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Episode #11
Twenty steps to prevent heart ailments and heart attacks in young people:
1. Increase physical activity but gradually; avoid overexertion.
2. Eat healthy, reduce refined carbohydrates and packaged foods.
3. Ensure a colourful food plate. Ensure good gut health. However, dont consume too much of probiotics or yogurts, many have excess sugar and are detrimental to health.
4. Include nuts and dry fruits in snacks and meals.
5. Limit salt and salty foods. For salt, Lower is better.
6. Monitor blood pressure with a home device, as and when you wish to, but at least once in every six months.
7. Check cholesterol and lipid levels; consult a doctor if any marker is deranged and specially if LDL levels exceeds 130 mg/dl for otherwise healthy. For those with pre-existing health issues, it should be less than 100 mg/dl.
8. Use less cooking oil, use a variety of oils, with a monthly limit of 500–700 ml per person. Oil use a common marker for all members of family.
9. Learn your family’s heart disease history; be cautious and take extra measures, if at risk.
10. Buy a bathroom weighing scale and put in most visible corner of your house. Weight awareness may help in getting active.
11. Maintain optimal weight. BMI below 23, weight as height (cm) minus 100 (men) or height in cm minus 105 (women), and waist circumference under 90 cm (men) or 80 cm (women).
12. Get Treated for preexisting health conditions and ensure proper control of those conditions. Get your diabetes under control, if you have.
13. Get annual health checkups after age 35, even if you feel you are healthy.
14. Start preventive checkups at 25 if there’s family history, every 1–2 years, guided by a physician.
15. Sleep at least 7 hours daily.
16. Reduce stress and screen time.
17. Stop smoking.
18. Reduce alcohol, better stop completely.
19. Learn about various heart and health risk scorings to get self assessment. These are available for heart, liver and kidney health amongst other.
20. Read reliable health information. Discuss how to stay healthy with your friends and families.
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Episode 10
The A1 or A2 milk debate is a marketing gimmick. You don't need to worry about A1 or A2 milk categorization.
in India, You're likely drinking A2 milk.
It is not A1 or A2 but the fat content in milk, that you should be aware about: Full cream, toned, double-toned, and skimmed milk are common types available commercially.
After six months, children can have cow milk alongside breast milk, or buffalo milk for calorie-dense needs.
Most adults without co-morbidities can drink any milk, but lower-fat options like double-toned milk (1.5% fat) are ideal for all ages. 'Double toned milk' is considered a "free food," meaning you can consume it freely.
For those overweight, obese, or with conditions like high lipids or diabetes, double-toned milk is best and can be consumed without restriction.
Ignore A1 or A2 milk debates; they're irrelevant.
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Episode #7
It is useful to understand the difference between a heart attack, cardiac arrest, and heart failure?
Lets understand this way,
the heart has three key parts:
arteries supplying blood to the muscle, (Pipes)
the heart muscle that pumps, and (Pumps)
the electrical circuit that maintains the heartbeat. (Switches)
Interestingly, our heart and circulatory system has uncanny similarity to water fitting in houses and buildings: Pipes, Pumps and Switches and so on.
A heart attack happens when heart arteries are blocked, reducing or stopping blood flow to the heart muscle,
initially causing angina (mild pain- if it is only a relatively insignificant and small portion of heart is affected) and, if fully blocked, a heart attack.
Cardiac arrest occurs when the heart’s electrical currents malfunction, causing palpitations or rapid fibrillation, potentially leading to collapse. if one of the electrical circuit stop sending message, everything comes to a halt.
In this situation, Cardio pulmonary resuscitation (CPR) can save life. That is why every adult should learn how to do CPR.
It is a life saving procedure and one need not to be a medical expert to do CPR. All of us should learn CPR.
More on CPR in some other post.
Heart failure occurs when the heart muscle pumps poorly, causing blood to flow partially forward or back into the lungs, leading to breathlessness, fatigue, and difficulty working or walking.
Heart functioning can be assessed by Echocardiography.
The information in this tweet is a precursor to more on heart health, which you would read in coming days, weeks and month.
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Episode #6
Doctor, how can I differentiate between a heart attack and gas or acidity?
@DrLahariya 's Response:
Gas or acidity (or Heartburn in medical language)-- is often mistaken for a heart attack.
Gas or acidity often involves
bloating,
belching (or hiccups), and
fullness in the stomach,
starting from the epigastrium (or the the upper central region of the abdomen).
A heart attack typically causes
a constricting chest pain (that is very characteristic), like a tightly tied rope.
Heart attack can sometimes have stomach burning.
The pain of heart attack often radiates to the jaw or hands, accompanied by breathlessness and sweating.
While we should not assume or discount any pain,
we should not be too much worried, unnecessarily. It is important consult a doctor and get an ECG to rule out a cardiac event. Misinterpretation or delay can be life threatening.
In these days, when there are often reports of young people getting heart attack, people are more worried.
However, worrying does not solve any problem.
Consult a doctor, if you are more than 40 year old, get annual preventive health check up and some essential investigations based upon the advise of doctors.
However, if you have any pre-existing risk factor, or there is family history of heart issue, these consultation may be more regular and some additional investigations may be needed.
If you are interested in knowing your 5 year, 10 year and lifetime risk of atherosclerotic heart disease, there are some good online calculator and you can assess your risk. All you need is pulling out your most recent lab report, specially lipid profile and include your behavioural factors such as smoking
One such calculator is from American College of Cardiology
https://t.co/Y922DID6Ck
More importantly, educating ourself our basics of health, adopting healthy lifestyle would help you keep healthy.
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Episode #5
Doctor, Do I Need Vitamin D3 Supplementation?
Vitamin D3, a fat-soluble vitamin, is essential for the human body, yet many Indians are deficient.
Isolated Vitamin D3 testing costs Rs 1,000–1,600, while annual cost of weekly or fortnightly supplementation could be in range of Rs 600–800.
However, when done as part of comprehensive check up, the cost comes down. Therefore, as part of routine annual health checkups and comprehensive testing, everyone should test Vitamin D3 and B12 levels to guide supplementation.
How and how much ViT D3 supplementation should be done, consulting a doctor is the best approach.
Vit D3 Tablets or capsules are available in 1,000, 2,000, or 60,000 IU.
In deficiency, doctors may prescribe 60,000 IU weekly for a few weeks, then biweekly, and monthly for sufficiency. Given the prevalence of deficiency in India, adults may benefit from monthly 60,000 IU supplementation, on routine basis.
Daily supplementation offers no distinct advantage over weekly, but costs more.
Supplementation should be doctor-guided, as excess Vitamin D can be harmful.
Here, one of the important age group for supplementation is Infants, who need 400 to 800 IU daily, as their diet often lacks sufficient Vitamin D.
Elderly, people living with diabetes are other groups who need Vit D supplementation.
Lets deep dive.
Sunlight exposure, even in India, is inadequate for sufficient Vitamin D, requiring 20–30 minutes of exposure daily. Fortified foods like milk and cereals may not meet daily Vitamin D needs, as consumption may vary.
A level of 30 ng/mL (75 nmol/L) or above is considered sufficient; over 100 ng/mL (or 250 nmol/L) is excessive. Many Indians have levels below 10 ng/mL.
**Deficiency associated Risks**:
Weakened bones, fatigue, and a compromised immune system.
**Recommended Doses**:
- Infants (0–12 months): 400 IU/day
- Children (1–18 years): 600–1,000 IU/day
- Adults (19+ years): 600–800 IU/day
- Older adults (70+ years): 800 IU/day or higher
Considering Vit D is fat soluble vitamin, therefore, any approach to supplementation: daily, weekly, fortnighly or monthly, as recommended by Doctor is fine.
**Forms**:
Vitamin D2 (ergocalciferol) or D3 (cholecalciferol). D3 is more effective.
**Toxicity**:
Excessive supplementation can cause hypercalcemia and other issues.
**Timing**:
Take with food for better absorption.
**Roles of Vitamin D**:
- **Bone Health**: Aids calcium absorption for strong bones and teeth.
- **Immune Function**: Supports a robust immune system, reducing infection risk.
- **Overall Health**: Impacts mood, cardiovascular health, and cognition.
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Popular notion:
“Drinking #Beer can treat high #uric acid and #Gout”
@DrLahariya ‘s Take:
Nothing is cured or should be attempted to be cured by drinking either Beer or any type of Alcohol.
Food modification can reduce uric acid levels but may not be able to treat hyperuricemia.
Best approach is to combine dietary modifications with medication.
#FoodisMedicine
Hyperuricemia or high levels of uric acid is a medical condition which leads to Gout.
Certain foods and drinks contain high Purines- a natural chemical. When a food with purine is consumed, it breaks down into uric acid. The high uric acid in blood results in formation of sharp crystals which get deposited in your joints, causing swelling and pain. Reducing uric acid levels in body can help prevent gout. Low purine diet can reduce uric acid.
*In high uric acid and gout, avoid these foods*:
§ Sugary drinks and sweets.
§ High fructose corn syrup.
§ Alcohol. In fact, alcohol prevents your kidneys from eliminating uric acid, pulling it back into your body.
§ Organ meat, Red meats, Certain seafood such as codfish, tuna
Food which can help to reduce uric acid levels and gout:
Most types of fruits and Berries and cherries and anything which has vitamin C- Strawberries, and blueberries have anti-inflammatory properties that give relief from joint pain. Vitamin C rich foods which disintegrate uric acid and force it out of the body through urine. Good sources of vitamin are Amla or Indian Gooseberries, Amrood or guava, kiwi, sweet lime, oranges.
Apple is a rich source of malic acid which helps in neutralizing uric acid. Consume one to two apple daily to reduce uric acid and for other benefits.
Cherries have known anti-inflammatory properties, and they may also help reduce uric acid in your body.
Vegetables such as French bean and sunflower seeds, capsicum, lemon, tomato, and green leafy veg including broccoli, and cucumbers. Fresh tomato is alkaline by nature and when it is exposed to the bloodstream it increases the alkalinity of the blood.
High fiber food. Dietary fibre may help absorb uric acid in your bloodstream, allowing it to be eliminated from your body through your kidneys. Increase the consumption of dietary soluble fibers such as isabgol, broccoli, apples, oranges, pears, strawberries, blueberries, cucumbers, celery, and carrots, barley. Bananas are also beneficial in lowering uric acid.
Coffee and Green Tea. Drink as much as you need. drinking coffee breakdown of purine into uric acid and speeds the rate of excretion.
Skimmed or double toned milk. It speeds up the excretion of uric acid in your urine and also reduces your body’s inflammatory response to uric acid crystals in your joints.
Water. People who drink eight glasses of water a day are less likely to experience gout symptoms. Impaired kidney function is one factor that can contribute to gout.
In short
When it comes to gout and hyperuricemia, Food is medicine.
The well-planned food items can help to reduce uric acid levels but may not be enough.
You would need medications as well.
The best approach is to combine food modifications and medications in the beginning.
Once uric acid levels are in normal range, ensure your diet has low purine food and low uric acid food.
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