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October 20, 2016 By Dr Anand Kulkarni 3 Comments

OSTEOPOROSIS

osteoporosis

How often have you come across your parents, grandparents or an elderly relative who has had a minor fall in the bathroom, slipped on the floor or had a terrible jerk while travelling on a bumpy road and sustained fractures of bones with a lot of pain, suffering and disability.

It has been noticed that the culprit for such incidents is OSTEOPOROSIS.

Osteoporosis is one of the most common disabilities encountered in the elderly. It literally means POROUS BONE. The condition results in reduced density and increased fragility of bones resulting in higher risk of fracture with minor falls, cough, sneeze, or minor bumps.

osteo1

The condition is observed worldwide. There are more than 10 million cases per year in India. In the USA about 55% of its population aged 50 years and older have Osteoporosis. One third have disabilities and one third regain their pre-fracture status. The health costs from fractures are tremendous amounting to billions of dollars annually.

It is very important to learn about osteoporosis because it is a ‘SILENT DISEASE’ except occasional bone pains. You may not know that you have osteoporosis until your thin weakened bones fracture in a bump or fall. The more common sites are Hip, Spinal Vertebrae and Wrist.

Clinical studies suggest that approximately 1 in 2 women and 1 in 4 men aged 50 years and older will break a bone due to osteoporosis. Such people in this age group usually present with chronic vague backache, loss of height, or stooping (Kyphosis) and should consult doctor immediately.

osteo2

THE RISK FACTORS ARE,

  • Advanced age
  • Family history of osteoporosis
  • Early menopause
  • Short Stature
  • Lack of Exercise
  • Poor nutrition with lack of Calcium
  • Lack of Vitamin D
  • Chronic Cigarette Smoking and Excessive Alcohol Consumption
  • Medical Illnesses- like hyperthyroidism, surgical removal of ovaries, long term steroid therapy and rare inherited bone disorders like Osteogenesis Imperfecta.

SCREENING is advised for all elderly above 65 years of age and Men and Women less than 65 years of age who have increased risk of fracture or already suffered from fracture.

DIAGNOSIS – is by bone scan which measures-Bone Mineral Density (BMD). The test called DEXA (Dual Energy X ray Absorptimetry) gives indication of likelihood of fracture due to osteoporosis.

It is also used to monitor response to treatment.

Result.— T score a)   ( -1) and above ——- normal

  1. b)   (-1) to ( -2.5) ——- mild bone loss or osteopenia
  2. c)     ( -2.5) and below —- osteoporosis

Our aim should be to prevent bone less or slow down the occurrence of Osteoporosis and encourage healthy bone mineralization.

Following measures are recommended:

  1. Healthy Nutritional Diet – To be incorporated during childhood and adolescent period itself with adequate calcium and magnesium intake. Calcium intake should be 1000 to 1200 mg per day. Common calcium rich foods are dairy products, cheese, ragi, broccoli, spinach, cabbage, green beans, soy beans, okra, dates, egg, salt water fish and fruits like orange, figs.
  2. Vitamin D intake of 800 IU per day is a must. We encourage exposure to SunLight and supplementation as Vitamin D requirement cannot be fulfilled through nutrition alone.
  3. EXERCISE plays a major role. Weight bearing exercises like walking, playing golf, Dancing, Hiking, Racket sports like Tennis, Squash promote mineralization of bones and make them healthy. Muscle strengthening exercises like weight lifting benefit by increasing muscle strength and Non- Impact activities like YOGA help in balancing, posture, agility of joints and benefit people with osteoporosis by decreasing the risk of falls and fractures.

Studies have also reported an increase in BMD in the spine of those who do YOGA regularly. Exercise should be tailored to the individual person based on BMD report and medical condition in consultation with health care professional.

osteo3

osteo    

  1. Other Lifestyle Changes – Have a Positive Attitude towards Life, avoid the use of tobacco and Cigarette Smoking, moderate alcohol intake if any, and measures to avoid falls like having railings, avoid slippery floors, having a mat or carpet on the floor helps etc.

Medications—You may also require osteoporosis medications to either build or maintain bone density. People have been treated with medications like Bisphosphonates, Hormone Therapy in Women, Calcitonin, Parathyroid Hormone. Stem Cell Therapy is also being tried out in severe cases.

But, any of these modalities of treatment should be undertaken in consultation with your Doctor. The doctor is the only one who will be able to decide the right treatment for you weighing the benefits and risks of the therapy.

Cultivate healthy living and enjoy life!

October 17, 2016 By Leah Burkhart 3 Comments

What is Coaching, Anyway?

fitness-trainer-north-hollywood

GOQii’s mission is to provide global access to health professionals who can help you to reach your best health potential. To do that, GOQii has cultivated a community of health coaches to help you on your journey towards better health habits and (by extension) a better quality of life.

Just one thing, though….

What is a health coach?

Is it, like…a guy who is going to blow a whistle at me and tell me what to do throughout the day?

Nope.

Oh…so it’s someone who is just going to tell me what to eat and when?

Not….exactly…no.

Well – what the heck is a health coach, then?

Coaching is a relatively new vocation so far as vocations go. A purist working in an organization like the International Coaching Federation would say that coaching is:“A professional who will partner with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential.”

Huh?

Basically…using this definition – a coach is intended to facilitate a relationship whereby YOU make the decisions about what goals YOU want to commit to. The coach is there to help ask the right questions to help you land on the appropriate goal. The coach is there to provide insights about the patterns he/she notices about what you are doing now. Finally, the coach is there to provide accountability for you by checking in on you regularly and asking about the goals you set in motion.

They use skills like Motivational Interviewing (an evidence based approach that helps people navigate confusion and ambivalence about changes they want to make in life) as well as visualization exercises and Socratic questioning.

So..then…what is a health coach?

A Health Coach is someone who integrates the skills and techniques of coaching (motivational interviewing, socratic questioning, etc.) alongside health education (giving you information that you may not know in order to help you make habit changes that are appropriate for the kinds of results you want to have).

Your GOQii coach is a health coach. They are trained health professionals who are qualified to give you information if you need it. BUT -the philosophy we follow, here, at GOQii is as follows:

  • Most people actually already know what to do – the challenge is in implementing it. They really just need accountability
  • Health isn’t about revamping your entire nutrition plan or following complex exercise routines all at once. It’s about making sustainable changes over time that turn into life-long habits and evolve into robust health in the long-term.
  • YOU know what you need better than anyone. Our job as your coach isn’t so much to tell you what to do as it is to help you unlock your own potential.
  • Yes – occasionally, you really do need some information. You might have read an article about health that confused you. You might not be sure about the next best step. If that is the case – we can and will help you by providing options for first steps – but at the end of the day, YOU are in charge. YOU decide.

So What Will Your First Coaching Call Look Like? 

  1. First, your coach will ask you what your long-term BIG PICTURE goal looks like.
    • What do you want to see change in the next year?
    • What kinds of people do you envision spending your time with?
    • What kinds of actions do you want to be doing?
    • EXAMPLE: “I want to be able to run a marathon by the end of the year.” or “I want to lose 40 pounds by the end of the year.”
  2. Second, your coach will ask you your
    • What will that change get you that you don’t have now?
    • What is motivating you to make that change?
    • EXAMPLE: “I used to love  I felt empowered by it. And lately, I haven’t felt very empowered. I want to feel that way again.” Or “I want to lose some weight so that my knees don’t hurt as much. I am struggling to keep up with my little 3-year old. I want to be able to play and run and hide and seek right along with her. I feel like my current weight is making that challenging for me because exercise is causing me physical pain.”
  3. Third, your coach will get you to identify a check-point to try and commit to in the next month.
    • In the next month, what would indicate to you that you were moving in the right direction?
    • How far do you want to try and be toward that long term goal by the end of the month?
    • EXAMPLE: “I want to be able to run at least 2 miles without stopping.” Or – “I would really like to have lost at least a couple of pounds by the end of the month.”
  4. Fourth, your coach will help you to take that goal and frame it into actions. It’s one thing to say you want to run a marathon. But that takes practice. Sure you might want to lose weight. But both of those things are Now you need to figure out which actions you want to take to get you there!
    • What is a specific action that you can take between now and next week that will move you toward your monthly check-point?
    • How will you monitor your progress on that?
    • How might you arrange your environment to optimize your success?
    • Who will you recruit as your support for that goal?
    • How will you reward yourself every time you engage in this behavior?
    • EXAMPLE: “I will make a commitment to run 20 minutes per day at least twice this week. I’m not sure, yet, how long I can go without stopping. But I will run/walk both times and push myself as far as I am comfortable. To monitor my progress, I’ll check in with the GOQii app and check it off on the list when I have completed my task. In order to assure that I run….I will put my running clothes out the night before so that I do it first thing in the morning. I’ll keep my GOQii coach for support, and I will reward myself after my run by allowing myself a download of a song on my music device or will download a new audiobook every time I complete the weekly goal.
  5. Fifth – your coach will wind up the conversation by summarizing what you have committed to. He or she will ask if you have any questions or are in need of any resources. Perhaps you are looking for some workout videos that are free. Or maybe you are looking for a quick and easy breakfast recipe that you might look at after your run. Whatever the case, your coach can help point you in the right direction and hold you accountable. And after wrapping up, your coach will set a follow-up appointment with you for the following month.
  6. Finally – your coach will follow up with you every day during the week via text to make sure you have all that you need. If you have questions along the way, you can reach out. If you feel like you’re struggling to find the motivation, your coach can help you identify what will get you back in the game.

Make no mistake – You are always the one in the driver’s seat. But your coach is there to be your copilot along the way. Your coach will help guide you along your journey and hold you accountable to the habits you want to put in place in order to get to the destination you ultimately want to get to.

Good luck – and Be The Force!

October 4, 2016 By Komilla Pareek 1 Comment

High Fructose diet and Vitamin D

high_fructose_corn_syrup_570

We are all aware that lack of sun exposure and spending more time indoors makes us prone to Vitamin D deficiency. But, did you know that Vitamin D deficiency could also occur due to an unhealthy diet –especially one that is loaded with high fructose.

In fact, what led me to write this blog is a recent conversation with a close friend of mine. Anita, as I knew her was always conscious about her diet and what she ate. Her seemingly healthy breakfast included packaged cereals and fruit yogurt. Trying to keep her meals small and frequent, her snacking included salads from fast food joints and her quick fix dinner at home mostly comprised of fruit juices with a veg sandwich.

But, something seem to bother hear off late. When I casually asked her how she was doing and that she looks a bit perturbed, she mentioned about her recently diagnosed Vitamin D deficiency at the age of 35 years.

What triggered the check up? Well she had a fall and fractured her right hand. It intrigued me to find out more. Anita was also keen to find out if there was anything in her diet that had led to the Vitamin D deficiency. She was obviously under the impression that she was eating healthy.

As a nutritionist, let me tell you that the sunshine vitamin-Vitamin D, can have reasons other than insufficient exposure for its deficiency. Fast paced lifestyle and dependence on packaged foods pointed to high fructose in the diet, which could be a major cause. Precisely, what triggered the deficiency in Anita as well?  Surviving on packaged foods is not a good idea at all.

Fructose, as we know is a fruit-sugar; unfortunately, it’s not fruits from where we get most of the fructose in our diet. A large part of fructose in our food enters via HFCS – High fructose corn syrup which is an alternative to sugar in most packaged foods.

This low cost sweetener is favorite of food processing industries.Being stable in acidic foods and beverages, HFCS is attractive alternative to sucrose and is found in many unsuspecting packaged foods such as – Packaged fruit juices, carbonated drinks, breakfast cereals, flavored yogurt, salad dressing, ketchups, soups, sauces, nutrition bars etc. Baked products such as biscuits and breads, which is a classic case of ‘HFCS camouflaged with the whole grain marketing’.

When we consume high levels of fructose, an enzyme called  24-hydroxylase (which is responsible for degrading vitamin D3) becomes more active, while another enzyme, 1α-hydroxylase (which helps synthesize vitamin D) becomes less active.  As a result of this high level of fructose consumption, the body tends to start breaking down whatever levels of Vitamin D you have. In other words Fructose reduces blood levels of active Vitamin D.

Vitamin D in the form of calcitriol plays a critical role in maintaining calcium levels in blood. It regulates active calcium transport in the intestine, helping increase its absorption from food. In fact, in Vitamin D deficiency, we absorb only about 10 to 15% of the dietary calcium we eat!

We need calcium for proper functioning of nerves and muscles, including the cardiac muscle –Heart. When calcium levels go too low,in its survival mode body starts pulling calcium from bones. Boom: suddenly we enter a state of bone-tissue breakdown, because of a chain of events initiated by excess fructose. Over time, skeletal health becomes compromised, and the risk of osteopenia, osteoporosis, and fracture may go up.

A study published by PLOS One in April 2014 demonstrated that a chronic intake of high levels of dietary fructose can lead to a decrease in circulating levels of Vitamin D and also creates physiological increases in calcium requirement. They quoted this finding as highly relevant since fructose, a sugar contained in many types of foods that are being consumed at high levels, may contribute to the increasing prevalence of vitamin D insufficiency, especially in sensitive populations with high, processed sugar intakes. (http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0093611).

Before it’s too late, cut down on your fructose intake. Less than 40 g of fructose from whole foods sources per day is a great target. For reference, that’s what we’d get from 1.3 whole mangoes or 3.5 apples. Yes, 2-5 servings of fruit per day (depending on fruit choice, stick to max 2 if high fructose fruit) is perfectly fine!

September 14, 2016 By Saba Mirza 4 Comments

Know about ‘PROCESSED’ foods and its harmful effects

425-food-bad-effects-of-fast-foods

Processed foods are something we humans cannot seem to stay away from. What starts with saying “once in a while,” invariably becomes an addiction that cannot be given up easily.

Why are they so hard to refuse? First off…the term ‘Processed foods’ can be a bit ambiguous. It can encompass foods that is commercially prepared to ease their consumption. Given that vague definition…it’s important to note that not all the processed food are bad. Some foods, for example,are “processed” mechanically and are still considered “whole foods.” One good example of this would be like packed, chopped vegetables, fruits cut and packed would be another example. In their own juices are few examples.

For the purposes of this article, we are referring to foods that are industrially processedand chemically altered in a fairly significant way.

In other words, the foods we are concerned about include:

  • Instant noodles (& please keep in mind..am not just talking about maggi!!)
  • Chips such as potato chips.
  • Pretzels
  • Beverages such as soft drinks, juices
  • Fast food
  • Candies,
  • Cookies
  • Canned products such as soups and pasta
  • All ready to cook food items like ready to cook soup packets, oats, and pasta
  • Packaged mixes like cake mixes, mac & cheese, brownie mixes and different gravymixes

In other words, when I say “processed food” I’m primarily referring to those foods considered “junk food.”

But It’s Just Food. What Could Possibly be the harm in Eating Food?

It’s a fair question to ask. After all…why should we avoid them if our FDA has approvedall these products in the market and deemed them “safe” for consumption?

Well…the thing is “safe” is a relative term. The FDA has found it to be true that none of these foods will kill you on the spot but that doesn’t mean they won’t cause cumulative harm in the long term. Nor does it mean it won’t disrupt your health…

Here is why you should run away from all these devils…

A) TRANS-FATS: (http://goqii.com/blog/trans-fat-the-biggest-enemy-of-your-heart/)

This should be the single most pressing reason for you to leave all your favorite noodles and chips.. But what are Trans-Fats, anyway?

  • Trans-fats are the hydrogenated oils which after processing act as saturated fats. Have youever noticed that vegetable oils are liquid? But butter is solid? A trans-fat is a fat that began as aliquid, but by changing the chemical structure of the oil, became a hardened fat. Think…margarine.
  • They are considered as the most dangerous fats more harmful than saturated fats.
  • They increases the levels of bad cholesterol (LDL) and decreases good cholesterol (HDL) thus making you more prone to heart diseases,hypertension.

SO WHY FDA IS ALLOWING THEM IN THE FOOD?

Yes, FDA has made it mandatory for all the food companies to mention trans-fat levels on their nutritional labels.But a ‘zero’ level of trans-fat doesn’t indicate that the product is completely trans-fat free.The products which contain trans-fat below 0.5g are free permitted to omit or to market it as ‘trans-fat free’,So, a product which is containing 0.4g of trans fat can claim is as ‘trans-fat’ free…But 0.4 g is a significant level to be harmful (at least cumulatively)and, moreover, we don’t stop with a single serving of these items.

How often have you foundyourself opening a bag of potato chips only to find you have dug your way through half the bag?That’s well over a single serving. And that double serving will for sure make a huge impact.. Thus, even if a package says it is “free of trans fats” – check the ingredient list. Make sure it doesn’t say “hydrogenated oils” in the list. Any hydrogenated oil is a trans-fat.

WHICH FOODS CONTAIN TRANS-FATS?

You’re most likely to find them in processed foods which are either fried or processed in fat or oil. Trans-fats tend to be cheaper to make, so you’ll also find them in low-cost foods like instant noodles,chips, and ready- to- make flour mixes. Another section to keep an eye on is in the bakery. They are often put in cookies, cakes,and breads made in stores. Trans-fats can help preserve these foods longer, so it makes for a useful ingredient for those making them behind the scenes.

B) SUGAR: (http://goqii.com/blog/are-you-a-sugar-addict/). Most of the processed foods contain very high amount of sugar. In many cases, a single serving of these packaged foods contain a sugar amount that is higher than the recommended daily intake of sugar. That’s right. That one serving of cake from the store may have more than the total daily amount of sugar that you should consume.

For example. A half litreof coke contains 70g of sugar..this means you are taking in

12-14 teaspoons of sugar you are drinking in one go!!! Why should you worry about this?

Read this earlier blog on Sugary drinks: (http://goqii.com/blog/hidden-dangers-of-sugary-drinks/) Well…high amounts of sugar in our diet is linked with Diabetes, heart disease and even cancer.That’s true even if you stay lean and manage your weight.

A study published in the British Medical Journal finds that people in the habit of drinking one sugar-sweetened beverage — such as a soda or sweetened tea — every day had an 18 percent increased risk of developing the disease over a decade. That’s compared with people who steer clear of sugary beverages.

C) SODIUM: (http://goqii.com/blog/salty-facts/)

We derive our daily sodium dose from the common salt we use in our kitchen. As we all know, there are harmful side effects associated with an excess dose of sodium including hypertension,water retention, and kidney dysfunction.We should take sodium in limited amounts.

The upper safe limit to take sodium is 2200 mg/day …which we are able to get from whole food sources such as meats, beans, dairy, grains and even some vegetables.

Almost all the processed foods contain relatively high amounts of sodium. It makes sense! Doing so increases the flavor as well as the shelf life of the product. That’s great news for the company trying to sell the food…and but, as a single serving of most of these products often cover more than half of your recommended daily intake, it’s not really good news for you or for your health.

D) FIBER CONTENT: (http://goqii.com/blog/finding-health-through-fiber/) Most processed foods lose their fiber contents during all those chemical processes. Fiber makes the food harder to cook. Removing it makes their preparation easier. Again – that is great for the food industry, but it’s NOT so good for your health. They turn a profit. All you are left with are empty calories without any nutritional value.

Bottom Line:

Almost all the junk foods are devoid of any nutritional value,contain very harmful substances (or substances in higher amounts than our bodies need) making you prone to different life style diseases like hypertension,obesity,cardiac disorders and type 2 diabetes.

So stay away from them and go for real food!!

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