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.

Soy Protein is Dangerous – Myth or Fact?

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Many people approach soy protein with trepidation. They have heard that

  • It is dangerous for women with history o breast cancer or with family history of breast cancer
  • Men can develop gynecomastia – ‘man boobs’
  • Those with thyroid deficiency cannot take soy protein.

 

So let us examine the evidence.

We’ll take the subject of breast cancer first.

There are several studies which show that soy protein is actually protective against breast cancer.

This study found that   Intake of protein containing soy was associated with reduced breast cancer risk . The researchers also found an inverse association between total tofu intake and breast cancer risk among premenopausal women and they concluded that increased regular soy food intake at a level equivalent to traditional Korean consumption levels may be associated with a reduced risk of breast cancer, and this effect is more pronounced in premenopausal women.

In another study, researchers found that soy protein may protect against the development of a more aggressive breast carcinoma.

This study concluded that Isoflavones (phytoestrogens) also possess nonhormonal properties that are associated with reducing cancer cell growth. Thus, there are several possible mechanisms by which soy may reduce the risk of breast cancer.

Yet another study resulted in the conclusion that the existing data should provide some degree of assurance that isoflavone exposure at levels consistent with historical Asian soyfood intake does not result in adverse stimulatory effects on breast tissue.

This study did not show that the adult consumption of soy affects the risk of developing breast cancer or that soy consumption affects the survival of breast cancer patients. Consequently, if breast cancer patients enjoy soy products, it seems reasonable for them to continue to use them.

Now let us determine why this may be so. In other words, where is the conflict?

Soy contains phytoestrogens (plant estrogens) and it is erroneously believed that this can fuel the growth of breast cancer cells. In reality, not all, about 80% of breast cancers respond to the hormone estrogen.This means, 20% don’t even respond to estrogen.

So how is soy protective against breast cancer? It is because the phytoestrogens in soy are weak estrogens compared to the native estrogen in the body. These weak estrogens occupy the estrogen receptors – docking sites – on the cells, blocking the action of the stronger estrogen produced by the body. This means it is like wearing a bulletproof vest, protecting against estrogen ‘bullets’.

 

Gynecomastia – the same argument applies.

 

Thyroid :

This review evaluated 14 studies and concluded that the findings provided little evidence that in normal individuals, soy foods, or isoflavones adversely affect thyroid function   In individuals with compromised thyroid function and/or whose iodine intake is marginal, soy foods may increase risk of developing clinical hypothyroidism. Therefore, it is important for soy food consumers to make sure their intake of iodine is adequate. However, hypothyroid adults need not avoid soy foods.

 

There are other benefits to soy protein:

  • It is the only complete protein of vegetable origin.
  • This study showed that consumption of soy protein is associated with a lower risk of cardiovascular disease.
  • Another study revealed that there is convincing evidence that soybean products have beneficial effects on cardiovascular disease risk factors.
  • This study showed that dietary soy protein can lower plasma levels of lipid and improve kidney function in type II diabetes with nephropathy.
  • A soy protein diet for 5 weeks improves endothelial (lining of blood vessels) function in renal transplant patients.
  • A lower rate of prostate cancer developed in the groups of men given soy compared to the milk casein group.
  • Modest amounts of soy consumed during childhood and/or adolescence reduces breast cancer risk. Evidence also suggests that soy reduces prostate cancer risk and inhibits prostate tumor metastasis. Soy protein is reduces cholesterol and lower risk of coronary heart disease. In regard to bone health, soy intake is associated with marked reductions in fracture risk. Soybean isoflavones also modestly alleviate hot flashes in menopausal women. Finally, other than allergic reactions, there is almost no credible evidence to suggest traditional soyfoods exert any harmful effects in healthy individuals when consumed in amounts consistent with Asian intake.

It is quite understandable that, when advised against the use of soy by your health professional, doubts may arise.  However the evidence clearly refutes this belief and one would advise that you take your decision based on credible, recent research. Your body is yours. Not anyone else’s, certainly not your doctor’s. .

 

Now about quality. Are all soy protein powders available in the market equal? Sadly, no. Look for a quality product using quality, certified organic ingredients with high protein content and low carbohydrate content, from a trusted source, for best results.

 

Finally, is soy or whey protein better?

As we have seen, soy is the only complete vegetarian protein. Soy is therefore added to whey to make it complete. Muscle building requires branched chain amino acids found in whey so if that is a priority, go for whey with soy. For all others, either one is good enough.

Milk – All you Ever Wanted to Know

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This video answers all the questions you had about milk but didn’t know who to ask:

The very first, basic one : Should one drink milk?

If yes, should it be fat free? Low fat? Or Horrors! Full fat?

Should one add anything to milk?

I hope you enjoy.

Do you drink milk? Do you add various ‘doodh ki shakti’ products? Leave your comments below.

 

Should you eat Fruit for Breakfast?

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Is this your breakfast?

Over the last month and a half, an overwhelming majority of my patients have proudly proclaimed that they eat only fruit for breakfast. Somehow, it’s only at breakfast, and it’s only fruit, unadulterated with any proteins or fats. :) And none of them were able to answer coherently, whose recommendations they were following. Obviously, they had high blood sugars, which is why they were seeking help.

Fruit seems to have an exalted position in our nutritional psyche. Possibly because of its cost; the subconscious correlation being that expensive equals good.

Let’s take a look at the science on this subject.

  1. This article in the magazine ‘Scientific American’ explains that the fruit today is very different from the fruit that was available fifty years ago. Soil depletion has led to the mineral content of the fruit being reduced markedly, so the fruit ends up as a sugar bomb. This can cause a spike in blood sugars. This means that the supposed nutritional benefit, for which we are consuming the fruit, is really not available any more.
  2. Fruits contain a form of sugar known as fructose. Only the liver, and no other cell in the body, is able to use fructose. When we eat fruit, the fructose is sent directly to the liver, bypassing the systemic circulation. In the liver, Dr Jason Fung explains that after converting into glycogen, the excess fructose is converted into fat, leading to fatty liver and Insulin resistance. Excess fructose can contribute to the development of metabolic syndrome and increase uric acid levels.
  1. Recently, the PURE study, consisting of over 135,000 individuals from 18 countries (Dehghan et al., 2017) found that carbohydrate intake was associated with increased total mortality. Excessive intake of carbohydrates leads to high blood sugar levels. The cells ‘refuse to accept’ more than they need, so that the circulating level of sugar in the blood rises. In oversimplified terms, this is what leads to the high blood sugar levels in diabetes,

So should anyone with diabetes stay off all fruit?

No, a recent study in the British Medical Journal found that greater consumption of specific whole fruits, particularly blueberries, grapes, and apples, is significantly associated with a lower risk of type 2 diabetes, whereas greater consumption of fruit juice is associated with a higher risk.

So how do we make sense of all this?

The advice is to consume fruit in moderation. A small piece of low glycemic fruit a day, taken along with a fatty food such as nuts or peanut butter (unsweetened!) to slow the absorption, is probably a good idea. Blood sugar levels may need to be monitored to ensure that this is being tolerated well.

Berries and pomegranates have many health benefits.

An apple a day keeps the doctor away? We may need to rethink this.

WHY DIABETES IS A REVERSIBLE CONDITION

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We have been conditioned to believe that diabetes is a chronic, progressive condition which will stay with us and we have to resign ourselves to suffer its complications. This is what we are taught in medical college and our entire treatment focus is geared to suppressing the symptom of diabetes, the high blood sugar levels. But this does NOTHING to prevent the development of complications.

Using insulin to lower blood sugar levels might seem logical, and it even works to an extent, but the truth is that it does not affect the disease process in any way. In fact, insulin itself is obesogenic, ie, it aids in the deposition of fat and increases inflammation, which increases disease.

Diabetes occurs because of:

  1. INSULIN RESISTANCE

Blood sugar levels are high but the cells are already flush with sugar and ‘refuse’ to accept more. The body makes more insulin, ‘thinking’ that low insulin is why sugar levels are high. This extra insulin is ineffective in driving the sugar into the cells. Put in a very simple way, this is Insulin Resistance.

The way to reverse Insulin Resistance, thereby to allow the sugar to enter the cells, thereby to lower blood sugar levels, is to prevent insulin spikes. And this is easily done by restricting refined carbohydrate consumption.

  1. HORMONE IMBALANCE

Stress causes cortisol levels to rise, and because stress in our lives is chronic, the cortisol rise is also chronic. Cortisol was expected to rise in response to the ‘fight or flight’ response in cave dwellers faced with a sabre toothed tiger. The adrenalin secretion allowed our eyes to dilate so we could see better, our hearts to pump faster so more blood could reach the muscles so we could run faster, increased flow to the brain so we could think better, and so on. Short term response to an acute stressor. During this event, activities like digestion, reproduction, hormone secretion took a backseat as these are not urgent, and energy has to utilized for the urgent. No point digesting food if we’re going to be eaten by the tiger!

In recent times, stress has become chronic. Thus the imbalance in the body response has also become chronic.

  1. LIFESTYLE

The sedentary lifestyle we have all adopted, including our little children, increases the risk for developing Type II Diabetes. Men watching more than 40 hours a week of TV had thrice the risk as those watching for an hour.

  1. NUTRITION

The food we eat today is lacking in nutrition compared to the same foods eaten say, 50 years ago. This is because of soil depletion, modern farming methods, use of pesticides, not to mention adulteration and the growth of fast ‘foods’. It stands to reason that a cheese curl full of chemicals cannot be the nutritional equivalent of an organic fresh green vegetable. Chemicals block cell receptors in the body, blocking enzymatic reactions. If the cell cannot function optimally, the body cannot either.

  1. GENETICS

A family history of diabetes may load the gun, but the trigger is pulled only when lifestyle and poor nutrition contribute.

So there’s always a way.

Diabetes is unique among the chronic illnesses in how completely patient behavior influences it, and therefore it can be completely reversed. And the patient can actually look forward to regaining health and vitality, without fear of complications, without the constant stress of monitoring food and activity.

PCOD – why it happens, what to do

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PCOD  is an increasingly common condition in young women.

When I was a student – almost 40 years ago! – it was rare, seen in significantly overweight ( which was itself uncommon!) women in their 20’s and 30’s. Now we see it in young teens, most of them of normal weight or even thin! What went wrong?

There was a recent report that there are 10 million young ladies with PCOD in India.

PCOD, like any condition, occurs when genetics, lifestyle and nutrition come together to create either wellness or derangement leading to illness. It is very obvious that our lifestyles have changed pretty drastically over the last 40 years, and so have our eating habits. Is it a wonder then, that illness should follow?

 

What happens in PCOD

  1. Increased secretion of Luteinising Hormone by the pituitary leads to impaired maturation of ovarian follicles, so that no single follicle matures and the ovum is not released. This leads to anovulation and infertility.
  2. This also leads to male features like acne, hair loss and facial hair.
  3. There is Insulin Resistance leading to obesity.

If untreated, the high levels of male hormones lead to endothelial dysfunction and high insulin level causes sodium retention which in turn leads to high levels of the hormone angiotensin II. These increase the risk of developing high blood pressure, altered lipids and coronary artery disease.

The Insulin Resistance can lead further to Type II diabetes and obesity.

The altered features can lead to anxiety and depression, and social isolation.

When the patient does conceive, it may end in miscarriage in up to 40% of pregnancies.

The risk of developing endometrial cancer is 3 times higher than in a normal woman.

 

What can be done

All these years I have been advising conventional treatment, consisting of glucose-lowering medications like Metformin, even though there is no prospective randomized double-blind study supporting the use, and cycle regulating hormones like oral contraceptive pills and male hormone antagonists like cyproterone. None of these address the root cause, which is  metabolic disorder. Nor do they prevent progression of disease.

An integrative Medicine approach does address the underlying pathology.

  1. An anti-inflammatory diet which leads to weight loss. Focus on a variety of vegetables and a limited number of fruits. Maintain adequate intake of protein and good fats.
  2. Hormone Balancing using natural, bio-identical hormones, not synthetic chemicals which the body is unable to process safely.
  3. Exercise improves insulin sensitivity.
  4. Supplements such as chromium, vanadium, Vit D, which improve glucose metabolism.
  5. Saw palmetto reduces acne, facial hair and hair loss by reducing the conversion of testosterone to DHT.
  6. Antioxidants such as omega 3 fatty acids to reduce inflammation and counter the effects of oxidative chemicals from pollution, pesticides, etc.
  7. Mindfulness, Stress Reduction, Meditation.

 

This approach can improve the quality of life and may restore normal cycles and fertility. Not to mention confidence and wellbeing.

I remember my patient AK, aged 25. She had never had regular cycles since menarche. She was not overweight but had significant facial hair and required regular maintenance. I suggested treatment and advised her to return in a couple of months. I warned her that the hair cycle is 6 months, so she should not expect instant results.

She returned in 3 weeks as she was going out of town. Her face was clean, which was unremarkable; I assumed she had recently taken care. But no, she hadn’t done anything! I was myself pleasantly surprised that she had not needed any care since starting the treatment advice.

 

A lifestyle approach is simple, safe and effective and can give lasting results.