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.

Common Food Myths, Busted!

We know we need to be healthy and avoid lifestyle complications, and we do sincerely try, too.
And yet we are getting more and more ill by the day. Every day we read reports of a 28-yr old undergoing 7 vessel bypass, or another 21-yr old collapsing in office. It is very common for a 35-yr old patient to say, in a very matter of fact manner, that they have been suffering from high blood pressure since 15 years!
So the sad fact is that while we’re trying to get healthier, the reverse is happening. Very often this is because we don’t quite know what to do. We hear so many claims and opinions out there, and we follow well meaning advice, only to make matters worse.
So here are a few myths regarding food.

 

FRUIT JUICE

I started to drink, and also to give my children, fruit juice out of a pack. Believing it to be better than soft drinks. But is it really?

Answer : NO! Packed fruit juices often contain up to 10 tsp of sugar, as much as or even more than a can of cola. Not to mention the added color, flavoring, preservatives, and whatnot. So don’t go near them. Not even if they claim to be natural, no sugar added or any other such.

But I only drink fresh fruit juice, you say? When bought at juice stalls, they often have sugar added. Lots of it. Because the fruit they use is not necessarily at peak ripeness, and could be less than ‘optimally fresh’  :) !

OK. But I only drink juice which I make at home, with no sugar added. And I feel quite virtuous doing so :). So is that OK?  Unfortunately, the answer is still no.

Because the fiber is removed, we don’t feel full and may consume maybe 5 oranges while we may have eaten just 1 or 2. So the calorie count has gone up drastically. And the sugar is absorbed quickly, giving a sugar high, raising insulin levels inordinately. One glass of juice can be the sugar equivalent of 3 bars of chocolate! Over a period of time, obviously this can lead to ill health.

That “healthy” berry blend at a smoothie shop can have a whopping 80 grams of sugar, 350 calories or more, little protein, and often no fresh fruit. Fruit “concentrates” are often used instead of fresh fruit. And sorbet, ice cream, and sweeteners can make these no better than a milkshake.

Food Fix: Get the “small” cup. Ask for fresh fruit, low-fat yogurt, milk, or protein powder to blend in protein and good nutrition.

So don’t drink your calories!

Make your own smoothie at home. Blend, don’t juice.

And add a tablespoon of coconut oil for extra creamy, flavorful, healthful result. 

What do you give your child for school lunch? Fruit, cut up. Not whole, it is likely to come back.

 

SALAD

What? What can be healthier than a salad?

Bear with me. :)

Salads can pack in calories when doused in mayo, in fat laden dressings, and when fried elements are added, such as fried chicken or fried fish. So it doesn’t matter if its advertised as ‘fresh garden salad’ or whatever. Look for the additions. Best, avoid store-bought, ready dressings. Make your own simple vinaigrette.

 

CHARGRILLED FOOD

Now isn’t that taking it too far? All diets advise eating grilled meats rather than fried. And that char grilled flavor, those grill marks – that’s man food!

Be aware that charring can create carcinogenic compounds. Meat that is cooked on an open flame or at very high temperatures creates chemicals known as heterocyclic amines (HCA) and polycyclic aromatic hydrocarbons (PAH) that have been connected to cancer. Other research suggests that the high fat in meat increases hormone production, which in turn can increase the risk of hormone-related cancers like breast or prostate.

Research at the Mount Sinai School of Medicine in New York shows that frying or grilling certain foods at high temperatures produces compounds that can increase inflammation in the body, leading to diabetes, heart disease, Rheumatoid Arthritis and Osteoarthritis.

The compounds, called advanced glycation end products, appropriately called AGEs in short, are known to be scoundrels. They shorten life. Period. 

Prefer food steamed, stewed, poached or lightly pan fried in good quality oil.

Of course, the method of cooking does not take away from the fact that meats, especially red meats, contain saturated fats which contribute to heart disease. And the animals are fed food laced with growth and fat enhancing hormones, which we ingest when we eat the meat. This disrupts our own hormones, and thus, our health. So look for organic meats.

To clarify : almost every English word that connotes organic – natural, naturally raised, free rangehormone-free and additive-free – can be used to describe meat, but it is far from being “certified organic”.   Organic meat comes from an animal that has not been fed anything grown with toxic or synthetic fertilizers, pesticides, herbicides, fungicides or fumigants; has not been given any kind of growth hormone, antibiotic or genetically engineered product; has been conceived by organically raised animals; and has been butchered and processed following organic regulations.

 

SUGAR SUBSTITUTES

Substitutes like honey, agave, jaggery, date sugar, maple syrup, molasses – may seem natural and healthy. The truth is, they are no different from sugar. They have the same calories and the same effect on our bodies and our health, as does sugar. Use with the same caution as you would sugar.

Artificial sweeteners – Acesulfame potassium (Sunett, Sweet One), Aspartame (Equal, NutraSweet), Saccharin (SugarTwin, Sweet’N Low), Sucralose (Splenda), may be derived from naturally occurring substances, including herbs or sugar itself, and so may sound attractive. However, they are chemicals, and the long-term effects on the body are known to be harmful or not yet clear. They should be avoided.

They leave a sweet after taste, creating further craving for sugary foods or drinks through the day. Stevia does not add calories but acts like artificial sweeteners in the sweet craving it can cause. Agave is very high in fructose.

Choose to eat fruit for your sugar fix. I have always had a sweet tooth, But now  that I know, I keep off sweets, and really, I have started to develop a slight dislike of most sweets. Some I still can’t resist! But I stick to fruit for the most part.

 

DIET DRINKS

Diet drinks are so called because the sugar content – massive! – is replaced with the artificial sweeteners above. They may not have the calories but they do have all the artificial flavorings, preservatives, all the chemicals as the original, and also the sweet craving effect stays.

Energy drinks also have caffeine with its side effects.

Avoid!

 

ORGANIC FOODS

Just because it’s organic, it’s not necessarily good for you.

Organic foods are obviously to be preferred over the hormone and pesticide-laden varieties. But use your judgment. If you use organic brown sugar, for example, be aware that is brown sugar and has the same metabolic consequences as sugar. So first see that is a food you want to add to your diet and only then choose the organic option.

 

LOW FAT FOODS

Check out very thoroughly. Low fat foods usually have sugar added to make them more palatable. and remember, sugar is poison!

Regular Granola VS Low-Fat Granola

The low-fat version of this crunchy cereal has only 10% fewer calories and is still full of sugar. Plus, the low-fat label can easily lead you to overeat. A study at Cornell University found that people ate 49% more granola when they thought it was low fat — easily blowing past the measly 10% calorie savings.

Low fat milk, Skim Milk is NOT the ideal choice. Enjoy full fat milk. Again, Sugar makes you fat. Fat makes you thin!

 

EGGS

This one has always been a bit confusing. Eggs are good for us. Eggs have cholesterol, avoid. No, eggs are safe. Eggs can harbor salmonella organisms, avoid.

Where is the truth?

Don’t be afraid of eggs. They are a super health foodThe yolks in fact are actually a very healthy food, if consumed in moderation. They are a beneficial source of healthy fat. Many nutrients, such as vitamin A, are better absorbed with fat, making eggs a very good source of vitamin A. Research has documented that eggs do not appear to promote heart disease risk.

Current thinking is that one can eat three whole eggs every day to keep the doctor away. Whole. With yolks.

But every egg is not created equal. It’s best to buy any source of protein from an environment that is as natural as possible. For egg-producing chickens, this environment is often called “cage-free” or “free-range.”

Lightly cooked or raw eggs can carry salmonella bacteria, and should be used with caution or avoided, especially by pregnant women.

 

FROZEN FOOD

Always eat fresh food, right? Avoid anything  packaged and stored.

Not necessarily. 

Fruits and vegetables – these two food groups are just as good purchased frozen as they are fresh. In some cases, they may actually be better, because if you keep vegetables and fruits in your fridge for a long time, they lose some of their nutritional value. Whereas, buying them frozen and then defrosting when you want the fruit/vegetable can actually retain more nutrients.

Plus, they do not need preservatives added. They are convenient to have on hand and to use. Probably something you have never associated with frozen food is that you can help the planet. Buying frozen food means you can take fewer trips to get groceries, thereby reducing your individual carbon footprint.

Freezing home cooked food for later use is a great option to save on time and effort.

 

But obviously, food which you would avoid fresh, is not healthy frozen!!

 

COCONUT

coconut bud

The coconut has long been reviled for its saturated fat content, as a contributor to heart disease. I have spent 30 years telling my patients to avoid eating coconut and using coconut oil.

But the truth is that it is a superfood.

Considered one of the most treasured foods of all time, coconut products — including coconut flesh, coconut water, coconut oil, and coconut cream — each deliver superb health benefits.

New data is showing that saturated fats are harmless. Many massive studies that include hundreds of thousands of people prove that the whole “artery-clogging” idea was a myth (2).

Additionally, coconut oil doesn’t contain your average run-of-the-mill saturated fats like you would find in cheese or steak.

No, they contain Medium Chain Triglycerides (MCTs) – which are fatty acids of a medium length which are metabolized differently. These can even increase 24 hour energy expenditure by as much as 5%, and reduce appetite, potentially leading to significant weight loss over the long term.

Studies show that coconut oil improves important risk factors like Total, LDL and HDL cholesterol, which can actually reduce risk of heart disease. A study in 40 women with abdominal obesity, showed that supplementing with 30 mL of coconut oil per day led to a significant reduction in both BMI and waist circumference in a period of 12 weeks!

And coconut oil is one of the safest oils to use in cooking, especially cooking at high temperatures such as frying, due to its high smoking point. Plus, this ultra-safe oil can give your body important antioxidants that can help build stronger cells and improve your overall health and well being.

Coconut water is completely pure and sterile, which is one reason why it can be used for blood transfusions. It has the highest  electrolyte concentration of anything found in nature.This makes it an excellent treatment for dehydration.

It improves immunity, hair, teeth, bones, lipid profile, etc, etc.

Coconut milk – fresh, not packaged, is a great alternative to dairy. Not to mention its creamy, luscious richness added to curries. Yum! So now I tell my patients to cook in coconut oil!!  :)

Scrumptious Thai Coconut Red Curry. Photo by Krista Roes

 

Eat Healthy, Stay Healthy!

Lifestyle Medicine and Bio-Identical Hormones

Mrs AA, 48 came to me for a gynec complaint. She also has knee joint pain due to osteoarthritits, and is diabetic, and has digestion problems, and has high blood pressure. She is seeing three different doctors, one for each of these complaints. Each doctor has prescribed some medication. Since these doctors work independently, there is no communication, so the drugs she is taking could interact positively or, more likely, have deleterious interactions. Plus, all these drugs would have their own set of side effects.

Lifestyle Medicine goes beyond – ‘upstream’ – and identifies the imbalances in the body at the cellular, hormonal, molecular and physiological level, leading to all the above ailments. By correcting these imbalances, we remove the artificial boundaries between organs, modulate inter-organ function and restore normal and even optimal function.
All this means, Mrs AA can hope to be free from her diabetes and her blood pressure and her knee joint pain, and live healthy without medication and without repeated physician visits.
My goal is that patients are able to take charge of their health and not have to visit doctors or take medications.

Let us take a simple example.
People suffering from hypothyroidism – low thyroid function – usually gain weight and find it very difficult to get the weight off, despite rigorous diet and exercise regimes.
In fact, gyms and slimming centers don’t like to make any assurances re weight loss.

Is that familiar? And frustrating?

So why does that happen? Well, metabolism is slowed down due to low thyroid and that makes weight loss difficult. But then these patients are being treated, they are receiving thyroid replacement, you say. So then why aren’t they losing weight?

Simple. The replacement they are receiving is the synthetic hormone, Thyronorm or similar, which contains the synthetic molecule thyroxine or T4. But the metabolically active hormone is Triiodothyronine or T3. That means the hormone responsible for weight loss is T3. And that is not being replaced. So no wonder weight loss remains elusive!

As Lifestyle Medicine practitioners, we use Bio-Identical hormones rather than synthetic hormones. This means the hormone molecule is identical to the one we have in our bodies. Therefore, we are simply replacing what the body lacks, and since it is bio-identical, it acts naturally and safely. And the natural thyroid hormone contains both, T3 and T4. So the patient finds herself losing weight easily, the energy returns, skin starts to glow again – she’s just a different person!

Being the agent of change – restoring not just their health, but also their vitality, energy and joy, preventing all the complications associated with debilitating lifestyle disorders – is it a wonder I am so excited to share my experiences?

I hope this inspires you to seek out an Anti-Aging medicine practitioner near you, and see how your health can be restored.

Losing weight

blog

 

Does it often seem like this? I do feel this way sometimes :)

Seriously, though, losing just 5% body weight can lead to very significant health improvement. It definitely does not require us to go in for a variety of fad diets, which end up leaving us unhealthy, depressed and frustrated.

A simple principle, if followed, will serve us well : Any food we eat should pay for itself in nutrients. Meaning, if we avoid eating empty calories, we’ll be fine.

What gets measured, improves

Easy way to get results with your weight goals? Measure! Smartphones are almost ubiquitous now, its so easy to keep track of our weight loss / maintenance goals, and to get back on track in case of straying. Happens often with me :)

1. Download a Pedometer app. It measures the number of steps you take every day. You don’t need to switch it on or anything, just carry your phone with you, and it will go about its job of recording the number of steps you take. Aim for 10,000 per day. But its great even if you hit 5000. That would be approximately 3 km for an averagely tall person. The recommendation is 150 min of exercise per week, recently upped to 250 min for Asian men. This can be recorded too.

2. Maintain a Food diary. eg SuperTracker, MyFitnessPal, WebMD, etc. Be diligent and consistent with recording every single bit of food that enters your mouth. These apps will give you the total calories consumed, along with breakup of major food components, ie proteins / fats / carbs / sodium consumed. It also gives you your BMR, the number of calories you need for just normal body function. And when you enter your exercise, it calculates calories burnt. Aim for 500 calories per day LESS than your requirement, if you aim to lose weight in a gradual, healthy way. Just the act of maintaining the diary creates a consciousness and automatically, you start to make healthy choices and begin to see results. Try it, it really works. Its easy, and free!

3. BMI calculator. BMI is the ratio of height to weight. Definitely aim for a level below 25, and ideally for Asians, below 22. This app also gives you another important value, the body fat percentage. Aim for 25 – 30% if you are a

woman, and 18 – 24% for men.

When you aim for weight loss, it is very important to look for fat loss rather just weight loss, which could be muscle loss and that’s not healthy. So when you go to a ‘Slimming Clinic’ and triumphantly lose weight, check. Is it fat, or muscle you’ve lost. Talk to the staff before starting a program, and make sure you’re going in the right direction. How you lose fat will depend on your individual exercise program and your diet but essentially its important to reduce your carbohydrate intake and maintain adequate protein intake.   Measure also the ratio of waist circumference to hip circumference, this tells you about your ‘visceral’ fat – the fat around your organs. Higher visceral fat is more dangerous for the heart than, say , fat on the arms or thighs. This ratio should be no more than 0.7 for women and 0.8 for men. In absolute numbers, women should aim for a waist circumference of 80 cm ( 31 inches) and men, 90cm, 35 inches. Above this, your health is at risk.

Waist to Hip Ratio Men Women
Ideal 0.8 0.7
Low Risk <0.95 <0.8
Moderate Risk 0.96-0.99 0.81 – 0.84
High Risk >1.0 >0.85

4. You can share your goals and progress with friends you can invite on the same apps. This makes you accountable and makes it easier to achieve your goals. And provides support if you happen to slip ( it will happen, don’t beat yourself up over it.)

So StayHealthy!

Planning a family? Ensure your child’s health even before she is conceived.

Environment during the time of conception, during pregnancy, and during infancy, can influence genes and the risk of developing chronic degenerative diseases in adulthood. We usually believe that we develop degenerative diseases because of some things we did, or did not do, as adults. But studies show that factors, especially maternal diet – malnutrition, low protein, high fat, stress and environmental toxins during early life can all ‘switch on’ some ‘bad’ genes and ‘switch off’ some ‘good’ genes, leading to various conditions such as heart disease, diabetes, etc.

This has extremely important implications – our health can impact that of our children too, and therefore our responsibility to maintain good health through life, especially for those planning a family, grows many, manifold.

It is crucial that the couple pay careful attention to their own nutritional status – yes, men too – starting before planning pregnancy, and continue to be careful with the child thereafter through to adulthood.

Some important requirements are:

1. Folic Acid. It can help reduce the risk of birth defects of the brain and spinal cord (called neural tube defects). It is recommended that all women of childbearing age consume 400 micrograms (0.4 mg) of folic acid each day. For men, lack of folic acid can change the chemistry of the sperm’s DNA. These can affect the development of the unborn baby.

2. Protein from healthy animals, or vegetarian sources. 60 – 80g / day. This is required for the development of the baby, its organs, brain, immune status, etc.

3. Omega 3 Fatty Acids are critical for the development of the baby’s brain and nerves. It helps lower the risk of preterm delivery, promotes better eyesight, intelligence and hand-eye co-ordination in the baby. Each day pregnant women would need an additional 400 to 550 mg of omega-3, of which about 225 mg should be DHA from low mercury fish.

4. Anti-oxidants – We are constantly exposed to toxins, be they in the environment, or food, or chemicals. These can obviously impact the baby’s health, To counter these, anti-oxidants present in organically grown, brightly colored fruit and vegetables can help. 9 – 13 servings per day are recommended. Alternatively, supplements from a trusted organic source may be consumed.

5. Smoking and Alcohol are highly damaging to the infant, and should be avoided.

BeHealthy, StayHealthy!