Heart Health | deepikachalasani

Heart attacks are increasingly becoming common and even people in their 20s are falling prey to them. Heart Disease has become the No. 1 killer with about 25 % of medically certified deaths in the age group of 25 to 69 being attributed to it. Telangana leads with 51% of heart diseases in overall India.

Look beyond the LDL

People above 40, especially those with a family history of heart attacks, and many employers are concerned about the increasing incidence of heart diseases. This goads them into getting regular blood tests, which can reveal a lot about their heart health if interpreted properly. But most of the time, the spotlight is on LDL Cholesterol and Fasting Blood Sugar (FBS), which are controlled, if necessary, with pills and cursory advice to improve the lifestyle. The Pills and lifestyle changes done proactively can protect the heart from diseases. Taking action after LDL and/or FBS are out of healthy range is like locking the stable after the horse had escaped because a lot of irreversible damage might have taken place by that time. The time for action is when TG/HDL ratio, a surrogate marker for insulin, is more than 1.65 in women and 1.74 in men. The high TG/HDL ratio precedes the high LDL/FBS by a decade or so. High insulin in the body increases the triglycerides which further leads to increase in the LDL at a much later date. But by then fat accumulation in the arteries and heart has already taken place. People with high LDL should get their APO B checked, as high APO B is an indication that the small dense LDL predominates, which is a bigger risk for heart problems than the large dense LDL.

APO (a): APO (a) is another test that is useful for people with a family history of heart problems as it indicates a genetic predisposition to heart problems. The test needs to be done only once in a lifetime as the score does not change. Genetic predisposition does not mean one should lose hope. LDL, APO (B), and triglycerides can be controlled with nutrition, lifestyle changes, and physical activity and therefore proactive action is necessary to be taken at the correct time.

Calcium in Arteries and Heart:

Coronary Artery Calcification Score (CAC): CAC test, which often is a neglected part of heart care can be useful in predicting future heart problems and cerebrovascular diseases (brain stroke), especially in those who are above 40 and have a healthy lipid profile. This test indicates the calcium deposits in the arteries, which also indicates calcium deposits around the valves of the heart.

Insulin resistance(IR):
The food we eat comprises largely of three macronutrients – carbohydrates, proteins, and fats. These convert in the body to glucose (sugar), amino acids, and fatty acids, respectively. The composition of the food we consume in a meal can make our body insulin-resistant depending on our body type. Most Indians fall into the category of insulin-resistant body type. When the body is insulin resistant, the muscle cells are not receptive to the glucose, so, it is diverted to fat cells causing fat accumulation which shows up as high triglycerides, first and after a decade or so as high LDL.

Note: Most insulin-resistant body types in India fall into the normal BMI category. Obese people have a higher BMI while TOFIs (Thin outside fat inside) have a lower BMI. Such body types, at least initially, have fat only around the belly or abdomen.

Tame the Insulin Spike:
Indians generally believe that they are eating healthy. In common perception they eat food that is light for the body, which comprises largely of quick-digesting refined grains throughout the day, causing insulin spikes and dips. Indians eat the least amount of fat but have one of the highest fat percentages in the world. Because it is not the fat in the diet that puts on fat; it is the insulin spike that puts the body in the fat storing mode. There is a French dish that requires the fatty liver of a duck. To get it, ducks are force-fed with refined grains and not fat. Quick-digesting carbs like white rice / rotis made of super-fine atta are devoid of fiber and good fats cause insulin spikes. So, eating least processed grains like brown rice / coarsely ground chakki atta, along with sufficient vegetables, adequate protein in every meal, and good fats is a rational way to prevent fat accumulation.

Lifestyle changes:

Time-restricted eating (TRE) makes the body to survive on its fat. TRE means having two Meals and a Snack in an eating window of 10 to 12 hours and fasting of 12 to 14 hours without any nibbling in between the Meals. However, it is sustainable and healthy only with meals that do not spike insulin. They include Cell-wall-intact carbs like vegetables and whole grains; non-fattening proteins like grass-fed meat; casein-rich dairy protein like Paneer, and Hung curd; and non-inflammatory fats like Ghee, Unrefined oils, etc. TRE not done with fat-burning foods further increases the problems like back pain, by pushing health parameters into the unhealthy zone.

Physical activity:

If an adequate and balanced diet is the food in the pot on the stove, exercise is a spark that lights the stove. Both are required to keep the body healthy. Putting the food in the pot and not lighting the stove leaves the food uncooked, whereas lighting the stove with the empty vessel on it burns the pot in this case. Adequate physical activity is essential for maintaining the good health.

Cardio-Respiratory Fitness:
A healthy CRF is a key to preventing heart disease. It can be improved by doing physical activity outside of the comfort zone for 30 to 40 minutes a day. You need not have the highest CRF in order to protect your heart. Improving CRF from present to next stage is sufficient to give all the benefits enjoyed by person having highest CRF. Fitbit or any activity tracker can show your CRF on a daily basis which can serve as a good investment for long term health.

Our Support:

To provide nutrition support that is sustainable with a structured program to monitor and motivate
Lifestyle changes are often difficult as you have acquired the taste of food which started while you were in your mother’s womb. Also FAMILIARITY is one of most basic instincts of human being and CHANGE is often out-of-comfort zone. Therefore the transition to a new lifestyle is designed through a structured program that supports your mindset and a pace of change that you can handle.
To Provide
- coaching to re-look at limiting beliefs & pace the lifestyle changes to suit your comfort
- real time support that help make quick modifications to make our program effective
- practical approach & modifications that suit your current life context of work, family priorities etc.
- dishes that suit your palate to make it sustainable
- inclusion of your favorite foods to ensure balance of health and pleasure
- energy and fitness, gastrointestinal health & overall well being
Recommendations of appropriate physical activity and monitoring are the part of our program
Monitoring your blood reports to ensure the lifestyle changes you have made are adequate and supportive of your inner health and recommending suitable modifications to support the results as required.