Tag Archives: diabetes

Oil-free and Plant-Based Food Serve Up A Healthy Desi Diet

Two years ago, I could not imagine cooking and eating oil-free food. Cooking good food was synonymous with a liberal splash of cooking oil in everything from simple sabji to biryani.

I loved cooking all my recipes  with lots of oil, though I knew it was bad for my health. Every dish began with a bottle of cooking oil right beside me.  As a foodie I relished food glazed with oil.

Homemade chakalis were my favorite. As a vegetarian, I assumed that oily snacks were okay, given my healthy vegetarian diet of fruit smoothies, brown rice, sambar, vegetables and beans.

But I often wondered why I was putting on weight despite my plant-based diet. In Atlanta, I met Shobha, and my perspective drastically changed. Shobha is an advocate of plant-based foods, inspiring folks to thrive on plant-based fare with zero oil!  That simple conversation with her had a profound impact on me.

I joined Shobha’s WhatsApp group and my plant-based health education began.

I discovered that the persistent ache in my knees was inflammation from the excessive oil in my diet.

I was shocked to find out that all cooking oils, from soybean to canola oil are highly processed. High temperature and chemicals are used to extract oil, a  process that make their nutrients go rancid.

When I learned that one tablespoon of oil has 120 calories, I nearly fainted. I felt so guilty! All that processed oil in my everyday food!

The more I discovered, the more I realized how little I knew about how cooking oil affects the body.

Processed oil is responsible for so many health issues – obesity, constipation, inflammation, heart attacks, and more.

And yet, the information you read on websites and news articles is really so confusing and overwhelming.

Are cold pressed sesame oil and coconut oil safe? Is olive oil as healthy as  nutritionists claim?. And what about using “just a little oil’. Vloggers and sharers of recipes suggest 4 to 5 tablespoon of oil per pound of vegetables. Doctors and nutritionists urge folks to include oil in their diets, as oil fat is essential in the absorption of some vitamins, and the healthy functioning of cells and tissues.

So what’s the truth?

Our modern diet and lifestyle is driving the upsurge in diabetes, heart disease, and blood pressure. The reality is that oils have extremely low nutritive value. Both the monounsaturated and saturated fat they contain is harmful to the endothelium, the innermost layer of the artery, and that injury is a gateway to vascular disease.

So it doesn’t matter if it’s olive oil, coconut oil, or canola – my takeaway is to avoid all oil. And since diabetes and heart disease run in my family, I made an intentional decision to drastically cut back on oil in my everyday cooking.

At first, it was hard. I automatically reached for the oil when I started cooking. I had to really make a conscious effort to stop myself!

Magically, my WhatsApp group delivered. They shared amazing pictures  of oil-free recipes and dishes.

In the span of few months I was cooking up a storm of  tasty, zero-oil dishes, from upma to masala vadas, and cookies to cakes. No unhealthy oil!

Now, I’m on a roll. Here’s how.

In delicious cakes and cookies, I substitute applesauce and banana for oil .

I get healthy fats from fresh coconut, guacamole, almonds, walnuts and sesame seeds. My zero-oil channa masala and rotis are delicious. To sauté onions, I just use a tablespoon or two of water instead! Going oil-free has helped me to explore so many interesting food items and cooking techniques .  Fortunately, my family loves it too!

I’m simply awed by the tasty and nutritious dishes I can make without a drop of oil!

Growing up, I loved deep-fried peanuts and spicy lentils. Now I simply roast sprouted green gram, channa dal and peanuts in the oven, and while it’s still warm, I mix in chili powder and salt. Yummy! My husband couldn’t believe it had no oil at all!

Studies show that Indian Americans have high rate of heart disease. In fact many vegetarians assume that they are thriving on a healthy diet, even though their food is rich in carbohydrates, fats, cholesterol and sugar. Sugar and all-purpose flour are white poison. I realize that cooking oil is colorless poison.

Once or twice in a week, I  use cold-pressed sesame or peanut oil as they offer a healthier option than highly processed vegetable oils.  Occasionally, I have a deep fried treat, during festivals and on special occasions, but no longer need to open my chakali box!

My mindful eating habits have produced a happy result – fortunately, I no longer suffer from knee pain  and my weight has stabilized.  I know my new plant-based diet with zero oil, and thirty minutes of exercise, is playing a pivotal role in my leading a healthy lifestyle.


Kumudha Venkatesan is based in Atlanta and often writes about the vegan lifestyle and spirituality.

Edited by Meera Kymal, Contributing Editor at India Currents
Photo by Nadine Primeau on Unsplash
Photo by Jo Sonn on Unsplash

Madhumeha: Ancient Origins, Recent Epidemic

Diabetes has existed for millennia. It has been recognized by several ancient cultures including Indian, Egyptian, Chinese, and Persian. Sushruta, a surgeon and physician who lived around 600BC in the Varanasi area in northern India, documented it in his works. They recognized that ants were attracted to the urine of affected individuals and it was named Madhumeha (Sanskrit; madhu- honey).

Ancient physicians also recognized that there were two types of conditions that involved excessive urination and loss of weight. This recognition of excessive sugar in individuals affected by diabetes was refined over the next 2000 years, and in the 18th century, England Johann Peter Frank is credited with the identification of two forms of diabetes- diabetes mellitus and diabetes insipidus. Mellitus (Greek; honey) was associated with high levels of sugar in the urine, while insipidus was not. In fact, diabetes insipidus is an unrelated condition related to hormonal control of the kidneys, leading to excessive urination. 

By the 5th century physicians in India and China had noticed that there are two kinds of diabetes mellitus- one of which was prevalent in older and heavier individuals. Methods to recognize, understand and treat diabetes mellitus have evolved with technological developments. Relatively rapid progress since the 18th century has identified insulin as the hormone secreted by the pancreas that plays a central role in this indication, and also defined type 1 and type 2 diabetes.

Type 1 (also termed ‘early onset’ and ‘insulin dependent’) is a condition that generally develops in children and younger individuals where insulin production by the pancreas is compromised or completely shut down due to several reasons. Type 2 diabetes (also termed ‘adult onset’ and ‘non-insulin-dependent’) is the focus of this article and has become a global health problem. 

In its current trend of prevalence Type 2 diabetes, or T2D, has blurred two boundaries. It was previously confined to low- and middle-income countries but is now on the rise even in the higher-income countries. Secondly, the age of onset is not confined to older patients. Among the Indian population worldwide, T2D is gaining numbers within India and also within expatriate Indian and southeast Asian communities. Some studies put the number of Indians in the US as the group with the highest incidence of diabetes than any other racial group at an age group above 20. Similar reports have been made with respect to Europe and UAE. Within India itself the numbers of T2D in adults 20 years and above has tripled over the past 3 decades.

This appreciable increase in T2D in southeast Asian expatriate communities, and also within their countries especially India and China, is thought to be due to the relatively recent cultural changes in diet and lifestyle over the past 50 years, such as an increase in consumption of fried foods, fast food, refined grains and sugars, lack of dietary fiber, and sedentary lifestyles.

In addition to these behavioral changes T2D is caused by an interplay of genetic and environmental factors, and familial history serves as an indicator for individuals to be forewarned about their own health. That said, considering the speed with which changes in the age of onset and frequency of T2D are being documented, it appears that environmental, diet, and lifestyle changes are the major contributors to the current epidemic. Also, in general, Indians have a higher degree of insulin resistance than Caucasians, which occurs when the cells of the body lose the capacity to respond to insulin even when it is being produced by the pancreas. 

The burden of the long-term health effects of T2D are significant to the individual and from a public health perspective. The more stark chronic manifestations include neuropathies, foot ulcers, blindness, kidney dysfunctions, accelerated aging, and a general decline in health and productivity. In addition to insulin, newer medicines exist to control blood sugar and insulin response, and other therapies are being developed including stem cell therapeutics. 

If there is a good aspect to T2D it is that it can be prevented or the onset delayed. The fact that onset can be delayed is a point of practical importance, as most of the clinical manifestations arise due to cumulative effects of high circulating sugar. Prevention is the best cure, as the adage goes. A regular health check-up will flag a ‘pre-diabetes; condition. Glucose intolerance tests, HbA1c levels in the blood, body mass index, and overweight are common tests to gauge pre-diabetes. This indication should be taken as a warning, and acted upon seriously and with a positive attitude. 

The trinity of diet, exercise, and stress management are often called upon. Eat less. Eat on time. Walk more. In general, the lifestyle changes that are recommended are geared towards helping maintain an even level of blood sugar and reduction to, or maintenance of, an optimal body weight.

Processed grains, and refined carbohydrates like maida (all-purpose flour), have a high glycemic index. As against whole grains, they are quickly metabolized to sugar and result in a sudden spike of increase in glucose in the blood. Our standard fare includes white rice or chappatis/other breads as a base, and this can be substituted with brown rice and atta (whole wheat).

Instead of serving up a plate with a large portion of rice and sides of vegetables and protein, switch around the amounts and serve up rice as a side dish instead. Control portion sizes, and maintain steady time intervals between meals and snacks. Include soupy low-calorie items which will serve to fill up the stomach. Fasting is not recommended. Eat a diet of high fiber which includes green leafy vegetables and excludes starchy vegetables, skim milk-based yogurt, and whole grains. High fiber dals (moong, masur, urad, etc., along with sprouted whole dals) and beans (such as chole and rajma) should be a mainstay. Including methi (fenugreek) regularly in cooking, and in salads and dals after sprouting (sprouting methi completely reduces its bitter taste) adds flavor and a health benefit. Fruits that are delicious and low in sugar include papaya, guavas, blueberries, and jamoon

Items to be conscious of and exclude, or eat in disciplined quantities, include fried foods and fatty foods in general (including our delicious tea-time snacks!), foods that include sugar and artificial sweeteners (yes, some sweeteners and bulk additives added to sweeteners can produce a sugar spike!), and processed grains. While regulating these will help with the maintenance of body weight, avoiding sugar, sweeteners and the inclusion of whole grains will maintain even levels of blood sugar. Depending on the stage of diabetes fruits may be eaten in moderation, but high sugar fruits such as mangoes, grapes, and sapotas should be avoided. 

As with diet, steady exercise is highly recommended for diabetes. Even our hoary sage Sushruta recommended this, and in some studies, the inclusion of exercise had the most obvious ameliorative effect. The type of exercise will need to vary based on the individual’s age and capacities, but even a basic activity like a daily brisk walk for about thirty minutes would make a difference. Obviously, more will be required if weight loss is an objective. Although yoga is excellent for weight maintenance, it will not suffice for weight loss regimes. Walking, yoga, and exercise, in general, will also help in stress management, and others may be included, such as reading, meditation, etc., depending on individual preferences. 

Tackling the diabetes epidemic at the global level would need to start with the individual. 


L Iyengar has lived and worked in India and the USA. A scientist by training, she enjoys experiencing diverse cultures and ideas. She can be found on Twitter at @l_iyengar .


 

Califiornia’s Deadliest Spring In 20 Years

The first five months of the COVID-19 pandemic in California rank among the deadliest in state history, deadlier than any other consecutive five-month period in at least 20 years.

And the grim milestone encompasses thousands of “excess” deaths not accounted for in the state’s official COVID death tally: a loss of life concentrated among Blacks, Asians and Latinos, afflicting people who experts say likely didn’t get preventive medical care amid the far-reaching shutdowns or who were wrongly excluded from the coronavirus death count.

About 125,000 Californians died from March through July, up by 14,200, or 13%, from the average for the same five months during the prior three years, according to a review of data from the state Department of Public Health.

By the end of July, California had logged about 9,200 deaths officially attributed to COVID-19 in county death records. That left about 5,000 “excess” deaths for those months — meaning deaths above the norm not attributed to COVID-19. Deaths tend to increase from year to year as the population grows, but typically not by that much.

A closer look at California’s excess deaths during the period reveal a disturbing racial and ethnic variance: All the excess deaths not officially linked to COVID infection were concentrated in minority communities. Latinos make up the vast majority, accounting for 3,350 of those excess deaths, followed by Asians (1,150), Blacks (860) and other Californians of color (350).

Map by Phillip Reese for California Healthline Source: California Department of Public Health

The overall number of excess deaths across all races and ethnicities was ultimately tempered because, compared with the three prior years, there were actually 383 fewer deaths among white Californians than would be expected in the absence of COVID-19. In addition, California Healthline adjusted the overall numbers to reflect more than 320 COVID deaths that could not be categorized by race or ethnicity because that information was missing from state records.

Several epidemiologists interviewed said they believe a sizable portion of the excess deaths among people of color did, in fact, stem from COVID infections but went undetected for a variety of reasons. Among them: a shortage of coronavirus tests in the early months of the pandemic; an uneven strategy for how and when to administer those tests, which persists; and inadequate access to health care providers in many low-income and immigrant communities.

Dr. Kirsten Bibbins-Domingo, chair of the Department of Epidemiology and Biostatistics at the University of California-San Francisco, is among those who suspect the excess deaths reflect a COVID undercount in minority communities. She noted that several chronic health conditions that disproportionately affect Blacks and Latinos — including diabetes, high blood pressure and heart disease — also place them at higher risk for severe complications from COVID-19.

In addition, Bibbins-Domingo said, the prolonged shutdown of medical offices in the early months of the pandemic — and with them non-urgent surgeries and routine medical care — likely accelerated death among people with those chronic conditions.

“Shutdowns always come at a cost,” she said. “It is our most marginalized communities that experience the cost of a shutdown.”

According to state Department of Public Health data, deaths in California attributed to diabetes rose 12% from March through July when compared with the average for the same period over the past three years. In addition, deaths attributed to Alzheimer’s disease rose 11%.

“Dementia is also a disease where we have racial, ethnic minorities already at greater risk,” said Andrea Polonijo, a medical sociologist at the University of California-Riverside. “Now that we have the pandemic, they’re more socially isolated. Social isolation we know can cause deeper cognitive decline.”

It’s hard to determine whether a death is due to COVID-19 if the victim never sought medical care, said Jeffrey Reynoso, executive director of the nonprofit Latino Coalition for a Healthy California. Latinos in California are less likely to have health insurance, he said. They may face language barriers if their medical provider — or contact tracer — does not speak Spanish. Latino immigrants working in the U.S. without authorization may hesitate to visit the doctor.

“Immigration is definitely a driver in creating a fear and a mistrust of systems, and that includes our health care system,” Reynoso said.

Polonijo said the fact that Latinos make up the bulk of the excess deaths correlates with their dominant role in farming, meat processing, manufacturing and food service, jobs all deemed essential during the pandemic.

“This population is also more likely to live in more crowded conditions,” she said. “So not only are they exposed at work, but they are bringing disease home and with it the possibility of spreading it to their family, bringing it to the community.”

Bibbins-Domingo noted that, while a major portion of COVID deaths overall have occurred among seniors and nursing home residents, a disproportionate number of the state’s excess deaths are of working-age adults.

“The excess deaths that we’re seeing in communities of color and in low-income communities are deaths that are occurring at younger ages,” she said. “These are deaths that are occurring in these ages from 20 to 60, generally speaking — the ages when people would be out working.”

Kathy Ko Chin, president of the Oakland-based Asian & Pacific Islander American Health Forum, said Asian Americans also tend to be overrepresented in essential worker occupations, noting that a large proportion of the state’s nurses are Filipino. In addition, she said, government officials have not done enough to translate COVID educational materials into the many languages spoken by California’s Asian Americans. The Trump administration’s rhetoric on immigration during the past four years, she added, has had a “chilling effect” that has kept many foreign-born Asian Americans from visiting a doctor.

“People were really, really scared,” Chin said.

Counties in Southern California and the largely rural Central Valley — places with a high proportion of Latino residents — tended to have high rates of excess deaths from March to July. Among counties with at least 100,000 people, Kings County, an arid expanse north of Los Angeles that is home to industrial-scale agriculture, had the highest rate of excess deaths per capita.

Officials at the Kings County Department of Public Health did not return a message seeking comment.

Bibbins-Domingo and others said it is important for state and county health officials to take a hard look at their excess death numbers. Excess deaths matter, she said, because they expose shortcomings in health care delivery. In addition, local and state responses to COVID-19 are grounded in data; if that data is inaccurate, the responses may be misguided.

“Deaths are important because they also help us to understand how much severe COVID is there in the community that we have to worry about,” Bibbins-Domingo said. “I think when we undercount that, we both fly blind for the overall pandemic management, and we might fly particularly blind in understanding the impact of the pandemic in particular communities.”


Phillip Reese is a data reporting specialist and an assistant professor of journalism at California State University-Sacramento.

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Photo by engin akyurt on Unsplash

Punjabi Truckers Find A Warm Welcome At US Highway Dhabas

A billboard promising a taste of India looms across American interstate I-40. The new Route 66, I-40 is the spine of the Sikh trucking world. Every 100-200 miles you will find a Punjabi dhaba serving heart-healthy meals to diabetes-prone Punjabi truckers. 

Tucked into truck stops with names like Jay Bros (in Overton, NE.) and Antelope Truck Stop Pronghorn (in Burns, WY.), the ubiquitous dhaba serves the needs of the increasing numbers of Punjabi truckers driving down I-80.

Raja Sekhon

Raja Sekhon, an ex-Indian Air Force officer who drives his truck through Canada and the US doesn’t stop at them. When he embarks on his 5-day journey, carrying fresh produce across US and Canada, he packs his own food. 

“From home I bring 4 spelt flour rotis (flatbread), daal (lentil soup), saag (spinach curry) and dahi (plain probiotic yogurt). That’s my diet on the road,” says Sekhon, a graduate of National Defense Academy, (NDA) India’s Westpoint. 

After having flown Air Force fighter jets and other professional jobs, he started driving a truck after retirement at the age of 61.

“Every day on the road I eat a banana, apple, date, fig, and prunes along with a cup of black coffee with haldi (turmeric),” says Sekhon who includes ginger and vitamins as part of his daily diet. Maintaining a healthy glycemic index is key.  

Of the 1.5 million truck drivers on US highways, says the Punjab Truck Association, about 150,000 Punjabis work in the trucking industry. Increasingly, Punjabi drivers are filling the depleting ranks of truck drivers many of whom are leaving due to health problems.

 A pilot study on health and safety for truckers published in the Journal of Occupational and Environmental Medicine, found that commercial truck drivers have a 50% higher risk of developing diabetes compared to the general population and that  87% of truck drivers have hypertension or prehypertension.

As a double whammy, South Asians like Sekhon have a four to fivefold higher risk for Type 2 diabetes compared to other Asian migrant groups. In a study on the dietary patterns and diabetes prevention strategies for South Asians in Western countries, Dr. Sherly Parackal from the University of Otago states that “Dietary patterns have been attributed as an important independent modifiable risk factor.” 

On an average road trip of ten days, food carried from home by a truck driver will last a few days before it spoils. Most long haul drivers will stop on the road at dhabas to refill their boxes for the rest of the trip. They heat the food on the camping stove that accompanies each trucking duo and make a cuppa chai to go with it.

Balvinder Singh Saini operates Punjabi Dhaba food truck with his wife, Mansi Tiwari, and a small staff of relatives in Bakersfield, California. Saini, 44, was once a truck driver himself, but health problems forced him to find another way to support his family.

“I make sure the food served to truckers is heart-healthy. The oil we use is cold press, the vegetables are non-GMO and organic, the flatbreads whole wheat, and the food portable. At times they pick up forty flatbreads at the start of their journey,” says Saini.

Even on the limited COVID menu, Saini makes sure that a good serving of vegetables is available: Shahi Matar Paneer (peas & cheese), Chole Masala (garbanzo beans), Aloo Gajar Matar Sabzi (potato, carrots & peas), Daal Makhani (pulses), with hand-rolled whole wheat bread Tawa Roti.

“Most Punjabi drivers are vegetarian on the road,” says Gurjeet, who drives a truck with her husband. “It is harder to find vegetarian food on the road. We find long lines of truckers at Subway ordering the vegetarian sandwich.”

In her study, Dr. Parackal associated “animal protein”, “fried snacks, sweets, and high-fat dairy” with greater insulin resistance and lower HDL cholesterol. A “mixed” dietary pattern was associated with obesity and hypertension and a “western” dietary pattern was linked to overall risk for Metabolic Syndrome. Another observation showed a “70% increase in the odds of diabetes per standard deviation in grams of protein intake.” 

Parackal recommends diabetes prevention strategies such as “Registered dietitian-directed wellness programs that include education, support, and cooperation of truck-stop restaurants are critical to reduce obesity and risk of disease in this population.”

Heart health coach Anita Sathe at the South Asian Heart Institute which guides South Asians in the management of their heart risk, suggests “A plate that is half full of vegetables, a quarter full with grains and a quarter with protein.”

At the Punjabi Dhaba off I-5 in Bakersfield, California, tables have been set up outside and masked clients are seated at a distance of six feet apart. There is ample parking space for truckers to pull in. Twelve dollars will buy four whole wheat rotis, daal (lentil soup dressed with a tadka of ginger, garlic, caramelized onions, and fire-roasted tomatoes) and, for the meat-eater, a treat of lean goat meat curry. Creamy steaming chai is a possibility. 

Balvinder Singh Saini knows that truckers are required to take a break before they complete 8 hours of driving and must stop driving after clocking 11 hours. The truck’s log system records and reports the time spent on the road. His dhaba is perfect for that thirty minute stop.

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As the pandemic unfolded earlier this year, truckers have soldiered on through closed rest stops and food chains to deliver essential goods. Balvinder Singh and the Punjabi Dhaba have kept the wheels turning come rain, sunshine, or pandemic, plying truckers with heart-healthy fare. 

The dhaba feels like a piece of home. It has Punjabi music and Punjabi movies on the wall-hung TVs. The ladies in the kitchen, like aunts back in Punjab, wear Indian salwar trousers and kameez shirts and share family gossip while they hand-roll rotis. Balvinder Singh Saini himself stops and chats beside the outdoor tables with tales of his own, watching indulgently while his customers devour their meals.

“It is not just the body of the trucker, it is the spirit that gets nourished at these rustic eateries,” says Balvinder Singh Saini.

Dhabas on US Highways

  • Punjabi Dhaba 2546 S Union Ave Bakersfield, CA 93307
  • Punjabi Truck Stop (I-40, exit 26) -11561 N 1900 Rd, Sayre, OK 73662. (580) 928-2500
  • Panjabi Dhaba Restaurant & Vega Truck Stop 3650, I-40, Vega, TX 79092
  • Punjabi Dhaba 48243 Memorial Dr, Newberry Springs, CA 92365
  • Taste of India 2405 NM-469, San Jon, NM 88434
  • Dillon Truck Stop, San Jon, NM (I-40, exit 356) 
  • Punjabi Dhaba 2650 N Roundup Ave, Kingman, AZ 86401
  • Punjabi Dhaba 7311 Hwy 104 N, Cedar Grove, TN 38321
  • Tandoori Indian Restaurant 12501 Valley View Rd, Shawnee, OK 74804
  • Pilot Truck Stop, southside of Indy (I-495, exit 4) 
  • Spiceland Truck Plaza, New Castle, IN (I-70, exit 123)
  • Spicy BiteTA Truck Stop, Milan, NM (I-40, exit 79) 1203-1299 Motel Dr, Milan, NM 87021
  • Demming Truck Plaza, Demming, NM (I-10, exit 81) 
  • Punjabi Dhaba 7800 Batavia Rd, Dixon, CA 95620
  • Speed Way Cafe I-80 exit, 4, Wendover, UT 84083
  • Punjabi Dhaba 500 A Truck Inn Way, Fernley, NV 89408
  • Jay Brothers Truck Stop Taste of India Rd 444, Overton, NE 68863
  • Akal Travel Center 168 Hunt Rd, Laramie, WY 82070
  • Akal Travel Center Exit 360 off I80 Nebraska
  • Antelope Truck Stop Pronghorn Indian & American Restaurant 4850 I-80 Service Rd, Burns, WY 82053-9808. +1 307-547-3355
  • Jay Brothers Truck Stop Taste of India.

Read other articles in this series:

Road Warrior

Doctors Open Doors To Sick Punjabi Truckers


Ritu Marwah wrote this series while participating in the USC Center for Health Journalism‘s California Fellowship.

 

Doctors Open Doors To Sick Punjabi Truckers

The doctor leaned over Jitamber Singh Bedi and inserted the needle of the injection into his eyeball. Jitamber had a blockage in his vein that was causing his eyesight to cloud up. Vision problems are a side effect of diabetes. Like eighty-eight percent of truck drivers, Jitamber Singh Bedi too had Type 2 diabetes. 

In order to operate a commercial vehicle on the road, a driver must be able to prove they are maintaining stable blood sugars. Jitamber medical exam report is part of his driving record. It is filed electronically by the Medical Examiner (ME) with the US Department of Transportation (DOT) bi-annually. Any drop in health indices would mean he loses his license or at best, gets recertified every year. 

Over half of all long haul truck drivers suffer from hypertension and/or diabetes. These comorbidities put them at a higher risk for COVID.

“Sedentary lifestyle and erratic sleep gets you, if bad food on the road doesn’t,” says Jitamber Singh Bedi. “Sitting for ten hours a day for ten days at a stretch, the truck driver is a sitting duck for diseases like diabetes. And when they do take a break it is easy to pull out a cigarette.”

“At every rest stop I ended up smoking,” says Jitamber. 

Irregular eating habits and dehydration further strain the system. Jitamber is always worried about taking restroom breaks and therefore restricts the intake of fluids and food which can lead to the taxi cab syndrome. The inability of drivers to relieve themselves regularly throughout the workday leads to voiding dysfunction, infertility, urolithiasis, bladder cancer, and urinary infections as compared with nonprofessional drivers wrote Alon Y Mass, MD, David S Goldfarb, MD, and Ojas Shah, MD. from the Department of Urology, NYU Langone Medical Center. Paid by the mile, every restroom stop costs precious time.

“Sssssslow suicide behind the wheel,” says Jitamber, “with the pandemic that could take a quick turn for the worst.”

Jitamber graduated from Mayo College, where he went to school with the sons of India’s upper classes, princes, and nobles. After immigrating to the US, he worked for ten years as the Assistant Manager, Special Reporter and Editor for India Post, a California publication. Jitamber started driving a truck in the US in 2012.  

Jitamber & his wife Lisa

He still maintains his A1 license to drive a truck and is married to Lisa, a librarian at the county library. Jitamber is on his wife’s medical plan. Kaiser is their health insurer. Kaiser, a California company, has agreements with other providers to provide coverage all over the US thinks Jitamber. He does not really know how his health insurance will play out if he falls sick on the road.

Raman Dhillon of the North American Punjabi Trucking Association (NAPTA) has negotiated a health plan that truckers can buy into. Portability of insurance plans from one state to the other has been a bottleneck to seamless healthcare access. NAPTA wants to ensure that the trucker has access to pharmacy anywhere and medication can be prescribed to and picked up by the driver from the pharmacy closest to him. 

President Trump’s Emergency Order in the face of the COVID pandemic opened up anywhere anytime access to healthcare.

Anywhere Anytime Access 

Of the 1.5 million truck drivers on US highways, says the Punjab Truck Association, about 150,000 Punjabis are working in the trucking industry. The South Asian gene makes the Punjabi drivers more vulnerable to acute myocardial infarction (MI). Studies by UCSF, Stanford and El Camino hospital’s South Asia Heart Center, show that heart disease strikes South Asians at a younger age and more malignantly than the general population. “South Asians represent approximately 17 percent of the world’s population – yet they account for 60 percent of the world’s heart disease patients,” says Anita Sathe of the South Asian Heart Center which runs a program to help South Asians manage their heart risk.

The ability to access and monitor healthcare on the road is crucial to the health of Punjabi truckers.

COVID-19 opened the door for truckers to access technology-based ubiquitous healthcare. Under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act, the incorporation of telemedicine into routine medical care on a temporary and emergency basis, has lightened the burden on truckers. The waiver has loosened former requirements that the patient and provider be in the same state or that the patient must be in physician shortage areas to access telemedicine; so a doctor in New York now can be reimbursed for consulting with a patient out of California. 

The rule that a new patient could not use telehealth and must have an established relationship with the doctor has been relaxed as have some of the HIPAA requirements like data transfer and storage. The new criteria allow the use of tablets or smartphones, so a driver can call a nearby doctor from his smartphone. However, all calls must be video calls;  audio-only calls may not be made. 

“From March 6, 2020, a range of providers, such as doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers, offered telehealth to all patients,” says Apexon Healthcare executive Siva Sundar. “Meeting the doctor through zoom or Facetime has become the norm for everyone during the quarantine.” 

Telemedicine and walk-in medical clinics located at truck stops and Pilot and Flying J Travel Centers proliferated with the advent of COVID. For the sake of the truckers, these new rules must outlast the pandemic and become the new normal. 

Checking For Sugar On The Road

Jitamber Singh Bedi would find it useful to wear body sensors that alert him, his family, and his doctor to potentially serious changes in his health status. 

Continuous glucose monitoring devices to monitor the driver’s blood sugar – motivates healthy behaviors says Rajeev Sehgal, Jitamber’s classmate from Mayo College, who has been wearing the Dexcom 6 device for over 6 months. “In the same way that wearing a Fitbit can be motivational for meeting daily fitness goals, real-time monitoring of blood sugar levels might reinforce good behaviors around eating and exercise,” he says. 

The tiny sensor he wears on his stomach sends real-time reading of his blood sugar levels to his phone every 5 minutes.  “It is extremely comfortable to wear. I can swim with it. I change the device every ten days,” says Sehgal who highly advocates its use by drivers. The device allows quick remedial actions for timely diabetes management and the information can be kept private or shared with family members when the driver is on the road.

If the sensor indicates high sugar and blood pressure levels, the trucker can consult with a doctor by teleconference over Facetime. If they’ve embarked on a trip without getting a refill or forgetting to pack their meds Telemedicine can get them their meds at a pharmacy close to where they are. 

“At present, the sensor is prescribed and covered by insurance for people who have uncontrolled type 2 diabetes but it should be authorized for truck drivers who are managing their diabetes,” says Sehgal. 

Monitoring blood sugar levels on the go will allow the trucker to take immediate remedial action. A brisk walk could fix a spike in blood sugar levels following a sugary lunch or in case of a drop in sugar levels, a quick pop of sugar will prevent deterioration in vision like the one Jitamber had to face. A year ago he noticed he couldn’t read street signs. Retinal vein occlusion and macular edema caused big brown blobs to float in front of his eyes. After a series of shots at regular intervals, Dr. An Ngoc Huynh, MD at Kaiser Irwindale California declared his vision to be 20:25.

“The main thing I want to better understand is, how different things I do affect my glucose levels,” says Jitamber. “I will track my blood sugar levels to see how it responds to food, sleep, and exercise. Fasting, exercise, stress, or sleep can be tweaked to get the marker to the right place. Precision in targeting our health issues can prevent shots in eyeballs,” said Jitamber.

Read other articles in this series:

Road Warrior

Punjabi Truckers Find A Warm Welcome At US Highway Dhabas


Ritu Marwah wrote this series while participating in the USC Center for Health Journalism‘s California Fellowship.

 

Sushant Singh Rajput Jolts Global Mental Health Dialogues

Trigger warning regarding mental health and suicide.

Sushant Singh Rajput, Disha Salian, Sudha Devi lost to mental health

Mental health has been exacerbated during the COVID-19 pandemic. Headlines relating to suicide have sent shock waves through the community. A successful tinsel star, Sushant Singh Rajput and his former manager, Disha Salian, succumbed to their mental health within one week of each other. And in a tragically poetic fashion, as Sushant Singh Rajput’s last rites were performed, his sister-in-law, Sudha Devi, passed away, who had allegedly stopped eating upon learning of his death. The rippling effect of mental health ran its course.

Popular for his acting in both TV and film, the 34-year-old actor, delivered a strong anti-suicide message in his last seen 2019 film ‘Chhichhore’. On June 14, 2020, the actor was found in his Mumbai home. He was reportedly suffering from depression. A week earlier, he had written a heartbroken Instagram story addressing the suicide of his 28-year-old former manager, Disha Salian.

Is it the lockdown and the resulting loneliness or is it the disease itself?

“It is both,” said Dr. Farida Sohrabji, Regents Professor and Interim Head, Department of Neuroscience and Experimental Therapeutics, Texas A&M College of Medicine, at a webinar organized by Ethnic Media Services, June 12, 2020. Both the molecular impacts of the virus and the pandemic-related isolation leads to depression,” she said.

The impact of social isolation can be quite devastating in many ways. Social isolation increases the risk of cardiovascular ailment, heightens the symptoms of autoimmune disease, and increases mental health issues. Not interacting with people increases the stress hormone cortisol and weakens the immune system. People who don’t have the virus but are being socially isolated slip into depression. The senior population, or those with comorbidities like diabetes, hypertension, etc., are isolated for their own good. They are entrapped by voluntary confinement and fall prey to depression.

And then there are those that are infected by the virus.“The virus enters the body through the nose,” says Dr. Sohrabji, “The nose is somewhat exposed to the brain and the virus can end up in the brain in the olfactory system (how we smell things). This area is strongly implicated with depression.”

Additionally, the full-blown inflammation caused by the virus has an effect on the brain and mood of the patient. “The proteins that fight the virus slash and burn cells in the war against the virus and the resulting inflammation can lead to depression,” she said. “ The medical community’s first thought was that the virus is akin to a respiratory disease but it has been noticed to be more than that. A broad basket of mental issues has been caused by it.”

Social distancing to prevent the spread of the virus can lead to depression and anxiety, while those infected with COVID-19 can experience mental health issues, including depression. Being cognizant of the dangers caused by the lockdown can help us help each other stay sane and safe. 

What can help?

A study by Harvard Medical School has a unique solution. Foster a pet. Pets have a calming effect. Dogs’ calming effect on humans appears to help people handle stress, the study says. Research suggests that people with dogs experience less cardiovascular reactivity during times of stress. That means that their heart rate and blood pressure go up less and return to normal more quickly, dampening the effects of stress on the body.

The power of touch appears to be an important part of this “pet effect.” Several studies show that blood pressure goes down when a person pets a dog. Having a dog is good for your heart too, says the study. Besides, dog owners tend to get more exercise as well. As coronavirus spreads across the US, Americans have stepped up to foster and adopt animals, keeping them out of shelters.

Contextualizing

”We come up with our sort-of explanations, even if they are not particularly persuasive, and then file the event away,” says Malcolm Gladwell on suicide. “I keep coming back to how important context is in understanding behavior.” 

The incontrovertible fact is that Sushant Singh Rajput, Sudha Devi, and Disha Salian were casualties of mental anguish during the lockdown. Rest in peace to all the lives that have been lost due to mental health.

Ritu Marwah is an award-winning author whose interest in history has led her to chronicle our life in times of COVID. How many more must we lose?

Healthy Ways to Gain Weight

Are you trying to gain weight? Trying to gain weight may seem like an easy problem to solve, however, healthily putting on weight may not be as easy as you think. So, whether you are underweight and want to reach a healthy weight or are trying to gain muscle, you need a balanced approach to gain weight.

As a general rule, you need to consume between 300 and 500 more calories than you burn to gain weight. Unfortunately, many people are not aware of the number of calories they eat, or they misestimate it. This is where a weight gain calculator comes in handy. It helps you plan your meals properly with an adequate amount of proteins, fats, and carbohydrates.

What are the risks of being underweight?

Almost two-thirds of the US population is overweight or obese, which can lead to health problems. Similarly, being too skinny or underweight can also be unhealthy. If you have a BMI of less than 18.5, you are considered underweight (1). Not only does being underweight lower your self-esteem, but it can also lead to malnutrition and have a severe impact on your health. A diet that is very low in calories can cause fatigue, nausea, hair, and skin issues. When you are underweight, you can also develop a weakened immune system, osteoporosis (2), infertility, eating disorders, and developmental issues.

Causes of being underweight

There can be many reasons why a person is underweight (3). Sometimes there may be multiple related causes. Often medical conditions can also make a formerly healthy person to lose weight.

1. Family history

Some people have naturally low BMI that may run in their family. If a person has a high metabolism, he may not be able to gain much weight despite eating high calories foods. 

2. High levels of physical activity

Some people like sportspeople and athletes burn much more calories, and this may result in low body weight.

3. Infections

Parasites, tuberculosis, HIV, and other infectious diseases can make the body use most of its energy in fighting off these diseases, which may lead to drastic weight loss.

4. Diabetes

When people have diabetes, insufficient insulin levels prevent the body from getting glucose from the body’s cells to use as energy. The body then starts burning fat and muscle for energy, and this leads to weight loss issues.

5. Hyperthyroidism

Hyperthyroidism can accelerate your metabolism, causing unintentional weight loss.

6. Celiac disease

Celiac disease is an autoimmune disease that can lead to weight loss. The body has an autoimmune response to gluten, and the small intestines are damaged, which affects the absorption of nutrients and causes weight loss.

7. Mental illness

Mental health conditions like depression, anxiety, obsessive-compulsive disorder, and eating disorders like anorexia and bulimia can affect a person’s ability to eat. If you lose bodyweight drastically without making a change to your diet or exercise pattern, you may have one of these illnesses. Seek medical advice and follow a plan to gain weight healthily.

How to gain weight healthily?

Just like a weight loss program, a weight-gain program also needs a balanced approach. Eating calorie-dense junk food may lead to weight gain, but you may still have nutritional deficiencies. Here are some general tips for gaining weight safely –

1. Eat frequent meals

Eat three to five meals every day. Eating more meals makes it easier to take in additional calories. You can also increase the number of calories consumed by snacking between meals (4).

2. Add healthy calories

Eating healthy is not difficult. You can increase your overall calorie intake by adding nuts and seeds and cheese to your dishes. Add healthy side dishes. Whole grain toast, sunflower seeds, almonds, and fruits like bananas and avocados are some great options (5).

3. Eat enough protein

Our body uses protein to build lean muscle mass. The RDA for protein is 0.4g per pound of body weight. So if you’re trying to gain muscle mass, you should exceed this amount significantly. Some of the favorite calorie-dense high-protein foods include fattier cuts of beef, pork, and chicken. You can also include salmon and eggs in your diet. Peanuts, walnuts, macadamia nuts, and walnuts are also rich in proteins.

4. Consume healthy carbs

Avoid refined carbohydrates and go for whole-food sources of carbohydrates like brown rice, oats, and beans. Sweet potatoes and yams are also good for your diet. 

5. Eat healthy fats

Learn to distinguish between healthy and unhealthy fats. Healthy fats are monounsaturated or polyunsaturated, and nuts, avocado, vegetable oils, and fish are rich sources of these fats. Unhealthy fats include saturated fats and trans fats. Limit saturated fats and avoid trans fats. 

6. Weight training

Weight training is essential for healthy weight gain as it helps in gaining and maintaining lean muscle mass. You may need to modify your workout over time by increasing the weight or number of sets to continue gaining muscle mass. 

People who do weight training break down their exercise routines into specific muscle groups. Some of the leg building exercises include barbell squats, leg press, leg extensions, calf raises, leg curls, and barbell squats. Some of the upper body exercises include dumbbell pullovers, incline row, incline chest press, lateral raise, supine ventral raise, and side pullovers.

7. Cardio exercises

Many people who want to gain muscle try to avoid cardio. However, you must include these exercises into your routine as well. Cardio exercises are great for a healthy heart and lungs. Running, swimming, and walking are great ways to get some cardio exercise.

You can use a weight gain calculator

This weight gain calculator helps you to determine your daily calorie intake for your weight gain goal. You first need to input your age, gender, weight, and height. You then choose the number of meals you plan to eat per day. Since you have to eat more food during the day, it is advisable to divide your intake into more meals. 

The calorie boost option is available for those people who find it very difficult to gain weight. The activity level is based on three weight training sessions per week, with little or no cardio. Click on calculate to find out the number of calories you should eat in a day. The results also give you a break-up of the carbohydrates, proteins, and fats that you should eat per meal and per day. As a general rule, only one-third of your fats should be from saturated fats.

How does this calculator work?

When you input all your details in the calculator, it estimates your daily maintenance level using the Mifflin St Jeor formula and adds a percentage of calories to the total (6).  The calculator then estimates the optimum levels of essential nutrients to ensure healthy weight gain. Your protein intake is calculated at 1.1 gram per pound of body weight. Around 30% of your intake should come from fats. The rest of your daily intake should come from carbohydrates.

Final thoughts

Being underweight can be extremely bad for your health. When you are underweight, you can also develop a weakened immune system, osteoporosis, infertility, eating disorders, and developmental issues. To reach a healthy weight, you must calculate how many calories you need to eat with a weight gain calculator. Plan a healthy and balanced diet that includes lean proteins, healthy carbs, and fats. You must also incorporate weight training and cardio exercises into your daily routine. 

Manveen Sibia had an illustrious career in journalism and writing. She is the mother of a super active 7-year-old. While chasing her around the house, she also finds time to pursue her passion for writing on parenting, education, health, fitness, and entertainment.


Disclaimer: This article is for general information purpose only. Please do not consider this as a substitute for qualified healthcare provider’s advice, diagnosis, or treatment.

South Asians, Stay Heart Healthy During COVID Isolation

South Asians have the highest risk of heart disease of any ethnic group. The facts are sobering – 1 in 4 heart attacks occur before the age of 40.

In fact, South Asian men and women have a significantly higher likelihood of having a heart attack before age 50 that is more lethal compared to any other ethnic group.

Although cardiovascular disease remains the leading cause of death all over the world, why do South Asians carry an especially heavy burden of this disease?

Stanford’s South Asian Translational Heart Initiative – (SSATHI) is trying to find answers.

Helping South Asian Heart Health

At SSATHI we are helping South Asians – people from India, Pakistan, Bangladesh, Nepal, Bhutan, Maldives, and Sri Lanka – better understand what makes them predisposed to cardiovascular disease and providing culturally tailored, medical and lifestyle changes to help them lower their risk factors.

We are the first cardiology clinic dedicated to the detection and long-term management of heart disease risk among  South Asians.

Health Impact of the coronavirus pandemic

Since the shelter in place began on March 17, our clinic has seen many South Asian patients whose lifestyles have grown increasingly unhealthy.

These profound changes in lifestyle  include poor diet, reduced physical activity, increased alcohol consumption, weight gain and increasing levels of stress.

South Asians must be vigilant about staying heart healthy during social isolation.  At SSATHI, we are dedicated to increasing awareness about risks and lifestyle choices and offering advice on how to improve heart health.

 Dr. Rajesh Dash MD, PhD, Medical and Scientific Director of SSATHI

Partnering with SSATHI for Clinical Services

SSATHI’s team of clinicians – behavioral psychologists, dietitians, nurses, pre-diabetes specialist and cardiologists – offer comprehensive heart risk assessments, as well as medical and lifestyle interventions aimed at aggressive risk reduction.

As one example, the clinic offers the oral glucose tolerance testing that provides detailed insight into blood sugar and insulin regulation, and helps to identify patients at risk for pre-diabetes. This insight helps our providers tailor treatment by going beyond traditional markers such as hemoglobin a1c (Hba1c – three-month blood sugar mean).

Our pre-diabetes specialist Dr. Fahim Abassi,  has developed several tools to help providers and patients better understand blood sugar regulation and to develop personalized lifestyle recommendations.

The SSATHI clinic also offers virtual care so patients can access clinic services from the convenience of their homes and offices.

SSATHI Clinical Trials

In addition to clinical care, SSATHI has a robust research effort underway to uncover the underlying causes of South Asians’ increased risk for heart disease. Our clinical trials focus on genetic and hormonal risk factors behind heart disease, and a more recent trial on the effects of lifestyle intervention delivered by telemedicine has shown promising results. SSATHI is currently recruiting for a trial that studies the effect of plant sterol supplementation on LDL cholesterol levels. Trials like these helps explore alternative treatments beyond standard medication therapy.

Dangers of Covid19

Though our community has been making steady progress in managing their health, COVID-19 presents a whole new danger. People with co-morbidities such as high blood pressure, diabetes, and heart disease are at an increased risk of developing complications from COVID19. It is therefore more important than ever that we pay attention to our physical and mental health.

Recommendations to improve heart health during shelter in place

In addition to observing city and state mandates for masking and sheltering in place, and continuing proper hand washing, it is equally important to follow positive lifestyle behaviors.  Good nutrition, regular physical activity, consistent sleep schedule and instituting positive coping mechanisms to manage stress, will enhance our ability to deal with the pandemic.

NUTRITION

Sheltering in place has forced us to change the way we shop for groceries so dedicate a couple of pantry shelves to nutrient dense shelf stable foods. Channel your culinary curiosity towards creating more vegetable and lentil-based dishes and learn to cook with whole intact grains.

Avoid

  • Refined & processed starches/carbohydrates such as Maggi noodles, poha, sooji, instant mixes of idli,  or dhokla,

Choose

  • Whole grain alternatives like whole wheat noodles, steel cut oats,
  • Coarse cracked wheat or dahlia, quick cooking farro,
  • Barley, bulgur, quinoa, brown and red rice.

Must have

  • Fresh vegetables and fruits, organic low-fat dairy,
  • Plant-based protein sources like lentils and beans
  • Whole intact grains like quinoa, millet and brown rice.
  • Frozen vegetables

Snack Mindfully

  • Avoid using sugar and other refined and processed snacks as a crutch to get through your mid-afternoon slump.
  • Choose low fat organic yogurt and or fresh fruit as a refreshing wholesome snack instead.

Create a schedule to obtain groceries on a regular, biweekly basis and consider online delivery or in-store shopping with safety practices.

EXERCISE

Setting aside a few minutes – even as little as 20 minutes to go for a walk could make a big difference in your mood, energy levels and digestion. This could also be a great way to get some sun exposure and restoring your vitamin D levels while giving you an opportunity to clear your mind and getting some exercise.

SLEEP

It is particularly important to establish a consistent sleep schedule. Positive sleep habits include avoiding late night eating (eating after 10:00 pm), unwinding at least an hour before bed (even if it means going to bed later) and allowing sleep to unfold help support a good night sleep.

Getting up around the same time every day, getting light exposure shortly after waking up and blocking blue light on electronic devices 1 – 2 hours before bedtime are all valuable sleep strategies recommended by Stanford sleep specialists Dr. Rafael Pallayo and Dr. Rachael Manber.

REDUCING STRESS

As COVID can add a higher degree of stress and anxiety, SSATHI’s behavioral psychologist Dr. Valerie Hoover recommends practicing patience and compassion by lowering your expectations in areas of your life that you cannot control.

Instead, focus on parts of your life that you can control, whether it is health, finances, recreation or relationships. Separating work and non-work activities if you are working from home, creating daily routines such as showering and dressing up, further helps us deal with the lack of daily structure and disrupted routines.

We wish you all good health and optimism!

Vijaya Parameswaran MS, RD, CDE is a clinical researcher, dietitian and certified diabetes educator. She has developed a virtual lifestyle intervention program (NEST – Nutrition, Exercise, Sleep and Transcendence) at the SSATHI clinic. She is also the program manager for Stanford’s telemedicine program CardioClick.

Edited by Meera Kymal, contributing editor at India Currents

 

How to Build a Healthy Plate – Indian Style

Sukham Blog

My article  All That You Need to Know About Nutrition for South Asians introduced a framework to develop individualized, varied and nutritious meals that you would enjoy every day. This sequel provides suggestions to develop and sustain nutritious, healthy eating habits on a South Asian diet, distilled from conversations with Dr. Ranjita Misra, Editor of the 2nd edition of the AAPI Guide to Nutrition, Health and Diabetes, and Dr. Padmini Balagopal, Editor of its first edition. Dr. Balagopal – a Clinical Nutritionist with a commitment to community education in preventive health – is a Registered Dietitian and a Certified Diabetes Educator (CDE) who practices both in the United States and in India.

This is a practical guide to help you get from where you are to where you want to be.

Dr. Balagopal recommends the ABCD approach: use Anthropometric, Biochemical Clinical testing as the starting point to develop your Diet plan. Anthropometric measurements include height, weight, BMI, weight-to-height ratio, and waist-to-hip ratio. Biochemical includes metabolic, blood chemistry and other tests your physician would order, and Clinic stands for the examination he or she would perform – blood pressure, reflexes, heart and lungs etc. These measures, a customized interview and your physician’s guidance provide the basis to develop and sustain a nutritious, healthy diet optimized for you and your health condition.

Drs. Misra and Balagopal stress the role of a lifestyle change. “People would do better to focus on all aspects of their health – the whole chakra – and not just their particular health condition,” says Dr. Balagopal.” Physical activity, relaxation and mental health are also critical.  “No diet is complete without physical activity, and chronic stress can create a lot of damage.” Meditation, exercise, yoga are essential supplements to your dietary plan.

How you implement your new diet is also critical. Dr. Misra suggests you begin where you are and make a series of small, incremental and sustainable changes to your diet. She points to rice as an example. Most Indians are used to and like white rice. “If I asked my dad to switch to brown or red rice, he would throw a hissy fit,” she says. Instead, start with an equal-parts mixture of rice and quinoa or millets (available in India and in some stores in the US).  If you must, have just a little white rice at the end of your meal to satisfy your palate. “Cut your portion sizes and eat in moderation”, she advises. Allow yourself to indulge once in a while. “Food should be an enjoyable experience and you don’t have to give up everything you like.” Train yourself to take a balanced approach. A small cup of ice cream for comfort food after a bad day is okay if it makes you feel better and helps with your mental wellbeing, as long as you get back on track the next day. “Be aware of what you eat!”  A slice of pizza once a week is better than one every day.

The first step in adapting the Dietary Guidelines for South-Asian cuisine is to address grains. Less processed is better. Use brown or red rice. Consider alternatives like quinoa, bulgur wheat, and millet as substitutes for rice, or use a combination; they provide more protein with less carbohydrates. Refined carbohydrates “end up in the belly area” as triglycerides. If you must, have a very small quantity of white rice at the end of the meal to soothe your palate.  Many South Asians have hypertriglyceridemia resulting from high refined carbohydrates – the white rice factor. Use whole wheat flour for chappatis and rotis.  Ensure you eat plenty of fruits and vegetables. Introduce more color in the diet. Fresh is best, frozen is the next alternative. Canned food should be a last resort.  Add non-fat or low-fat yogurt to your meal for probiotics that are good for digestion and gut bacteria. The DASH meal plan is a good model to follow, especially for low sodium diets. Eat at least three hours before going to bed to aid in digestion and keep your blood glucose in check.

A plant-based diet comprising fruits, vegetables, legumes, and whole grains is the ideal way to go. It is also consistent with the Sattvik diet described in the Bhagavad Gita and other Yoga Shatras.  Furthermore, studies have shown that the prescribed plant-based diet  diet can help prevent and treat diabetesheart disease, some cancershigh blood pressure, and other long-term conditions. A recent article provides evidence that this kind of diet  also helps with Crohn’s’s disease,  and it’s not difficult to reach the Guidelines’ goal of nine servings of fruits and vegetables daily.

‘Tadka,’ or ‘Oggarane’ – tempering – is a fundamental step in South Asian cooking; it provides those mouth-watering flavors by liberating essential oils in spices and condiments. Drs. Misra and Balagopal encourage this – we must enjoy our food – but urge us to minimize the quantity of oil, and suggest that canola and olive oil are better than other options, since they have lower trans- and saturated-fat content. Avoid saturated fats and limit ghee to occasional use. Avoid deep-fried food.  Above all, never reuse oil left over from deep frying. “When you heat oil to a certain temperature, it generates acrylamides – chemicals known to be carcinogenic,” Dr. Balagopal warns.

Another  essential key is portion control.  “Set your tummy thermostat to half-full and get up when you get there,” Dr. Balagopal urges. A high-fiber, whole-grain diet, while good for other reasons, also makes you feel fuller, and helps in this context.

We’ve given you a plate-full of suggestions to get started.  Future articles will focus on the health benefits of certain spices and condiments, and eating with chronic illnesses.

With sincere thanks to Anna Pelzer at Unsplash for the use of her beautiful photograph.

Sukham Blog – This is a monthly column focused on health and wellbeing.  

Mukund Acharya is a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area established to advocate for healthy aging within the South Asian community.  Sukham provides information, and access to resources on matters related to health and well-being, aging, life’s transitions including serious illness, palliative and hospice care, death in the family and bereavement. If you feel overcome by a crisis and are overwhelmed by Google searches, Sukham can provide curated resource help. To find out more, visit https://www.sukham.org, or contact the author at sukhaminfo@gmail.com.  

 

Yoga For Diabetes

Diabetes Mellitus is the leading cause of death and disability all over the globe.  It is also the leading cause of chronic kidney disease, heart disease, blindness and other complications.  

The role of stress is underestimated in diabetes. Most of the chronic conditions including diabetes occur when one goes through persistent stress for long periods.  Stress is not the external circumstance alone, but more importantly about how we react to the situations that trigger stress. In spite of the stressful conditions around us, we can learn to live peacefully. Our expectations, desires, attachments, and aversions result in stress because life is not always presented to us, the way we want. With the regular practice of yoga, we develop mental awareness and strength to handle stress. The concept of happiness is beautifully explained in the philosophy of yoga. Happiness is simply our own inner state; we move away from health and happiness when we stress ourselves with undue expectations.

Studies have shown that diet, exercise, and stress-free lifestyle help regulate blood glucose levels. Yoga offers several techniques to help change stress response, improve sleep patterns, and promote positive thinking. Yoga as a system of healing includes physical postures (asanas), breathing techniques (pranayama), relaxation techniques (shavasana), meditation (dharana and dhyana) and injunctions for healthy lifestyle such as moderation in diet. Yoga also promotes positive thinking; yogic edicts such as yama and niyama prescribe non-violence, truthfulness, moderation in sensual pleasures, acceptance of situations and of life as they come. Positive thinking and a healthy lifestyle bring inner peace and harmony, thus reducing stress and contributing to regulated blood glucose levels. Numerous scientific investigations have found a significant role of yoga in the prevention and management of several chronic health conditions, including diabetes.  

Yoga Bharati brings classical and authentic yoga with research-based understanding. Yoga Bharati conducts yoga classes, yoga therapy, and yoga courses in holistic Ashtanga Yoga. Our upcoming workshop on diabetes aims to educate people on diabetes management through yoga. We have an expert Yoga Therapist and Chief Medical Doctor from SVYASA University Bangalore giving the workshop on Diabetes on Sunday, June 2nd at 10 am in N. San Jose. For details, please visit:

https://yogabharati.org/ba-event/yoga-for-diabetes-workshop-by-dr-nagarathna-svyasa-bangalore

 

This article was provided to India Currents by Yoga Bharait.