Dr harold Gunatillake

Health & Views – October 2019 2nd issue – By Harold Gunatillake






Health & Views October 2019 2nd issue

Health & Views: Health Newsletter for the Sri Lankans & others , globally
October 2019 2nd issue
Why So Many Bacteria Live on the Surface of Your Eye
By Tony St. Leger, University of Pittsburgh

You may be familiar with the idea that your gut and skin are home to a collection of microbes — fungi, bacteria and viruses — that are vital for keeping you healthy. But did
you know that your eyes also host a unique menagerie of microbes? Together, they’re called the eye microbiome. When these microbes are out of balance — too many or
too few of certain types — eye diseases may emerge.
With a recent study showing bacteria live on the surface of the eye and stimulate protective immunity, scientists are beginning to discover the microbial factors that can be
exploited to create innovative therapies for a range of eye disorders like Dry Eye Disease, Sjogren’s Syndrome and corneal scarring. One day it may be possible to
engineer bacteria to treat eye diseases in humans.

I’m an immunologist studying how the eye prevents infection. I became interested in this field because humans get only two eyes, and understanding how bacteria affect immunity
may be the key to avoiding up to 1 million visits to the doctor for eye infections and save US$174 million per year in the U.S. alone. Only recently have scientists found the human
eye has its own microbiome.

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Exercise may prevent, and treatment made easier with Cancer – Good advice by Harold Gunatillake

Dr. Harold GunethilakeCancer is a dreaded disease on the increase globally, a disease we do not want to have, even our enemies.

Did you know that one in three people in Denmark develop cancer? In 2014, around 267,500 Danes lived with cancer diagnosis.

The WHO age standardized incidence of breast cancer in Sri Lanka was observed to have increased from 9.2 per 100,000 in 2001 In a population of 20 million people, 23,530 new cases of breast cancer, and 14,013 cases have died, in a survey done in 2018. The incidence of cancer seems to be high in Sri Lanka due to the poor lifestyles, consuming processed foods much cheaper and tastier on the taste buds, than un-processed foods, and having no time for exercise.

The incidence of colorectal and prostatic cancer among males, seems to be very high in Sri Lanka.

When your doctor tells you., you have cancer the degree of shock and self-devastation is self-implicit and further description is not required. You think of your self and your loved ones you leave behind soon, in most situation causing extreme depression and helplessness.

You can avoid this situation.

The conventional treatment, including surgery, chemotherapy, radiotherapy and immunotherapy that your oncologist plans is not an absolute cure, it is all temporizing regimes to prolong your agony of extended living. This opens the avenues for the charlatans to boast of cancer cures and extract money from the distressed victims.

There is one avenue to prevent and make therapy easier, and that would be daily exercise.

Flexibility exercises (stretching), resistance training (lifting weights or isometric exercise), which builds muscles, or just walking daily 20,000 steps (with smart health watch in your wrist) is all that you need to do. The smart-health watch is an encouragement and impetus for your daily walks.

A new study shows that exercise is an effective way to prevent cancer. Adrenalin released during intensive training prevents the spread and development of metastases elsewhere in the body. This not only restricts the spread of cancer but also makes it easier to treat.

Exercise lowers blood estrogen, it helps lower a woman’s breast-cancer risk. Exercise also reduces your insulin secretion from your pancreas, being a cancer growth factor, reduces its resistance. Even old women after attaining menopause do produce estrogen in their fat cells. So, staying slim reduces fat (triglycerides) in your fat cells and your risk of cancer is lowered.

There are other factors we do not know, but analysis showed that an “exercise-dependent induction of adrenaline accounts for all the beneficial molecular mechanisms.

Red meat and cancer risk Beef, lamb, and pork are all red meat. Pork looks white, but it is red meat. Researchers do not know yet how red meat can cause cancer of the breast colorectal and pancreatic cancer.

One known factor is that red meat has no fibre, and high fibre diets seems to lower the risk of cancer, diabetes and heart disease, among others. Gut microbes play an important role by fermenting fibre to produce short chain fatty acids and butyric acid that prevents damage to the inner lining of the gut that may be a factor in cancer development. Eating high fibre diets consuming less red meat reduces the risk of Colo-rectal cancer.

Bottom line: Do some form of exercise daily, find the time for it, focus on a vegetarian diet and be a winner in life.

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Health & Views – October 2019 1st issue – By Harold Gunatillake

Health_Views October 2019 1st issue







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Farewell Dinner to ever popular Hon. Lal Wickrematunge Please enjoy and share




Hon. Lal Wickrematunga has been the most popular Consul General we have ever had in Sydney.He has been accorded with many felicitation-farewell parties, by business associations, combined community associations and old school associations and many private parties.

This video is to be shared by the viewers to appreciate his personality, popularity and a farewell speech he made which appealed to the hearts of all participants.Farewell Dinner to ever popular Hon. Lal Farewell Dinner to ever popular Hon. Lal Farewell Dinner to ever popular Hon. Lal Farewell Dinner to ever popular Hon. Lal Farewell Dinner to ever popular Hon. Lal Farewell Dinner to ever popular Hon. Lal Farewell Dinner to ever popular Hon. Lal Farewell Dinner to ever popular Hon. Lal WickrWickrWickrWickr ematunge matunge Please enj Please enj Please enj Please enjoy and share oy and share oy and share

Lastly, this is what I have to say about our most popular Consul General who has been associating with the Sri Lankan community much more than the previous consuls.Lal has been Consul General in Sydney for nearly four years. He has been successful in uniting all ethnic communities under one Sri Lankan banner. He has also tirelessly supported all community events and has showcased Sri Lanka at a high-level judging by the excellent National Day events.

He has brought professionalism into the Consulate and the staff are now very attentive, courteous and efficient. He leaves a high-quality legacy which hopefully be maintained in the future.Affable and ever approachable we will miss him and wish him the very best in Sri Lanka

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Prediabetes by Harold Gunatillake


Prediabetes is the steppingstone to full blown diabetes

If you are a non- diabetic you are blessed to be free with your dietetic habits, but over-indulgence may catch you in some other ways for the same risk factors, such as heart disease, high blood pressure and so on.

So, do not be complacent being free of diabetes, to consume high glycaemic foods.
High glycaemic foods are those carbs that have a GI of over 60. These include round grain rice like samba, also called shortgrain, or any other white rice has a GI of 73 when glucose is
based as 100.

Boiled brown rice has a lower GI of about 68 and over. This difference is, the brown outer covering in brown rice referred to as bran delays digestion with slower absorption.

The other common high GI foods are potatoes, white bread, foods made from processed wheat, white rice and those with added sugar as in ice-cream and beverages.

Basmati rice has a GI of 59 and is preferred for diabetics to eat when rice is chosen. The common low GI foods are soy products, some fruits, pasta, grainy bread, porridge, lentils and other high fibre foods.

Sri Lankans are blessed, because they love lentil curry that goes well with any other staple food and quite cheap too, for the average man.Medium GI foods, i.e. those between 55 to 65 are orange juice,honey, basmati rice, wholemeal bread and so on.

Any form of resistant rice seems to have a low GI as the absorption is very slow, and most of it passes through to the large gut for the benefit of the microbiota. All carbs with high fibre content have lower GI than processed low fibre foods.

The definition of prediabetes is when your HbA1c ranges between 5.7% to 6.4%. Non-diabetics have a Hb A1c of less than 5.7% and full-blown diabetics have a higher GI of over
7% and varies according whether diabetes is controlled. Most of you may not know what HbA1c test is.

Simply explained, the blood sugar gets into the haemoglobin in the red cells and are stored for 2-3 months. So, HbA1c is referred to as a memory test because it refers to the amount of
glucose stored in the red cells for that period through a process called glycation.

When you test your fasting, post-prandial (after food) or random blood sugar, you check on the blood sugar reading at that moment.

The advantage of the HBA1c test is that the reading gives an estimate of the consumption of sugars for over 2 months. This is the most reliable blood sugar test to diagnose and assess the control of your diabetes.

In terms of the instant fasting blood sugar test- if the reading is 100- 125 milligrams per decilitre (mg/dL) and the HbA1c is between the range of 5-7% to 6.4%, you are labelled as a prediabetic.

In the US about 86 million people over the age of 20 are prediabetics.

You could image the over-indulging lifestyles of these people for being born an American.

In the third world countries people need to eat high glycaemic processed foods because they are cheaper and provide quick energy for survival. Most unprocessed foods are not within the reach of the average person. A good example is bread. White hot bread produced by the local bakery costs 70-80 rupees, whilst brown bread and multigrade varieties are over three times the cost in Sri Lanka. Furthermore, white bread seems to give a better pleasing taste to go with curries than the brown unprocessed varieties.

How can one know whether he or she is a prediabetic when there are no symptoms? But really there are symptoms that go unnoticed.

You could feel extra thirsty and pass more urine. Your vision could be blurry and may be tired at the end of the day.
If you feel that you experience any of the above early symptoms you need to have first a fasting blood sugar, and a HbA1c test.
You may also have early metabolic syndrome needing control,too Metabolic syndrome is a cluster of signs that occur together,
increasing your risk of heart disease, stroke and type 2 diabetes.

The syndrome includes high blood pressure, high blood sugar, excess fat around your waist and high cholesterol and triglycerides.

Controlling metabolic syndrome reverses prediabetes.
Most important are dietary changes by switching on to low
carbohydrate with low glycaemic, high fibre foods
Avoid sugar sweetened beverages
Avoid foods containing trans-fat.
Avoid white bread, Pasta and white rice
Fruit flavoured yogurt
Sweetened breakfast cereals
Flavoured coffee drinks
Dried fruits.
High glycaemic foods result in a quick spike in insulin and blood sugar. Low glycaemic foods have a slower, smaller effect.In addition to diet restrictions the good news is that people with pre-diabetes can start some regular exercise and lose weight to prevent progressing into full blown diabetes.

Walking 10,000 steps a day seems to be the panacea to prevent and cure most diseases, including cancer.
Reversing pre-diabetes is not a cure but maintaining the blood sugar level within normal range with strict discipline Suitable foods for breakfast are- smoothies, oatmeal, eggs, plain unsweetened yogurt, brown bread and fruits containing low sugar Sri Lankans love their rice and curry for lunch and dinner.

Brown and red rice are unprocessed and are preferred to white polished rice.

Do not eat more than half a cup of rice and fill the plate with high fibre curries and leaves, such as lentils, and green leafy veggies, including the crucifers like cabbage, cauliflower, kale, broccoli, Brussels sprouts, bok choy and so on. These veggies have been linked with many health benefits such as a reduced risk of cancer and heart disease Eating fried rice and biriyani do not give blood sugar spikes, because the rice is more resistant being cooked with added oil.

They may increase your waistline if you eat regularly.The better choice is to add a teaspoon of oil whilst the rice is boiling, keep it overnight in the fridge and enjoy the next day.
This rice seems to be more resistant and most of it passes into the large bowel for the benefit of the microbes.


Keep your weight down, exercise daily, et low glycaemic high fibre foods with low salt and that regime would reverse prediabetes.
Hope this video was useful. Goodbye until we meet again.

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What are Ketones and Keto Diet- Is it confusing-By Dr Harold Gunathilaka

Is keto diet though popular as a weight reduction method, is it superior to other standard weight management plans?

Are there health risks involved including nutritional deficiencies in a keto diet?

That’s what we are going to discuss today.

Sri Lankans eat rice and curry as the staple diet. This is a balanced diet consisting of a large amount of carbs as rice, or a few slices of bread and spicy curries to accompany. Curries such as the veggies, fish, meat or the salty dried fish with an occasional egg curry, provide the required proteins, fats and other micronutrients.

The answer to the Western salad, Mallum’. It is a bevy of greens wilted, spiced and combined with shredded coconut amongst other spices. Onion pickle is always there on the dining table as a ‘rice puller’ that feed the microbiota in your gut.

This would be the ideal diet for the hard-working labour class of person who need much sugar to provide quick energy to burn, required for the heavy physical work they perform.

They have no weight problem as such, and the majority remain skinny.When it comes to the affluent sedentary class of people, having a weight problem need to seek dietary restrictions to reduce their body weight. Then, they think of starting on a fancy weight loss diet.

The new keto diet seems to be catching up and considered to be the most beneficial way to quickly lose weight.

Now let’s find out the nitty gritty of this slimming diet.

Ketosis and ketone bodies

We need to know what ketosis is, to understand how the keto diet works.

Ketosis is a normal process that happens when your body doesn’t have enough carbs to burn for energy. Instead the fat reserves in your body starts mobilising to provide energy through a substance called ketones.

This is a life-saving natures method or call it a ‘survival kit’ when you get lost in the jungle for many days deprived of food or during starvation.

Ketosis is a popular weight loss strategy where you reduce your carbohydrate intake to 50 gams daily. Usually in your normal balanced diet you do consume as much as 200 grams of carbs mainly as rice or bread. Keto diet is a low carb diet like the eating plan which was propagated by Atkin and in the Paleo diet which stress proteins and fats for fuelling your body. The idea is for you to get more calories from protein and fat and less from carbohydrates.

The low carb, high fat keto diet causes the metabolic state known as ketosis, in which substances known as ketones or ketone bodies accumulate in your blood.
When you start on this low carb diet ketosis kicks off in after 3 to 4 days of eating less than 50 grams of carbs per day.

50 Grams of carbs is 3 slices of bread, or two tablespoons of boiled rice, a cup of low-fat fruit yogurt and two small bananas.

So, when you cut back on your carbs, fat in your fat cells stored as triglycerides,seem to mobilise and used for energy through ketone body formation in the liver.The liver produces three ketone bodies. They are: Acetoacetate, beta hydroxy butyrate and acetone. To go further, these ketone bodies are formed from acetylCoA found in the mitochondrial matrix of liver cells when carbs are scarce that energy must be obtained from breaking down of fatty acids.
In addition to recommending the keto diet for weight loss, it is also recommended by doctors for children and adults having epilepsy- a special high fat diet which seems to prevent seizures.

Keto diet may help people with heart disease, and certain brain diseases and acne, but there needs to be more research in those areas.
Some researchers suggest that keto diet might help lower the risk of heart disease, though the intake of fats is high. Other studies show that this diet with low carbs can help people with metabolic syndrome, insulin resistance as among type 2diabeticsWhen you start on a low carb diet, especially Sri Lankans who indulge in large quantities of rice in their daily consumption, may feel bad and restless during the first week on this diet. This is due to sugar and carbs withdrawal.

Keto diet includes high fat foods where one can eat up to 70-80% fat, and proteins and restrict carbs. Most keto diets include processed meats, fatty cuts of meat,including red meat, lard and butter. Unsaturated fats like oily fish, nuts and seeds and plant oils are also included.

Keto diet avoids all carbs sources including both refined and unrefined products.Foods to avoid include all breads, including whole grain, cereals, pasta, cookies and baked goods, rice, starchy veggies like corn, and potatoes, and fruits and their juices.

The side effects of keto diet could be – headache, fatigue, brain fog, irritability, constipation and so on. Low carb diets can lead to kidney stones or high levels of acid in your body called

If you have uncontrolled diabetes, ketosis can become dangerous when the ketone body build-up is high. It may lead to dehydration and change in the body chemical balance of your blood becoming acidic may result in a coma or death.

This condition is called diabetic ketoacidosis (DKA), when your sugar level is very high in your blood when you don’t take enough insulin to control your blood sugar level.

So, please control your blood sugar levels before you plan to start on a keto diet, if you are a diabetic.

Some people without diabetes can get ketoacidosis, too., due to heavy alcohol intake, starvation, or an overactive thyroid.

Should diabetics go on a keto diet because of the forced low carb intake? Mice experiments have revealed that keto diet may increase the insulin resistance, i.e. poor glucose tolerance, and yet it does seem to question the safety of excess fat that is consumed on the keto diet.

So, presently, the advice given to the diabetics is to be vary of going on a keto diet because of the low carb intake.

Red Meat: Eating more red meat may shorten your life People who increased their red meat intake by just half a serving a day boosted their risk of dying over the next eight years by 10%, the study authors said.

Processed meats are dangerous Processed meats are smoked, cured, salted, canned, dried, or preserved. Cold cuts, hot dogs, bacon, sausage, salami, beef jerky, ham, corned beef, and other processed meats are linked to a variety of health problems. In several studies, people who ate the most processed meat had higher rates of diabetes, heart disease, and some types of cancer. Excess salt, preservatives, and fat in the products are to blame. Eat more meatless meals, cut back on the amount of processed meats you eat, and up your intake of fruit and veggies to protect your health.

It is important that you need to take enough dietary fibre for gut health and wellbeing. Fibre itself is a carb that the human gut cannot digest. Therecommended daily intake is 25 grams for women and 38 grams for men Sri Lankans get more fibre from tropical fruits like jack and breadfruit and theveggies. Jack provides in one serve 2.5 g of fibre. Jack fruit is also rich inantioxidants eliminating the toxins produced by the body as well as the free radicals
which harm for us. Such toxins and free radicals formed in the body daily is known to cause cancer.

Breadfruit has 4.9 g of dietary fibre i.e. 13% of your daily requirement.

It is a starchy fruit and you are deprived if you are on keto diet.

High protein and high fatty foods have no fibre. Red meat has no fibre.

Fibre is a prebiotic that the microbes in your gut feeds on and produces butyrate and other short chain fatty acids that protects your gut inner lining from chronic debilitating diseases like Crohns, ulcerative colitis, and cancer.

In keto diet the fibre intake is low, and that may be detrimental to your health and wellbeing.

It is sound advice to eat a balanced low calorie low dense diet, exercise daily at least walk 10,000 steps a day and limit your alcohol consumption. Focus on eating unprocessed carbs like brown rice and multigrade bread That would be the long-term regime to control our weight.

Just imagine you are carrying a sack of potatoes on your shoulder and walking about. If you have put on that amount of weight, your body must carry that amount daily. That would put a strain on your heart, joints and more.

Hope this talk was useful. Now please enjoy the you tu.be
My new website: www.doctorharold.com

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The Way Heart Works-By Dr. Harold Gunatillake

Keep your heart rate between 60 to 80 beats per minute

If you use an average of 80 beats per minute, your heart beats about 4,800 times per hour. That’s a whopping 115,200 times per day. Over the course of a year, your heart would beat about 42,048,000 times!

Let’s listen to a healthy steady heartbeat.

That is the way you must keep your heart beating through life. Take care of your heart and your heart will give you a healthy good lifespan.

Athletes and others who do strenuous exercises, may bring down their heart rate according to the extent of training. Olympic athletes bring down their heart rate to 40 beats per minute, for competitive performance

If you are sedentary, your heart rate may go up to 90 per minute, or more

If your heart rate is more than 90 beats per minute you need to see your doctor to check the reason. In such a situation if you neglect your heart may go into failure without your knowing or may have a stroke or sudden arrest and death.

To be on the safe side, please check your pulse at your wrist, or side of neck, regularly at rest. During exercise it raises physiologically.

When the heart rate is rapid, we call it ‘tachycardia’ Sinus tachycardia is when the heart rate increases due to physical activities. In such situations, the increased rate does not harm your heart

Your heart rate may be regular or irregular. It may be irregular due to a dropped beat. Please see your doctor early.

Your heart rate gets rapid if you are malnourished and anaemic. This is the commonest cause of tachycardia among many rural people in Sri Lanka. They need a nourishing diet to make the heart work healthily.

Frequent coffee drinkers have a rapid heart rate. If you eat chocolate bars daily, your heart becomes rapid due to the stimulation by the caffeine in the chocolate,There is a term called inappropriate sinus tachycardia. About half of the time, this phenomenon occurs after recovery from a serious illness, usually a viral illness. And most often, those affected are women in their 20s and 30s.

Inappropriate sinus tachycardia does not damage your heart.

The commonest cause of rapid heart rate is Atrial fibrillation. The term atrial or atrium is used for the upper two chambers of the heart and the term ventricle is used to the lower two chambers.

When you go for your blood pressure check- up, in addition to upper and lower readings, the pulse rate is as important in the management of high blood pressure So, remember to know your pulse rate i.e. your heart rate, when you next visit you doctor.

Atrial fibrillation may be due to irregular electrical impulses in the two upper chambers or atria.

This raised irregular heart rate may be due to some heart disease, high blood pressure, heart valve disorder, increased thyroxine hormone liberated from your thyroid glands in your neck, we call it hyperthyroid state.

If you have an over-active thyroid there are other symptoms like, loss of weight even when eating lot of food, thin and moist skin, bulging eyes, loose motions, tremors in your fingers and so on.

Heavy alcohol abuse is another cause of rapid heart rate. Now let’s talk about irregular heartbeats- doctors call it Arrythmia.
You may feel that you are skipping a beat, or having added a beat When there are added beats, we call it “flutter”

When the beat is irregular the rhythm may be fast or slow or too early. Many arrythmias are harmless and many people live with it.

It could be harmful too-then it is serious-may be due to damaged heart and you must see your doctor immediately.

With irregular heartbeat if you feel dizzy, breathless or feel rapid heartbeats we call
palpitations – then it is serious. The causes of irregular heat-beats are:
• alcohol abuse
• diabetes

• drug abuse
• excessive coffee consumption
• heart disease like congestive heart failure
• hypertension (high blood pressure)
• hyperthyroidism (an overactive thyroid gland)
• mental stress
• scarring of the heart, often the result of a heart attack
• smoking
• some dietary supplements
• some herbal treatments
• some medications7
• \
If you feel a burst of fast irregular heartbeats lasting for a few minutes to a few
hours and back to normal – this condition is called Supraventricular tachycardia. For this condition there are medications like beta-blockers and calcium channel blockers. Many people with this condition have a procedure called catheter ablation. The other irregular heartbeats are:

Atrial flutter,AV nodal re-entrant tachycardia
Ventricular tachycardia, ventricular fibrillations, and so on. The bottom line is – you need to check your heartbeat i.e. your pulse rate in your neck or wrist occasionally. You may even experience palpitations, dizziness, fainting attacks.

You need to see your doctor immediately and take remedial measures before your heart goes into failure.

The bottom line is- If you feel that your pulse rate in your wrist or the neck is rapid, very slow, or irregular, you must see your doctor as soon as possible.Hope this talk was useful. Until we meet again, Goodbye.


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