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

Wow! Your smartphone congratulates you, gives a new badge, throws glittery papers over your figurine and motivates you to push further hard to achieve your health goals! Yes, its nothing but the fitness trackers and health apps playing their role in improving your wellness and weight loss. People often play number games with their body and health. Ideal body proportion for women is defined to be 36-24-36 inches, women love their body weight to remain well below the desired weight and people aim at completing 10,000 steps a day. Though the number 10,000 seems wholesome, complete and believable how good is it when it comes to achievability, practicality and efficiency? The number was not something that’s been established by the World Health Organization (WHO) or the American Heart Association (AHA) but was the brainchild of a successful Japanese marketing campaign in the mid-1960s. This campaign did not have any scientific explanation behind its promotion but simply wanted to promote their pedometer named ‘manpo-kei’ which literally translates to 10,000-step meter. Surprisingly, WHO, AHA and other reputed health organizations started following the 10,000 steps plan but there have been doubts and questions lingering on their efficiency and correctness.

Walking: The Most Underrated Exercise Form
Walking still exists as the best physical activity that can be performed by anyone residing in any corner of the world. Still, its effectiveness and usefulness in our health remains underrated and underrecognized. Even for someone who has remained sedentary all his/her life its easy to start walking as this is an activity that we are used to performing while doing our day-to-day chores. An activity that can be performed anytime of the day, walking helps in reducing the risk of cardiovascular disease by 31% and cuts down the risk of death by 32%. But all these benefits only when the duration and intensity are on par with the recommended levels which is not 10000 steps day but doing moderate-intensity exercise for 30 minutes at least five times a week or doing high-intensity exercises for at least 20 minutes thrice a week. Just as how curious we are, a group of curious researchers investigated the how many steps were needed to gain health benefits.

They recruited almost 17,000 women aged between 62 and 101 years who were provided with a fitness tracker measuring their step count, speed and distance covered during all times of the day except while sleeping or performing water-based exercises such as swimming. The women were asked for their diet, lifestyle and medical history for the 4-year follow-up period. During this period almost 500 women died and results showed that women who took more than 4,400 steps daily were at a 41% lower risk of death and the risk further declined until about 7,500 steps after which the effect of the step’s effect wore off. A surprise element here in this study is that it did not consider the pace of the activity but only the duration which contradicts previous study results that show that walking pace is indeed linked to longevity. While the results might be applicable on men of the same age, we cannot predict about individuals of other age groups. Still, most people who don’t lead a sedentary life walk at least 4,000-5,000 steps a day and its still good. There are many studies comparing the health effects of people who walked 5000 steps a day to those of people who walked 10000 steps a day by measuring calories burned, BP and glucose levels. Indeed 10000 steps is going to give us better results and we don’t know for sure until we compare it with other numbers such as 7000 steps or 11000 steps.

But if you compare the recommended daily activity levels that amounts to 30 minutes of activity five days a week the total number of steps taken each day comes close to 7500 and maybe that’s the number all of us must aim for! This is far better than the recommended 10000 steps a day as we have no clue about the intensity with which these steps must be walked which does play a crucial role in deciding upon the overall health of an individual. It is suggested that we walk a minimum of 100 steps per minute (https://www.theguardian.com/lifeandstyle/2018/sep/03/watch-your-step-why-the-10000-daily-goal-is-built-on-bad-science) if we want to reap any benefits from our exercise routine and this is not a big deal considering the fact that it’s the kind of pace someone follows when he/she heartfully hopes to stay healthy and lead an active lifestyle.

Keep it Simple
Mathematical formulas scare the hell out of some individuals and numbers confuse many. Likewise, the number 10000 seems unattainable and grueling for some individuals. But keep in mind that we do have evidences pointing to the fact that every single step you take brings you closer to good health. Even 2 minutes of exercising adds value to your overall health and studies do show this with evidence. Nutritionists, dietitians and health experts suggest various ways to stay health and this includes taking the stairs whenever possible, parking the car further away from the parking lot or walking while talking over the phone-all these might be trivial ways to stay active but they do add to your good health when practiced over a long period of time. So, while you do have to set definite targets and aim for different ways to achieve these targets don’t let go of simple and doable activities to keep you going. Involve in gardening, take a bus to office, walk for a kilometer before taking a bus from your second-nearest bus stop or do some stretches during your coffee and lunch breaks. Maybe you can even squeeze in a 10-minute walk after your lunch to clear your mind off the sleep and also get some exercise in between.

Fitness trackers could have brainwashed you with their 10,000-steps-a-day target but I hope that we can at least walk close to 7500 steps that fulfills our 150 min/week of physical activity requirements.

References
You Might Not Need the 10,000 Steps a Day Your Fitness Tracker is Telling you to Take: https://time.com/5597557/do-you-need-10000-steps-a-day/
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10,000 Step a Day? Maybe you Don’t Need Them All: https://www.aarp.org/health/healthy-living/info-2019/7500-steps-daily-is-enough.html?intcmp=HEA-HL-FEED
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Walking: Your Steps to Health: https://www.health.harvard.edu/staying-healthy/walking-your-steps-to-health

Is gaming a passion for you? Well, its time to buckle up and stay cautious as a new research shows that intense gaming can land you with arrhythmia. We still live in an era where gifting children with PlayStation and smartphones are happening at full swing as a reward/recognition for their academic performance or simply as a gesture of encouragement too. Ironically, parents who must be the No.1 individuals to motivate kids to go out and play curb the very same by spoiling them with such gifts. Later on, they are the same ones who also blame the society rather than correcting their own lifestyle for all the spikes in obesity and overweight rates in their children. Worse, during weekends we take them to fun zones and play areas that contain exclusive video games that become an addiction to adults too in course of time.
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Super Mario and Pac Man are irreplaceable but now the gaming industry is even more inclined to develop more violent, thrilling and sadistic games that ruin the innocent minds of kids, adolescents and adults as well. Mortal combat, Game of Thrones and few others are the favorite of most of us but there are few other video games that guarantee heart-stopping action in the literal sense too! Does the idea of suffering from heart-related problems due to playing video games bother you? It should and it would. Though the idea sounds absolutely crazy and impractical there seem to be cases of young kids hit by irregularities in heartbeat popping up everywhere around the world that it does make each of us think twice before picking up on a game CD on our visit to the shop next time!

A letter published in the reputed ‘New England Journal of Medicine’ brought into limelight the pathetic situation of three boys aged between 10 and 15 years who lost consciousness while being engrossed in playing a war video game. Its generally observed that kids who play such games are greatly excited, their heart rates are up and adrenaline levels increase tremendously in the body. If a child suffers from any underlying heart problem this can cause the heartbeat to become irregular (beating too quickly or slowly) resulting in a condition known as arrhythmia. The condition is called as tachycardia when the heart beats faster than normal and according to experts, each of these kids suffered from ventricular tachycardia as they had extremely severe heart abnormalities due to the structure/function of the heart muscle. Such abnormalities can cause a blackout in the concerned person when he/she is at the pinnacle of the game. Its just like situations where some people fall down during an intense sports match or even in the middle of an interview. They cannot be blamed and it is the action of their abnormality in heart structure which is further triggered by extreme stress/exertion increasing the risk of sudden cardiac death.

Such blackouts in the middle of a video game are serious indications which require timely intervention. It’s not exaggeration when people normally comment that a person suffered from a heart attack on hearing the demise of a beloved one or was so frightened that it led to sudden death of the individual. Exertion is a very bad phenomenon that can change a person’s life in and out.  In the case of the three boys who collapsed playing video games the first boy (10 years old) suffered from a genetic disorder that interrupted the electrical conduction in his heart, the second boy (11 years old) had a massive heart palpitation and the third boy (15 years old) had undergone surgery for a heart defect that was diagnosed when he was an infant.

Fainting is sometimes seen in kids, especially when they stand under the hot sunshine during assembly, play out regardless of the heat or skip their meals. But any fainting that occurs due to excitement or stress is not normal and is a sign of danger. It needs to be immediately addressed as they mostly point towards some underlying heart condition. 

Every infant is like clay ready to be molded into any form wished by his/her parents but as the baby grows, he/she starts accepting or rejecting things based on discretion. I am not trying to say that the baby’s character, attributes and personality are the sole discretion of parents but I mean it when I say that parents have a greater responsibility in nurturing their children into better citizens. Today’s world is complicated and today’s kids are like little adults making choices and deciding things right from their younger years. Even a 5-year-old child clearly knowns his/her ‘wants’ in life, is ready to plan the weekend and chooses between dresses while getting ready for an outing. Their thinking capability is beyond par and most of the times they out win parents when it comes to decision-making skills. But a child is a child and every child’s first role model is his/her parents around whom the child’s entire life revolves, at least during first few years of life. What parents eat, how they behave, what they talk and how they react are seeded inside the child’s brain and their outcomes are visible as and when situations arise.
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Eating habits last a lifetime and are the foundation for a healthier life. Every family has their own style of cooking, preparing dishes and serving them. What type of dishes you prepare and how often you eat out determine your child’s choice of foods too. We cannot expect our child to choose between carrot sticks and boiled broccoli when we want bread rolls and cutlets. I strongly believe that every parent tries to impart healthy eating habits to their children right from infancy when we start giving mashed potatoes or beans. I’ve had a roller-coaster experience with my baby girl who sent out outright rejections to many of the veggies including carrots, beets and beans. But this did not deter me from my path and now she loves a bowl of boiled broccoli, peas and corn any time of day! While food preferences are largely learned dislike is the primary reason why many parents stop offering vegetables, fruits and other healthy foods to their kids. But now, we have a new study that proves that repeatedly offering a variety of vegetables to kids improves their acceptance and intake.

The research team involved in the study chose 32 families where their children consumed extremely low amount of produce. All the children were between 4 and 6 years of age and their parents completed an online survey before becoming a part of the study group. The study participants were split into three groups-those receiving a single vegetable, kids receiving multiple vegetables and the third group whose eating habits were not changed in any way. The study team collected information on food intake in different ways- vegetables consumed at home, school or daycare was recorded through food diaries and the research team served two dinner meals at the research facility which included broccoli, cauliflower and green beans. Every parent was provided with vouchers to buy veggies and also were instructed on how to cook them and also the portion sizes that could be offered to their kids. Those parents serving one vegetable introduced broccoli and those serving multiple veggies included broccoli, zucchini and peas. Every child was served a vegetable thrice a week for 5 weeks and those kids who tried a vegetable were given stickers as rewards. One has to note the conscious decision of providing non-food rewards in the absence of which the entire study could become meaningless (food rewards only make children crave more for processed foods). While no group showed any difference in vegetable intake at the start of the study vegetable acceptance increased both for single and multiple vegetable groups during the intervention. A significant difference in intake was noticed in families consuming multiple veggies-from 0.6 to 1.2 servings (the increase in portion size lasted up to three months after study completion) while changes were not noticed for those eating a single vegetable or in those who did not change their eating habits. Most of the parents were grateful as they found serving vegetables to be quite easy thereon from what was considered to be a daunting task earlier.

Despite improvements in portion sizes none of the families met the required portion intakes that’s pretty saddening. Nevertheless, this can be a first step towards accommodating increased veggies portions in kid’s meals that could improve their health. For more help regarding planning healthier meals for children please visit www.firsteatright.com.

Restaurants serving barbequed food witness a constant flow of customers for their grilled specialties especially the meats that are marinated with specialty herbs, sauces and salt to get the special taste and texture. But we do have complaints that well-done and charred meat increases the risk of cancer especially, pancreatic, colorectal and prostate cancers.
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But not everyone’s grilled meat tastes so yummy and mouth-watering. If you love to make the perfect grilled meat, the first to ensure is that the meat is red and not grey in color before it hits the grill. Myoglobin is the heme iron containing protein that gives meat its color. Just like how the hemoglobin stores oxygen in blood cells myoglobin stores oxygen in muscle cells. The red color of the meat depends on the myoglobin content present in it. Charcoal grilling is preferred over gas grilling for maximized flavor of the meat as charcoal and smoke from wood chips create flavorful aromas. The aroma is further heightened when the juice from the meat drips onto the charcoal. Your mouth waters at the sight of the meat and you are ready to indulge in the hotdogs and well-done burgers for a tasty treat. But you do think twice before hogging the food as it evokes fear of cancer. This is really annoying and heart-breaking-you have a yummy meal still you don’t eat it happily fearing health hazards. How true is this claim and if so, why aren’t we cutting down on such meat production and consumption too?

Toxic Chemical Box
The grilling box creates toxins at high temperature called heterocyclic amines (HCAs) or heterocyclic aromatic amines (HAAs) that are a class of chemicals formed mostly in cooked red meat and sometimes in fish and poultry. We are excited over the superb flavor created when juice from the meat drips on the charcoal but it also causes creation of a class of chemicals called polycyclic aromatic hydrocarbons (PAHs) that once again are linked to cancer (https://time.com/5613194/grilled-meat-cancer-risk/). HAAs and PAHs are metabolized by enzymes and some of the byproducts can cause damage to the DNA that exists as the root cause for cancer formation. Sometimes, it’s more than the open flame that causes health effects. Even the International Agency for the Research of Cancer brands these processed meats as carcinogenic and consuming 50 grams of processed meat can increase the risk of colorectal cancer by 18%.

While all this is true, there is also another side to the story. The amount of HAA in the meat purely depends on certain factors such as cooking time, duration, method of cooking and type of meat. Those that have the highest concentration of HAA include well-done cooked meats and charred meats. But not all those who eat such meats become victims to cancer and sometimes it does depend on the genetic makeup of the individual to determine how they respond to chemicals and risk the development of cancer. But the question also arises whether its only charred or well-done meat that invokes cancer risk. Eating salami, bacon and hot dogs is pronouncedly seen in those who eat grilled or charred meat and the rise in cancer risk might be even due to the consumption of processed meats such as bacon and salami. We have quite contradictory results from studies too as some support this theory while others deny it. We do have few other studies showing that consumption of fried and grilled meats does increase the risk of diabetes and dementia. This also paves way for understanding the connection between diabetes and dementia-presence of diabetes doubles the risk of dementia. Eating healthy food, exercising regularly and refraining from smoking reduce the risk of dementia. Hence, it comes as no surprise when chemicals in cooked foods such as burgers and chicken are linked to dementia.

A Drill on the Best Way to Grill
Marinating helps in preventing toxins from entering your meat thereby suppressing the carcinogenic effect on the meat for reasons still unknown. What you use for marinating also determines how much effect it has on cancer risk. For instance, a herb marinade reduces the risk by 72% while a Caribbean marinade drops the risk by 88%. In another study researchers tested the effect of rosemary on ground beef patties. The extract was applied to both sides of the meat and results showed that higher the concentration of the extract, greater was the reduction in heterocyclic amines (as much as 90% reduction rates).

Also, while meat tastes great when grilled you can always try grilling fruits and vegetables too such as zucchini, strawberries, guavas, watermelons and pineapples but before doing it remember to clean the grill. Otherwise the leftover carcinogenic agents might cling onto the new foods that are grilled.

References
The Claim: Rosemary Helps Reduce Toxins in Grilled Meat: https://www.nytimes.com/2010/06/01/health/01real.html
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Fried & Grilled Meat might Raise the Risk of Dementia: https://www.theguardian.com/science/2014/feb/25/fried-grilled-meat-risk-diabetes-dementia-glycotoxins