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| HEALTH TRIBUNE | Wednesday, July 31, 2002, Chandigarh, India |
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Eating little & often a useful tactic
Rabies: facts and misconceptions AYURVEDA & YOU INFO CAPSULE
Against early morning exercise |
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What to eat and what to avoid During my two-year tenure with the Indian cricket team as doctor-cum-physiotherapist the most daunting task was looking after the players’ “diet”. Though they were well aware of the wrongs and rights, implementation needed a strict vigil. The difficulty arose when during dinner time, official invitations had to be attended to — or a friendly invitation. Under such circumstances, I had to contact the host and request them to prepare the food according to the players’ requirement. Problems arose when vegetarians had few alternatives to pick from when abroad. During the tour to New Zealand the team management had to arrange the food during matches from the local Indian restaurant. It was heartening though to see the Kiwis relishing spicy Indian preparations than their own food. Food fads is a recent trend even in Indian sports although teams from abroad have always been very particular, at times even cynical. I still recollect an incident during India’s Test match against Australia at Chennai when Shane Warne created an unnecessary furore in the Press by issuing a statement regarding the unavailability of baked beans in the hotel. Cans of baked beans were immediately dispatched from Australia, although this could have easily been taken care of by the Indian hotel authorities. In all games, at international levels where a lot of money and honour is at stake in addition to the correct training methods, physical fitness and psychological sessions for mental toughness, diet has become the key factor in achieving optimal sporting performance. Carbohydrates and fats are the two main sources of energy whereas proteins make a relatively small contribution. Carbohydrates is the body’s limiting fuel, and when stores (glycogen) are depleted fatigue sets in. It is well established that a high carbohydrate diet will allow rapid recovery of glycogen stores and prolong the time of exhaustion during endurance exercise. During general training the carbohydrate needs will be the highest. At other times it is important to ensure enough for recovery, and to optimise blood glucose level. Carbohydrate is stored in the liver and skeletal muscle in the form of glycogen. When required for energy, glycogen is released and broken down to provide the glucose necessary for energy. Glycogen stores are limited and need to be replenished daily. The average amount of energy available from stored carbohydrate is only 8.4Mj (2000 kcal), which would provide fuel for a run of approximately 40 km. Endurance training increases the capacity of the muscles to store
glycogen. Untrained individuals have muscle glycogen stores which may be even half than the trained individuals. While all sportspersons should be aiming for a diet with at least 60 per cent of energy from carbohydrate, it is easier to estimate individual needs based on body size. During light training and rest days a sports man requires around 5 gm of carbohydrate per kg body-weight. This requirement increases up to 7 gm of carbohydrate per kg body-weight during the intensive training session.
Some tips
Bread, rice, potatoes, sweet corn, noodles, fresh/ dried/ canned/ banana, grapes, oranges, peaches, plums, legumes — baked beans and lentils, low fat yogurt/milk, honey, jam, breakfast cereals like oats/porridge. Fat provides the body’s largest store of potential energy. The energy storage capacity of fat is more than twice the equivalent quantity of carbohydrates or protein. Body fat content varies considerably from athlete to athlete. However, even the leanest athlete, who may have only 7 kg of body fat, would have enough energy stored as fat to run up to 750 miles (1200 km). We all now know that a high fat diet is a problem for heart disease and certain cancers. The most important aspect is that a high fat diet usually means a diet that is too low in carbohydrate. For a sports man this translates to low performance. To meet your carbohydrate needs you should be aiming to eat no more than 30 per cent of total energy from fats each day. For most of you this will mean no more than 80 to 100 gms of fat each day. If you are trying to reduce your body fat levels, you should be aiming for less than this. A low fat diet can be easily achieved by looking for low fat alternatives where available or substituting carbohydrate-rich foods in place of high fat foods.
Useful suggestions (1) Use a nonstick pan for cooking. Spray a little cooking spray rather than frying in oil. (2) Micro-waving food generally requires little or no fat, and retains the nutritional value of food well. (3) Instead of adding butter or margarine to bread or toast, use honey or jam, tomato sauce, chutney. (4) Choose chicken or fish rather than red meats, salamis, sausages, etc. Have a boiled potato or jeera aaloo rather than chips. Include plenty of low-fat dairy foods, particularly cheese, and look for light icecream and yoghurts. (5) Avoid fried food generally and look for alternatives, cooked without added fats and oils. The contribution of protein to energy production is generally small, contributing between 5 per cent and 10 per cent of total energy needs. Energy is obtained from the breakdown of dietary and tissue protein to amino acid, which are then converted to glucose. The contribution of protein to total energy increase with the duration of exercise and with the depletion of carbohydrate stores. Proteins are obtained through beans, lentils, chicken, fish, low fat, yogurt, etc. The fuel required by the body depends on the intensity and duration of the exercise. In high intensity exercise of short duration — one to two minutes — almost all energy is supplied from glycogen stored in the muscle. Fat does not provide a significant energy source as the breakdown of fat is too slow to meet the immediate requirement. For the long-duration exercises, fat supplies a much higher proportion of energy by releasing free fatty acid. The longer the time spent in exercising, the greater the contribution of fat as a fuel. In a nutshell, an Indian sports man should take carbohydrates in his/her diet as the main component. The fat requirement which is less than 30 per cent is met from the traditional Indian food, which is basically cooked in oil. The writer is a former doctor/ physiotherapist of the Indian cricket team.
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Eating little & often a useful tactic My work and social life being what they are, it is not uncommon for me to find myself sitting down to eat in some restaurant or other. Nice though this is, it’s also true that eating establishments are not renowned for offering a large and varied selection of healthy, nutritionally balanced meals. Despite knowing better, I can still find myself tempted by fat-filled entrees and sugar-charged desserts. Over the years, I have discovered cunning ways with which to navigate the nutritional minefield that eating out presents. Put them into practice, and you may well find that you can pile in the food without piling on the kilos. Listen to most doctors and dieticians and you would be forgiven for believing that the principle cause of excess weight is simply eating too much. With this thought firmly entrenched in our minds, many of us will attempt to compensate for an indulgent meal out by eating more frugally at other times. The odd skipped meal and a ban on between-meal snacking are common tactics used when a blowout is anticipated. However, cutting back on food is a recipe for disaster. Skipping meals and eschewing snacks is a sure-fire way to sharpen the appetite. Problem is, once we have sat down in a restaurant, it’s amazing the ferocity with which hunger can bite. Two or three bread rolls and a pat of butter can disappear rapid style. Plus, a raging appetite can make ordering with any degree of self-control very difficult - it can take an iron will to choose salade nicoise over steak and chips. In my experience, a better tactic is not to eat less before eating out, but more. Regular meals, perhaps with healthy snacking in between, is one sure way to keep the appetite in check, and this can make choosing healthily in a restaurant a veritable breeze. In practice, I have found that eating a half-decent breakfast is often a critical factor in controlling appetite throughout the day. A bowl of muesli with yogurt and fresh fruit should do the trick. Snacks of fresh fruit and perhaps a handful of nuts are a useful ploy, too. Good times for a spot of re-fuelling are the late morning and afternoon. Hungry or not, eating a healthy snack at these times keeps us out of a lot of trouble later on. Tactical eating, I call it. With a little something already in the stomach, a salad-based starter and lean main course accompanied by plenty of veg may be enough to satisfy your appetite. You may wonder what effect grazing your way through the day will have on your waistline. Fret not — studies show that eating little and often is a useful tactic in keeping weight in check. The Observer
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Rabies: facts and misconceptions Lick or bite by a healthy and vaccinated dog who has had no contact with a stray dog or a rabies-suspected animal cannot be a cause of rabies. Even a healthy street dog, when it bites, may not cause rabies. In other words, all stray dogs are not rabid. But since they are not vaccinated and their history is unknown, their chances of contracting rabies are. If every dog was a carrier of rabies, as the myth exists, the incidence of rabies would have been unimaginably high at least among the people living in villages and old cities where stray dogs are the natural inhabitants of every street, lane, roadside dhaba, sweet shop and other market places, etc. Interestingly, even in a city like Chandigarh the stray dog scene is almost the same and is growing for the last few years. It is wrong to presume that every dog is a carrier of rabies. The carrier status in dogs is yet not convincingly established. Although the risk of rabies is high from stray and unvaccinated dogs, not every human being or dog bitten by suspected rabid animals will develop the disease. It is estimated that about 50 per cent of the people bitten will never know about the disease even if they received no treatment. However, there should not be a compromise in taking all preventive measures once the animal in question is suspected. How badly and where the victim is bitten, will certainly affect the outcome, as well as the victims state of health at the time of bite and the amount of virus which was present in the bitters saliva. Bites on the head and the face are most dangerous because of the proximity to the brain. Prompt post-exposure treatment helps in keeping the death rate low. Vaccinated vs unvaccinated dogs Chances of a properly vaccinated dog developing rabies are remote. A pet dog duly vaccinated with a good vaccine in the right manner has enough protective antibodies to protect itself even when exposed to or bitten by a suspected or active rabid dog/animal. Post-bite treatment in dogs has a far better success rate in vaccinated dogs than unvaccinated. It is recommended that the unvaccinated dog when suspected for rabies should not be given any post-bite treatment and must be observed for 10-14 days. If the clinical symptoms are suggestive, the dog should be sacrificed and confirmed for rabies in the nearest laboratory. In case of the furious form of rabies, the dog/animal should be shot or destroyed at the earliest and full treatment should be initiated for the victim, whether man or animal at the earliest. In the case of street dog, if available for observation, whether lick or bite even by a healthy looking dog, the preventive immunisation must be started because of its zero vaccinated status and unknown history. Many a times the dog in question, when unvaccinated, has to be sacrificed to confirm the diagnosis. This is a very hard decision when the dog is your pet. If the pet owner is unwilling to do this, the pet should be caged and kept under strict isolation for six weeks. If the exposed dog has a good vaccination status there is no need for taking this harsh decision; it should be revaccinated and observed. (To be concluded) |
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AYURVEDA & YOU Abhya (which allays the fear of illness), pathya (beneficial in all diseases) and vyastha (which helps gains longevity), that is how haritaki has been named in ancient Sanskrit literature. Popularly known as hararh and scientifically as terminalia chebula, haritaki is one of the oldest herbs known to mankind. Its moderate-sized deciduous tree is found throughout the greater part of India and it is the dry pulp of its fruit which is used as medicine. Haritaki fruit is predominantly astringent but at the same time is also bitter, sweet, pungent and sour in taste and light, dry and hot in effect. It pacifies vata, pitta and kapha, all the three doshas. Ayurveda has differentiated seven types of haritaki which include varieties ranging from its different stages of ripeness to the species found according to the diverse places of its origin. Haritaki has been abundantly praised for its extraordinary healing properties. Ancient texts have described it to be gentle and caring like a mother. With a vast array of action on human body, haritaki is primarily digestive, carminative and laxative in nature. It stimulates liver functions, corrects metabolism, kills intestinal worms and has tonic effect on all body organs, including the lungs, heart and brain. Haritaki is also known for its anti-inflammatory, wound healer, anti-obesity, aphrodisiac and, above all, rejuvenating properties. In its efficacy and usefulness haritaki has been considered to be equal to that of amla. The famous Charak Samhita has described it as a drug of choice in the loss of appetite, indigestion, constipation, upward flow of abdominal gas, sprue and piles. Besides curing the swelling of liver and spleen, haritaki is also beneficial in cough, asthma, hiccup, anemia, jaundice. sinusitis and diseases of the urinary tract. Haritaki helps to dissolve glandular swellings and also has salutary effect in conditions arising due to the excessive use of alcohol. Haritaki is therapeutically prescribed as a preventive and restorative measure. Though contra-indicated in pregnancy and also forbidden for prolonged use, ayurvedic texts have described different methods to use haritaki in different seasons and diseases. During summer it should be taken with jaggery. In the rainy season, winter and spring, haritaki is advised to be taken with rock salt, ginger and honey, respectively. In the diseases arising due to vitiated vata, haritaki should be taken with ghee, in pitta diseases with sugar and in kapha problems it is indicated to be used with salt. As a household remedy, haritaki is best used to clear the bowels. If it is combined with a equal quantity of amla and baherha a unique combination is achieved which is known as triphla. Ayurvedic texts have described several uses of triphla, which, besides being attributed with anti-aging properties, is also given independently or as an adjunct to cure a number of diseases. There are numerous classic ayurvedic medicines where haritaki is used as a chief ingredient, Chitrak haritaki (sinusitis), vyaghri haritaki (asthma), pathyadi qwath (migraine), abhyarishta (piles), vaishvanar churna (rheumatism) lead a vast list of classic formulae which puts haritaki at an exalted place in ayurveda. Apart from its easy availability and low cost, it is the unmatched efficacy of this herb which even today makes its use as popular as it was thousands of years ago. The writer is an Ayurvedic consultant based at Ludhiana. |
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INFO
CAPSULE New
Delhi: Diabetes, a common disease prevalent globally, has no cure so far; it can only be controlled. But an Australian company has claimed that researchers using its embryonic stem cell lines have made a breakthrough that could lead to a cure by 2009. The US collaborators of the Melbourne-based biotechnology company have cured diabetic mice using pancreas cells grown from embryonic stem cells. The company was now negotiating the intellectual property details of the process. The breakthrough/using embryonic stem cell lines owned by it offered hope to the world’s 300 million diabetics.
INFA Waiting for heart transplant Washington: Hearts are in short supply — each year about 6,000 to 8,000 Americans are told that they need new hearts to survive, but only about 2,500 hearts are transplanted, and many people
simply die waiting. In the complicated world of heart transplantation, actually making it to the waiting list is considered a hopeful sign. These “lucky” patients also must be “healthy” enough to be considered good candidates for a transplant, meaning their doctors think they still are strong enough to survive the rigours of surgery. Then, if they make it through surgery, they face a lifetime of taking powerful drugs that suppress their bodies’ immune systems as well as other drugs that keep cholesterol and blood pressure within normal ranges. When patients make it to the top of list, they usually are moved into special units as transplant centres. These units become home, sometimes for months and months.
UPI Viagra for lung disease London: Doctors are giving infants and babies the anti-impotency drug Viagra to save them from a life-threatening lung condition even though it has not been tested on children, a magazine has said. The drug, produced by US pharmaceutical giant Pfizer, has already been used to treat a small number of children with pulmonary hypertension (PHT) in India, the USA, Canada and Britain with promising results. “Critics have expressed serious concern at the fact that no clinical trials have taken place for this use of the drug and at the wide variation in doses used,” New Scientist magazine said in its online version.
Reuters Clap for good health New
Delhi: Clapping is no child’s play, especially for 82-year-old Kishan Chandra Bajaj, who clamis to have got cured of glaucoma, a degenerative eye disease, all because of clapping. Despite knowing about age-old therapies like yoga, reiki and accupressure, Kishan Chander Bajaj decided to try a novel “clapping yogasana”, when he lost his eyesight suddenly a decade ago. Explains Bajaj, “if a person claps in a correct way it can help maintain a good health and cheerful mind. It is not at all tiring. Our palms have pressure points for the whole body, which get stimulated during clapping and benefit people”, says Dr B.B. Mittal, honorary senior consultant at Jaipur Golden Hospital.
PTI Surgery using remote link Wellington (New Zealand): A doctor at a US base in the South Pole carried out a delicate knee operation using video and radio links to a surgeon in the USA. The “telemedicine” operation to repair a damaged tendon in the knee of meteorologist Dar Gibson was carried out by Amundsen-Scott base doctor Timothy Pollard earlier this month, the US Antarctic Program said in a statement. The operation on Gibson’s damaged knee tendon was monitored and directed by orthopaedic surgeon Bertram Zarins and anaesthesiologist Vicki Modest by video and radio link from Massachusetts Genera Hospital in Boston.
AP New Alzheimer’s scan Stockholm (SWEDEN): Brain researchers report that by using high-tech brain scans and computer simulations, they are now able to detect subtle, almost invisible changes in brain function 40 years before those changes cause the memory lapses, confusion and dementia associated with Alzheimer’s disease. Such early detection may be the key to devising effective treatments to prevent the onset of symptoms. The findings were reported at the Eighth International Conference on Alzheimer’s Disease and Related Disorders.
UPI Hepatitis-B vaccine New
Delhi: At a time when Hepatitis-B has emerged as one of the major public health concerns worldwide, India is set to take a leap by providing free vaccine to infants. The government, for the first time, would offer free hepatitis-B vaccines in slums in 15 cities and 32 districts across the country beginning September. With the launching of the programme, the government hopes to control the deadly Hepatitis-B which results in the death of 1,00,000 Indians annually. The pilot project, which will be integrated into the country’s routine immunisation programme, is to be expanded in a phased manner during the Tenth Five-Year Plan.
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Against early morning exercise London A study of competitive swimmers, many of whom train at dawn, found that levels of cortisol — a hormone which suppresses the immune system — were higher in the morning compared to the evening before exercise and significantly higher after exercise. The researchers from Brunel University’s Department of Sport Sciences conclude the best time to train is in the evening when cortisol levels are lower and salivary flow rate peaks.
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