The Corona craziness

Who would have thought the March Madness will mean a different type of madness this year. The excitement of the basketball court, being replaced with an extreme sense of panic in every corner of America. Even the luck of the Irish could not save the St.Patrick's day celebration. The usually crowded pubs, restaurants around this time of the year were left deserted due to the government-mandated curfew in many cities. St.Patrick's day parade, one of the largest celebrations in the world, canceled for the first time ever due to this virulent virus.
A fragile microorganism makes the stock market to plummet, schools to close, and businesses to shut down. Broadway pulled its curtains indefinitely, Hollywood turned off its lights, a record number of flights came to a squealing halt, restaurants turned their chairs upside down.... the entire world in lockdown due to this rapidly spreading pandemic. It makes us all feel so vulnerable. Never in our lifetime have we all witnessed an outbreak of this magnitude. There seem to a shortage of everything from canned food to compassion, respirator to respite, masks to mercy. The Corona induced craziness is unbelievable. People hoarding supplies from the stores as if there is no tomorrow!
I believe that adversities are indeed the litmus tests to differentiate an altruist from egoistic.
During hurricane Sandy, in 2012, strangers from the community gathered to pile sandbags on the beaches, deliver food to the elderly, rescue residents from their flooded basements... a real act of kindness at a time of need. Similarly, the Chennai floods in 2015 not only demarcated the low-lying area of the city but also spotlighted those incredibly selfless people who resurrected the city successfully in a few months. We are now seeing thousands of health-care workers on the frontline who have put their lives at risk to save others. Many working even without proper personal protective gear, their patience, and resilience put to the test. My own friend Anu, an infectious disease specialist, has been an altruist angel being in the eye of the storm and braving it.

The handwashing that we have been emphasizing forever suddenly takes center stage of every conversation, news, and talk shows. The so neglected disinfectants are suddenly getting sold like hotcakes, and the protective gears that stayed on the storage units of the hospitals are being used like water.  This pathogen gave a new face to this world that is the masked face. Handshakes and hugs being substituted by elbow shakes or our good old Namaste! The social distancing putting the already distanced community into social isolation. Corona in Greek means a crown, this virus definitely takes the crown for causing the maximum damage to mankind.
This unseen enemy has induced greater fear and uncertainty than the terrorist attack of 911. Despite the advanced technology and medical science, we all feel so unprotected with our new battle against this pandemic. COVID-19 is an equal opportunity provider.... does not spare anyone, from Tom Hanks to Kevin Durant to Mrs. Trudeau to Aam Adhami, everyone is in its wrath. It makes us all realize that despite one's financial status or fame or title, we all are equal in the eyes of a pathogen and in the face of death.
While the cops were happy with the decline in the incidence of motor vehicle accidents, they were annoyed by the dramatic increase in domestic violence for obvious reasons! China saw not only a record number of Coronavirus infection but also a record number of divorce rates in recent months. Divorce lawyers see gold mines in this crisis while the rest of the working class is running to file for unemployment benefits. Everyone in this world seems to be suffering from some fever or other; if not Corona, then it is Cabin fever. Cabin fever has brought out a lot of hidden talents, we see Smulers, Tik-Toker cropping up every day of this lockdown period. Quarantine taught us the value of companionship, social distancing made us long for the warmth of the human touch and most important of all it taught us the fragility of our existence.
In my own experience, it felt bizarre to screen every patient as a potential COVID-19 infected patient, to wear the N-95 ask that covered 95% of my facial expression and the gloves that concealed that warmth of my touch. Even my staff obsessing with spraying aerosols in every room, wiping off all the surface with loads of disinfectant wipes while saying a prayer or two to oust this microscopic menace. We are all slowly getting used to this new normal.
After a long stressful day, as I hopped into my car, the near-empty parking lots and streets gave me a strange sense of loneliness. The thought of being trapped in a tunnel or navigating through a maze in an unknown land! Just then, I noticed the Daffodils, Tulips popping out with their colorful faces trying to tell me the brighter days are ahead! Life goes on... and we all will live to tell our grandchildren about the pandemic of 2020. 

The new social norm

The new social norm

When I was growing up in the 80's-90's friendship meant so much. Our lives revolved around our social circle. There was great excitement in making new friends. We even made pen pals through letter chains from far away cities. When emails, social media was a far-fetched thought, we managed to keep in touch with near and far ones through letters. The blue color folded inland letter carried every emotion from love, heartbreaks, marriage proposals to casual chitchats. Technology has revolutionized the way we communicate with each other. I'm not sure if it is good or bad.
Facebook, more than a decade ago, was the go-to social media from teens to seniors alike. Now we have Instagram, Snapchat, and whatnot. The kids unable to tolerate the postings of their parents quickly moved out of FB and found their hub on Instagram, Snapchat. FB branded its platform in terminologies like "like," "friends." In the FB world, the word "Friend" got a new meaning. He/She may be a person whom you have never met or set eyes on, like your sister-in-law's friend's son's ex-girlfriend! For many FB friend's lists grew in 100's to 1000's enough to make them believe that they can challenge Rajini in popularity. Moms and dads got carried away with the thought of sharing their glories with their so-called FB friends. Friendship also got a new measure in the FB world .... the number of likes! People found instant gratification in sharing their mundane moments that got the much-expected reaction in the number of likes. The privacy factor was quickly tossed into the trash bin. There is no limit to what people could post on FB.
Another breakthrough a few years back was WhatsApp. It was a dream come true to carry those international chitchats initially through text, then came audio and video calls that too all for free! Groups cropped up in WA from mommy's to alumni to professional groups. The life span varied from a few days to a few years.  The shortest one I was ever on lasted 5 days. Group dynamics change too, the admin who is the creator of the group might vanish into thin air, and the most active member might be the one who no one knows in real life. Members can be categorized as the incessant chatters, the attention mongers, the smart heads, the life-givers, the trouble makers, etc. Some people in WA are forever asleep, while a few are always in a meeting, while some roam around with dying cellphone battery all the time! Some manage to be silent spectators but still will not let go of the membership status. Some get their adrenaline rush by actively sharing their lives moments while others post controversial topics and get in trouble. Chat groups are supposed to mimic living room chitchats, but except that the person sitting next to you on your living room couch will most likely respond to you, but in WA chat rooms, there are no courtesy, decorum or even rules. People choose to ignore when they want to or actively choose to respond when it is convenient. The purpose/agenda of the group changes too, one group which was started for travel ended up being a political battleground with candidates running for election from a professional organization on each other' s throat to win the election.
We all live in a different era now, and it is required to embrace these societal changes. It keeps the community together on the surface, whether it strengthens the bonds is a million-dollar question. The happiness that a simple handwritten postcard brought is still missing in the technologically advanced instant messages delivered by our fancy gadgets. 

Holidays are about giving...not gaining. Holiday survival guide to tip the scale in your favor!

The holiday season is a wonderful time of the year when we all come together with family and friends. As the weather gets frightful, we all find warmth in the company of our loved ones. Getting together always revolves around food. Every holiday has been associated with its signature food from time immemorial. It may be music to every foodie's ear but not for a person watching their waistline. Here are a few suggestions to survive this holiday without adding extra pounds:

• Game Plan - Have a set plan for the holiday parties, whether you are hosting or attending. Plan ahead about what to eat and what to avoid. Allocate your calorie quota for the party, but make sure you do not go overboard on the alcoholic beverages and dessert. Drinking a warm drink like hot tea or even a cup of warm water will improve satiety. Fill your plate with salads and vegetables. Take a dessert plate for the main course; in that way, you consume fewer carbohydrates, fat. If you have a sweet tooth, go for that apple pie or creme brulee without feeling that you deprived yourself of the pleasure of the holiday meal but stop with one serving the size of a custard cup or a ramekin. 
• Assertiveness - Never be afraid to say "NO." You can politely decline the food that you don't want to indulge in without being obligated to eat. If your aunt Karen tries to push her freshly baked butter cookies on you, you should be assertive and not be shy about explaining your weight loss goals. 
• Partner - Having a weight loss partner will make this journey towards your goal painless, especially during the challenging times. Exchanging tips, healthy holiday recipes, and even ways to handle the foodies in your life can be more meaningful if you share it with someone with a similar ideology. 
• Diet - Maintain your caloric intake as close to normal as possible. It can be very challenging with holiday parties, travel, guests, etc. As long as you are mindful of what you eat, you will not fall off the wagon. 
• Exercise - If going to the gym is not possible, aim for 10,000 steps/day. Another option to burn off the calories from that cheesecake is by getting on the dance floor. A pair of dancing feet on the dancing floor for half-hour can help you burn 200-400 calories.
• Sleep - We are all creatures of habit. So once our routine is disrupted, a good night's sleep may be challenging to squeeze in during the holidays. Always make sure you get at least 7 hours of sleep/night. If you are too tired during the day, taking a power nap for 30 minutes can help recharge your body.
• The day-after - Tighten your belt the day after the party, don't eat the left-overs, clear all the pies/pastries from your refrigerator, write down your new goals and plan. Get right back into the routine with the excitement of setting the right foot forward from the New Year.

             Wishing you all a very joyous holiday season. 

Eggless,Meatless,Milkless.....what does it mean?

                                                                   
With the buzz now for various weight-loss diets, the Vegan diet is very much on the spotlight. Vegans constitute about 2% of the US population but continue to be a growing number.
What's a Vegan diet? A vegetarian diet that excludes all animal-based food. That means no meat, no fish and no dairy products. Vegetables, fruits, beans, legumes instead become the staple.
What are the health benefits of a Vegan/Vegetarian diet? Studies have shown that dietary fibers, folate, antioxidants in fruits, vegetables and whole grains decreases the risk of hypertension, diabetes, colon cancer, and obesity. The risk is further decreased slightly among vegans.
What are the harmful effects of a Vegan diet? A diet that is mainly plant-based is deficient in Vitamin B12, Vitamin D, Protein, Calcium, and Iron. Vitamin B12 deficiency is very common among Vegan. Vitamin B12 deficiency may manifest as fatigue, anemia or as neurological problems. Vitamin D is essential for bone health so is Calcium. Bone pain, bony deformities, brittle bones maybe some of the symptoms of Vitamin D deficiency. A diet low in protein will not provide enough nutrition for building the muscle mass. A decrease in the muscle mass will not only decrease your muscle strength/endurance but also decrease your metabolic rate. Iron deficiency presents itself as anemia or hair loss. Hence it is highly recommended that vegans take Vitamin B12, Vitamin D, and Calcium supplements. Always consult with your physician before starting any supplement.
Is Vegan same as Vegetarian diet? No. A vegan diet is even more restricted than a Vegetarian diet since dairy products are eliminated as well. Among vegetarians, there are pesco- vegetarians, ovo-lacto-vegetarians, and vegans.

Classification of dietary patterns *

Dietary Pattern	Definition	Beef	Poultry/Fish	Dairy/Eggs
Non-vegetarian	Eat red meat, poultry, fish, milk, and eggs more than once a week
Semi-vegetarian	Eat red meat, poultry, and fish less than once per week and more than once per month
Vegetarian
Pesco-	Eat fish, milk, and eggs but no red meat nor poultry
Lacto-Ovo	Eat eggs, milk, or both but no red meat, fish, nor poultry
Vegan	Eat no red meat, fish, poultry, dairy, and eggs

* Adapted from Gary E. Fraser [15].

What is a Vegan's substitute for meat?
Beans, soy, lentils, nuts, quinoa are the main source of protein for vegans. Meaty texture or taste is often mimicked by the use of eggplant or mushroom. Similarly, vegan/veggie burger made from beans, tofu is available in the grocery stores as well as in select vegan-friendly restaurants.
Meat substitutes for Vegans are :

Food	Serving size	Grams of protein
soybeans	1 cup	29
peanut butter	2 tablespoon	8
lentils	1 cup	18
beans, such as chickpeas, black beans, and kidney beans	1 cup	15
tofu, firm	4 ounces	11
quinoa	1 cup	8

What's a Vegan's substitute for dairy products?
There are non-dairy milk, cheese, butter, etc are available in the market. They are made from nuts like almond, cashew, and soy.

What's a Vegan substitute for eggs?
Flax seeds and chia seeds are used as an egg substitute for baking. Commercially available yeast is also used for baking instead of egg.

Where do the Vegans get their supply of Omega-3 fatty acids?
Since Omega 3 fatty acids are mainly found in fish/seafood a Vegan diet may not provide the required supply of essential fatty acid which is very important for many bodily functions. Flaxseed, Chia seeds, Walnuts, Soybean oil, Canola oil are few plant sources of Omega 3 fatty acids.

What should be in a Vegan's pantry?
Absolute "must-have": Lentils, black beans, soybeans, red kidney beans, nuts, tofu, rice, quinoa, yeast, vegetable stock or broth, soybean/canola/olive oil.

What are the best Vegan websites/apps?
Happy Cow, americanvegan.org, chooseveg.com are few helpful online resources for vegan recipes to restaurants.

"Veganism" as they call it, is a way of living that excludes the use of animal-based products not only for nutrition but for clothing, cosmetics, etc. On the compassionate ground, Veganism does stop the butchering of animals to put food on our table. It also curbs the exploitation of innocent animals by humans for our selfish needs. There are good alternative food sources that we get from the earth. In my opinion, it is wrong to say that all foods from an animal source are unhealthy since the nutritional benefits of dairy products, fish, etc cannot be discounted. So whether you are pesco-vegetarian, semi-vegetarian or a vegan choose your plate prudently to maintain good health.

Reference: National Institute of health

Ghosts from the past

They came alone, they came in pairs and a few in the same bunch as in the past
Some looked taller, some heavier but all definitely older
Few reminisced with friends in sentimental talks while some laughed with their partners in crime from the past.
Some put on an air and some simple with no flair
Few shared their ups and downs with their peers, while some flew high propelled by their own ego.
Many found solace in the reunion while a few seemed untouched by the bond from the past.
The toppers, the last benchers, the athletes, the artists, the nightingales, the ballerinas all wearing the same title... "The Alumni."
Some awestruck by the power of the human connections and some over the materialistic acquisitions.
Be it a ghost or an angel from the past, it has had an impact!
Time changes everything, but one thing that will remain untouched is the warmth of a genuine friendship.
Until the next time, let us share, laugh, live, cherish, and savor every moment together!. 

Hidden facts in your food

As the cold air gives way to brisk air perfused with the fragrance of the freshly bloomed flowers, as the bright green leaves start spurting out from the trees and as the squirrels, birds, and bees dash out from nowhere, we know that spring has sprung. What does that mean? Allergy season has arrived.
We all are aware of the seasonal allergies with itchy, watery eyes, runny nose, and the sniffles triggered by the environmental allergens. Do you know that hidden allergens in your diet can trigger an inflammatory response in your body leading to weight gain?

Food intolerance or food sensitivity is a hot topic in the field of medicine now. It is quite different from food allergies. While an allergic reaction to food can vary from a mild rash to a life-threatening anaphylactic reaction, symptoms of food intolerance often times are subtle. Food intolerance/sensitivity can cause vague symptoms like fatigue, indigestion, weight gain, etc. Thus making the diagnosis very challenging.

If you are struggling to lose weight in spite of a strict calorie restricted diet, exercise then talk to your doctor about food intolerance. A person can be intolerant to any food or even to food additives, coloring agents, and preservatives. If you are not sure, getting a blood test done for food sensitivity will be very useful. Avoid processed food. The preservatives and additives in those foods may be the culprit in triggering food sensitivity. Also, keep away from Genetically Modified foods which alter your immune response by providing unnatural food and toxins. They are not nutritionally balanced either. Eliminating the food that you are sensitive to will help with controlling your cravings for food thus paving a path for weight loss.
If you are yo-yo dieter with rapid fluctuation in your weight, it is time to think about food sensitivity.
Once you know the trigger, it is vital to eliminate it from your diet for a minimum of 6 months to make your body forget it and to re-introduce it slowly after 6 months. This way you are giving your immune system a second chance to handle the same food in a different way. Rotation diet has been validated for food sensitive individuals. It is avoiding the same food not more than every 4 days in order to prevent the development of food intolerance.
The immune system can go haywire due to stress, unhealthy diet, lack of sleep, etc, thus causing a skewed response to food. Maintaining a healthy immune system with a daily supply of Vitamin B complex, Vitamin C, good night sleep, exercise, and meditation can mitigate this abnormal response to food.

What you need to know & do :

• Think outside the box -If your symptoms do not fit in any typical medical diagnosis or if you are caught in the vicious cycle of weight loss and weight gain, it is time to consider food intolerance.
• Do not mix up - Food allergy is very different from food intolerance.
• The litmus test - Simple avoidance can pin the diagnosis for many with Gluten or Lactose intolerance. Most of the patients do require the help of blood testing to find out the foods they are intolerant to.
• The 3"R" remedy - Remove, Rotate and Re-introduce. Remove the food that you are intolerant to from your diet strictly, rotate your food on a 4 days cycle and re-introduce the food that you are sensitive to after 6 months. 

         Stay healthy and enjoy life!

          Dr.Aparna Chandra

Caution with Carbs!

Does your palate crave for a piece of scrumptious cake with creamy rich chocolate filling after dinner? Do you feel that once you take the first bite of that sugar-loaded piece of heaven that your willpower to say "no" flies out of the window? You are not alone....join the club of millions of people inflicted with sugar addiction. Here are some facts about the most talked about macro-nutrient:
Basic Facts about Carbohydrates:
Carbohydrates are one of the macro-nutrients that are broken down to glucose to provide energy for bodily functions. They are divided into simple, complex carbohydrates and fibers. Simple Carbohydrates are sugars like glucose, fructose, and sucrose, whereas complex carbohydrates are starches that are made up of many sugar molecules, joined together. Fibers are the carbohydrates found in plant-source only.
Functional Facts about Carbohydrates:
1. Natural Vs Added - Carbohydrates that are found naturally in the foods like fructose in fruits or lactose in dairy products are a good source of carbohydrates than added sugars found in sweetened beverages, desserts, and other processed foods.
2. Go with the colors - Green colored kale, orange colored carrots, and red kidney beans not only add color to your plate but also provide you with a healthy source of carbohydrates.
3. Wipe off the whites - Say "no" to the refined carbohydrates found in the white food like white bread, potato, and sugar. Refined carbohydrates get absorbed quickly increasing the sugar level in the body. As Johny rightly said "Eating Sugar, No Papa"!
4. Interpreting the labels - Beware..sugar can go by different names like sucrose, high fructose corn syrup, molasses, agave nectar, fructose sweetener, dextrose etc. Paying attention to these added sugars on the food label will help you to make a healthy decision. Higher the position on the label, larger is the quantity of it in that particular food.
5. Fit in Fiber - Fiber usually comes from the plant source and are not absorbed by the body. Hence they do not increase the sugar levels. Chose your fiber source from legumes, peas, apples and green beans. Daily quota of 25-30 grams of fiber from natural plant-source is essential to maintain digestive health, improve satiety and decrease cholesterol level. The easiest way to get 25-30 grams of fiber/day is to start with whole grain cereal like oatmeal, eat at least 1 whole fruit/day, snack on raw vegetables and substitute meat with legumes, white rice with brown rice or quinoa and white pasta with whole grain pasta.
6. Advice on Artificial sweeteners - Sugar-free may not be completely sugar/carb free. There are 6 FDA approved sugar substitutes in the US. These artificial sweeteners are 100 times sweeter than sugar and must be used in very small amounts only. In my opinion, natural sweeteners like agave or honey are preferable to artificial sweetener.
7. Diabetic diet - If you have diabetes, it is advisable to consult with a Dietitian or Diabetic educator to learn about carb counting and to customize your meal plan.
8. Curbing the cravings - Avoid taking that tempting first bite, if you indulge in one it will soon push you into an avalanche of carb indulgence. Space meals equally during the day so that there is no rapid fluctuation in sugar level, low sugar level itself will cause the cravings. Fool your body with natural sugars in fruits instead of added sugars. A bowl of blueberries or strawberries with a dollop of fat-free whipped cream may satisfy your sweet tooth as good as a bowl of ice cream! Anytime chose water to quench your thirst over sugar-sweetened beverage or soda.
9. Zero-in on the diet -There is nothing called Zero-Carb diet since all foods have some amount of carbohydrate. Instead of avoiding carbs completely, I recommend choosing the right type of carbs found in legumes, fruits, vegetables, dairy, and whole grains.

Carbohydrates are the main source of energy to our body. We all need it for survival. It is not all that bad as it has been portrayed in recent years if it is from right, natural source. So make your choice of carbs wisely, consume in smaller portions, combine it with other macro-nutrients like unsaturated fat and protein, most importantly stay away from the added sugars.