Replies of FAQ by Dr Pallavi

What are lifestyle diseases and do you really need Medicines?

Diseases which are primarily because of wrong lifestyle habits especially wrong Nutrition are called lifestyle diseases.
Diabetes, thyroid, even some cancers, allergies, fibromyalgia, low immunity and Metabolic Syndrome are some of lifestyle diseases.

How would you define fitness?

Fitness has a tripod approach: physical, mental and spiritual. They all go hand in hand.
The most important is to have a positive approach and a healthy and happy lifestyle.

Why did you start this campaign of Saying No to Medicines?

Being a doctor, I know how harmful medicines are.
Hence I want everyone to follow the holistic approach to health. We are focusing too much on unnecessary medication rather than holistic health.
My mantra is Use Food as Medicine!

What inspired you?

In spite of being a doctor, I myself fell prey to Diabetes and hypertension and hence moved into the field of Nutrition to cure myself.
Once I myself became well, I decided to use my research to spread awareness and to generate knowledge about food.

Why is it so difficult to maintain diet?

Diet means Deprivation. I do not believe in any such word. My goal is to make people understand their bodies and make necessary changes.
Each body is different and hence no single diet plan suits everyone.

How prevelent is childhood diabetes and Obesity?

It is extremely prevalent and is now almost an epidemic in our country. We as parents are responsible for the well being of our children.
We have to teach them to avoid fried and junk food and processed food. Such food items not cause harm both to the external and internal environment.
Exercise and movement has to be an integral part of life.

What is meant by low carb and keto diet?

A low-carb diet keeps insulin levels down and is essential in treatment of Diabetes and PCOD. A keto diet leads to fat adaptation and using fat as fuel through process of ketosis. The carbohydrates in the diet have to very low with protein being the fulcrum.
Usually the diet is also high in dietary fat, though a lot of added fat is not needed. The non veg can get their fat from the meat itself. The vegetarians need full fat dairy. Added fat is in the form of saturated fat like ghee and virgin coconut oil. Monounsaturated fats in the form of virgin olive oil is good as well. For a strict keto , a no sugar and no grain protocol is usually advocated.

What is meant by Intermittent fasting?

Studies show that periodic fasting can cause a healthy decrease in blood glucose and insulin, improve immune function, and reduce excess body fat and weight. These are the keys to reducing the risk of cardiovascular disease, cancer and diabetes, among other chronic illness. Fasting period can be 14:10, 16:8 or even more. It's best achieved by skipping breakfast.
An important benefit of fasting is the increased levels of ketone bodies, which trigger various health benefits. The best way to move ahead with intermittent fasting is to fast overnight and then avoid having breakfast. It can occur without caloric restriction, without the risk of nutrient deprivation, and can have other systemwide benefits too, such as improvements in gait, reduced markers of aging, and cognitive function.

Why is healthy living important?

Would you ever think of neglecting your prized possession. If not then please remember to treat your body well and let not your tongue rule you.
Do not be greedy for food but eat correct and smartly.

How much food has to be eaten before and after a workout?

Stored glycogen is available to the body for use for about 90 mts. If the workout is going to end within that time no additional pre- workout food is needed. If the workout is going to last more than that, a small bowl of quinos / millets with some peanut butter or honey with curd works well. More than that will be difficult to digest and cause digestive issues. It is better to carb load a day prior for a longer workout. Post workout meal should be about 50 gms of carbohydrates and about 20 - 30 gms of easily absorbing protein , ratio being 4:1. A good post workout meal will be a boiled egg with vegetables or a simple chocolate milk. Whey protein smoothies with whey isolate is good and can be made with coconut milk and chia seeds.

How should we tweak the nutrition in order to lose weight and body fat?

Intermittent fasting is the best way to lose body fat. Fasted workout can be done and the body can stay in fat burning mode for some time after the workout. The fast can be broken by a high protein meal with some good quality fats. Carbohydrates can be avoided unless it's been a long workout of more than 90 mts.

What is the source of energy for muscles?

Working muscles need energy. Carbohydrate is the form of energy that muscles prefer. Carbohydrates are stored in the body in limited amounts as glycogen in muscles and the liver. When an exercising the body faces glycogen depletion, the athlete experiences bonking or hitting the wall and can no longer maintain exercise intensity. Carbohydrate demand in a fit athletes is 3 to 5 grams of carbohydrate per day per pound of body weight whereas normal people do not need more than 1.8 to 2.0 grams per pound per day. As a general guideline, somewhere around 40-50% carbs, 25-30% protein, and 20-30% fat is recommended.

What is suggestion therapy?

If you expect something to happen—if someone or something suggests to you a specific outcome—your expectations of that outcome play a major role in its occurrence. The expectation or suggestion alone, often unconsciously, changes your behaviour and your responses to help bring into reality the outcome you are expecting.

What kind of exercise strategy would you like to suggest?

1) Endurance, or aerobic, activities increase your breathing and heart rate. Brisk walking or jogging, dancing, swimming, and biking are examples.
2) Strength exercises make your muscles stronger.
3) Balance exercises help prevent falls.
4) Flexibility exercises stretch your muscles and can help your body stay limber

Why did you choose this profession?

I chose this profession as I myself have had a battle with health in spite of being a doctor. It was then I realised that health and wellness is very important and we need to build a medicine free life. Lifestyle diseases are very prevalent. Mindful eating and exercise is only the key to building a life which is indeed healthy. Life span has been increased by medicines but what about the health span. That can be only increased by correct Nutrition.

How to break the myth of diet and nutrition?

There is no word as a diet. It is all about food as nutrition, food as fuel for the body. We are what we eat hence clean and green eating as well as portion control and being mindful is important. Understanding one’s own need of the body is also important. There should always be a personalized approach to the needs of each and every person as according to their nutrition requirements.

Why is it so difficult to maintain diet?

Anything which is not compatible to our lifestyle can never be sustainable. A diet means bringing about changes which are not beneficial to our bodies hence can never be sustainable. If we focus on nutrition and be mindful about our hunger and the demands of our body, it becomes sustainable. We have to train our bodies to eat correctly and also according to the rhythm of the hormones.

What is an easy option/alternative to tackle the nutrition issues?

Simple baby steps can be brought about as food exchanges and by slowly eliminating sugar and refined flour from the diet. It has to start from childhood and children should focus on clean and green eating. Good habits should be cultivated in children and then it just becomes a nature. Parents should be made aware of not to use food as reward or in times of stress.

Work out and diet what's the connection?

One thing is for sure: you cannot out exercise a bad diet. The amount of calories in and out matters, and even more than that the quality of calories taken matters. The truth is that the body is built in the kitchen. High calorie nutrient empty food like refined and processed flour and sugary so-called energy drinks are very harmful. They give a rapid boost of energy and lead to sugar crash later on.

Is healthy living sustainable?

The need of the hour is healthy living. India is sitting on a time bomb of diseases like diabetes and cancer. We have to make healthy living not an option but a must by slowly looking into food alternatives and portion control as well as adding exercise to our daily schedule.

What are three tips that'd you'd give?

1) Portion control and intuitive eating
2) Hydration
3) Say no to sugar and junk food

How important is hydration?

It is very important to keep hydrating especially in the hot summers of India .During exercise, particularly rigorous, our bodies produce sweat for a variety of reasons, mostly to assist the control of body temperature, and through this sweat, electrolytes are lost. Electrolytes are minerals present in the body needed for a variety of purposes such as the catalyzation of chemical reactions, contraction of muscles and even the regulation of water in the body. Consuming electrolytes can re-hydrate the body by providing these lost electrolytes, unlike water, to help you continue working out. As I am concerned about sugar and artificial content, coconut water or homemade sports drinks can serve as a healthy substitute. Check for thirst, dry mouth and colour of urine. Lemon/orange water with honey and himalayan pink salt is a good option . Keep drinking almost 500 ml per hour .Pinch the skin and see for dehydration. Dizziness, headache and nausea indicate electrolyte imbalance.

What are inflammatory food?

Inflammatory foods are food items like sugar, refined oil, refined flour, trans fat and fast food and they lead to inflammation and metabolic disturbances within the body.

What should be kept in mind to avoid cramps?

Micronutrients and electrolytes are a must to avoid cramps together with hydration. Sodium, potassium, calcium and Magnesium are essential. Focus should be on nutrition rich in such food items like nuts, seeds, broccoli, pink salt and green leafy vegetables. Hydration and electrolytes are also important one day prior.

Is it important to focus on weight loss only by going on a hypocaloric diet and doing a lot of cardio?

There has to be fat loss and not muscle loss. One cannot loose fat very fast only by calorie restriction and cardio as there is always associated muscle loss too. Adequate diet targeting fat loss is a must otherwise there will be metabolic disturbances. Loosing 1 pound of fat is equivalent to 3500 cal.Safety guidelines recommend curtailing about 500 cal per day if looking into weight loss which can lead to a loss of 1 pound per week. Focus more on fat loss and lean muscle gain through strength training and high intensity interval training.

How to manage digestion issues when doing HIIT or a cardio workout like running or cycling?

The only way is to avoid simple and processed carbs and too much sugary drinks. Increase the day to day intake of fibre especially seeds and chia seeds. Avoid eating too much fibre the night before and the morning of the event. Do not load yourself with too much energy gels before and during the run. If you're faced with irritable bowel issues then it's best to use Imodium tablets and go slow on carb loading diet.

Please explain about the significance of low carbohydrate high fat diet for Athletes?

Fats give more energy to the body vis-a-vis carbohydrates. There's a lot of research which is showing that low carbohydrate, high fat diet together with fasted workouts work on the fat adapted mode and gradually the body moves from using carbohydrate as a source of fuel, to fat as fuel. Intermittent fasting can also be added. Longer heart rate based workouts are advocated in the fasting period. Once a person is fat adapted, the need for intake of too much carbohydrates comes down. This is very beneficial for the body and the immunity. The use of too much carbs by athletes is leading to the onset of Diabetes and increased body fat in the best of athletes.

What are the important points to be give to the people who are interested in increasing weight?

It is imperative that they check BMI and Body fat Index. Focus should be on muscle gain not fat gain for which one has to be disciplined about weight training together with adequate protein with some complex carbs like sweet potato, quinoa and banana. Protein intake is a must. Fats in the form of nuts and seeds, avocado and coconut oil can also be consumed. Caution has to be used in taking in too much carbohydrates as that will increase both muscle and fat quotient. There can be an increase in belly fat in men and thighs and chest in women.

What are the recent views on intermittent fasting?

Studies show that periodic fasting can cause a healthy decrease in blood glucose and insulin, improve immune function, and reduce excess body fat and weight. These are the keys to reducing the risk of cardiovascular disease, cancer and diabetes, among other chronic illness. An important benefit of fasting is the increased levels of ketone bodies, which trigger various health benefits. The best way to move ahead with intermittent fasting is to fast overnight and then avoid having breakfast. It can occur without caloric restriction, without the risk of nutrient deprivation, and can have other systemwide benefits too, such as improvements in gait, reduced markers of aging, and cognitive function.

How can we prevent cramps?

Electrolytes: sodium and potassium
Stop gluten
Add protein
ENO helps: before the run
Take Magnesium Glycinate