About Komilla Pareek

I am a Nutritionist with varied experience, having worked with reputed hospitals, research institutes and educational establishments. Eating right is not a choice but our duty towards our body to keep it moving. Along with diet, right amount of sleep and exercise is essential to look good and feel good. Doing what is right starts with motivation, but lasts with a habit. Therefore, my goal here is to motivate you and make ‘healthy living’ your favourite habit.

Coach Skills

Dietetics and Clinical Nutrition. Nutrition Research with emphasis on Micronutrients and their bioavailability.

My Mantra

A Lifestyle with No Finish Line!

Certification

Masters in Food and Nutrition, Fellowship from Indian Council of Medical Research, Member of Indian Dietetic Association (IDA) and Nutrition Society of India (NSI)

February 20, 2020 By Komilla Pareek 3 Comments

How Antacids Are Making Your Heartburn, GERD or Acid Reflux worse!

If you’ve ever suffered from heartburn, Zantac and Ranitidine might have been your knights in shining armor and if you’ve never had the misfortune of going through this, the aforementioned Over-The-Counter (OTC) drugs are used to cut down the production of acid in the stomach. There are many other OTC antacids such as Gelusil, that neutralize the acid in the stomach. While self-prescribing for relief from heartburn or GERD, have you ever considered that these antacids might actually be making your condition worse?

What is Heartburn or GERD?

Heartburn or GERD is characterized by a burning sensation in the chest. This burning sensation is caused due to the acid reflux that happens when contents from your stomach move up into your esophagus (food pipe). Most of us associate this with high stomach acidity and reach out to over the counter antacids for quick relief.

Heartburn or GERD is not caused due to high levels of stomach acid. The incidence of heartburn and GERD increases with age, while stomach acid levels generally decline with age. Just as studies show acid secretion declines with age, it is also well established in scientific literature that the risk of GERD increases with age. In fact, when stomach acid is measured in people suffering from heartburn and GERD, it is almost always low, not high.

Why Do We Get Immediate Relief From Antacids?

I agree, symptoms of heartburn and GERD are caused by stomach acid refluxing into the esophagus. What’s crucial to understand is that any amount of acid in the esophagus is going to cause problems. That’s because the delicate lining of the esophagus isn’t protected against acid like the stomach lining is. You don’t have to have excess acid in your stomach to have heartburn.

Also, symptom relief doesn’t imply that the underlying cause of the problem has been addressed.

Stomach acidity may not be the actual reason for your heartburn. Instead, the prevailing scientific theory is that GERD is caused by a dysfunction of the muscular valve (sphincter) that separates the lower end of the esophagus and the stomach. This is known as the lower esophageal valve, or LES. The LES normally opens wide to permit swallowed food and liquids to move down easily into the stomach. If LES is working efficiently, stomach acid will not enter your esophagus. If the LES is malfunctioning, as it is in GERD, acid from the stomach moves up back into the esophagus and damages its delicate lining. It doesn’t matter how much acid there is in the stomach. Even a small amount can cause serious damage. Unlike the stomach, the lining of the esophagus has no protection against acid.

What Causes the LES to Malfunction?

Increase in Intra-Abdominal Pressure (IAP) can cause your LES to malfunction. Acid reflux occurs when pressure causes gastric distention (stomach bloating) that pushes the stomach contents, including acid, through the LES into the esophagus. Overeating, obesity, smoking, bending over after eating, lying down after eating, and consuming spicy or fatty foods may be contributing factors.

How Do Antacids Make This Condition Worse?

Malabsorption of carbohydrates leads to bacterial overgrowth, resulting in increased Intra-Abdominal Pressure which drives reflux. Low stomach acid, as caused by your antacids, can contribute to both bacterial overgrowth and carbohydrate malabsorption.

One of the chief roles of stomach acid is to inhibit bacterial overgrowth. But when stomach acid is insufficient and the pH of the stomach rises above 5, bacteria begin to thrive. Stomach acid (HCL) supports the digestion and absorption of carbohydrates by stimulating the release of pancreatic enzymes into the small intestine. If the pH of the stomach is too high (due to insufficient stomach acid), the pancreatic enzymes will not be secreted and the carbohydrates will not be broken down properly.

The fermentation of carbohydrates that haven’t been digested properly produces gas. The resulting gas increases IAP, which is the driving force behind Acid Reflux or GERD.

FDA Cautions Against Common Heartburn Drugs

In September 2019, FDA has communicated about the detection of an impurity, which is a carcinogen (cancer-causing agent), in common heartburn medications (ranitidine, commonly known as Zantac, and nizatidine) available over the counter or by prescription. Several countries have banned these medications.

Minimise or avoid use of OTC medications. Use proper lifestyle modifications to manage and treat your symptoms. Reducing bacteria loads and limiting carbohydrate intake have both been shown to greatly improve, and in some cases completely cure, acid reflux and GERD.

We hope this article helps you make the right choices and #LevelUp your health. Do leave your thoughts in the comments below. For more sessions on how to ease GERD and Acid Reflux, tune in to our experts on GOQii Play.

#BeTheForce

December 5, 2018 By Komilla Pareek 46 Comments

Are you eating your beans right?

My friend Neetu, recalls an incident from her childhood when she went to receive her aunt at the railway station who was arriving from Lucknow. On seeing Neetu, her aunt spontaneously asked her, “Guess your favourite thing that I’ve brought for you” and Neetu spontaneously replied “Rajma Chawal”! (Of Course, it was not Rajma Chawal that her aunt was referring too !!)

Kidney beans or Rajma is liked by kids and adults alike. It’s not just the taste but, the nutritional profile which makes it my favourite too. While it’s a rich source of protein and fibre, it’s also packed with several micronutrients, especially molybdenum, folate, copper, manganese, phosphorus, vitamin B1, iron, potassium, and magnesium. Dietary fibre in these beans helps in lowering cholesterol and prevents the rapid rise in blood glucose levels after consuming a meal.

However, in kidney beans, these nutrients exist with certain anti-nutrients or natural substances that can be harmful to our health.

1) Phytohaemagglutinin (PHA): This substance is classified as a lectin-glycoprotein. Lectins are known for their ability to agglutinate red blood cell types, alter cell membrane transport systems, alter cell permeability to proteins, and generally interfere with cellular metabolism. Even a small amount of PHA can have a negative effect on health. You may not consume enough to become noticeably sick, but continued exposure can result in poor growth, malnutrition, or liver damage. White kidney beans contain about one-third the amount of toxin as the red variety.

2) Raffinose and Stachyose: These are carbohydrates that are not digested in the small intestine by human gastrointestinal enzymes. They are passed into the large intestine where they are fermented by intestinal microflora with the production of gas. It is this behaviour which is responsible for flatulence, bloating that many of us experience after consuming these beans.

Central Public Health Laboratory (PHLS, UK ) and FDA (US) recommends this procedure to render kidney, and other beans safe for consumption:

Soak in water for at least 5 hours.
Pour away the water.
Boil briskly in fresh water, with occasional stirring, for at least 10 minutes.
Undercooked beans may be more toxic than raw beans.

Tips for cooking –

1) Add salt to the soaking water and cooking water as it helps remove raffinose and stachyose and thus reduces gas producing tendency of beans. Also, salt improves water absorption so beans are evenly softened and cooked.

Isn’t this what we have been watching our grandma and mum doing – Soaking overnight in salt water! Now we know the scientific basis for that.

1) Acids, including tomatoes, lemon etc; prevent beans from absorbing water efficiently and thus may result in uneven or partial cooking, thereby retaining anti-nutrients. Always add tomato/tomato puree after boiling the beans.

2) Microwave cooking is not recommended. Microwaves do not heat food evenly. This can cause parts of beans to remain undercooked. Boiling /pressure cooking is best. Cook for 15-20 minutes.

Next time when you enjoy beans, make sure they are safe as well!

March 6, 2018 By Komilla Pareek 25 Comments

Simple guide to Protein-Uric Acid Connection

When Rohit came to me for consultation, he was suffering from hyperuricemia- a condition which is associated with high levels of uric acid in the blood. Increased levels of blood uric acid predispose to gouts and very high levels may lead to kidney failure. Uric acid is produced from the natural breakdown of body’s cells and from the foods rich in purines. Thus, in hyperuricemia, purine rich foods are avoided.

Though purines are present in all living things (and food) as they provide part of the chemical structure of our genes, some foods contain concentrated amounts of purines. For the most part, these high-purine foods are also high-protein foods and thus purine restriction gets wrongly translated as protein restriction in most cases.

A detailed discussion around Rohit’s food intake revealed that his diet was very low in protein. He was avoiding all pulses, milk and milk products and meat & eggs. In addition, to that, he was doing one hour of intense workout to reduce weight. He reported muscle soreness, weakness, and cramping which I could easily relate to his visible signs of protein deficiency – sparse hair, pot belly, and swollen hands.

Contrary to the notion that protein is necessary only in growing age, we need protein at every age for normal wear and tear of tissues. Most of the enzymes involved in important metabolic processes are proteins. Thus, like everyone, hyperuricemia patients too need this nutrient in adequate quantities.

Let’s make this complex protein -uric acid connection simpler through this guide on what to include and what not –

Dairy products – Not only do they provide good quality proteins, scientific studies have demonstrated that milk when taken in moderate quantities actually help in reducing and managing gouts. However, fermented milk products such as yogurt, buttermilk, curds and aged cheese have purines from the nucleic acids of the bacterial cells that proliferate during fermentation. They should be avoided. Non-fermented milk products such as cottage cheese, paneer, whey protein can be taken.

Eggs– The yolk of an egg contains the nucleic acids, but the egg white is pure protein without purines.

Nuts – Nuts are naturally low in purines and can be eaten daily by those on a low purine diet. Good sources of low-purine nuts and seeds include walnuts, almonds, flaxseeds and cashew nuts. Keep in mind that nuts are rich in calories, so eating too many of them could cause you to gain weight.

Pulses– Beans and pulses contain low to moderate amount of purines. However, researchers prove that purine from plant sources are less likely to harm and one serving of pulses per day can be safely taken by gout patients.

Meat – Meats including bacon, beef, pork, and lamb; Organ meats, such as brains, heart, kidney, liver, and sweetbreads; anchovies, sardines, herring, mackerel, and scallops are high in purine and should be avoided.

Epidemiological research has demonstrated that all purine-containing foods are not the same, and that plant purines are far safer than meat and fish purines in terms of gout risk.

Hope this information helps you meet protein requirements and lead a normal active healthy life on a low purine diet.

February 13, 2018 By Komilla Pareek 2 Comments

The Weight Loss Link You May Be Missing – Dietary Minerals

The most challenging case for a Dietitian is perhaps – Weight Loss! Why – because, each case is unique and the most important task is to find out the root cause of weight gain (which, contrary to popular belief, is not always overeating or lack of physical activity). It is prudent that the underlying cause be identified and targeted, not only to ensure sustainable weight loss but also because these reasons are linked to diseases in waiting as well. Genetic predisposition, low BMR, stress, lack of sleep, hormonal disturbance, chronic mild dehydration etc. are few recognized causes of weight gain.

However, if adjusting your diet, water intake, exercising more and controlling your stress and sleep hasn’t helped you reach a healthy body weight, check your mineral status. Mineral deficiency often happens slowly over time and can be caused by an increased need for the mineral, lack of the mineral in the diet, or difficulty absorbing the mineral from food.

You may be suffering from deficiencies because the nutritional value of the produce has been steadily degrading for the last couple of decades. Increased intake of processed foods is another reason devoiding you of not only fiber but also many of the vitamins and minerals.

Since the deficiency symptoms of these minerals are largely general, they go unnoticed and hence get overlooked while diagnosing unexplained weight.

I have discussed these in my previous blog: http://goqii.com/blog/hidden-hunger-are-you-suffering-from-it/

Let’s discuss four major minerals (or their deficiencies) that are directly or indirectly associated with your weight –

CHROMIUM: Chromium is an essential mineral that regulates insulin action and its effects on metabolism.Insulin is essentially the fat-loss gatekeeper, so anything that improves insulin efficiency is great for fat loss.

Chromium determines the way our body uses insulin. The glucose tolerance factor (GTF) interacts with insulin and regulates how much glucose (sugar) enters a cell. GTF encourages energy production (burns calories) and may also curb feelings of hunger.

Identifying the link between chromium and weight loss is crucial because someone who is overweight is often at high risk of becoming insulin resistant (diabetic).

Chromium is lost in the process of refining foods. For example, when sugarcane is refined into white sugar, 93 percent of the chromium is lost. Because our soils are depleted of chromium and because we consume more processed foods nowadays, chromium deficiency is becoming increasingly prevalent.

IODINE: The thyroid gland depends on iodine to manufacture thyroid hormone. The thyroid’s main function is to manage the body’s metabolism.

A shortage of iodine can cause changes to the thyroid gland and an under active thyroid gland slows your metabolism; you thus burn dramatically fewer calories and feel sluggish. Also, under active thyroid gland promotes excess weight and cellulite by causing water retention.

Inadequate intake of iodine was once a recognized problem that was solved by universal iodization of salt. Salt was fortified with Potassium Iodate to ensure controlled consumption by all sections of society. Once this was done, the obvious symptoms of severe iodine deficiency disappeared from view, and little further thought was given to matter, though sub-clinical symptoms remained. Today’s health conscious consumers have lowered their salt intake and now fail to get even that small amount of iodine in their diets. Presence of goitrogens in certain foods is another cause of iodine deficiency arising from inadequate iodine utilization.

MAGNESIUM: Magnesium is needed to extract nutrients from food and for optimal insulin function. The more nutrients you extract from food the less you have to eat to feel full. When we aren’t getting what we need from our diet, the body will crave more food in an effort to obtain those vital nutrients.

Magnesium is also a vital nutrient for reducing stress which is one of the most important keys in fighting obesity. Magnesium supports healthy adrenal glands that control the release of adrenaline and cortisol, two hormones related to stress response. While these hormones are vital to living, too much of them can cause weight gain and other health problems. Magnesium helps regulate these hormones so they are not overproduced.

One of the major causes of Magnesium deficiency is over-medicating with pharmaceutical drugs. They prevent the body from absorbing magnesium.

IRON: Iron is a critical nutrient because it is essential for the synthesis of hemoglobin, a metalloprotein that carries oxygen from lungs to all the tissues in body. Diminished oxygen carrying capacity can leave you feeling very fatigued, lethargic and irritable. In this state, your body signals you to slow down physical activity and you may find yourself seeking opportunities to sit or lie down, thus leading to weight gain.

Also, low iron promotes fat storage and cause abnormal blood sugar elevation.

Reasons responsible for iron deficiency can be dietary as well as non-dietary. Your excess body weight too can contribute to iron deficiency. Inflammation associated with excess body weight elevates a hormone hepcidin, which has the net effect of reducing iron absorption from digestive tract.

Now, before you finish reading this article and jump to quick fix by googling for these mineral supplements, a word of caution -Over dose of these minerals, especially from synthetic sources, are extremely harmful. Do not take these minerals as supplements without professional guidance.

You may improve your mineral intake by following the golden rule – Go low on processed foods and buy your foods fresh, local and seasonal to remove any possible degradation in nutrient quality.

Don’t eat less, eat right and live a healthy active life.