HEALTHY EATING DURING THE EXAMINATION

- Sheela Paul, Ninu V Rajan - Dietitians

Examinations are a time of anxiety and nervousness not only for students, but also for parents. To increase productivity and take the exams well, besides studying hard, it is also necessary to focus on eating habits, sleep patterns, and mental and physical fitness. When examinations are just around the corner, eating well may be the last thing on one’s mind. However, a good diet during exam time can actually help you do much better.


Exam fever affects the mind and health of students. It results in the neglect of their diet which in turn has a direct effect on their health. Examination worries kill their appetite and with the rush to complete the syllabus they do not worry about their diet.

A little modification in eating habits is needed during the examinations. Students spend long hours studying. Eating the right food in small quantities will keep them stimulated and alert.

A balanced diet is important. Always have a well-balanced meal before and after the exam. Fresh fruits and vegetables provide children with reserves of energy and increase their ability to concentrate. If your examination is in the morning, give yourself time to eat breakfast, and include protein rich foods and fruit for energy.

Have a small light meal before the examination. This will help you to be more awake during the exam. A heavy meal will make you drowsy and sluggish. Reduce the intake of white flour or rice. Use whole grains like oats, brown rice, and wheat.

Fill yourself with protein-rich foods like pulses, eggs, low dairy products, yogurt and cottage cheese during breakfast and lunch on the day of the test. The benefits will last throughout the day. Drink a protein shake, smoothie or other healthy energy drink if you are too nervous to eat. This gives you the energy you need to keep going until you can eat properly.

Include almonds in your diet. Soak almonds overnight and eat them in the morning. Nuts are full of DHA, which is needed in high levels in the brain and eye for learning and memory. Fruits or fruit juices will stop you from feeling drowsy. Banana is believed to be a good source of energy. Parents should encourage their children to eat green leafy vegetables, fresh vegetables, salads, carrot, beet root, potatoes during examinations.

Have green tea twice a day for good exam health . It is good to keep the body hydrated. Avoid excess tea, coffee and chocolates. Though they stimulate you temporarily, they will make you tired. Leave out the caffeine as a meal substitute. Overdosing on coffee and energy drinks may cause you to become too anxious and collapse.

Drink plenty of water to keep hydrated before and during an examination. Dehydration may make you lose focus or feel sick during the test.

Parents should teach their children to eat slowly and chew the food well

Snack healthy: Choose almonds, cashewnuts, pista, pumpkin seeds and roasted ground nuts or channa Instead of samosas, burgers, savories, chips and deep fried foods.

Avoid fried, refined foods (bread, maida products) which make you more sleepy and lethargic.

Don’t reheat food — it will destroy the nutrients of food , release unpleasant smelling sulfur compounds and may cause gas.

Ensure that the child doesn’t chew gum.- The chewing action causes him to swallow more digestive juices, which will increase his hunger.

Good and sound sleep is very important before examinations. Keep yourself happy. Listen to relaxing music during study breaks. So, follow these tips and write the examination without ruining your health.





GOOD LUCK

Kids can’t weight FOR HOLIDAYS

THE VACATIONS ARE HERE. BUT BEWARE OF THE EXCESS WEIGHT THAT YOUR HOME-BOUND CHILD IS PRONE TO GAIN TIMES NEWS NETWORK

The six-week summer break is when your child is more likely to fatten up, says a study.

The Chennai slim-and-fit programme – a project for childhood obesity prevention by MV Hospital for diabetes – assessed the weight of 128 overweight and obese children in CBSE schools before and after holidays in 2011. It showed that 93% of children had put on weight after holidays. Among those who showed an uptick in weight, more than one in 10 had a 20% increase.

When schools shut, most children tend to eat without burning the stacked-up calories, leading to weight gain. And it’s necessary to get your kids out of the couch and show the door – to the playground. Teachers in CBSE schools warn that overweight children are less likely to grow out of the fat, turning them into obese adults.

Doctors say it is not a coincidence that most overweight children start packing on the pounds during holidays. When at school, students are constantly on the move. But during holidays, they idle at home, watching TV, reading books or surfing internet. Parents too are happy to not let kids out of the sight, freezing them up in the house for most of the day.

During counselling sessions at schools, children admit parents and grandparents featherbed them during holidays. Diabetologist Dr Vijay Vishwanathan says most children said they visited their grandparents’ houses during the break, where they got to lay their hands on yummy (read rich) foods. Children stuff themselves up with treats such as milk sweets, chocolates or fried foods like muruku’ and thatais. “They never let the kids out as it would be too hot, and the safety of kids, too, is high up on their mind,” he says.

At school, counsellors like Dr A Vigneshwari, an epidemiologist, have been tutoring children on having regular eating schedule -- including a breakfast. Children tend to sleep past breakfast time on holidays and parents give them on brunch. Those who have morning meal tend to eat less for lunch and are less likely to go tip-toeing around the shelves for candies, cookies, she says. Children who skip breakfast every day may be twice as likely to be obese, research has suggested.

CBSE schools that are part of the slim-and-fit progamme have told children to eat calorierich foods in moderation. Even at parties children have been asked to wink at dessert after one serving.

Children aren’t completely averse to the idea. “It’s going to be difficult to say no to more than one or two treats. But now I know treats made of butter, milk and sugar are high on calories. If I eat more, I will feel guilty,” says nine-yearold R Anirudh, who will be off to Coimbatore to meet his grandparents.

Anirudh has also registered for a swimming and football camps for four weeks. He plans to set aside one hour each day for physical activity. He and a group of six friends will also maintain a scrapbook, where they would record everything they eat and the calories they spend. “We are eager to check their weight after they come back. This is their first year of holidays after counseling. Hope the weighing scales won’t trip,” says Dr Vigneswari.

Congratulations

M.V.Hospital for Diabetes presents the first Dr. M Viswanathan National Award for Excellence in Medical Teaching and Medical Care to Dr. Ramchandra Dattatraya Lele, emeritus professor, National Academy of Medical Sciences. The award was given away by British Deputy High Commissioner, Mike Nithavrianakis at a function in Chennai on Saturday, March 17.

• “Diabetes is a silent killer. More deaths occur due to diabetes than HIV/AIDS, malaria, and tuberculosis combined. India has the second largest population of diabetics (61.3 million) after China (more than 90 million).” - Dr. Gojka Roglic, WHO at the DRC Gold Medal Oration 2011 organized by M.V.Hospital for Diabetes, Royapuram.

• Interventional studies indicate that children who are taught at a young age about the need for a healthy lifestyle and good food habits remember what they have learnt and modify their lifestyle accordingly.

• Link between TB and Diabetes

In an unpublished study , researchers at M.V. Hospital for Diabetes , who had screened TB units in urban, semi-urban and rural areas found that 25% of TB patients enrolled in the revised national tuberculosis control program in Tamil Nadu are diabetic. The Kerala government has also found high occurrence of diabetes in TB patients.

As a result a study has been initiated where 2 centres in Chennai- Sri Ramachandra University and M.V. Hospital for Diabetes- will conduct a bi-directional study where TB patients will be screened for diabetes and diabetics for TB.

• FM salve for heart patients and Diabetics.

The budget may bring some relief to those suffering from heart disease, diabetes and other lifestyle disorders. Customs duty has been reduced and excise duty removed on blood pressure monitors, blood glucose meters, certain medical devices and stents.

Vitamin D, the bone builder vitamin has other benefits too!

Children who approach life with great enthusiasm and can learn new things and excel in them easily usually are those who have a variety of activities and also get sufficient Vitamin D in their diet and get enough exposure to sunlight.

Most mothers are aware of the fact that Vitamin D and Calcium are very important for their children for optimum growth of muscle and bone. Vitamin D is required for the absorption of calcium in the body and the best sources are milk, eggs, omega fatty acid rich fish and cod liver oil. In addition, exercise and outdoor activities are very essential for the bones to absorb vitamin D and calcium.


Other not very well known benefits of vitamin D is that children get fewer diseases, have stronger bones and muscles, and are less prone to depression , pain and inflammation.

Vitamin D also:

• Plays an important role in the absorption of calcium and phosphorus in the body and helps keep bones and teeth healthy and strong.
• Boosts immunity and prevents the development of autoimmune diseases.
• Is a very powerful anti inflammatory agent and can help reduce pain.
• Helps to reduce the risk of hypertension.

Children with lower levels of Vitamin D are more predisposed to diabetes.

Too much TV, too few outdoor activities and poor diets in urban lifestyles today are silently eroding health. All work and no play makes Jack a dull boy!

Sleep Deprivation and Weight Gain

Sheela Paul and Manonmani.S

-Dietitians, M.V. Hospital for Diabetes, Royapuram.



Most people live hectic lives trying to cope with all their responsibilities. Finding time for work, family, household chores, and recreation is so delicately balanced that many say... "Why waste time sleeping!"

Sleep deprivation has an impact on weight gain by increasing the levels of a hunger hormone and decreasing the levels of a hormone that makes one feel full which can lead to overeating.

Researchers have concluded that :

• People who sleep for only two to four hours every night are 73% more likely to be obese than those who get seven to nine hours of sleep.
• Those who get five or more hours of sleep at night are 50% more likely to be obese than those who get normal sleep.
• Those who sleep six hours are 23% more likely to be obese.
• Those who get 10 or more hours are 11% less likely to be obese.

Most people think that sleeping too much results in obesity, but that is a false notion.

Causes of poor sleep habits:


• An undiagnosed medical illness might cause poor sleep habits. Someone with an underactive thyroid gland, for instance, will feel fatigued and gain weight. And someone who suffers from sleep apnea will wake up repeatedly during the night.
• Physical problems including sleep apnea and diabetes awaken people from sleep. People with diabetes often have to make several trips to the bathroom during the night. Sleep apnea, often seen in overweight and obese people, is a condition of waking up repeatedly throughout the night.
• Coping with stress often results in many sleepless nights. People may eat to relieve stress.

How sleeplessness affects the appetite –

Sleep deprived people eat more because they're hungrier; they're awake longer and may be tempted by all types foods where ever they go. They often consume more calories than they burn in the extra hours they are awake.

The major activities of the body, including temperature regulation, hormone secretion, and brain chemistry production, run on a 24-hour cycle. In the absence of a regular sleep pattern, hormones that regulate the feeling of fullness or of hunger do not function properly, so all the normal signals for eating are changed.

Leptin and ghrelin are a kind of "checks and balances" system to control feelings of hunger and fullness.

Leptin, whch is a satiety or fullness hormone, is released by the fat cells. A high level of leptin indicates that the body has enough food, and the person feels full, whereas a low level points toward starvation and an increase in appetite.

Ghrelin is an appetite-stimulating hormone produced in the gastrointestinal tract. When ghrelin levels are up, people feel hungry.

When a person does not get enough sleep, leptin levels go down, which means that there is no feeling of satisfaction after eating. Lack of sleep also causes ghrelin levels to rise, which results in a heightened appetite.


The two combined, can set the stage for overeating, which in turn may lead to weight gain.

How does poor sleep affect choice of food?

People who don’t sleep well are often tired and fatigued during the day and they don’t always make healthy food choices. They may make the following wrong choices:

• A snack at bedtime to relax.
• A quick pick-me-up snack during the day when sleepy or fatigued.
• Relying on higher calorie comfort food when tired and sleep deprived.

While the obvious solution is to sleep eight hours each night, the real-life answer is not so easy. Here some steps you can take so that lack of sleep will not interfere with your weight-loss efforts:


• Try to set a regular schedule.
• Eat regularly — at least four to six times each day.


• Aim for seven hours of sleep.
• Make sleep a priority.
• Don’t use food to "wake you up."


• Always think before you eat and make healthy choices.
• Avoid junk food, which may be comforting, but will not help you much. If you feel like you need an energy boost, eat a piece of fresh fruit, half a sandwich filled with dhal and vegetables, low-fat yogurt, curd, hot soup, a handful of nuts, or roasted, or boiled sprouted whole grams.


• Try to reduce your stress levels by taking a 20-minute walk, and by increasing your activity of daily living. This can help promote a more restful sleep.
• Wear a pedometer and monitor your activity.
• Get up and move around to feel awake . Walking pumps oxygen through the veins, brain, and muscles.
• If working at a desk, get up frequently for short walks. It will make you feel more alert and refreshed.
• Don’t take a nap for more than an hour and not too close to your bedtime. It’s best to nap about six or seven hours before you would normally go to bed.


• Napping on the job can be touchy. Sleeping at your desk is usually not a good idea. If you can’t nap, rest with your eyes closed for 10 minutes.
• Watching a little less TV at night and get into bed earlier.
• See your doctor to rule out any medical illnesses contributing to lack of sleep and weight gain.

"More and more we have to realize that healthy eating, healthy sleeping and regular exercise are three important things that everyone should do".

PROBIOTICS FOR DIABETES MANAGEMENT

Probiotics for Diabetes Management

Mrs. Sheela Paul , Dietitian
Ms. Vimala , Dietitian
M.V.Hospital for Diabetes, Royapuram

Diabetes is an incurable but extremely manageable lifestyle disorder. Management of this disorder requires a flexible and active approach that involves drugs, dietary changes, lifestyle changes, and complementary therapies.

If blood glucose levels are uncontrolled, it leads to many secondary complications such as kidney failure, blindness, serious skin and foot infections, heart problems, birth defects, stroke, disability, and death.

People with diabetes are also prone to infections and stomach upsets.


Over the last decade, there has been a significant increase in research on probiotics.
Research studies published a year ago imply that probiotics may have a role to play in managing diabetes. One study has found that the bacteria that live in the digestive tract are significantly altered in people with diabetes (1).
Probiotics are live microorganisms thought to be useful to the host. According to the currently adopted definition by FAO/WHO, probiotics are: "Live microorganisms which when administered in adequate amounts confer a health benefit on the host organism". Lactic acid bacteria (LAB) and bifidobacteria are the most common types of microbes used as probiotics; but certain yeasts may also be used. Probiotics are commonly consumed as part of fermented foods with specially added active live cultures; such as in yogurt, soy yogurt, or as dietary supplements.

Why are probiotics good for health?

* Probiotics improve gut microflora, boost immunity, promote digestion, increase absorption of nutrients, increase production of biotin in the gut, improve synthesis of vitamins and essential fatty acids, and also prevent some bacterial and yeast infections.


* In recent research, probiotics have proved to be important in Type 1 and Type 2 diabetes. Type 1 diabetes is an autoimmune disorder. Probiotic supplementation was found to modify gut micro flora favorably, decrease oxidative stress, inflammation, and reduce intestinal problems.

* Lactobacillus acidophilus was given in the form of a supplement to people suffering from Type 2 diabetes which improved their blood sugar control. It was inferred that this improvement was the result of improved insulin sensitivity due to increased probiotic intake.

* Diabetic neuropathy, a secondary complication of diabetes, affects the functioning of the digestive system, because changes in nerve control of the small intestine cause diarrhoea. Probiotics can help control this condition.

* People with diabetes also tend to suffer from gastrointestinal problems like abdominal bloating and constipation, and infections like urinary tract infections, which can be easily prevented or managed by using probiotics.

* Expectant mothers given probiotics on a regular basis throughout pregnancy had reduced chances of developing gestational diabetes.

* Probiotic foods increase the absorption of calcium and prevent allergies. They also help in treating diarrhoea. If a pregnant woman consumes probiotic food for about a month before her delivery, this will help prevent the new born infant from contracting allergies to some extent. Also, if infants who are six months and older are given probiotic food, it helps to build their immunity.


* Probiotics make the gut environment acidic, which is not very good for the growth of pathogenic bacteria.

* There is a natural balance in the micro-organisms present in the stomach and intestines, which sometimes gets destroyed due to strong antibiotics or drugs, illnesses, excessive consumption of alcohol and even stress. Though antibiotics are prescribed for treating illnesses, their frequent intake can also destroy the good bacteria, which in turn can affect digestion and absorption of nutrients in the body. The long-term use of antibiotics can also prevent the replacement of these useful bacteria. Probiotics play an important role in supplementing the good bacteria in the body.

The Indian diet provides probiotics in the form of a variety of fermented foods. Fermented foods such as ‘idli’, ‘dosa’, ‘dhokla’, ‘curd’ and ‘kadhi’ are some of the lactobacillus fermented cereals and legumes that are commonly consumed in India. They are known to possess health benefits because they enhance the nutritional quality of foodgrains. Fermented foods increase the absorption of vital minerals from the gastrointestinal tract, thus preventing mineral deficiencies. Bread, ‘appam’, wine and beer are some of the yeast-based fermented foods and beverages.





A normal healthy person can consume a daily dose of probiotic food containing about two million live organisms.

People suffering from long-term illnesses like cancer or diabetes must consult with their doctors before regularly incorporating probiotics in their diet.

Having too much of anything is bad. Sometimes, excessive intake of probiotics might result in indigestion and bloating. This differs from person to person. While buying specially manufactured probiotic food, check the expiry date, because in outdated products, the live organisms will remain ineffective.

Things to Remember while Using Probiotic Therapy

● Probiotics are not a cure for diabetes, they can only help in the management of the health condition.
● Always consult your doctor before introducing any new probiotic product or supplements in the daily diet.
● Monitor blood glucose levels regularly.

1. Larsen, N., F. K. Vogensen, et al. (2010). "Gut microbiota in human adults with type 2 diabetes differs from non-diabetic adults." PLoS One 5(2): e9085.

Research on Diabetes

India, China and the United States are estimated to have the highest number of people with diabetes. Apart from environmental factors that contribute to Type 2 diabetes such as obesity , smoking , sedentary lifestyle, and certain drugs; genetic factors also play a role in the onset of this disease.



Department of Biochemistry & Molecular Genetics, Prof. M.Viswanathan Diabetes Research Centre & M.V. Hospital for Diabetes has researched diabetes from a genetic perspective and has found that there are changes in some genes in diabetic individuals. The information from these studies could be used for identifying precursors to diabetic conditions or its complications and people at risk could be assisted before the disease strikes or gets more acute!



Heat Shock Protein-70 (HSP70) a protein which is very active in the immune system is suppressed in people with diabetes because of cellular stress. Western studies have reported the association of this gene (HSP70) in diabetic individuals through its effect on insulin sensitivity.

Our researchers studied this effect on T2DM and its complications among South Indian population and have found the mutation of this gene in T2DM and in those with both micro- and macro vascular complications.

This novel gene could be used as a marker to identify people with increased risk of diabetes and its complications and take precautionary action at an early stage.

STRE in the LASY promoter region is important for the synthesis of Lipoic Acid Synthase gene which produces Lipoic Acid that acts as an antioxidant. Under normal conditions, Stress Response Element binds to STRE site and helps in the production of antioxidant enzymes such as Catalase LASY which helps to control oxidative stress.

Our researchers have found that in the case of T2DM with complications- neuropathy, nephropathy or retinopathy, this enzyme production is reduced due to single nucleotide polymorphism.

This provides vast scope for further investigation into the use of this information in treating complications of diabetes.

Dhamodharan U, Ezhilarasi K, Parthiban M, Indira Padmalayam, Rama Rajaram, Vijay Viswanathan

(Department of Biochemistry & Molecular Genetics, Prof. M.Viswanathan Diabetes Research Centre & M.V. Hospital for Diabetes in collaboraton with Department of Biochemistry & Biomaterials, Central Leather Research Institute , Adyar, Chennai.)