Editorial


Getting started on your healthy habits

Think positive. Believe that you will lose weight. You have to really want it for it to happen. You must do it for yourself, not for anyone else. Think about yourself, your physical and mental well being. Imagine a slimmer, fitter you; it always works. Take some pictures of yourself and put them up around the house. Put one on the refrigerator door, it will serve as a constant reminder and will strengthen your resolve to loss weight. Looking at the picture every once in a while during the course of your programme will inspire you to continue.



Close your eyes and imagine yourself, the way you want to look. Do this as often as possible, self-visualation is a very powerful tool. Give it a try, everything is worth a try. Imagine yourself getting around without getting out of breath, no more pulled muscles, no more indigestion. People smiling at you, the way you look, as you walk by. Treat yourself every once in a while. Put a little money away every time you resist a food craving and then go and splurge on something that will make you feel special, like a new outfit or make-up. Remember, you are losing weight for more than just your appearance. You are losing it for the experiences that will come after you have achieved your goal. Always stay focussed on why you are doing it. The beauty of the whole experience is that you will never know how good it feels until you get there.



Hints for recording weight : Always use the same weighing scale so you get an accurate measure of your progress.



Make sure you weigh yourself before eating and after going to the bathroom.



The first thing to do in the morning is to weigh yourself.



Water retention is a common problem for women before their periods, so don’t get discouraged if you tend to lose less weight during that time of the month. It is only temporary.

Cover Story

Obesity Care in Unani System of Medicine

The Weight Loss Food Guide Pyramid is an outline of what to eat each day based on the Dietary Guidelines. It’s not a rigid prescription but a general guide that lets you choose a healthful diet that’s right for you.

The Pyramid calls for eating a variety of foods to get the nutrients you need and at the same time the right amount of carlories to maintain healthy weight.

What counts as one serving?

The amount of food that counts as one serving is listed below. you eat a larger portion, count it as more than one serving. Be sure to eat least the lowest number of servings from the five major food groups listed below. You need them for the vitamins, minerals carbohydrates and proteins they provide. Just try to pick the lowest fat choices from the fats groups. Specific serving size is given for the fats, oils and sweets group because the message is “Use Sparingly”.



Milk, Yoghurt and Cheese

1 cup of Milk or Yoghurt or 45 gms.of Cottage Cheese/Paneer



Meat, Poultry, Fish Dry Beans, Eggs and Nuts

60-70 gms. cooked Lean Meat, Poultry or Fish.

1/2 cup of cooked Dry Beans, Egg or 2 tablespoons of Peanut Butter (count as 30 gms. of lean meat).



Vegetables

1 cup of raw leafy vegetables or 1/2 cup of other vegetables (cooked or chopped raw),

3/4 cup of vegetable juice.



Fruits

1 medium apple, banana, orange or 1/2 cup of chopped, cooked or canned fruit or 3/4 cup of fruit juice.



Bread, Cereal, Rice and Pasta

1 slices of Brown Bread or 30 gms. of ready-to-eat Whole Cereal or 1/2 cup of cooked whole cereal or Brown Rice.



Foods to eat, foods to avoid

Fats, Oils, Sweets, Red Meat & Refined Carbohydrates

Use sparingly.

Restrict adding fats to foods while cooking or the table - like butter, margarine, gravy, salad dressing. spread.

Choose few foods that are high in sugar like candy, jelly, honey, sweet deserts, soft drinks.

Avoid the use of pork, mutton & other glandular meat.

Foods like white flour, white bread and polished rice, which are highly refined and low in vitamins & minerals, should be used less frequently.

Cut down on convenience foods like biscuit, pastries and cakes, as they are rich in invisible fat and refined carbohydrates.



Gear-up for a neutral eating habit

Avoid acid forming foods.

Certain foods like sausages, nuts, macaroni and even chicken and spaghetti are acidic in nature.

Take alkaline foods.

Foods of the alkaline range are primarily plant derived. The most effective are spinach, molasses, celery, carrots and dried beans.

To put your body in the neutral state, increase your fruits and vegetables intake.

Raisins, when soaked in water at night and consumed in the morning, are an excellent way to combat acidity.

Mixed carrot and cabbage juice (1:1) also help in reducing acidity.



Eat right

Never skip a meal. Doing so will reduce your BMR, making you inactive. You will tend to over-eat at the next meal. Instead, have smaller, more frequent meals at regular intervals.

Always have breakfast, as it is the most important meal of the day. It is that time of the day when you nutrient requirements are the highest and a proper breakfast will energise you throughout the day.

Don’t fall asleep soon after dinner, as sleep slows down the body’s metabolism and you tend to burn fewer calories and accumulate fat. Instead, have a light and early dinner and give yourself a 2 to 3 hour gap before going to bed.



Add fibre to your diet

Include a lot of fruits and fresh vegetables in your diet; these not only detoxity the body but are good for the skin too.

Substitute fruit juice with actual fruit, for fibre in your diet.

Never overcook vegetables. They are healthiest when eaten raw.

The skin of fruits and vegetables, like apples and baked potatoes, are goods for you. Remember to wash them before consumption.

Choose whole grain cereals, whole wheat bread, whole pulses and brown rice instead of highly refined alternatives.



Healthy Cooking

Avoid frying foods; instead grill, steam or boil foods to minimise fat content.

Wash vegetables before chopping them to prevent loss of water soluble nutrients like Vitamin C, Riboflavin, Thiamin and Niacin.

Avoid use of baking soda while cooking pulses and vegetables as soda inhibits the absorpiton of calcium.

Avoid repreated washing of rice and pulses, as valuable nutrients are lost in the process.

Preserve vitamins in food by cooking whole vegetables in their skin.

Substitue cream with skimmed yoghurt, as it contains less fat.

Seasonal vegetables and fruits have the highest nutrient content so include them in your diet as often as possible.

Use non-stick cookware and minimise the oil content in your food.

Obesity care in

Unani System of Medicine

How to order when eating out

Eat something healthy before going out, so you will not be tempted to eat more when at the restaurant.

Read the menu carefully to judge which are the least fatty foods.

Choose clear soups instead of creamy ones. Clear soups are just as nutritious and filling but don’t contain as much fat.

Green salads and veggies with low fat dressings are deliciously refreshing and contain lesser fat. Lemon juice, salt, pepper and vinegar are great low-fat dressings. Avoid potato and macaroni salads, as they are high in calories.

Choose grilled, steamed or poached foods over those with rich, creamy gravy/sauces.

Choose tandoori roti, romali roti or missi roti over breads with high butter content.

Grilled items like tandoori chicken, baked fish, pasta with tomato sauce and paneer tikka make great entrees.

Specify that you would prefer as little use of butter and oil in your dishes.

Try to resist ordering dessert, but if you must, then choose fresh fruit or frozen yoghurt.

While Travelling for business or pleasure, pre-plan meals and snacks to reduce stress and to keep your energy high. Take along mineral water, iced tea, vegetable juice and some low fat snacks like whole wheat sandwiches, salad and fresh fruits.



Food Myths

Myth 1 : Juices help reduce weight and cut calorie intake.

Fact : Juices are concentrated sources of energy and have added sugar content. Eating whole fruit whould be more beneficial for your health.

Myth 2 : Refined oils are 99% fat free.

Fact : All refined oils are 99% fat, irrespective of their composition and trade name. 1 teaspoon of refined oil gives 45 cal.

Myth 3 : Honey is good for weight loss.

Fact : Honey consists of 75% sugar (glucose & fructose) and 25% water. It increases the blood sugar and provides 3 Cal per gram of honey.

Myth 4 : Refined oil is preferable to ghee or butter.

Fact : The ideal combination of oil should be as follows : PUFA : MUFA: SFA = 10:12-13:6-8.

PUFA (sunflower oil/safflower oil)

MUFA (olive oil/mustard oil/groundnut oil)

SFA (ghee/butter)

Myth 5 : Toasted bread has less caloreis than the normal brea.

Fact : Toasting bread only converts starch into dextrins. The caloric count however remains the same, i.e., 1 slice of bread = 70 Cal.

Myth 6 : Healthy foods means bland food.

Fact : This is not true. Traditional spices provide the necessary taste and flavour to the foods. At the same time, they are rich in micronutrients, anti-oxidants and fibre. There is no reason to avoid spices, unless they are not tolerated. Theonly restrictive feature of healthy diet is its low sals and fat content.

Myth 7 : Fat content of milk may be reduced by adding water.

Fact : If water is added, all other nutrients in milk also get diluted. Skimming is the best way to remove fat from the milk. Other nutrients are retained in skimmed milk.

Myth 8 : Low calorie foods can be eaten in unlimited amounts.

Fact : Even low calorie foods have calories which add up and must be burned off regardless of what kind of food we eat. Balance is the key to success.

Myth 9 : Buttermilk has only carbohydrates.

Fact : Buttermilk is a very good source of proteins & calcium.



Water helps keep fat away



Water is the key part of any weight loss programme. You should drink at least 10-12 glasses of water everyday. It is essential for you as it helps remove body fat and is good for you overall health.

The benefits of water are manifold :

It helps suppress your appetite.

It reduces build up of sodium in your body.

It reduces fluid retention. It is when your body does not get enough water that it starts retaining fluids.

It reduces fat deposits.

It helps maintain proper muscle tone.

It helps you body get rid of waste and toxins.

It relieves constipation.

Among other fluids, Nimboo Pani should be preferred.

Fresh lime soda (without sugar), Buttermilk, Coconut water, Vegetable Juice and clear Soups are also recommended for healthy body.

Start your meals with one of the above or just a glass of plain water.

Water Retention

Water Retention happens when excess water gets stored in the tissue spaces between cells. It is caused due to the following factors :

(a) Salt Intake - Restrict consumption of Sodium in your diet. Foods high in sodium will cause water retention.

(b) Hormonal Imbalance.

(c) Pre Menstrual Retention - Pre menstrual retention of water can be minimised by drinking plenty of water, maintaining an active programme & restriciting your salt intake.



Foods with high sodium content

You should avoid the following items if on a low Sodium diet :

:: Salt

:: Baking Powder

:: Bicarbonate of Soda

:: Mono-Sodium Glutamat (Ajinomoto)

:: Cheese

:: Bacon, Ham, Sausages, Dried Fish

:: Meat and yeast extracts like Marmite

:: Salted Chips, Nuts, Popcor, Biscuits and all varieties of Papad.

:: Salted Pickles, Chutneys.

:: Commercial salad dressing and sauces, pudding mixes.

:: Soft drinks containing Sodium Benzoate.

:: Soup cubes

:: Proprietary drinks containing Chocolate.



Walk daily, be fit for life

Whatever your age, whatever your level of fitness, walking is the simplest and most effective form of activity for losing weight.

While walking, you should wear loose clothes and well-fitting canvas shoes.

Start at a slow pace and be careful to build up your speed and distance gradually.

Walk briskly with rhythmic movement of your arms and feet. Walk fast enough to become a little breathless and slightly tired but never leave yourself gasping for air or completely exhausted. You should be comfortabel enough to carry on a conversation while walking.

Regular walks will slowly improve your heartbeat, endurance and all-round levle of fitness.

Walking builds long learn muscles, which help in burning calories all the time, day and night, even while you are asleep.

Preferably walk on an empty stomach or 2-3 hours after the last meal.



Easy ways to boost your activity level

Walk as much as possible throughout the day, use your car as less as possible.

Always take the stairs instead of the elevator.

When parking your vehicle, park it as far away as possible from where you want to go.

Hide all your remote controls, operate everything manually.

Whenever possible, stand instead of sitting. If you are desk bound at work, stand up when you are on the phone; walk over to give messages to colleagues rather than using e-mail or phone. During break at work, walk the stairs, around the building or down the halls.

While doing household chores, exaggerate your movements and make them big.

While doing household chores, exaggerate your movements and make them big.

Plant a garden, take up gardening as a hobby.

Spend quality tiem outdoors with your children or grandchildren.

Take up an outdoor with your children or grandchildren.

Try to work out as much as possible, but at your own pace. Reward yourself, not by getting yourself a snack, but maybe by buying a new wardrobe for your trim body.



Tips to control your food intake

Keep a daily reocrd of your food intake in the diet diary.

Do not shop when you are hungry. Buy only non-fattening food. Read lables carefully before buying.

Always eat in one room, at the same place and avoid pairing you eating with other activities like watching TV, cooking or reading.

Always keep at hand low-calorie foods to use as snacks, like fruits and raw vegetables.

If you feel like nibbling on something, you can have “saunf”, “ilayachi” or nibble on pieces of chopped apple, etc.

Make small portions of food appear larger by using a small plate or by spreading the food.

Eat slowly and chew food thoroughly. This helps to eat less food but absorb more vitamins and minerals.

Store food wisely. Keep high-calorie items in places which are hard to reach, like high shelves.

Don’t think just because you are eating low fat/low calorie food, you can eat all you want. The calories still add up and must be burned off. Balance is the key to success.

Depression

What is depression?



The word depressed is a common everyday word. People might say “I’m depressed” when in fact they mean “I’m fed up because I’ve had a row or failed an exam or lost my job” etc. These ups and downs of life are common and normal and most people recover quite quickly.

However, depression is a mood disorder characterized by feelings of sadness, hopelessness, helplessness and worthlessness.

Women are more likely to become depressed than men. The higher risk may be due in part to hormone changes during a woman’s life.

It lowers motivation and energy levels. Depression permeates through the body and mind. Symptoms can become sever enough to interfere with day-to-day activities. When depressed, you may often experience feelings of low esteem, guilt and self-reproach driving you to take irrational decisions.



Who gets depression?

Depression affects people of all ages, geographic locations, demographics and social positions.

About 2 in 3 adults have depression at some time in their life. Sometimes it is mild or lasts just a few weeks. However, an episode of depression serious enough to require treatment occurs in about 1 in 4 women and 1 in 10 men at some point in their lives. Some people have two or more episodes of depression at various times in their life.

Women are more likely to become depressed than men. The higher risk may be due in part to hormone changes during a woman’s life.

Men are les likely than women to get help for depression. They may show the common symptoms of depression, but they’re more likely to be angry and hostile and few may mask their condition with alcohol or drug abuse. The risk of suicide is greater for men than for women.

Elderly, older people may become physically ill and less active than they once were. They may lose their loved ones or may have to live alone.

These changes can raise the risk of depression.



What are the symptoms of depression?

The following is a list of common symptoms of depression. It is unusual to have them all, but several usually develop, if you have depression :

Low mood for most of the day, nearly every day. Things always seems ‘black’.

w Loss of enjoyment and interest in life, even for activities that you normally enjoy.

:: Abnormal sadness, often with episodes of crying.

:: Feelings of guilt, worthlessness or uselessness.

:: Poor motivation. Even simple tasks seeks difficult.

:: Poor concentration. It may be difficult to read, work, etc.

:: Sleeping problems, excessive sleeping, insomnia.

:: Lacking in energy, always tired.

:: Difficulty with affection, including going off sex.



“Life is too beautiful a gift to waste.” Depression may not kill one’s body but it certainly kills one’s spirit if you’ll let it. Don’t be a victim.



:: Poor appetite and weight loss. Sometimes the reverse happens with comfort eating and weight gain.

:: Irritability, agitation or restlessness.

:: Physical symptoms such as headaches, palpitations, chest pains, and general aches. Symptoms often seem worse in the mornings.

:: Recurrent thoughts of death. This is not usually a fear of death, more a preoccupation with death and dying. Some people get suicidal ideas such as ... “life’s not worth living”.

The severity of the symptoms can vary from mild to severe. As a rule, the more symptoms from the list above that you have, the more severe the depression is likely to be.



How is depression diagnosed?

Depression is typically diagnosed simply by a clinical interview asking about the core depressive symptoms.

People tend not to recognize depression, even it’s right before their eyes. Never overlook the various symptoms. Being honest with one’s self, is the key to be able to cure such an illness. Depression shouldn’t be something that one fear of, instead, one should just start taking charges of his/her life and actually face this illness and fight it.

“Life is too beautiful a gift to waste.” Depression may not kill one’s body but it certainly kills one’s spirit if you’ll let it. Don’t be a victim.



What causes depression?

The exact cause is not known. Anyone can become depressed. Some people are more prone to it and may develop for no apparent reason. An episode of depression may also be triggered by a life event such as relationship problem, bereavement, redundancy, illness, etc. In many people it is a mixture of the two. For example, the combination of a mild low mood with some life problem, such as work stress, may lead to depression.

Women tend to develop depression more often than men. Particularly common for women to become depressed is after childbirth (postnatal depression) and menopause.

A chemical imbalance in the brain might be a factor. This is not fully understood. However, an alteration in some chemicals in the brain is thought to be reason why antidepressants work in treating depression.

Trauma and stress from major life changes.

Serious medical conditions like heart disease,cancer, HIV, arthritis and certain drugs can contribute to depression because of the physical weakness and stress they impart.



Some do’s and don’ts about depression:

Don’t bottle things up and ‘go by alone’. Try and tell people who are close to you how you feel. It is not weak to cry or admit that you are struggling.

Don’t despair most people with depression recover.

Do try and distract yourself by doing other things. Try doing things that do not need much concentration but can be distracting such as watching TV. Radio or TV is useful late at night if sleeping is a problem.

Do eat regularly, even if you do not feel like eating.

Don’t drink too much alcohol. Drinking alcohol is tempting to some people with depression as theimmediate effect may seem to relieve the symptoms. However, drinking heavily is likely to make your situation worse in the long run.

Don’t make any major decisions while you are depressed. It may be tempting to give up a job or move away, to solve the problem. If at all possible you should delay any major decisions about relationships, jobs or money until you are well again.

Do tell your doctor if you feel that you are getting worse, particularly if suicidal thoughts are troubling you.

Sometimes a spell off work is needed. However, too long off work might not be as good as dwelling on problems and brooding at home may make things worse. Getting back into the hurry flurry of normal life may help the healing process when things are not improving. Each person is different and the ability to work will vary.

Sometimes a specific psychological problem can cause depression, but some people are reluctant to mention it. One example is sexual abuse as a child leading to depression or psychological difficulties as an adult. Tell your doctor if you feel something like this is the root cause of your depression.



Will Obesity lead to depression or vice versa?

Obesity is largely to blame for an epidemic of anxiety, mood disorders, depression and other mental disease. Past studies have also proved this fact that people who are obese have also suffered from depression. It is not yet confirmed that whether depression causes obesity or obesity may result in depression. People who are suffering from depression sometimes suffer from hormonal disorder which can be easily treated. The treatment of depression and obesity should be integrated.



How Unani experts can help you manage your condition?

Unani experts can help you to manage this condition by helping you to lose weight and advising appropriate changes in diet and lifestyle. A balanced diet approach focusing on consumptionof fruits & vegetables, whole grains, non fat dairy products, lean meat, fish and low in saturated fat, total fat and refined carbohydrates is recommended. Regular physical activity helps in lifting the mood. The physiotherapists, fitness experts & counselors at Unani plan an exercise program comprising both active and passive exercise as per your lifestyle, fitness level and health condition.

Our counselors act as transient support system to motivate clients. They will help you explore what the depression may be about. With their help you will also learn to recognize stress in your life and develop strategies to manage them.

Gall Stones?

What are gall stones?

Gallstones are small, pebble like substances that develop in the gall bladder. Gall stones can be as small as a grain of sand or as large as a golf ball. The gall bladder can develop as just one large stone, hundred of tiny stones or a combination of the two.



The two types of gall stones are :

Cholesterol stones are usually yellow - green and are made primarily of hardened cholesterol. They account for about 80 percent of gall stones.

Pigment stones are small, dark stones made of billirubin.

The gall bladder is small, pear shaped sack located below the liver in the right upper abdomen. Gall stones form when liquid stored in the gall bladder hardens into pieces of stone like material.

Gall stones can cause acute inflammation of the gall bladder with sever pain, high fever & chills. Also if left unoperated can slip down to the common bile duct & cause cholangitis or jaundice, thereby making surgical intervention risky.

Bile is made in the liver and then stored in the gall bladder until the body needs it. The gall bladder contracts and pushes the bile into a tube called the common bile duct that carries it to the small intestine, where it helps with digestion. Bile contains water, cholesterol, fats, bile salts, proteins and billirubin-a waste product. Bile salts break up fat and billirubin gives bile and stool a yellowish - brown color. If the liquid bile contains too much cholesterol, bile salts orbillirubin it can harden into gall stones.



What are the causes of gall stones?

The gall bladder stones bile which contains cholesterol, water, billirubin and bile salts.

Gall stones can form under the following conditions :

Too much absorpiton of bile salts from the bile.

Too much absorption of water from the bile

Too much cholesterol in the bile.

Inflammation of the lining of the gall bladder.

What are the risk factors of having gall stones?

Gall stones are more common in women than in men.

Incidence increases with age, especially in women beyond 60 yrs.

Women with high estrogen levels due to pregnancy and contraceptive use or hormone replacement therapy.

Obesity, especially in women.

Use of cholesterol - lowering drugs.

Diabetes & insulin resistance.

Rapid weight loss and fasting, especially after bariatric (weight loss) surgery

Previous gall stones.

Diseases of the gall bladder and ducts.

Blood diseases including sickle cell anemia.



Will obesity lead to Gall stones?

Obese individuals are more likely to develop gall stones than those who are at a healthier weight. Researchers have found that obese individuals tend to produce higher levels of cholesterol than normal. This leads to production of bile that contains more cholesterol than can be dissolved. When this happens, gall stones can form from undissolved cholesterol. Additionally, in the obese, gall bladders may not empty normally or completely.

Research has also shown that those who have excess fat around their waist (abdominal obesity) may be at greater risk for developing gallstones than those who carry excess fat mainly around their hips and thigh areas. As BMI increases, the risk for developing gall stones also rises. Women with a BMI greater than 32 may be as much as three times as likely to develop gall stones as those with a BMI of 24 or 25. The risk may be seven times higher in women with a BMI above 45 than in those with a BMI under 24.



What would happen if the gall bladder is removed?

You do not need a gall bladder to digest food, Bile still flows from the liver to the gut once the gall bladder is remove. However, there is no longer any storage area for bile between meals. The flow of bile is therefore constant, without the surges of bile that occur from a gall bladder when you eat a meal.

You can usually eat a normal diet without any problems after your gall bladder is removed. However, up to half of people who have had their gall bladder removed have some mild abdominal pain or bloating from time to time. This may be more noticeable after eating a fatty meal. Some people notice an increase in frequency of passing stools (motions or feces) after their gall bladder is removed. This is like mild diarrhea. It can be treated by anti-diarrheal medication if it becomes troublesome.



Will losing weight help prevent or improve your condition and its complications?

It’s important to note that weight loss due to crash dieting or rapid weight loss can actually increase your chances of developing gallstones, too. As the body metabolizes fat during prolonged fasting and rapid weight loss through “crash diets”, the liver secretes extra cholesterol into bile, which can cause gall stones. Slower weight loss of about half to one kg. a week is much less likely to cause gall stones. Although losing weight may increase the risk of developing gall stones, obesity posses an even greater risk. Weight loss can lower the risk of developing gall stones and many other obesity related diseases. Just a 10% reduction of body weight can lower disease risk.



How Unani expers can help you manage your condition?

Unani experts can help you to manage this condition by helping you to lose weight and advising appropriate changes in diet and lifestyle. Diet plan for clients with gall stones takes into consideration a balanced diet approach focusing on consumption of fruits & vegetables, whole grains, non fat dairy products and low in saturated & total fat. Low fat dairy products are advised as they are low in purine content and contain casein which stimulates uric acid diuresis.

Regular exercise helps in energy expenditure and reduce the changes of gall stone formation. The physiotherapists, fitness experts & counserlors at Unani plan an exercises program comprising both active and passive exercise as per your lifestyle, fitness level and health conditions.

GOUT

What is gout?

Gout is a metabolic disease, often familial, associated with hyperuricemia (high uric acid in blood) leading to acute arthritis, usually inflammation of the big toe, but may also effect other joints. Hyperuricemia can be because of over production or under excretion of uric acid, sometimes both.

Note : Some people have a high level of uric acid but do not form crystals or have gout. Also, rarely some peopel with a normal level or uric acid get gout attacks. However as a rule the higher the level of uric acid, the greater the chance of developing gout.



Why does uric acid build up?

It is often familial. Alcohol and certain medicines are important secondary causes. Alcohol ingestion promotes hyperuricemia by increasing urate production and decreasing the renal excretion of uric acid. Certain foods may tip the balance to raise your uric acid higher than normal. In particular, if you eat a lot of heart, herring, sardines, yeast extracts or mussles it may increase the level of uric acid. Some medicines such as diuretics and aspirin may raise the level of uric acid. People with certain other conditions such as obesity, kidney damage, diabetes, mellitus, bone marrow disorders and lipid disorders have an increased risk of developing gout?



How common is gout and who gets it?

Gout affects about 1 in 200 adults

Men are more commonly affected than women. Six out of 1,000 men develop gout, compared with one out of 1,000 women.

A first attack of gout typically develops in middle age, but it sometimes occurs in younger people. The first attack of gout in men most often occur between the age of 30 and 50. In women, it is rare for gout to occur until after menopause.

It tends to run in some families as there is family history of gout in about 1 in 5 cases. The genetic make up that you inherit from your family may be a factor in becoming an ‘under-excreter’ of uric acid.



What are the symptoms of gout?

Gout usually occurs in ‘attacks’. An attack typically develops quickly over a few hours. Acute gouty arthritis is characterized by its sudden onset, frequently nocturnal, either without apparent precipitating cause or following rapid fluctuations in serum urate levels. Either increase or decrease in the serum urate level can precipitate a gouty attack. Common precipitants are alcohol excess (particularly beer), changes in medication that affect urate metabolism and fasting in hospitalized patients before medical procedures.



How is gout diagnosed?

Gout is usually diagnosed if you have the typical symptoms and a raised blood level or uric acid. If you think you have gout, see your general physician. He or she will ask about your symptoms and examine you, He or she may also ask about your medical history, especially family history. A blood test will measure the levels of urate in your blood but the level may also be high in healthy people who don’t have gout. Fluid may be removed from your swollen joint with a needle. This usually causes no more discomfort than a blood test. If urate crystals can be seen in the fluid under a microscope, you have gout. If calcium crystals are seen, you have a similar condition called pseudo gout. An x-ray of your affected joint may be taken to rule out other medical conditions. It is also important to screen the kidneys in all cases with gount. Uric acid kidney stones are present in 5-10% of patients with gouty arthritis. Hyperurecemia correlates highly with the likelihood of developing stones, with the risk of stone formation receding 50% in patients with a serum urate level above 13 mg/dl. This and associated risk factors like hypertension, alcohol use and diabetes can lead to renal failure. Once diagnosed as a case of gout your base line uric acid should be maintained at 5 mg/dl and below.



What the complications of gout?

Kidney damage

Arthritis and joint immobility

Urinary stones-increased risk

Is gout serious?

A gout attack can be very painful. However, other effects from gout are uncommon. Joint damage may occur if you have recurring attacks. In a few people, uric acid cystals form kidney stones or may cause some kidney damage. Sometimes the crystals form bumps (tophi) under the skin. These are usually harmless and painless but sometimes form in awkward places such as the end of fingers. Tophi occasionally become infected.



Will obesity and consumption of certain foods lead to gout?

Obesity is common cause for gout according to current research. At least half of all gout sufferers are overweight, if not obese. The obese body puts a heavy load on the kidneys, above and beyond what they were meant to handle.

Research is also showing that it is not the protein that adds to the gout problem, but actually “purine rich foods”. These include beans, peas, anchovies, liver, brains and (ironically enough) kidneys. Beer is also purine rich. It is the breakdown of the purine that causes uric acid to be formed. If the extra uric acid cannot be flushed from the system, they crystallize and lodge in joints, causing gout.



How Unani experts can help you manage your condition?

Unani experts propose the following measures for people with gout.

Weight loss : if you are overweight. This will quickly reduce the load on your kidneys and help ease the gout.



Dietary advise : A high uric acid level may be lowered by avoiding a high protein intake and foods rich in purines such as organ meats, sea food, yeast/yeast extracts, beer, other alcoholic beverages, beans, peas, lentils, oatmeal, spinach, asparagus, cauliflower and mushrooms. If you drink a lot of sugar-sweetened soft drinks, especially those containing fructose, it may help to reduce the number or cut them out altogether. Avoid dehydration by drinking plenty of water (upto 2 litres/day). If you drink a lot of alcohol, reduction in the amount you drink, may help. Avoiding binge drinking and keep to within the recommended levels of alcohol which is 21 units/week for men and 14 units/week for women.



Medication : If you are taking any medicines, check whether they are cause of gout. An alternative medicine may be available. Your doctor will advise to have your blood pressure checked at least once a year. High blood pressure is more common in people with gout.



Physical activity : The risk of gout is lower in men who are more physically active. The physiotherapists and fitness experts at Unani can help to formulate a customized physical activity pattern based on your fitness level, lifestyle and health condition.

With the help of the above lifestyle changes, many people only have an attack of gout every now and then. All you may need is to have some anti-inflammatory pain killers on ‘standby’ to treat each attack. For some people, attacks occur more often. In this situation, you can take a medicine prescribed by your doctor to prevent attacks.

Polycystic Ovary Syndrome

What is Polycystic Ovary Syndrome (PCOS) and why does it occur?

PCOS is a common endocrine disorder. The primary lesion is unknown. Patients have a steady state of relatively high estrogen, androgen and Leutinizing Hormone (LH) rather than fluctuating condition seen in ovulating women. Increased levels of estrone come from conversion of ovarian and adrenal androgens to estrone in body fat (in obesity cases). The high estrone levels are believed to cause suppression of pituitary Follicle Stimulating Hormone (FSH) and a relative increase in LH. Constant LH stimulation of the ovary results in anovulation, multiple cysts and theca cell hyperplasia with excess androgen output.



In addition, there is insulin resistance leading to high levels of insulin in the blood which further leads to weight gain and obesity.



Insulin - Resistance

Hyperinsulinemia

Excessive fat



Ovarian and adrenal androgens are converted to estrone in excessive amounts.



High estrone levels suppress pituitary - FSH and relative increase in LH.

Increased LH will result in.



Anovulation - will lead to oligomenorrhoea.

Multiple cysts in ovaries

Theca cell hyperplasia.

Increased androgen output : Acne, Alpecia, Hirsutism.



It is very important to distinguish between PCO (polycystic ovaries) and (PCOS) polycystic ovary syndrome. Having PCO does not necesarily mean you have PCOS. A syndrome is usually defined as a pattern of symptoms belonging to particular disease. Medical studies using ultrasound have found that around one in four women has polycystic ovaries (PCO), but most of them have none or few of the other symptoms associated with (PCOS) polycystic ovary syndrome.



Excess hair on the body (hirsiutism) - Heavy periods.

Acne & other skin problems - Fertility problem

Scalp hair loss - Insulin resistance

Irregular or missed periods - Weight issues.



Did you know PCOS can lead to obesity and obesity leads to infertility?

Did you know people with a strong will power can lose weight and improve their PCOS - a leading cause of infertility?

Did you know the first line management includes diet modification, weight loss and stress reduction?

Are there any long term effects if PCOS is left untreated?



Even if specific symptoms are not causing an immediate problem, PCOS can have significant long-term effects, including diabetes, heart disease and endometrial or breast cancer. This happens because of unopposed estrogen secretion. So seeking treatment is critical.



In addition they show hyperinsulinemia and insulin resistance which leads to early onset diabetes Type-II and therefore hyperlipidemia and its complications.



Investigations :

FSH / LH Ratio

Serum total and free testosterone

DHEA

E2

These above investigations should be done on the second day of the menstrual cycle. Ultrasound Ovaries - many rely solely on this investigation not realizing that the percentage of successfully diagnosing PCOS by this method is only 30-60%.



How Unani experts can help you manage your condition?

In obese patients with PCOS, weight reduction is often effective. A decrease in body fat will lower the conversion of androgens to estrone and thereby help restore ovulation.

Dietary modifications as for insulin resistance and diabetes type II should be followed. Exercise has a major role to play especially because of insulin resistance. Hirsuitism may be managed with epilation and electrolysis. Spironolactone and aldosterone antagonist is also useful for hirsuitism.

As this condition affects the skin and hair there are special cosmetological and dermatological treatments available in Unani medicine with excellent results for acne and hirsuitism. This condition is often worsened by stress, diet, smoking, alcohol and lack of exercise. Out team of experts comprising of counselors, doctors, cosmetologist, dermatologist and fitness experts ensure that special care is taken to improve your health status.

The diet for all facets of PCOS i.e. overweight, insulin resistance, acne, etc. is complicated and is pain stakingly organized and implemented by our dieticians. This is done after taking a meticulous history both dietary and medical. A BCA (Body Composition Analysis), BMI and waist hip ratio helps to decide the exact therapy for the individual.

Cardiovascular Disease

What is Cardiovascular disease?

Cardiovascular disease (CVD) is an abnormal function of the heart or blood vessels. It can increase the risk for heart attack, heart failure, stroke, cardiac rhythm problems, thus resulting in decreased quality of life and decreased life expectancy. When doctors use the term ‘Cardiovascular Disease’ they usually mean diseases of the heart or blood vessels that are caused by atheroma.



What is atheroma (atherosclerosis)?

Patches of atheroma are small fatty lumps that develop within the inside lining of arteries (blood vessels). Atheroma is also known as ‘hardening of the arteries’. Patches of atheroma are often called ‘plaques’ of atheroma. Over months or years, patches of atheroma can become larger and thicker, making an artery narrower, which can reduce the blood flow through the artery. For example, narrowing of the coronary (heart) arteries with atheroma can cause angina.

Sometimes a blood clot (thrombosis) forms over a patch of atheroma and completely blocks the blood flow. Depending on the artery affected, this can cause a heart attack, a stroke or other serious problems.



What are the cardiovascular diseases caused by atheroma?

The cardiovascular diseases than can be caused by atheroma include :

Heart disease : The term ‘heart disease’ or ‘coronary heart disease’ is used for conditions caused by narrowing of one or more of the coronary (heart) arteries by atheroma. This can cause angina, heart attack and heart failure. Heart disease is common in people over 50 years.



Cerebro-vascular disease - stroke and TIA :

Cerebro-vascular disease means a disease of the arteries in the brain. This can lead to TIA (transient ischemic attack) or a stroke. A stroke means that part of the brain is suddenly damaged. The common cause of stroke is blocking of an artery in the brain by a blood clot (thrombus) which usually forms over some atheroma. A TIA is a disorder caused by temporary lack of blood supply to a part of the brain, resulting in weakness in part of body. If left untreated it can progress to stroke (paralysis).



Peripheral vascular disease :

Peripheral vascular disease is narrowing due to atheroma that affects arteries other than in the heart or brain. The arteries that take blood to the legs are the most commonly affected.



What are the risk factors?

Everybody has some risk of developing atheroma. However, certain ‘risk factors’ which increase the risk include.



Lifestyle risk factors that can be prevented or changed :

Obesity

Lack of physical activity (a sedentary lifestyle)

An unhealthy diet and eating too much salt.

Excessive alcohol intake

Smoking

Treatable or partly treatable risk factors :

Hypertension (high blood pressure)

High cholesterol

High triglyceride

Diabetes

Kidney diseases



Fixed risk factors - ones that you cannot alter :

A strong family history a father or brother who developed heart disease or a stroke before they were 55, or a mother or sister who developed heart disease or a stroke before they were 65.

Being male

An early menopause in women.

Age. The older you become, the more likely you are to develop atheroma.

Ethnic group. For example, people who live in the Uk with ancestry from India, Pakistan, Bangladesh or Sri Lanka have an increased risk.

If you have a fix risk factor, you can make an extra efforts to tackle any lifestyle risk factors that can be changed.



Assessing your cardiovascular health risk.

The following people should be assessed to find their cardiovascular health risk :

All adults aged 40 or more.

Adults or any age who have.

A strong family history of early cardiovascular disease.

A first degree relative (parent, brother, sister, child) with a serious hereditary lipid disorder. For example, familial hypercholesterolemia or familial combined hyperlipidaemia.

Obese and over weight adults having a BMI of over 23.

Diabetic.

Hypertensives

Smokers



What does the assessment involve?

A Doctor will advise a blood test to check your cholesterol and glucose (sugar) level.

Measure your blood pressure and your weight.

Ask you, if you smoke.

Ask, if there is a history of cardiovascular disease in your family. If so, at what age the disease started in the affected family members.

A score is calculated based on these factors plus your age and your sex. An adjustment to the score is made for certain other factors such as strong family history and ethnic origin.



What does the assessment score mean?

You are given a score as a % chance. For example, if your score is 30% this means that you have a 30% chance of developing a cardiovascular disease within the next 10 years. This is the same as saying a 30 in 100 chance (or a 3 in 10 chance). In other words, in this example, 3 in 10 people with the same score that you have will develop a cardiovascular disease within the next 10 years.

Note : the score cannot say if you will be one of the three. It cannot predict what will happen to each individual person. It just gives you the odds.



You are said to have a :

High risk - If your score is 20% or more. That is, in 10 chance or more of developing a cardiovascular disease within the next 10 years.

Moderate risk - If your score is 10-20%. That is, between 1 in 10 and 2 in 10 chance.

Low risk - If your score is less than 10%. That is, less than 1 in 10 chance.



Who should be treated to reduce their cardiovascular health risk?

Treatment to reduce the risk of developing a cardiovascular disease is usually offered to the people with :

Risk assessment score of 20% of more

An existing cardiovascular disease (to lower the chance of it getting worse or of developing a further disease)

Diabetes, if you have diabetes, the time that treatment is started to reduce cardiovascular risk depends on factors such as: your age, how long you have had diabetes, your blood pressure and if you have any complications of diabetes.



Will losing weight help prevent or improve your conditions and its complications?

The increased health risk of obesity is most marked when the excess fat is mainly in the abdomen rather than on the hips and thighs. Asians are prone to Metabolic Syndrome, with a high risk for developing diabetes and subsequently heart disease and stroke. A waist measurement of 90 cm or above for (Asian) men and 80 cm or above for (asian) women is a significant health risk. If you are obese or overweight you can greatly reduce you health risk by losing 5 - 10% of your weight. This is often about 5-10 kg.



How Unani experts can help you manage your condition?

Unani experts can help you to manage this condition by helping you to lose weight and advising appropriate changes in diet and lifestyle. Diet plan for clients with/at risk of heart problems takes into consideration a balanced diet approach focusing on consumption of fruits & vegetables, whole grains, non fat dairy products, lean meat, fish and low in saturated fat, total fat and refined carbohydrates. Diet counselor act as transient support system to prepare & motivate clients to incorporate gradual changes. Unani counselor advise behaviour and lifestyle modification to reduce both weight as well as waist circumference. Regular physical activity helps in energy expenditure and also reduces your risk of having a heart attack or stroke. The physiotherapists, fitness experts & counselors at Unani plan an exercise program comprising both active and passive exercise as per your lifestyle, fitness level and health conditions.

Obesity

Effect of high fat % in the body on health

Being too high in body fat can have a number of serious ramifications for your health. It also usually means that you are not as attractive as you might want to be in terms of having a toned, fit and healthy-looking body.



Hypertension

Additional fat tissue in the body needs oxygen and nutrients in order to live, which requires the blood vessels to circulate more blood to the fat tissue. This increases the work load of the heart because it must pump more blood through additional blood vessels. More circulating blood also means more pressure on the artery walls. Higher pressure on the artery walls increases the blood pressure. In addition, extra weight can raise the heart rate and reduce the body’s ability to transport blood through the vessels.



Diabetes

Obesity is associated with an increased risk of developing insulin resistance and Type-II diabetes. In obese individuals, adipose tissue releases increased amounts of non-esterified fatty acids, glycerol, hormones, pro-inflammatory cytokines and other factors that are involved in the development of insulin resistance. When insulin resistance is accompanied by dysfunction of pancreatic islet-cells-the cells that release insulin-failure to control blood glucose levels and diabetes results.



Heart Problems

Atherosclerosis (hardening of the arteries) is present 10 times more often in obese people compared to those who are not obese. An obese person has more body fat, which means more fatty molecules (such as cholesterol) are in his blood vessels. These fats constrict the blood vessels, which mean that the heart experiences difficulty in pushing blood through the vessels. This constriction also worsens the strain on the heart because the heart has to wrok overtime both to pump large amounts of blood and to push the blood through the blood vessels. Narrowed arteries and reduced blood flow to the heart can cause chest pain (angina) or a heart attack. Blood clots can also form in narrowed arteries and cause a stroke.



Arthritis

Increased fat levels and higher body weight contributes to the development of osteoarthritis - a degenerative disease of the joint. Added body weight causes trauma to weight carrying joints and accelerates osteoathritis. Being overweight or obese for long periods of time greatly deteriorates the hip and knee joints.

Respiratory difficulties

Obesity impairs respiratory function leading to the following problems :

Expansion of chest wall is decreased.

Work of breathing is increased.

Lung capacity is decreased.

Therefore, obese individuals are more prone to bronchitis, worsening of asthma and pneumonia.

Sleep apnea

Sleep apnea causes people to stop breathing for brief periods, interupts sleep through out the night and causes sleepiness during the day. It also causes heavy snoring. Excess body fat on the neck and chest constricts the air-passage ways and sometimes causes restricted breathing.



Gall stones

Obese individuals are more likely to develop gallstones than those who are at a healtheir weight. Researchers have found that obese individuals tend to produce higher levels of cholesterol than normal.

This leads to production of bile that contains more cholesterol than can be dissolved. When this happens, gallstones can form from undissolved cholesterol. In the obese, gall bladders may not empty normally or completely.



Gerd

People who are obese are more likely than people who are not obese to have gastro-esophageal reflux disease (GERD) of which heart burn is a major symptom.



PCOS

Excessive fat accumulation, particularly in the abdominal region is partly responsible for insulin resistance and associated hyperinsulinemia which play a key role in increasing the male sex hormone in women with PCOS.



Cancer

Fat tissue is important in the production of estrogen and prolonged exposure to high levels of estrogen increases the risk of breast cancer.

Visceral fat around the stomach organs and subcutaneous fat over the abdominal muscles promotes an inflammatory response in the body which increases the risk of developing cancer of colon, uterus, cervical and prostate.



Do you know?

An increase in BMI by 1 can increase your chances of getting diabetes by upto 20 times.

Obesity can lead to gestational diabetes (Diabetes during pregnancy). This increases the risk for a primary caesarian and pre term birth in all women.

Obesity and insulin resistance are reversible, but unchecked will lead to type II diabetes mellitus which is irreversible.

Just a 10% reduction of body weight can lower the risk of developing gall stones.

Decreasing BMI by 2 units is associated with reducing one’s risk of developing osteoarthritis by approximately 50%.

Factors involved in Obesity

Factors affecting the proportion of body fat include genetics, level of energy balance, composition of diet, level of physical activity, environmental & societal influences, endocrinal factors, psychological factors, medication and smoking.



Genetics

A person is more likely to develop obesity if one or both parents are obese. If both parents are of a normal weight only 7% of children will be obese. If one parent is obese, the incidence of obesity in children is 40% and it rises to 80% if both parents are obese. Genetics also affect hormones involved in fat regulation. Leptin is a hormone produced in fat cells which controls weight by signaling the brain to eat less when body fat stores are too high. If for some reason the body cannot produce enough leptin or leptin cannot signal the brain to eat less, this control is lost and obesity occurs. Lipo protein lipase (LPL) is an enzyme which promotes fat storage. Obese also have high LPL activity in their fat cells than lean people.



Dietary habits

Dietary habits particularly the level of fat and energy intake is strongly associated with excess body weight. Excess dietary fat is readily stored in fat depots of the body. Excess carbohydrates can also be converted to fat. Overeating, irregular eating habits, nibbling in between meals, eating at night due to insomnia contribute to high energy intake and thus obesity. Alcohol intake provides empty calories and contributes to increase in central obesity. Consumption of fast foods that are high in fat and refined carbohydrates and low in fiber often used as regular additions to the diet also contribute to increased energy intake.



Level of physical activity

Increased mechanization, improved transport and working facilities reduce physical activity and promote sedentary lifestyle and weight gain.



Environmental and societal influences

Social pressures and official commitments of eating out and attending parties is a common cause of excessive intake of food and energy.



Endocrinal factors

Certain genetic disorders as well as some hormonal problems such as hypothyroidism, insulin resistance, Cushing’s syndrome can cause weight gain. The female sex hormones also play a role, as obesity may occur after pregnancy, after removal of ovaries or uterus or at menopause.



Psychological factors

There may be a physical connection between depression and obesity. For an individual who is lonely, discontented or depressed eating can be a solace. Obese people seem to be affected more by taste and appearance of food rather than hunger and satiety. Tension, anxiety, fear may further make a person resort to food for emotional satisfaction.



Drugs

Drugs such as steriods, most oral hypoglycemics, anti-epileptics, non steroidal anti-inflammatory drugs, oral contraceptive pills and some antidepressants may also cause weight gain.



Smoking cessation

Smoking causes a marked increase in metabolic rate and tends to reduce food intake. Smokers frequently gain weight when they give up this habit.



Stress and weight gain

When faced with a stressful situation, our brain signals an acute immediate response causing the adrenal glands to release a hormone called cortisol and release of a chemical in the brain called neuropeptide Y, along with norepinephrine. When cortisol levels increase in response to stress, blood sugar levels rise as proteins are converted to glucose to serve as additional fuel. The unused glucose ends up being stored as fat once the stress is over, resulting in weight gain. Exposure to cortisol over long term can lead to weight gain, as your appetite and insulin levels are continuously increased. Neuropeptide Y is a powerful appetite-stimulating chemical which especially increases the desire for carbohydrate-rich foods. Yoga and other relaxation techniques are beneficial to combat stress. You need to become aware of situations that make you feel extra strain at home or at work and try to find ways to deal with this. Make sure that you have some time for yourself each day. You could gofor a walk, get a relaxation massage, do meditation or breathing exercises.



Did you know that people who get inadequte amounts of sleep are likely to gain weight?

With sleep deprivation, there is a reduction in metabolism and an increase in appetite. Inadequate sleep lowers levels of leptin, the hormone that causes you to feel full, while increasing levels of gherlin, the hormone that makes you feel hungry. Sleep deprivation also influences your food choices, making you crave high carbohydrate/high sugar foods. Sleep loss and stress decreases insulin sensitivity, putting the sleep deprived at higher risk for developing type II diabetes.



There are certain significant periods of life when an individual may be more vulnerable to the development of obesity. These are :



Prenatal

Status of maternal nutrition during pregnancy affects the development of size, shape & body composition of the fetus along with the metabolic competence to handle macro-nutrients. Close relationships exist between patterns of intra-uterine growth and the risk of abdominal fatness, obesity and their co-morbidities later in life.



Adolescence

Irregular meals, changed food habits, periods of inactivity alongwith physiological changes promote increased fat deposition especially in females.



Pregnancy

If females excess weight gain may occur during pregnancy or following it.



Menopause

Women tend to gain weight during this period due to reduced physical activity, declining muscle tone, increased caloric intake and other effects of aging. Postmenopausal women have reduced lipolysis, the process by which stored fat is released from fat cells.



Maternal nutrition during pregnancy is an important determinant of the birth weight of the infant. Epidemiological studies have indicated that the origin of major degenerative diseases such as diabetes and coronary heart disease in adults, which have not emerged as major public health problems in India accounting for considerable morbidity and mortality, may in fact be traced to intra-uterine growth retardation (IUGR) arising from poor maternal nutrition during pregnancy (Low birth weights : Significance and implication)



It becomes imperative to focus on the nutritional status of “Future Mother” at the prenatal stage than to make the future child face multiple health problems in later life. This can be a purposeful strategy to look forward to a more healthful nation by avoiding the unhealthy future human resource to some extent.



To give shape to this concept Un



Preventing obesity in children



Positive changes families can make to promote healthy eating & exercise habits and ideal weight in children.



Our body needs a regular, well balanced supply of nutrients to be healthy and fit. Proper nutrition in childhood can inculcate and lay the foundation for lifelong eating habits that contribute to the child’s overall well being and help them to grow up to their optimum potential without being overweight. By providing the child with a balanced diet as per the recommended dietary allowances for different age groups, we can give them a firm foundation for years to come and reduce the risk of nutrition-related diseases in the forthcoming years.



Parents should foster healthy eating and activity habits, be a good role model, offer a nutritious selection of food and involve children in making smart food and physical activity choices. Make the new health behavior easy for them by placing a bowl of washed fruit, such as grapes or apples, on the table which they can pick as snack when hungry. Create opportunities for your family to spend time together doing something active. Plan fun and active things for your family to do together, such as play in the park, walk through the zoo, tour some local sites, hike or swim.

How to Lose Weight and Maintain it...

Losing and maintaining a healthy weight reduces your risk of health problems and increases your ability to enjoy an active, healthy life.



Getting Started

Did you know that simply losing as little as 10% of your current body weight can make a difference in your health.



Achieving this initials weight loss goal will help to lower your risk for heart disease and other conditions, including high blood pressure, type II diabetes and certain types of cancer.



Did you know that a reasonable and safe weight loss is 0.5 - 1 kg per week.



While it may take longer to lose the weight, it will make it easier to keep the weight off and will also give you the time to make new healthy lifestyle changes such as eating a healthy diet and increasing your physical activity level.



Did you know that it is better to maintain a moderate weight loss over a longer period of time than to lose lots of weight drastrically and regain it.



How to lose weight

To achieve scientific reduction in BMI and fat mass with preservation of lean body mass, a temporary negative energy balance needs to be created in the body so that the fat stores are used for energy. To be successful at losing weight, you need to adopt a new lifestyle. This diet with healthy foods, being more physically active and learning how to change behaviors. Over time, these changes will become routine.



Calories

To loss weight, you need to cut down on the number of caloreis (units of energy) you get from food and beverages and increase the physical activity. For a weight loss of 0.5 - 1kg per week, daily intake should be reduced by 500 calories.



Eating plans containing 1,000-1,200 calories will help most women to lose weight safely.



Eating plans between 1,200 calories and 1,600 calories each day are suitable for men.



Healthful eating plan

The energy restricted diet should be adequate in proteins to preserve the lean mass, rich in complex carbohydrates and low in fat and sugars.



Food that can be eaten more include those that are lower in calories, total fat, saturated and trans fat, cholesterol and sodium (salt). Examples of these foods include fat-free, low-fat-milk, milk products, lean meat, fish, poultry, high-fiber foods such as whole grains, breads, cereals, fruits and vegetables. Canola or olive oils and soft margarines made from these oils are heart healthy and can be used in moderate amounts. Unsalted nuts can also be built into a healthy diet as long as you watch the amount.



Foods higher in fats are typically higher in calories. Foods that should be limited include those with higher amounts of saturated and trans fats and cholesterol. These particular fats raise blood cholesterol levels, which increases the risk for heart disease. Saturated fat is found mainly in fresh and processed meats, high-fat dairy products (like cheese, whole milk, cream, butter and ice cream). Trans fat is found in foods with partially hydrogenated oils such dalda, commercially available fried foods and some bakery goods. Cholesterol is found in eggs, organ meats and dairy fats. Saturated fats should be replaced with moderate amounts of monounsaturated fats and polyunsaturated fats. It’s also important to limit foods and beverages with added sugars such as desserts like canned fruit packed in syrup, fruit drinks and sweetened beverages. Foods and beverages with added sugars will add calories to your diet without giving you needed nutrients.



Increasing the physical activity level

Staying physically active is most helpful for reducing weight, preserving the lean mass and vital in maintaining the lost weight. In addition, it has the benefit of lowering the risk of certain diseases such as heart disease and diabetes.



A few individuals can lose weight by participating in 30 minutes of exercise per day, but most people need 60 to 90 minutes of daily physical of daily activity for proper weight management (the 30 minutes of exercise are included as part of the 60 to 90 minutes of physical activity).



For the beginner, one way to be more active is to do more “everyday” activities, such as taking the stairs instead of the elevator, stretching or taking a walk during breaks at work, spending ess time watching television and working on the computer. Also, try spending more time doing activities such as gardening, household chores, pushing a stroller, ironing or cooking.



The next level would be light activities, such as slow walking house cleaning, child care, golf and recreational sports such as table tennis.

Once comfortable with this level, try adding more moderate activities such as faster walking, weeding a garden, carrying a load, cycling and dancing.



Whatever sort of exercise you-do

Gradually build up the amount of activity by starting slowly and then gradually build up the time you spend doing the activity and how often you to do it.



Each time you exercise, start slowly for the first few minutes and build up gradually. At the end, spend some time going more slowly and cooling down.



Choose a variety of exercises and ones that you enjoy, to remain motivated.



You may squeeze in two or three bouts of 15 or 20 minutes of activity in a day. It is just as effective as doing it all at once.



Small changes can make a big difference



Listen carefully to your internal hunger and satiety cues and follow them.



Start with a small serving and then get more if you’re still hungry.



Eating slowly will help you to feel satisfied when you’ve eaten the right amount of food for you. It takes 15 or more minutes for your brain to get the message you’ve been fed. Slowing the rate of eating can allow you to feel full sooner and therefore, help you eat less.



Don’t buy problem foods

Using smaller plates helps to moderate portions so they don’t appear too small.



Eat only in one room at a designated time.



Make small portions look large by spreading them over a plate.



Slow down eating put down utensil between bites.



At fast food restaurants, order small or regular sized foods and beverages.



Leave some food on your plate.

Reward yourself personally and immediately for positive behaviours e.g. buy a new dress, buy a ticket for movie/concert.



Maintaining weight

Once you’ve reached your weight loss goal, maintaining your lower body weight can be a challenge. They key to weight maintenance is to continue the healthy lifestyle changes that you have adopted. Staying on a healthy diet and aiming for 60-90 minutes of physical activity most days of the week will help you maintain your lower weight.



Though obesity is a syndrome complex with genetic, nutritional imbalances and metabolic errors contributing to chronic diseases such as cardiovascular, diabetes, gall stones, arthritis and significantly increase the mortality associated with BMI and central distribution of fat. Management of obesity is notoriously difficult, but when handled scientifically and with understanding can meaningfully help to re-adjust the dietary energy intake along with an increase in physical activity more or less permanently to succeed.



It is better not to lose weight, than to lose it unscientifically.

Mother care and care of body during pregnancy with Unani Ailments

A pregnant woman may have mixed feelings. She may feel happy and proud but at the same time, may be anxious and uncertain. In fact, during pregnancy, feelings may change frequently from one day to the next. The mixture of feelings is quite normal, while adjusting to pregnancy and to the idea of parenthood. The pregnant women should be educated about good care of health because caring for herself during pregnancy means good care for the baby.



The following are some guide line how the pregnant women care about her pregnancy and her body during pregnancy.



Antenatal care :

The care women receive before the baby is born during pregnancy is called antenatal care. Women who start antenatal care early as much as possible to ensure a normal pregnancy with delivery of a healthy baby from a healthy mother.



Pregnancy Care

Sleep & Rest : The patient may continue her usual activities throughout pregnancy, but hard work should be avoided. Pregnant women should get enough rest, especially during later months. A rest during the day is good and the night sleep is at least 8 hours.



Medicine : During pregnancy, especially during first trimester, women should not take any medication at all; because during first three months there is organ formation occurs.



Diet : Is important on three counts; viz; the health of mother herself, her developing foetus and the alleviation of minor disorders of pregnancy. Pregnant women should be explained about regular intake of food which ensures regular supply of nutrients to the unborn baby. The pregnant diet ideally should be light, nutritious, easily digestable and rich in protein, minerals and vitamins. Therefore their meals should have portion of meat or fish, eggs or high proteins at lunch and dinner should take plenty of fresh fruits, milk, cheese etc.



Travelling : Travels by vehicles having jerks are better to be avoided specially in first trimester and the last 6 weeks. Long journey mainly limited in second trimestar. Rail route is preferable. Air craft is contraindicated in cases with placenta praevia, pre-eclampsia, severe anaemia and sickle cell anaemia.



Bowel : There is a tendency of constipation during pregnancy, which may be related with back ache and abdominal discomfort. Regular bowel movement may be facilitated by regulation of diet taking, plenty of fluids, vegetables and milk.



Sexual intercourse : There is no reason to stop having sex during pregnancy, but if there is a history of miscarriage, better to avoid in first trimestar and during last 6 weeks.



Smoking & Alcohol : Better to stop smoking not only during pregnancy but even thereafter. Heavy smoker have small babies and there is also more chance of abortion. Similarly alcohol consumption is to be drastically avoided, so it prevents fetal maldevelopment or growth restriction.



Care of breasts : If nipples are anatomically normal, nothing is to be done beyond ordinary cleanliness. If the nipples are retracted, correction is to be done in the later months by manipulation to easy feeding.



Bathing : The patient should be daily bath but be careful against stipping in the bathroom due to imbalance.



Weight control : The pregnant women should expect to gain about 10-12kg in weight during her pregnancy and not to exceed.



Dental Care : Brush the teeth thoroughly at least twice a day, and if pregnantn women have dental carey or tooth problem take more care, it take safeguard to the fetus.



Skin : During pregnancy the body colour specially cheek, neck become dark due to hormonal changes and it will be clear-up after delivery.



Clothes & Shoes : Pregnant women should wear loose garments and it should be cotton. And wearing bra makes the breast firm. The shoes be flat and avoided to wear heel.



Immunization : Immunization against tetanus not only protects the mother but also the neonates. In unprotected women, 0.5ml tetanus toxioid is given intramuscularly at 6 weeks interval for 2 such, the first one to be given between 16-24 weeks.



Pregnant women frequently suffer from a variety of minor medical problems that may cause significant distress, anxiety and loss of emotional feelings. Some of these problems are unique to pregnancy, some are a continuation of previous problems and some are common ailments that all of us have from time to time.



Exercise : Exercise in pregnancy should be encouraged, though with advancing gestation physical constraints may limit sporting activities. Exercise can improve cardio vascular function, lower blood pressure and improve self-esteem and confidence. Swimming is often helpful throughout pregnancy because it is non-weight bearing exercise.



Minor Problems

Backach : During pregnancy due to changes in posture, relaxation of the ligaments, high heel shoes leading to increase the back pain. Doing massage with Roghane gul and Roghane qusth alleviates the pain and if due to calcium deficienty giving Qurs marwareed and Kameere marwareed is good.



Nausea & Vomiting : It is commonly appear in following first or second missed period and subsides by the end of first trimester (first 3 months). This is especially in the morning, soon after getting out of bed. So advice them to move the limbs for few minutes before getting out of bed or taking dry toast or biscuit before rising from the bed and avoidance of fatty foods and liquids in empty stomach. If these simple measures fails taking following drugs are helpful.



Sikanjabeen

Adrak (Ginger) juice

Sharbat anar shireen

Leemoni juice

Jawarishe kamooni



Constipation : This is due to contraction of the lumen (gut) and pressure of pregnant uterus on large intestine. This relieved by taking Roghane badam and Isapghoul with water.



Leg cramps : This is due to deficiency of calcium and phosphorous level in blood. Commonly occur on back and calves muscles. This relieved by massaging the legs with Roghane gul and Roghae qusth and application of local hot heat and warm bath.



Acidity : There is burning sensation in stomach and throat due to pregnant uterus compress the stomach, causes back ward return of acid. This is relieved by sleeping in semi-reclining position and using following medicine also beneficial. And also giving Jawarishe kamooni, astringent fruits like Amla, Haleela and Baleela.



Varicose veins and Haemorrhoids (Piles)

Commonly occur in legs, vulva or rectum in later months, due to obstruction in the venous return by the pregnant uterus. For legs varicosities applying elastic crape bandage during pregnancy. And elevation of the limbs on rest helpful. For piles using laxatives helpful to soft the bowel. And sitz bath (Abzan) with Kmno4 solution and hot fomentation with joshandae posth khaskash is beneficial.



Ankle oedema : This is due to over weight on feet and ankle, so it is relieved by doing nutool with Tukhm khurfa and Tukhm kahu and also Fafol with juice of Anbub salab leaves.



Vaginal discharge & Pruritus vulvae : This is due to increase vascularity of genital tract and changes of vaginal pH, so assurance the patient and advice them to maintain the hygiene. Additionally using Safoof e sailan and taking sitz bath with Safoofe zaj is good.



Carpet tunnel syndrome : During pregnancy, due to fluid accumulation causes median nerve compression, so patient will suffer from numbness on fingers and palm. So doing massage with Roghane zaitoon and avoid salt in diet.



Loss of sleep : Loss of sleep due to anxiety, fear and worries. Better to counselling them and ask to take warm water at bed time.



Palpitation : This is due to increased cardiac out put, so morning walk and stay in well ventilated room is beneficial. Taking Khameer marwareed, Arq gulab and Arq gauzaban. Dawaulmisk, Zaranbad is beneficial.