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Medical Science - Discussion

Discussion in 'Hangout' started by RaviHegde, Mar 15, 2015.

  1. Ravi_M

    Ravi_M Regolare

    Linea 1.3
    Hello @Aanand,
    I am visiting this thread after some gap. I have read some of your longish posts with interest, but not thoroughly, but I liked those.

    This post is to get some advice for me and maybe members in similar situation.

    I did a lipid profile last week and was surprised to get LDL >170 and HDL <30 (haven't seen the figures, but doctor told this while immediately prescribing a pill for a month - the doctor is reliable!). Surprised because I am quite fit, with 63 kg wt. at 55 age and 163 cm height and no tummy. I have been doing exercise for >20 years. I have been riding bicycle to office ( total 10 kms) daily for more than 3 months. My diet is quite simple, dal-roti-sabji with little oil-ghee, salad, fruits and frequent dose of sweets(laddus, chocolates).

    Two years ago, a lipid test indicated close to limit LDL and low HDL with their ratio beyond limit, but that was just after Deewali and doctor didn't prescribe any medicine.

    My query is this -- What error in my routine could have caused this? / Can such a thing happen due to some internal imbalance in body? / Or may be the test is in doubt and I should repeat it? / Or some heavy dinners prior to the test can result in this, meaning that it is not actual condition?

    Some people say that in spite of all other exercises, WALKING / RUNNING is essential to control LDL. Is it true?

    While I am searching elsewhere as well, I thought to share this here and see if some one can advise. It may be useful to others as well!
  2. Aanand

    Aanand Amatore

    1. I am not a doctor. Hence, I cannot dispense any advice. So, take what I say with a pinch of salt.
    2. Look up the various articles by Dr. Mercola regarding Cholesterol.
    3. Look up the presentation on YouTube by Dr. Peter Attia titled "The Straight Dope on Cholesterol"
    4. Weight Training to put on muscle may help. Suggest doing this under supervision.
    5. Avoiding processed carbohydrates, sugars and starches may help. Of course, nothing drastic should be done overnight.
    6. Getting adequate protein in daily diet may help. Eggs, chicken, or whey powder.
    7. Getting Omega-3 fatty acids in your diet may help. You can easily get alpha-linolenic acid (often abbreviated "ALA") from Flaxseed.
    While fish oil capsules contain the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

    163 cms and only 63kg of weight with no tummy? I envy you.
  3. Aanand

    Aanand Amatore

    Get this book:
    Read the reviews at:
    http://www.amazon.com/product-revie...ase Energy and Avoid Disease&showViewpoints=1
    Read his blog:
    See his videos on YouTube

    My summary of this book:
    South Asian Health Solution – A Summary
    The author is a doctor of Indian origin.
    He is an internal medicine specialist in the Silicon Valley of California where he treats a number of NRIs.
    The book is for Indians, particularly those living in the USA, but also those living elsewhere in the world.

    1. Insulin Resistance is the predominant cause of heart disease and related conditions in South Asians.
    Metabolic Syndrome is a cluster of insulin resistant conditions that can clue you in to early heart disease risk.
    Many standard risk factors and tools measured by physicians often overlook insulin resistance in South Asians.
    Attack insulin resistance early at the root, rather than medicating its branches.
    Insulin is the hormone that controls fat metabolism. Increasing body fat makes you more ‘insulin resistant’ and thus more susceptible to fat storage after a given meal. Conversely, reducing body fat makes you more ‘insulin resilient’ with less potential fat storage after a given meal.

    2. Inflammation is a far greater cause of heart disease and chronic disease than is high cholesterol.
    To reduce inflammation, eat an antioxidant-rich diet.
    (a) Increase activity.
    (b) Manage stress. (Also see 12 below)

    3. Cholesterol. Follow the six rules (given in the book) for interpreting cholesterol results to gain a better understanding of what your numbers mean.
    Don’t overemphasize LDL per se. It’s the size of LDL that matters.
    Total cholesterol alone is misleading. (It’s not useful in determining cardiovascular risk in most South Asians).
    Pay closer attention to triglycerides, HDL, and the following two ratios:
    (a) Total cholesterol-to-HDL ratio.
    (b) Triglyceride-to-HDL ratio.

    4. ‘Metabolic 6-pack’. These are a set of goals so termed by the author. Use these as a better overall assessment of heart and chronic disease risk. These are:
    (a) In general, trim your waist circumference to less than 90 cms (35 inches) in males and 80 cms (31 inches) in females. In particular, this should be about less than half your height.
    (b) Drop your triglyceride level to less than 100 mg/dl
    (c) Raise your HDL cholesterol above 40 mg/dl if you’re male and above 50 mg/dl if you’re female.
    (d) Reduce systolic BP (top number) at or below 120 and diastolic BP (bottom number) at or below 80 mm Hg.
    (e) Decrease fasting blood glucose below 100 mg/dl.
    And, decrease HbA1c less than 5.7%.
    (f) Get hs-CRP level below 1.0 mg/dl.

    5. High blood pressure is a ‘silent killer’ that normally does not cause symptoms.
    So, screen annually, and monitor frequently if there are abnormal values.
    (a) Insulin resistance, worsened by excessive carbohydrate consumption, is a major cause of hypertension in South Asians.
    (b) Know the link between carbohydrate consumption, insulin resistance and hypertension.
    (c) Go beyond ‘limit sodium in the diet’ to focus on optimizing the sodium-to-potassium ratio by reducing processed foods and increasing natural foods.
    (d) Do not underestimate the impact of stress on high blood pressure. Make stress management a key part of blood pressure control. (See 12 below).
    (e) Sedentary behavior can raise blood pressure levels.

    6. Sarcopenia (degenerative loss of muscle) is very common in South Asians and may contribute to insulin resistance.
    (a) Reverse the dangerous combination of increased body fat and reduced muscle by reducing excess carbohydrates in the diet, and incorporating strength training into your exercise program.
    (b) Metabolically Obese Normal Weight (MONW) i.e. ‘skinny fat’ is very common in South Asians. So, aim to lower the fat to muscle ratio.
    (c) Lowering body fat through carbohydrate reduction and increased physical activity can help improve inflammatory markers like an elevated hs-CRP and liver transaminase levels.

    7. Abdominal fat is a major cause of inflammation and chronic disease in South Asians. Visceral fat is directly correlated to heart attack risk because it releases chemicals that promote oxidation, inflammation, and coagulation.

    8. The three major weight loss myths are common barriers to weight loss.
    These are, firstly, ‘weight is gained when you eat more calories than you burn’, secondly ‘eat low-fat foods and you’ll lose excess weight and fat’, and thirdly ‘exercise alone helps you lose weight’.

    9. Diet.
    (a) Carbohydrates cause more body-fat storage than dietary-fat or proteins do. South Asians have a very high-carbohydrate diet that, amongst other negatives, promotes a chronic state of fatigue. (Also see 12 below). Cut carbohydrates down to less than 100 gms per day, in general. (Some may need to consume less than 50 gms). (One fist-size apple is about 20/25 gms of carbohydrates. So, don’t over-emphasize fruit.)
    (b) Fats. Forget about low-fat diets. Incorporate healthy fats (Omega-3 and Monounsaturated) into the diet and minimize Polyunsaturated fats.
    Remove the stigma about saturated fat.
    Instead, focus on cutting down on excess carbohydrates.
    Eliminate all trans-fats that are found in most South Asian restaurants and processed snacks.
    (c) Protein. Add enough protein like eggs, paneer, chicken.
    (d) High quality, natural, unprocessed sources of saturated fat and dietary cholesterol simply and unequivocally do not increase blood cholesterol and heart disease risk - especially when consumed in the context of a lower carbohydrate diet.
    (e) Calories. There’s no need to count/restrict calories. Eat when hungry and stop when you begin to feel satisfied i.e. follow your own natural instincts and hunger signals. Don’t force meal and snack timings.

    10. Follow the ‘CARBS’ approach to burning fat. Progressively, reduce and then cut out these from your diet. The major fat-promoting CARBS are:
    (a) C – Chapaties. This includes Indian flatbreads, and breads in general, even those made from (whole) wheat.
    (b) A – Aloo. This includes mainly potatoes and other starchy vegetables (peas, corn, and such like).
    (c) R – Rice. This includes rice and grains (barley, millet, semolina, sorghum, etc.).
    (d) B – Beans. This includes lentils, chickpeas, and kidney beans.
    (e) S – Sugar. This includes syrup and assorted sweet-tasting foods and beverages.

    11. Exercise to become healthier.
    Aim to increase strength, endurance, speed, flexibility, balance and agility.
    (a) Reduce sitting time. (Sitting is a serious health risk).
    (b) If you are unmotivated and too tired to exercise, it’s likely due to insulin resistance and excess carbohydrate intake. Tackle your diet first and then incorporate exercise.
    (c) Begin with the aim of doing 5000 steps daily, 20 squats, 10 lunges, 10 pushups and 10 surya-namaskars. Progressively increase these.
    (d) Then, gradually build up by incorporating resistance training, yoga and conditioning exercises.

    12. Reduce fatigue by managing the 5 S-factors, i.e. Stress, Sugar/Starch, Sleep, Substances (e.g. caffeine, alcohol, medications), Sedentary lifestyle. (Also see 9(a) above).
    Make stress reduction a high priority. (Refer to Inflammation mentioned in 2 above).
    Chronic stress should not be considered a normal part of life.
    Look out for nutritional anemia in vegetarians.

    13. Liver Enzyme (Function) Tests. Get this done annually, at least for AST and ALT.

    14. Kidneys Test. Get this done annually. This would include a urine test for albumin and a blood test for creatinine.

    (a) The book has a number of patients’ cases that help explain the above points.
    (b) Also, the book has one chapter each on South Asian women, children and the elderly.
    (c) Additionally, the book has some Indian recipes – reinvented to match the recommendations in the book.
    Ravi_M, gpunto75 and asimpleson like this.
  4. asimpleson

    asimpleson Esperto

    Linea 1.3
    rusticnomad likes this.
  5. Aanand

    Aanand Amatore

    Thanks asimpleson.
  6. Aanand

    Aanand Amatore

    Reference the book South Asian Health Solution recommended in post 73 above.
    At the end of each chapter, there are some bullet points 'For Professionals'.
    These may well be interesting to our doctors here.

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