First Eat Right - Dietitian Nutritionist Dr. Nafeesa's Diet & Nutrition Clinic

Mom, dad, grandma and grandpa who were our superheroes and superwomen in our lives suddenly become a burden and an excess baggage that most children are ready to throw away. We hate our grandpa requesting us to read out his passbook account number due to his ageing vision, we dread our grandma starting tales of her younger life time and again and pray that our parents don’t ask us to spend a weekend together with them trying to relive olden golden days. A hearty welcome to all of you who have either been accepting this nodding your heads vigorously or dismissing all/any of these with a broken heart. Today is International Day of Older Persons-a great opportunity to correct our harsh attitudes towards the ageing generation and surround them with warmth and regards.
​
There are more than 700 million people over the age of 60 living across the world most of them suffering from physical pain, emotional trauma or both together. Time is not far away (estimated to be 2050) when more than 20% of the world’s population would be those above the age of 60. Developing countries face maximum growth in the number of elderly persons with Asia topping the charts. 

International Day of Older Persons
United Nations started embracing a day to celebrate the existence of the elderly population in the 1990 and ever since that, Oct 1st is designated as the International Day of Older Persons. The theme for 2018 is “Celebrating Older Human Rights Champions” and this theme aims at glorifying our older heroes who dedicate their lives trying to improve human rights.
​
This is a day to stand against ageism and bring about a social change in the society to make this world a better and comforting place to people across age groups. This also gives us an opportunity to reflect on the complications and struggles of ageing in today’s world. The World Health Organization (WHO) defines ageism as the stereotyping, prejudice and discrimination towards people on the basis of age. It can also be termed as ‘age discrimination’ when someone treats you unfairly because of your age. Highly prevalent among societies, ageism is largely accepted and remains unchallenged (unlike racism or sexism) as people subconsciously accept it and move on. It would be better if we remember that aged people love to grow home in the comforts of their home rather than being shifted to community centers. Ageism, its disadvantages and the society’s view are clearly elaborated in the website www.firsteatright.com. 

Older people are an asset to this world. Their value-system, experience, versatility and wisdom are unmatchable attributes that help in guiding the younger generation. But, to use these attributes efficiently we must ensure to take good care of their health, both emotional and physical. Healthcare facilities in every country are obliged to offer excellent facilities to our older generation. These people are generally prone to communicable diseases but also suffer from non-availability of health insurance coverage which makes the younger generation treat them as a burden in life. Governments are also responsible for establishing suitable healthcare facilities and policies to keep the elderly generation healthy and able. Individuals too are equally responsible for taking good care of their aged parents, attend to their requirements and make them as comfortable as possible with the resources available. After all, didn’t our mom and dad sacrifice their needs to satisfy our desires? Please think over it, reconcile your views on their inabilities and treat them as your children in their old age. Give back your precious time and efforts to bring about a smile on their face, eat meals together, take your ageing parents on a holy trip, allow them to play freely with your children without imposing a list of do’s and don’ts (after all, what harm does a little pampering cause anyways) and above all, pamper them with abundant love and affection. Us this day as an opportunity to correct your attitude and thank your elderly population for all they have done.

The roaring thunderous noise alighted from one corner of the classroom and the entire bunch of students started to laugh uncontrollably at one individual. You guessed it right-he farted! History has always used flatulence/farting as a piece of comedy or as a representation of humor in books and magazines. Flatulence is normal, common and nothing to worry about mostly.
​
Farting
Flatulence, farting or wind is the act of passing gas from the digestive system through the anus. We do pass gas through the mouth, but this is called as burping or belching. While we think than flatulence is rare or confined to certain individuals, the truth is that everyone has gas and most of us pass gas between 5 and 15 times daily. It is something regularly experienced by everyone with only numbers, characteristics and intensity varying from individual to individual.

The word is derived from the Latin word ‘flatus’ meaning a blowing or breaking wind and there is an entire area of study dedicated for this known as flatology. While it is common for individuals to fart, it varies from individual to individual in terms of volume and frequency and smell that can vary in concentration depending on the individual. Some people pass gas which goes unnoticed or pass healthy gas that is harmless without odor.

Although purely biological, this process is often laughed at which can make the person feel embarrassed and guilty when he/she is present among others. Lifestyle changes, diet modifications and exercise can control flatulence.

Science of Farting
Along with the food, water and saliva that we swallow, we also gulp in small quantities of air that gets accumulated in the digestive tract. Trying to digest food can sometimes cause gases to build up and our body struggles for a way out to expel these unnecessary air and gas. Farting or belching is the answer to our struggle.
​
Hydrogen, methane and carbon dioxide are the main gases released during digestion that cause no odor. Most of the time we don’t realize passing wind as these gases are mostly odorless and released in small quantities. But sometimes, there is a bad smell due to the presence of gases such as Sulphur that crop up when we eat foods that are difficult to digest. The excess smell might also indicate an underlying health condition or might be the side effect of medications such as non-steroidal anti-inflammatory drugs (NSAIDS), laxatives, antifungal medicines and statins.

Some Do’s and Don’ts to prevent the occurrence of excessive or smelly fart include:
Do

• Eat smaller meals frequently
• Take time and chew your food
• Exercise daily to aid faster digestion
• Eat a well-balanced diet
• Drink peppermint tea
  ​

Don’t

• Wear loose-fitting dentures
• Chew gum, smoke or suck pen tops or hard sweetmeats as these can pave way for more air to enter your mouth
• Eat too many foods that are difficult to digest
  
  

Foods to Avoid
When we say that certain foods can enhance farting, there must be a solid reason behind this. Closely observing these foods shows that foods causing flatulence are usually those high in certain polysaccharides (especially oligosaccharides) such as inulin. Examples of such foods include:

• Cabbage, broccoli, Brussels sprouts, cauliflower, pulses, dried fruits, onions, turnips and garlic
• Cereals such as wheat or oats
• Dairy produce
• Nuts such as cashews
• Dairy produce when an individual suffers from lactose intolerance
  
  

Beans: The tiny kidney bean or the chick pea serve as a healthy treat in sabjis or when boiled and consumed as a snack. We don’t realize their effects until after some time when the complex carbohydrates start showing their power. The microorganisms in the gut called as the gut flora that produce methane digest these beans. Once the CO2 reaches the lower intestine bacteria feed on them and produce gas.

Lactose intolerance: When people with lactose intolerance consume milk or other dairy products that contain lactose but lack the enzyme to break it down, the bacteria feed on the lactose. This can lead to gas production in these people.

Artificial sweeteners: Sorbitol and similar sweeteners are found in candies, chewing gums and other sugar-free sweets which can cause some people to develop diarrhea, gas or both.

Fizzy drinks: Carbonated drinks and soda can cause a build up of gas in the intestinal tract.

Farting Due to Health Conditions
Certain health conditions that can cause flatulence include:

• Indigestion
• Constipation
• Irritable bowel syndrome (IBS)-Stomach cramps, bloating, diarrhea and constipation that comes and goes
• Celiac diseases-Intolerance to a protein called gluten found in wheat, rye and barley can cause indigestion, constipation, diarrhea and stomach pain. Gluten intolerance can affect a person seriously when he/she consumes food containing gluten. Read more on gluten intolerance and the list of foods that must be avoided to safeguard yourself from celiac disease from the website www.firsteatright.com.
• Lactose intolerance
• Gastroenteritis which is a stomach and bowel infection
• Giardiasis-infection of the digestive system caused by tiny parasites
  
  

Treatment
Changing your lifestyle and eating healthy food can help in controlling flatulence but it is better to visit a GP if you lose weight without any reason, notice bloody stools, repeatedly get constipation or diarrhea or have constant stomach ache/bloating. The GP might suggest charcoal tablets or clothing containing activated charcoal to reduce the effects of foul smell released during flatulence. The charcoal tablets are suitable only if the individual does not consume any other medication as charcoal has the tendency to absorb the medication and make it less effective. Probiotics might also be prescribed to reduce flatulence as the friendly bacteria aid in digestion and reduce the symptoms of farting. 

Cardiovascular disease is the world’s No.1 killer today taking lives of more than 17.9 million people amounting to 31% of all global deaths (WHO). Our heart is where our life is. Any problems to the heart and our life is doomed. One might go heartbroken over relationships which can be mended to a certain extent but suffering from a troubled heart due to diseases and health conditions puts a person’s whole life at risk.
​
Noncommunicable diseases (NCDs) are those that are not the result of an infectious agent but long-term chronic diseases that are the result of genetics, physiological, environmental and behavioral factors. Cardiovascular diseases (CVDs), cancers and diabetes are all NCDs, but CVDs top the list accounting for nearly half of all NCD deaths. Taking all these into concern, in the year 2012 countries across the world decided to slash down mortality rated from NCDs by 25% by 2025.

World Heart Day
The World Heart Federation (WHF) created the World Heart Day in the year 2000 with the aim of creating awareness among people about the grueling effects of CVD, its heavy toll on human life and suggesting various changes that every individual can implement in his/her life to avoid/control CVD. Various banners, posters, leaflets, logos and guidelines are distributed, events are organized and landmark buildings are flashed with red light to highlight the importance of this day. Families, individuals, communities and governments participate in these campaigns uniting as one world fighting against the deadly effects of CVD inspiring each individual to take a step forward towards better heart-healthy lives.

Decrease Intake of Certain Foods, Increase Longevity
This World Heart Day, why don’t all of us make a promise to live a heart-healthy life? The WHF lays down a simple promise…for My Heart, for Your Heart, for All Our Hearts. Use this day as an opportunity to start cooking healthy food, eating nutritiously, staying active, helping children to play outdoors frequently, quitting smoking and helping your loved ones too quit smoking.
​

1. Eat five portions of fruits and vegetables daily
2. Swap out salty and sugary foods and bring in healthier ones such as cut fruits, whole grains, nuts and dairy
3. Cook at home and eat as much as possible
4. Do physical activity for at least 150 minutes five times a week
5. Play with children, involve elders in your activity time and engage in interesting ones such as football, gardening or dancing.
6. Quit smoking. This is the best of your things that you could pursue. In a few years down the line the risk of CVD decreases to that of a non-smoker
7. Minimize stress by doing meditation, yoga and other stress-relieving activities listed at www.firsteatright.com.
   
   

To those unaware, 75% of CVD deaths occur in low-income and middle-income countries and 85% of all CVD deaths are due to heart attacks and strokes. Such negative consequences can be curbed and people’s life improved only if all of us work together towards betterment in our lives and others lives as well. Let’s make utmost use of the world’s biggest awareness-raising platform for CVD and improve our heart-health standards.

Knees are pivotal for balancing our entire body in a stable way and is a joint that causes problems/pain in most people, especially the female population. All of us experience knee problems sometime in life and most of these problems are due to everyday wear and tear, overuse or injury which happen mostly due to recreational activities, work-related tasks or home projects. In general, knee buckling is a problem that can strike anyone at any age.
​
Knee Buckling
Knee buckling is when one or both of your knees give away when you try to bear weight on your legs. Also called as knee instability or weak knees, it can be accompanied by pain, but this is not mandatory. Most individuals would have experienced this once or twice in life, but it could be due to some other reason, maybe you just tumbled over! When it does happen frequently, it becomes a case of serious concern.

Know Your Knees
Our knee is the largest joint in the body and this makes us even more responsible for safeguarding it nicely! But often our knees succumb to too much body weight due to obesity/overweight and give away. Staying on a healthy weight is essential to maintain overall health and it is high time to get in touch with an RDN at www.firsteatright.com to lose weight. The knee connects the thighs and the legs and consists of two joints. It also has 4 bones-the femur, tibia, fibula and patella-all of which are functional in the knee joint except the fibula. One knee joint (tibiofemoral joint) is present between the tibia and femora while the other joint (patellofemoral joint) is present between the femur and patella. 

The femur is the longest and strongest bone in the human body. The upper and lower bones of the knees are separated by two discs called menisci. These menisci consist of connective tissue with extensive collagen fiber containing cartilage-like cells. There are also tendons (these connect leg muscles to knee bones), ligaments (connect knee bones together) and muscles connecting the upper leg bone (femur) and the lower leg bones (tibia and fibula). Cartilages are elastic tissues that help the joints slide smoothly over each other and pave way for flexible knee movement. The bone surfaces inside the knee joint is covered by cartilage which ensure these functionalities (flexible movement and shock absorption).

Causes
While a knee problem is mostly due to an injury, there might also be other reasons such as job, sports and recreation activities, old age or the presence of diseases such as osteoporosis and arthritis that increase your probability of a knee injury. Most individuals too associate knee buckling with osteoarthritis but there is a study which disproves this! This study showed that more than 50% of the people complaining of knee buckling did not show any signs of arthritis in the X-rays.

Knee consists of joints, tendons, ligaments, bones and muscles, each doing different functions to enable proper functioning of our knee joint. Damage to any of these parts or a combination of both, an injury and damage to any of these parts can cause knee buckling. Other important factors that contribute towards knee damage include:

1. Arthritis that can lead to extreme pain in the knees and cause unstable joints. Wear and tear of cartilages, diseases and injury can cause arthritis.
2. Torn meniscus, ACL tear or fragments of bones/cartilages floating within the knees or trapped between bones
3. Dislocation of the kneecap
4. Ligament tear that normally occurs due to some hard-hitting object on the knee or a sudden twisting motion
5. Inflammation of the medial plica (a fold in the middle of the membrane covering your knee joints) causes Plica syndrome which can also cause clicking sounds in your knee, pain on the inside of your knee and pain/tenderness in your knee cap.
6. Multiple sclerosis can also cause knee buckling in some people. Multiple sclerosis causes the immune system to attack the central nervous system.
7. Femoral nerve is one of the two main nerves in your lower leg. Dysfunction of the femoral nerve (femoral neuropathy) can weaken your knees and cause knee buckling.
   ​

Treatment
Exercise is the main treatment offered for knee buckling. Specific exercises help to strengthen the leg muscles, improve knee stability and provide flexibility, all of which help to minimize/prevent knee buckling. A physical therapist devices certain sets of exercises depending on the person’s problem. While the therapy can be for anywhere from 1-4 weeks, patients are recommended to continue all exercise henceforth to prevent further pain and problems. Initially, the patients might find it difficult to follow these exercises, but slowly build up strength and flexibility in their legs and knees. Instead of doing this, some people start limiting their activities, reduce their walk timings, go out less-often and even stop doing physical activity which can lead to even more damage.

Other treatment options include rest, compression, ultrasound, support in the form of braces, bandages and tapes, medications or surgery. Changing your lifestyle for the better such as losing excess weight, avoiding stairs and making use of lifts, ramps and escalators and making use of canes to assist walking can also help individuals go easy with knee buckling.

It is better to meet a physician if you experience pain, swelling in the knees for more than a couple of days, walking difficulty, clicking sound with pain, fever or limitations in your routine activities along with knee buckling.