Health
Non-Sugar Sweeteners are not your friend: This is why
Non-Sugar Sweeteners: Good Bad and Ugly.
Give anything ten years’ time, and the truth and false of it comes out. Like Soya oil , nonsugar sweeteners just lost all their glitz and glimmer.
Briefly (Source )
World Health Organization (WHO) new guideline on nonsugar sweeteners (NSSs): Don’t use them to control weight or reduce the risk for diabetes, heart disease, or cancer(noncommunicable diseases).
Sweeteners include- aspartame, acesulfame K, advantame, saccharine, sucralose, stevia, and stevia derivatives.
A few years back a relative while making tea for us asked me whether I wanted sugar or a popular brand of nonsugar sweetener. I said no to both. But being me I asked whether she was taking these sweeteners under a doctor’s prescription. She very enthusiastically told me that she and her husband were proactively taking these non-sugar sweeteners to cut down sugar intake and lose a few kilos. I carefully explained the side effects of non-prescription supplements and nonsugar sweeteners peddled by celebrities, health coaches/gurus/apps/games. If you want to skip sugar, skip these too.Sometimes its very difficult, but you need to do what you need to do.
Artificial sweeteners: Wolf in sheep’s clothing?
The Good: They are zero calories and may be prescribed under certain conditions.
The Bad and Ugly: It’s said that aspartame is very addictive to the brain (source ). It’s 700 times sweeter than sugar. In fact, it’s a much more difficult substance to stop using because people tend to overuse it in larger quantities to get the sugar hit. This causes your body to crave more and more of it. You think it’s zero calories (which it is) but it’s not zero harm as your body ends up having excessive stimulation and dopamine overload. Plus these sweeteners can alter your gut bacteria (source ) and cause havoc just like carrageenan.
Saccharin, sucralose, and aspartame even at low concentrations promote pathogenic changes in gut bacteria.(source)
283 studies were reviewed. In adults, pregnant women, children and it was seen they can increase the risk of type 2 Diabetes, Cardiovascular events. The very thing they were being touted to protect against.
What were the Outcomes measured?
The health outcomes of interest for adults and children were identified by the WHO Nutrition
Guidance Expert Advisory Group (NUGAG) Subgroup on Diet and Health as:
- Measures of adiposity (e.g. body weight, body mass index [BMI], overweight/obesity, fat and
- lean mass);
- type 2 diabetes and pre-diabetes (incidence and intermediate markers of glycaemic control);
- Cardiovascular diseases (incidence and intermediate markers, such as blood pressure and
- lipids);
- cancer;
- dental caries;
- chronic kidney disease;
- Eating behavior (e.g. appetite, satiety, energy intake);
- sweet preference (e.g. subjective measures, sugars intake);
- neurocognition;
- mood and behavior; and
- Asthma and allergies (for children only).
So what exactly does WHO recommend?
Cut down on the sweetness of your diet. Skip the sugar and if you really want a sweet treat a whole fruit is a better option than any refined, processed food. Sugar is addictive (source)Consumption of free sugars has been linked to escalating rates of overweight and obesity (2,3), as well as the development of diet-related noncommunicable diseases (NCDs), including dental
caries, type 2 diabetes, cardiovascular diseases, and cancer. There’s even a possibility that the WHO will classify some of these as potential carcinogens
While fruits contain fructose, the artificial nonsugar sweeteners are a horror unto themselves.
About fructose
Briefly, fructose is a fruit sugar that skips the natural feedback loop and satiety of glucose from the brain and promotes denovo lipogenesis that is the liver makes more and more fat droplets to fill your fat cells. While regular intake of whole fruits releases fructose slowly since they also contain fibers, fruit juices don’t give the same protection and can destroy the delicate balance. Even overconsumption of high glycaemic index fruits like mangoes can be a problem if someone has diabetes.About this some other time. Nutrition and health are not easy topics, so don’t cut corners if you want to stay healthy. Take the stairs, skip the chocolate(it’s hard I know), and definitely don’t buy hyper-processed packaged food. Give this blog post a reading through.
Reference :
Health effects of the use of non-sugar sweeteners: a systematic review and meta-analysis
. Rios-Leyvraz M, Montez J. Health effects of the use of non-sugar sweeteners: a systematic
review and meta-analysis. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO.
Healthwealthbridge Disclaimer:
This is for education and awareness and not be taken as medical advice. Kindly consult your doctor for any advice related to your health and diet.
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Hearing Loss in Kidney Disease:What You Didn’t Know
Will the poor health of the kidneys damage Hearing? Yes, they can work in more ways than one. However, this side effect of chronic kidney disease is not talked about very often.
Sensorineural hearing loss in chronic kidney disease is common. Hearing loss often happens due to the illness itself and sometimes ototoxic drugs needed to treat kidney diseases. It happens from 27 to 77% of people suffering from chronic kidney diseases. The percentage varies between countries, depending on the burden of NCDs. Hearing loss is often long-lasting and worsens over time[1]. All CKD patients need regular hearing assessment to guard against this and treat accordingly. Timely intervention can prevent and protect Hearing.
All CKD patients need regular hearing assessment to guard against this and treat accordingly. Timely intervention can prevent and protect Hearing.
Dr.Amrita Basu
What kind of hearing loss is seen in CKD patients?
Sensorineural hearing loss, moderate to severe involving higher frequencies, is seen in CKD. It’s bilateral and symmetrical in most cases.
Tinnitus, a ringing sensation in the ear, may be associated with SNHL(sensorineural hearing loss). CKD patients are at three times greater risk of tinnitus than the general population. A patient may also present with Sudden Severe Hearing Loss.
CKD patients are at three times greater risk of tinnitus than the general population. A patient may also present with Sudden Severe Hearing Loss.
Dr.Amrita Basu
While evaluating hearing loss, a necessary part of the workup includes questions about comorbidities and ototoxic drugs. Non-communicable diseases like hypertension, Diabetes mellitus, individually and together, pose a risk to HearingHearing. Ototoxic drugs are toxic to the ear(oto) but often necessary to treat chronic kidney disease. It is the classic case of side effects where the risks and benefits of treatment are weighed in. Loop diuretics and Aminoglucosides are common drugs that can cause hearing damage.
How does kidney disease affect the ears?
Systemic disease can affect every part of the human body. All systems are related, and when it comes to nerves, they are extra sensitive.
Ourkidneys remove waste toxins from our bodies. They also play a role in balancing the electrolytes. The cochlea in our inner ear responsible for Hearing has fine hair cells and a delicate ionic balance which gets disrupted by-
1)Uraemic toxins
2)Distorted ionic balance
3)Ototoxic drugs are used to treat severe kidney infections.
4)Haemodialysis in some instances is due to multiple factors.[2]
The effect of all this may be superadded to damage the cochlear hair cells. It may present as a ringing sound in the ear or reduced Hearing.
Your nephrologist will advise about the ototoxic nature of certain drugs and the need for an ear checkup. During the early stages of mild hearing loss, you may not realize the problem. However, a tuning fork test and Pure tone audiometry by a registered ENT surgeon will help diagnose it.
When to visit an ENT surgeon if you have CKD?
- Annual Pure tone audiometry needs to be a part of CKD treatment. Get tested on time: at least an annual ENT checkup and Pure tone audiometry for screening.
- In case of reduced hearing in one or both ears.
- In case of a ringing sound in the ear
- If you have a problem with balance.
- In case of a change of medicine
- After Haemodialysis
How to prevent further hearing damage?
- Regular hearing assessment
- Better control of Blood urea creatinine, Serum electrolytes.
- Better control of comorbidities.
- Avoid acoustic trauma
- Avoiding ototoxic drugs
What to do in case of hearing loss?
If you suspect you hear less or are a CKD patient’s caregiver, visit an ENT surgeon. Your doctor will check the eardrum, do a tuning fork and advise the following tests.
- Pure-tone Audiometry
- SISI(Short increment sensitivity index)]
- TDT(tone decay test).
In case of hearing loss, a Hearing Aid trial and suitable Digital Hearing aid are advised.
What other things will your doctor tell you if you have hearing loss with CKD?
- Counseling and family awareness
- A support system and community to encourage productive habits.
- Avoid topical or systemic Ototoxic drugs(Aminoglycosides, Frusemide).
- Neurovitamins
- Strict control of blood pressure and blood sugar will prevent super-added damage.
- Maintain ear hygiene, avoid pond bathing, diving, self-cleaning of the ear, and forceful Valsalva.
The strict control of other non-communicable diseases like hypertension, Diabetes mellitus is essential because they increase nerve damage.
Increasing age and age-related aggravation of sensorineural hearing loss are typical. Like all diseases, prevention is helpful.
Healthwealthbridge Disclaimer health information provided on this blog is for general awareness and doesn’t in any way replace a doctor’s professional medical advice. Kindly consult your doctor in case of any decision regarding your health, and diet.
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Who is responsible for selling and buying unhealthy products? Belling the economic cat
Finally! The Indian Supreme Court has stated that personalities that endorse consumer products have a duty to ensure the products are neither misleading or harmful to the consumer.
So.. let’s start with Colas and Sugary drinks. 10% if Indians have diabetes, and 50% diabetics don’t know they have it! The personalities that promote Cola’s and other sugary drinks must now add that Colas are huge health risks ..Shekhar Kapur on Tweeter tweeted this.
That’s one way of dealing with it.But primordial prevention would help more.Don’t make or sell products which are proven to be harmful! Brands, Governments,celebrities,consumers everyone needs to take a stand.Its not okay to deliberately sell unhealthy, harmful,products.
1.Tobacco and all tobacco products.In some parts of India women not only work at Bidi factories but also start chewing tobacco paste called gul.Both may start as early as eight years of age.The work feeds the habit and kills good health,common sense and escalates healthcare expenses.
2.Alcohol.
WHO Finally admitted that no level of alcohol consumption is good for health. Seed oils,moderate amount of alcohol,soyabean, aspartame are things WHO supported and promoted once .Something to think about there.
Alcohol and tobacco together are responsible for most cases of oral and Head-neck cancer .There’s no upside to these two evils.Indirect advertising ,brand promotions work as bad as anything else.
3.Ultra processed, sugary, salty, fatty food.Includes fast food,cold drinks,frozen deserts, ice cream, chocolate,cakes sold in packets.Sometimes food branded as health-food fail the health test.Have you read my book Nutrition Diet Myths and Life? It’s an eye opener for health food and what you must avoid.
It can’t just be the money, or is it? Is that the reason famous movie stars endorse products from brands selling tobacco ,alcohol and fast food?How can youth icons sell addictive substances ,gambling apps and unhealthy products ?The youth has all the resources to find out the truth behind these products.Something we didn’t have growing up.That’s the reason I hope they will deliberately give a cold shoulder to the so “stars” who promote death,disease and addiction as food,fun and entertainment. Be a responsible consumer and not a blind follower.
Plus, I hope brands will make and sell good products promoting health ,wealth and wellness and not things which will harm both the individual and the society. There’s no harm in hoping and praying, right?
Reference :
WHO:NO TOBACCO
https://healthwealthbridge.com/tobacco-cancer-responsibility/
https://healthwealthbridge.com/truths-about-chewing-tobacco/
https://healthwealthbridge.com/cancer-preventionliving-life-meaningfully
https://healthwealthbridge.com/gulchewing-tobacco-the-untold-horror-story-of-rural-bengal/
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Shingles:Cause, Prevention
One in 3 people has the risk of developing Shingles. That’s what the CDC says.But why do you need to know this? If you or a relative is aged fifty or more, it’s a good idea to get vaccinated and you must have seen Big B talk about it on the television.But let’s start from the beginning.There are many strange articles and misinformation online about this disease.
Tldr:First of all, it’s not a STD or sexually transmitted disease .Second, it’s a viral disease and caused by the same virus that causes chicken pox, but Shingles occur most commonly in old age.
According to Harrison Internal Medicine, Varicella Zoster is a virus which causes two distinct clinical presentations :chicken pox and Shingles.
Chicken pox is most common in children and has characteristic vesicular rash while Shingles occur as dermatomal rash in specific parts of body .Chicken pox in adults is a serious disease and may have extensive systemic involvement and complications.Incidentally vaccination exists even for chicken pox where like all other vaccines one may get infected still but the expression and clinical disease may limit severity.
So what is Shingles? It’s caused by the Varicella Zoster virus.
You remember I mentioned chicken pox also known as the Varicella zoster virus?If that virus getting reactivated in old age Shingles(Herpes Zoster) is what happens.According to the medical science these chicken pox virus stays sleeping or dormant in the nerve cells and during episodes of immune suppression weakness gets reactivated and starts giving you trouble.They characteristically have a burning sensation associated with skin lesions along the area of distribution of that nerve and make life difficult .It causes a dermatomal rash The regular painkillers don’t work and prevention is the best policy .
They may suffer multiple episodes with waxing and waning i between with itching ,tingling ,burning sensation in specific areas associated with rashes.The rash can appear on the third to fifth day with or without fever.The herpetic neuralgia or pain is difficult to manage and is one of the main reason behind poor quality of life.
In my ENT clinic, Ear manifestation of Shingles present as earache with rashes over the pinna and in the ear canal .
Statistics:
India : A million cases of Shingles each year.Incidence of 705 per million population per year. In USA approximately 1 out of 3 people develop herpes zoster during their lifetime Shingles, and about half of people over age eighty have had shingles.The Shingles vaccine for people above 50 years is a good way to ensure no trouble from this virus .
So when can Shingles occur?In people above 50 years of age having any cause of immune suppression, because of disease or drugs.Like HIV,Cancer treatment,Cancer itself,autoimmune disease,diabetes,severe cardiac ,liver or kidney disease .Any disease which over powers your immune system can cause Shingles.So the best way to prevent it ,is to have healthy habits,eat nutritious food and get vaccinated on time.
Shingles Vaccine in India: Shingrix Zoster Vaccine[source]
2 doses needed at a gap of two to six month.Protection is said to be for ten years ;Age group-Above 50 years.India has 260 million people above 50 years who can be saved from a disease causing poor quality of life with a vaccine.
Who should get vaccinated?
At-risk group.Age greater than fifty.Those who have suffered one episode of shingles.Those who received a chicken pox vaccine previously.
Consult your doctor for checking whether you are eligible for the vaccine.This is not a replacement for a medical consultation and is strictly for the purpose of awareness.Though we try to keep updates current, since medical science is a rapidly evolving field, inadvertent additions and omissions while unfortunate is occasionally unavoidable .The author or the website under no circumstances will be held liable for the same.Kindly consult a health care provider for personalized vaccine recommendations
References
1.Harrison’s Infectious Disease
2.https://medwinpublishers.com/MJCCS/can-india-let-go-the-opportunity-to-minimize-million-shingles-cases-annually-as-india-launches-shingrix-zoster-vaccine-in-april-2023.pdf
3.CDC
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Nose bleed and Thalassemia
Nose bleeds in children are common.In nine out of ten cases its due to nose picking.It’s the rest which we need to rule out.
What you should do if your child has nose bleed?
1)Don’t panic.Seeing you panic or cry will scare your child scared and he/she will start to cry.This can cause the nose bleed to become worse.
2)Pinch the nose and ask child to breathe gently through the mouth.Child should be bending forward over a wash basin ,or you can hold a vessel in front of his mouth .
3)Talk to the child gently and calm him down.
4)You can then hold a cold damp cloth over the nose bridge.This helps control bleeding too.Pinching the nose helps stop bleeding within 5 to 10 minutes.
When should you worry and visit your nearest emergency?
1)If the bleeding happens for longer than 10 minutes.
2)Happens frequently and takes a long time to stop .
3)Bleeding also from other places ,like from gums,while peeing etc.
4)Baby is very pale and blood tests show hemoglobin to be low .
5)Even minor cut injury ,takes a long time to stop.
6)There is history of swelling of knee and other parts of body with discolouration even with minor trauma.
7)When bleeding causes baby to become lethargic.
8)There’s family history of similar bleeding.
9) There’s family history of consanguinous marriage.
10.Preconceptional testing not done for Thalassemia.
11.Family history of Thalassemia trait in one parent and other not tested.
What tests will your doctor suggest?
If its the first episode and bleeding stopped quickly few tests may be suggested depending on history and clinical examination
But if the doctor has grounds for clinical suspicion ,a thorough checkup may be needed.Nasal bleeding can sometimes be a danger sign of bleeding problems like, Thalessemia,Haemophilia and Leaukemia and other bleeding disorders.
A complete blood work up like:
- Haemoglobin
- Complete blood counts
- Platelet levels
- Prothrombin time
- APTT(Activated partial thromboplastin time)
- Liver function test
- Peripheral blood smear
- Haemoglobin electrophoresis to rule out Thalessemia
Radiology can be suggested keeping in mind history and clinical features. CTPNS (Computed tomography Paranasal sinus) helps rule out nasal masses.
If nose bleeding is due to trauma, it will stop with the first steps explained.After that nose drops ,oral antibiotics and topical antibiotic creams will be prescribed.One of the commonest preventable cause of nose bleeding in children is Thalessemia.
This prevention happens through blood tests done before marriage or atleast before planning to have a baby(preconception test).
Even now with massive awareness around this disease,there is multiple examples of Thalassemia baby ,especially in Eastern part of India
Data
Every year 10,000 to 15000 babies are born with Beta Thalassemia major in India.
India
1.5% of Global population are Beta Thalassemia carriers.60,000 new symptomatic patients every year make this a cause for concern.
Thalassemia Screening is crucial
High prevalence of Thalassemia in the Indian subcontinent.Carrier state high and often goes undiagnosed because it’s remains asymptomatic except for anemia .
Awareness about pre-marital counseling and tests – for all couples should be mandatory to avoid unfortunate problems.
For arranged marriages its highly adviced to avoid marriage between two individuals with Thalassemia trait.High risk of Thalassemia Major babies in couples with carrier state in both parents.
Nose bleeds in kids :3 Things you must know
Management of Pediatric epistaxis:Scientific Paper
Juvenile Nasopharyngeal Angiofibroma
Previously published on mycity4kids
