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

Obesity has become a grave problem, just like diabetes or heart disease. It is one of the costliest and devastating health problems and can leave us deep down the dumps if not treated immediately. An effective treatment plan by primary care providers is problematic sometimes, as they are challenged with delivering appropriate treatment counseling in a limited time frame.
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Although lack of time is the most-quoted reason for ineffective weight counselling, there is not much proof supporting that more time beyond the usual 5 to 10 minutes of counseling is advantageous. The tragic part in such counseling sessions is that, physicians recommend clients to eat less, move more and lose weight (obese patients have come to the physician in the first place to lose weight!) and this is not going to serve any purpose. For instance, when a client approaches a physician for obesity treatment and the physician sends him/her off with one small phrase of ‘We will do it’, what is the outcome? It is no better than telling a person with depression to ‘cheer up.’

Let Go of the Conventional Idea
Even physicians speak with a mindset that obese people are lazy people who eat too much without any willpower to maintain a healthy diet. Hence, they tend to spend minimum time and speak very little to discuss effective treatment options for patients with obesity.

Weight loss is a difficult but feasible process which poses challenges, both for the patient and the physician. When chemotherapy or insulin injection is not effective on a client we never blame the client but the treatment! But in the case of obesity treatments, it is almost always the client who is blamed for lack of results. We need to understand that obesity is a complex process that involves genetic, developmental and environmental factors as well, along with the client’s effort. Don’t assume falsely that these factors will prevent weight loss, but only try to understand that sometimes we need to work harder to get our perks.

Obesity is not a lifestyle choice but a dysfunction of a highly regulated system. Positive ideologies and proposals encourage clients to work more towards their goal rather than demotivating them using pejorative words that may burn their intentions.

Explore Different Options
While we know that a 5-10% loss of body weight can decrease the patient’s risk of chronic diseases, not every patient’s body responds in the same way.

Patients who do not respond positively to behavioral modification can be subjected to lifestyle interventions. Morbid obesity cases are mostly treated with bariatric surgery which can assure the client of a 20-35% body weight loss after 1 year. It is always better to remember that one size does not fit all. Similarly, one diet or lifestyle change is not effective for all people with obesity.

The effectiveness of the treatment depends on how we treat the patient with excess weight and be compassionate about their condition, similar to the way we treat patients with other health problems. While a 20-minute counselling session with a registered dietitian nutritionist may not solve your problem, it can be a fresh start to a long process of weight loss journey. To get in touch with reputed RDNs to lose weight in a healthy way and stay fit, please visit the website www.firsteatright.com.

A fracture is a broken bone and the bone might be completely or partially fractured depending on the cause most frequent of which include accidents, falls or sports injuries. Fracture can be of many types and one of them is hairline fracture.
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Hairline Fracture
Tiny cracks on the bone that develop on the foot or lower leg (less commonly on the upper limb) are called hairline or stress fractures. This happens mostly due to overuse or repetitive jumping/running actions performed in sports events which is in direct contrast to larger bone fractures that occur due to conditions such as a fall or an accident. Hairline fracture is common in those individuals who are seriously into physical activity and who do repetitive movements that can put a strain on a bone or a group of bones. While they are hard to find out initially, the pain starts slowly but develops over time into an intense one.

Causes
Bones are rigid but do have a certain degree of elasticity beyond which they break (just like our ruler scales). They can withstand some of the impacts that activities such as walking, jumping or running have on the bone. But over time the impact can result in cracks in the bone called as hairline fracture. A classic example is a long-distance run that can strain the lower leg, foot and ankle in course of time which in sometime can develop into hairline fracture.

Risk Factors
Sports such as basketball, tennis, ballet, football or rugby, soccer, hockey, ballet and field/track sports are significant risk factors for a hairline fracture. Even if the person is performing the same activity if the duration, frequency or intensity of the activity changes it can pave way for a hairline fracture. One must also remember that these injuries can occur irrespective of the physical activity performed. Factors that increase the risk of a hairline fracture include:

1. Gender plays an important role as hairline fractures are commonly observed in women with irregular menstrual cycles
2. Flat feet or high arches can increase risk
3. Conditions such as osteoporosis
4. A previous hairline fracture that makes the bones susceptible to repeated fracture
5. Diets lacking in important nutrients such as calcium and vitamin D essential for bone health
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Symptoms
While a severe fracture sends a seeping pain throughout the body, hairline fracture symptoms are different. The pain here intensifies as a person engages in regular activities that strains the injured bone affecting a person’s mobility. Other common symptoms include swelling, bruising and tenderness.

Diagnosis & Treatment
The physician does a physical examination looking out for the person’s reaction when he/she applies pressure on the affected area. Further confirmation is done with the help of an MRI or X-ray. While a hairline fracture is a minor complication leaving it untreated can lead to a non-union fracture.

Most hairline fractures heal by themselves when the person doesn’t apply strain over the affected area and refrains from using it for any activity. For up to 48 hours the patient is suggested to elevate the affected area and treat it with ice whenever possible. Once pain starts decreasing in a course of a week or two it is suggested to reintroduce weight-bearing activities. Never involve in any sports activities during the recovery process which takes anywhere between 6 and 8 weeks. The doctor might suggest using a protective footwear, splint or crutches to minimize the strain applied on the fractured bone during movement. In extremely rare cases, a surgery might be suggested.

Prevention
Hairline fracture is impossible to prevent in those engaging in frequent sports activities or suffering from conditions such as osteoporosis. Generally, the risk of hairline fracture can be reduced by:

• Eating a well-balanced healthy diet that includes the required quantities of calcium and vitamin D. Getting in touch with registered dietitian nutritionists at www.firsteatright.com can help you plan your diet chart keeping in mind your list of illnesses or diseases, if any.
• Resting enough between exercise sessions and not ignoring pains associated with exercises seeking the advice of a medical professional immediately
• Gradually increasing the duration, intensity and frequency of activity rather than suddenly over-doing some exercise
• Supporting anatomical abnormalities such as flat feet by wearing insoles

A menstruating woman is like a boiling pot ready to explode with emotions. It is not the woman but her hormones that are to be blamed for this! How about coming across a group of women who menstruate at the same time? It might seem highly unlikely but it does indeed happen in every part of the world unofficially termed as ‘period syncing.’ Quite new to many, this term has been highlighted in many of our web series enlightening people’s knowledge about synced menstruations. For those unaware, period syncing is a term to define women who spend more and more time together that they start menstruating on the same date every month.

The McClintock Effect
Though the idea of period syncing was passed on from one generation to the other (great grandma to grandma, grandma to mom, mom to child and so on) the theory was conceptualized way back in 1971 by a researcher named Martha McClintock. The study conducted on 135 women who lived in a dormitory for a period of over 6 months was published in the reputed journal ‘Nature.’ The study found a definite synchronization among roommates and groups of women who identified each other as their closest friend than among random pairing of women-while the difference in period start day was almost 6.5 days apart in these besties and it was reduced to less than 5 days at the end. Though the researcher did not give scientific explanations backing the theory, the most prevalent theory was that it was an evolved strategy for preventing women from becoming a harem for a man (https://www.bbc.com/news/magazine-37256161).

Period syncing was also called as the ‘McClintock Effect’ named after the researcher and this study was quoted often until 1978 but a researcher in 1992 pointed out serious mistakes in the study. Replication of the study often did not bring out the same desirable effect but it was not until 1999 that a researcher called Strassmann brought into limelight a fundamental flaw in the period-syncing logic. According to him, women commonly have a 28-day cycle and the maximum that two women can be out of phase is for 14 days. Onset would be 7 days apart and more than 50% times they should be even closer. Menstrual cycles last from 5-8 days and hence, it is not uncommon to see friends/family experience overlapping period cycles. According to his theory, most women have their periods at the same time as other women but we simply don’t know because women don’t keep going around publicizing their period cycles. Yet another study in 2006 on a group of 186 women living in a dorm in China showed that women don’t sync up their periods. But another study in 2017 found that 44% participants involved in the study experienced period syncing.

Lunar Theory
The word ‘menstruation’ is derived from a combination of Latin and Greek words meaning ‘moon’ and ‘month’. According to a 1986 study, 1 in every 4 women have periods during the new moon phase and it is hence, not highly surprising that a group of women staying together might experience similar period cycles.

There are also beliefs among women that when women spend a significant amount of time together their periods are synced to one of the women’s cycle and it is usually in line with the dominant woman. Though there is no theory behind the idea we have always as a society believed in dominance and hierarchy and it is no surprise that it is the dominant woman’s cycle that’s become the norm for other people in the group.
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Of late, the market has been loaded with a variety of period tracking apps such as Clue, Glow and My Calendar none of them provide accurate data. Period sync might happen only due to laws of probability rather than science. For instance, you have periods for 1 week of the month and you live with four other friends the odds are that at least two of you will have your period at the same time. Living with someone for a year or so can make you experience a sync in period cycles only due to mathematical calculations and there is nothing more to this. While you might feel extremely close with your roommate or bestie as you experience period cycles too together it is nothing more than mere coincidence.
 
References
Why the Myth of Period Syncing Wont Go Away: https://www.theatlantic.com/family/archive/2019/09/period-syncing-almost-definitely-isnt-real/598714/
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The Myth of Period Syncing: https://www.nytimes.com/2019/06/06/well/the-myth-of-period-syncing.html
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Women who Spend More Time Together End Up Having Periods at the Same Time. Myth or Fact? https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/women-who-spend-more-time-together-end-up-having-periods-at-the-same-time-myth-or-fact/photostory/71292326.cms

Even today the society is in the presumption that heart attacks strike only those above the age of 60 and that women are not victims to it most of the times. If this has been your ideology too until now please wake up! We are living in 2019 where diabetes is more common among children, there are an equal number of obese kids and adults in the society and where even youngsters die owing to unexplained causes of death more commonly than before! This is an era of diseases, infections and ailments that’s attacking many of us owing to our very own sedentary lifestyle practices and unhealthy eating routines! Heart disease is one such chronic disease that affects a majority of the population owing to rise in obesity/overweight rates and inactivity. But sometimes, a heart attack is not just a heart attack but is the result of spontaneous tearing in the coronary artery wall that happens due to SCAD-spontaneous coronary artery dissection. You might think that SCAD is just an addition alongside atherosclerosis (plaque buildup in arteries that restricts blood flow) that causes blockage of blood vessels leading to a heart attack but in SCAD, the victims are usually women especially otherwise healthy women in their 40s or 50s.
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The artery wall has three layers and when a tear occurs the blood passes through the layers and gets trapped in the innermost layer bulging inward. This causes a block or narrowing of the artery resulting in a heart attack as the blood does not successfully reach the heart muscles. Most of the times it is atherosclerosis that’s the reason behind a heart attack and when a young patient does not exhibit any symptoms of it but does show symptoms of heart attack it might be SCAD. Although according to a 2018 statement by the American Heart Association (AHA) SCAD is the reason behind just 1-4% of all incidents of acute coronary syndrome its impact in women is highly disproportionate and AHA has concluded that SCAD might be responsible for up to 35% of heart attacks in women aged 50 or below.

Science Behind SCAD
Experts aren’t yet sure how SCAD happens but there are some studies that show a hormonal link where post-partum women (30% SCAD cases have this background) and those nearing or experiencing menstruation are at a greater risk. Estrogen and progesterone hormones can weaken blood vessels increasing the risk of tears as the one seen in SCAD. There are also theories that SCAD might be the number one reason for heart attack in pregnancy and post-partum period as this is the time when women experience fluctuating hormone levels. Some studies show that many of the SCAD patients have fibromuscular dysplasia where there is an abnormal cell growth in the arteries that causes bleeding, narrowing or tearing in the artery walls (aneurysm).

It is commonly observed that SCAD patients suffer from mental conditions such as depression, chronic stress and anxiety at a higher rate compared to other heart attack patients. It is also likelier that sudden stress that’s intense (such as when you hear the sudden demise of a loved one) can cause increase in blood pressure and heart rate that can end up in arterial tear. Coincidentally, women suffer more from depression and mental health conditions compared to men owing to numerous conditions such as the pressure to put the family’s priorities above their personal needs, lack of power in the society, absence of economic stability and victims of gender discrepancies and gender-based violence. In men, it is mostly physical exertion that triggers SCAD in them that includes anything like lifting something extremely heavy or running extremely hard in the race.

The distressing part about SCAD is that it is very difficult to diagnose before it causes damage to the heart as it silently does its job without showing any warning signs. Hence, this makes it even more necessary for the common man to be able to diagnose the symptoms of a heart attack that include chest tightness, shortness of breath, profuse sweating and dizziness. Other upsetting factors include the fact that its women who comprise of 90% of the SCAD population, SCAD doesn’t have risk factors such as high blood pressure or diabetes that’s typical of other cardiovascular diseases, occurs in those who have not reached the normal heart attack age which is 70 and might strike people who have not even reached the age of 55 where typical risks start arising.

Treatment for SCAD depends on the triggers and there are higher chances of recurrence which makes it necessary that these patients reduce the risk of heart disease as much as possible by leading a clean and healthy lifestyle. Learn how to prevent the risk of a heart attack with the help of the tips available at www.firsteatright.com. Being young doesn’t give you the privilege of a healthy heart. If you are a young woman who suffers from chest pain it is mandatory that you meet your physician and discuss about it.