What is Driving us to Eat More and Fall Sick?

Eating, long held to be an essential act of replenishment energy we spend at work, is now emerging as the major killer of urban India fueling the epidemics of obesity, diabetes and heart disease and fatty liver.

Sounds paradoxical, but true: it is no longer lack of food or starvation, but consumption of amounts in excess of what we need that is killing us.

Scientists have identified patterns of eating behavior that could explain the present phenomenon.

“Homeostatic” eating is when we consume food to fulfill the calorie and protein requirements of the body. After a hard day’s labor, we eat to satisfy our hunger, consuming cereals, pulses, regional seasonal veggies or what-ever come our way. We are not fussy about the taste of food, but eat to regenerate energy and prepare ourselves for another day’s work. Most such eaters do not suffer from obesity, diabetes, hypertension, coronary artery disease or fatty liver.

It is ”Hedonic or “pleasure” eating is what is in vogue now. As many of us prospered, we started relishing “good” food; preparations that would attract us and satisfy our taste buds. There came “fast foods” and pastries that were carefully crafted and prepared to tickle not just one type of taste buds ( sweet or salt) at a time , but several types (salt, sweet, hot, sour) at one go. No wonder once we put a tasty “masala” potato wafer, “khatta meetha” namkeen or chocolates (sweet, salt, bitter) in our mouths, we cannot stop ourselves from reaching out for more!

Hedonic eating has become so pervasive that we fail to realize how difficult it has become to say “NO” when offered an attractive pastry or cookie or salted nuts. And though we leave home after a heavy breakfast, we are unable to restrain when the bowl of salted cashews is passed around the office table!

The easy access, availability in abundance of “Pleasure foods”, even in small towns, coupled with sedentary life style have joined hands and fueling the present surge in metabolic syndrome (overweight, diabetes, hypertension, increased cholesterol in blood, propensity for heart disease) and fatty liver disease. 

And the food industry is discovering more innovative ways to lure us on!

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Seasonal Affective Disorders or Winter Blues

As the days shorten with the coming of winter, many people begin their struggle with their drooping moods. 

If some of you are feeling low, suffering from fatigue and having a disturbed sleep cycle these days, you could be suffering from “Winter Blues”.  In foggy wintery times, when the days are not just cold, but dull and dark, many begin to  feel lethargic, gloomy and down overall. 

Plunging moods during winter that spring back with the coming of spring is a well-recognised entity called Seasonal Affective Disorder or SAD. It is characterized by feelings of sadness, dullness and negative thoughts that affect normal relationships at home or work. Usually seen in women, SAD sets in every year when the sun starts loosing its brightness to fog and clouds, the day begins to shorten and the temperature dipd and remains low.

The primary culprit of both the winter blues and SAD is the lower level of natural sunlight we are exposed to in winter. This leads to:

1. Disruptions in circadian rhythms (your body’s internal clock), which help control sleep-wake cycles
2. Alterations in melatonin, a hormone associated with both mood and sleep, and serotonin.

Some of the common symptoms are

• Feeling less social than usual, depressed, or sad.

• Difficulty taking initiative, low activity levels, struggling to work at home or office
• Loss of interest in hobbies you typically enjoy
• Withdrawing and isolating yourself from friends and family
• Difficulty sleeping

• Struggling to focus and perform at work or home
• Having thoughts of worthlessness

How to Fight Winter Blues?

Sunlight: It is mportant to get outside whenever the sun is out. Some prefer to go to sunny places to spend the winter.

Light therapy that replicates natural light with light boxes by using white fluorescent bulbs to mimic sunlight, has been proven to help . It regulates the release of melatonin.

Exercise: Research consistently shows a strong exercise-mental health connection, particularly for those with depression. It can increase serotonin and endorphins, which both affect mood. Moderate exercise of at least 30 minutes most days of the week may provide the biggest mood boost.

Medication: If more conservative treatments are not providing adequate relief, you may need antidepressants to regulate the chemical imbalances associated with the winter blues and SAD. 

If you spot it early you don’t have to waste the next few months. Act quickly.

Balancing Skill and Health

One of the disheartening sights is the unusually large number of wheelchairs lined up at arrival terminals at airports when a flight from India arrives. 

With our average life expectancy being around just 70, do we get infirm and immobile early, taking to the wheel chair or seeking physical support too easily as we grow old? And if we do show signs of aging early, is it just “genes”, or how we looked after ourselves in the preceding decades leading up to it?

Dr Michael Roizen from the Cleveland Clinic, an expert on longevity and aging, points out that our ability to maintain balance is a good indicator of how long and healthy we are and can expect to live. 

He describes a “one leg test”, that is a senior person’s ability to stand on one leg for 10 seconds; those who can achieve the feat are three times more likely to live longer and healthier lives than their same-aged counterparts who could not!

Holding balance indicates three aspects of a person’s health. For one it gives an idea about the strength of our leg, spine and body muscles. 

Second, the act of balancing requires nerves, muscles, eyes, vestibular system (behind our ears) and brain to fire and function in a balanced and coordinated manner, and provides a quick assessment of the state of neurological decline that accompanies aging. 

And third, patients who suffer from neuropathies, especially diabetics, find it hard to perceive sensations from the legs, and hence their balance.

He noted that those who could hold their balance, were more alert and had better cognition or learning abilities.

How then can we hold on and strengthen our balancing skill? The tree-pose or Vrikshasan asana seems tailored for just that. 

Other methods include toe-heel walks, walking on a straight line or walking up stairs without holding the rails. 

Walking on a wall or a beam, or in its most challenging form, on a rope, is what it is all about. Many elders would reminisce how they used to do it then when they were young and active. Wouldn’t of course advise my senior compatriots to revisit their agile childhoods now!

Giving up too easily and taking to the wheel chair could enhance our motor deterioration. Regular practice could slow our age-related  decline in movement, and of our balancing skills. 

Car Crashes, Seat Belts and Deaths.

The “health related” news that shook most of us up last week was undoubtedly that of how the two front seat passengers escaped death in a high speeding high-end car crash while the two back seat passengers died instantaneously.

This fateful road traffic accident caught much media attention partly due to the high-profile passenger who died in the crash being Mr Cyrus Mistry, erstwhile chairman of Tata Sons and a young business tycoon in his mid-fifties, and partly because the car that crashed was a high-end Mercedes known for its high manufacturing and safety standards.

The question that kept cropping up repeatedly is why did the two back-seat occupants die while the front seaters (driver and partner) managed to escape, and the answer is pointing to the only variable:  SEAT BELTS!

The front seaters were wearing seat belts, while the back-seat passengers were not, and it is being speculated that when a car travelling at high speed suddenly crashes and comes to halt, those not wearing seat belts are flung in front against the front seats, steering wheel dash board or wind screen as they have nothing to restrain them.

Wearing seat belts for front-seaters has been mandatory in India now for quite a while, and thanks to checking by traffic police, most drivers and front seat passengers have come around to accepting and implementing the practice. Many of us however did not pay much attention or follow seat-belt rules while sitting at the back.

Most developed nations follow strict seat-belt protocols for backseat passengers in their countries. This unfortunate accident has served as a harsh reminder that seat belts are essential for protection, not just for front seat, but for back seat passengers too. 

There are over 150,000 annual road traffic accident (RTA) fatalities in India, which works out to around 1200 accidents per day. Research shows that helmets for two wheelers, and seat-belts for car-passengers are the first and main lines of defense, the latter reducing fatality rates by 50%. Air bags are less important and work when the body is restrained by seat-belts.

It is time we learnt our lesson from this tragedy and tightened our seatbelts in the back seats too.

Can Heart Attacks be induced by Stress?

The recent sudden death of the 53-year old singer KK of a heart attack after a grueling evening performance in an overcrowded hall has shocked not just the public but medical scientists too.

The circumstances do not seem to leave much space for doubt. He was a non-smoker, and was not known to suffer from the usual known co-morbidities such as diabetes, hypertension, obesity, high cholesterol or previously known heart condition. Many who knew him personally, in fact testified on television that he was quite a health freak, with no “bad” habits.

What then could have caused his sudden fatal heart attack? Circumstances are clearly suggesting “stress”, that nebulous factor scientists have not yet learnt to define and measure. There were 7000 people thronging an auditorium meant for 2500 and it was unusually hot in there due to lack of adequate air-conditioning. The performance had been long requiring him to sing 20 songs back to back, perhaps as a part of the contract. And to top it all, he had to put on a friendly, high energy appearance and please the audience while he was clearly uncomfortable and sweating!

Medical science often tends to deny something that it finds it difficult to prove or measure. Although it may look fairly evident to the common on-looker. Let me therefore share another episode from the last fortnight.

Joe Garcia, the 47-year-old husband of one of the two teachers slain along with 19 children, in the devastating school shoot out at Uvalde, Texas, died of heart attack the next morning. The circumstances compel us to invoke that nebulous trigger again: It was not just the loss of his wife of over 24 years,  but the agony and unexpected manner in which it all happened.

He died suddenly soon after attending the memorial service of his wife, from what the press described aptly as “of a broken heart”. 

Observations form real-life strongly indicate that unusual stress, physical, mental or emotional, can precede or induce a heart attack. Cardiac events are the commonest cause of death across the world, particularly in urban India.

Learning how to manage stress may not sound all that scientifically erudite, but awareness, insight and  preventive strategies to deal with it may hold the key to our survival when conventional medical knowledge is not measuring up.

Slowing Down the Racing Mind

One of the most difficult challenges most of us face is slowing down the mind when it decides to go on a racing spree, looping repeatedly around one thought that keeps bobbing up and occupying center stage.

These thoughts are often frightful and generate a good deal of anxiety. They are notorious for robbing us of our sleep. And many a time, we desperately yearn for “rest” from our own mind.

Everyone has faced phases of obstinate “negative” thinking. Some common situations are

1. Frequent constant worrying about the welfare of a child, parent or spouse; irrational fear of an accident during a child’s first school trip, or the fear of an air crash during your spouse’s first solo trip that refuse to go away.

• Worrying about the uncertain outcome of a deal or decision or outcome, at work

• Anxiety over what might be the response from an advance you have made towards a person you desire

• Ruminating and frustrating over an unexpected response from a friend or colleague or boss

• Ruminating and regretting over a mistake in the exam or business, and blaming self endlessly for the stupid act.

These are some situations where one wishes one could press a switch to turn off the unstoppable volley of thoughts.

Distraction is of course a good option, provided it works. That is, you are able to disengage the negative spiral of thoughts and turn to something else.

Millions have used the Jedi mind trick and found it useful to slow down the mind and give the much-needed break from your stressful thoughts.

The method merely requires you to ask yourself, “WHAT IS MY NEXT THOUGHT GOING TO BE?” You will then observe your thought and let it pass, leaving your mind clear. Allow another unrelated thought to come in. You may repeat the process as many times as you want, till your mind becomes clear.

This developed by experts in Positive Psychology and Cognitive Behavior Therapy, mutes your racing brain as if putting it on the “airplane mode”. It may obviate the need for a pill or a drink It is there, but numbed and in control, allowing you to focus it on something else.

Try it and share your experience.

Bullying: Could Bystanders Help

It is difficult to believe that bullying has ceased to exist at workplace or educational institutions.

Recent studies from across the globe have revealed that 60 to 80% of interviewed people admitted witnessing bullying in their organizations. When administrators or teachers vehemently deny the existence of this menace in their institutions, it is often the “Ostrich phenomenon” wherein it does not seem to happen because we choose to keep our eyes shut and not see it.

Bullying occurs when a student or employee is subjected to repeated negative behaviors that harass, exclude, humiliate or frighten him, and may range from physical violence to the subtle mocking, ridiculing, excluding or ostracizing conducts. It can seriously impact the victim’s health – physical or mental, and can sometimes lead to harm or suicide.

Up until now, the conventional approach to tackling bullying has been to formulate strict rules, try and catch the bully, and punish him. This requires someone to stick his neck out and report, risking retaliation and vengeance. Further, what this approach does is merely push bullying underground and changing the format to psycho-social than physical forms.

Recent research is shifting the focus to the role of bystanders in controlling the practice. There are 2 broad types, each with 2 subtypes:

1. Constructive:
   1.  The Active Constructive bystanders actively discourage or confront the bully or report him or her to the authorities. If they are in significant numbers, bullies tend to become the minorities, and often change their behavior.
   2. The Passive Constructive ones may not directly take on the bully, but empathize and support the victim, mitigating some of the trauma caused.
2. Destructive:
   1. The Active Destructive type encourages the bully, often joining him in the act. This is how “bully groups” are formed and expand in size, each one member venting his bullying instinct on the victim.
   2. The Passive Destructive ones, who often watch but do nothing, often finding the whole episode amusing, thus encouraging the bully.

Bullying is a psycho-social disease, and its control requires much more than strict rules and action. Sensitizing and converting workers or students to play constructive anti-bullying roles could be the workplace environment changer.

How much Water to Drink Daily?

The answer just cannot be a single fixed number that applies to everyone.

Indian summer is when one has to drink plenty of water to remain healthy, hydrated and energetic. Most scientific recommendations range from a minimum of 3.5 liters in men to 2 liters in women. As a general tip, at least 8 glasses would be a reasonable rule of thumb in normal circumstances.

This may vary from somewhat less if one is living a sedentary life and spending most time in an air-conditioned environment, to much more if one is engaged in manual work under the hot sun. The body may sometimes require 10 liters (40 glasses) per day. The requirement goes up during fever, sweating, diarrhea, vomiting or fasts.

Our thirst usually serves as a good monitor, but relying only on it can be misleading at times as the sensation is not always heeded during a busy day, and secondly, it kicks in AFTER the body has started drying up.

Beating Indian summer is indeed a challenge. A good way is to start the day with 3-4 glasses of water, and drink another 2-8 glasses during the day, without waiting for “thirst” to remind you.

If you are passing urine 3-4 times a day, and it is colorless or light yellow, it usually means that your water intake is adequate. If it tends to be dark and scanty, it suggests inadequate water intake. You need to take heed.

Adequate water intake helps in the following ways:

• Keeps the body hydrated (does not let it dry up and wilt)
• Gets rid of wastes through urination, perspiration and bowel movements
• Keeps your temperature normal
• Lubricates and cushions joints
• Protects sensitive tissues, especially the kidneys

On rare occasions, excess water intake can be detrimental such as in congestive heart failure, some forms of chronic kidney and liver disease and low sodium states..

If you are feeling fatigued and irritable all day at work, it could be due to inadequate water in your body. Making it up by evening is not good enough. Start charging yourself with a few glasses of water in the morning before stepping out and before you start feeling thirsty, and see the difference.

But please avoid using plastic water bottles and make the earth warmer!

Sugar Addiction and Fatty Liver

The word “addiction” brings to mind alcohol, tobacco and psychotropic drugs. But sugar is emerging as a new addiction that we might be ignoring, and passing off as just an innocuous fancy.

Many of us describe ourselves as having a “sweet tooth”, and indulge our taste buds and liver with excess of sugar.

In a recently concluded National Conclave on Fatty Liver Disease, doctors described how true addiction to sugar and sugary drinks is emerging as a major cause for concern.

Statistics are worrying. Several Indian hepatologists reported excess fat in the liver of up to 50% of Indians, especially those living in cities. The Body mass Index (BMI) of urban school children have been rising with over 30 % being overweight. And what seems to be the common denominator is excess consumption of sugars, sweets and fruit juices.

Addiction to sugar is now established. Those suffering from it show all the typical symptoms from regular “wants”, to increasing demands, to craving. And if one is to go without sweets for a day or two, show anger and irritability (withdrawal) as well.

A special subset of sugar addiction is FRUCTO-HOLISM, fructose being the predominant sugar in fruits and juices. Scientists have noticed that that fructose sugar causes more accumulation of fat in the liver compared with the regular SUCROSE.

In a chilling account of what we have always considered innocuous, and perhaps even healthy, excess fructose have been shown to get converted to fat and deposited in the liver, causing fatty liver.

But why should that worry us? It is now clear that those who have extra fat in the liver are at increased risk of developing the METABOLIC SYNDROME: a conglomeration of excess body weight, diabetes, hypertension, high blood lipids and all of them translating into increased risk of cardio-vascular disease.

Cardiovascular (heart attacks) and metabolic diseases (diabetes) have emerged as the commonest cause (60%) of death and ill health in India. And what might be fueling them could be our social practice and indulgence in sweets and fruit juices. “It is time we took note and changed our practices and preferences.

Parties, Social Gatherings & Happiness Hormones

Do you feel refreshed and rejuvenated after attending a social gathering, meeting up with old friends and catching up on chatting!

Most people do, as humans have been describes as an ultra-social species, requiring human interactions not just for happiness, but well-being and survival too.

What could be the bio-molecular basis to explain how social gatherings influence our mood and happiness?

It is now fairly clear that feelings and mood are determined by levels and interplay between four HAPPY HORMONES: Serotonin, Dopamine, oxytocin and Endorphins. They however are somewhat specific in what they do.

Oxytocin, referred to as “LOVE HORMONE” is the one that plays a crucial role in our bonding, love and trust. You can feel its gush when you look into the loving eyes of your partner. Why dog-lovers become so fond of their pets is because they get surges of oxytocin when they look into their eyes.

Meeting old friends and looking at their smiling “eyes” (yes, love and empathy are expressed better through eyes than stretched mouths and lips!) generates outpouring of oxytocin.

This hormone, in turn causes release of SEROTONIN, the chief chemical responsible for the happy feeling. It stabilizes the mood and creates a sense of well-being making one linger on at a good party. It also makes one feel cheerful through the night and the next day.

Party addicts get their periodic stimulation by unfailingly attending social gatherings. If deprived of parties, they become gloomy, depressed and start sulking.

The other two hormones are Dopamine and Endorphins; Dopamine is the neurotransmitter that provides pleasure sensation, say while playing or watching an exciting game or movie. It is also called the reward hormone, as we experience surges of this chemical when we have achieved or succeeded at something, like cracking an examination.

Endorphins give relief from pain and provides the sensation of relaxation. They play a crucial role in “coping” and gives the “cool” feeling.

Interestingly, serotonin or the “feel good hormone” is produced predominantly in the gut, making scientists wonder whether serotonin linked happiness is felt by the brain (the mind is believed to reside in the brain) or at the level of the gut!)

While modern science at this stage might scoff at the idea of the gut replacing the brain as being the center of our happiness ‘chakra’, it is struggling to reconcile two baffling bits of evidence. One, there is unquestionably several times more of these neuro-hormones produced and found in the gut than in the brain. Why would nature do this if brain was their target organ?

The other is the puzzling question: why “successful” parties have food as an essential component?

Parties and social gatherings are indeed crucial to our well-being and happiness. Many are realizing this now more than ever before, after the two long years of social isolation imposed by the Covid pandemic.

Think twice before refusing to go for an interesting party with good old friends!