Category Archives: Hormones

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.

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.

TREATING DIABETES

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Your Diabetes didn’t just show up one fine day as Diabetes.

Your illness is your body trying to communicate to you that something is really wrong!

Your Diabetes is like a big, blinking NEON SIGN warning you – LOOK HERE. THERE’S SOMETHING WRONG HERE. This is a WARNING that there is an imbalance or a deficiency in your body that needs to be identified and serviced – just like that red, blinking light on your car’s dashboard when it too needs to be serviced.

In fact, your DIABETES once started as an imbalance or a deficiency which was left unidentified or untreated, and eventually progressed to DIABETES.

Now, here’s the big aha! moment:

Your DIABETES is being treated as a “symptom”. Meaning, the prescription medication, regular insulin injections, constant daily monitoring, etc. are all superficial treatments that treat the symptom itself, and mask the underlying cause which created the symptom, to begin with.

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And, if left untreated, without identifying the underlying imbalance or deficiency, your DIABETES will eventually progress into a disease more acute and damaging than the DIABETES itself. Such as heart disease. Or kidney disease.

The reason I’m clearing this up with you is so you can start to pay attention to these big, blinking NEON SIGNS.

  1. YOUR NUTRITION: Most of us are just throwing junk food into our bodies because we don’t have the time for anything else, or we’re driven by taste and convenience. But our bodies are paying the price.
  2. SLEEP: One day of inadequate sleep is more damaging than six months of inadequate diet.
  3. EXERCISE: Prolonged sitting – which we are all subject to at work – and couch potato-ism at home affects the body’s metabolism and leaves it unable to utilise glucose properly.
  4. STRESS: the stress hormones raise sugar levels. Chronic stress leads to chronically raised sugar levels.
  5. TOXINS: environmental pollution, food additives and even mental pollution damage your systems.

A systematic approach to all these factors, including mind body balance, is the only way the body can achieve balance and regain its lost health.

Natural Ways to Control Your Blood Sugar

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It’s Ramzan, time for fasting and also for feasting! Sadly, often time to gain weight!

What if you’re diabetic? Here’s how to eat and still control blood sugar levels.

1.Increase Your Fiber Intake

Try to include both soluble and insoluble fiber in your daily diet. Berries, nuts, vegetables and beans like rajma and chowli are a great way to slip in the fiber daily. Aim to include 40 to 50 grams of fiber in your daily regimen for every 1,000 calories you eat. You may want to start measuring the foods you eat each day until you are able to estimate how much fiber and carbohydrates you are eating.

2.Reduce Your Net Carbs

A low-net-carbohydrate diet reduces the stress on your body, reduces inflammation and reduces the amount insulin required to use the energy from the food you eat. You’ll want to reduce the number of net carbs you eat, for most people this ranges between 50 and 80 grams per day.This is calculated by taking the grams of carbs you’ve eaten and subtracting the number of grams of fiber. In this way a high-fiber diet also helps you to lower the amount of insulin you need to utilize your food for fuel.

3.High-Quality Fats

When you reduce your carbohydrates, what are you going to replace them with? Your best alternative is high quality, healthy fats necessary for heart health, feeding your brain and to modulate genetic regulation and prevent cancer. The idea that fats are bad for you, is OUTDATED.

Healthy fats include:

Avocados Coconut oil Organic butter from organic grass-fed milk
Organic raw nuts Olives and Olive oil Grass-fed meat
Organic pastured eggs Palm oil

4.Exercise

Exercise helps your cells become  sensitive to leptin. This reduces your potential resistance to insulin and therefore your risk of diabetes.

5.Hydration

When you become dehydrated, your liver will secrete a hormone that increases your blood sugar. As you hydrate blood sugar levels lower naturally.

Stay well hydrated by monitoring the color of your urine during the day. The color should be light yellow. Sometimes your first indication your body requires more water is the sensation of being hungry. Drink a large glass of water first and wait 20 minutes to determine if you’re really hungry or you were thirsty.

6.Reduce Your Stress

When you become stressed your body secretes cortisol and glucagon, both of which affect your blood sugar levels. Control your stress levels using exercise, meditation, yoga, prayer or relaxation techniques. These techniques may reduce your stress and correct insulin secretion problems. Combined with strategies that reduce your insulin resistance, you may help to prevent diabetes.

7.Sleep

Enough quality sleep is necessary to feel good and experience good health. Poor sleeping habits may reduce insulin sensitivity and promote weight gain.

Diabetes is not a sentence! It’s easily reversed.

How Diabetes can break your Heart

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Diabetes is a chronic illness and can cause fear once slapped with the diagnosis. Fear of complications like kidney, eye and limb damage. What is less well known is that diabetes also raises the risk of heart disease by four to five times compared with people without the disease. The treatment goals for people with diabetes are more strict than those for people without diabetes. In a study, out of 20,000 Indian patients with type 2 diabetes mellitus, 60% had coronary artery disease .
Even when glucose levels are under control it greatly increases the risk of heart disease and stroke. That’s because people with diabetes may have the following conditions that contribute to their risk for developing cardiovascular disease.
• High blood pressure
When patients have both hypertension and diabetes, which is a common combination, their risk for cardiovascular disease doubles.
• Abnormal cholesterol and high triglycerides
Patients with diabetes often have unhealthy cholesterol levels including high LDL (“bad”) cholesterol, low HDL (“good”) cholesterol, and high triglycerides.
• Obesity is a major risk factor for cardiovascular disease and has been strongly associated with insulin resistance. Obesity and insulin resistance also have been associated with other risk factors, including high blood pressure.
• Lack of physical activity is another major risk factor for insulin resistance and cardiovascular disease. For overall cardiovascular health, the American Heart Association recommends a minimum of 30 minutes of moderate-intensity aerobic activity at least 5 days per week for a total of 150 min/week.
• Poorly controlled blood sugars (too high) or out of normal range
Diabetes can cause blood sugar to rise to dangerous levels.
• Smoking puts individuals, diabetic or not, at higher risk for heart disease and stroke.

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The ABC’s of diabetes control
Having diabetes increases your risk for cardiovascular disease, including heart attack and stroke. If you have diabetes, you should pay close attention to the factors which can increase your risk for heart trouble. These are often referred to as the “ABC’s:”
• hemoglobin A1c (HbA1c) blood sugar test
• Blood pressure
• Cholesterol.
“ABC” Goals
HbA1c Less than 5.5%
Blood pressure Less than 130/80 mm Hg
LDL (bad) cholesterol Less than 100 mg/dL
Triglycerides Less than 100 mg/dL
HDL (good) cholesterol More than 50 mg/dL in men and 60 mg/dL in women
And also
Fasting Serum Insulin 2 – 5 IU/ml

HbA1C above 6% indicates higher risk of Kidney Failure. Above 4.6%, risk of CVD doubles for every 1% rise in HbA1C, which measures blood sugar control over the preceding 3 months. In a French study, people with Diabetic Retinopathy averaged an FBS of 130mg% and HbA1c OF 6.4% over a period of 9 years. While those without eye damage averaged an FBS of 108mg% and an HbA1C of 5.7%.

An Integrative medicine approach will help not just control your diabetes but actually reverse it, so that you are healthy Again. No more diabetes! No more drugs, no more doctors!