Wednesday, September 28, 2011


Genetics: Ressearch has always shown us the there is a direct correlation betweeen genes and obesity.
Can we modify it yes
How: via envionmental changes , life style modifications like diet and exercise.

Stress: no matter how small will Increase hormone called cortisol and it is a known weight gaining hormone especially if you have abdominal fat- Destress by exercise, yoga or meditation.
keep your cortisol levels in check by taking multivitamins daily.
Use of DHEA (hormone) is slightly controvertial but use it on my patients with excellent results.

Food cravings : the thought of food which can only be satisfied till we eat it, Almost everyone will go through this at some point n their lives.
Causes: psychological and physiological.

: example you eat lunch at 12 everyday then you have been tuned to do that and you will hungry at 12.

Phsiological factors include the intestinal hormonal levels
LEPTIN : satiety hormone, funny that its highest when we are asleep.
GHRELIN:hunger hormone its secreted in the stomach increases in fasting and also Increases food intake)
ADIPOCYTOKINES and ADIPONECTINS: also hormones that are associated with hunger and satiety.
pancreatic polypeptide (PP), intestinal peptide YY 3-36 (PYY), oxyntomodulin: Under lot of research these days especially as they get altered after gastric bypass.

Lact of Serotonin is has been widely as a cause for obesity and depression.
If you getting treaed for depression with serotonin reuptake inhibitors (SSRI) then it should help with the weight as well.
You can also try 5HTP a precursor of serotonin plant derived which can stablize mood and help with craving.
I wont depend on foods to increase serotonin its very trick as carbohydrates and chocolates can elevate it.

Hypothalamus the center for satiety: our body has center in the brain for food satisfaction, Funny that it cant distinguish between hunger and thirst so best is when you are hungry at unusual times drink a big glass of water and wait minute if you still hungry get a healthy snack.

Tuesday, September 27, 2011

Indian cooking and challenges

Main problem areas in Indian cooking are high fat content, fried foods, and high carbohydrate, overcooking of vegetables.

People so universally like our Indian food across the world, I am proud of our cuisine, in fact my friend has started a healthy dosa joint in New York (Indian Creperies)
I was impressed to see how little oil they used for cooking and used high protein fillings like shrimps and chicken and cheese in dosas.

Here is my solution to healthy Indian cooking.

1.Tadka (we use oil to roast spices and vegetable):
Biggest challenge is the cooks or our moms. Its not wrong to educate them about low saturated fat food, they grew up in different era where physical activity was much higher.
2.Personally stand with them when they start cooking to let them know that no more than a teaspoon of oil should be used to roast the cumin/jeera seeds (best is canola or peanut or coconut or mustard or sesame/til oil). Don’t heat olive oil.
3.Use an oil dispenser with a narrow opening when pouring out the oil, straight from the bottle is very tricky, you almost always pour out more.
4.Invest in good cookware, use anodized material, and stay away from other non-stick and aluminum.
5.Don’t overcook the vegetable they lose all their minerals and vitamins when that happens. Grill them on the pan or oven. Best is to use of small amount of any PUFA (polyunsaturated oils) with a basting brush to cover them with small amount of oil.
6.Use generous HALDI (turmeric) its known to be healing.
7.Limit halwas, pooris, and pakoras for festivities.
8.Roti is very healthy, when you make the dough make sure you have fiber in the flour, my personal choice is to add (channa flour, wheat bran/oat bran, and flax seed powder). Fiber will decrease the overall carbohydrate in the roti and it’s the best fresh bread I have ever eaten. But again like bread more than 2 will contribute to weight gain.
9. Eat lots of Dahi (home made) lots of probiotic properties good for the intestines, in fact raita (without boondi) and Lassi is famous in USA available in all health food stores.
10.Dont eat two carbs in same meal like Rajma (kidney beans) and rice.
Switch to brown rice or Quinoa: “Should be available in some stores”.
11.We Indians also tend to eat dessert after supper that habit can be curbed by either taking a little walk after dinner or having green tea or chamomile tea.
12. If you are a non-vegetarian stick to roasted or grilled tandoori type foods.
13. Many Indian dishes like stuffed baingan (eggplant) or stuffed capsicum (green pepper) are so yummy when baked in oven (my own experience).
14.Garnish the food with the herbs like cilantro (green fresh Dhaniya) it increases taste of food as well as many antioxidant properties and lipid lowering qualities.
15. Challenge your friends to host the healthiest food parties especially those who like to do kitty parties.
16.Unless you have high blood pressure there is no need to have low salt a recent study shows that low salt consumption can lead to high cholesterol and triglyceride levels and even insulin resistance.
I think this can be a starter, if I get more information or ideas I will post them.

Thursday, September 22, 2011

Vegetarian Protein Options

SOY is your best choice.

Now if no matter where in the world you are you can have access to soy in form of soy chunks(Nutrela Brand), they look like small meat balls, cook them in gravy or just steam and eat with salads or vegetables.These soy nuggets are laden with protein, per 100g is about half small packet is about 54 g proteins so get atleast cup and a half at one time.

Other options for people in USA are:(some foods maybe available in India).

Fat free Cottage chesse(not paneer)/ fat free Ricotta cheese, Greek yogurt (non fat:recipe below)),

Tofu : for indian palate and taste I suggest get firm Tofu and make like our matar paneer, as tofu is bland, chinese take away food has tofu but its usually deep fried so we defeat the whole purpose of healthy options.

In USA we also get Morning star products in organic section just browse.

Buy low carb protein powder and make a couple low carb protein smoothies at home with antioxidant berries and you have a super food ready for Veges.

Milk has about 7 g protein in a cup and people with lactose intolerance get Soy milk its same proteins.

chickpeas have protein too but also very high in carb so they are good on maintenence diet.Same is the case with Lentils (dals) sprouted or unsprouted but they better than gobbling up any other fried or sweet food.

And to answer a question about our Indian food and how to make it healthy I think I will have to built up a whole section on this, If diets deviate too much from what we are used to no body witll stick to them.

Featured Recipe:Non fat GREEK yogurt:
Its like when you make Dahi(curd at home)
1.You boil fatfree or 1% milk and then
2.let it cool to room temperaature
3.Put the previous day spoonful of yogurt (should be live :one we make at home is live yogurt laden with good bacteria),
4.Set the milk for the night or 6-7 hours at a warm temperature.
5.Once yogurt is set then hang it by putting in a mesh/very think silken cloth over a container that will rain out excess water.
and let it hang for 1 hour,
6.And your greek yogurt is ready .
Throw away the drained water.
FACT: it has about 19-20 g protein in one cup

Wednesday, September 21, 2011

Thyroid and metabolism.

There is majority of patiets who eat right and exercise and still don't lose weight

Guess what get your hormones checked!!!!

Go to your physician and check your TSH, Free T3 And Free T4.

Why is Thyroid gland so important?

Its your basic metabolic hormone : Fat and carb metabolism is directly related to it.
Basically it affects almost all body systems and a prolonged untreated deficiency can lead to severe reproductive and cardiac troubles apart from feeling crappy.

How to recognize you should get your levels checked:
1.Fatigue and anemia.
2.Hair loss.
3.Cold intolerance.
5.Trouble losing weight.
6.Infertility( it interesting that one patient was having trouble getting pregnant and when her T3 was optimized she concieved and did not abort)Talk to your doc.

If your TSH is high means your thyroid hormones are low, remember T3 is at the cellular level if that is not optimized as well then you have not corrected the Thyroid issues.

Monday, September 19, 2011

Famous diets and their quick review.

Number of diets have claimed to help people lose weight, most of us have heard about them in the past or present.

I am lisiting the famous ones with brief pros and cons.

1. Atkins: Used to be my favourite diet, reduces weight fast, have to be non veg but also can lead to kidney and cholesterol problems if you are not careful,water intake has to be generous.

2.Zone diet: Easier for people who like to cook and eat healthy, easier to stick to but needs good knowledge of how to count calories and takes time to train yourself mentally to know how much each food group has.Good maintenence diet.

3.Mediterrarean Diet: Healthy good food but can end up over eating, is rich with olive oil canola oil instead of butter and includes all food groups. Allows wine, so can go overbeoard. Maybe good for maintenence.

4.Caveman diet: My favourite diet: nothing from bag, box or jar, eat it if you can pluck it off the tree/ground you can have it or if you can hunt it or fish you can have it.

5.Dukan: Recently in media gained lot of attention, tough to follow on long term basis.

6.My diet: anything low carb is good, vegetables as complex carbs,quinoa instead of rice,decent protein and no fried foods, will make you leaner and plus exercise regularly to avoid future risk of heart disease/stroke/hyperlipidemia ad other obesity related conditions.

Sunday, September 18, 2011

Lap band or gastric bypass or liposuction!!!

Many patients ask me if they should get a lap band or a gastric bypass and they are unable to decide. Some even ask about liposuction.

To start any kind of weight loss you have to know that you will relearn how to eat and live an active life just the way we teach kids everything,

Behavioral and life style modification is by far the most important aspect.

Firstly you need to know what your BMI (body mass index) is, refer to Internet or my previous posts to know how to calculate it.

If your BMI is >30 if are obese category you can do strict weight reduction with help of medical assistance and medications and then maintain it when you are about 23 BMI,
You can get a lap band but its surgery and has its own complications. Lap band is somehow more advertised and is not seemingly successful much if your BMI is higher than 35.

If you BMI are >35 you are at risk for many conditions like heart disease, diabetes, sleep apnea, and osteoarthritis, High blood pressure.

Now if you have any of these conditions already then you can plan for a gastric bypass from any center of excellence. In India there are a few in all major cities.
Diabetics get completely cured after bypass; it’s a safe procedure if you have a good follow up.

Make sure you follow up regularly after the bypass with a MD since you will have to make sure you don’t get deficient in vitamins and essential nutrients.
There is still a fear of weight regain if you don’t keep up with the follow up.

If your BMI is >40 then its highly likely that gastric bypass will be the way to go since your body is under extreme stress and eventually you will end up getting the above diseases.

As for liposuction you must make sure that your BMI is in normal range and you are getting the fat out from the problem areas only.
But before you take that plunge its vital to get your hormones checked you may be deficient in thyroid, if you don’t replace that then you will get your fat back in a year or 2.

Overall any extra weight should be lost and lean muscle mass should be increased for longevity.

Be patient give your weight loss at least 6 months and slow weight loss will be more permanent than quick weight loss.

When someone tells you they have a machine that can reduce your weight/ inches in 3 weeks or so then it’s a red flag because, fat loss only happens if you take less calories and spend more.

Don’t fall for gimmicks learn how to stay fit forever. Its new learning and don’t be afraid to try it.

Saturday, September 17, 2011

Kick start weight loss part 2

Another sample to fit diet and workout in your daily routine for especially for working force.

Always: Note here that you want to first check with your physician before any weight loss program.
You should not eat under 1200 calories per day otherwise your BMR (basal metabolic rate with drop and you will gain the weight back).

1. Start the day with some spot jogging for 5 minutes and a few stretches, if you can squeeze in a quick workout it’s the best time, 2 glasses of water.

2. Eat a full healthy breakfast to keep yourself from starving at other times of the day.
A healthy breakfast includes whole-wheat toast / egg white/fresh fruits/low fat cheese/low fat milk/tea or coffee optional.
For roti/ idli lovers just avoid the fried stuff.
Coconut chutney is good.
Basically you want to include all food groups at this time.

3.Snack in about 3 hours: good ideas are an apple or a pear, or 10 almonds, 10 walnuts (loaded with omega 3 fatty acids). Nuts keep you full and are protein laden.
Sugar free gum is another good one.

4.If you can pack your lunch to work its great and just choose from following options Sandwich with salad and cheese or firm minced tofu, non veg can have grilled tandoori chicken, 1-2 chapatti/roti with 2 cups of dal/avoid potato, add at least 1 full cup of low fat yogurt to your meal. 1 glass of water around this time.

Eat slowly enjoy this meal this time is a real break from work.

5.Snack time again in 3 hours. At this time you can have a whey protein shake, plus 1-2 glasses of water, or a fistful of roasted unsalted channa/ soy nuts/low fat cheese.
Check my blog post from August 6 for some more ideas.
Soon I will posting making your own 100 cal snack packs to carry around.

6.Exercise ½ to 1 hour (get a brisk walk or cycle or treadmill or cross trainer or weights or golf or swim).

7.In evening your body is preparing to get lazy so are your intestines so don’t over eat at this time.
Make healthy choices for dinner plate whether you eat out or eat at home: 1/3 protein, 1/3 carbohydrate, and 2/3 vegetables.
Avoid frequent desserts, reserve them for weekends. Avoid fruits at night they ferment in the colon during the night.

If you drink alcohol and can’t stop it then limit to one drink with lots of ice and go slow.

Instead wind up with a chamomile tea at night its super relaxing. Some patients have told me they stopped alcohol/dessert completely after starting this tea before bed.

Remember studies have shown that 7-8 hours of sleep keeps your hunger in check during the day.

Tuesday, September 13, 2011

Vitamin B complex

Slightly more complex set of B vitamins many types.(water soluble)

now every B of the complex has its own benefits

B12 is great for nerves and is great if you looking to shed some pounds/kilos: gives you energy to increase your exercising capabilities,
If you had a gastric bypass you have no stomach acid so you have to supplement it all your life.
make sure you understand that if you are on Metformin or antacids they may decrease absorption.
If you are vegetarian you need it period.

B6 is great for kidney functions , nerves, alcoholics, PMS: found in meat, poultry,fish and fruits, cheese: 1.3-1.5 mg per day usuallu a good multivitamin will have it.

B3 is excellent for reducing choelsterol especially if you have elevated triglycerides.

B1 is very essential for people who like alcohol or have a poor appetite,diarrhea or have inflammatory bowel disease, canker sores(mouth ulcers). Deficiency can cause serious problems a nervous problem called Wernike Korsakoff syndrome.A good multivitamin will have it along with healthy diet.
Some studies show maybe helpful if diabetics kidneys.

Riboflavin:or B2:
Great vitamin for migranies,burning feet, acne, will increase iron absorption in the body. CAn be found in meats, vegetables,nuts,eggs.

B5:Pantothenic acids:same sources as riboflavin,
Has been used for good skin,ADHD, baldness, asthma ,arthritis,muscle dystropies. Not many studies to warrant above benefits but usually will be present in all multivitamins.

B7:Also called BIOTIN great for hair and nails. and hormone synthesis.

B9:folate: I think everyone knows about this one, very essential for all women of child bearing age to prevent developmental anomalies in the babies in womb. Basically it maintains DNA and Red blood cells.
Alcoholics or people with poor appetite or pregnant or wish to become pregnant need extra 1 mg per day.

Friday, September 9, 2011

Vitamin C

VItamin C is a great antioxidant

how much: 75 mg per day

symptoms of deficiency are Fatigue, depression, inflamed gums, skin spots, bad hair, joint pains.

sources citrus fruis, most of the multiviatmins have it,


Antiaging: it helps in collagen synthesis,

Smokers need about 100 mg perday REALLY!!

Antioxidant: traps free radicals

Cancer prevention

You get less common cold if you regularly take it.

Wednesday, September 7, 2011

new request by a reader: how to get good legs?

Get running baby, running burns maximum calories and tones up your legs beautifully.

Lunges various types, side with forward lunge

one leg forward without and with weights as tolerated,

Squats without and with weights

alternate running cycling as running may cause excessive knee damage.

make sure your diet has good supplements and you eat balanced diet and water.

If you need more info I suggest a certified trainer.

Vitamins and supplement section 1.

Been preparing this section, taken a while to post it,folks this is free source and in very layman terms so enjoy and take what you you have to from it.( ALL this info is based on research trials done in USA periodically )

There are many essential vitamins and trace elements that are often undertaken by most of us.
Its a stressful life and we often dont take enough nutrition and as we age, we get depleted of the stores.

Basically you should know what are your best bet especially when you want to remain fit,have fat loss, are antioxidants and increase metabolism.

Today I will take up calcium and Vitamin D as they are inter related.

Most important is the CALCIUM,

Its available as citrate(less elemntal calcium per dose) and carbonate(more elemental caclium), citrate you can pretty much take any time of the day but carbonate needs stomach acid so needs to be taken with food. Daily dose from 19 yrs to 100 yrs is ~1200 mg per day,Always take divided doses since one time absorption by body is limited to 500mg.

Tests for blood serum calcium unless very deficient are not done routinely.

( milk yogurt and cheese withh give about 250-400mg max in plain low fat yougurt)

Basic natural sources are cheese and yogurt milk , remember more fat lower calcium in a food product,

Coffee tea and alcohol increase caclium excretion from body (basically deplete your calcium levels)

High protein intake helps absorb more calcium from gut

Generally deficiency is caused if really had a stomach surgery or kidney failure or malnourished,

But its necessary to keep optimal upper limit levels

Benefits are:

1. Increases fat excretion from the body ,plus absorbs excess fat from diet. vegetarian need to be more careful as they have oxalic and phytic acids from plan which may decrease absortption still would go case to case basis. BASICALLY calcium keeps you thin especailly if dervied from diet.

2. bone health/osteoporosis.

3. heart health.

4. Protects from some cancers.

Note dietary calcium doesn't cause kidney stones and calcium supplements have higher risk.

Next is vitamin D : FAT SOLUBLE vitamin :its governed by sun exposure and promotes calcium absorbtion from the gut. Not a great supplement to be had from diet ( Fish esp Salmon, tuna and mackarel) interesting vit D is found in egg yolk(only 41 IU per yolk). SHould be taken together with CALCIUM.

tested by doing blood serum levels as 25 hydroxy vitamin D.

Mostly low in people who are a BMI >30 (obese category )

Represented as diseases called osteomalacia (adults) and rickets(chiildren).

Good dose is 600 IU(international Units) during 19-70 yrs of life people above 70 need about 800 IU

Reasons for taking vitamin D

1.Bone health/osteoporosis/fracture prevention as we age. gastric bypass or having fat malabsorption.

3.prevention of certain cancers like colon, prostate and breast.

Coming up next will be the antioxidants......