Ask Dr. Nandi

  • How Healthy Is the “Keto” Diet?
    [youtube https://www.youtube.com/watch?v=gcyuz12t0cA?rel=0]

    (WXYZ) — The Keto Diet has been making headlines as celebrities publicly argue over it through social media. So exactly what is the ketogenic diet? And what exactly is good or bad about it?

    Now I know that the Keto Diet is very trendy at the moment, but popularity certainly doesn’t mean an automatic stamp of approval

    And as many of you know, I am not a “diet” fan but let’s put that aside for now and look at what the science says.

    What you might not know is that the Keto Diet is actually prescribed by medical professionals to a select few who suffer from epilepsy. It’s usually to children who don’t respond to seizure medications and they are closely monitored by dietitians.

    Now the Keto Diet is a high-fat, low carb diet – 80% of calories come from fats. And by cutting back on carbs, your body starts a metabolic state called ketosis. And this burns body fat.

    Now looking at research, studies found low-carb diets tend to do better than low-fat diets when it comes to dropping weight. And the Keto Diet is no exception, it can lead to short-term weight loss.

    Now the downside is that you allowed eating protein that’s high in saturated fat, such as beef, pork, and bacon.

    Too much saturated fat can increase your bad LDL cholesterol, and that’s linked to heart disease

    Also, cutting back on healthy carbs like fruits, sweet potatoes and whole grains is not a good idea because you could be missing out on valuable nutrients and fiber.  Understand good carbs vs. bad carbs here.

    Other potential risks include liver problems due to so much fat having to be metabolized, kidney problems as this diet could overload them, and constipation and fuzzy thinking.

    So if you want to lose weight, what should you do? Here are my prescriptions:

    Partha’s RX

    1. Don’t fall for trendy diets. Too many people pack the pounds back on once they return to your old eating habits.
    2. Don’t yo-yo diet. Losing weight and then gaining it back has been linked to a higher risk of having a stroke or heart attack.
    3. Reduce your portion size and eat till your two-thirds full. Also, drink 60 ounces of water a day, and skip energy drinks and soda.
    4. Cut out processed foods. Instead, fill your plate with plenty of vegetables. And chose real foods, ones that are closest to their natural state as possible.

    Eating healthier overall, and not depriving yourself will not only help you lose weight in the long run, but you’ll feel great too.

    Copyright Scripps Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
    Data pulled from WXYZ

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  • How Does IBS Affect The Quality of Life?

    What is IBS And How Does IBS Affect The Quality of Life?

    Irritable bowel syndrome (IBS) is a gastrointestinal (GI) disorder that can cause patients to experience chronic and/or recurrent abdominal pain that can either be relieved, or further aggravated, by a bowel movement (defecation). IBS patients are typically classified according to whether they predominantly experience constipation (IBS-C), diarrhea (IBS-D) or a mix of both stool patterns.

    It is estimated that almost 20% of the global adult population is affected by some form of IBS, thereby making this disorder the most common complaint to gastroenterologists around the world. There are various underlying causes that have been associated with IBS, of which include:

    • Genetic factors
    • Diet
    • Infections
    • Disturbances in Intestinal Microbiome
    • Activation of the Immune System
    • Disordered Bile Salt Metabolism
    • Changed Brain Function
    • Changes in Serotonin Metabolism
    • Anxiety
    • Depression1

     

    IBS and the Gut Microbiome

    In a healthy individual, the intestine will contain a healthy microbiota that is comprised of more than a thousand microbial species. The microbiome is in a mutualistic relationship with each human being – that is, the microbes of the gastrointestinal (GI) tract harvest energy and nutrients obtained from the foods we eat to survive, and, in return, the microbiome protects our bodies against invasion from potentially harmful pathogens2. Changes in how these microbial organisms function, as well as their diversity within our intestines, has been associated with IBS.

     

    How are IBS and SIBO Connected?

    The overlap between small intestinal bacterial overgrowth (SIBO) and IBS has been extensively studied. SIBO, which is defined as an increase in the number of bacteria, which may or may not be accompanied by a change in the type of bacteria, within the proximal part of the small intestine. Quantitatively, SIBO is diagnosed in patients who have 105 or more colonies of bacteria present within each milliliter of small intestinal fluid (aspirate). It has been reported that up to 78% of IBS patients also suffer from SIBO3; therefore, the connection between these two conditions is extremely relevant.  

    The three main hypotheses connecting IBS and SIBO include:

    1. SIBO develops first, which is then followed by the development of IBS.
    2. IBS develops first and causes various motor and visceral disturbances to occur within the small intestine. This dysfunction promotes the overgrowth of bacteria to follow.
    3. SIBO and IBS are two entirely different disorders that do not have any similar physiological characteristics3.

     

    Frequency of SIBO in IBS Patients Reference
    34/76 (44.7%) Park et al. (2010)
    28/43 (65%) Scarpellini et al. (2009)
    55/127 (43%) Carrara et al. (2008)
    89/258 (34.5%) Mann et al. (2009)
    64/98 (65%) Nucera et al. (2005)
    157/202 (78%) Pimentel et al. (2000)
    14/59 (23.7%) Sachdeva et al. (2011)
    35/98 (36%) Reddymasu et al. (2010)
    49/200 (24.5%) Lombardo et al. (2010)

    Table 1: Clinical studies that examine the prevalence of SIBO in IBS patients.

     

    In the medical community, IBS is often referred to as a heterogeneous condition, which refers to the fact that a wide range of factors can contribute to IBS. These factors can include changes in the gut microbiome as previously mentioned, as well as changes in the permeability of the intestines (the ability of nutrients to easily pass through the GI tract), the ability of the immune system to function properly, changes in the movement of the intestines and much more.

    The heterogeneity of IBS, which includes the ability of this disorder to cause patients to exhibit one type of stool pattern more often than another, can be used to support the connection that exists between IBS and SIBO. For example, SIBO patients will typically exhibit an excess amount of gas present within their GI tract as a result of the increased presence of gas-producing bacteria. An increased amount of gas often causes patients to experience more frequent bloating, which is often a complain of IBS patients.

     

    What It’s Like to Live with IBS

    While everyone experiences stomach aches at some point in their life, people with IBS often experience chronic pain and discomfort that can prevent them from performing normal daily tasks. In addition to these symptoms, additional digestive complains associated with IBS may include:

    • Bloating
    • Gas
    • Constipation
    • Diarrhea
    • Alternating bouts of constipation and diarrhea
    • Bowel movements are difficult to pass
      • May feel incomplete
      • May be uncontrollably urgent
    • Clear or white mucus within the stool5

     

    One of the most troubling aspects of having IBS is being told that your symptoms are “all in your head.” The doubts that your friends, family and even health professionals may have on the reality of your symptoms can lead to vague diagnoses that may end up doing more harm than good.

     

    The Brain and IBS

    While it is clear that IBS is not just “all in your head,” there has been a significant amount of research connecting this GI disorder to structural changes that occur within the brain. For example, a recent study that has compared with brain anatomy of patients with IBS with healthy patients has found that patients with IBS consistently shown a thinning of the gray matter within their brain, which is an area of the brain that is particularly rich in neurons, which are the cells of the brain and spinal cord6. Thinning of this area of the brain can lead to a cascade of psychological problems, some of which include an oversensitivity to bowel sensations, inability to control emotions when faced with chronic pain, as well as the ability of IBS patients to control their pain. Additional brain-related symptoms associated with IBS can include lower back pain, anxiety, depression and headaches.

     

    Symptoms Journal

    Living with IBS goes far beyond just taking your medications. Since there is ultimately no cure for this disorder, it is important for patients to recognize what types of foods and/or situations may trigger their symptoms to occur. As a result, it is often recommended that IBS patients keep track of their symptoms throughout the day. In a symptoms journal, patients are urged to write down when they experience stomach pain, any type of discomfort, bloating, diarrhea or constipation, as well as what what they were doing when these symptoms came on.

    1. What symptoms are you feeling?
    2. How did that symptom make up feel?
    3. What did you eat right before you began to feel this way?
    4. What medication did you take before you began to feel this way?
    5. Did eating some type of food make your symptom(s) go away?
    6. Did taking a certain medication help your symptom(s) improve?

     

    By taking detailed notes on their symptoms and any factors that may have contributed to them, patients can use this information to determine any lifestyle factors that may trigger their IBS symptoms to flare. Furthermore, patients can work with their doctors to better recognize these triggers to ultimately devise a treatment plan, such as modifying their current diet or treatment regimen(s) in some way, to prevent these problems and/or symptoms from controlling the patient’s life.  

     

    The Challenges of Treating SIBO

    Since SIBO and IBS patients often experience similar symptoms, it is extremely common for SIBO to be misdiagnosed by physicians as IBS. Furthermore, since SIBO patients can experience a wide range of symptoms, it is also not uncommon for this disorder to be undiagnosed altogether. As a result, the symptomatic treatment of patients may provide temporary relief to their symptoms, but ultimately does little to address the root of the problem.

     

    Current Treatment Options for IBS

     

    Diet

    The incorporation of various diets has been shown to dramatically alleviate IBS-related symptoms to ultimately improve quality of life. Some of the most common diets that have been used by IBS patients include:

     

    Low FODMAP Diet

    FODMAP is an acronym that describes the five different sugars commonly found in foods, of which include fermentable, oligosaccharides, disaccharides, monosaccharides and polyols. Each FODMAP sugar is associated with poor absorption within the small intestine, as well as the ability to rapidly ferment, both of which can lead to increased GI symptoms such as bloating, gas, abdominal pain, nausea, diarrhea and/or constipation. Numerous clinical studies have found evidence supporting the success of a low FODMAP diet for both IBS and SIBO patients.

    To find out more about exactly what a low FODMAP diet entails, click here.

     

    High-Fiber Diet

    Increasing your fiber intake will increase the bulk of your stools to ultimately push stools through your intestines at a fast rate. As a result, some IBS patients have found that increasing their fiber consumption through foods such as fruits, vegetables and whole grains can help to alleviate their constipation. While this may be true for some patients with IBS, it is crucial to recognizes that high fiber diets may actually make IBS symptoms worse, especially when SIBO is being considered. Therefore, it is highly recommended that you speak with your doctor before incorporating high-fiber foods into your diet.

     

    Low-Fiber Diet

    As previously mentioned, high-fiber foods can actually worsen IBS symptoms. If you have experienced worsening symptoms after consuming high-fiber foods and are considering completely eliminating fiber from your diet, it is instead recommended that patients focus on ingesting food products that contain more soluble fiber. Since soluble fiber dissolves better in water, patients can better digest these food products and benefit from the good properties of fiber without experiencing any unwanted symptoms. Some foods that contain soluble fibers include:

    • Carrots
    • Apples
    • Berries
    • Oatmeal

     

    Gluten-Free Diet

    It is not uncommon for people who are gluten-intolerant to also experience IBS. In this type of situation, the elimination of grain products such as barley, rye and wheat from your diet may improve IBS symptoms.

     

    Elimination Diet

    The elimination of certain foods for a given period of time may help patients figure out if a specific food is causing their symptoms to worsen. Some of the main food items that patients tend to eliminate first include coffee, chocolate, insoluble fiber and nuts. It is recommended that patients eliminate a single food item for about 12 weeks and note down any differences that may occur in their symptoms in their symptoms journal before moving on to the next food item to be eliminated.  

     

    Antibiotics

    When bacterial overgrowth is expected, it is common for physicians to turn to antibiotic treatment. Antibiotics are often used to specifically target the bacterial strains that are growing uncontrollably within the small intestine of SIBO patients. Rather than completely remove all bacteria from the GI tract, since a healthy amount of bacteria does play an important role in our bodies, antibiotic treatment for SIBO patients is focused on improving the symptoms that may be caused by an increase in the number and/or diversity of these bacteria.

    Unfortunately, it is very difficult for physicians to specifically target bacteria for each patient through antibiotic treatment. As a result, the scientific community does not have a standard choice of what type, dose and/or duration of antibiotics should be used for SIBO treatment. Physicians will therefore prescribe antibiotics that affect a wide range of bacteria to treat SIBO, of which include:

    • Ciprofloxacin
    • Norfloxacin
    • Amoxicillin/clavulanate
    • Metronidazole
    • Cephalexin
    • Rifaximin4

     

    Regardless of which type of antibiotic is used to treat SIBO, it is not uncommon for patients to require multiple courses, or even long-term use of antibiotics. To prevent potential antibiotic resistance from occurring, it is recommended that physicians repeat breath testing on SIBO patients when symptoms such as abdominal pain, diarrhea, bloating and/or flatulence recur.

     

    Probiotics

    Probiotics are live bacteria that are the same, or similar to, the bacteria that is naturally found within our digestive tract. For example, Lactobacillus, which can be found in most yogurts and other fermented foods, as well as Bifidobacterium, which is found in most dairy products, are two of the most common bacterial species that are found within our bodies, as well as in many probiotic supplements. By introducing healthy bacteria colonies into our digestive system, probiotics have been shown to ease some of the symptoms of IBS, such as constipation and improved functioning of the immune system.

    Prokinetics

    For patients that predominantly suffer from constipation, the use of prokinetic agents is common. As implied in its name, “pro,” meaning for, and “kinetics,” meaning movement, are used to promote the movement of stool through the GI tract. Some of the most common prokinetic agents used in the United States include metoclopramide and erythromycin.

     

    Herbal Medication

    Unfortunately, conventional treatment approaches do not always work with helping relieve the often-debilitating symptoms of IBS. As a result, patients often look to herbal medications as a way to improve their symptoms without risking any significant adverse effects. Some of the most common herbal medications used for IBS include:

    • Peppermint oil
    • Artichoke leaf extract
    • Aloe vera
    • Blond psyllium (plantago)
    • Turmeric (curcumin)
    • Iberoglast ®
    • Padma lax ®

     

    To learn more about the numerous herbal medications that have been shown to help IBS patients combat their symptoms, click here.

     

    References

    1. Holftmann, G. J., Ford, A. C., & Talley, N. J. (2016). Pathophysiology of irritable bowel syndrome. Gastroenterology & Hepatology 1(2); 133-146. DOI: 10.1016/S2468-1253(16)30023-1.
    2. Salem, A., Singh, R., Ayoub, Y. K., Khairy, A. M., & Mullin, G. E. (2018). The gut microbiome and irritable bowel syndrome: State of art review. Arab Journal of Gastroenterology 19(3); 136-141. DOI: 10.1016/j.ajg.2018.02.008.
    3. Salem, A., & Ronald, B. C. (2014). Small Intestinal Bacterial Overgrowth. Gastrointestinal & Digestive System 4(5). DOI: 10.4172/2161-069X.1000225.
    4. Sachdev, A. H. & Pimentel, M. (2013). Gastrointestinal bacterial overgrowth: pathogenesis and clinical significance. Therapeutic Advances in Chronic Disease 4(5); 223-231. DOI: 10.1177/2040622313496126.
    5. “Irritable Bowel Syndrome (IBS) Symptoms” – WebMD
    6. Seminowicz, D. A., Labus, J. S., Bueller, J. A., Tillisch, K., Naliboff, B. D., et al. (2010). Regional Gray Matter Density Changes in Brains of Patients with Irritable Bowel Syndrome. Gastroenterology 139(1); 48-57. DOI: 10.1053/j.gastro.2010.03.049.

     

     

     

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  • Fitness Equipment For Schools: Are your school students fit enough to win at life?

    All school kids should get about 60 minutes of exercise per day, says an Institute of Medicine report. They do not have to work out for an hour straight. In fact, the best results come from children engaging in physical activities for about 30 minutes during school hours and 30 minutes before or after school. School is the best premise for children to adopt an active lifestyle. They can learn new games, participate in competitions and work on their skills together with their friends.

    Why should your school pay more attention to the physical health of students?

    The reports of the American Heart Association state that about 10 million kids and adolescents between the ages of 6 and 19 are overweight. 25% of the children in 2018 do not participate in any physical activity. Most children spend more than 9 hours sitting throughout the day. Mobile phones, social networking and online games have replaced outdoor activity. Most kids take the bus or get drops from their parents to school instead of walking or biking. There is an increasing incidence of the lack of physical activity among the children and adolescents of 2018.

    According to the Let’s Move campaign, 33% of the children born after 2000 may have type two diabetes in their adulthood and others may suffer from sitting diseases and obesity-related health problems including cancer, high blood pressure, heart diseases and asthma. Check out HireFitness for more information on how getting new equipment for your PE class can boost the overall health of your students.

    How can new fitness equipment in the school gym help children?

    Physical education programmes that boost physical health and mental fitness should be mandatory in all schools. Sometimes, running and sports are not enough for attending to the fitness needs of children of growing ages. School gyms require physical education classes with special training and fitness equipment. Moderate to vigorous activity is necessary for children to burn the excess calories they consume from junk food and to reverse the ill effects of sedentary lifestyles.

    Here are a few reasons most schools should consider adding new fitness equipment to their school gyms –

    Increase in interest

    For years, PE classes have been synonymous to dodgeball and football. It is finally time the schools paid more attention to new gym equipment to boost enthusiasm among the kids. New leverage equipment, dumbbells and cable machines can add a layer of excitement to the otherwise drab physical fitness classes. New programmable treadmills, electrical rowing machines and stationary exercise bikes will not only help the children focus on improving their core strength, but they will also enable them to participate in a healthy competition of endurance, strength and fitness among each other.  

    Reduction in stress levels

    Kids today attend school, participate in extracurricular activities and prepare for competitive exams regularly. Their stress levels are always high, and they hardly ever catch the break they deserve. Adding new equipment to their fitness regimen might seem counterintuitive, but it can improve their mental fitness along with their physical fitness. Working out regularly stimulates the release of serotonin and endorphins that are the natural painkillers cum stress-busters of the body. These are the happiness hormones that help fight depression. That should help them perform well in other fields as well.

    Develops healthy habits

    Working out at the school gym regularly will help the kids develop healthy habits for life. No matter what professions they choose, they will seek out fitness regimens and maintain their gym memberships. They will learn to take care of their bodies and minds. Good habits should form early in the lives of kids to give them the maximum benefit. They will acquire control of their emotions, learn discipline and perform well in class. If they manage to carry these habits back into their adulthood, they will be able to prevent injuries later in their life.

    Improvement in social interactions

    Learning to share and care during the PE classes helps the kids work in collaboration with each other. Collaborative exercises give them the opportunity to form new friendships. Social networking and messaging are not enough to build or maintain real relationships in life. Team spirit and sportsmanship always begin in the field, but social interactions and new friendships always form at a healthy and well-equipped gym area. Your school should think about getting new gym equipment for the children. It can encourage the kids to help each other to achieve new landmarks.

    Increase learning abilities

    Since physical workout reduces stress and improves mental health, in general, it also enhances the learning ability of the kids. Schools with dedicated physical education classes and proper fitness equipment show better performance of their students in state-level examinations than those without dedicated PE equipment or PE instructors. It is no longer enough to have a football coach and dodgeball sessions to ensure extraordinary performance from the children. The kids of the 21st century need more impetus than the baby boomers, and Gen X ever did. They need fitness machinery that piques their interest and challenges their physical abilities.

    Reduces the chances of obesity and sitting diseases

    Sitting diseases include type 2 diabetes, cardiovascular ailments, lung problems, arthritis and spondylitis. In fact, any form of physical disorder and discomfort that can arise from the gross lack of enough physical activity and movement can be a sitting disease. Obesity is one of the leading causes of concern among the parents of today’s kids. Most kids are busy preparing for tests, playing video games, watching TV or gorging on junk food. Combining that with the lack of physical activity is the perfect recipe for obesity. Adding new training equipment to your school gym can increase the average fitness of the students and reduce their chances of suffering from any of these lifestyle diseases significantly.

    There is nothing bad about adding some exercise to someone’s daily routine irrespective of their current age, fitness level, and busy schedule. With increasing levels of automation and technology in their lives, kids require a dose of physical activity to their daily routine more than anyone else in the world!

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