Saturday, August 1, 2015

Dimensions of wellness

This is the time of the year corporations encourage its employees for fitness tests and offer incentives for the same. It is a win-win. The providers of these tests compute a numerical value for the wellness based on several questions and the results from the blood work. I recently filled one such questionnaire and was surprised to note physical wellness formed only a portion of the evaluation. Others being social wellness, emotional wellness, spiritual wellness, environmental wellness, occupational and intellectual wellness. I found an acrostic hiding in holistic wellness-POESIES: the art of writing poems. Your wellness is a poem written by you!  The yoga sutras written by Patanjali two thousand years ago seem to give us the words, grammar, voice, rhyme and rhythm. Is Samadhi the wellness of 21st century? Social wellness (ability to connect and relate to people around you); emotional wellness (ability to understand our self and cope with the challenges); spiritual wellness (ability to establish peace and harmony in our lives); intellectual wellness (ability to open up our mind for new ideas and experience and translate them for the betterment of humankind) are my favorites among the holistic wellness. I will save those for another occasion and focus on physical wellness.

Heart health seems to be the major factor in our physical health. American College of Sports Medicine (ACSM) and American Heart Association (AHA) have some recommendations and guidelines: Do moderately intense cardio 30 minutes a day, five days a week; or, do vigorously intense cardio 20 minutes a day, 3 days a week and combine those with eight to 10 strength-training exercises, eight to 12 repetitions of each exercise, twice a week. Moderate-intensity physical activity means working hard enough to raise your heart rate and break a sweat, still able to carry on a conversation. These recommendations are for the average healthy adult to maintain health and reduce the risk for chronic disease. In 2014, European Journal of Preventive Cardiology reported that practicing yoga had the same effect on improving cardiovascular markers (LDL, HDL, triglycerides, total cholesterol, BP) as other aerobic exercises.  However yoga, still, does not count towards physical activity requirements of 150 minutes of moderate intensity aerobic activity per week. This may be due to the various levels of exertions in the yoga classes (from very slow and mild to highly aerobic) offered.

Our food habits, indeed, influence cardiac health. Reduce red meat; avoid egg yolk; eat food rich in fibers (at least 35 grams per day) and reduce alcohol consumption. Soluble fibers combine with bile acids and take it out of the system. The body is forced to produce more bile acid from cholesterol and cholesterol level goes down. Fermentation of fiber produces propionic acid which inhibit HMG-CoA reductase, an enzyme required for the production of cholesterol. Inhibition of this enzyme reduces cholesterol level. This is somewhat similar to the action of cholesterol lowering drugs, statins. In addition, fibers maintain colon integrity and bowl regularity.
Few years ago one of my friends introduced a recipe made of avocado, jalapeno, onion, garlic and tomato. According to her, the preparation reduced the cholesterol level of her husband significantly. Science support the beneficial effects of this guacamole to reduce total cholesterol and LDL; and increase the level of HDL
  
·         Avocado has number of vitamins, minerals and phytonutrients. These ingredients get absorbed better by human body in avocado medium. Avocado has Vit-B3 (Niacin), which in pharmacological doses has proven to reduce total blood cholesterol and LDL. It's a good source for mono and poly unsaturated fatty acids.
·         One of the ingredients in garlic is a hypolipidemic compound- allicin. It's produced immediately on crushing fresh garlic cloves and is an unstable compound. Being very unstable, allicin is not present in cooked garlic. It's possible that the hypolipidemic effect is from allicin; while avocado enhances it.  
·         This guacamole also contains capsaicin - the chemical giving heat to jalapeno. This is an anti-inflammatory compound. Studies have shown that capsaicin can reduce the risk of arrhythmia (irregular heart rhythm).
There are several supplements in the market that claim to control the cholesterol level. One such supplement that caught my attention was red yeast rice. According to a study published in American Journal of Cardiology, red yeast supplements reduced LDL cholesterol by 21%. It's a good alternative to lowering LDL for people who are intolerant (muscle pain, lethargy, gastro-intestinal intolerance) to statins. The whole research and development of statins started with the red yeast rice. One of the many reasons men who take statins mention for their inability to get onto treadmill or elliptical is lethargy - lack of energy or enthusiasm to exercise. The explanation generally is: "I am getting old." There is some truth in it. Research shows statins interfere with the production of energy in the body. The pathway statins block hinders ATP - energy currency- production too. What does that mean? Lethargy. Lethargy, low exercise, inflammation, further reduction in exercise, and more inflammation. It is a spiraling effect. Talk to your physician if you have symptoms of these secondary effects.

Inhabitants of Southwest France have high life expectancy even though they consume copious amounts of foie gras (dish made from super-fattened duck or goose) and confit de canard (dish from duck leg poached with fat). Incidence of Coronary Heart Disease is very low in them. The consumption of red wine by the French is attributed for this paradox. Red wine has been under scrutiny for some time. In several studies, scientists found red wine reduced total cholesterol and increased HDL by 16%. In 2005, scientists from Denmark came to a conclusion that all beneficial effects of wine came from its alcohol content (British Journal of Clinical Nutrition, 2005). I was skeptical. There should be something more than just high calorie alcohol.Red wine has plenty of anthocyanins (purple, red , pink pigments) A glance through literature will reveal antioxidant, anti-diabetic, anti-inflammatory and anticancer properties of these pigments. In a 2009 study (American Journal of Clinical Nutrition) the pigments in red wine was found to increase HDL by 13.8% and decreased LDL by 13.5%. According to the data benefits are due to the inhibition of a protein, CETP (Cholesteryl Ester Transfer Protein). Anthocyanins stop the cholesterol "trafficker" maintaining a healthy HDL/LDL balance. Putting the puzzle together, moderate consumption of red wine seems to be beneficial for cholesterol management. 

Wish you all a healthy heart!


 Jay.

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