Health & Views –February 2020 – 3rd issue By Harold Gunatillake
Fidgeting like shaking your legs can help you to lose weight- burn 350 cal. A day Sitting for more than six hours greatly increases your risk of a clot forming in your calf veins. No matter how much you exercise, eat well, avoid smoking, excessive sitting will cause problems according to Tom Rath best-selling author of ‘Eat Move Sleep’ which is sold more than six million copies:
As soon as you sit down, electrical activity in your leg muscle shuts off! Enzyme production, which helps break down body fat, drops by 90 percent.After two hours of sitting, your good cholesterol drops by 20%.
Continuous body motion, including fidgeting, is a healthy use of daily calories and keeps your weight down.
In the interesting new study in Australia, researchers recognized that excessive sitting time is associated with worse health. Shaking your legs whilst being seated, tend to improve your health.
You are aware travelling for many hours in a plane you are reminded of rotating your ankles frequently to avoid deep vein thrombosis on flights.
Furthermore, there are positive associations between cancer risk and sedentary behaviour.
Shaking your lower limbs vertically or from side inwards keeps the leg muscles active and calories are lost. Some, especially women tend to shake their feet cross legged while reading a book in bed.
You may lose more calories sitting down and shaking your legs continuously and rhythmically than walking.
You can now buy electrical shaking machines to do the same job. One issue with such machines is that the rhythmic motion of the foot plate tends to shake the feet and legs and may not improve circulation such as sending venous blood more rapidly towards the heart. Shaking your legs rhythmically functions better than the machine, as far as movement of the blood flow.
When you are in a nervous state you may unintentionally shake your legs, and that sends a message to everyone around you about your feelings of anxiety or irritation or being bored.
Shaking your legs isn’t always a sign of boredom. Some people in the North of Sri Lanka, do it while they are concentrating on a task or problem.
I have seen personally many Jaffna people shaking their legs unknowingly when engaged in serious auditing work.
Or for some people it is traditional to shake their legs -inwards and outwards whilst talking or just doing nothing. It is a perpetual habit, while some others do it subtle, situational tremor.
Most old people in Sinhalese homes in the rural areas while chewing beetle and relaxing on the reclining chair called the “Hansi putuwa’ seem to shake their legs, like no other business, most relaxing and satisfying.
Shaking your legs is beneficial to your health, especially if your job is sitting down long hours, say at the computer.
Shaking your legs seems to increase blood flow significantly. So, if you are not a leg shaker, you should take a break, get up and walk every few hours.
In some cases, leg shaking goes beyond subconscious behaviour and may be a
cause of underlying disease.
There is a condition called restless legs syndrome (RSL) which has no connection to the habit of shaking your legs. RSL, occurs more in bed when you sleep. It is a feeling to move your legs in order to alleviate crawling, itching, aching Leg tremors are different to leg shaking. A person with leg tremors may notice their leg shaking while a muscle or group of muscles pulses or spasm out of control.
This situation is common in multiple sclerosis, stroke, traumatic brain injury.
When your liver or kidney failure may also cause tremors.
So, shaking the legs as in the Jaffna tradition is a healthy movement. It is not considered obnoxious and being involuntary may not be able to control.
Jaffna man has strong wiry legs and leg shaking gives good blood flow, better skin health, may be considered a factor for strong healthy legs for walking long distances.
Strong healthy legs are linked with healthier brain aging. Their brain health has influenced them to study well and become professionals.
Now you know why Jaffna man is wiser
‘Today, three billion people around the globe depend on seafood as their primary protein source’.
Fresh fish or frozen fish
Should you go for fresh fish from the fish monger, fish market, or for frozen fish in the supermarkets?
In Sri Lanka, along the seacoast there are wayside fish stalls selling fresh fish. That fish could be fresh because they are kept in containers with ice for sale direct from the fishing boats.
Fish, when caught are flash frozen on the boat right after it’s caught. In Sri Lanka, though the fish is not frozen in the boat, they are quite fresh and lively when brought to the shore early hours, when bidding takes place. They are removed in containers with ice and sold to the local markets and waysides.
If the fresh fish is kept exposed for a day in these wayside stalls, it is best to avoid purchasing them.
Fresh fish should have a mild scent and moist fresh and appears freshly cut.
If you get that strong fishy odour it would not be fresh. Whole fish should have bright, bulging eyes and bright red or pink grills.
In the fish markets, in Sri Lanka, fish is always fresh closer to the sea, as in Colombo or any coastal towns like Negombo, the northern coastal areas in the west coast.
One of Negombo’s most popular sites is the fish market, known by locals as “Lellama “; the second largest in Sri Lanka. It gives tourists the chance to meet the local fishermen, watch the daily fish auctions, organise fishing trips or boating tours of the lagoon and ocean beyond
Sea fish that is available in the central provinces of Sri Lanka are kept fresh, because they are transported from Batticaloa or Trincomalee in ice freezers overnight and then thawed out behind the supermarket counters. https://youtu.be/8xEJWHW8WYw
Frozen fish at your supermarket will not have the same fresh taste as those in your fish markets. Freezing does change the texture and the flavour
The slices of big fish you buy at the supermarket are oily fish, such as salmon, sardines, barramundi, snapper, John Dory., pilchards, trout, sprats mackerel, among others.
There are very good reasons to purchase frozen fish, including the convenience and being already cleaned and sliced. Frozen fish prices are cheaper at the supermarket.
Frozen fish is just as good as the fresh ones with no loss of nutrients and health benefits. Frozen fish can be kept in your deep freezer for about six months, and convenient to stock if you are far away from town areas.
Freezing fish kills any bacteria and other organisms including parasites and safer than the fresh. Gastrointestinal upsets are more with eating fresh fish.
Oily fish has at least ten per cent of healthy omega-3 oils. The oil has two important fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These fatty acids are considered important for the development of the brain in the foetal stage and has cardiovascular system benefits.
Fish liver also has beneficial oils. Cod liver oil comes from the liver of the cod fish. It has less omega-3s but is very rich in vitamin A and D.
Another popular supplementary oil is the halibut-liver oil from the halibut, also contains vitamin A, quite popular in the past, in Sri Lanka.
Fish is rich in Vitamin D and B2 (riboflavin), calcium and phosphorus, and a great source of minerals, such as iron, zinc, iodine, magnesium and potassium.
Eating fish regularly seem to lower your blood cholesterol and reduce the risk of heart disease.
Fish has top quality protein like the eggs.
Barramundi, native to Australia and the Indo-Pacific, also known as Asian sea bass, has delicate flavour and moderate fat content, and as such is impossible to overcook. It does not give a strong odour like most other fish like salmon and other oily fish. It offers desirable taste and culinary properties: it’s packed with heart-healthy Omega-3s and is a hardy species that lends itself to farming without antibiotics or hormones.
Common Commercial Fish Types of Sri Lanka
Seer fish in Sri Lanka is Spanish mackerel. It is also called Thora in Sinhala. This is the most expensive fish. It has the main skeletal bones only and can be eaten quite safely without small needle like bones been pickup whilst eating.
Thala path or Sail fish is cheaper and quite popular in Sri Lanka. They grow quickly, reaching 1.2-1.5 m length in a single year.
There are about 100 species of common commercial fish around the country.
Contamination with chemicals
Big fish can be contaminated with mercury and PCBs, but their benefits are much more likely to outweigh the risks.
Raised mercury concentrations are found in Japanese people as they eat lot of raw fish daily, shellfishes as “Sashimi” and Sushi”
Mercury is found in underwater sediments and in polluted water. Fortunately, seawater contains only small concentrations of methylmercury.
Larger fish eat the smaller fish containing small amounts of mercury. Mercury is not excreted from the body of the fish and tends to accumulate.
Overall, larger and longer-lived fish tend to contain the most mercury, these include shark, swordfish, fresh tuna and king mackerel.
Swordfish has the highest amounts of methyl mercury, as much as 0.995 ppm. While canned tuna has only 0.128 ppm. Trout has only 0.071 ppm.
Those who eat fish more than twice a week need to check their blood mercury levels. A normal mercury level is less than 10 ug/L (micrograms/litre) and less than
20ug/L in urine. Higher levels suggest toxic exposure.
U.S. government agencies recommend keeping your blood mercury levels below 5.0 mcg per litre
The early toxic symptoms of methylmercury from ingestion are peripheral vision impairment, pins and needle sensations in the limbs and mouth, loss of coordination, muscle weakness and other impairment of speech and hearing.
Mercury exposure is also linked to high blood pressure.
It is also linked to conditions like Alzheimer’s, Parkinson’s, autism, depression and anxiety.
If you have early symptoms as described, please see your family doctor for a blood test.
Benefits of eating fish
Benefits of eating healthy fish twice a week piles up. The Omega-3s lowers blood pressure, softens your blood vessels, cuts the risk of irregular heartbeats, and drops fatal heart disease.
The Omegas lower the risk of stroke, some cancers, improves your mood, and being anti-inflammatory helps prevent arthritis.
Oysters as an aphrodisiac?
The belief that oysters raise your libido is not true. Possibly, certain nutrients like, selenium could make you friskier.
Servings per week
The American Heart Association recommends at least two servings of fatty fish per week. Each serve is about the size of your palm of your hand.
Eating raw fish
Eating any form of raw fish as in Japanese cuisine poses a high risk of food-borne illness than cooked seafood. But Japanese seem to get away from that risk of infection by eating fresh raw fish or meat sliced into thin pieces and often eaten with soy sauce and forms an important part of food culture around the world.
Avoid eating especially larger species being linked to higher levels of mercury in the body.
Marine Fish that is discarded and leftovers are dried and sold as dry fish. The fish is bisected, wide opened cured with salt and sundried, or boiled.
The species that are used for drying are Katta, Balaya, Keeramin, Seer an Maduwa.
One could call them “Processed Fish”
Dried fish is a rich source of proteins like the fresh ones, containing 0-85% protein.
These processed fish retain antioxidants and omega-3 benefits of the fresh fish, while constituting a healthy food for both people and dogs.
Most dried fish contain little salt though it is being cured with salt. As awareness of the obesity problem among most people and increase in diabetes and heart disease, the demand for dried fish will increase as well.
Another advantage of dried fish is that they are not contaminated with germs and parasites and fear not to consume unlike the fresh fish.
Nutritional benefits are many by eating fish, provided you keep an eye on toxic symptoms as described above, on mercury poisoning.
Hope this article was useful.
72nd National Independence Day in Sri Lanka was celebrated in Sydney with invited local guests at the “Great Hall”, University of Sydney, Camperdown. The chief guest was the Governor of NSW, Hon. Margaret Beazley. It was a splendid evening with speeches, traditional dances and other events.
Over 400 Sri Lankans and invited guests had a splendid cultural evening with speeches, dances, and other traditional events.
Catering was done by Siva of Blue Elephant.
MC was Duke Ramachandran
The video was done by Dr. harold Gunatillake
The Australian Sri Lankans in Sydney (NSW), most passionately, evolved a project to collect funds for the victims of the recent devastating bushfires, killing 28 people, destroying over a thousand homes, and decimated wildlife.
Sri Lankan community minded associations, forums, past-pupil of schools, clubs, business-men, including the Consul General for Sri Lanka in Sydney & staff, joined in hands in unison and passion to make the project worthwhile, collect maximum amount of funds and donate to the Rural Fire Service (RFS), and the event was organised for the 1st Feb 2020 , at the Croatian Hall, Punchbowl.
It was a great success.
Australia assisted us at the time of need for the Tsunami disaster in December 2004 by providing $25.8 million in assistance including $ 5 million to the Asian (Sri Lankan) Tsunami Fund to re-establish essential services, transport and livelihoods,
Now, our turn has come to reciprocate that gratuitous act of the Australian government
My website: www.Doctorharold.com
Sri Lankans have been eating rice and curry as the staple diet for centuries. Our Sinhalese Kings had the technology to build giant tanks, reservoirs, irrigation canals for vast hectares of rice cultivations in the Northern and Southern Provinces, since the beginning of our recorded history.
A plate of rice is the food that gives the calorie requirement for our people and that commitment should never be changed.Sugar is considered the primary source of energy for every cell in the body, and the brain so rich in nerve cells use much of the sugar energy in the body.
Fats cannot provide such beneficial energy through their conversion to ketone bodies.
On the same token, fructose found in fruits and veggies, soft drinks and sweets can damage brain cells. Rice has no fructose.
With energy reserves from carbs, the neurones may be able to ward off disease’s stressors, whilst a keto diet may cause neuronal stress.
Diabetics must be cautious starting on a keto diet, because ketosis (ketone bodies in your blood), can triggers dangerous condition called ketoacidosis. This happens when the body stores up too much of ketone bodies- a biproduct of burning fat, and the blood becomes too acidic which can damage the liver, kidneys and the brain.
Your brain needs fat for its function, but it needs to be the right kind of fat from omega-3 fatty acids, as these are the building blocks in the brain, and important for learning and memory.
Our change of food and choices affect our brain, heart, liver and other parts of our body and such changes for short periods cause no harm.
Keto diet is specific for losing weight, treat medication resistant epilepsy and recently found that it may supports its potential use in Parkinson’s.
Especially for dieting, and when one loses the required amount of weight should revert to a well-balanced diet.
It is the healthy diet long term helps the brain performance, control of blood sugars, blood pressure and cholesterol management.
The American Diabetic Association does not recommend any single diet. The 2017-2018 nutritional recommendations from the American Diabetes Association specifically says 15-20% of calories should come from protein, and 20-35% of calories should come from fats. That means the balance of calories (45-65%) come from carbohydrates, and not 10:20:70 ratio (carbs: proteins: fats, respectively).
Hypoglycaemia: People having diabetes starting on the keto diet needs to be very cautious that they could go into hypoglycaemia without any prodromal symptoms.
All researchers recommend a low carb diet, just reducing your starchy foods, sodas and other drinks with added sugars, to reduce the blood sugar levels and to diminish insulin resistance that it may cause.
High Fibre diet: You need a high fibre diet which includes the cruciferous veggies, nuts, pulses, salads, and low sugar containing fruits (less than 15 gm. per serve)
DR Paul’s talk on ‘Evidence based keto: How to lose weight and reverse diabetes- vide above link
The talk is exceptional, great speaker, facts shown with graphs are correct, but he does not discuss the harm and the side effects, such diets can cause, to those diabetics tempted to go on low carb diets.
Can you reverse diabetes? A big mistake Paul makes is by saying, “Reverse Diabetes”
There is no way you can reverse diabetes other than in the stage of pre-diabetes (spring diabetes), when you could improve your insulin sensitivity by eating the right foods. Low GI diets, including keto diet will control diabetes, but reversing is a miracle.
Once a diabetic, always a diabetic.
Conclusions: For all purposes and good health, enjoy a low carb, low dense diet with less fat and more proteins, and the minimum 10,000 steps walk daily, we recommend.
Evidence show that 25,000 steps walk daily (3 and a ½ hours broken with intervals) is preferred, if you wish to lose weight and dissolve those plaques in your arteries. I have tried, it worked for me.
Hope this article is helpful.
“Limiting the intake of carbohydrates is the central concept of the keto diet”.
Normally, our staple diet is ‘rice and curry’, we all eat a high carb diet, with less fats and proteins. A high carb diet is suitable for physically hard-working people like those in the building industry, farmers, or road workers who need more energy for their daily work and provide the fibre, fat, protein, and the micronutrients
That is the best-balanced diet that has stood the test of time for the hard-working Sri Lankan.
Sedentary people mainly the affluent class need to eat less rice with the same quantities of fat and proteins, but unfortunately this category of people is overweight and need to visit a gym for workouts or do a brisk walk to be fit and healthy.
When it comes to people having diabetes, doctors recommend a low carb, including low glycaemic index foods, with restriction of fat and not proteins.
Today’s discussion is whether keto diet is most suited to control blood sugar among people suffering from diabetes and is it the modern diet for them?
Normally, for quick energy we eat a high carb diet as described before.
In a ketogenic diet the carbs are restricted, and the body use dietary fat and protein to get the calorie requirement.
In short, it is a diet that shifts your calorie requirements from carbs to mainly fats, and this shift your metabolism into nutritional ketosis, meaning your body uses ketones in your blood for energy.
These ketones are produced from fat in your liver
In such a diet you cut down carbs that are easy to digest, like sugar, soda, pastries, white rice and white bread to less than 50 grams day.
When you eat less than 50 grams of carbs a day, your body runs out of fuel, then you’ll start to breakdown protein and fat for energy as mentioned earlier.
This is a diet recommended to lose weight, for epilepsy, heart disease, certain brain diseases and even for acne on your face.
Keto diet is beneficial to prevent some types of cancer
Insulin secreted by your pancreas is a factor that can cause cancer. With less production of insulin due to less carbs being consumed, seems to protect you against some kinds of cancer.
Keto diet seems to be beneficial to prevent heart disease
Keto diets reduce bad cholesterol in your blood and raise good cholesterol. This may be because lower manufacture of insulin from these diets can stop your body from making more cholesterol.
So, the incidence of heart disease will be less in people who consume ketogenic diet.
Diabetes and keto diet.
In keto diet you consume less than 50 grams of carbs a day. So, the blood sugar level will tend to be low, ideal situation and supportive for diabetes.
This diet may reduce the risk of diabetes in people who do not yet have but has a family history.
It improves glycaemic control in people with diabetes and helps to lose weight.
Scientists do warn that those following the keto diet with insulin regime medication might have a higher risk of developing hypoglycaemia.
You may need to reduce your insulin medication in such a situation by discussing with your family doctor.
Majority of the health professionals do not recommend the keto diet for managing diabetes.
The American Diabetes Association (ADA) do not recommend any single diet like the keto, over another.
Accumulation of ketone bodies in the body in type 1 diabetes on keto diet may shift in the metabolism resulting in nutritional ketosis. These ketone body accumulations are toxic to the body and damage your kidneys.
On the other hand, if a type 1 diabetic does not take his insulin regularly the correct dose, will go into a condition called ketoacidosis, a medical emergency that could be fatal.
Keto diet does not allow the body to properly use insulin, so blood sugar may not be properly controlled, and may lead to insulin resistance which can raise the risk of type 2 diabetes.
High dietary fibre foods
Furthermore, you need to consume a food fibre from a variety of sources. Total dietary fibre intake should be 25 to 30 grams a day from food and supplements.
Unfortunately, keto diet being a low carb diet does not provide adequate daily requirement of dietary fibre.
You need to eat a balanced diet with high fibre to look after the beneficial microbes in your gut.
If you care for your allies in your gut, you need to eat foods good for your gut microbiota.
Gut health and nutrition are a hot topic and, now that it is known this is key to overall health.
So, keto diet is not a healthy diet, and not recommended for diabetics.
Instead a healthful balanced diet with plenty of low sugar fruits and vegetables is recommended.
You need to spread the intake of carbs out evenly throughout the day.
Chinese do it right. They eat a small amount of rice or noodles in a bowl every three to four hours, so that your blood sugar level is maintained at a healthy level with no spikes of blood sugar.
So, it is important to eat smaller meals more often rather than a large meal once or twice day.
Keto diet is not the overall best diet to control blood sugar levels among diabetics.
Stick to a balanced diet with low GI carbs focusing on high dietary fibre, less fat and moderate amount of proteins for your key to overall health.
About the author: Dr Gunatillake-Health editor is a member of the Academy of Medicine, Singapore. Member of the Australian Association of Cosmetic Surgery. Fellow of the Royal College of Surgeons (UK), Corresponding Fellow of the American Academy of Cosmetic Surgery, Member of the International Societies of Cosmetic surgery, Fellow of the International College of Surgery (US), Australian diplomat for the International Society of Plastic, Aesthetic & Reconstructive Surgery, Board member of the International Society of Aesthetic Surgery, Member of the American Academy of Aesthetic & Restorative Surgery, Life Member of the College of Surgeons, Sri Lanka, Batchelor of Medicine & Surgery (Cey). Government scholar to UK for higher studies and training.
Written by Dr. harold Gunatillake FRCS (UK), MBBS (Cey), AM (Sing), FICS (US), FIACS (US)
“Man does not live by bread alone, even resliced bread.”
Bread is made from wheat flour, salt, yeast, oil, refined sugar, preservatives and white bread is enriched with some nutrients.
High intake of carbohydrate as in white bread can lead to weight gain, and a risk for diabetes, heart disease and other lifestyle chronic diseases.
Therefore, diabetics are recommended bread baked with unprocessed wholemeal wheat and limited to two slices.
The various types of bread made in different ways are addictive to the taste buds and the desire to eat another slice is tempting. Most dieticians recommend two slices and no more.
White bread is highly processed and easily digested but has little nutritional value. White bread does more harm by adding excess calories and few nutrients.
Unprocessed wheat flour is used to bake brown bread. They are digested and absorbed slowly causing no sugar spikes in your blood, unlike the processed white bread and provide vitamin B, fibre and minerals.
Brown bread is not always baked from unprocessed whole grain. In Sri Lanka people buy brown bread assuming to be more healthy than white bread and highly priced.
Molasses added to the white bread quite common in Sri Lankan bakeries, gives a brown colour and reading the ingredient list when printed, is important.
“Multigrain” bread isn’t whole meal. Always buy bread where the label states whole meal, which means that whole wheat grain is used, and the label should be read before purchasing. Whole meal bread has also high fibre and is removed in refined white bread.
You need to differentiate between “Enriched” bread and whole meal bread. Enriched means that vitamin B and iron are added back after processing and refining. Fibre may not be added back to enriched bread.
The label enrich is found on processed white bread made of refined grains. Refining is a process which makes the bread light, airy and gives it a longer shelf life. This is the reason the bread you purchase in your supermarket give a longer expiry date and could be kept on their shelves for a longer period. You need to check on the expiry date before purchasing the bread.
Storing bread in the fridge as some do will make it go stale quicker.
If you leave it exposed to the air, it will stay fresh for 2 to 4 days
If you need to store bread any longer than 2- 4 days, it is best to put in the freezer when it could be fresh for 2 to 3 months.
If you see green or black fuzzy spots on the slice of bread, it is advisable not to eat and better toss out the whole loaf.
The blue grey green fuzzy mould is okay because that fungus is the same fungus that produces penicillin.
When you eat bread, you eat lot of salt, too. A slice of wheat bread has about 147mg sodium when the daily requirement is less than 2.300 mg per day as recommended for the Americans
Eating bread in all three meals can raise blood pressure and put you at risk of heart disease and stroke.
Gluten is a protein found in wheat, barley and rye. Some people are intolerant to gluten and cause gastro-intestinal upsets, like bloating, diarrhea and stomach pain. They should avoid bread made with wheat flour and request for gluten-free breads made with white or brown rice flours and starches like arrowroot, potato and tapioca.
To lose weight.
Many people who don’t eat bread or on ketogenic diet lose much weight. You could live on foods without eating bread, and still you crave for it limit to two slices a day- brown or white.
Bread has little nutritional value, but it is delicious, and the tendency is to eat more.
Conclusion: Stick to eating wholemeal bread, and limit to two slices.
Some reference to food & recipes WebMD