There has been an alarming increase in the number of cancer cases in India in the last few years, particularly among the younger population. Estimates indicate that in our country, there were 1.16 million cancer cases in 2018 alone. The incidence is increasing and of the six most common types, the number of breast cancer cases stands at 162,500, as per the International Agency for Research on Cancer (IARC) and the World Health Organization (WHO). Further, about 1 in 28 women is likely to develop breast cancer during her lifetime. What makes treatment difficult is the lack of awareness about the risk factors and symptoms, which further leads to a delay in diagnosis of the condition. As we are observing Breast Cancer Awareness month, there is a need to focus on the importance of early detection and diagnosis to prevent fatalities.
While research is on to find out the exact cause of breast cancer there are certain risk factors associated with its occurrence. It is usually seen in women over the age of 55 years but increasingly younger women are being diagnosed with the disease as well. Genetic history has a major role to play in breast cancer as about 13% to 19% of women diagnosed with the disease have an affected first-degree relative (mother, daughter, or sister) compared with slightly fewer (8%–12%) of women without it. In many women, cancer in one breast can increase the risk of being diagnosed with cancer in the other one. Women with a history of early menstruation, late menopause, or those who had late pregnancies are at a higher risk.
Certain women have dense breast tissue, which can make the detection of lumps difficult. An unhealthy sedentary lifestyle with a diet high in saturated fat and processed food along with obesity, smoking and alcohol contribute to the risk. Also, undergoing radiation therapy of the chest before the age of 30 can increase the risk of breast cancer. Women on Combined Hormone Replacement Therapy (HRT) for menopause are particularly susceptible.
It is important to remember that this disease is not contagious. It also cannot be caused due to things like bras, deodorants, perfumes, caffeine, microwaves and cell phones. Such myths need to be busted by creating more awareness about breast cancer. Women who are above the age of 45 should get a screening mammogram every year until the age of 54. In women older than this age, the screening should be done biennially. Due to Covid-19, women are wary of going to hospitals for check-ups and may miss their mammograms, causing a delay in diagnosis. However, even though hospitals visits are to be avoided to reduce exposure to the virus, the importance of prevention cannot be underscored.
Tips to prevent breast cancer:
• Limit alcohol consumption to 1 drink per day as even small amounts can increase risk.
• Research indicates that there is a link between smoking and breast cancer and therefore, it is best to quit the habit.
• Control your weight and be active as obesity increases the risk of breast cancer. Indulge in physical activity for about 30 minutes a day to reduce weight.
• Breast-feeding might play a role in breast cancer prevention. The longer you breast-feed, the greater the protective effect.
• Combination hormone therapy for more than three to five years increases the risk of breast cancer. Use the lowest dose that works for you and continue to have the doctor monitor the length of time for which you take the hormones.
• If you have a family history of breast cancer in your mother or sister get a cancer tumour marker done regularly as advised by your doctor.
The writer is a Gynaecologist and Consultant Women’s Health at Medtalks
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CUSTOMISED BEAUTY SOLUTIONS AS ‘YOU ARE ONE OF A KIND’
Ayurveda originated in ancient India more than 5,000 years ago and is an intricate system of health and well-being. It believes that well-being can be achieved through mind-body balance and promotes natural ingredients and a balanced lifestyle. The word Ayu means life and Veda means knowledge. So literally the word Ayurveda means the knowledge of life.
The core of Ayurveda is customisation. Ayurveda believes that every person has a body constitution that is specific to him or her. Ayurveda gives a personalised solution to each individual based on prakruti, doshavastha (condition the doshas), and dhatus (tissues in the body). According to Ayurveda, prakruti is defined as body constitution or nature. It is formed by tridoshas (vata, pitta, and kapha) and is genetically determined by various factors.
By leveraging technology to capture information related to individual prakruti, new-age brands can offer the same level of customisation that was so far offered by an ayurvedic expert in an offline environment. Brands like ours have tied up with Ayurvedic experts to create a detailed questionnaire that allows them to identify individual prakruti and match it with the right product. This allows customised beauty brands to reach millions of customers all over the country without establishing a costly and time-consuming offline presence. Ayurveda as a thesis for designing beauty products has got a high level of acceptance in India and even globally. But generic Ayurveda inspired products can’t deliver efficacy. It is the customised approach of Ayurveda that distinguishes it from the rest of cosmetic beauty brands on a shelf both digital and virtual.
The journey of customising beauty regimes would begin with customers taking questions that give brands insight into their actual skin and hair problems. Sometimes the doshas fall out with each other due to the quality of water, location, the air we breathe in addition to our lifestyle. If we have to leverage tech, the data inputs have to be precise and hence the questions have to be extremely well-framed so that with each answer, the Ayurveda expert gets to know you better.
This has to be followed up by a rigorous feedback cycle. Unlike offline environments where the feedback cycle is often very long and in many cases broken, online brands can collect feedback faster and use them not only in further improving the product efficacy but also quickly identifying emerging problem areas and creating new Ayurvedic products. Many D2C brands are taking this approach as it gives them the flexibility of making changes in their products, and learning directly from the customer without increasing operational expense. Once you have understood your market and customers well, D2C brands can also explore the marketplace route as by then you would have reached a certain maturity in your business cycle, stabilised cost of running operations, and clocking revenues along with being a well-known brand name.
We believe, customisation doesn’t stop at hair or skincare, overall wellness of the body and a healthy mind form the basis of Ayurveda inspired customised beauty regime. There is a legit opportunity in customised wellness regimens which should consist of a personalised range of detox and gut health supplements to suit individual prakruti. We believe the future of wellness will be anchored around customisation as not everyone needs the same combination of herbs and in the same dosage.
The global beauty and personal care market is worth close to $500 billion and is expected to grow at a 5% CAGR by 2025. At $80 billion, the herbal beauty industry is about 17% of the overall industry. However, the share of herbal products should increase driven by demand for such products as customers embrace a more sustainable lifestyle. Increasingly consumers are demanding products that are made to suit their skin/hair/body type. Ayurvedic formulations, with their focus on herbal ingredients and a view toward customisation, are well-positioned to leverage this trend.
Therefore, while Ayurveda might be 5,000 years old, it is more than ever relevant in today’s age because of its potential to create customised beauty and wellness solutions that leverage herbal and natural ingredients.
The writer is Business Head, Vedix.
70:30 & STEP DIET: THE NEW FITNESS MANTRA
Have you been looking for ways to lose weight on Google? You need not do so anymore as the answer is quite simple – follow a ‘Step Diet’ plan. Basically, this means that you have to ‘move more and control portions’. The step diet requires you to walk 10,000 steps each day. It permits you to eat most things that you relish but you have to cut down on portion sizes by 30%. One can begin by walking 2,000 steps a day (15 minutes walk) and gradually increase the pace to 10,000 steps per day (burning a minimum of 400 to 500 calories per day). By walking on the treadmill at a speed of 4.5 mph for 30 minutes, the average individual would burn about 150 calories. Eating more consciously is an important part of this diet. For example, by skipping guilty pleasures such as that extra bowl of ice cream at night, a serving of aloo pakoras, or coke, one would further cut down their calorie intake by 300 to 375 calories. A simple way to maintain fitness is by following the 70:30 principle – i.e., fitness is 70% of what we eat and 30% of exercise.
The daily calories intake for a normal individual, as recommended by the USDA, is 2000 calories/day. For a successful weight loss of 0.5-1 kg, a calorie deficit of about 500 to 1000 per day is recommended. For healthy weight loss, exercise sessions should be a mix of strength training and cardiovascular training, not only cardio. Both modes of exercise burn calories, which in turn leads to stored fat being used as a source of energy.
By walking 10,000 steps a day and by making small dietary changes, we can address the obesity of our nation. Moreover, in the current Covid pandemic situation, as most of the citizens are advised to remain home, one tends to turn into a couch potato. Research shows that people who are leading a sedentary lifestyle (< 5000 steps/day) or are almost inactive (<2000 steps/day), are at a higher risk of severe Covid-19 disease.
THE STARVATION MODE
People often experience a point in their weight loss journey when the needle on the weighing scale stops falling lower and they get demotivated and give up. This phase is called ‘the starvation mode’ where the body tends to resist weight loss as we are eating lesser than earlier. The brain thinks that it might not get sufficient food and would have to starve and starts to conserve the food that we eat in the body. It instructs the body to store food in the form of fat, which is why weight loss plateaus after the successful shedding of a few pounds. To avoid going into ‘starvation mode’, strength training is essential. It speeds the metabolism back up and one keeps losing weight steadily.
Hence, by walking 10,000 steps a day and a minimum of 15 minutes of strength training, at least four times a week, one can push past plateaus and achieve the ultimate goal of weight loss, instead of a fad crash diet which helps to shed more of water and muscle weight (protein) initially but leads to a relapse of lost weight once the diet is terminated. It is quite straightforward if followed routinely. One need not run marathons to control weight, rather, strap on a smartwatch, lace up a pair of sneakers and put one foot in front of the other. Yes, you need to be more active!
The writer is Senior Physiotherapist, Aster RV Hospital.
HOW TO MANAGE HAEMOPHILIA PATIENTS DURING PANDEMIC
The second wave of the Covid-19 pandemic has hit full force. Apart from people infected by the condition, those with diseases, particularly rare ones like haemophilia, have been particularly affected. This is because most hospitals are occupied with Covid-19 patients and visiting them in these times is fraught with risk. The onus, therefore, falls on the patients and their families at home to take precautions and manage the condition. Apart from keeping their vitals under check, they should also consult their healthcare providers in case of any Covid-19-like symptoms. There is a need to raise awareness about haemophilia as well as managing it during the ongoing pandemic.
Haemophilia is a rare genetic bleeding disorder in which the blood does not clot properly. As a result, a person suffers from spontaneous bleeding and may bleed for a longer time following an injury. This occurs due to the absence of clotting factors that are required to stop the bleeding. The intensity of the condition depends on the amount of clotting factor present in the blood.
Haemophilia is of three types: A, B, and C, and the difference between the three lies in the deficiency of a specific factor.
Females are carriers of haemophilia. It is not a life-threatening disorder unless the bleeding extends into a vital organ. However, it can be severely debilitating and there is no known cure for this disorder. About a third of new cases are caused due to a new mutation of the gene in the mother or the child. In cases where the mother is a carrier and the father does not have the disorder, there is a 50% chance of the male child having haemophilia and a 50% chance of the female child being a carrier. One should see a doctor in case the following symptoms show up – a severe headache, repeated vomiting, neck pain, blurred or doubled vision, extreme sleepiness, and continuous bleeding from an injury.
Under the current scenario, patients with haemophilia should also practice preventive measures against Covid-19. This includes rigorous hand hygiene and social distancing to avoid any external contact. For children with haemophilia, parents can undertake home therapy with guidance from their specialist through teleconsultation. This becomes important for both the treatment and prevention of bleeding. This will not only reduce the existing burden on healthcare centres but also allow patients to stay away from the risk of acquiring infections. In case of any emergency situation, it is imperative to keep the bleeding disorder card/disease status handy.
Some other general tips for haemophilia patients are as follows:
• Adequate physical activity can help maintain body weight and improve muscle and bone strength. However, avoid physical activity that can cause injury and resultant bleeding
• Avoid blood-thinning medication such as warfarin and heparin. It is also better to avoid over-the-counter medicines like aspirin and ibuprofen
• Clean your teeth and gums thoroughly. Get tips from your dentist on how to do this without making the gums bleed
• Get tested for blood-borne infections and get your doctor’s advice on hepatitis A and B vaccinations
In case of any complications, one should reach out to the treatment centre so that bleeding episodes can be managed. The centre can also help provide inputs on preventing Covid infection.
The writer is President, Medical Services, Portea Medical.
Under the current scenario, patients with haemophilia should also practice preventive measures against Covid-19. This includes rigorous hand hygiene and social distancing to avoid any external contact. For children with haemophilia, parents can undertake home therapy with guidance from their specialist through teleconsultation. This becomes important for both the treatment and prevention of bleeding. This will not only reduce the existing burden on healthcare centres but also allow patients to stay away from the risk of acquiring infections.
NUTRITIONAL GROWTH: DIETARY SECRETS OF B-TOWN CELEBS & SPORTS STARS REVEALED
Bollywood and Sports stars are worshipped in this country. The aam janta has a keen interest in their favourite celebrities’ lives and wants to acquire as much information as possible.
I, too, get asked these questions very often. What nutrition strategy led to Sushil Kumar winning two Olympic medals? What was Aamir’s Dangal diet? What Virat eats on matchdays? How diet was genetically aligned to Abhishek Bachchan’s training and fitness regimens? What are the diet secrets that helped us break two Guinness World Records in human performance?
Even when people love to imitate their role model/favourite celebrity, it is imperative to understand that nutrition is bio-individual. Each of us is unique; we have different needs, lifestyles, goals, objectives, food cultures, genetics, etc. hence nutrition should be customised.
One man’s food is another man’s poison. I remember asking Shikhar Dhawan to quit Milk, against the common notion that Milk is a must for athletes because his gene report showed that he was lactose tolerant.
India women’s cricket team captain Harmanpreet Kaur, who took the world by storm after scoring jaw-dropping 171 against Australia in the 2017 World Cup semi-final, struggled with her post-match recovery, as she was gluten intolerant. Being a Punjabi, her diet was loaded with wheat-based foods, which was creating havoc in her body.
So there is a lot of science behind what you see on a celebrity’s plate. Before giving them diet suggestions, we capture a lot of data in the background and then work around it to identify key foods and nutrients that would work for their body.
What data do we capture?
1) Blood Reports
We analyse their blood chemistry. It gives us an internal picture of the body’s health status. It also helps us to identify if there are any existing nutrition deficiencies. So when a leading actress told me that she often feels fatigued during a shoot, her blood test report came back saying that her haemoglobin levels were low.
If the body is hardware, genes are your software. Your genes are a gift from your parents. You can’t change it; you have to live with it. Best, acknowledge & work on it, and you probably might end up getting the best results out of them. I have seen Gluten Intolerant athletes, once they do away from wheat, they start performing well. For any movie stars, this could be the reason why you are not getting that flawless skin.
3) Body Measurements
A lot of celebrities come to me to lose weight. I ask them they want to lose weight or fat? Modern-day nutrition planning takes into perspective fat and muscles. A 60kg person with 10% body fat has a greater metabolism and calorie demand than the same 60kg with 20% body fat.
4) Medical History
Since many illnesses run in families, this knowledge provides your nutritionist with a wealth of information about what’s going on with your health. It also helps to determine what health problems you may face in the future.
Training, Traveling, Matchdays, Shoot days, Rest days: we have different calorie needs to different days. Also, it helps to plan your nutrition in advance so that you can carry your food or get it arranged to meet the calorie requirements.
6) Food culture & preferences
It is crucial to understand how flexible a person is on taste buds. Different cuisines offer different nutrients and benefits. No food is bad until you abuse it. Once we get a clear picture of your eating habits they can be aligned to meet calorie requirements based on goals and objectives.
Apart from these, a lot of data is captured to scientifically customise a nutrition plan.
Sharing a list of favourite foods that I like to feed my celebrity clients:
• Beetroot – Beetroot is well-known for its ability to increase energy levels. Beetroot contains a compound called nitrates, which aids vasodilatation, or the ability of your blood vessels to expand and bring more blood and oxygen to your exercising muscles while also removing more carbon dioxide and lactic acid.
• Eggs – To satisfy your protein needs, you can eat up to four whole eggs a day, plus egg whites. Based on your physical activity levels protein requirement ranges from 1 to 2 gm per kilogram of body weight.
• Dates – Dates provide iron, calcium, potassium and other minerals. Great food to have a fast boost of energy. If you have low iron levels or haemoglobin, which causes fatigue, include dates in your diet. Dates are easy to carry while travelling, during training and shoots.
• Berries – Berries are high in anti-inflammatory compounds and vitamins, which may help you, avoid premature ageing. Berries are also high in vitamin C, which helps to keep skin healthy. The antioxidants in berries protect against harmful free radicals, which can trigger wrinkles and disease.
• Cinnamon – Cinnamon increases the metabolic rate, which aids weight loss. Cinnamon also helps to control blood sugar levels and increases insulin function. It also contains a lot of fibre, which keeps you complete for a long time. This leads you to eat fewer calories, resulting in weight loss.
The writer is the Founder of QUA Nutrition as well as a Celebrity & Sports Nutritionist.
ASTHMA AND COVID-19 COMPLICATIONS
Tackling an asthma attack effectively, especially in Covid positive patients, is crucial in saving lives.
Asthma, a condition constricting the airways carrying air into the lungs, can not only make it hard for people to breathe but can often lead to wheezing, chest tightness, breathlessness, and coughing. The Covid-19 pandemic has only worsened the situation for asthma patients as they are much more susceptible to contracting the virus. Also, their Covid-19 symptoms can be amplified considerably more.
Respiratory viruses can trigger and worsen asthma symptoms, and if a person has uncontrolled asthma, they may develop or face severe Covid-19 symptoms. Uncontrolled asthma can mean that there will already be inflammation in the lungs, and airways will be compromised so in many cases Covid-19 may even lead to pneumonia, fibrosis (thick and stiff lung walls), or other intense respiratory diseases.
Elaborating on how to tackle an attack especially if the patient is not sure if it is due to asthma or Covid-19, Dr Sandeep Nayar, Senior Director & HOD, Chest & Respiratory Diseases, BLK-MAX Super Speciality Hospital said, “People feeling breathless may sometimes confuse between Covid-19 symptoms and an asthma attack. The major symptoms seen nowadays in Covid positive patients are breathlessness instead of fever or any other common Covid-19 symptoms such as sore throat, headache, cough etc. In such a situation it is best to use the inhaler so the asthma attack can be managed. In the case of asthma patients having contracted Covid-19, inhalers and bronchodilators, as well as other medications, should be continued as per schedule. Nebulisers are again very useful in handling Covid induced bronchospasms. Asthma patients can easily use nebulisation, with or without steroids, to help alleviate chest congestions and pressure.”
Dr Nayar stressing upon the need for vaccination, “All asthma patients above 18 years of age must get vaccinated to prevent the deadly implications of the virus even if they get infected. Vaccination will not just help in protecting from the virus but will also help reduce the severity of the symptoms. However, those having had an immediate or severe allergic reaction to the vaccine or any of its ingredients must consult their physician.”
The doctor suggests some measures that asthmatic patients must observe to stay safe:
• If you’ve recently recovered from an acute Covid-19 infection, delay getting the vaccine until you’re fully recovered and done with self-isolation and quarantine measures
• If you had the infection after receiving the first dose of vaccine, then wait for at least one month after recovery before getting the other dose
• If, along with asthma, you also have other conditions causing immune deficiency like HIV or cancers, consult your doctor before getting the vaccine
• Do not step out of the home. If unavoidable, wear a double mask while going out
• Quit smoking as it can be very dangerous for patients with asthma or other respiratory illnesses
• Avoid outdoor exercises, focus on breathing exercises, and doing yoga indoors
• Take prescribed medicines and inhalers. Keep necessary medicines stocked up
• Eat a healthy diet rich in nutrients and proteins. Avoid foods rich in oil and eating out
• Take steam twice daily to avoid chest congestion
• Keep anxiety and stress levels as low as possible
Asthma may not be considered a serious condition by most people, however, asthma compounded by other infections can increase the risk. A crucial aspect for all patients is to know the triggers so one can stay away from them and be protected from another attack.
HOW CAN NATUROPATHY & YOGA BENEFIT BRONCHIAL ASTHMA PATIENTS?
While modern medicine works in a reactive approach to manage symptoms of asthma when they arise, naturopathy works to eliminate the cause and reduce the severity of the disease.
One of the most common chronic diseases of the respiratory system, asthma affects more than 300 million people across the world with around one-tenth of them in India. Every year, World Asthma Day is celebrated on the first Tuesday of May. This year, it is being observed on 4 May. This day is observed to raise awareness about chronic respiratory disease and to break the stigma around it.
While the prevalence of asthma is higher in developed countries, the burden of asthma-related deaths is much higher in developing countries like India. In fact, according to a report published by the World Health Organization (WHO), over 80% of asthma deaths take place in developing countries.
While environmental allergens like dust, pollen, insects, and domesticated animals are the leading triggers of asthma, outdoor air pollution has also emerged as a problematic trigger. Researchers from the French Institute of Health and Medical Research found that high traffic intensity and ozone exposure has increased the risk factors in individuals living with asthma. With rising environmental pollution, the incidence of respiratory disease is increasing in India, particularly among children. It is important therefore to introduce a holistic approach towards the management of this condition through the use of naturopathy and yoga. Evidence suggests that a naturopathic approach can offer long-term health benefits to people with asthma by reducing the intensity of the disease, improving symptoms, and lung function while significantly reducing drug requirement.
BRONCHIAL ASTHMA AND ITS TRIGGERS
Bronchial asthma is a condition that causes inflammation in the airways of the lungs. This results in narrowing of the air pathways and excess mucus cause wheezing, cough, and difficulty in breathing. The disease is chronic and interferes seriously with daily life. If not treated properly, this chronic inflammatory disease is not just debilitating but can even turn fatal. Our environment has all the asthma triggers. Even dust accumulated in curtains and pollens in the environment is enough to trigger an attack in addition to the harmful emissions from motor vehicles. Modern medicine relies heavily on the use of steroid inhalation and anti-inflammatory drugs to manage the condition. These drugs work by reducing inflammation and mucus production in the airways, thereby improving symptoms and controlling the condition. However, the high cost of drugs and their potential side effects remain a cause of concern. A naturopathy based treatment, on the other hand, uses a drugless approach that is much safer and sustainable.
THE NATUROPATHY AND YOGA APPROACH IN TREATING ASTHMA
Naturopathy is holistic rather than a compartmental way of treating and managing a condition. While modern medicine works in a reactive approach to manage symptoms when they arise, naturopathy works to eliminate the cause and reduce the severity of the disease. The alternative system of medicine believes that all diseases are caused due to an accumulation of toxins, morbid matter in the body, and negative vibrations in the mind. The therapeutic plan in naturopathy is executed in three phases – the eliminative phase, which focuses on cleansing the body of accumulated toxins, the soothing phase, which focuses on rejuvenating the body and supplying the necessary nourishment, and the constructive phase, in which the body’s metabolic activity is regulated.
To establish the efficacy of naturopathy, a significant study was conducted at Jindal Naturecure Institute, Bengaluru between the year 2003-2006. A total number of 60 patients between 25 years to 70 years of age was treated for bronchial asthma for 21 days as part of their research programme. Their treatment procedure was divided into three therapy sections – Nature cure therapy, Diet therapy, and Yoga therapy.
Nature Cure therapy consisted of a chest pack applied from 30 minutes to an hour once or twice a day depending upon the clinical condition of the patient. This was accompanied by a combination of hot foot and arm bath, partial massage therapy to upper back and chest, fomentation, asthma bath, oxygen bath, steam and sauna bath, enema, steam inhalation, and drainage therapy.
Under the Diet therapy, patients were prescribed nutritionally calcium-rich, non-mucus, and non-acid generating food items along with herbs such as tulsi, pudina tea etc, and lots of water. All foods which are traditionally known to increase the production of mucus were avoided. Also, the foods which are allergic in individual cases were identified and avoided. The general observation of asthma patients also revealed that animal milk is one of the triggering factors and must be replaced with soya milk.
Yogic kriya, Yogasana, Pranayama, and Yoga Nidra spanning into a three-week programme with a gradual gradation in the severity of the practices was the third pillar of the treatment approach.
The study combined with a year follow up of patients had shown highly promising results. The naturopathy approach helped these patients to improve their lung function and symptoms while reducing the requirement of drugs in most patients. When Jindal Naturecure Institute began this study with 60 patients, there were only five cases that required no medication at the time of admission.
However, during the discharge, the cases of no medication increased from 5 to 48, after a gap of 21 days only. Further, the treatment proved to have long-lasting effects on the majority of patients. Nearly two-thirds of the patients did not have to use any other medication as observed at different intervals during one year.
With the high burden of asthma affecting our country, we will do well to use some of our traditional knowledge in dealing with this menace. Modern medicine has so far failed to find a cure for chronic diseases such as asthma. Their treatment protocols focus mostly on relieving symptoms without doing anything to address the root cause of the disease. Naturopathy, on the other hand, incorporates a holistic and individualistic approach for treating different diseases and uproots the disease from its core. This implies treating the individual rather than the disease.
The writer is Deputy Chief Medical Officer, Jindal Naturecure Institute.
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