Author Archives: Lily Kiswani

About Lily Kiswani

I am an Integrative medicine practitioner. I transitioned into Integrative medicine after three decades of Gynecology practice and Endoscopic surgery. I was the first female Laparoscopic surgeon in India. I have co-authored a textbook, Endoscopic Gynecologic Surgery, available on Amazon. Now, after all these years, with the realisation that I can help people regain their lost health, I find myself inordinately excited and blessed to have this opportunity.

Why belly fat is dangerous and what to do

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Fat around the midsection, what we commonly refer to as belly fat or a spare tire, can be a dangerous predictor of major health complications, even in people who are not obese as defined by BMI.

How do we know that?

Here are a few published studies:

1. In this study published in the European Journal of Preventive Cardiology, the researchers concluded that abdominal obesity was common in post-myocardial infarction patients and a larger waist circumference was independently associated with recurrent atherosclerotic cardiovascular disease, particularly in men. They recommended utilising waist circumference to identify patients at increased risk of recurrent atherosclerotic cardiovascular disease after myocardial infarction.

2. Another study in the March 6, 2018 issue of the Journal of the American Heart Association involved about 500,000 people, ages 40 to 69, in the United Kingdom. The researchers took body measurements of the participants and then kept track of who had heart attacks over the next seven years. During that period, the women who carried more weight around their middles (measured by waist circumference, waist-to-hip ratio, or waist-to-height ratio) had a 10% to 20% greater risk of heart attack than women who were just heavier over all (measured by body mass index, or BMI, a calculation of weight in relation to height). The authors concluded: “Our findings support the notion that having proportionally more fat around the abdomen (a characteristic of the apple shape) appears to be more hazardous than more visceral fat, which is generally stored around the hips (the pear shape).”

3. Another study in the Journal of the American Heart Association concluded that waist circumference is an independent risk factor for hypertension, but skinfold thickness (total body fat revealed by BMI) was a poor marker of body fat and could not be used to predict hypertension.

There are many more, but you get the idea.

Why is belly fat dangerous?

In addition to heart disease, belly fat increases risk for diabetes, cancer and stroke. This happens because the excess visceral fat triggers a low-level inflammation in the body, which is why it can lead to chronic disease and faster ageing.

Why does belly fat develop?

  1. Incorrect balance of nutrients and excess Insulin: Our diet is preponderant in carbohydrate content. This can lead to insulin resistance. Insulin is an obesogenic hormone – it promotes obesity – and it leads the body to store the excess carbs in the liver and in the visceral tissue.

  • Cortisol – Stress causes the secretion of the hormone, cortisol. Compared with subcutaneous fat, abdominal fat cells have four times more cortisol receptors; hence the excess stored fat is directed to our middle.
  • Sedentary habits: The carbohydrates we consume are not ‘used up’ and get stored as fat.

What to do?

  1. Correct the diet: Get in touch with someone who can provide the right guidance. This post provides a detailed guide to structuring a healthy eating plan: https://drlilykiswani.com/what-should-i-eat/.
  • Stress management: Practices such as meditation help lower cortisol levels and decrease inflammation in the body.
  • Sleep: This study showed that In those younger than 40 years, ≤5 h of sleep led to a greater accumulation of fat compared to sleep duration between 6 and 7 h.
  • Get off that chair! Keep moving. Even if it is just walking, even if it is in short bursts, it still helps burn off the carbs. Not just calories, mind. Burn carbs.

What doesn’t work?

Doing ab exercises! Crunches will help tone the abdominal muscles but will do nothing to target the belly fat underneath. So stop punishing yourself and focus on what works.

Simple steps, performed consistently, and you can transform your health and get that six-pack!

Images from Unsplash.

INDOOR AIR QUALITY IS KEY TO STAYING HEALTHY IN THESE TIMES

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Indoors is where one escapes to, to rest, relax, and feel comfortable, to get respite from the extremes of temperature, humidity, and exposure to some pollutants found in the “outdoors.” But do we know that the indoors can be up to 100 times more polluted as the outdoors?  

Air pollution is not just the smoke spewing from factories and traffic, with toxic fumes converting the atmosphere into a gas chamber. It is more pervasive than that and it includes, regrettably, the air quality inside of our homes, the air our little children breathe – and it can have serious, even hazardous health consequences.

What are these possible consequences?

There can be short term symptoms, such as

  • coughing
  • sneezing
  • watery eyes
  • fatigue
  • dizziness
  • headaches
  • Rhinitis, nasal congestion
  • Nose bleeds
  • Difficulty of breathing
  • Sore throat, cough
  • The long-term health consequences  of indoor air pollution include even more serious conditions such as
  • Hearing loss
  • respiratory problems – wheezing, asthma
  • Severe lung disease
  • Brain health including Alzheimer’s and autism
  • Heart disease
  • cancer

which can show up years after exposure has occurred.

Non health consequences also occur – productivity can be adversely affected by pollution.

As we know, the COVID-19 virus passes through droplets in the air. And other indoor pollutants – including volatile organic compounds, chemicals, smoke, mold, pollen and allergens, toxins in household cleaning products – can also persist in the air, affecting our health and quality of life.

But there is a solution.

  • Ventilation – Be sure to open windows to air out your home …
  • Maintain a wide variety of healthy plants that possibly help purify the air such as snake plant, spider plant and jade.
  • Avoid using of toxic household and personal care products.
  •  Use a good quality air filter in all confined spaces – your home, office and car. As we spend unprecedented amounts of time in our homes to shelter ourselves away from life-threatening airborne viruses – – pure indoor air isn’t just a luxury. It’s a necessity!  And this is not just now during lockdown times. What will happen when our freedom is restored? An unsuspected, undiagnosed person who visits your home or office can leave behind droplets by just talking and breathing. According to many integrative healthcare professionals, a good quality, better than HEPA can filter out the virus, which is between 0.2 and 0.05 microns in size, according to a Lancet study. So your filter has to be able to capture particles smaller than 0.05 microns to be effective.
  • Avoid air fresheners, deodorants, perfumes and perfumes cleaning products. These are all chemicals and toxic.  Essential oils have therapeutic benefits and they smell great.

 Without doubt, clean air is the #1 determinant of good health. Followed by water, and then food. Just think about it. You can live for days without water, for weeks without food, but only a couple of minutes without air. Still, most  people are more concerned about their diet, supplement & exercise regimens and neglect the air that they breathe… innocently allowing toxins into their body! Little children are much more vulnerable to the dangers of toxic air due to their higher respiratory rates.

You may be shocked to finally know what good health feels like:

 ⚫ allergies vanish

 ⚫ Inflammation, aches and pains disappear.

⚫ Brain fog clears up.

Take the step, clean your air and restore good health for your family.

Healthy sugar? Really?

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Often patients will state, with a self-satisfied sense of virtue, that they are not consuming any sugar at all. But by now I know better than to take this at face value. A little digging will lead to statements like –

I only use honey

I used dates

I use jaggery (unrefined cane sugar)in my tea.

And fruits do not count as sugar at all! In fact most of them see fruit as necessary and a large proportion of diabetics will state that they eat only fruit for breakfast.

Also their food intake is replete with carbohydrates, which are not taken into consideration at all!

The truth is that honey is a natural sugar in that it occurs naturally in nature. But it is an ‘added’ sugar when added to food, it is not naturally occuring in food like fruit sugars do. Most importantly, honey / jaggery/ dates / coconut sugar – any form of sugars are metabolised in the body in exactly the same way that table sugar is. They all lead to a blood sugar surge followed by an insulin surge. Thus they all carry the risk of causing complications just like sugar does. The small amount of nutrients these sweeteners contain does not justify the large metabolic risk they carry.

 

All carbohydrates such as wheat, rice, alternative grains like jowar, bajra and similar, are converted to glucose before absorption and again these are metabolised the same way in the body. So even if you give up sugar and you eat bread – even the so-called healthy types – or biscuits, or poha, or upma, or idli, or dosas, you are adding to the sugar load on your body. Additionally biscuits contain a harmful kind of fat called trans fats, which keeps them from spoiling for several months. Bacteria, worms and fungi understand that these biscuits are not edible, but we happily consume them. Remember, Advertising is not Nutritional Information.

fast food high in carbohydrates and trans fats

 

 

Fruits are held in very high esteem for some reason. But the sugar in fruit, fructose, is even more harmful than table sugar which is sucrose. This post: https://drlilykiswani.com/diabetic-eat-fruit-breakfast/ explains the issue in detail.

Artificial sweeteners can raise blood sugar levels even more than sugar itself! This includes compounds like saccharine, aspartame and sucralose. Read more here: https://drlilykiswani.com/551/. However natural sweeteners like stevia can be used, so can sugar alcohols like erythritol and xylitol, though they can cause a bit of digestive upset. A combination of stevia and erythritol often works well.

Consuming sweets, even when the sweetener is non caloric like stevia, can cause the brain to develop a sweet addiction.

So save the sweet for a special occasion.

5 DIABETES MYTHS

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We are staring at a global diabetes epidemic. And the powers that be, such as the American Diabetes Association, Diabetes Australia, Diabetes UK and similar, form policies which drive treatment and all these associations assert that diabetes is a chronic progressive disease, eventually requiring increasing doses of medication to keep blood sugar levels in check.

But nothing could be further from the truth.

So let’s examine a few myths associated with the condition which even we as doctors have been ‘fed’ and determines how we dispense advice.

  1. DIABETES OCCURS BECAUSE THE PANCREAS DO NOT PRODUCE ENOUGH INSULIN

Type II diabetes, which is the common variety seen in adults, is due to insulin RESISTANCE, not underproduction. I have explained this in the post: https://drlilykiswani.com/insulin-resistance/ .

This means that we are not helpless because the body is not making insulin. It means that we have CONTROL because we can reverse the Insulin Resistance.

2. DIABETES IS A CHRONIC IRREVERSIBLE DISEASE

No, diabetes is a CONDITION that has occured due to various causes such as stress, unhealthy lifestyle, drug reactions and can be REVERSED by identifying and reversing the underlying causes. This can be done by an Integrative Medicine Specialist.

3. YOU NEED CARBOHYDRATES FOR ENERGY AND FOR YOUR BRAIN

I know, this is what I believed and also advised my patients. This was because medical college curriculum almost ignores nutrition and that encourages us to ignore it, too.

The truth is, the body and the brain both function a lot more efficiently on ketones, which are fat breakdown products. Here are some studies: https://www.ncbi.nlm.nih.gov/pubmed/23852511, and https://www.psychologytoday.com/us/blog/evolutionary-psychiatry/201104/your-brain-ketones.

So ditch the carbs. Fat is our friend. Here’s a guide on how to eat to become healthy and to stay healthy: https://drlilykiswani.com/what-should-i-eat/.

4. IF YOUR BLOOD SUGAR LEVELS ARE ‘IN CONTROL’ ON DRUGS, YOU ARE SAFE.

Sorry, but this is not so. You are still at risk of developing complications. This is because the root cause has not been addressed and the damage to organs continues to occur. Here’s how to correlate blood sugar levels and risk of complications: https://drlilykiswani.com/prediabetes-are-we-at-risk/ .

Therefore the only real option is to reverse your illness and return to true health.

5. IF YOU ARE ‘PREDIABETIC’, YOU ARE SAFE.

Sorry, but this is not true as well. In fact the term ‘prediabetic’ confers a false sense of security precluding action. The truth is that complications begin to occur at blood sugar levels defined by the estimable organisations above, as being in the prediabetic range.

So if you are told that a fasting blood sugar level of 110 is acceptable, run to find an Integrative Medicine practitioner.

Diabetes is preventable even if you have a strong family history.

Diabetes is reversible. You are NOT doomed to ill health.

Nutrition before, during and after pregnancy

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Pregnancy is a very special occasion in a woman’s life. Creating and bringing a new life into this world is very special and also involves a huge responsibility as every parent wants the best health for their child. Giving a child the best start in life, begins early, long before conception.

Human biology is amazingly wise. The body receives signals from the environment and ‘informs’ it that the environment is abundant and allows for the growth and nutrition of the coming baby. So if the to-be mother is nutritionally depleted, the message to the body is that conditions are unfavorable for new life, and the body may decide that this is not the appropriate time for pregnancy. And conversely, being nutritionally replete could be all that is required to conceive, in a case of a couple with no other identifiable complication.

It is evident that for such signals to reach the cells and to be incorporated into the DNA, they have to come from natural, plant sources and sometimes animal sources such as omega 3.The cells in plants and animals carry information which can be read by the human cells. Pharmaceutical, chemical products cannot carry this information and can actually be detrimental. Cell membranes carry receptors which act like doorways or every single nutrient which enters the cell. Fake, chemical supplements are sufficiently alike the natural molecules to be accepted by the receptors but also sufficiently unlike that they can gum up the works, damaging the cell membrane, the cell, the tissue, the organ and ultimately the body.

The mother-to-be needs to be replete with nutrients to ensure the optimal well-being of the baby. These need to be started early enough, at least three months before conception.

The very early embryo, even before implantation,  can sense and react to the environment in which it develops.

Prepregnancy nutrition requirements

Folic acid                                               

This one is well known. Folic acid supplementation is important and its role in preventing neural tube defects such as spina bifida in the newborn is well documented.

Omega 3 Fatty Acids

Starting Omega 3 six months before you conceive, allows the body to build up its stores of essential fatty acids. This can improve fertility by reducing fertility issues related to chronic inflammation-. Omega 3 is important in the development of the baby’s brain – intelligence, visual acuity, memory.

A Multivitamin multimineral  tablet contains (hopefully!) all the vitamins, all the minerals one needs so that the mother’s nutritional status is optimal.

Once again I would reiterate that it is crucial that your multivitamin come from a natural, organic source. I would go so far as to say that it is better to not take anything than to permit a chemical to enter your body. At least you are not wilfully doing harm.

During Pregnancy

Omega 3 fatty acids are a major constituent of the fats in the brain and involved in the development of the eyes. Thus supplementation with omega 3 improves visual acuity, attention span, learning and cognitive ability of the baby. They help prevent preterm birth and low birth weight babies.

How much and what source? Vegetarian sources such as walnuts and flaxseed contain the compound ALA which needs to be converted into DHA, the compound in the brain. This conversion in the body is inefficient, about 1-10% of ingested ALA gets converted to DHA. Fish sources are likely contaminated with mercury, therefore choose fish oil from salmon fished in cold, deep waters.Ideally take a minimum of 300mg DHA daily.

Iron – The pregnant woman needs daily oral iron supplementation, with 30 mg to 60 mg of elemental iron to prevent anaemia, low birth weight, and preterm birth.

Calcium – 1200mg a day. Make sure the calcium you choose is balanced with magnesium, Vit D and Vit K.

Probiotics – help prevent allergies in the baby.

Protein – is essential for growth of the baby and the mother needs about 1.2 gm/kg body weight per day. This amount is usually difficult to obtain from the diet and certainly a vegetarian diet is inadequate. Choose a source which provides all essential amino acids and is concentrated enough to help achieve the required levels.

Vit D helps prevent respiratory infections in the baby and prevent gestational diabetes in the mother.

Continue with the multivitamin and Folic Acid.

After pregnancy, during lactation

All conditions remain the same as the growing baby’s needs continue and indeed, increase. And so all the supplements used in pregnancy must continue.

Wish you a healthy pregnancy and a healthy baby!