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Keto Diet, Ketosis and Keto breath!

Everything comes with a price, even diets -KK

Ketogenic Diet (or keto diet) is a high-fat, moderate-protein, low-carbohydrate diet designed to help you achieve ketosis. 

What is Ketosis?
Ketosis is a natural metabolic state that occurs when the body is forced to resort to burning fat stores as a source of energy due to depleted glucose stores (the main source of which are usually derived from carbohydrates). Healthy persons normally experience mild ketosis during periods of fasting, overnight or following strenuous exercise.

With the consumption of ketogenic diets becoming popular as part of weight-loss regimens all over, several theories on how ketogenic diets promote weight loss have been proposed including decreased food cravings due to the high-fat diet, reduction in the appetite stimulating hormones, promotion of fat loss secondary to low insulin levels and increased burning of calorie from fat conversion to produce energy.

Medically speaking!

Historically ketogenic diets have been prescribed to reduce epileptic seizures in children with difficult-to-treat epilepsy. This is possible because with little carbohydrate remaining in the diet and the liver converting fat into fatty acids and ketone bodies. This ketone bodies pass into the brain to replace glucose as an energy source resulting in reduction in the frequency of epileptic seizures.

Around half of children and young people with epilepsy who have tried some form of this diet saw the number of seizures drop by at least half, and the effect persists even after discontinuing the diet.

Ketogenic diets have also been tested and used in closely monitored settings in diabetics, Alzheimer’s disease, polycystic ovary syndrome and cancer patients

Despite the various medical and weight loss benefits of ketogenic and other low-carb diets. One of the characteristic indications of ketosis is however the “keto breath”, call it an unwanted side effect if you like. Keto breath or odor is different from halitosis or the normal bad breath. It is more of a distinct metallic, fruity smelling, nail-polish remover-like, strong odor or taste in the mouth.

Why the Keto breath?
With the body breaking down fat to produce energy, fatty acids are converted into ketones, which are natural chemicals your body produces when you burn fat for energy. These include beta hydroxybutyrate, acetoacetate, and acetone (an ingredient of nail polish).

Though ketones are usually harmless and released from the body through exhalation and urination, your breath smelling like nail polish-remover in particular, as unpleasant as that may be is a good indicator of ketosis.

What to do?
A few things can probably help in reducing the bad odor, including practicing good oral hygiene, masking the odor with mints, increasing your water-intake, eating less protein or unfortunately, if it's really bad… just stopping the diet! 

Treadmill vs Outdoor running

"Runs end, Running doesn't" - Nike

Treadmill running vs Outdoor running: Sounds like a debate we've either heard or been involved in before. Certainly both are worthy "heart-healthy" exercises that are tremendously beneficial to the muscles and the body as a whole.
They are in fact the same kind of activity in different settings! But yea ,there's more!

People will tell you that running outdoors improves stability by forcing you to navigate ever-changing terrains while others will claim that a treadmill forces you to sustain speed and performance levels that might other lag outdoors.

Ultimately, both settings surely have their pros and cons based on the training needs and goals of the individual.


If you can enjoy a good run and multitask while at it, why not? 
Treadmill running does provide a good an effective avenue to exercise and maximize your indoor workout time.
The same way the airport escalators propel you, the treadmill probably propels your running in a manner that is different from how you propel yourself when running outdoors.

While some may look down on treadmill running as a second class form of running, it definitely can help runners get the best of their time, when weather or environmental conditions don't permit.

Treadmill running has many advantages.

Advantages of Treadmill running

Treadmills are one of the most popular pieces of cardiovascular equipment in gyms all over the world these days.While treadmills are considered the safer option for running exercises by most users, large numbers of treadmill-related injuries running into thousands are reported yearly. Injuries in form of sprains, falls, head injuries, and even cardiovascular events in people who might have pushed too hard are among the most commonly reported.

Outdoor Running

There really is something special about lacing up your trainers and heading into the Great Outdoors (sense the bias?). There is certainly a physiologic difference between both exercises. Some experts believe that by running outdoors, you are stimulating the muscles in your feet and legs in a different way, getting a more well-rounded workout for your legs and ankles actually. Outdoor running also allows you engage different muscles groups by running downhill and uphill which most treadmills don't allow to.

While elite athletes will use a treadmill as part of their training routine, they will do the majority of their running outdoors on tracks, trails, or pavement. 

Which do you benefit the most from?

Basically the amount of effort you apply determines how much you get from a running workout or most workouts for that matter. You can get the same workout whether running on a treadmill or outside as long as you maintain the same effort level. But "effort," in and of itself, is a highly variable measure.

Medically speaking, effort is based on your heart rate and a phenomenon known as perceived exertion. Perceived exertion refers specifically to how "hard" you consider an activity to be, irrespective of how your body responds to that activity.

For example, the perceived exertion of running indoors will generally be less than running outdoors on a rainy day even if you burn more calories or have a faster heart rate. Even on a sunny day, the very act of running up a hill may be perceived to be "harder" than running at the same incline and distance on a treadmill.

The harder we perceive a workout to be, the sooner we tend to give up.This psychological component tends to influence how much we get out of one exercise compared to the next.

Our Verdict

So it all depends on what you intend to gain from running. If your sole intention is to meet and maintain your cardiovascular fitness goals, then a treadmill should suffice. 

On the other hand, if you are training for a race you will clearly benefit more from running outside, and you may incorporate treadmill running to train your endurance and improve your cardio health.

And it may just be down to which environment you prefer!

Medic-ALL 2018

Don't Miss A Stroke! Save a Life

One out of Six people will suffer a Stroke during their lifetime!

A Stroke or Cerebrovascular accident is caused by an interruption in the blood supply to the brain resulting either from  the bursting of a blood vessel or the blockage of a vessel by a clot.

The major symptoms of a stroke include a sudden weakness of usually one side of the face, arm or leg (could involve all at once), numbness, confusion, difficulty speaking or understanding speech; it could also cause a difficulty seeing with one or both eyes; difficulty walking, dizziness, loss of balance or coordination; severe headache with no known cause; vomiting; fainting or unconsciousness.

One of the key ways to "save a life" or help facilitate timely medical attention in someone suffering from a stroke is to know what a stroke looks like by becoming familiar with the symptoms listed above. Such knowledge will enable you "act fast" to save a co-worker, friend, or relative. Although stroke risk increases with age, strokes can—and do—occur at any age.

To prevent strokes, physical activity and healthy eating play a huge role. Keeping a good watch on vascular disease and stroke risk factors such as elevated blood pressure(hypertension), high blood sugar or diabetes and high cholesterol levels are also very important in every part of the world.

Here are some of the latest recommendations by the World Health Organization to stress these prevention measures

Eat a healthy diet: A balanced diet is crucial to a healthy heart and circulation system. This should include plenty of fruit and vegetables, whole grains, lean meat, fish and pulses with restricted salt, sugar and fat intake. Alcohol should also be used in moderation.

Eating foods high in cholesterol can build up fatty deposits, called plaque, on the walls of your blood vessels. These deposits can block the flow of blood to the brain, causing a stroke

Take regular physical activity: At least 30 minutes of regular physical activity every day helps to maintain cardiovascular fitness; at least 60 minutes on most days of the week helps to maintain healthy weight.

Being overweight or obese can raise total cholesterol levels, increase blood pressure, and lead to diabetes

Avoid tobacco use: Tobacco in every form is very harmful to health - cigarettes, cigars, pipes, or chewable tobacco. Exposure to second-hand tobacco smoke is also dangerous. The risk of heart attack and stroke starts to drop immediately after a person stops using tobacco products, and can drop by as much as half after 1 year.

Smoking cigarettes also raises your blood pressure!

Check and control your overall cardiovascular risk: An important aspect of preventing heart attacks and strokes is by providing treatment and counselling to individuals at high risk (those with a 10 year cardiovascular risk equal to or above 30%) and reducing their cardiovascular risk. A health worker can estimate your cardiovascular risk using simple risk charts and provide the appropriate advice for managing your risk factors.
  • Know your blood pressure: High blood pressure usually has no symptoms, but is one of the biggest causes of sudden stroke or heart attack. Have your blood pressure checked and know your numbers. If it is high, you will need to change your lifestyle to incorporate a healthy diet with less salt intake and increase physical activity, and may need medications to control your blood pressure.
  • Know your blood lipids: Raised blood cholesterol and abnormal blood lipids increase the risk of heart attacks and strokes. Blood cholesterol needs to be controlled through a healthy diet and, if necessary, by appropriate medications.
  • Know your blood sugar: Raised blood glucose (diabetes) increases the risk of heart attacks and strokes. If you have diabetes it is very important to control your blood pressure and blood sugar to minimize the risk.
Medic-ALL 2018

Ref: WHO

Whats in your cup of coffee?

Humanity runs on coffee - Unknown

In the midst of all the addictions our world has to offer, coffee is one that has certainly stood the test of time across generations. Coffee has become both the "waker" and "day-starter" for most in different parts of the world.

But seriously speaking..whats in that cup of coffee?

Of course, the active ingredient , Caffeine, which is a stimulant that acts in the brain by blocking an inhibitory neurotransmitter called Adenosine. Caffeine is the most commonly consumed psychoactive substance in the world today, taking only about 15-20 minutes to get into the bloodstream, reaching its peak level in 30-60 minutes and effects lasting up to 6-10hours.

A cup of Coffee is more than just black water with a rich smell.

A single cup of coffee contains several important nutrients, including Riboflavin, Pantothenic Acid, Manganese, Potassium, Magnesium and Niacin.
Certainly it has it benefits, but as with everything in life, moderation is key! even with coffee consumption. Some studies have shown that drinking coffee regularly in moderation reduces the risk of heart failure for example.

Still on Caffeine...
Coffee containing caffeine can cause insomnia, nervousness and restlessness, stomach upset, nausea and vomiting, increased heart and breathing rate, and other side effects. Consuming large amounts of coffee might also cause headache, anxiety, agitation, ringing in the ears, and irregular heartbeats.

The Benefits!

The caffeine in a cup of coffee might help small blood vessels work better. Coffee consumption has been linked with a lower incidence of heart rhythm disturbances in both men and women, and lowered stroke risk for women. Among 13,000 people, those who drank one to three cups every day were 20 percent less likely to go to the hospital for arrhythmias than abstainers.

Lowers Diabetes Risk

Coffee has also proved beneficial in the context of cardiovascular disease risk factors like Diabetes. Recently, Australian researchers found a correlation of about 7% drop in the odds of having type II diabetes for every additional cup of coffee drunk daily following 18 studies of nearly 458,000 participants. Six to seven cups of either caffeinated or decaffeinated coffee tanked the chance of getting the disease by a third.

It is important to add however, that regular coffee, contains caffeine which can raise the blood pressure, as well as blood levels of the fight-or-flight chemical epinephrine (also called adrenaline),

While it is known that caffeine intake reduce the risk of forming gallstones,study reports have also indicated that coffee protects against liver cirrhosis (Link)

Other Benefits of Coffee


Though, the evidence of a cancer protection effect of coffee is weaker than that for type 2 diabetes, the drink has proven to be more effective against liver cancer, where it lowers the chances of developing the disease by half. There is also a link between coffee and lung cancer, but only those who got the disease because they smoked. On the other hand, drinking it was actually found to be a protectant for non-smokers with lung cancer.

Keeps the Brain Sharp
Coffee has also been linked to lower risk of dementia, including Alzheimer’s disease. That characteristic mental jolt coffee provides which most medical students and doctors can relate with may extend a lifetime. Recent studies have shown that Parkinson’s, age-related cognitive decline, and maybe even Alzheimer’s could be kept at bay by coffee. The Alzheimer’s and dementia risk may be lowered by an amazing 65 percent thanks to coffee! (link)

Helps You Withstand Pain
Interestingly, coffee may be the answer to mild pain relief. This is according to a national study done in Norway, in which coffee-takers in an office reported a lower pain-intensity level when compared with those who abstained. Other studies have shown linked caffeine with reducing muscle pain after working out (Link)

Most Importantly, Lowers Death Risk

This is according to a meta-analysis of 20 studies with 1 million participants carried out by the National Institutes of Health. They found that coffee somehow helped lower ones chances of dying from any cause. The AARP Diet and Health study showed that men can lower their chance of dying by 6 percent with just a cup a day. The more they drank, the lower that chance went — five cups, of course, was the maximum recommended.

After all said....Lets Drink it up..but in moderation

To be continued.....

Athritis: Challenging the Pain!

Physical activity-even if you don't lose an ounce you'll live longer, feel healthier and be less likely to get cancer, heart disease, stroke and arthritis. It's the closest thing we have to a wonder drug. - Tom Frieden

An approximate staggering 350 million people (young and old) worldwide suffer from some kind of athritis! Call it a global epidemic if you like, but even more intriguing is the role that regular exercises and maintenance of optimal body weight can play reducing the risk of developing athritis and towards attaining a "pain-free life".

What is Athritis?
It is the inflammation of any joint that is commonly associated with pain and stiffness. 

Regular effective exercise is vital for arthritis patients
Though there are more than a 100 types of athritis (CDC 2016) each with its own causes, symptoms and complications.

Osteoathritis and rheumatoid athritis are 2 of the most common types.

Osteoathriritis(OA) is the most common joint disorder worldwide which occurs due to aging and wear and tear on a joint that could result from obesity, excessive use in certain occupations/sports and advancing age is known to be one of the strongest risk factors. 

Rheumatoid athritis (RA) on the other hand is an autoimmune athritis resulting from the body's own immune cells mistakenly attacking the tissues of the joint lining resulting in stiffness, swelling and pain. Patients with RA may manifest with dry eyes, dry mouth, swollen digits and eye symptoms.. Though it may occur in anyone, it is more common in women and older adults.

The key differences between both conditions is in how the symptoms present. The pain of OA is worse with activity and relieved by rest in contrast to the pain of rheumatoid athritis. Whilst morning stiffness experienced in OA  resolves within 30 minutes, it lasts longer in rheumatoid arthritis.Also, RA is also found to be symmetrical in that it tends to affect the same joint on both sides of the body.

Treatment of both OA and RA  consists of non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, use of corticosteroids and even surgery. While RA treatment also involves the use of anti-thematic and biologic agents in addition to the above.

The role of physical therapy in the management of joint problems cannot be over-emphasized. Physical therapy helps to restore the use of the joints by improving mobility, increasing the strength of the muscles around the joints and maintaining fitness. 

Athritis may be not curable, but surely it is manageable, even more manageable when the patient is involved.

So how well can the patient be involved?
Exercise, regular effective exercise is vital for patients with athritis, and non-drug treatment options are an integral part in the management of the condition. This have been shown to improve symptoms in many patients. 

As important as exercise, is weight loss (some amount of weight loss is always great). Being overweight has been linked to the development of athritis of the knee and its worsening, hence weight loss can   help to reduce pain particularly in the knees and hips as well as lower the risk of OA even in advancing age.

Though the development of many kinds of athritis is strongly associated with aging, here are some signs to be on the look out for that may necessitate scheduling an appointment with your doctor.

  • Pain, swelling or stiffness in one or more joints
  • Warm or reddish discoloration around a joint
  • Difficulty moving a joint or doing daily activities
  • Any concerning joint symptoms

Finally, exercise and physical therapy with gentle muscle-strengthening exercises are always helpful as is range of movement exercises to maintain flexibility and good posture.

Medic-ALL 2018


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