The Cost of Untreated Diabetes in India

Diabetes mellitus (DM) is one of the most common noncommunicable diseases and the seventh leading cause of death globally.

India is estimated to be the World Diabetes Capital by the year 2030. In a developing nation like India, a majority of people experience hospitalization cost burden from out-of-pocket (OOP) expenses. And lack of insurance schemes and policies further escalate the cost of diabetes care. 

Diabetes is often called a silent killer as the disease progresses without too many external signs and symptoms. Unfortunately, the typical signs which are indicative of blood sugar problems like extreme daytime sleepiness, difficulty waking up in the morning, excessive sweet cravings (especially after major meals), unexplained hunger, thirst, urination are often passed of as random events that people blame on their lifestyle or lack of willpower while ironically, these are the precise symptoms that can help in early diagnosis of the disease.

If prediabetes is suspected, it becomes necessary to dig deeper and go one step further by analyzing your Insulin levels which are a more accurate indicator of diabetes risk than just fasting blood sugar levels. Majority of the population with the diagnosis of diabetes are busy bringing their high blood glucose levels in control, while totally ignoring the actual problem- Insulin resistance! It is insulin resistance that needs to be absolutely prioritized while treating diabetes. 

Growing evidence also suggests that insulin resistance (IR) is an important metabolic driver behind numerous other diseases and health risks with diabetes on the top of the list. Insulin, a hormone that the pancreas makes, allows cells to absorb and use glucose. In people with insulin resistance, the cells are unable to use insulin effectively.

IR is when cells in your muscles, body fat and liver start resisting or ignoring the signal that the hormone insulin is trying to send out—which is to grab glucose out of the bloodstream and put it into our cells. So it is of utmost importance that IR is diagnosed at the primary stage of diabetes treatment in order to save cost. 

Studies and data from across the globe is now proving that those with underlying insulin resistance had a higher incidence of fatal outcomes with Covid-19. Insulin resistance and the inflammation it triggers is the real pandemic of our times. 

As per WHO estimates, diabetes drains a significant percent of the health budget by cost toward diabetic care. The complications (short and long term) of both type I and II DM occurring during the most productive years pose an economic and social burden for the patient. The cost of diabetes can be categorised into three groups:

The average direct cost of diabetes is estimated to be ₹18,890 per annum (which means if you live with diabetes for 20 years, it’s  going to cost you around 4 lakhs) while the spending ranges anywhere between ₹999 to ₹1,09,344 (1).

Medicines, diagnostics, transportation cost and hospitalisation take up the majority of the expenditure.

As high as ₹1000 is spent on hospital visits on a daily basis. And these are just the costs of monitoring your blood sugar levels and keeping them in control. 

Diabetes is a disease that comes with associated comorbidities and complications. Fluctuating blood sugar levels over a long period of time can lead to increased inflammation and damaged organs (especially brain, heart, liver and kidneys).

Diabetes results in both short and long term complications, mostly manifested as Cardiovascular diseases, nerve damage (neuropathy), kidney damage (nephropathy), eye damage (retinopathy), foot damage, skin changes, hearing impairment and also PCOD. Each of these add to the costs of living with diabetes especially as some of these health complications require surgical interventions. 

Research suggests that cost on diabetic drugs and exogenous insulin (insulin injections) constitutes 50% of the total direct costs. Most of these costs can be totally eliminated by just reversing insulin resistance. This is a condition that is literally triggered by faulty eating patterns and disturbed lifestyle practices.

Diabetes can be completely prevented and also reversed once the root causes are identified. While prevention would lead to substantial long-term cost savings from treating the disease, it may also extend the life expectancy of you and your loved ones.

Reach out to us if you want to learn more about Diabetes. 

References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299136/ 
  2. https://care.diabetesjournals.org/content/37/12/3137#:~:text=Given%20a%20cost%20of%20undiagnosed,earlier%20in%20the%20disease%20process.
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299136/#:~:text=Results,p.a.%20for%20the%20west%20zone.
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4279984/
  5. https://www.ijcm.org.in/article.asp?issn=0970-0218;year=2019;volume=44;issue=2;spage=113;epage=117;aulast=Mathew
  6. https://www.jpbsonline.org/article.asp?issn=0975-7406;year=2016;volume=8;issue=4;spage=314;epage=320;aulast=Acharya
  7. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30556-4/fulltext#articleInformation
  8. https://catalyst.phrma.org/costs-and-consequences-of-not-treating-diabetes
  9. https://care.diabetesjournals.org/content/37/9/2557 

Causes of Insulin Resistance

Discovery of insulin, in 1921, was a Big Bang from which a vast and expanding universe of research into insulin action and resistance has issued. Growing evidence suggests that insulin resistance (IR) is an important metabolic driver behind numerous diseases and health risks.

Insulin resistance is when targeted cells primarily in your muscles, fat, and liver do not respond well to insulin and cannot use glucose from your blood for energy. Insulin, a hormone that the pancreas makes, allows cells to absorb and use glucose. In people with insulin resistance, the cells are unable to use insulin effectively.

Insulin resistance is when cells in your muscles, body fat and liver start resisting or ignoring the signal that the hormone insulin is trying to send out—which is to grab glucose out of the bloodstream and put it into our cells.

Causes of IR

The great majority of people with insulin resistance fall into the acquired categories, viz.,

  1. Obesity/Excessive fat (adipose tissue)- 

One of the most important risk factors for IR is Obesity or excessive fat accumulation. Possible mechanisms in different research studies suggest that excessive fat secret substances called Adipokines which are known to impair the targeted Insulin receptor tissues and cause IR. 

It has been suggested that obese individuals are associated with a greater rate of fatty acid breakdown and uptake compared with lean individuals, and this higher flux is postulated to be an important mediator of insulin resistance. 

  1. Lack of movement, exercise

It is well established that exercise is associated with substantial improvement in insulin sensitivity. A single bout of moderate intensity exercise can increase the glucose uptake by at least 40%.The beneficial impact of daily exercise on insulin resistance would be magnified if associated with diminished body fat because exercise can influence the fat deposition in your tissues.

Individuals with diabetes due to insulin resistance can be reversed by habitual physical exercise. As excess adiposity in the waistline contributes to insulin resistance, regular exercise assists in reduction of body fat, thus increasing cellular insulin sensitivity.

Indeed, combined with the fact that modest exercise reduces the morbidity and mortality associated with cardiovascular disease and diabetes, it is an effective therapeutic strategy for reducing insulin resistance and, more importantly, improving overall quality of life and wellbeing. 

  1. Nutritional imbalance 

Several nutritional insufficiencies can also ultimately lead to IR. Glucose toxicity or glucotoxicity is a condition resulting from untreated high blood sugar. It is accepted that glucose toxicity is involved in the worsening of IR by affecting the secretion of β-cells.

Glucotoxicity not only affects the secretion of pancreatic hormones but also participates in insulin resistance of insulin-sensitive tissues (liver, skeletal muscle, and adipose tissue). Oxidative stress is strongly suspected to be involved in glucotoxicity induced insulin resistance. 

High fat intake from n-6 PUFAs are known to worsen and cause Insulin resistance. Largely present in vegetable oils, these n-6 fats cause the adipocytes (fat stores) to signal to peripheral cells to become insulin resistant, as Paul Saladino, a Carnivore MD says. He also states that it is the n-6 PUFAs which initiates the process of IR rather than the carbohydrates.

Moreover, it is worth noting that vitamin D deficiency is very common and may be associated with the pathogenesis of insulin-resistance-related diseases, including obesity and diabetes. Evidence suggests that vitamin D seems to be a regulator of numerous sequential events that are responsible for enabling the pancreatic β-cells to secrete insulin, and thereby to control blood glucose level.

  1. Thyroid dysfunction (Hyperthyroidism and Hypothyroidism)

Insulin resistance is defined as a glucose homeostasis disorder involving a decreased sensitivity of muscles, adipose tissue, liver and other body tissues to insulin, despite its normal or increased concentration in blood. Thyroid hormones have a significant effect on glucose metabolism and the development of insulin resistance.

In hyperthyroidism, impaired glucose tolerance may be the result of mainly insulin resistance in the liver, whereas in hypothyroidism the available data suggests that the insulin resistance of peripheral tissues prevails.

  1. High inflammation/ elevated inflammatory markers

Development of IR is mainly associated with tissue-specific inflammatory responses induced by various pro-inflammatory and/or oxidative stress markers notably pro-inflammatory cytokines such as interleukin-1 beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), numerous chemokines and adipocytokines, glucolipotoxicity.

Chronic exposure of pro-inflammatory mediators stimulates the activation of cytokine signaling proteins which ultimately block the activation of insulin signaling receptors in β-cells of pancreatic islets.

  1. Medications (glucocorticoids, anti-adrenergic, protease inhibitors, antipsychotics)

Treatment with cancer therapeutics such as glucocorticoids, chemotherapy, hormonal therapies and targeted drugs can actually induce insulin resistance. Current literature regarding the incidence of cancer-therapy induced insulin resistance describes the intracellular changes that occur in insulin signalling pathways and glucose metabolism.

Protease inhibitor use is associated with a potentially serious syndrome of metabolic abnormalities characterized by central adiposity, hypertriglyceridemia, hypercholesterolemia, and insulin resistance.

Other categories of drugs like anti-adrenergic and antipsychotics are also linked to cause Insulin resistance. 

  1. Aging

With increasing age, body’s insulin sensitivity and glucose regulation ability decreases gradually along with muscle wasting. Studies have shown that, compared with younger males (30 years old), older males (65–70 years) have reduced glucose metabolism and decreased expression of skeletal muscle.

The underlying mechanism behind aging and insulin resistance is related to a series of changes in skeletal muscle during the aging process. During skeletal muscle aging, a series of other changes also tend to occur, including mitochondrial dysfunction, fat accumulation, increased inflammation and oxidative stress. These changes can impair skeletal muscle insulin sensitivity and increase the risk of insulin resistance.

  1. Smoking 

Smoking reduces the effectiveness of insulin, inflames your whole body and also increases the oxidative stress. Nicotine from cigarettes makes the working of Insulin less effective, keeping you in a continued insulin-resistant state. Inflammation occurs when chemicals in cigarette smoke injure cells, causing swelling and interfering with proper cell function, explains the CDC.

Inflammation is one of the key factors responsible for insulin resistance. Oxidative stress is a condition that develops when the smoke inhaled from your cigarette combines with the otherwise healthy oxygen in your body. Your entire body relies on the healthy delivery of oxygen to keep it healthy — and now it’s receiving oxygen that is severely contaminated and can ultimately be the reason behind insulin resistance.

In addition to the above factors, there are a number of unrelated genetic syndromes with associated insulin resistance Myotonic Dystrophy, Ataxia-telangiectasia, Alstom syndrome, Rabson-Mendenhall syndrome, Werner syndrome, Lipodystrophy).

In our work at ThriveFNC we’ve seen that insulin resistance is a silent disease and dangerous and begins without any evident symptoms.  The only way to detect Insulin Resistance is by testing your blood for related parameters. You can approach ThriveFNC if you or your loved ones are suffering from insulin resistance.

References-

1)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038351/#:~:text=The%20mechanisms%20by%20which%20visceral,draining%20into%20the%20portal%20vein.

2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3782965/

3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569266/

4)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738809/#:~:text=Glucose%20toxicity%20means%20a%20decrease,the%20secretion%20of%20%CE%B2%2Dcells.

5) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6520736/

6) https://journals.viamedica.pl/endokrynologia_polska/article/view/37310

7) https://jbiomedsci.biomedcentral.com/articles/10.1186/s12929-016-0303-y

8) https://dmsjournal.biomedcentral.com/articles/10.1186/s13098-020-0523-x#:~:text=During%20the%20aging%20of%20skeletal,activated%20RAS%20all%20induce%20skeletal

9) https://academic.oup.com/jcem/article/82/11/3619/2865959

10)https://sci-hub.tw/10.1158/1055-9965.EPI-19-0206

11) https://www.ncbi.nlm.nih.gov/books/NBK507839/

11) https://www.ncbi.nlm.nih.gov/books/NBK507839/

12) https://www.sciencedirect.com/science/article/pii/S0092867413001335

13) https://doi.org/10.1016/j.amjmed.2006.01.009

14) https://care.diabetesjournals.org/content/31/Supplement_2/S262

15) https://sci-hub.tw/10.1158/1055-9965.EPI-19-0206

16) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6170977/

17) https://sci-hub.tw/

18) https://doi.org/10.1016/j.ijcard.2014.01.087

18) https://sci-hub.tw/10.1042/BSR20170947

20) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5435954/

21) https://sci-hub.tw/10.1038/s41598-018-29087-1

22) https://sci-hub.tw/10.1089/met.2018.0016

23) https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-019-1220-6

24) https://pubmed.ncbi.nlm.nih.gov/27426616/

25) https://pubmed.ncbi.nlm.nih.gov/29169589/

26) https://sci-hub.tw/10.1038/s41598-017-09522-5

About the Author

Ria Jain
Ria has a Master’s in Nutrition and Dietetics and is in a permanent research mode and keeps the rest of us at ThriveFNC updated with her latest findings in the field of Nutrition. Her articles on ThriveFNC’s blog are an expression of her research findings. We really don’t know what we’d do without her support and her focus.
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All you want to know about Cardiovascular diseases

What are cardiovascular diseases or CVDs?

Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels and they include:

coronary heart disease – disease of the blood vessels supplying the heart muscle;

cerebrovascular disease – disease of the blood vessels supplying the brain;

peripheral arterial disease – disease of blood vessels supplying the arms and legs;

hypertension- also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure.

atherosclerosis- a process of progressive thickening and hardening of the walls of medium-sized and large arteries as a result of fat deposits on their inner lining

rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria;

congenital heart disease – malformations of heart structure existing at birth;

deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs,

heart attack- blockage due to build-up of fatty deposits that prevents blood from flowing to the heart,

stroke- bleeding from a blood vessel in the brain or from blood clots.

heart failure- happens when the heart isn’t pumping well enough, either because the walls of the ventricles are enlarged, weakened, damaged or too stiff, or the heart’s valves don’t work properly.

The top symptoms of cardiovascular health problems

Often, there are no symptoms of the underlying disease of the blood vessels and that’s why they are often silent killers. A heart attack or stroke may be the first and often final warning of an underlying disease.

Symptoms of a heart attack include:

pain or discomfort in the centre of the chest;

pain or discomfort in the arms, the left shoulder, elbows, jaw, or back.

In addition the person may experience difficulty in breathing or shortness of breath; feeling sick or vomiting; feeling light-headed or faint; breaking into a cold sweat; and becoming pale. Women are more likely to have shortness of breath, nausea, vomiting, and back or jaw pain.

The most common symptom of a stroke is sudden weakness of the face, arm, or leg, most often on one side of the body. 

Other symptoms include sudden onset of:

numbness of the face, arm, or leg, especially on one side of the body;

confusion, difficulty speaking or understanding speech;

difficulty seeing with one or both eyes;

difficulty walking, dizziness, loss of balance or coordination;

severe headache with no known cause; and

fainting or unconsciousness.

Symptoms of rheumatic heart disease include: shortness of breath, fatigue, irregular heart beats, chest pain and fainting.

Symptoms of rheumatic fever include: fever, pain and swelling of the joints, nausea, stomach cramps and vomiting.

The 7 most significant risk factors of cardiovascular diseases. 

There are numerous risk factors associated with Cardiovascular diseases. Some of them, such as family history, cannot be modified while other risk factors like high blood pressure can be mitigated with the right nutrition

  1. High dietary fat intake

A high intake of dietary fats strongly influences the risk of developing cardiovascular diseases.

Saturated fatty acid commonly found in dairy products and meat raise cholesterol levels. Moreover, studies have also shown trans fatty acids, found in industrially hardened oils, increase the risk of coronary heart disease. While they have been eliminated from many parts of the world, trans fatty acids are still found in deep-fried fast foods, processed food and baked goods.

  1. Behavioral factors

The most important behavioural risk factors of heart disease and stroke are unhealthy eating patterns, physical inactivity, tobacco use and alcohol consumption. The effects of behavioural risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risks factors” can be measured via simple blood tests and are helping in indicating an increased risk of developing a heart attack, stroke, heart failure and other complications.

  1. Stress

Studies suggest that the high levels of cortisol from long-term stress can increase blood cholesterol, triglycerides, blood sugar, and blood pressure. Cortisol is the body’s main stress hormone. It works in this way- more the stress, more is the Cortisol level. This stress can also cause changes that promote the buildup of plaque deposits in the arteries. 

  1. Hereditary

Approximately 40% of the risk for cardiovascular disease lies in hereditary factors and remains a non-modifiable risk factor.

  1. High Homocysteine and CRP levels

High levels of Homocysteine can lead to hardening of the arteries and can also result in blood clot formation. In addition to being clinically useful as a measure of systemic inflammation, high CRP levels are indicative of CVDs risk as they are prominent markers of inflammation.

  1. Hemochromatosis

Haemochromatosis is an inherited condition where excessive levels of iron in the body gets absorbed, leading to iron overload. Over time, this overload leads to a build up of iron in different parts of the body, including the heart. Cardiomyopathy caused by haemochromatosis usually causes symptoms of heart failure.

  1. Toxin overload on the Liver

“The connection between fatty liver and early signs of plaque in the coronary arteries is increasingly compelling,” says Dr. Tracey Simon, a hepatologist at Harvard-affiliated Massachusetts General Hospital (MGH) because of dangerous accumulation of fat in the liver. This overload can be due to chronic alcoholism or heavy metal ingestion. 

There are numerous risk factors associated with Cardiovascular diseases. Some of them, such as family history, cannot be modified while other risk factors like high blood pressure can be mitigated with the right nutrition

  1. High dietary fat intake

A high intake of dietary fats strongly influences the risk of developing cardiovascular diseases.

Saturated fatty acid commonly found in dairy products and meat raise cholesterol levels. Moreover, studies have also shown trans fatty acids, found in industrially hardened oils, increase the risk of coronary heart disease. While they have been eliminated from many parts of the world, trans fatty acids are still found in deep-fried fast foods, processed food and baked goods.

  1. Behavioral factors

The most important behavioural risk factors of heart disease and stroke are unhealthy eating patterns, physical inactivity, tobacco use and alcohol consumption. The effects of behavioural risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risks factors” can be measured via simple blood tests and are helping in indicating an increased risk of developing a heart attack, stroke, heart failure and other complications.

  1. Stress

Studies suggest that the high levels of cortisol from long-term stress can increase blood cholesterol, triglycerides, blood sugar, and blood pressure. Cortisol is the body’s main stress hormone. It works in this way- more the stress, more is the Cortisol level. This stress can also cause changes that promote the buildup of plaque deposits in the arteries. 

  1. Hereditary

Approximately 40% of the risk for cardiovascular disease lies in hereditary factors and remains a non-modifiable risk factor.

  1. High Homocysteine and CRP levels

High levels of Homocysteine can lead to hardening of the arteries and can also result in blood clot formation. In addition to being clinically useful as a measure of systemic inflammation, high CRP levels are indicative of CVDs risk as they are prominent markers of inflammation.

  1. Hemochromatosis

Haemochromatosis is an inherited condition where excessive levels of iron in the body gets absorbed, leading to iron overload. Over time, this overload leads to a build up of iron in different parts of the body, including the heart. Cardiomyopathy caused by haemochromatosis usually causes symptoms of heart failure.

  1. Toxin overload on the Liver

“The connection between fatty liver and early signs of plaque in the coronary arteries is increasingly compelling,” says Dr. Tracey Simon, a hepatologist at Harvard-affiliated Massachusetts General Hospital (MGH) because of dangerous accumulation of fat in the liver. This overload can be due to chronic alcoholism or heavy metal ingestion. 

There are numerous risk factors associated with Cardiovascular diseases. Some of them, such as family history, cannot be modified while other risk factors like high blood pressure can be mitigated with the right nutrition

  1. High dietary fat intake

A high intake of dietary fats strongly influences the risk of developing cardiovascular diseases.

Saturated fatty acid commonly found in dairy products and meat raise cholesterol levels. Moreover, studies have also shown trans fatty acids, found in industrially hardened oils, increase the risk of coronary heart disease. While they have been eliminated from many parts of the world, trans fatty acids are still found in deep-fried fast foods, processed food and baked goods.

  1. Behavioral factors

The most important behavioural risk factors of heart disease and stroke are unhealthy eating patterns, physical inactivity, tobacco use and alcohol consumption. The effects of behavioural risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risks factors” can be measured via simple blood tests and are helping in indicating an increased risk of developing a heart attack, stroke, heart failure and other complications.

  1. Stress

Studies suggest that the high levels of cortisol from long-term stress can increase blood cholesterol, triglycerides, blood sugar, and blood pressure. Cortisol is the body’s main stress hormone. It works in this way- more the stress, more is the Cortisol level. This stress can also cause changes that promote the buildup of plaque deposits in the arteries. 

  1. Hereditary

Approximately 40% of the risk for cardiovascular disease lies in hereditary factors and remains a non-modifiable risk factor.

  1. High Homocysteine and CRP levels

High levels of Homocysteine can lead to hardening of the arteries and can also result in blood clot formation. In addition to being clinically useful as a measure of systemic inflammation, high CRP levels are indicative of CVDs risk as they are prominent markers of inflammation.

  1. Hemochromatosis

Haemochromatosis is an inherited condition where excessive levels of iron in the body gets absorbed, leading to iron overload. Over time, this overload leads to a build up of iron in different parts of the body, including the heart. Cardiomyopathy caused by haemochromatosis usually causes symptoms of heart failure.

  1. Toxin overload on the Liver

“The connection between fatty liver and early signs of plaque in the coronary arteries is increasingly compelling,” says Dr. Tracey Simon, a hepatologist at Harvard-affiliated Massachusetts General Hospital (MGH) because of dangerous accumulation of fat in the liver. This overload can be due to chronic alcoholism or heavy metal ingestion. 

Higher your risk factors greater is the likelihood that you will experience cardiovascular problems, unless you take actions to mitigate your risk factors

The Inflammatory process

We always hear that inflammation is the root cause of development of X disease. But ever wondered what this inflammation actually is and how does this inflammatory process affect your health? Here’s how:

When  tissues are injured by bacteria, trauma, toxins, heat, or any other cause like poor dietary habits or inactivity, there occurs inflammation. This inflammatory response is made evident by something known as Pro-inflammatory markers. As the name suggests, these are substances capable of producing inflammation and it is no good. Some of the pro-inflammatory markers are IL-1 beta, TNF-alpha and Interferon- gamma.

This inflammatory process contributes to all stages of CVDs, from the development of atherosclerosis to end stage complications. It all starts from poor dietary habits like increased consumption of foods rich in saturated fats (meat and dairy products mainly) which leads to high levels of LDL-C. Low density lipoprotein cholesterol (LDL-C) is  also known as ‘bad’ cholesterol. It contributes to fatty buildups in arteries (atherosclerosis), thus narrowing them and increasing your risk for heart attack and other conditions.

Accumulation of LDL-C in the arteries has shown to trigger the inflammatory response by activating the pro-inflammatory markers, CRP and finally resulting in a heart attack or stroke. There are anti-inflammatory nutrients which aid in avoiding this process.

Nutrients that are of help

When we expose it to alcohol, tobacco smoke, radiation, pesticides or unhealthy foods, certain particles are formed called as- Free Radicals. These are highly reactive and damage our healthy cells. Antioxidants are substances that may protect your cells against free radicals. The benefitting nutrients that we are going to talk about, have protective effects for precisely this reason. The antioxidant and antiinflammatory properties of these nutrients make their consumption on a daily basis, much more important.

Following is a list of certain nutrients which are important for protection from CVDs-

  1. Vitamin E

Studies have suggested that supplementation with vitamin E might reduce serum CRP levels.

  1. Vitamin C

Vitamin C is also known to exert potential antioxidant and anti-inflammatory effects, increasing the levels of HDL-C and decreasing CRP levels. 

  1. Vitamin D

Researchers have  shown that vitamin D-supplemented groups had lower levels of TNF-α, one of the proinflammatory markers.

  1. Folic Acid, Vitamin B6 and B12

An adequate  intake of folic cid, Vitamin B6 and Vitamin B12 could possibly reduce the risk of coronary heart disease by significant reduction in Homocysteine concentrations. High levels of Homocysteine can contribute to blood vessel damage and blood clots in your blood vessels. 

  1. Magnesium

Several studies have suggested that Magnesium supplementation helps with cardiovascular health

  1. Co-enzyme Q10

CoQ10 has shown potent antioxidant properties in numerous studies. 

However, when it comes to supplementing with nutrients, please consult a functional medicine/ functional nutrition specialist as you could easily overdose on some of these. 

Bioactive compounds from food that are of help

Multiple bioactive compounds (omega-3 fatty acids, carotenoids, polyphemols or flavanoids) present in our food have beneficial effects on atherosclerosis development. All of them act to reduce levels of LDL-C and inflammatory biomarkers. 

  1. Omega-3 fatty acids-

Polyunsaturated fatty acids (PUFAs) are a class that includes many important compounds, such as essential fatty acids (EFAs). EFAs are fats  that humans must ingest for good health because our bodies cannot make them. EFAs include- alpha-linolenic acid (ALA)/ omega-3 fatty acid, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) and have been reported as potential agents for prevention from formation of blood clots. 

  1. Carotenoids

Carotenoids are a family of fat-dissolvable shades found chiefly in plants. Humans cannot produce them too, so they are important in their eating routine.  They are known to help in battling Atherosclerosis with their antioxidant and antiinflammatory properties. Following are some of the potent Carotenoids-

-Lycopene: This is present in red-colored fruits and vegetables, such as tomatoes, papaya, or watermelons among others. Studies suggest that lycopene might reduce CVD risk, particularly in early stages of atherosclerosis, preventing endothelial dysfunction and LDL accumulation.

-Lutein: It’s found in oranges, honeydew melon, and higher concentrations in dim green vegetables, for example, turnip greens, kale, parsley, spinach, and broccoli. Lutein prevents advancement of atherosclerosis.

-Beta-carotene: Beta-carotene is a standout amongst the most generally examined carotenoids. It is also known as Pro-Vitamin A. It’s found in carrot, orange, kale, spinach, turnip greens, apricot, and tomato, low serum carotenoid levels may reflect  high LDL-C levels which may further increase the risk of developing CVDs.

  1. Polyphenols-

Polyphenols are a large class of organic compounds of plant origin, tend to be colourful and possess a wide range of health effects in the prevention of CVD.

Many studies have been focused on the antioxidant power of these polyphenols from most commonly consumed plant-derived foods, with very high values found for spices, herbs, berries, fruits, nuts, and vegetables. 

Highest antioxidant value is reported for cranberries, blueberries, and blackberries among fruits and for celery, Ginkgo biloba, onions beans, artichokes, and russet potatoes among vegetables. 

Moreover, nuts (pecans, walnuts, almonds, pistachios and hazelnuts) and spices (turmeric, ground cloves, ground cinnamon, and oregano) have also been reported as good sources of antioxidants.

  1. Flavanoids-

Flavanoid compounds that occur in a variety of foods such as citrus fruits, berries, onions, apples and legumes could also possibly reduce the risk of coronary heart disease. Flavonoids show high antioxidant, anti-inflammatory and antiallergic properties.

Cardioprotective foods and herbs

The role of certain nutrients is quite clear in CVDs. But the question is where do we get these nutrients from? The answer is right around the corner. Yes, foods and herbs.

When it comes to food, there is only one true saying- The whole, the healthier!

Some good plant based sources of all the important nutrients are:

Vitamin C: Guava, Amla (Indian Gooseberry), Capsicum, Oranges

Vitamin E: Sunflower seeds, Almonds, Hazelnuts, Avocados

Folic Acid: Legumes- beans, peas, lentils sesame seeds, green leafy vegetables- spinach and kale, Asparagaus

Vitamin B6: Chickpeas, Carrots, Sweet potatoes, Bananas, Green peas

Magnesium: Brazil nuts, almonds, pecans, walnuts, pumpkin seeds, flaxseeds, sunflower seeds, sesame seeds,cumin seeds, peach apricots, avocado, banana, blackberries, spinach, okra, broccoli, beetroot,  buckwheat.

However, for nutrients like Vitamin B12, Vitamin D and Co-enzyme Q10 there is need for supplementation because of scarcity of natural sources from food.

Herbs that help with heart health include the following

Caraway oil and seed, 

Cardamom seed, 

Cinnamon bark, 

Cloves, 

Coriander seed, 

Dill seed, 

Fennel oil and seed, 

Garlic, 

Ginger root, 

Licorice root, 

Mint oil, 

Paprika, 

Parsley herb and root, 

Peppermint leaf and oil, 

Rosemary, 

Sage, 

Thyme, 

Turmeric root, 

White mustard seed,

Ginseng 

Sprinkle these on your salads and soups or use them during your cooking process itself and reap the benefits of these healing powerhouses 

Did you know? 

CVDs are the number 1 cause of death globally: more people die annually from CVDs than from any other cause.

An estimated 17.9 million people died from CVDs in 2016, representing 31% of all global deaths. Of these deaths, 85% are due to heart attack and stroke.

Over three quarters of CVD deaths take place in low- and middle-income countries.

Out of the 17 million premature deaths (under the age of 70) due to noncommunicable diseases in 2015, 82% are in low- and middle-income countries, and 37% are caused by CVDs.

Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol using population-wide strategies.

People with cardiovascular disease or who are at high cardiovascular risk (due to the presence of one or more risk factors such as hypertension, diabetes, hyperlipidaemia or already established disease) need early detection and management using counselling and medicines, as appropriate.

References:

https://www.who.int/cardiovascular_diseases/about_cvd/en/

https://sci-hub.tw/10.3390/ijms19123988

https://medcraveonline.com/PPIJ/natural-foods-and-indian-herbs-of-cardiovascular-interestnbsp.html

https://www.mdpi.com/1422-0067/21/4/1250

https://sci-hub.tw/10.1007/978-981-13-1745-3_3-1

https://www.cardiosecur.com/magazine/specialist-articles-on-the-heart/heart-attack-genetic-risk

https://www.cardiomyopathy.org/about-cardiomyopathy/haemochromatosis-and-cardiomyopathy

https://www.health.harvard.edu/heart-health/fatty-liver-disease-an-often-silent-condition-linked-to-heart-disease

Puberty, PMS, Menopause: 3 things you could do to make it pain and struggle free

If you are a woman reading this, you need no introduction to the subject. If you are a man reading this, then you aren’t too much of a stranger to this subject either, unless you’ve been living on Mount Athos

For 80%  of all menstruating women, that time of the month when your uterus makes it’s presence known loud and clear is a not a laughing matter. More than 150 symptoms have been attributed to PMS! The symptoms are so common that the medical community considered discarding the term “PMS” and accepting the symptoms as normal! This attitude trivializes the daily significance of PMS for the millions of women women who suffer from it.

For at least 5% of all menstruating women, the symptoms of PMS are so severe that they are incapacitated on a monthly basis. For many women, even moderate PMS can interfere with work and can disrupt everything from parenting to social relationships. In addition, if PMS symptoms weren’t enough, for most women menopause has become something to dread. Plus, now that little girls as young as 8 and 9 are hitting puberty (which isn’t normal, but more on that subject in another blog post), that’s far too many years of you being your held hostage by your biology right from puberty up until you hit menopause.  

But is it really your biology holding you hostage? What’s really going on? Most theories blame your hormones, inflammation, prostaglandins, neurotransmitters etc making you believe that you really have no control over what’s going on in your body.

Symptoms such as depression, diarrhea, bloating, anxiety, insomnia, migraines, and mood swings are often blamed on PMS. That blame is inaccurate. 

These symptoms, like the supposed symptoms of menopause (night sweats, hot flashes, fatigue, dizziness, weight gain, digestive issues, bloating, incontinence, headaches, moodiness, irritability, depression, anxiety, panic attacks, heart palpitations, trouble concentrating, memory issues, insomnia and other sleep disorders, vaginal dryness, breast sensitivity, joint pain, tingling, hair loss or thinning, dry or cracked skin, and dry or brittle nails), are actually from underlying health conditions such as a sensitive central nervous system, IBS, heavy metal toxicity or chronic viral and bacterial infections. 

These symptoms become more apparent at this particular time in your cycle because the menstruation process takes up 80 percent of your body’s reserves. The 20 percent left over cannot manage the health conditions that your immune system normally keeps at bay. This is another prime example of how far conventional medicine is from understanding women’s health.

Rather than pointing to the reproductive system as the reason for a woman’s suffering at her time of the month, we should look at it as a messenger. Rather than drowning the signals in painkillers, steroids, immunosuppressants and antibiotics we need to support both the immune system and the reproductive system with healing foods and herbs.

Your uterus is a maker of life. It sustains life for 9 months. It’s a space where a living being has to be nurtured and protected. Your uterus is a fierce protector of life. This is its primary role. Does it make any sense at all that a healthy and natural life process should be causing so many problems?

Over the last few decades thanks to an overload from the environment, we have been overexposed to radiation, toxic heavy metals, mutated versions of viruses and bacteria and chemicals like DDT. These are invisible intruders in our lives, and are the root cause of the chronic illness epidemic that we are witnessing in our times. We are exposed to these and absorb these over our lifetime.

These can even be passed down generation to generation and can get stored in our internal organs like the brain, the gut, the liver, pancreas and even the uterus. These cause your underlying health dysfunctions, the ones that become so apparent during PMS and menopause.

Your biology is not holding you hostage.It’s in fact sending you signals that there are intruders in your body that need to be dealt with.  Your depression, diarrhea, bloating, anxiety, insomnia, migraines, and mood swings are all indicators that something deeper needs to be fixed.

What triggers the pain though?

Well, the space in our abdominal and pelvic cavity is actually quite cramped. Every organ fits in there snugly and there’s no empty/ extra space. When any of the above factors triggers lymphedma or fluid retention, this excess fluid starts putting pressure on everything around it, there really is no place for your internal organs to go.

This pressure itself makes everything uncomfortable. The nerves in your abdominal and pelvic cavity are being touched by this pressure and start sending pain signals to your brain, and that is what triggers the pain. To relieve yourself of the pain and discomfort, here are 3 things that you can do reduce your pain and suffering. 

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1. INCLUDE the following foods in your diet 

Wild blueberries, Asparagus, Avocados, Apples, Spinach, Black grapes, Cranberries, Cruciferous vegetables, Leafy greens and Cucumbers

These will boost your immune system and support your reproductive system

2. ADD the following herbs and nutrients to your daily routine

Lemon balm, Red clover, Nettle leaf, Licorice root, Zinc, Vitamin B12, Folic acid, B-Complex, Vitamin D3, and Plant based Omega-3’s

3. EXCLUDE the following foods from your diet

Dairy, Wheat, Eggs, Corn, Canola Oil, MSG/ Natural Flavors/ Preservatives, Refined Sugar, Processed Foods

These foods not only cause inflammation, but also feed pathogens leading to a higher toxic load on your system.

If you struggle with issues you’ve always thought of as PMS, reach out to me to explore what could really be causing your symptoms and let’s address that true cause. Periods should be easy. You needn’t go through the pain. You deserve a stress-free menstrual cycle.

 

Top 6 ways in which obesity can harm you

As a Functional Nutritionist I have often asked my clients the crucial question – ‘Why do you want to lose weight?’ The answers vary from ‘I want to look good’ to ‘I cannot take the back pain anymore’. Rarely does anyone tell me that they want to ease the strain that they are putting on their body every day.

Yes, obesity wreaks havoc on your body and is proof of bodily functions gone wrong within. I think returning your body processes to optimum is the number one reason you should be shedding those extra kilos immediately.

Being overweight puts a lot of stress on your organs and sets you up for misery that will come sooner than you think. This might sound harsh but it is the scary truth that reveals itself once you know your body.

This post will educate you on the workings of your body the relation of obesity with various illnesses and health risks. Bear in mind that most of the below health risks are not the effect of obesity but go hand in hand with it. Some of them are even the cause of obesity. For example, insulin resistance or Type 2 Diabetes leads to weight gain and not the other way round.

But first, let’s define what being overweight or obese is. This is determines by your BMI or Body Mass Index. Calculate your BMI using the following formula:

BMIInterpretation
18 - 23Normal
24 - 25Overweight
26 and aboveObese

Health Risks

Obesity is closely related to increased risk of type 2 Diabetes, hypertension, sleep apena, heart stroke, asthma, certain cancers, high blood pressure and high cholesterol. In fact, obesity is said to be linked with more than 50 different health problems.

Why Being Overweight is related to so many health problems? 

Extra fat in your body puts strain on your cardiovascular system. Your heart has to work harder to pump blood to all the extra fat and lymphatic fluid you are carrying around. Although being overweight increases all these problems it is not at the heart of all the illnesses. To know the real cause we must get to the root of weight gain itself.

Obesity is not the normal way of a body. A lot of people think that obesity is just a matter of too much eating and too little exercise. While these factors do play a role they are not enough to get you on the path to become obese. Consider the case of childhood obesity.

There are more than 10 million cases of childhood obesity in India alone! Cases of obesity are seen in children as young as 2 to 5 years today. Clearly, it’s not the result of too much food and too little exercise. Something else is going on here. Weight gain is actually a case of your cellular metabolism gone wrong.

The truth is- it can happen to anyone. Insulin resistance, a thyroid dysfunction, toxic load in our environment, stressful lifestyle, sedentary jobs, inflammatory, poor diet and nutrient deficiency are all to be blamed for the metabolic syndrome.t is the seed that grows into a host of other chronic illnesses including obesity. Obesity is hence a marker of metabolic dysfunctions in your body and the start of many chronic illnesses.

Diabetes and Obesity

There have been numerous studies linking weight gain with diabetes. In fact, experts have coined the term ‘diabesity’ as diabetes and obesity go hand in hand. The famous Harvard study that studied 170,000 people over the span of 10 years found that obesity increases the risk of diabetes by 20 times! However all these studies measure risk of diabetes by correlating obesity with presence of diabetes? It doesn’t necessarily mean that obesity is the cause of diabetes. In fact it may be the other way around.

Insulin resistance is at the heart of type 2 diabetes. Insulin acts as a gate pass for glucose to enter into cells for its conversion into energy. Insulin resistance happens when your cells refuse to take in the glucose and shut off to the insulin in your blood. This is caused by poor lifestyle factors, consuming too much PUFA's or genetics. This extra glucose in the blood is then stored in fat cells causing you to gain weight.

Insulin resistance points to a metabolic syndrome in the body and it usually precedes weight gain. This means that if you are overweight there is a good chance that you are already suffering from metabolic syndrome and insulin resistance. This is more likely if you easily put on weight on your waist.

Hypertension and Obesity

Hypertension is the measure of pressure that blood applies to the inner walls of your arteries. Abnormal glucose metabolism increases inflammation and can lead to plaque in the arteries and thickening of the arteries. This leads to high blood pressure. Again, your heart has to work harder to pump blood around your body and leading  to increased risk of heart attack.

Cancer

Observational studies have shown that obese persons are at a higher risk of many types of cancer. This includes endometrial cancer (cancer of uterus lining), liver cancer, brain tumor, gall bladder cancer, breast cancer and prostate cancer.

The exact mechanisms of how obesity causes cancer are yet to be discovered. As of now, there are only theories that best support the evidence of higher incidences of cancer in obese people.

One of the theories is that the chronic low-level inflammation that obese people often have leads to DNA damage that leads to cancer. Yet another link is the excess estrogen produced by fat tissue in obese people. Excess estrogen is known to be associated with breast, endometrial and ovarian cancer.

Fat cells also produce adipokines, hormones that can mess up the growth stimulation and inhibition mechanism of cells. Increased level of insulin in the blood is also known to help certain cancers.

Stress on organs

All the extra body mass obviously puts strain on the organs of your body which are meant to handle much less. Increase in fat tissues means that your heart has to pump harder to reach through more blood vessels in your body. Fat deposits also diminish the lung’s capacity to hold air according to studies.

Extra weight also causes structural burden on your skeleton. Obesity usually leads to osteoarthritis, back pain and joint pains.

Mental Health

The relation of mental health and obesity is again the story of chicken and egg. We do not know for sure which one comes first.  People with mental health issues have a two to three times higher risk of obesity and people with obesity have a 30% higher risk of mental health issues.

The reason of overlap could be the common risk factors such as stress. Cortisol levels are known to be higher in both obese and depression patients. Inflammation in body and increased stress can lead to a flight or flight response in body which can cause both depression and weight gain. Depression and obesity can lead into a vicious cycle where loss of self-esteem can lead to binge eating which leads to more weight gain. Mental health issues associated with obesity include anxiety, depression, PTSD.

Social Health

The social effects of obesity may not be acknowledged medically with a term, but they are just as damaging. Not being able to fit into your favorite dress and gaining weight every week attacks your self-esteem. Constant low energy takes away your favorite activities and hampers your daily routine. Repeatedly failing to lose weight despite your intention is enough to lose confidence and give-up on life itself.

Many people with obesity become averse to interaction and avoid social events. Obesity affects not just your relations with the outside world but also your relation with yourself. Emotions of frustration, guilt, self-loathing and self-victimization are common because of the illnesses and stigma attached to obesity.

Conclusion

Obesity is a result of metabolic processes gone wrong. This root cause is common to many other illnesses like diabetes, cardiovascular complications and mental illness. This is the reason that weight gain goes hand in hand with so many health problems and many times is a marker for chronic illnesses to come.

If you've struggled with weight issues all your life or if excess weight is a recent issue that's cropped up, set up a consultation with us and we'll help you find out the root causes for your weight gain

About the Author

Ria Jain
With a Master’s degree in nutrition and two decades’ experience in health and wellness, Mugdha has successfully healed many people at ThriveFNC since 2017. Mugdha herself was struggling with finding solutions when her health took a nosedive. With modern principles of functional medicine and ancient wisdom about food, paired with spirituality, she beat several chronic illnesses.
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How being obese or overweight can harm you

What do you mean by obesity?

Obesity is defined as a weight that is considered above the normal, desired amount. It can be attributed to many factors. Some of them are junk food, unhealthy routine, lack of exercise, or chronic diseases such as thyroid or diabetes.

Overweight is not just about how you look

Being obese can be a constant source of criticism. The stereotype that being fat means that you are ugly is completely ridiculous and not true. But, while we fight to keep these stereotypes at bay, we must also consider the serious side effects, health wise, that come with being obese.

What does it do to your body?

The Global Burden of Disease Study (GBD) focused on the relation between mortality and obesity. The study showed that the prevalence of obesity has more than doubled since 1980 and is now 5% in children and 12% in adults. These findings show similar global trends in type 2 diabetes. The finding that we should worry about the most is the tripling rate of obesity in young adults and kids. This trend is mainly seen in kids belonging to developing and developed countries. The study shows that an early onset is likely to transform into type 2 diabetes, hypertension and chronic kidney disease.

Obesity and Body Mass Index

“A BMI in the 50th to 74th percentiles, within the accepted normal range, during adolescence was associated with increased cardiovascular and all-cause mortality during 40 years of follow-up. Overweight and obesity were strongly associated with increased cardiovascular mortality in adulthood”, said a study published in the New England Journal of Medicine.

Obesity and Chronic diseases

Obesity in women was linked to higher rates of osteoporosis, breast cancer, arthritis and other complications, A study showed . It also contributed to 40% of their heart problems. Moreover, your chances of developing diabetes goes up by 77% if you are overweight. There are over 200 million obese people in Europe alone, which tells you the extent of this epidemic.

According to Stanford Health Care, it has these long term effects on your body :

High Blood Pressure :  Additional fat tissue in the body needs oxygen and nutrients in order to live, which requires the blood vessels to circulate more blood to the fat tissue. This increases the workload of the heart because it must pump more blood through additional blood vessels.

Type 2 Diabetes : Obesity is the major cause of type 2 diabetes. It causes a resistance to insulin, which keeps the blood sugar level high.

Heart Disease : Obesity can cause deposits of fat to build up in the arteries which cause a reduction of blood flow to the heart. This is a major cause for coronary heart disease, atherosclerocis (hardening of the artery) and stroke.

Cancer: Several studies have explored why being overweight or obese may increase cancer risk and growth.

The possible reasons that obesity is linked with cancer include:

-Increased levels of insulin and insulin growth factor-1 (IGF-1), which may help some cancers develop

-Chronic, low-level inflammation, which is more common in people who are obese is linked with an increased cancer risk

-Higher amounts of estrogen produced by fat tissue, which can drive the development of some cancers, such as breast and endometrial cancers

-Fat cells may effect processes that regulate cancer cell growth.

Joint problems: Being overweight or obese can cause the cartilage on the end of your bones to become damaged or worn and this can ultimately lead to stiffness and sometimes swelling in your joint.

Sleep apnea and other sleep related problems: Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. Excess body weight contributes to sleep apnea by causing increased pressure on upper airways, leading to collapse and decreased neuromuscular control from the fatty deposits. These fatty deposits contribute to decreased lung volume and make it more difficult to breathe.

Conclusion

In conclusion, only one thing can be said, even if it’s a long and painful process : there is a road to recovery. Healthy changes in one’s lifestyle can help. Changes such as healthy diet, plenty of exercise and taking help for your mental problems go a long way. Also, restraining yourself from sugars and caffeine is essential. Obesity is a dangerous epidemic, but with careful and efficient planning, it can be countered with effectively.

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