MV Hospital

Welcome to M.V Hospital for Diabetes, established by late Prof. M.Viswanathan, Doyen of Diabetology in India in 1954 as a general hospital. In 1971 it became a hospital exclusively for Diabetes care. It has, at present,100 beds for the treatment of diabetes and its complications.

Monday, August 3, 2015

Role of Diet and Nutrition in the Prevention of Chronic Diseases

Ms Thameena, 
Dietitian,MVH  
         
Hunger and malnutrition , rapid changes in the diets and lifestyles, "nutritional transition",  where traditional foods such as cereals and potatoes are increasingly being replaced by diets that are richer in added sugars and animal fats,  increased caloric content of  food ,increased fat content, excessive consumption of  meat, dairy products, and eggs, individual risk factors such as  unhealthy diets,  low levels of exercise,  and  genetic factors   are all responsible for the high levels of chronic diseases .

The risk of developing chronic disease can be reduced at any age, therefore people of all ages can benefit by eating healthy food, maintaining optimum weight, and exercising.

A well balanced diet consisting of different food groups as well as increased physical activity can prevent chronic diseases.

‘Safe range’ guideline to healthy eating



  • Total fat intake should be 15 to 30% of total dietary energy intake.
  • Free sugars found in soft drinks and many processed foods should be less than 10% of total energy intake.
  • Consume at least 400g of fruits and vegetables per day. Along with wholegrain cereals this can provide sufficient fibre.
  • The WHO also makes recommendations about body weight – in terms of Body Mass Index (BMI) – and physical activity. 
  • Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults. 
  • For good cardiovascular health, at least 30 minutes of moderate physical activity such as brisk walking every day is recommended for people of all ages.






  • Certain types of foods and eating habits such as snacking, binge-eating, and eating out can contribute to excessive weight gain and obesity. 
  •  Regular physical exercise
  •  High dietary fibre intake
  •  Healthy food and activity choices at home, school and workplace
 …provide protection from obesity
Some factors that may increase the risk:







  • Sedentary lifestyles, particularly sedentary occupations and recreational activities such as watching television









  • Large portion sizes








  • High intake of drinks containing added sugars  
Prevent obesity by encouraging healthy habits early in life. Maintain a healthy Body Mass Index and control waist size. Do moderate to high level of regular physical activity such as  walking for one hour per day, and limit consumption of foods and drinks that contain high amounts of fats and sugars.









The number of cases of diabetes is currently estimated to be around 150 million worldwide, but that number is expected to double by 2025.


  
Inactive lifestyles and excessive weight gain increase the risk of type 2 diabetes, especially when excess fat is stored in the abdomen.

Efforts to prevent excessive weight gain and cardiovascular disease can also reduce the risk of developing diabetes. Measures include maintaining a healthy weight, engaging in at least one hour of moderate physical activity every day, consuming sufficient fibre from fruits, vegetables and wholegrain cereals, and limiting consumption of saturated fats.
  








Cardiovascular Disease 

 


Certain dietary fats, especially those that are commonly found in dairy products, meat and hydrogenated oils increase the risk of cardiovascular disease. Other dietary fats, such as those found in soybean and sunflower oils, can lower the risk of cardiovascular disease. Fish oil which is found in fatty fish is also beneficial.

A high intake of salt can increase blood pressure and the risk of stroke and coronary heart disease, whereas eating a diet high in fibre and wholegrain cereals can reduce the risk of coronary heart disease. 

 A high intake of fruits, vegetables, and fish can contribute to good cardiovascular health and reduce the risk of developing certain cardiovascular diseases. Alcohol consumption should be limited. 

Prevent cardiovascular disease 
  • Limit intake of dairy products, meat and cooking fats such as clarified butter or ghee. 
  • Eat 400 to 500g of fruits and vegetables every day 
  • Have fish once or twice a week. 
  • Restrict salt intake to less than 5 g per day and 
  • Exercise for at least 30 minutes a day 







Dental disease
Diet is an important factor that can cause dental disease. Caries develop due to the presence of sugars from the diet and bacteria. The tooth surface can also be attacked by acids from some foods and drinks. 






Sugar consumption is the most important factor for dental caries. Studies have found a strong link between the amount and frequency of sugar consumption and the development of caries. 








Eating certain foods, such as cheese, may stimulate secretion of saliva which can protect against the development of dental caries. Breastfed babies tend to have less dental caries in early childhood than babies fed on formula milk. ..

To reduce the risk of dental diseases:
  • Cut down on the amount and frequency of consumption of sugar,
  • Ensure adequate exposure to fluoride, and 
  • Avoid certain nutrient deficiencies.  










Osteoporosis

Osteoporosis is a disease affecting millions of people around the world that leads to brittle bones that break easily. The risk of osteoporosis increases with age and can lead to illness, disability, and even premature death.








Calcium and vitamin D deficiencies increase the risk of osteoporosis in older people. A healthy diet, increased sunlight exposure, increased physical activity, eating more fruit and vegetables, and consuming less alcohol and salt can reduce the risk.

In short, a lifestyle combining physical activity with healthy food is the best way to reduce the risk of developing chronic diseases.

Tuesday, July 21, 2015

Chronic diseases and diet

Ms Revathy,
Dietitian, MVH

Chronic diseases such as obesity, diabetes, cardio vascular disease , cancer, dental disease, and osteoporosis are long-term diseases that are not contagious and largely preventable. More than 95% of all chronic diseases are related to one’s diet - food choice, toxic food ingredients, nutritional deficiencies, and to a lack of physical exercise.













Health conscious people eat good and healthy food - fruits, vegetables and whole grains. However, if these foods are grown in depleted soils or contaminated soils, they can cause more harm than good. Depleted soils produce crops that have a low concentration of nutrients .Chemical fertilizers and pesticides produce crops that can cause health problems. So choose your food carefully.











Good health habits
  • Walk daily
  • Eat organic where possible
  • Reduce stress, be happy
  • Enjoy life                                                                                                            
  • No steroids,  or other body building supplements
  • No diet pills, stimulants or fat burning pills
  • No fad dieting (no starving, quick weight loss diets)
  • Avoid medicines as much as you can. Don’t buy them without a doctor’s prescription.







Stay away from…     
  • Hydrogenated oils ( at risk for heart disease)
  • High-fructose corn syrup / sugar / sucrose (  at risk for obesity and other related conditions such as diabetes )
  • Homogenized milk fats (at risk for heart disease and cardiovascular disorders)
  • Soft drinks, junk foods, snack foods or fast foods
  • Processed and ready to serve foods .
  • Fried foods and refined flour


Achieving good health is not complicated. Just provide your body with good nourishing food so that it has the building materials it needs to heal. Avoid foods and food ingredients that cause disease.

Friday, July 10, 2015

Yoga and Diabetes

Is yoga an effective way to manage diabetes?











Research  studies conducted at  MVH  suggest that it can. So convinced are we of the benefits of this exercise on blood glucose levels that we have a yoga clinic  in the hospital for patients .

Regular practice of yoga reduces stress,  promotes weight loss , induces muscular relaxation, lowers blood pressure and cholesterol levels  all of which are extremely important  specially for people with diabetes . As a result, diabetic complications take a longer time to occur and they are less severe.











Asanas, pranayamas and meditation form the core of Yoga.

Asanas are movements (or postures) which help to tone and build muscle, and stretch and massage internal organs and glands. They help people with diabetes by making the pancreas work more efficiently and by improving blood circulation and thus increasing the absorption of glucose by the body cells.

Pranayamas are breathing exercises that can be done anywhere and at any time. They improve blood circulation and increase energy levels. They also reduce stress and improve the endocrine functions of the body. They strengthen the lungs, calm the nerves and gradually harmonize the activities of the organs of the body.

Meditation and relaxation techniques are absolutely essential for people with diabetes as they help relax the body and mind, improve the way the body functions and increase energy levels. They are useful in stress management.

What to do before you start your routine…
  • Your stomach should be empty. Do not wear shoes or socks.
  • Practice early in the morning in a clean and airy room in calm, quiet surroundings. 
  • Exercise for about 45 minutes to 1 hour.
  • Inhale and exhale deeply. Use your abdominal muscles to take in and push out air from your lungs. Do not hold your breath. 
  • Exercise on a yoga mat or on a folded blanket.
  • Wear loose clothes so that you can do the asanas comfortably.
  • Exercise at a slow pace.
  • Leave all your cares at the door of the yoga room. Your mind should be free of thought.
  • Do your exercises regularly as your body can turn stiff if you stop for a period of time and you will have to start from the beginning.
Consult your doctor before you begin any exercise.

Warm up before you exercise by doing neck, shoulder and body stretches as it loosens the muscles and makes your body  more flexble.










Surya Namaskar prepares the body for the asanas. It is a set of twelve positions performed continuously one after the other. Each position stretches the body in a different way and also regulates the breathing. When practiced daily, it makes your spine and joints flexible and keeps your waist in shape.

Asanas can be done in the lying down, sitting or standing positions. Here are a few examples of asanas for people with diabetes.

Lying down postures:

1. Uttana pada asana

Lie on your back. Inhale and raise both your legs in three steps- first to 30°, next to 60° and finally to 90°. Hold the position for 10 seconds. Exhale while lowering your legs.


Repeat 5 times.
This pose reduces obesity and abdominal disorders and increases blood circulation to the pancreas thus stimulating it.

2. Pavanmuktasana

Lie flat on your back. Place your hands by the side of your body. Inhale raising both your legs, bend your knees and hold them tightly with your hands.

While exhaling, bring your thighs close to your chest. Hold this pose for 30-40 seconds.







Repeat 3-4 times.  
This pose makes your abdominal muscles, liver, spleen and pancreas strong. It helps prevent constipation.

3. Dhanurasana

Lie on your stomach. Bend your knees. While inhaling, stretch your arms backward and hold your ankles. Hold this pose for 10 seconds. While exhaling, release your ankles and carefully return to the original pose. 






Repeat 5 times.    

This pose makes your kidneys, your back and your thigh muscles strong and is very good for diabetic control. This pose reduces fat on your waist. It stimulates the pancreas and so helps control diabetes.

Sitting postures

1. Pachimottasana 

Sit on the floor, legs together, extended in front of torso. While exhaling bend forward and hold your toes. Hold this position for 10 seconds. While inhaling, come back to sitting position slowly.







Repeat 1-2 times.    

This pose relieves stress and mild depression. It stimulates the liver, the pancreas and the kidneys, improves digestion and prevents obesity. It tones the complete spine.

Virasana 









Sit in Virasana. Bend your body forward till your forehead touches the floor. Straighten both your hands and bring them above your head with your palms together. Hold the pose for 30 to 60 seconds. 

Repeat the pose 2 times.

This posture reduces tension. It also reduces fat around thighs and calves.

3.Mandukasana











Sit in the ‘vajrasana’ position. Fold your palms into fists and place them on your lower abdomen. While exhaling, bend forward. Hold the position for 10 seconds. While inhaling, return to original position.

Repeat 10 times.  

This pose relieves stress and mild depression. It stimulates the liver, the pancreas and the kidneys, improves digestion and prevents obesity and is good for people with diabetes and dyspepsia,

Standing postures

Trikonasana

Stand with your feet apart. Stretch out your arms to the side. While exhaling, bend sideways and touch your right foot with your right arm. Hold this pose for 10 seconds. While inhaling, slowly return to the original pose.











This pose helps people with diabetes and dyspepsia.










Pranayama  - breathing exercises

Kapalabhati

Inhale slowly and breathe out vigorously and wait for a second after each action. Abdominal muscles and the diaphragm are used to put pressure on internal organs. This helps to purify the nasal passage and lungs, throws out foul air from the lungs, activates the spleen, pancreas and abdominal muscles and improves digestion.

A word of caution : Consult your doctor if you have high or low blood pressure, and eye or ear complaints before doing this exercise.

Anulom Vilom Pranayam 

This has a calming effect on the nervous system and reduces stress. It also helps to create a balance between a person’s creative and logical thinking. 






Meditation  is the art of learning to control your mind and relaxing your body. To do this successfully, you have to focus your mind at one point and make it empty of all thought.

Tips for safe exercise
  • Learn yoga from a yoga instructor.
  • Highlight special health conditions – Inform your yoga instructor if you are pregnant or have had any injuries, heart condition, high/low blood pressure, surgery, or any other such special conditions.
  • Don’t compete – Enjoy the yoga exercises and do them gently according to your ability.
  • Stay within your limits – Know your limits and don’t go beyond your capacity.
  • Listen – Only you know best what is good for your body and wellbeing.
  • Be patient – You cannot master all yoga poses as soon as you begin. Start slowly.
  • Stop if you are tired.
The practice of yoga keeps weight under control and prevents or delays the onset of diabetic complications. It also improves the quality of life by reducing stress. 

Contact the Yoga therapist/physiotherapists at MVH for a safe and effective program for you.

Thursday, June 18, 2015

USE A DASH OF SALT

Mrs. Sheela Paul,  
Dietitian, MVH

Salt is used to preserve food and to enhance its taste. There are many different types of salt. Cooking salt or table salt is a combination of the minerals sodium and chloride.  A gram of salt contains 400 mg sodium and 600 mg chloride. Sodium is both an electrolyte and mineral. It helps keep the water and electrolyte balance of the body. Sodium is also important for nerves and muscles to function well. The blood and lymph stream have most of the sodium in the body.

Most foods contain sodium naturally or added during cooking. The common food sources of sodium are table salt, baking soda, animal products (meat, milk and eggs) and preserves (pickles) & processed foods. Many medicines and other products also have sodium in them.

Sodium levels in the body are partly controlled by a hormone called aldosterone that tells the kidneys when to hold sodium in the body instead of passing it in the urine. Small amounts of sodium are also lost through the skin when you sweat.

Most people consume a lot of salt, much more than what is required by the body. This could be because they add a lot of salt to their food to enhance the taste or because they consume a lot of processed and instant foods.

Why we need to reduce the salt in our diet. 

A diet high in salt increases your chances of developing many health problems. Too much sodium in your system affects blood pressure levels and increases your risk of heart disease. 

People who are over 51 years old or have high blood pressure, diabetes or chronic  kidney disease,  should consume less salt  to reduce sodium intake.

The estimated safe and adequate daily dietary intake is 500mg-3000mg.  The minimum sodium intake is 500mg/day for healthy persons over 10 years. Sodium requirements vary with its losses through urine, faeces and sweat.  

Sodium intake has to be changed in certain disease conditions like renal disorders or cardiac failure to maintain water balance and prevent fluid over load and reduce hypertension. 

Diabetic mellitus
Patients with Diabetes should be encouraged to reduce their salt intake to 6 gm/day  
Hypertension
To prevent or treat hypertension, salt intake has to be regulated. For mild to moderate hypertension in people with diabetes, 6 gm/day of salt is recommended.                 

Ways to reduce sodium in the diet: 
Make the changes gradually so that your body gets time to adjust to lower sodium levels.

Make your plate colourful. 

Add 1- 2 cooked vegetables and a salad to your main meals. Fruits and vegetables provide minimal amounts of sodium. Fresh whole fruits, including pears, mangoes and apples, each provide fewer than 10 milligrams of salt, or 4 milligrams of sodium. You can also fill your plate with tomatoes, spinach, salad greens and carrots. These vegetables provide fewer than 100 milligrams of salt, or 40 milligrams of sodium, per serving. 

Eat Fresh

Avoid canned fruits and vegetables as much as possible. Eat less of chips, papads and pickles and be cautious of sauces and chutneys and peanut butter. They often have high sugar and salt content, which are used to preserve produce during bottling or canning.

Prepare your own paneer, sauces and salad dressings instead of buying them.

Cook Creatively








Using herbs, garlic, ginger, chilli, and lemon juice for flavour can help reduce the quantity of salt in cooking.

Have a Healthy Eating Plan   
Add an extra serving of vegetable cooked with no salt  at lunch and dinner and eat a fruit daily. Have more of fat- free and low – fat milk.



Be Aware of the Cooking Process   
Whole grains are naturally low in salt, but this can increase drastically due to cooking processes. For example a cup of brown rice cooked in water has 25 milligrams of salt, or 10 milligrams of sodium. However cooking this in chicken stock can double or triple the sodium content. 

A cup of popcorn has 3 grams of salt, or 1 gram of sodium, but the added butter and salt on the popped snack increases the salt content quite a lot. 

A slice of 100% whole-grain bread can have as much as 330 milligrams of salt, or 130 milligrams of sodium because of the added salt. 














A bowl of high fibre cereal with low-fat milk and fruit is a healthy way to start the day. However, check the package for sodium content too or your healthy meal could turn out to have high sodium. To avoid sodium in cereal, look for shredded wheat brands and plain oatmeal.








Salads provide the health benefits of greens and veggies. Also, a salad with dinner is filling. But be careful of the dressing which could be a source of high sodium in your diet.









Use Lean Meats and Seafood   
     

Lean meats and seafood are naturally low in salt. Skinless chicken, salmon and shellfish each provide less than 100 milligrams of sodium per 100g.  This amount is under 240 milligrams of salt. But be careful of the other ingredients added during cooking which might raise the sodium level.

Check Labels Carefully  








What’s on a food label? We can get a lot of information such as date marking, product name, net weight, ingredient list, nutrition information, usage instructions and manufacturer’s details. Many people check food labels for calories, fibre, and sugar and rarely look at the sodium content. Multiply sodium level by 2.5 to calculate the salt content.

Tip of the Week

Tip of the Week
Choose the right shoe and socks