WHY ARE YOU GETTING FAT?

Appearance today remains the last bastion of discrimination and the fat guys and girls are finding it difficult to compete both socially and physically, with those having a naturally thin built. Yes, fat people look happy and contended, but let’s face it, they also look somewhere in a scale ranging from not very attractive to outright sick.

There are numerous hormones in the human body that can contribute to weight gain if their levels are out of balance. Gaining weight is easy, and is influenced by factors such as stress, age, genetics and poor lifestyle choices. Sadly, losing weight is not so easy. Having any of these 9 hormones out of balance can lead to weight gain.

1. Thyroid hormones 

Located in the neck, straddling our windpipe, the thyroid gland produces T3 and T4 hormones together with calcitonin, which are responsible for maintaining the body’s metabolism. Underproduction of these hormones leads to hypothyroidism, which can lead to water-retention and weight gain.

Remedy:

•   Consume iodized salt.
•   Eat well-cooked food and avoid raw vegetables.
•   Take vitamin D supplements.
•   Consume food rich in Zinc content such as oysters and pumpkin seeds.

2. Insulin 

Insulin is a hormone that’s produced in the pancreas and helps to carry glucose into the body’s cells, which are in turn used as energy or stored as fat. This is how the body maintains glucose levels in the blood. Insulin production can be affected by genetics, overconsumption of processed food, unhealthy snacks, alcohol or artificially sweetened drinks.

The body develops a resistance to insulin, which means that glucose stays in the bloodstream rather than being absorbed by muscle cells. In turn, this causes a spike in blood sugar levels, leading to weight gain and Type 2 diabetes.

Remedy:

·         Consume green leafy vegetables, seasonal fruits, and seasonal vegetables.

·         To improve your omega-3-fatty acid levels, consume fatty fish, nuts, olive oil, flaxseeds.

·         Drink at least 4 liters of water every day.

·         Morning walk 4 kilometers in 40 minutes daily.

·         Avoid alcohol, late night snacks, aerated and artificially sweetened drinks.

·         If a known diabetic then keep the fasting and post-prandial sugar levels in check

3. Cortisol  

Cortisol is a steroid hormone produced by the adrenal glands. It is mainly secreted when we are stressed, depressed, anxious, nervous, angry, physically injured, etc. The two primary functions of cortisol are energy regulation and energy mobilization. Cortisol regulates energy by deciding which type of energy (carb, protein, or fat) is required by the body to do a certain function. Cortisol helps to mobilize energy by transporting fats from fat reserves to the “hungry cells” or working muscles. Basically, cortisol is needed to handle short-term stress (mental, physical, real, or imagined) response. But due to poor lifestyle choices and bad eating habits, the body can be in a constant state of stress. This leads to an increased secretion of cortisol that makes the body hyperinsulinemic, increases visceral fat deposition, and stimulates the maturation of fat cells

Remedy:

·         Get at least 8 hours of sleep every night.

·         Avoid processed food, deep fried food, and alcohol.

·         Practice deep breathing, yoga, and meditation for at least one hour every day. It helps in reducing stress levels.

·         Spend time with your family and close friends. There is no better way to unwind!

·         Make a to-do list and tick the ones that you complete. This will not only be a reminder to complete those tasks but also make you feel good about yourself.

·         The best way to reduce stress levels is to take out time for yourself. Take up a hobby that you always wanted to, learn new skills, read books, watch movies that interest you etc.

·         Stop worrying about what people think of you.

4. Testosterone 

Although testosterone is usually associated with men, it’s also secreted by females. Its function in the body is to boost fat, strengthen bones and improve libido, but its production can be affected significantly by factors such as age and high-stress levels. In women, this leads to the loss of bone density, muscle mass, and obesity. Women also create lower levels of testosterone (15 – 70 ng/dL). Testosterone helps to burn fat, strengthens bones and muscles, and improves libido. In women, testosterone is produced in the ovary. Age and stress can significantly reduce the testosterone levels in women. And a lower level of testosterone is associated with loss of bone density, loss of muscle mass, obesity, and cause depression.This can increase stress and inflammation leading to more fat accumulation.

Remedy:

·         Workout regularly. It helps improve testosterone levels.

·         Consume protein supplements.

·         Include fiber-rich food like whole grains, pumpkin seeds, and flaxseed in your diet.
 Take vitamin C, probiotics, and magnesium supplements to prevent constipation.

·         Avoid consuming alcohol as it can potentially damage the liver and kidney.

·         Take zinc and protein supplements to improve testosterone levels.

5. Progesterone

Progesterone is a steroid hormone that’s secreted by the corpus luteum to stimulate a woman’s uterus in preparation for pregnancy. It’s important for levels of this hormone to remain balanced in order for the body to function properly because it can cause weight gain and depression when levels drop. Progesterone levels are affected by things such as the use of contraceptive pills and the onset of menopause. Progesterone is known to:

1.      Helps use fat for energy

2.      Natural diuretic

3.      Natural antidepressant

4.      Facilitates thyroid hormone action

5.      Normalizes blood sugar levels

6.      Restores sex drive

Remedy:

•   Exercise regularly.
•   Try meditation.
•   Avoid stress.

6. Estrogen 

Levels of the primary female sex hormone need to remain as balanced as possible in the body, and this is because high estrogen levels can lead to weight gain and the cells that produce insulin in the body becoming stressed. High estrogen levels arise as a result of natural overproduction in the body, or due to consuming a diet that’s rich in estrogen.

In contrast, low estrogen levels tend to arise in premenopausal women. Seeing as the body goes in search of other estrogen sources when levels are low, the body starts converting all available sources of energy to fat, which can lead to weight gain. Estrogen is known to:

1.      Increases body fat

2.      Salt and fluid retention

3.      Depression and headaches

4.      Interferes with thyroid hormone

5.      Impairs blood sugar control

6.      Decreases sex drive

Remedy:

•   Consume whole grains, fresh vegetables, and fruits.
•   Avoid alcohol.
•   Exercise regularly.
•   Avoid processed meat.

7. Leptin 

Leptin is the body’s “energy expenditure” hormone, which regulates energy balances and inhibits feelings of hunger. Under normal conditions, the hormone leptin signals that you are full and should stop eating. But due to overconsumption of foods that are high in sugar content such as candies, chocolates, fruits (that are modified to contain a lot more fructose), and processed foods, the oversupply of fructose is converted to fat that gets deposited in liver, belly and other regions of the body. Now, fat cells secrete leptin. As we keep consuming more fructose-containing foods, more fat gets accumulated, and more leptin is secreted. This, in turn, desensitizes the body to leptin and the brain stops receiving the signal to stop eating. This ultimately leads to weight gain.

Research shows that sleep deprivation can cause the leptin levels to fall and therefore the brain misses the signal to stop consuming food. So, make sure you sleep at least 7-8 hours a day.

Remedy:

·         Avoid food rich in sugar content. Consume no more than 3 servings of fruit per day.

·         Consume dark green leafy veggies.

·         Avoid processed food.

·         Get proper sleep. 7-8 hours of daily sleep is recommended.

·         Keep yourself hydrated as dehydration can also make you feel hungry!

8. Ghrelin

Ghrelin, the hunger hormone, stimulates appetite and increases fat deposition. People experience elevated levels of ghrelin when they’re on a strict diet or while fasting. Popularly known as the “hunger hormone”, ghrelin helps stimulate appetite and increases fat deposition. It is secreted by the stomach mainly. A small amount of ghrelin is also secreted by the small intestine, brain, and pancreas. Higher levels of ghrelin in the bloodstream may lead to weight gain, and obese people are more sensitive to this hormone. In fact, Ghrelin levels are also high when people are on a strict diet or while fasting.

Remedy:

·         Workout regularly.

·         Eat every 2-3 hours.

·         Have 6 meals a day.

·         Eat fresh fruits, vegetables, protein source, dietary fiber, and healthy fats.

·         Drink 1 ½ cup water 20 minutes before a meal.

·         Keep yourself active.

. 

9. Melatonin

Melatonin regulates sleep and wakefulness and is released while we sleep to help the body heal, improve body composition and build lean muscle. However, this process is disrupted if we don’t get enough sleep, and ultimately could lead to inflammation-induced weight gain.

Remedy:

•   Do not eat late at night or just before going to bed.
•   Get sufficient sleep.
•   Sleep in a dark and cold room.
•   Turn off all gadgets before sleeping.

So weight gain has to do with our life style and our diet. Though genetics has a role to play, it is mostly our hormones which are orchestrating our fat gain and fat deposition. The good news is that these hormones are not autonomous, we can control them and feel good and look better!

MY CONCEPT OF CENTENARY CELEBRATIONS

While we are gearing up for the centenary celebrations of our Alma-mater, King George's Medical College, Lucknow in December 2011, have we clearly understood the significance of the occasion, or are we, in the midst of all the busy meetings and detailed planning sessions, forgotten that this is an occasion which has come after hundred years, and none of us would be around in this world to see the next one!

Whenever a really big occasion beckons us, we have a tendency to get lost in its magnum opus and forget a simple thing….how will the future remember this occasion and gauge us? Will they consider our effort as a really worthy one, or will the say that we fizzled away the glorious opportunity? Yes, we need a big party, a 3 day cultural and academic extravaganza, but is that all we need to do to celebrate 100 years of existence of our Alma-mater?

Think about it! Should we not leave behind a legacy, so that our successors look back and feel proud of us? Every monumental occasion needs a legacy planning and I am not sure we have one so far.

What is legacy?

Legacy is ensuring that as many sustainable benefits as possible are generated by the event for the institution, the city, the region and the country

Legacy is delivering these benefits well before, during and long after the event for all stakeholders and communities

Having a legacy vision and plan to leverage every possible opportunity is the hallmark of a good organizing committee. Merely gloating that we are a breed apart and the very best of the best is not and will not be good enough.

Celebrations without a social cause looks very selfish and self centred. We must think that on the occasion of the Centenary of our Alma-mater what we are offering to the city of Lucknow, the state of Uttar Pradesh and to India.

A. To the city:

1. The city lacks a trauma pick up system and we could arrange for a fleet of ambulances fully equipped with life saving devices to pick up trauma victims from anywhere within a radius of 50 Km from our Trauma Centre.

2. We could start a Centenary School Health Education Programme in which we could adopt certain Government and Non Government schools and arrange for some useful and interesting interactions with students on various health related topics like sanitation, safe drinking water, nutritious diet, tobacco usage, safe driving, breast self examination etc.

3. We could adopt the poorest village in our district and cater to all its health needs

B. To the State:

1. The most burning health issue of the State is the Japanese Encephalitis endemic. We can start a JE eradication programme, complete with research and clinical wings so that we can be of best use to the State.

2. We can initiate a Centenary Polio and Cerebral Palsy rehabilitation programme with the dual aim to make the State polio free and to make every disabled person live a respectable and dignified life

3. We can initiate a Centenary Stroke Station which will pick up patients from home, treat them, rehabilitate them and reintegrate them in the society

4. We can initiate a Centenary Beating Heart programme to educate the masses, detect risk factors early, inculcate the concept of cardiac safety in the people of the state and offer world class treatment for one and all.

C. To the country:

1. If one KGMC / CSMMU could teach so many students in the last 100 years imagine how much we can contribute to the developing world by starting our satellite institutions in Nepal, Maldives, Mauritius, Sri Lanka, Bangladesh and countries of Sub-Saharan Africa. If IIMs less than 50 years old can open newer campuses in Colombo and Dhaka, if Apollo group can open hospitals in Colombo and Dhaka, why can we not do the same? Have we put forward this idea to the State Government? I do not think they will be terribly disinterested in opening institutions of excellence overseas, if they bear their chosen iconic names and statues.

2. The country needs to earn revenue from the competitive medical tourism market. Let us help this process by standardizing our various departments so that we turn out to be the number one destination of medical tourism in our country by opening wards exclusively for this purpose in the target departments.

3. Research is always a long term investment and areas of future successes like stem cell research and nano-technology need to be identified and on the occasion of the centenary we should be able to initiate work towards achieving these research goals.

D. To the Institution:

Centenary global integration programme: If we are the premier medical institution that we claim to be, and we are 100 years old, then what should we be looking like? Hundred year old institutions look like Oxford, Cambridge and Harvard, so why are we not in that same league? We are not because we have chosen to stay in isolation and not integrated with the world. And in today’s world of globalization, isolationism is a curse. We have to integrate with other medical institutions, both public and private and, both within our country and overseas. No department in itself can be considered complete but when post graduates from one unit go to another one, they are exposed to newer ideas, newer gadgets and newer way of doing things. This cross-pollination of ideas is vital for the development of any individual or institution. Inbreeding can only weaken the progeny. Not only at student level, but even at the faculty level this cross-pollination must be allowed. If Team India can have coaches from South Africa, Australia and Zimbabwe, why can we not have teachers from overseas? Our own alumni will help the Institution to arrange for the best teachers.

As a responsible organization, we must ensure that the city, the state and their residents are left with the most positive legacy in terms of services, infrastructure, expertise and experience from our Centenary celebrations!

MY FATHER’S GUIDE TO BUY FRESH FISH

I am a Bengali who brought up on ‘Macher jhol and bhat’, that is fish curry and rice for you all. We have fish in both the meals and of more than one variety on holidays and when entertaining guests. So it is quite natural that I am expected to identify the best fish in the market and purchase it. But this quality was not ingrained in my genes; I learned it from my father during our weekend trips to the fish market.

This story is about my bonding with my father and how I could pick up the pearls of wisdom just by looking at him and asking him silly questions. When we were young the father and son bond was a more distant one based on respect, of course not without its share of love. Yet, there was a kind distance based on a mix of fear and respect which had its advantages but also the fact that there was an emotional gap in the bond that was tough to bridge. These days, however, with younger men becoming dads, the relation has met with a dynamic change. Younger dads today remember the equation which they shared with their own fathers and are making an effort to not repeat the same faults they noticed. But are they taking their children, both boys and girls, to the fish market to make them worldly wise? I doubt. I don’t see children tagging along their dads in the fish market any more. They stay in sanitized home environment, play virtual games on cell phones and watch unimaginative Kid’s TV. The social introduction of the child to the outside world is a father’s responsibility and my father did it amazingly well.

So how do we buy the best fish? There are some thumb rules that you need to follow while buying fish and making sure that it is fresh.

1.      Go to a reputable store or fishmonger.

2.      Ask what is the freshest or check what the catch of the day is.

3.      Don't be misguided by the term "fresh." Most landlocked areas selling fish usually have two types of fish - thawed or frozen, unless it is an upstanding vendor who really likes freshness.

4.      The smell of fresh fish is specific to its origin (sea, lake, river, fish pond) and it is pleasant and neutral. Spoiled fish has an unpleasant, sharp smell of trimethylamine (bad fish) and rot.

5.      Check the eyes: Eyes of fresh fish are bulging and shiny. Eyes of old fish are cloudy and sunken into the head. Before you handle the fish, check the eyes. They should be crystal-clear, plump, wet, and shiny, with no sunken features. If the eyes look good, you can bet with reasonable confidence that the fish is fresh and healthy. Once the fish begins to deteriorate, the eyes dry out, become cloudy, and sink in or shrivel away. This indicates an unhealthy or improperly-handled fish 

6.      Check the Fins - The tail and dorsal fins of the fish should be healthy-looking, wet, and intact. A fish that's been mishandled will have torn or ragged fins, while an older fish's fins will be dry and brittle. Torn and ragged fins probably belong to a fish that was netted or held for too long. 

7.      Check the Gills – The gills of fresh fish are moist. In old fish they are dry, covered with sticky slime, grayish-brown in color and smell bad. Healthy gills are of a nice, bright red color. A truly fresh fish should have gills that are vibrant red, not brown. When first caught, a fish's gills appear bright red, and slowly darken over time. The brighter the color, the fresher the fish. The gills should also feel clean and cold, not slimy. Mucus will build as time passes, too, so as the fish ages.

Healthy fish has moist bright red gills which are moist but not slimy

8.      Check the Skin- The skin in live and fresh fish is moist, must be unharmed and have a naturally metallic glow. Scales must be tightly attached to the body. The surface of healthy, fresh fish must be tight and shiny so that fish slides out of your hands. Discoloration and cracked skin are signs of rotting fish. Old or bad fish has already started losing its scales. When no longer fresh, the flesh becomes soft and tends to fall apart. The appearance of a fresh fish should be shiny and wet.

9.      Slime is equally distributed over the fish, it is clear and odorless. With time, slime gets increased, murky and dirty and has a sour smell.

10. Poke the flesh - The body of a fresh fish is firm and has a specific consistency and appearance. When pressed it should bounce back. Soft, grey and inelastic fish is old or bad. The fish should feel cold, wet, and slippery, but not sticky. When pressed, it should spring back to its natural shape, just like if you were to press on your own flesh. If it doesn't spring back, it is a sure sign that the meat has softened and and is no longer worthy of your money. Fish that has lost its firm shape is no longer fresh.

11. Touch the scales: Scales are designed to protect the fish from a harsh watery environment. When a fish is fresh, the scales will be shiny and firm, a veritable armor against the elements. Less-fresh fish will often shed scales as you run your hand over them, and they may appear dry and flaky.

12. Belly of a live and fresh fish is shiny and undamaged, and the anal opening is tight. Anal opening of old and bad fish sticks out and is yellow-brown in color.

Buy whole fish whenever possible – It is easier to determine the freshness of a whole fish rather than a previously cut fish. My father used to say that if I do not see the head of the fish still attached to the body it is not worth wasting time on it. Once purchased the fish seller will fillet it for you the way you would like. To keep fish fresh for longer, transport it in an insulated cooler bag. Fish should be the last thing you buy in a bazaar and after that go straight home. As soon as you get it home, carefully remove any guts, rinse it under running water then pat dry. Ideally you should put the masala on and cook it the same day. If that is not possible then add salt and turmeric and store in the refrigerator until the next day.

Buying butchered fish – If you have a small family then buying a large fish may be uneconomical. But gauging the freshness of a fish that has not been cut in front of your own eyes is difficult. If you prefer to buy filleted fish, these tips will help you choose the freshest product. For the most part, visual cues are enough to indicate a fresh piece of fish, but some tactile clues may help as well.

1.      Look for cracks, breaks, and pooling water - Look for cracks in the filet that run between the muscles and collagen sheaths (the white lines running through the fish). Breaks in the muscle itself tend to indicate mishandling. Natural separation of the muscles along the collagen sheaths indicate that the fish is not very fresh because enzymes naturally present in the muscle tissue are degrading the collagen, causing the muscles to start to tear under their own weight. Pooling water inside the container usually indicates that the fish is aging and losing its ability to hold moisture. 

2.      Inspect the color and consistency of the flesh - For white fish, such as rohu or pabda, the meat should look fairly translucent. If it is very opaque and extremely white, it's a sign that the flesh is not fresh. 

3.      For all fish, make sure the flesh is wet and glossy. Fish that is sticky, dry, or chalky has likely been handled improperly (held at warm temperatures), frozen and thawed several times, or is just plain old.

4.      Colour - the flesh should be bright and very saturated in color. Look for a clear color contrast between the fat and the muscle as this is the best indication of a fresh butchered fish. 

Next time you go to the fish market take your children along with you and pass on your knowledge to them. Listen closely to the fish seller; he will invariably be keen to teach your children and you a thing or two. Whenever I go to the Kaisarbag fish market in Lucknow I am always welcomed by loud greetings from fish sellers and their now elderly present generation successors, because they have known me since I was a child. And this acquaintance and old friendship is the surest guarantee of the freshness of the fish I purchase.

FATHER AND SON QUALITY WATERMELON TIME

Whether we know it or not, our sons learn about being a man primarily by watching their fathers. A father's influence on his son's personal development is often unseen but nonetheless real. As a young man watches his father interact with his mother, he learns about respect (or disrespect), about how men and women interact and about how men should deal with conflict and differences. As he watches his dad interact with other men, he will learn how men talk, how they relate with one another and how they deal with masculine issues. Alas with work pressures and financial woes mounting father and son bonding is becoming a thing of the past.

Human beings are social animals and we learn by modeling behavior. In fact, all primates learn how to survive and function successfully in the world through social imitation. Those early patterns of interaction are all children know, and it is those patterns that effect how they feel about themselves, and how they develop. A child is vulnerable to those early patterns and incorporates those behavioral qualities in his/her repertoire of social exchange.

The father-son relationship can be complex. Fathers and sons with widely different interests can find it hard to relate to one another. Sometimes dads and sons feel competitive against one another. Sometimes their male tendencies to not communicate feelings are compounded as both want a better father-son relationship but neither one quite knows how to go about it. Understanding that a father's influence on his son is unmatched will help fathers think more deeply about their relationship with their sons and take that relationship more seriously. Focusing on our sons, spending positive time together and talking about life lessons, scattered with a large dose of quiet and engaged listening, will help fathers and sons develop nurturing and meaningful relationships and help our sons form attitudes which will allow them to develop into men in the richest sense of that term.

Today when I look back I can say with certainty that my father did a far better job of fathering than I did. His lessons were hands on and of everyday use. ‘Quality time’ did not come announced; it was there every time we were together and it left an indelible impression on my mind and helped me become a better person.

I would accompany him to the bazaar every Sunday for purchasing vegetables, fruits and groceries. One thing which always astonished me was he knew almost everybody he interacted by their first name! Not only that, he also knew whose mother was not keeping well, whose son was appearing in High School examinations and whose daughter was getting married. He would stop and talk to everybody, whether he was buying something from them or not and I was supposed to greet everyone with a polite ‘Namashkar’.

On one such day in the bazaar he taught me how to purchase the sweetest watermelon! Watermelons are one of my favorite summer foods, and to my mind, nothing tastes better in the Lucknow summer like a sweet and crunchy watermelon. On the other hand, there's nothing quite like the disappointment of biting into what you thought was a ripe watermelon, only to be rewarded by the bland and flavorless taste of an unripe melon. To reduce the disappointment of eating an unripe melon how can you pick the best watermelon from the heap? You won’t know if your father didn’t tell you!

So here are the tips which my father gave to me to choose the sweetest watermelons. Try them, they have never failed me:

1.      Look at its belly: Watermelons have an underside, or belly, which is in contact with the ground throughout its growth.  This is called a 'field spot' or ‘yellow spot’. This spot on a ripe watermelon will be yellowish (sometimes referred to as "buttery"), and not white, which indicates an unripe melon.

2.      Dull not shiny: The watermelon should not look shiny, that is a feature of unripe fruit. If should be dull in colour

3.      Round not oblong: Perfectly round watermelons are sweeter than the oblong ones which tend to be a bit watery

4.      Look for webbing: These web-like brown spots on the watermelon mean that bees touched the pollinating parts of the flower many times. The more pollination, the sweeter the fruit is.

5.      Thump it: Using your knuckles, rap on the middle of the watermelon while holding it up to your ear, or flick it with your finger (like flicking a crumb off your shirt). A ripe watermelon will have a hollow sound when knocked, which sounds more like a 'plunk' than a 'thwack'. An unripe watermelon will have more of a higher pitched sound, while an overripe one will make a 'thud' or a lower-pitched sound. Learning the difference between the sounds of an unripe vs. a ripe watermelon takes a bit of practice.

6.      Sniff it: Pick up the watermelon and carry it a little bit away from the rest of the melons (so you don't pick up the smell of other melons), and give it a good sniff. A ripe watermelon should smell slightly sweet, and similar to what a melon tastes like, but not overly sweet (which can indicate an overripe watermelon).

7.      Squeeze it: Gently squeeze the side of the watermelon to see if there's a bit of 'give' to it. The rind of the melon shouldn't be soft, as the skin of some fruits get when ripe, but it also shouldn't be hard as a rock, with no give to it at all.

8.      Check the approximate weight on your palm, for a similar size watermelon the ripe one would be heavier than the unripe one.

9.      Look at connection to the mother vine. A ripe watermelon can be plucked off the vine leaving no part of the vine attached to it, whereas an unripe watermelon invariably carries a part of the torn vine along with it.  A dried tail indicates that the watermelon is ripe. However, if the tail is green, it probably means that the watermelon was picked too soon and will not be ripe.

Now tell me, if your father did not teach you this, who else is going to impart this invaluable knowledge to you!

Helping a son be grounded spiritually is an important role for a father. Whatever your faith tradition, help your son understand the deeper meaning of life. If you don't have a faith tradition, help him reach for his inner self and try to have a perspective that will help him look at things deeper than on the surface. As a young man gets in tune with nature, God and himself, he will have a pattern in his life that will help him endure hardship and thrive personally. Buying a ripe watermelon was just something I am reminded of every summer but developing inter personal relationships in this world was a far more valuable lesson that I learned from my father during these trips to the bazaar.

One of these days I am going to tell you how to buy fresh fish!!