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Holistic Clinical Nutrition: Transforming Thyroid, Diabetes, and Cardiovascular Health in a Family Through Customised Dietary Interventions.

CASE STUDY & SUCCESS STORIES


Name: Keerthi, Venky & Manjusha

Age: 28, 68 & 56 years

Location: Vijayawada


Case History: Keerthi, a 28-year-old student, was diagnosed with thyroid dysfunction and was undergoing medication for the condition. She had a history of an accident, which resulted in persistent pain in her left leg near the leg and foot joints. Her blood reports indicated elevated erythrocyte sedimentation rate (ESR), suggestive of inflammation, hyperplastic obesity, low haemoglobin and low normal iron levels. 


Additionally, she exhibited thrombocytosis, possibly linked to elevated thyroid-stimulating hormone (TSH) levels. A urine analysis also revealed haematuria. Consequently, she sought a comprehensive plan to reduce weight, enhance physical activity, manage her weight, balance her thyroid levels, and curb snacking habits before and after meals.


Being an informed health seeker and a caring daughter, Keerthi was also concerned about her parents. Her father, Mr.Venky, a 68-year-old retired professional, had been diagnosed with gout and experienced difficulties with walking, excessive sweating, and severe breathlessness while even leisurely walking. Regular activities, such as cleaning the car, had become challenging due to excessive sweating, breathlessness and occasional loss of consciousness. His blood reports revealed hyperplastic obesity, elevated erythrocyte sedimentation rate (ESR), suggestive of inflammation, high cholesterol, and LDL levels, indicating a risk for cardiovascular disease. Additionally, he had low normal iron levels, high vitamin B12 levels, and non-alcoholic fatty liver disease (NAFLD), suggesting a risk of liver inflammation. He also exhibited high TSH and low T4 levels, possibly due to nutritional deficiencies. Consequently, he sought a comprehensive plan to reduce weight, improve his ability to walk without heavy breathing, reduce snoring, and curb midnight snacking.


While her mother, Mrs. Manjushah, a 56-year-old homemaker, had been diagnosed with type II diabetes and was taking medication for it, she complained of shoulder and knee pains. Her blood reports revealed hypertrophic obesity, HbA1c levels of 6.3%, fasting blood sugar of 274 mg/dl, and postprandial blood sugar (PPBS) of 165 mg/dl, indicating uncontrolled diabetes. A urine analysis indicated glucose in the urine culture, suggesting glucosuria. Her reports also showed an elevated erythrocyte sedimentation rate (ESR), indicating inflammation, normal low iron levels, and low normal albumin, indicating protein malnutrition. Consequently, she sought a plan to reduce weight, control sugar levels, and alleviate pain.


Approach by the best nutritionist/dietician in Hyderabad, Telangana, India, Deepika Chalasani:


As all three family members wanted to start their nutrition program simultaneously, it was imperative to address their individual medical conditions without having three separate food lists, which would be challenging to manage long-term. We incorporated food items that all three liked, making up 80% of the meal plan, with portions tailored to their blood reports. The remaining 20% included their individual preferences. Since Venky had higher uric acid levels, he could not have red meat, while Lakshmi and Keerthi needed red meat to improve their vitals. Therefore, the protein portions were different for two days each week. As a young girl, Keerthi enjoyed cakes, pasta, pizzas, etc., so we included these foods in her plan on specific days, ensuring the rest of the meal items were common to all. Her favourite meals were included once a week to satisfy her cravings.


After analysing their dietary recall and lifestyle, we observed that some foods were consumed at inappropriate times, potentially leading to imbalances in sugar levels. Their diet was low in complex carbohydrates, protein, dietary fibre, pro, and prebiotics. Since the family consumed the same meals, we carefully crafted a customised plan for them, making minor adjustments to ensure easy adaptation and adherence. The plan catered to their specific dietary needs and health conditions.


To address their needs, we ensured they received high-quality protein sources such as eggs, chana, chole and fish to promote satiety and manage weight. We incorporated complex carbohydrates like various millets, green roti, hand-pounded rice, and ample cooked vegetables in innovative forms to meet their dietary fibre and micronutrient requirements, supporting their health goals. We provided them with healthy snack options such as fresh fruits, nuts, seeds, and weak buttermilk in the evening to prevent hunger pangs and offered structured guidelines and plans for food selection.


Venky struggled with drinking water, often experiencing severe nausea. He typically consumed only 3 to 4 glasses daily, far below the recommended 3 to 4 litres. We educated him on the importance of water for boosting his sluggish metabolism and promoting fat mobilisation. We then coached him to start with a few sips every 30 minutes, gradually increasing to half a glass. Over time, he successfully learned to drink 3 litres of water daily.

Given their preference for South Indian foods, we incorporated them into the plan with improved combinations and healthier versions, such as pesarattu/lobia dosa, quinoa, and hand-pounded rice with abundant vegetables and proteins. Additionally, we recommended a suitable exercise regime for them to gradually incorporate into their routine. Continuous monitoring and guidance were provided throughout the process.



Results:


Within five months of following the plan, there were significant improvements in their health parameters and blood reports. Keerthi's weight decreased from 78 to 68 kg, her TSH levels decreased from 8.57u IU/ml to 3.5 u IU/ml for the first time in 10 years, and her vitamin D levels improved from 18.5 ng/dl to 49.2 ng/dl. She also registered in a gym and enjoyed a variety of workouts, including Zumba, CrossFit, and strength training. Venky's weight decreased from 105 to 90 kg, his total cholesterol levels decreased from 240 mg/dl to 225 mg/dl, and his ESR decreased from 20 mm/hr to 17 mm/hr. He was able to walk without difficulty. Initially, he was only walking steps through the day, not exceeding 5000 steps, and later, 10000. He was walking up and down the stairs of his house once in the morning initially and later 2 to 3 times a day. Manjusha’s weight decreased from 68 kg to 64.9 kg, her albumin levels improved from 4 g/dl to 4.75 g/dl, her iron levels improved from 55 to 96 ug/dl, and her fasting blood sugar levels decreased from 274 mg/dl to 132 mg/dl, with no glucosuria reported, For Manjusha it was household chores as lifestyle movements and walking out of comfort zone for 40 minutes a day in HIIT format. They are now able to manage their health with natural and homemade food.


Deepika Chalasani is a Clinical Nutritionist, Mind and Body Transformation Coach and co-founder of Fit4Life India, an integrated nutrition and wellness organisation for Indians that provides complete solutions, addressing health and wellness challenges of individuals by working on their overall well-being. Deepika, the best nutritionist in Hyderabad for weight loss and online dietician, can be contacted via email deepika.chalasani@gmail.com or Mobile +91 9381525943


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