices that can help lower cholesterol levels in as little as a month.

Begin with healthy breakfast

Starting your day with a nutritious breakfast can help lower cholesterol levels. Go for foods rich in soluble fibre, such as oatmeal topped with fresh fruit or whole-grain toast with broccoli. Soluble fibre helps reduce LDL cholesterol levels. According to a study published in the Journal of the American Medical Association, consuming just 5 to 10 grams of soluble fibre per day can lower LDL cholesterol by about 5 per cent.

Drink a glass of orange juice

A glass of fresh orange juice in the morning can also help lower cholesterol levels. Oranges are rich in flavonoids, which have been shown to reduce LDL cholesterol levels. According to a study published in the American Journal of Clinical Nutrition, drinking 750 ml of orange juice daily for four weeks can significantly reduce LDL cholesterol levels.

Going on a morning walk

Morning exercise can help raise HDL cholesterol levels and lower LDL cholesterol levels. Take a short walk around your neighbourhood or go for a jog in the park. Aim for at least 30 minutes of moderate-intensity exercise most days of the week. According to a study published in The American Journal of Cardiology, regular aerobic exercise can increase HDL cholesterol by up to 5 per cent.

Enjoy a cup of green tea

Green tea is rich in antioxidants called catechins, which have been shown to lower LDL cholesterol levels. Start your morning with a cup of green tea instead of your usual coffee. According to a study published in the Journal of the American Dietetic Association, drinking green tea regularly can help reduce LDL cholesterol levels.

Add flaxseeds to your breakfast

Flaxseeds are rich in omega-3 fatty acids and fibre, both of which can help lower cholesterol levels. Sprinkle ground flaxseeds on your cereal in the morning. According to a study published in the Journal of Nutrition, consuming 30 grams of ground flaxseeds daily for three months can significantly reduce LDL cholesterol levels.

​Take time out for meditation

Morning meditation can help reduce stress levels, which in turn can lower LDL cholesterol levels. Take 10 minutes to sit quietly and focus on your breath. According to a study published in Psychosomatic Medicine, practising mindfulness meditation can help lower LDL cholesterol levels.

Almonds to the rescue

Almonds are rich in monounsaturated fats, which can help raise HDL cholesterol levels and lower LDL cholesterol levels. Enjoy a handful of almonds as a morning snack. According to a study published in The American Journal of Clinical Nutrition, adding almonds to your diet can help improve cholesterol levels.

Cook with olive oil

Using olive oil instead of butter or vegetable oil in your morning cooking can help improve cholesterol levels. Olive oil is rich in monounsaturated fats, which can help raise HDL cholesterol levels. According to a study published in Circulation, a diet rich in olive oil can help increase HDL cholesterol levels.

Eat a handful of walnuts

Adding walnuts to your morning routine can also help lower cholesterol levels. Walnuts are rich in omega-3 fatty acids, which can help reduce LDL cholesterol levels. According to a study published in the Journal of Nutrition, adding walnuts to your diet can help improve cholesterol levels and reduce your risk of heart disease.

 

Side effects of taking too much vitamin D and iron supplements

 Source: https://timesofindia.indiatimes.com/life-style/health-fitness/health-news

Do vitamins become dangerous when consumed in high dosages?

Vitamins and minerals are essential for maintaining good health. They play crucial roles in various bodily functions, from boosting the immune system to supporting bone health. However, just like anything else, too much of a good thing can sometimes be harmful. Here is all you need to know about the potential side effects of taking excessive amounts of vitamin D and iron supplements.

Can vitamins at high doses harm the body?

Vitamins and minerals are vital micronutrients that play a fundamental role in maintaining overall health and well-being. These micronutrients are typically obtained through a balanced diet, but many people turn to supplements to ensure they are meeting their daily requirements. In fact, taking them in excessive amounts can sometimes do more harm than good. Overdosing on certain vitamins and minerals can lead to toxicity, causing a range of adverse health effects. Therefore, it's essential to understand the recommended daily intake for each nutrient and to avoid exceeding these limits without medical supervision.

What is vitamin D toxicity?

Vitamin D is essential for the growth and development of muscle cells, the proper functioning of the immune system, and the maintenance of skeletal health. However, excessive intake of vitamin D can lead to toxicity. Vitamin D toxicity, also known as hypervitaminosis D, occurs when there are excessive amounts of vitamin D in the body. This usually happens due to over-supplementation rather than diet or sun exposure. The main consequence of vitamin D toxicity is a buildup of calcium in the blood, known as hypercalcemia.

Symptoms of vitamin D toxicity and recommended dosage

Symptoms of vitamin D toxicity include elevated blood levels, nausea, vomiting, weakness, frequent urination, bone pain, and kidney problems, such as the formation of calcium stones. In severe cases, it can even lead to coma and death. While recommendations on optimal vitamin D levels vary, it is often suggested that levels between 30–60 ng/mL are likely optimal for most people. However, exceeding 100 ng/mL can be harmful. Most cases of vitamin D toxicity are caused by inappropriate supplement dosing and prescription errors.

Can your body say “No more iron, please!”?

Iron is another essential nutrient that plays a vital role in various bodily functions, including the transportation of oxygen in the blood. While iron is crucial for good health, excessive intake can be harmful.

Taking high doses of iron supplements, especially on an empty stomach, can cause several side effects, including:

- Upset stomach

- Constipation

- Nausea

- Abdominal pain

- Vomiting

- Diarrhea

- Inflammation of the stomach lining

- Ulcers

Severe side effects of too much iron and daily required dosage

How does vitamin D help us?

Vitamin D plays several crucial roles in the body, making it essential for overall health and well-being. Firstly, it is vital for maintaining strong and healthy bones by regulating calcium and phosphorus levels. Vitamin D promotes calcium absorption in the gut and helps maintain adequate calcium and phosphate concentrations in the blood, which are essential for bone mineralisation. Vitamin D is involved in the regulation of the immune system, supporting immune function and reducing the risk of infections. It also plays a role in muscle function and strength, improving muscle coordination and reducing the risk of falls and fractures, especially in older adults.