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.

What should I eat?

There’s so many opinions out there!

Eat protein.

Eat low carbs.

Eat no carbs.

This diet. That diet.

What can I do?? What should I eat? And what should I avoid?

A good diet should provide plenty of choices, relatively few restrictions, and no long grocery lists of (sometimes expensive) special foods. It should be as good for your heart, bones, brain, and colon as it is for your waistline. And it should be something you can sustain for years. It should be easy to prepare, include flavorful food choices and should be acceptable to and useful for the whole family. Such a diet won’t give you a quick fix. But it can offer you something better — a lifetime of savory, healthy choices that will be good for all of you, not just parts of you.

Here’s one such. Let me give you a few simple principles for eating a healthy, balanced diet, incorporating best practices from DASH, Mediterranean diet and hormone balancing diets.

1. AVOID ADDED CARBOHYDRATES

Especially refined and processed carbs. This means – no wheat, rice, potatoes, certainly no packaged or bakery goods. Most certainly no sugar, no sugar equivalents, no sugar substitutes. Remember, sugar is POISON. Eat the occasional piece of fruit for your sweet craving.

2. Eat 9 to 13 servings of vegetables and fruit daily. This will give plenty of carbs for efficient metabolism. Aim for a ‘rainbow’ of 7 colors in food daily.

What is one serving? One cup uncooked, half cup cooked fruit or veg, quarter cup dried. One cup is the size of a closed fist.

Do not juice your fruit and veggies. The fiber, and the fullness it provides, is invaluable. Fruit juice is a source of concentrated calories and causes a sugar spike. Fiber, in addition to contributing to fullness, helps control diabetes, high cholesterol, maintains bowel health, helps maintain healthy weight and eliminate toxins. Recommended intake is:

Age 50 or younger Age 51 or older
Men 38 grams 30 grams
Women 25 grams 21 grams

Institute of Medicine, 2012.

So make smoothies instead. That is, blend a combination of green leafy vegetables and veg you like, such as cucumber, tomatoes, capsicum, beans, with no sugar added. It is good if you add a tablespoon of coconut oil to this. It will be creamy and filling, and the medium chain triglycerides in the coconut oil are great for your brain and your hormones. vegetarians can add a scoop of good quality protein powder to boost their protein intake.

3. Protein with every meal.

Here I am writing as an almost-vegetarian Indian. Our breakfast, especially, is usually upma, poha, paratha – all carbs! There’s no protein there!

It’s important to get protein with every meal. Protein is more satisfying than carbohydrates or fats, and thus may be the new secret weapon in weight control. Getting enough protein helps preserve muscle mass and encourages fat burning while keeping you feeling full. Eating carbs makes you hungry soon after a meal. Eating protein keeps you feeling full. So be sure to include healthy protein sources, like yogurt, cheese, nuts, or beans, at meals and snacks.

How much protein? About 1g/kg body weight for an adult, more, around 1.5g/kg for the pregnant or lactating ladies, growing children and those exercising vigorously. How do we know how much we’re getting? Measure! Maintain a food diary. This will give total calories consumed, plus breakdown of major food groups, ie, carbs, protein and fats.

Avoid chargrilled meat as we have seen in a previous post.

Good quality protein – avoid processed, canned, deep fried stuff full of antibiotics and pesticides. Obviously. So no cold cuts. Grass fed, organically raised animals and poultry. If you can, organ meats are good.

4.  Avoid snacks between meals. This helps balance hormones and increase insulin sensitivity. If really required, opt for a small serving of seeds and nuts. They contain healthy fats. And protein.

Sunflower seeds are good. Since they have to be cracked open, it takes time, so portion control is easier. In general, portion size is 1 oz, the amount inside a closed fist. Seeds such as sesame can be sprinkled on salads.

So a good way to incorporate all the above, is a large salad, with some fish, chicken, cheese or beans for protein, and some seeds for good fats.

5. Eat your last meal at least 2 hours before you go to bed. So that your body can concentrate on building and repair like it is meant to, not on digestion.

Home cooked meals prepared with fresh ingredients, avoiding convenience foods, no need to keep track of portion size – that’s it! What could be simpler!!!!

And don’t forget the exercise!

These diet principles, if followed with discipline, will help us live longer, healthier, free of disease and maintain healthy body weight. The principles work well if

  • we are healthy, trying to remain healthy.
  • we want to lose weight in a safe, healthy manner.
  • we are diabetic. Just limit fruit servings to the occasional piece and avoid high glycemic fruits.
  • those who have high blood pressure. Limiting salt intake is not necessary.
  • most other health conditions.

As well as lose the football belly!

So a sample menu for the day would be:

Breakfast: Eggs cooked with plenty of butter / ghee/ coconut oil, with a side of spinach / Mushroom omelet.

For the vegetarians among us : sprouts. Dosa or idli made wholly with dal, no rice, and served with sambar and coconut chutney.

Lunch: Grilled meat or paneer with large salad as described above.  Dal and sabzi for the vegetarians.

Dinner : Soup with plenty of veg, such as minestrone, and added beans or meat. / Thai curry with coconut.

Vegetarians: Paneer, tofu, lentils, dairy, nuts, for the protein. It is difficult to get protein in the proportions required on a strict vegetarian diet, and supplementation is recommended.

For mid- meal snacks when required, choose options like hummus with vegetable sticks, nuts and seeds,  etc. Eating just twice a day allows the body to recover from the glucose overload, and so decreases insulin resistance and also increases growth hormone. Which are all good.

Notice that I have not included quantities. Its not crucial, because the fiber will keep you satiated.

This diet will keep you full, and will keep you healthy. Best, your waist size will drop! I lost 3 kg in 2 weeks on this diet. And I didn’t feel deprived ever!

Simple changes, with great results!

Dietary Supplements – the why, when and how

Dietary supplements are products we consume, in addition to the food we eat. They do not replace our diet.They are not medicines.

Aging is a disease accelerated by vitamin deficiency and malnutrition. Nutritional supplementation in optimum levels is needed to ensure adequate levels for cells to carry out repair and rejuvenation processes.

Ideally, all nutrition should be obtained from our diet.

 

Pesticide and antibiotic-free organic whole foods are the best source of vitamins, minerals and most nutrients. For most of us, though, finding these quality food sources is easier said than done.Unfortunately, for most people, aggressively advertised high calorie, high glycemic, inflammation- and oxidative stress-causing unhealthy foodstuffs are cheap, plentiful and readily accessible, and that is what harried parents rely on for their family needs.

Farming usually takes place away from cities, where open land is available. So produce has to travel to cities. By the time it reaches grocery shelves, it’s already a couple of days old. And then it sits in our refrigerator bins for a few days, because of course we can’t shop daily. And then we take the veggies and cook, and cook, and cook some more, till all semblance of nutrition is destroyed.

Cooking methods don’t just lead to loss of nutrition, they sometimes create harmful chemicals, as in grilling and prolonged cooking at high heat.

 

Junk, supersized !

All processed food is devoid of nutrition and packs in unhealthy fats, colorants, preservatives, etc, etc.

Quantity of nutrients obtained from diet is inadequate.

Let us take the example of one of the nutrients we need, Vitamin E, which is a very important anti-oxidant. The optimum daily requirement for an adult is 800 IU per day. Almonds are a good dietary source of Vit E. 1 oz of almonds gives about 10 IU of Vit E. So each adult would need 80 oz, 2.4 kg almonds daily. What would be the caloric content of two and a half kilos of almonds? And the cost? Of course, this is grotesquely impossible.

During the days when we were hunter gatherers, our daily caloric intake was about 5000 calories. And the food was all organic, because pesticides hadn’t been invented. In those days it was possible to obtain all nutrition, and good quality nutrition, from food. But now times have changed.

So its quite clear that we need supplements.

In fact WHO, the World Health Organisation, recommends all adults take a multivitamin supplement daily. The medical recommendation, however, goes a lot further.

Waiting to supplement till symptoms appear, might be fatal. In 50% of heart attacks , the first symptom is sudden death.

What kind of Supplements?

FDA provides poor regulation of Dietary Supplements. Fringe hucksters and quacks abound. Therefore, all supplements are not created equal. A supplement obtained from synthetic sources contains free radicals and will itself cause damage to the body. So opt for supplements derived from natural, organic sources, obtained from responsible and quality conscious manufacturers.

What Supplements

1. A good quality, general purpose, multivitamin multimineral supplement.

A daily intake of a good multivitamin supplement can help in improving physical and mental health. It helps to improve general bodily functions and promotes overall well being.  Pregnant women are advised by doctors to take multivitamins to ensure that there is sufficient nutrition for the mother and the unborn baby. It is true that a good multivitamin benefits your optimal health by helping promote your strong immune system, providing support for defense against a growing number of health concerns.

Assuming you’re taking a brand that provides ideal amounts of the various vitamins and minerals it contains (and not overly huge megadoses), and it contains the right vitamins/minerals for your specific needs, then a daily multivitamin is probably one the safest supplements there is. There are no research proven side effects when used in this manner.

I mean… hello… it’s a multivitamin. It contains the vitamins and minerals the human body is MEANT to consume each day for optimal health and function.

And if your brand provides vitamins from a natural, organic source, then it contains phytonutrients from plants, which give additional antioxidant benefits and help prevent many lifestyle diseases.

Do not opt for synthetic forms. Some may in fact, negatively impact your health and they should be flushed down the toilet.

You see, isolated vitamins are partial vitamins, combined with other chemicals. They’re a low-end alternative to whole, real complete food.

There are four problems with synthetic vitamins…

  1. Nature intended for you to consume food in WHOLE form because all the vitamins, minerals, antioxidants and enzymes are together in one package. They work synergistically to give your body the nutrition it requires for optimal health.
  2. Your body only absorbs a small percentage of an isolate form of vitamins and minerals – and it utilizes even less. You get the best bioavailability in whole food form.
  3. Synthetic vitamins often give you massive quantities of some nutrients (usually the most inexpensive ones) and insufficient quantities of others, not balance.
  4. You can experience side effects of synthetic isolates from the additives and the unnatural state of the synthetic supplement.

You want to be sure your multivitamin benefits you and has a real and significant contribution to your health, especially if you’ve already adopted healthy lifestyle practices.

 

2. Omega 3 fatty acids.

Benefits of Omega 3 – where do I even begin, and how do I get myself to stop? This one is by far my favorite supplement. If you take just the one supplement, let it be this one. The benefits are too numerous to list in detail. Just take it, and give it to everyone in the family, kids included and especially pregnant and lactating mothers.

  • Brain – this is brain food. Proper function of our nervous system – including our brain – depends on the presence of DHA. DHA is particularly important to brain function. Our brain is 60% fat by weight, and DHA makes up an average of 15 to 20% of all fat in our brain. If we tie these two facts together, we arrive at the following conclusion: DHA accounts for 9-12% of our brain’s total weight! Drops in brain DHA levels are known to associate with cognitive impairment or slower neurological development in children. Nervous system deficiencies of DHA have been associated with a wide variety of problems, including neurodegenerative diseases like Parkinson’s disease; cognitive problems including reasoning ability in children; and severity of multiple sclerosis.

It is useful in autism, Alzheimers, schizophrenia, depression, bipolar disorder, ADHD, and in infants and kids to improve attention span, alertness, intelligence. It has a beneficial effect on attention, behaviour and emotional problems of children.

It is brain food.

 

  • It is useful for the eyes, hair, skin. Effective for ‘dry eyes’, helps in age related macular degeneration.

 

  • Helps in Allergic Rhinitis.
  • Asthma, Cystic Fibrosis, Pulmonary Hypertension, chronic obstructive pulmonary disorder, pneumonia.
  • Heart.

 

Omega 3 fatty acids help reduce the risk of heart attacks, high blood pressure. arrythmias, coronary vascular disease, ischemic stroke, peripheral vascular disease. Reduce incidence of sudden cardiac death. Improve cholesterol profile, lowering total cholesterol and raising good cholesterol. I recommend omega 3 as first choice instead of statin drugs, except in patients who have had a heart attack or have ischemic heart disease. Help reduce high blood pressure, lowers triglycerides. Slows plaque growth. Reduced blood clotting leading to heart attacks.

  • Arthritis of any origin. Inflammation of any kind. Anything ending in -itis. Autoimmune disorders like Systemic Lupus Erythematosus and Psoriasis. Inflammatory bowel disease.
  • Diabetes. 

It prevents and reverses insulin resistance. Helps in fatty liver, in improving blood vessel function. In a study, administration of EPA (1800 mg/day for 48 weeks) to patients with type 2 diabetes resulted in significant beneficial effects on diabetic neuropathy and serum lipids as well as other diabetic complications such as nephropathy and macroangiopathy. EPA-E was found to improve coldness, numbness, the vibration perception threshold sense of the lower extremities, and significantly decrease serum triglycerides as well as excretion of albumin in urine.

  •  Helps in reducing Menstrual Pain.
  • Cancer. Reduces risk of colon, rectum prostate and breast cancer.
  • Pregnancy and Lactation.

The benefits of Omega-3 fatty acids are clear. To summarize recent research conclusions, Omega-3s…

  • Promote the development of your baby’s heart and lungs.
  • Support the development of your baby’s brain and eyes.
  • Increase the learning and cognitive function of your child, with effects measurable to age four.
  • Increase the attention span of your child ,a measurable component of intelligence early in life .
  • Support the pregnancy health of the mother, possibly reducing chances of  pre-eclampsia
  • May help prevent pre-term labor and premature delivery.
  • Helps prevent low birth weight.

As a Gynecologist, I recommend Omega 3 to all infertility patients, pregnant as well as lactating ladies. I have not had a low birth weight baby since I have started recommending Omega 3.

  • Helps in Weight loss, and in increasing Bone Density. 

How to obtain Omega 3 Essential Fatty Acids:

Vegetarian Sources : Walnuts, flaxseeds. These contain ALA, which is converted to the active Omega 3 – EPA and DHA. This conversion is partial, and that is why vegetarian sources, while helpful, are an inefficient way to obtain the daily dose of omega 3.

Different sources of omega-3 fatty acids.

Fish such as herring,mackerel,salmon,sardines,sturgeon,lake trout, tuna are rich sources of omega 3. However, fish caught in coastal waters  are likely to be contaminated with mercury, which can lead to heavy metal poisoning. So choose fish caught in deep cold waters. Also, oil obtained from the liver of the fish is more likely to be contaminated, as the liver’s job is to detoxify the body so it itself concentrates toxins. So eating fatty fish such as wild salmon thrice a week, or supplementation from a trusted source, is recommended.

 

3. Anti-Oxidants

The reason we do not enjoy the same good health as our grandparents did, is because we are exposed to pollution, pesticides, adulteration, chemicals, smoke, etc, etc. These contain a form of toxin called ‘free radicals’.

Free radical molecules are missing one or more electrons, so they aggressively attack other molecules in order to replace their missing parts. These reactions are called “oxidation” reactions. Oxidation is called “biological rusting” .

Free radicals steal electrons from the proteins in our body, which badly damages our DNA and other cell structures. They can create a “snowballing effect” – as molecules steal from one another, each one becomes a new free radical, leaving a trail of biological carnage. This damage, if it occurs in the cytoplasm, causes diseases like Diabetes, High Blood Pressure, Obesity, Cataracts, etc and if it occurs in the nucleus, can lead to cancer.

But all is not lost.

Nature has provided us with adequate defense mechanisms, in the form of ‘Anti-Oxidants’, which are primarily present in fruits and vegetables.

Antioxidants are electron donors. They can break the free radical chain reaction by sacrificing their own electrons to feed free radicals, but without turning into free radicals themselves.

Antioxidants are nature’s way of providing  cells with adequate defense against attack by reactive oxygen species (ROS). As long as we have these important micronutrients, our body will be able to resist aging caused by everyday exposure to pollutants. If we don’t have an adequate supply of antioxidants to help squelch free radicals, then we can be at risk of oxidative stress, which leads to accelerated tissue and organ damage.

Antioxidants also help slow down the aging process.

They are of many different types and act on different tissues of the body, at various stages in the metabolic process.

Vitamin C 

Dubbed the “grandfather” of the traditional antioxidants, vitamin C has a wide range of astonishing health benefits.

Vitamin C is also essential for collagen synthesis, which is an important structural component of bones, blood vessels, tendons, and ligaments.

We can get vitamin C from raw, organic vegetables and fruits, but we can also take it as a supplement. Personally, I am not fond of traditional vitamin C antioxidant supplements in the market, as they are not as bioavailable as they claim to be. When taking a vitamin C supplement, opt for one made from organic sources, which makes the nutrient more absorbable to your cells.

Vitamin C is water soluble and acts on the water containing parts of the body.

 

Vitamin E

Natural vitamin E is a family of eight different compounds: four tocopherols and four tocotrienols. You can obtain all these vitamin E compounds from a balanced diet composed of wholesome foods. However, if you take a synthetic vitamin E supplement, you will only get one of the eight compounds.

It is a fat soluble vitamin, and acts wherever fat is present in the body.

It is a very important vitamin for heart health, hardening of the arteries, high blood pressure, and cancer.

 

Carotenoids

Dietary carotenoids are a class of compounds which can be converted to vitamin A. They provide health benefits in decreasing the risk of disease, particularly certain cancers and eye disease. The carotenoids that have been most studied in this regard are beta-carotene, lycopene, lutein, and zeaxanthin. Lutein and zeaxanthin may be protective in eye disease because they absorb damaging blue light that enters the eye. Food sources of these compounds include a variety of fruits and vegetables, although the primary sources of lycopene are tomato and tomato products. Additionally, egg yolk is a highly bioavailable source of lutein and zeaxanthin.

In addition, there are many other anti-oxidants, such as green tea, which are highly effective and beneficial, and are generally used as required.

 

We are not helpless. We have the ability, the knowledge and the tools to keep ourselves healthy long into ‘old age’.  So why not make a start today and live long, healthy, productive lives?

Eating Healthy – Why Bother?

Really, why should we spend our life worrying about all this eating healthy business? After all, we have only one life, let’s enjoy it, right?

Well, its because we have only one life to achieve what we want to, that we need to take care of our health.

Very important, what we eat affects our DNA.

Food sends signals to DNA when consumed.

Consuming food that DNA has not adapted to, causes inflammation and disease.

Cardiovascular risk reduces by increasing fat and decreasing carbohydrate consumption. This is not a typographical error, its scientific fact. Honest.

Very very important, the changes in our DNA are passed on to our children, and also to our grandchildren. This means that if we eat unhealthy, we may be condemning our yet-to-be-born grandchild to higher risk of diabetes or cancer or whatever. Now you decide, when you’re eyeing that doughnut, what do you really want? A transient feeling of savoring the taste and then knowing that the apple of your eye can develop diabetes and blindness?

Its all about the money, honey

Pharmaceutical companies receive funding to develop drugs to prevent Alzheimers, treatment of which costs America 2 billion dollars annually.

One of the most respected medical journals, the Lancet, reported that being careful with food and exercise can reduce the incidence of Alzheimers by 54%.

How does one monetize this message?

This happens across the board, with all health conditions.

The challenge we face is that once we pass out of medical college, all our knowledge of drugs comes from these companies, which are driven by their commercial interests. That these interests run into billions of dollars is just by the way. The interest of the patient is, for sure, not the driving force.

This means that doctors, by and large, follow what the companies dictate. Not necessarily with malafide intent, but often because there is no alternative.

How does this affect us? We must check out what we’re being told, even by our trusted doctors. Again, not necessarily because they’re intentionally misguiding us, but they’re just misinformed. If possible, seek out a doctor practising Integrative medicine and be guided by them. Because the advice we give is like the one above – make lifestyle choices which don’t just suppress your disease condition, but actually improve your health so you’re never unhealthy again. With no doctors, no medicines.

Let’s Quiz – Glycemic Index

Here’s a simple question.

There are three options.

1.

A slice of white bread.

2.

A slice of brown bread.

3.

A teaspoon of table sugar.

 

Now the question is, if you want to make the healthful choice, which of these options will you choose?

Obviously the brown bread, right?

Up until just a few months ago, I did the same. But surprisingly, its not the best choice.

Let me introduce you to a concept called ‘Glycemic Index‘. This (GI) is a measure of how quickly blood sugar levels rise after eating a particular type of food. A food with a high GI raises blood glucose more than a food with a medium or low GI.

Glucose is the reference, having a GI of 100, creating a surge in the blood glucose level. We want our food to release sugar slowly, so the rise is slow and controlled. This helps maintain insulin levels in a stable, controlled range, so our risk of developing diabetes is lower.

Now back to the quiz.

Sugar has a GI of 58, white bread 73 and brown bread 71. So brown bread raises blood sugar more than sugar. Most brown bread is simply colored brown by adding molasses. Read the ingredient list. The first listed should be whole wheat flour, preferably cracked whole grain which has high fiber.

Two slices of whole wheat bread raise blood sugar higher than 6 teaspoons of table sugar. 

Low GI – 55 or less: Most fruits and vegetables, beans, minimally processed grains, pasta, low-fat dairy foods, and nuts.

Moderate GI – 56 to 69: White and sweet potatoes, corn, white rice, couscous, some breakfast cereals.

High GI – 70 or higher: White bread, cakes, doughnuts, croissants, waffles, most packaged breakfast cereals. Notice this list contains most bakery items? Avoid, avoid, avoid. Remember, sugar is poison. And refined carbs act just like sugar in the body.

So look for GI, and go for those foods which have lower GI.