Are you at risk of sleep apnoea?

Almost half of the people suffering from sleep apnoea are overweight. A thick neck and a double chin that presses on the airway when they lie down, is also seen as a cause. It’s more common in men than in women and the risk increases with age. The signs to look for are disruptive snoring, excessive sleepiness [not found in children though] and gasping in sleep [as witnessed by a bed partner]. Also, watch out for increased blood pressure, morning headaches, sexual dysfunction, and behavioural changes [this one especially in children].

Also read » Sleep Apnoea

The upper part of our airway system that includes the area around the back of the tongue is soft without any bony supports. They totally depend on muscle tone to maintain patency. In patients with sleep apnoea, this part of the airway is narrower, either due to obesity or due to the structure of the bone and soft tissues. In children, the enlarged tonsils and adenoids could pose as an obstruction to free breathing. When awake, the receptors and reflexes come into play making sure that the airway remains open. However, during sleep, the tongue falls back against the back of the throat, mechanically closing the airway and causing obstructive sleep apnoea.

Research done in a U.S. based hospital showed that this condition affects approximately 20 per cent of adults, out of which about 90 per cent are undiagnosed.

Is sleep apnoea really something serious?

Sleep apnoea, undiagnosed and untreated could lead to a few life-threatening situations—the main cause of concern being road accidents that could happen if the person falls asleep while driving, or accidents from falling asleep while operating machinery. The medical complications that could occur because of untreated sleep apnoea include high blood pressure, abnormal heart rhythms, and stroke. A study showing the relationship between sleep apnoea and abnormal heart rhythms found that the chances of a heartbeat abnormality were 18 times higher immediately after an episode of sleep apnoea than, during periods of normal breathing of sleep. An article in the John Hopkins University Gazette quotes Dr Naresh Punjabi who specialises in sleep medicine there, “Low blood oxygen levels during sleep are a particularly worrisome sign and that is the single biggest predictor of death in people with sleeping disorders.”

Apart from these, the person suffering from sleep apnoea may also face weak memory, further weight gain, headaches and impotence.

Change how you live, to sleep better

A few lifestyle changes go a long way in reducing sleep apnoea. The first focus should be on reducing weight. Weight loss reduces number of apnoea episodes, improves quality of sleep, reduces snoring and improves oxygen levels.

Taking alcohol or sedatives towards bedtime in the hope of a better night’s sleep is a big mistake and should be avoided at all costs, for it may make the problem worse. Sleeping on the side instead of the back may help in milder cases.

The first treatment option is the CPAP [Continuous Positive Airway Pressure] machine, which is the most common treatment for adults with moderate to severe sleep apnoea. The device is like an oxygen mask worn over the nose. A tube connects the mask to the machine, that forces air into the airway passages preventing it from collapsing and thereby preventing a dip in oxygen levels. The airflow pressure has to be adjusted such that it is strong enough to keep the airway open while sleeping.

The person needs to be connected to this device before going off to sleep every time and this may take a while getting adjusted to sleeping with a tube attached to the nose. The good news is that when sleep apnoea is treated with a CPAP machine, the blood pressure lowers not only during the night but also during the day. Sleep apnoea patients who also suffer atrial fibrillations [a common type of abnormal heart rhythm] when treated with methods like CPAP have only a 40 per cent chance of coming back for further treatment of their atrial fibrillation as against 80 per cent recurrence of atrial fibrillation in untreated patients. Treatment therefore reduces the complications associated with sleep apnoea to a considerable extent.

Another treatment option is to use dental devices in the mouth that keep the lower jaw forward, thereby leaving a space for the air to enter the lungs.

In some cases, where indicated, surgery to remove excess tissue from back of the throat, or having tonsils/adenoids removed in children facing sleep apnoea due to their enlargement are options. A study from the Henry Ford Hospital, Detroit found that patients with sleep apnoea who undergo surgery to improve their breathing are able to sleep better at night and have reduced daytime sleepiness. In the past, tracheostomy or making an opening in the windpipe was performed in these patients, but this is rarely done nowadays.

Raghu has finally gotten used to strapping on the CPAP machine before sleeping every night. He says that the effect on his energy levels is remarkable and he never falls asleep during the day anymore. His doctor has advised him to maintain an active lifestyle so that he doesn’t gain weight.

Difference between snoring and sleep apnoea

Snoring is a very common condition. All people with sleep apnoea snore but all snorers don’t have sleep apnoea. Snoring is more of a social problem while sleep apnoea is a disease condition that needs immediate attention. Snoring happens due to the vibration of the soft tissues in the throat as the air passes from the mouth/nose to the lungs. In snoring the airway may be narrow, but there is never a stoppage in breathing, while patients with sleep apnoea actually stop breathing up to 400 times throughout the night. There is a high chance though that a snorer may develop sleep apnoea.

According to the European Respiratory Journal, there are two main factors that determine if your snoring will progress to sleep apnoea —Body Mass Index [BMI] and Age. While you can’t prevent yourself from growing older, exercise and proper diet to ensure your body weight stays within limits, is a good way to prevent sleep apnoea.

This was first published in the February 2013 issue of Complete Wellbeing.

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Most Indian cuisines make good use of the beans/lentils by soaking and cooking them into dals or curries. There are some other interesting ways to use them such as salads, soups, burgers, chillies and dips. Mexican cuisine uses kidney beans in various recipes and chickpeas are liberally used in Middle Eastern and Mediterranean cuisine. These recipes will help you include beans to your diet in interesting ways.

Black eyed peas curry with freshly ground masala

Serves: 3 – 4

Ingredients

• ¾ cup white or red black eyed peas [Hindi: lobia, chawli]
• 3 medium tomatoes
• 1 tbsp oil
• 1 tsp cumin seeds
• A pinch of asafoetida
• ¼ tsp turmeric powder
• ¾ tsp salt
• ½ tsp garam masala powder or 1 tsp rasam/sambar powder
• Lots of chopped fresh coriander

To be ground into a paste

• 1 medium onion, peeled and chopped roughly
• 3 cloves garlic
• ¼ cup fresh coconut
• 2 tsp coriander seeds
• 3 dried red chillies
• ½ tsp grated ginger
• 1 medium cinnamon stick
• 3 – 4 cloves

Preparation method

1. Use a pressure cooker with separators. In one compartment, place the soaked peas with just enough water to cover.
2. Halve the tomatoes and place them in another compartment. No need to keep water in this compartment.
3. If you want to serve this curry with rice, cook rice in the third compartment. Pressure cook for two whistles and keep on low flame for 5 – 7 minutes. Then, remove from flame and open when cool.
4. The peas should be soft, yet should retain their shape. Tug off the tomato skins, mash with fingers and keep aside.
5. In a large kadhai/wok, heat 1 tbsp oil. Then, add one tsp cumin seeds and a fat pinch of asafoetida.
6. Once the cumin splutters, add the ground paste to the oil and fry on medium flame for around five minutes, until oil separates and the onion and garlic is cooked.
7. To the cooked paste, add the cooked black eyed peas and the mashed tomatoes. Add turmeric, salt and garam masala powder. Bring to a simmer. If it’s too dry, add some water.
8. Let this simmer for two minutes. Remove from flame and add fresh coriander.

Don’t have a pressure cooker? Boil the soaked beans in plenty of water for about 45 minutes [or until they become very soft]. Blanch the tomatoes in boiling water, peel and mash them with fingers and follow the rest of recipe as above.

Serve with steamed rice or rotis.

Chickpea Cabbage Salad

Serves: 2

Ingredients

• 1/3 cup small chickpeas [chana], soaked overnight or for 4 – 5 hours
• 1 tsp oil
• ½ tsp cumin seeds
• ½ tsp mustard seeds
• A pinch of asafoetida
• 1 cup finely shredded cabbage
• 1 medium onion, diced
• 1 medium tomato, deseeded and diced

Dressing

• 1 cup hung yoghurt
• Salt to taste
• Freshly-ground black pepper
• 1 tsp frankie masala or chaat masala or cajun seasoning
• A pinch of red chilli powder
• Shredded cabbage for garnish
• Roasted papad or baked tortilla chips / pita chips to serve with the salad [optional]

Preparation method

1. Pressure-cook the soaked drained chickpeas with 1½ cups water until soft—it took me three whistles and 6 – 7 minutes on low flame. Since chickpeas have thick skin, they don’t turn to a mush easily, so nothing to worry here. When the cooker has cooled off, drain the water and keep the chana aside.
2. In a wok, heat the oil. Add the asafoetida, cumin and mustard seeds.
3. Once they splutter, add the onions and cabbage with a pinch of salt, stir for two minutes on medium flame till slightly soft. Remove from the wok and cool.
4. In a large bowl, combine all ingredients for dressing. Whisk well. Add the boiled chana, the cabbage-onion mix and toss to coat evenly.
5. Garnish with shredded cabbage and serve with papad or baked chips.

Spinach Lentil Soup

Serves: 2

Ingredients

• ½ cup split masoor dal [split red lentils]
• 2 cups of washed and cleaned spinach leaves
• 2 cloves of garlic peeled
• 1 tsp oil or butter [ghee]
• Pinch of asafoetida
• ½ tsp cumin seeds
• ½ tsp ground black pepper

Preparation method

1. Wash the masoor dal well and place it directly in a small-size pressure cooker.
2. To this, add spinach leaves and garlic along with one cup water and pressure cook for two whistles and five minutes on a low flame.
3. Once the contents have cooled, puree finely in a blender. Keep aside.
4. In a saucepan, heat oil or butter.
5. Add a tiny pinch of asafoetida, cumin seeds and ground black pepper.
6. Once the cumin seeds splutter, add the pureed soup and water to achieve the desired consistency. Bring to a boil. Season with salt and some more pepper if required. Remove to a bowl.

Serve hot with soup sticks, bread or a salad.

Black eyed peas burgers

Makes: 12 medium-sized burgers

Ingredients

• 1½ cups of black eyed peas, soaked overnight
• 3 – 4 tbsp of coriander leaves, chopped
• 1 – 2 tsp of cayenne pepper powder [as per taste]
• 1 – 2 tsp of salt
• 1 tsp cumin powder
• 5 cloves garlic, finely chopped
• 1 – 2 tbsp roasted sesame seeds
• Oil to brush on the burgers

For assembly

• Slices of bran or whole wheat bread/burger buns
• A cup of onion slices pickled in vinegar and salt
• A cup of sliced tomatoes
• A cup of grated carrots/cabbage
• Coriander chutney [optional]

Sauces of your choice: I used the Mexican chilli sauce [Medium hot salsa picanta] and the green Salsa Habanera [made from the hottest chillies in the world]

Preparation method

1. Pressure-cook the soaked peas in four cups of water for two whistles. Keep on a low flame for five minutes. Switch off cooker. Cool and drain well.
   OR
   Cook them in boiling water for 35 – 40 minutes till the beans are soft but not fully mashed.
2. Preheat the oven at 200 degree celsius or heat your grill pan.
3. Place the drained peas with the other ingredients for the burgers [except oil] in a bowl.
4. Mash gently with a fork mixing all ingredients well. Taste for salt and spice.
5. Shape into burgers 2” in diameter. Place on a greased baking sheet. Brush the tops with oil and bake for 15 minutes. You can also grill them on a stove-top pan or a grill.
6. Assemble each burger between two slices of bread and the salad with your favourite sauces.

The post Recipes with pulses appeared first on Complete Wellbeing.

Science says

Modern science has discovered that ghee is rich in antioxidants. The fats in ghee aid absorption of fat-soluble vitamins and minerals from other foods, strengthening the immune system. It is also rich in butyric acid, a fatty acid with anti-viral properties, which is believed to prevent cancers and tumours.

Recent research has also detected presence of linoleic acid. Linoleic acid retards the growth of some cancers and protects us from heart disease. This acid is often lacking in a vegetarian diet.

According to Ayurveda, ghee made from cow’s milk promotes memory, intellect and digestion. It also promotes healing of wounds, keeps the skin lustrous and maintains immunity.

Although Ayurveda promotes its consumption for a variety of benefits, it also warns the obese to use this frugally.

According to B S Raheja, the ex-director of All India Institute of Diabetes, the present epidemics of diabetes, heart disease and some cancers is due to not including ghee in our diets.

Goodness of ghee

• Its is a source of beta carotene and vitamins A, D, E, and K. Beta carotene and vitamin E are vital antioxidants. Vitamin A is naturally present in ghee, which is lacking in other edible oils.
• It  has no milk solids, lactose or sugars. These get separated out when the butter is made into ghee.
• Organic ghee has no additives, preservatives, oxidised cholesterol or trans-fatty acids that clog arteries.
• It is highly stable and does not go rancid even at room temperature.
• It has a very high smoke point—it does not burn at high cooking temperatures. Even the Diabetes Association of India highly recommends ghee as a cooking media.
• It  is primarily saturated fat. One tablespoon of ghee provides 14g of saturated fat, 28mg of cholesterol and roughly 120 calories.
• Adding ghee to your diet reduces the serum cholesterol levels.

Make it at home

Collect the cream formed on milk over a period of days. When you have collected a substantial quantity, add yogurt culture to the cream to sour it. Pass the sour cream through a blender or shake it in a bottle, till the butter floats. Heat the butter in a heavy-bottomed pan till all the water content bubbles out. Soon, the milk solids start to separate to give golden-coloured ghee. The ghee remains good for a long time without refrigeration.

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Improper sleep for a month or more affecting daily life is called chronic insomnia, while that lasting for less than a month is called transient insomnia. Lifestyle factors are more likely to cause the latter. But if the same factors continue, transient insomnia can turn into chronic.

Let us take a look at some of the culprits that rob us of our well-deserved sleep.

Night-talk

While it is common knowledge that caffeine and stress cause problems in falling asleep, a new research suggests that having late night chats on your mobile phone can actually keep you from falling asleep. Cell phones emit microwave radiations that alter your brain waves. According to a report in the Scientific American, after a 30-minute exposure to cell phone signals in talk mode, people took nearly twice as long to fall asleep as they did when the phone had been off or in standby mode.

If you are in the habit of having late-night cell phone conversations and suffer from disturbed sleep, you could try a week of avoiding long calls nearing bedtime and see if it makes a difference.

Spice is not always nice

Eating a big spicy dinner close to bedtime disturbs sleep by causing acid reflux. Experts recommend no more than 600 calories for dinner at least two hours before bedtime. If your sleep gets interrupted by frequent tripts to the toilet at night, your fluid intakes must ideally stop 90 minutes before bedtime.

A report in the New England Journal of Medicine mentions that alcohol may seem to promote onset of sleep, but it tends to shorten the overall sleep time. It can also provoke acid reflux leading to disturbed sleep. So resorting to a brandy as a nightcap may not be the best idea for you, if you think you aren’t sleeping as much as you should. Try something soothing like a glass of warm milk or a cup of chamomile tea, both of which have mild sleep-inducing and relaxing properties minus the side-effects of alcohol.

Workout trouble

With everyone wanting to a ‘size zero’ figure and six packs, it is not uncommon to hit the gym post-work hours, sometimes very close to bedtime. Now, the relationship between exercise and sleep is a confusing one.

One belief is that exercise tires the body promoting good sleep, and the other is that it revs up the body and brain, thereby making it difficult to fall asleep. Studies prove that moderate exercise in the day time improves sleep onset as well as the duration. It is not very clear as to how many hours before bedtime should one exercise, as the effects vary from person to person. Stress hormone levels in the blood are higher immediately after a workout and they take time to come down. This is why people who have difficulty going to sleep, are recommended to exercise kept before late afternoon.

Stress on the job

Stress at work leading to insomnia and thereby reduced productivity at work is a vicious cycle. A study published in the British Journal of Health Psychology has proven the link between work-related stress and the development
of sleep problems.

Giving up the coffee breaks, unnecessary internet browsing and hanging around the water cooler can free up a lot of time for focused work. This in turn, means that you can leave early and enjoy a healthy work-life balance.Frequent international travel and the resultant jet lag can throw your biological clock out of gear due to rapidly traversing time-zones. Melatonin, a hormone that regulates sleep-wake cycles, is now prescribed for jet-lag induced problems. The timing of the dosage is very important. A paper published in the Indian Journal of Aerospace Medicine found that melatonin delays the circadian rhythms when taken in the morning and advances them when administered in the evening.

These are some pointers which may affect your sleep patterns. If the problem persists, consult your doctor, who can either prescribe medicines to aid sleep or refer you to a sleep specialist. Taking sleeping pills recommended by your friend or relative could be dangerous.

The post Sleep Killers appeared first on Complete Wellbeing.

— Buddha [563-483 BC]

May you have a long life is the most common blessing given by our elders and well wishers. Who wouldn’t want to live to a ripe old age, but who would want to grow into an over-ripe fruit up to no good? Growing old is inevitable, but getting worn-out is optional.

Ageing gets fast forwarded by eating the wrong foods, lack of exercise, stress, unhappiness, and lack of sleep. Here are some of the things you can do to postpone ageing.

Work out, stay fitter

Regular exercise keeps the heart ticking, prevents Type-2 diabetes, maintains and builds muscle mass, keeps up energy levels, and also elevates mood in a big way. It has been found that moderate low-impact exercise is the best solution to a long life. Small lifestyle changes like walking/cycling to your nearby destinations for chores, taking stairs, doing household chores, and gardening can go a long way towards prolonging your life. This is what Buettner calls “deconveniencing your home”!

Gardening is one of the few ways of getting exercise in a pleasurable way. It helps develop a nurturing attitude towards nature. Plus, being out in the sun gives a good dose of vitamin D. The benefit of reaping fresh produce from your own garden is quite unbeatable.

Yoga has been propounded as a tool for longevity since centuries. It is low on impact, but high on strengthening the muscles and ligaments, leading to more flexibility as we age. A loss of muscle mass, accompanied by a gain in fat mass, occurs with ageing. Yoga is great for longevity because it strengthens the muscles and ligaments that surround bones and joints without putting pressure on them. Movements become more fluid and less stiff overtime.

T’ai Chi, the Chinese art of choreographed meditative exercises, has been around for centuries. It is not only enjoyable, but also can be performed at any age. When practised for 30 minutes, thrice a week, it helps improve energy and balance, strengthen immunity, reduce stress, better sleep, and keep the body flexible.

Eat better, live longer

There’s plenty of truth in this old adage — “We dig our graves with our teeth.” We are what we eat, so it is no surprise that our diet plays a vital role in how we age. A research done on the centenarians in Japan and China revealed that they ate mostly fish, vegetables, mushrooms, seaweed, corn, buckwheat, and hardly any meat. Scientists have proven the health benefits of eating a plant-rich, meat-free diet. These geriatrics rarely suffered from heart or liver disease, cancer or degenerative diseases.

Dan Buettner [author of The Blue Zones, a book on longevity] recommends that you donate all the large plates in your kitchen and replace them with smaller plates. This will automatically reduce calorie intake by 30 per cent at least at dinner times.

Eating locally produced organic food is an added advantage. Sardinians swear by red wine as one of the aids to defy ageing, given that red wine is rich in antioxidants, it might as well be true. Drinking enough pure water through the day is also an important part of keeping cells healthy. Herbs and spices like turmeric, ginger, garlic, and pepper have several disease-preventing properties that one could benefit from.

Here are some foods that will help you lead a long healthy life:
• Whole grains reduce risk of heart disease, diabetes, obesity and some cancers [whole wheat flour, ragi, oatmeal, jowar, bajra, cracked wheat, buckwheat, and cornmeal]
• Calcium-rich dairy foods prevent osteoporosis [low-fat milk, dahi, low-fat paneer, and cheese]
• Protein from beans and lean meats result in stronger muscles and improved metabolism [dried beans, nuts, and fish]
• Fruits provide antioxidants and a variety of vitamins [choose a variety of colours]
• Vegetables help reduce the risk of some chronic diseases by providing vital nutrients [green leafy, orange coloured and starchy vegetables].

Grow older, think sharper

Age brings along senility, memory loss, and Alzheimer’s. These can be delayed or prevented altogether. Daily brain workouts like puzzles, chess and sudoku, and a diet rich in essential amino acids, omega-3 and vitamins ensure that you have a razor sharp brain for many years to come.

The following list of foods will keep your brain buzzing for long:
• Omega-3 rich fish: Salmon, mackerel and sardines
• Nuts and seeds: They are rich in omega-3 and protein
• Antioxidant-rich foods: Berries and green tea [2 cups a day]
• Choline-rich food: Cruciferous vegetables [cabbage, cauliflower, broccoli], eggs, peanuts, and rajma
• Monounsaturated fats: Olive oil, peanuts, sesame oil, flaxseeds and fish oil
• Microalgae: Spirulina and seaweed.

Beat stress, live lighter

Follow these simple steps to de-stress.

• Bond with family and friends
• Cut out stimulants like caffeine
• Cultivate a hobby and join a hobby group
• De-clutter with a passion. Give away anything that you haven’t used for six months
• Keep free slots in your daily planner for relaxation, or doing what makes you happy, including doing nothing
• Laugh like a child
• Give importance to a good night’s sleep
• Get a pet. A pet dog can bring you much happiness.

To live a long life full of vitality, you can start at any point, making small changes one at a time to improve for the better. Pursue longevity with a passion, and you will realise that it is not some elusive Holy Grail, but something very much attainable.

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What is placebo?

You might wonder what exactly a placebo is. It is actually nothing. An inert substance that has no inherent pharmacological activity – it resembles the comparable active drug in matter of looks, smell and taste. It’s a miracle that something so chemically inert and having no molecular properties of a drug can actually heal. Due to its inert nature, it does not cause reaction in the body, but triggers the body’s own natural response which could be called the healing power of nature. A placebo can cause a positive or a negative clinical effect on the patient.

How does a placebo work?

There are several theories that explain how a placebo might work. One of them is the “Natural Remission Theory” which states that the benefit brought about by the placebo is a natural progression which would have occurred even without it. Many of the placebo experiments did not have a no-treatment control group. Patients who were given medicine were compared with patients who were given an inert material. But there was no comparison with a group of similar patients that was not given any treatment.

So the chance that the patients would have recovered even without the placebo cannot be ruled out by such experiments. While this could hold true for acute conditions like a headache or a cold, it cannot completely explain the benefit in chronic conditions like long standing depression or high blood pressure. Another theory suggests that it could be a conditioning response, where the patient connects the act of taking a medicine to obtaining relief by prior conditioning. In a study done in 1998, it was proven that the body’s own feel-good chemicals called endorphins had a major role to play in placebo-induced pain relief.

A person’s faith in the treatment along with their suggestibility may have considerable bio-chemical effect in the body, affecting the person’s neurochemistry. The body’s hormonal and immune systems work on the neurochemistry and vice versa. Thus, a person’s positive attitude and faith can actually aid recovery by activating the immune and hormonal systems in the body which proves that the placebo effect is not all psychological and the problem is not ‘all in the mind’.

In fact, the placebo effect is a powerful part of all medical care, conventional or complementary, though its role is often undermined or misunderstood.

Proof that placebo works

The Scientific American magazine published a study performed by Tor Wagner, of the University of Michigan, and his colleagues. Functional magnetic resonance imaging [f MRI] was used to study the brains of volunteers who were exposed to harmless but painful stimuli such as small electric shocks or heat. In some cases, the researchers told participants that a pain-relieving cream had been applied to their skin.

When these subjects were shocked, they reported less pain on average than did participants lacking the “anti-pain” cream. Subjects under the influence of the placebo effect also exhibited increased brain activity in an area known as the prefrontal cortex, and decreased activity in well-known pain-sensing regions such as the thalamus, the somatosensory cortex and parts of the cerebral cortex. The results support the hypothesis that the placebo effect does not interfere with the body’s ability to sense pain but instead affects how the brain modulates its interpretation of the body’s signals. Paradoxically, the placebo findings could aid the development of novel therapeutic treatments for pain.

Some studies report actual physiological changes that result from placebo treatments. According to a NY Times report, doctors in one study successfully eliminated warts by painting them with a brightly coloured, inert dye and promising patients the warts would be gone when the colour wore off. In a study of asthmatics, researchers found that they could produce dilation of the airways by simply telling people they were inhaling a bronchodilator, even when they weren’t. Patients suffering pain after wisdom-tooth extraction got just as much relief from a fake application of ultrasound as from a real one, so long as both patient and therapist thought the machine was on.

So whatever be the mechanisms, placebos do seem to work.

The post The Healing Power of Nothing appeared first on Complete Wellbeing.

We learn about basic hygiene right from school. But with our lives becoming hi-tech, we question the effectiveness of these simple measures to keep ourselves and our family disease-free.

Why is hygiene essential?

In the developing world, roughly 40 per cent of deaths are attributed to infectious diseases. Gastrointestinal infections [which could be food- or water-borne] are rampant in developed as well as developing countries, majority of which could be prevented through good hygiene. Many respiratory and food-borne infections are now known to be of viral origin. Since antibiotics are ineffective against viruses, prevention is the only route. Certain pathogens are now being discovered as causative factors in cancer and chronic degenerative diseases, for e.g. H.Pylori and Hepatitis B virus. Our lifestyle and increasing travel throughout the world has shrunken the globe making it easy for transmission of pathogens. Hence, immense importance is given to improve home and personal hygiene.

HOME HYGIENE

Home hygiene is about tidying the hotspots of our home. This is an effective way to stop transmission of virus and bacteria to potential victims, thereby preventing illness. This doesn’t mean going overboard stocking different disinfectants at every corner of the house, and driving ourselves crazy with home-cleaning. It is all about keeping the right places hygienically clean.

Some specific targets are:

Toilets and washrooms

This is one area which, due to dampness and disposal of human waste, is a stronghold for bacteria. Wash the basins, toilet bowls, rims and covers with strong disinfectant at least 1-2 times a week. Wipe the contact surfaces with disinfectant sprays daily.

Every time a toilet is flushed, faecal matter and bacteria spray 20 ft in air. Make sure your toothbrush, hand-towel and soap are not in the firing line by keeping them in closed cabinets or by flushing with the lid closed. Sanitise your toothbrush daily by rinsing it with peroxide or mouthwash. Yes, the germs on your toothbrush are your own, but they can multiply enormously between uses.

At least one million skin cells are sloughed off each hour, so you can imagine the kind of cell debris on our bath towels. Instead of leaving them in the damp bathroom, dry them out in the sun after use and replace them at least once in three days. Use lighter towels that dry quickly.

Cleaning cloths

It is best to use disposable mops for cleaning. But in India, the paper-towel culture has not yet taken over and often cloths are used for mopping countertops, floors and other surfaces. These wet cleaning cloths are one of the largest reservoirs of germs.

• They must be decontaminated every time they contact any contaminated surface or material. The easiest way to sterilise these cloths is to microwave them for one minute at full power or boil them in a pressure cooker.
• After decontamination, they must be dried out as soon as possible, preferably in the sun, as keeping them in damp condition for long will promote bacterial regrowth.
• Mops used to clean heavily contaminated areas – such as spills of faeces or vomit – should be cleaned, rinsed with a disinfecting solution, wrung dry and then dried rapidly preferably at elevated temperatures. Better still, use disposable wipes for such infected surfaces.
• Sponges and scrubbers provide warm and moist conditions that are optimum for bacteria to thrive. They must be replaced every week and regularly cleaned with an anti-bacterial product. When not in use, try to keep sponges and scrubbers as dry as possible.

Homes with young kids

When babies begin crawling, most low-level surfaces are within their reach. The tendency to lick or put things in the mouth during the teething stages only increases the chances of developing gastrointestinal infections. Toys that the kids put into their mouths, cot/crib rails, diaper changing areas and potty training equipments are the key areas to be taken care of. Such toys when shared with other kids increase the chances of bacteria and virus transmission. Preferably, toys should be washed and disinfected. Faeces, urine, nasal discharge and vomit should be immediately cleaned and the cleaning aids disposed.

Homes with pets

• Keep pets immunised
• Keep them out of the kitchen and food-handling areas
• Pets’ living quarters and litter boxes must be cleaned on a daily basis. Their faeces must be handled with gloved hands and disposable paper towels, and flushed down the toilet
• Do not clean their cages or tanks in the kitchen sink
• Hands must be washed thoroughly with soap after handling pets and their belongings
• Pets in the house may be a risk to people whose immune systems are already at a low, such as pregnant women.

FOOD HYGIENE

Improper cooking, temperature-factors and food-handling techniques account for a majority of the food-borne infections. Here are some simple tips that can help prevent such infections.

Food preparation

Certain foods such as raw eggs, poultry, meat and fish have a higher risk of being contaminated and spreading the germs via kitchen surfaces. Vegetables – such as spinach and root vegetables – that have soil sticking to them are also at high risk for contamination.

The materials used in food preparation, such as the chopping board and knives, must be washed with soap and water. Separate boards must be used for raw meats and vegetables/fruits. Hands must be washed immediately after handling raw foods.

Food storage

Cooked food that is leftover or not going to be eaten immediately should be cooled and then refrigerated or frozen, preferably in air tight containers. The ideal temperature of a refrigerator should be between 4 -7 degrees celsius and a freezer at -18oC.

Refrigerator surfaces should be regularly decontaminated by cleaning and chemical disinfection.

Frozen food must be thawed and brought to a boiling temperature before serving it again.

PERSONAL HYGIENE

Hand-washing

Hands are the most common transmitting agents in the cycle of infection. Hands are potential disease-transmitting agents, to anyone who is next in their line of contact. Hand-washing works wonders in cutting the line of transmission and all it needs is soap and running water. Wash for 30-45 seconds, scrubbing between fingers and under nails.

When is it most important to wash hands?

[According to IFH guidelines]

• Before eating/cooking/handling food
• After using the toilet
• After handling pets, their cages, feeding utensils or other pet objects.
• After coming into contact with body fluids, such as nasal secretions, saliva and vomit or after changing nappies.
• After contact with a potentially contaminated reservoir site [e.g. a drain] or disseminator [e.g. a wet-cleaning cloth].
• Whenever hands are visibly dirty.
• Before giving or applying medication to another person.
• Before applying contact lenses.

Drinking water hygiene

• It is important to wash hands thoroughly before you fill water for cooking or drinking.
• Periodic cleaning of vessels/containers used to store water is obligatory.
• Buckets or vessels used for water shortage should be properly covered.
• Earthen matkas used for drinking purposes must be thoroughly scrubbed everyday, with potable water, before refilling.
• Water should be stored at home for the shortest possible time.

Following these simple hygiene measures at home will ensure a clean and healthy environment. It will also minimise the spread of infections.

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Impact of stress

Any stress response is translated in the body as a fight-flight reaction. This releases stress hormones like adrenaline and epinephrine. Adrenaline commands the liver to release stored sugars as glucose into the blood stream, anticipating a high energy activity to fight stress. Since this rarely happens, the excess glucose gets stored as fat. This is how prolonged periods of stress, in addition to the emotional effect, also leads to a physical effect i.e. weight gain. The constant stress from flight-fight reactions saps the body of energy, which can either lead to adrenal fatigue, mental breakdown, or a weak immune system. Most ailments are therefore known to have a psychosomatic [mind-body] connection.

How physical activity reduces stress

Endorphins: The feel good hormone

If you go to a park, you’ll see the slimmest of people doing the rounds. You might wonder, what motivates them to exercise? It is the feel good factor from the endorphins that is one of the biggest motivators that keeps the people running everyday. Endorphins are the body’s feel good hormones [endogenous morphine]. “Runner’s high” is an example of how prolonged physical activity can release endorphins. Endorphins are released during long, continuous workouts, when the level of intensity is between moderate and high, and breathing is difficult. Exercise also reduces the stress hormone cortisol.

Distracting the mind

Focussing on problems and thinking about them leads to mental anguish and stress, which is why a simple activity like walking, gardening or playing with kids can make us focus on the positive side of life. If the mind keeps going back to negative thoughts during a walk, it is a good idea to listen to your favourite music while walking, or observing the people and scenes around.

Support of friends

Taking a yoga class or a joining a walking group is a nice way to meet like-minded people who can become good friends and confidantes. Having a walking partner is great for sticking to schedule and also keeps boredom away as you talk about various things. You may also find comfort in venting out your problems to your friend.

Better body image

Any kind of physical activity is bound to tone the body and the improved circulation brings a glow to the face. A better looking person is always more confident and this brings about a feeling of self-worth, which in itself relieves stress.

Better health

Research is finding links between moderate exercise and better immunity. This could be because of improved circulation resulting in a quick movement of immune cells to capture disease-causing bacteria and viruses. The immune system returns to normal a few hours after the end of exercise, which is why regular physical activity is important to keep our functioning at optimum. Better health means a better state of mind. A daily dose of exercise also ensures restful sleep, which is also great stress-buster.

Rhythmic activities for mental peace

Often we hear people making excuses that “I’m feeling low, I don’t want to go to the gym.” In such situations, it is better to get out of the house for a leisurely walk, tending the garden, or doing a slow cycle. Such activities can de-activate the negative triggers.

Walk your way to health

Walking can be used to calm your mind. The rhythmic movements coordinated with your breath can be the perfect way to take your mind off nagging problems. I know of many people who recite mantras or chants and some who say their prayers during the entire walk so that it becomes exercise for the body and solace for the mind.

It is always better to choose a nice park or a beach as against the treadmill, where we can feel one with nature’s beauty. Instead of considering walking an “exercise”, take it as an opportunity to be aware of your body as it takes in more and more oxygen. If you are walking outdoors, use it as an opportunity to admire the beauty of nature.

Other physical activities that de-stress

Yoga

Many people who practise yoga experience a complete calming of the mind with markedly reduced nervousness, irritability, depression and emotional fatigue. Yoga also reduces blood pressure and anxiety.

Qi gong

Qi gong is an ancient Chinese art that combines breathing, meditation, gentle exercise, and flowing movements. Qi [pronounced chi] is the energy flowing through the channels in the body and this exercise promotes free flow of energy in the channels. When practised regularly, it is known to reduce blood pressure and heart rate.

T’ai Chi

T’ai Chi is a martial art form with a series of graceful, fluid motions. Being non-jerky and smooth, even older people can do this without much discomfort. It improves muscle strength and breathing capacity plus provides the bonus of improving balance too. These movements when practised regularly are known to reduce blood pressure.

Dancing

Dancing to your favourite music is a great way to feel a sense of abandon. You need not even know to dance for this. Just moving to the music and letting your body go can leave you feeling high.

Gardening

Whether you have a big space or just a nook in your balcony, the act of keeping plants, tending them and watching them grow is a big stress reliever. Being out in the sun and getting in “touch” with nature can bring a lot of good cheer.

Physical activity not only has effects on your body, but also has the pleasant effects on your mind. So what are you waiting for? Get going! Read more about the physical and mental health benefits of home gardening.

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Prickly heat

Characterised by tiny red bumps or blisters on the covered areas of the skin, this is caused when the sweat glands are blocked by dead skin, sticky sweat or bacterial debris. The intense itching may be also felt like a prickly sensation.

What can you do?

Dress in soft, lightweight cotton clothes. Avoiding the outdoors when the temperatures are at their peak can help. Resist the urge to scratch the inflamed areas as it could lead to infection. Ward off the urge by applying a cold sponge or soft cotton cloth to the itchy parts.

Calamine lotions or lotions that have oatmeal as one of the constituents can provide soothing relief. Lying in an oatmeal bath can also sooth the prickly symptoms. Do not use powders, oil-based creams and moisturisers as they tend to further block the pores. Applying a paste of pure sandalwood powder or multani mitti with rose water to the affected areas before a bath, and washing it off with cold water is a known remedy.

Sunburn

Sunburns are caused due to overexposure to ultraviolet rays, especially in open sunny areas like beaches, without taking adequate protection of clothes, hats and sunscreen. The burnt skin is red, warm and painful to touch.

What can you do?

Take a cool shower or soak a soft cotton cloth in cold water and use it to dab the affected areas. Salt from sea water can cause further burning, so take care to wash it off thoroughly. Apply a sunscreen to the affected parts, except where skin is raw and stay out of the sun, while the burns are healing. A mild water-based moisturiser can be used to prevent itching. Essential oils like chamomile or lavender oil are known to provide relief. Add a few drops to the bath, and soak for 15 minutes or so.

Heat headaches

Increasing body temperatures in summers can lead to headaches due to generalised dilation of blood vessels in the body. This when combined with other activities that increase body heat, such as intense physical activity or a hot bath, tend to increase the frequency.

What can you do?

Once you realise that your headaches get triggered off when out in the sun or when the mercury soars, it is best to avoid outdoor activities when sun is at peak. If you have to step out, drink plenty of water to stay hydrated. Loose fitting cotton clothes allow the body to cool off well. A wide brimmed hat or an umbrella helps to avoid direct sun rays.

To treat a heat-induced headache, drink lots of cold water and get into cooler spaces. Apply a cold compress with an ice pack or a bag of frozen veggies on the head. Loosen out any tight clothing. Consult a doctor if the pain gets unbearable.

Cramps, heat exhaustion, heat strokes

These are more common in areas where the temperatures rise above 40oC. Heat cramps are mainly involuntary muscle spasms that occur after/during a bout of heavy exercise without adequate fluid intake, in hot weather. Heat exhaustion can range from mild heat cramps to a life threatening heat stroke. Some symptoms include feeling faint, heavy sweating, queasiness, low BP, headache.

Heatstroke is an almost fatal condition. Body temperature above 104 F is the main sign with a rapid, shallow breathing and the pulse may go well over 130 beats per minute. The very young and the elderly are more susceptible to heat strokes.

What can you do?

For heat cramps, rest immediately and cool off. Drink an electrolyte rich sports drink or a fresh fruit juice with a pinch of salt. Gently stretch and massage the affected area to relieve the cramp. If not relieved, see your doctor.

For someone suffering with heat exhaustion, immediately remove the person to air conditioned/cooler surroundings and give cool water to drink. Loosen clothing, spray or sponge with cold water after laying the person down with legs elevated.

Conjunctivitis

Allergic conjunctivitis is more common in children. This is characterised by severe itching in both eyes, with a thick mucous discharge and it may start with the onset of warmer weather. It tends to occur every year around the same season until the age of 11-12 years.

Stye is an infection that occurs near the follicle of an eyelash when its opening is blocked by secretions. It can be painful but is not contagious. Increase in dust and pollen in the air when the temperature rises, causes bacterial conjunctivitis [pink eye] which is contagious.

What can you do?

For allergic eye conditions, bathe the eye with boiled and cooled water, using a fresh sterilized piece of gauze for each eye. Try not to scratch or rub the eyes, and avoid all irritants like smoke, contact lens and make-up.

Anti-allergic eye drops provide instant relief, but these should be used in consultation with your doctor.

For mild infectious conjunctivitis, anti-bacterial eye drops are useful. Before using the drops, it helps to clear out discharges with soaked sterile gauze pieces.

Food-borne ailments

It is easier to get food-borne infections at this time of the year, when you indulge in your favourite street food. Cases of typhoid, hepatitis A and E [jaundice] as well as cholera are found increasingly in the summer months in India. Vaccines for typhoid and hepatitis A provide reasonable protection, and are especially useful in children.

What can you do?

Take your food and water hygiene seriously. Do not neglect or self-medicate symptoms like vomiting or loose motions, Your refrigerator should be kept at lower than 5oC. Chilled food needs to be stored below this temperature, and hot foods need to be kept at a temperature of 60?C. Wash hands thoroughly with soap and water before handling food and use separate cutting boards/knives for handing meat and vegetables.

Swimming pool care

While it is fun to cool off in the pool, do not forget to use a water-proof sunscreen before getting into the pool. The other danger is of disease outbreaks, when sufficient pool hygiene is not maintained by other members. To protect others, people who have had diarrhoea should wait at least a week until after symptoms have completely subsided before using the pool. Also, it is important to confirm with the pool authorities that additional measures are being taken for cleanliness and maintenance of pool filters.

While summer in our country can be fierce and uncomfortable, taking good care of our health will help us enjoy the mango bounty and the ice creams and it won’t be that bad after all!

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While mango is a nutritious fruit, clamouring after them in January when they are priced at over Rs 100 a fruit makes no sense. Fruits and vegetables are at their nutritious best when they are in season and are allowed to ripen naturally, rather than the forced, chemical-aided ripening ahead of season. Though this might satisfy your taste buds, it is not doing your health much good.

On evaluating the nutrition for the cost we pay for each food item, it is surprising that we have many foods in our midst that are easily affordable. India, being a tropical country, produces the best of fruits and vegetables all year round, high in vital nutrition, suiting our genetic make-up too.

Some super cheap super foods

Bananas – Available around the year, they are a powerhouse of energy. Rich in vitamin B6, potassium, fibre and vitamin C. A favourite with sportsmen, we in India, are lucky to find this fruit sold at even street corners all through the year.

Papayas – Abundant in vitamin C, A, E and K, plus a healthy dose of folic acid, potassium and fibre.

Guavas – Rich in vitamin C, much more than oranges and high on dietary fibre, this non-glamourous fruit has everything going for it. Sold by cart loads, this packs in maximum nutrition at minimum cost.

Peanuts – Being good sources of vitamin E, niacin, folic acid and monounsaturated fats, they aid in keeping a healthy heart. Known to be rich in anti-oxidants, they are abundant in proteins too.

Lentils – These are a staple in any Indian cuisine. No meal is complete without dal and it is a rich source of protein for vegetarians, high in fibre, folic acid and iron. They are the perfect food for diabetics, giving them protein-rich food that slows down the rise in blood sugar after a meal.

Cabbage – Indian cuisine has multitude of ways to cook this wonder vegetable. Much hated by many Westerners for the smell it gives out on boiling – this is rich in vitamin K and C. Cabbage is also a decent source of fibre, B-vitamins and omega-3 fatty acids.

Spinach – This along with other green leafy vegetables available fresh in the open markets are must-buys almost around the year except for the monsoons. Spinach is blessed with almost 15 flavonoids [anti-oxidants] that protect us from a variety of diseases. One cup, providing over double the required vitamin K for the day, is good for maintaining bone health. Iron-rich spinach is a reliable source of the mineral for all.

Eggs – They are one of the best sources of low-cost, high-quality protein, providing around 5.5 gm of protein for just 65 calories. An egg a day or every other day for breakfast gives you a complete range of amino acids.

Other complex starches such as potatoes, sweet potatoes, yam, wheat flour — all these are nutritionally high-grade foods that can be used in our day-to-day meals.

Tips to eat healthy without breaking the bank

• Buy healthy stuff such as nuts, olive oil, organic non-perishables in bulk when you find offers in your supermarket, like “take one, get one free”.
• Eat fruits and vegetables in season, these are not only cheap but also have the best concentration of nutrients.
• Some things can be easily made at home such as paneer, yoghurt, peanut butter, pasta sauce and the like. Besides saving a lot of money, when you make them yourself, you can be sure about the quality and keep them free of preservatives and excess salt.
• Locally-grown produce is always cheaper than what has come from far-off states or countries. Besides, when you use produce from your nearby areas, you are consuming lesser “food miles” and lessening your carbon footprint.
• Some stuff like frozen peas or corn bought in bulk are quite economical for use when they are out of season. Since frozen/canned produce is picked at the peak of their season, you can be assured that they are high in nutrients.
• Herbs such as basil, oregano and mint are rich in micronutrients, but they tend to cost a lot for a very small pack. You can grow these from the seed in small pots on your window sill and snip some whenever you need them.
• Plan your weekly menu around the seasonally-available produce and the items on marked-down prices in supermarkets during that week. Do not buy large quantities of perishables though, if you do not have a plan on how you are going to use it all. A good way of taking advantage of bulk deals is to share it with neighbours or friends.

Eating and ordering out

The restaurants that serve the most expensive food are not necessarily the healthiest. Those that serve regional cuisine like Udipi, Maharashtrian or Bengali food, quite often stick to the traditional way of preparing food and are priced better than some of the so-called multi-cuisine restaurants. You might be surprised to note that the bill for beverages sometimes exceeds that of the food, and this money has been totally wasted on zero-nutrition liquids such as mocktails, colas or alcohol. Every restaurant is committed to providing you clean drinking water, so you can stick to that instead of adding to your waistline from the empty calories of most beverages.

You can make several pizzas with the freshest of ingredients for the cost of ordering out one pizza, where you are not sure about the quality of toppings used. Appliances like an oven might seem like an extra expenditure in the beginning, but when you can enjoy freshly-baked goodies in the comfort of your home, without extra sugar, salt and preservatives, the investment is very much worth it.

There is no need for us to go overboard spending on healthy foods. If we look around, we will find plenty of locally-produced, reasonably-priced foods that are as nutritious as their more expensive counterparts. The key is to buy fresh and local stuff, prepare them in the way that retains maximum of their goodness and eat fresh.

It is very much possible to eat healthy on a moderate budget too!

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