AKSHITA AGGARWAL

DIETITIAN

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OBESITY –THE FACT FILE –BY AKSHITA AGGARWAL

Obesity is one of the most talked about topic now a days. Most of the people think that losing weight is the only solution to deal with obesity. I would say that they are partly correct but what kind of weight loss, that , they fail to understand. So , here I would like to throw some light on some facts about weight loss.

Components of Body Weight:-

Let us first understand what is body weight? The weight that you see on the weighing scale is composed of many components.

  • Lean body mass or muscle mass
  • Fat mass
  • Bones and other components

LBM or lean body mass is the fat free mass of our body. It is the muscle mass of the body it comprises of 65% to 75% water. So, in other words we can say water is a crucial component of fat free mass. This tissue is the metabolically active tissue. The higher the LBM in body the higher will be your metabolism that is the more calories you can burn.

Fat mass is another component of our body which regulates our calorie burning capacity. This tissue is inactive and thus lowers your metabolism. So the higher the fat mass the lower the metabolism the lazier you will be.

What is obesity:-When the person is 20% above the ideal body weight he is clinically termed as obese.The best way to cure obesity is losing weight. But weight loss also has types. 

Types of Weight Loss:-

  • Actual weight loss
  • virtual or False weight loss

Actual weight loss is the one in which you eat a proper diet composing of all food components and you lose weight in gradual manner . There are no symptoms like weakness , hair loss , constipation ,  uncontrolled hunger , weak digestion , pale skin etc.

Virtual weight loss is the one which shows on the weighing scale but is not healthy. It is sudden and may be upto 15 – 20 kgs in few months. All the above mentioned symptoms may be present in such cases. Some of the ways of such weight loss will be addressed next week

Published in Hello East Update  on 28/4/2012

OBESITY (II)–THE FACT FILE –BY AKSHITA AGGARWAL

Last week we talked about what is obesity, components of body weight and types of weight loss. One of the types that I mentioned was virtual or false weight loss. Let us now discuss it at length.

Virtual or false weight loss:-

Virtual weight loss is the one which shows good results on the weighing scale but is not healthy. It is sudden and may be up to 15 – 20 kgs in few months. Symptoms like weakness, hair loss , constipation ,  uncontrolled hunger , weak digestion , pale skin etc. may be observed in such cases.

Few Examples:-

Salt Free Diet:-When a person observes salt free diet he tends to lose weight very easily .Here is the reason why. Common salt is sodium and chloride (NaCl) , sodium has a tendency to retain or hold fluid. When we leave or stop salt intake it makes our body lose the retained water. Since our body is 60-70% water, the weight loss appears in kilos. But it is highly dangerous and can cause fainting , low blood pressure and coma in severe cases.

High protein intake:-  Since carbohydrates require water for their digestion when we take a low carb high protein diet , our body tends to lose its water. As the water keeps going out of the body we keep losing weight. But mind you that weight is not  fat but water that is lost. These diets leave you severely dehydrated.

Medicines:- Sometimes some medicines are consumed for weight loss . Before taking such medicines please ensure that you are not taking any diuretic medicine. A diuretic medicine is the one which induces frequent urination , this causes great water loss and hence virtual weight loss.

Laxatives:- Many people have the tendency to take laxatives for weight loss. Laxatives are natural or synthetic compounds which stimulate bowel movement. Frequent defecation or passing of stool will not only dehydrate you but also make you lose important minerals. The use of laxatives may also affect your digestion adversely by making your digestion poor. Once you start laxatives, motion cannot be passed without it. So, please avoid it.

The weight loss which induces weakness is of no use so, kindly beware of the above mentioned .

 Published in Hello East Update  on 5/5/2012

OBESITY (III)–THE FACT FILE –BY AKSHITA AGGARWAL

Last week we talked about different ways of false weight loss.  Let us now discuss some malpractices that we undertake in order to bring about weight loss. These may or may not work out for our body but they surely do harm our system in many ways.So, here under I present a fact file about few such practices.

Few Examples:-

Skipping meals:- Some people wonder that despite of their very low intake they simply cannot lose weight. Here is the reason why. When we reduce our intake or take meals after long gaps our body goes into stress. Our body has a natural defense mechanism to reduce its metabolic rate in accordance with the intake of food. Also it goes into stress and stores whatever food it gets. So, when you eat after long gaps our body assumes we are in emergency situation and thus goes into stress which results in not only reduction in our metabolic rate but also storing of the food that we eat rather than digesting it. Due to accumulation and lack of digestion , we tend to put on.

Salad and Fruit diet:- Fruits and salads are very good for our health that every one of us knows , but surviving on salad and fruits alone isn’t that great a idea. Here is the reason why. Salads and fruits are good sources of vitamins , moisture and roughage or fibre thus they form an inevitable part of our diet but some people for weight loss make them their main course diet. Both vegetable salads and fruits lack macro nutrients or major nutrients like proteins and fat. When a person observes a fruit-salad diet for long he may lose a number of kilos but mind you that’s protein mass or muscle mass that is getting lost.this will eventually bring in weakness along with mineral deficiencies like iron deficiency ,calcium deficiency or zinc deficiency etc which can lead to anemia ,osteoporosis or memory disturbances.

Bran diet:- These days there is a trend of using brans for losing weight. The results it gives promotes its usage. But to every coin there is a flip side too. So, here I put some light on the flip side .The bran is insoluble fibre which has the tendency of adsorbing or binding important minerals. When we excrete it along with our faeces we also lose these minerals.  So, prolonged use may cause osteoporosis or anaemia.

Mono diet:- These are one of the most popular diets these days. These are characterized by consumption of one kind of food throughout the day or may be week. The main side effect of these diets is that they are not balanced diets. This makes our body prone to weakness and deficiency diseases .The side effect of a mono diet may not be obvious immediately but after some time may exhibit itself as hair loss , pale skin , digestion problem , chronic constipation , weakness , headaches and even fainting.

  Published in Hello East Update   on 19/5/2012

OBESITY (IV)–THE FACT FILE –BY AKSHITA AGGARWAL

First of all I would like to thank my readers for outstanding response to my obesity fact file series. This is the last article addressing obesity. In case you want me to write articles on any specific topic or health issue send it to 7838084954  or 7838381020 or mail at aggarwalakshita88@yahoo.com with your name and address. Now let us have a look at some of the points we need to know before  trying for weight loss.

  • Lemon , Honey and Warm Water:- This is one of the most traditional ways of losing weight.The sa part is that yes it is effective too , but what we miss is its side effect. While talking to a no. of my patients I observed that prolonged intake of this combination caused early onset of arthiritis , joint pain and osteoporosis. The simple reason is that this combination has found to be responsible for leaching out calcium from our bones , so slowly and gradually we move towards osteoporosis.
  • About fat cells:- When a person gains weight more than his ideal body weight the generation of fat cells occurs. Fat cells are nothing but kind of vessels to store fat. They are permanent in nature and can never be finished or destroyed from our body. The only thing that can happen is swelling up or squeezing of these cells. So , when a person loses weight he / she is actually causing their fat cells to squeeze. When this person eats more or eats wrong these hungry squeezed cells swell up and the person ends up gaining more weight than he lost. So, more than losing weight concentrate on maintaining lost weight.
  • About obesity gene :-  A very common problem has come up these days . A number of my pediatric  patients reported pigmentation of skin specially on the areas which are covered . Unexplained darkening of complextion , lot of weight despite eating less , lethargy , weak digestion , weak immunity etc. The age group ranged from as young as 7 yrs to 15 yrs of age both sexes included. For all the parents observing similar symptoms in their children let me inform you that this is the obesity gene. Children inherit obesity gene from their parents and exhibit these symptoms. But the good part is that this totally manageable. Cure has not been established as yet due to its genetic nature,  but right diet and exercise can make this totally manageable.

To conclude I would like to throw light on one more fact. As Asians we have a natural tendency of more percentage of fat as compared to other parts of world. Thats why Indians have a tendency to gain weight quickly.You must not forget this while aiming for weight loss. All the standards that we have are as per Americans or other nationalities. So , There is a difference in the theoretical  ideal body weight nad practical ideal body weight. You can calculate your ideal weight  by subtracting 100 from your height in centimeters.

Published in Hello East Update  .

Digestion-The Fact File By AKSHITA AGGARWAL

Digestion is the process of metabolizing the food which we eat. It is the most important but most neglected system of our body. A healthy digestive system promotes good health and well being.

The common signs of a healthy digestive system are:- (a)proper bowel movement or defecation (b) timely hunger and satiety reflexes .

Indigestion causes problems like:-

Constipation:- it is the condition in which a person fails to pass timely motion. Clinically a person is declared constipated if he does not pass stools for more than 3 days. Chronic constipation can lead to many degenerative disorders like GERD , hiatus hernia, diverticular disease etc.

Bloating:- when a person does not digest his/her food properly and does not pass motion timely he feels uncomfortable and feels full most of the time. This reduces his intake and constipation problem becomes more severe.

GERD:-it stands for gastro oesophageal reflex disease. In this condition the person feels bloated all the time. there is severe acidity and whenever he eats anything spicy or fried, the foods tends to come out .

Acidity:- when there is too long gap between meals the person suffers from acidity. The hydrochloric acid produced in stomach does not get food to act upon so it damages stomach lining and that causes pain and regurgitation or vomiting feeling.

All above problems can be cured by proper dietary habits. Generally a high fibre diet is suggested .

Note:- A lot of people are mixing bran with their flours to attain high fibre diet for various reasons but they are unaware of its side effects. A number of patients have reported hard stools , constipation , stomach discomfort , blood in stools and gas formation due to mixing of bran in their flours.

Published in East Delhi Update dated 4-3-2012

CONSTIPATION- THE FACT FILE BY Dt. AKSHITA AGGARWAL

One of the most common problems I observed in my clients was constipation. Almost every second person is suffering from constipation or suffers from constipation on and off. Let me throw some light on this digestion problem.

What is Constipation?

It is the condition in which a person fails to pass timely motion. Clinically a person is declared constipated if he does not pass stools for more than 3 days. Chronic constipation can lead to many degenerative disorders like GERD , hiatus hernia, diverticular disease , haemorrhoids etc.

Some facts about constipation related remedies:-

Use of bran in flour:- A common misconception is that adding bran relieves constipation but in maximum cases this may not be true. Adding bran may make the stools hard and thus difficult to pass, which further increases the problem.

Use of laxatives:-  A lot of people are dependent on laxatives for their bowel or motion cycle. Laxatives do relieve constipation but they are habit forming and they weaken your digestive system. Till you wont take that laxative you will be unable to pass motion. If in case somewhere you forget to carry them or they finish you can imagine your state.

Use of churn / digestive tablets/digestive syrups:-  These are the aids that we resort to for any constipation problem. Many people have the habit of taking it after their meals. But like laxatives they are also habit forming and in some cases they may cause serious damage to digestive system when their dosage is not watched. Children imitate elders in this although they do not know the right dosage this can lead to loose motion or stomach ache.

Eating less or skipping meals:- This is a very common practice. People justify it by saying that they don’t feel like eating since they feel full. When you eat less the passing of motion becomes more difficult since no input is there.  This further worsens the condition.

You must always keep in mind that a well balanced natural diet can easily cure constipation.Next week we will address some symptoms and conditions related to constipation and some tips to deal with it.

 

Published in Hello East Update  on 30-6-2012

Cholesterol-The Fact File By AKSHITA AGGARWAL

Cholesterol is one of the most worried about fat these days. Let us now understand what exactly is cholesterol and its effects on our body through this fact file.

What is cholesterol:-

Cholesterol occurs in our body in the form of lipoprotein or lipid and protein complex . The various types of cholesterol are :-

  • LDL (low density lipoprotein)
  • HDL (high density lipoprotein)
  • VLDL(very low density lipoprotein)

}  LDL:- Ldl is the most harmful cholesterol and thus is considered bad cholesterol . It promotes the process of deposition of cholesterol in the blood arteries and thus reducing the blood supply to organs associated with that artery. After some time this starts reacting with blood cells to form clot which ultimately blocks the artery. So, cholesterol deposition in coronary artery or heart artery is the most dangerous.

}  HDL:- hdl is just opposite to ldl it is considered as good cholesterol. The main function of hdl is to remove deposited cholesterol and remove the blocked arteries.

The desire level of Ldl is less than 160mg/dl of blood whereas hdl is more than 60 mg/dl of blood. The total cholesterol must not exceed 200mg/dl of blood.

Imp Note:- cholesterol is important for some vital body functions like vitamin D synthesis , organ cushioning etc. but the amount required is already synthesized in our body so whatever we take externally through diet gets deposited.

People having high cholesterol will have high blood pressure too since cholesterol thickens the blood and hence increases its viscosity. As the viscosity of blood increases it exerts more pressure on the arteries to flow and hence increases the blood pressure.

Cholesterol is very harmful for the health of the heart. The major reason for heart attacks and heart problems is cholesterol.So , it is very important to keep the cholesterol levels in check.

Published in East Delhi Update 

Blood Pressure-The Fact File by Akshita Aggarwal

First of all, I would like to thank all my readers for the overwhelming response to my previous Fact File Series. So, on public request here under I present the fact file on hypertension.

What is blood pressure?

When our heart pumps blood that blood exerts pressure on the arteries it travels in, this pressure is called blood pressure. It is of two major types:-

Systolic blood pressure:- When the heart contracts or squeezes to pump the blood out to all organs it is termed as systolic b.p . Since it requires traveling all over the body to all organs this is thrown with a lot of force and hence it is higher than diastolic b.p.  i.e 120

Diastolic blood pressure:- After pumping, the heart relaxes so that all the blood that is to be oxygenated or purified comes back and gets filled up in the heart. This pressure is diastolic b.p. It should be 80.

 Thus, the normal range of blood pressure is 120/80.

Factors that Elevate Blood Pressure:-                                           

  • Excess tea/coffee:-  Tea contains tannins and coffee, chocolates, cold drinks contain caffeine which have stimulatory effect. As soon as we consume these they stimulate our system to constrict our blood vessels .Due to reduction in the diameter of the vessels the blood exerts more pressure to travel.  So , those who drink lots of tea /coffee have a tendency of high b.p
  • Physical activity:- Whenever we indulge in a lot of physical exercise our blood pressure rises since heart has to pump more blood to cope up with the activity level and provide energy for the same.
  • Stimulants:- Stimulating things like alcohol , cigarette , stress, spicy food , tea/coffee all raise blood pressure since they lead to constriction of the blood vessels.
  • Cholesterol:- Whenever the percentage of cholesterol rises in the blood it leads to its thickening. Thick blood exerts more pressure on the blood vessels it travels in and hence elevate the blood pressure.

Important note:- Blood pressure fluctuates very quickly therefore if proper diet regime is followed it can easily be managed with less or no medicine.

Published in East Delhi Update 

Diabetes-The Fact File by Akshita Aggarwal

First of all, I would like to thank all my readers for the overwhelming response to my previous Fact File Series. So, on public request here under I present the fact file on diabetes.

Diabetes mellitus commonly known as diabetes is one of the major lifestyle disorders that are gripping Indians. India has now become the largest diabetic pool in the world. A diabetic person can lead a normal life just like others if he practices few simple life style and dietary changes.

Some important concepts:-

Glycemic index:-  Glycemic index is the ability of any food substance to release glucose in blood in other words it is the measure of how quickly any food releases sugar or glucose in blood. Glycemic index value if less than 55 is safe for consumption. White bread has glycemic index equal to glucose that is 100.

Glycemic load:- Glycemic load is the amount of carbohydrate contained per 100g of a food substance.

Now how to use both of the above in food selection :-While selecting any food you must just not see its glycemic index but also focus on its glycemic load. For Example:-  carrot and watermelon both have high glycemic index but their glycemic load is very less i.e. the amount of carbohydrate contained in them is too less, so even if the carbohydrate in them raises blood sugar quickly the amount is too less to be dangerous for a diabetic person . To conclude they can safely have carrots and watermelon.

Hypoglycemia:- When the blood sugar falls below normal  it is termed as hypo glycemia. We all are mostly bothered about hyperglycemia or high blood sugar but diabetic persons are also prone to hypo glycemia specially those on insulin. It is very dangerous and can be identified by the symptoms like shivering , sweating , fainting etc. Therefore it is very important to divide the carbohydrates properly.

A tip:- In case of hypo glycemia just leave whatever you are doing and relax. Sit down or if possible lie down and eat a toffee or chocolate.

Artificial sweetners:- These are the carbohydrate complexes which our body cannot digest. We do not have enzyme to digest these sugars and thus they pass undigested from our body. As there is no digestion they do not contribute any calories to our diet. If taken as per the safe limit mentioned on the packs they are totally safe.

Published in Hello East Update  on 30/3/2012

Hydration-The Fact File By AKSHITA AGGARWAL

www.dietitianakshita.com

Water –the most important but most neglected nutrient.50-60% of our body weight is water. It acts as lubricant, medium, solvent &temperature regulator .We tend to take care of most of the nutrients but we forget to pay attention to the most vital component of our diet. Thus here I am presenting a fact file about  hydration .

Few sources of dehydration:-

  • Airplane:-The humidified air atmosphere that is maintained in airplanes cause insensible or unknown loss of water from our body through our skin. Our body loses around 1.5L in 3 hour flight. So, all the people who travel a lot by air must pay special attention to their hydration.
  • Body surface area-our body loses water by evaporation all the time through our skin. The taller the person the more is his/her body surface area hence more is his/her insensible loss of water. So, tall people must do little extra effort to keep themselves hydrated.
  • Beverages: - many people have the misconception that cold drinks, tea and coffee can be counted in their water intake. All the above along with alcohol are very dehydrating. So, people who are too much into alcohol, cold drinks or tea/coffee should drink extra water to make up for the losses.

Recommendation of water intake:-

  • Recommendation for water intake is 35-40ml/kg body weight of adults and 150-160ml/kg body weight for infants.
  • Never gulp a glass of water together especially after meals since it dilutes your digestive juices and hinders digestion. Water should be taken in small sips. keep sipping water throughout the day
  • Never take fluids with straw as we tend to gulp in the air which causes gas problems. Fluids should always be taken orally

                                                                                                                                          published in east delhi update dated 11 feb 2012

 Fibre – the fact file by AKSHITA AGGARWAL

Fibre is one of the most crutial nutrients in our diet. Generally we do not pay attention to it as we think it is not important but the reality is that fibre is one those nutrients which has been proven to be effective in prevention and cure of many diseases. let us now understand more about it through this fact file.

Types:-

  • Soluble fibre
  •  Insoluble fibre

Soluble fibre is the one which is partially digested in our intestines by the micro organisms present there. Therefore it has significance in affecting our blood parameters .

Insoluble fibre is the one which does not get digested at all in our body and passes out un digested. This type of fibre helps in maintaining a proper bowel movement as it adds bulk to the faeces.

BENEFITS:-

Diabetes:- Fibre helps in reducing blood sugar levels as it increases the time taken for digestion by that carbohydrate. So the sugars are released in a gradual manner helping to maintain normal blood sugar level.

Blood pressure:- Fibre also helps in reducing blood pressure.

Cholesterol:- fibre binds with bile acids  which are the products of cholesterol metabolism. Fibre binds with these acids and helps in their excretion and hence reduces elevated LDL levels. 

Digestion:- fibre is beneficial in prevention of constipation and problems like GERD , bloating etc. it helps in ensuring proper bowel movement . It helps in clearing the stomach. 

Obesity:- fibre is beneficial in reducing weight as high fibre foods are low in calories and take time to get digested. They give a feeling of fullness hence reduce over eating.

So, 30g fibre for females and 40 g fibre for males is recommended.

Published in Hello East Update   dated 7-3-2012

CELIAC DISEASE- THE FACT FILE

Celiac disease (CD) is a hereditary auto immune disorder produced by intolerance for Gluten, found in wheat, rye and barley. Therapy of CD is a lifelong Gluten-Free Diet (GFD).

On attending a parent dietician meet I encountered some common myths among the parents of newly diagnosed celiac disease patients. These doubts or misconceptions could affect the lives of the patients as well as their parents. Hence here I would like to throw light on some of the most common misbelieves and present a fact file of celiac disease.

  • A 3 year old child who was recently diagnosed of CD was kept isolated by his family for around a week because of the fear of contamination. This idea was developed from an observation of a family in which the father of a CD patient was also found to be a celiac patient. This diagnosis was done after the child was diagnosed of CD. This lead to the belief that the disease has spread from child to father. Here I would like to clarify that celiac disease is a hereditary disease i.e. it runs in families therefore it is not at all contagious. This disease occurs because of defective genes not infection. In this case the father was living with the symptoms from long time but the disease was not diagnosed. When the child was diagnosed with CD, the doctors suggested the parents to take the diagnostic tests too and that’s how father’s CD was diagnosed.
  • Another common myth encountered was that many parents blamed the mother for the development of this disease. This disease is hereditary disease and as already mentioned above it is because of defective genes. It could be equally because of father or the mother. Therefore CD in a child is not because there is some fault in the mother.
  • Common gluten containing grains are wheat, rye and barley. Attention is to be paid here that rye here does not refer to the small black oil seeds that we use for bagar or tarka.rye is a kind of cereal grain which is not consumed commonly in India.
    • Diagnosis:- There are basically two main diagnostic tests for celiac disease. One is the blood test for the autoantibodies called immunoglobulin A (IgA), anti-tissue transglutaminase (tTGA), and IgA anti-endomysium antibodies (AEA). Second is the small bowel biopsy during an endoscopy.  Small bowel biopsies are usually done to confirm the diagnosis, even when the blood tests are positive. If the patient has positive blood tests and but negative biopsy he does not have celiac disease. One fact that I would like to highlight is that some parents don’t undertake biopsy and start GFD on the basis of blood test. Chances of 10% error are there in blood tests. i.e. 10 out of 100 positive cases are actually non celiac .therefore biopsy is a must.
    • Another question raised during the meet was regarding the marriage of celiac patients. I would like to state it very clearly that a celiac patient is absolutely normal in all respects. Only thing to be kept in mind is GFD. There is no problem faced of any kind in their marital life and they lead a family life as normal as anybody else.
    • Hing:- One of the hidden sources of gluten in our diet is asafetida(hing). So, mothers of celiac children must keep this thing in mind while preparing any dal or vegetable.
    • Discontinuation of GFD:- Many a times parents of the celiac patient tend to think that their child is cured of celiac disease when its symptoms start subsiding or disappearing. Celiac disease is a life-long condition. It cannot be cured but only managed by a GFD. When a patient starts GFD his symptoms starts relieving. This is because of healing of the intestinal mucosa. The moment the patient discontinues the GFD because of the misconception that he is cured the effect of taking GFD from so long is nullified and the patient reaches back to square one. Therefore it is very important to stick to GFD.
    • Oats:- Oats are controversial. Based on numerous studies conducted with adults and children in Europe and the US, it appears that the majority of people with CD can tolerate oats. However, due to the potential for cross contamination with wheat during harvesting, milling, or processing, it is still recommended that individuals with CD avoid oats. Oats contain protein sequences similar to those in gluten that stimulate the immune response to wheat gluten and that why some celiac patients cannot tolerate oats. Therefore the CD patients can include oats in their GFD in small amounts under close invigilation of their dietician and doctor.
    • Wheat allergy:- Many people confuse CD with wheat allergy. They can be differentiated as CD is a permanent adverse reaction to gluten and this disease requires a lifelong restriction to gluten. Wheat Allergy on the other hand is an immune response to wheat protein and may cause some symptoms similar to that caused by CD but the symptoms will persist only for a short time after the consumption of wheat. The reaction has skin manifestations like urticaria, atopic eczema, angioedema, gastrointestinal manifestations like oral allergy syndrome, abdominal cramps, nausea, vomiting and respiratory symptoms like asthma and allergic rhinitis. These reactions may be mild to severe but it is limited and unlike CD does not cause damage to the intestinal lining. A reliable diagnostic test is therefore important in identifying CD from wheat allergy.
    •   Published in Times of India dated 13 august 2011