Heart Care

We all know that it is the heart that keeps us alive but sadly, not all of us take good care of it. Here are some tips from Dr Devi Prasad Shetty who is a leading heart surgeon in India and a philanthropist. Hope these tips will enlighten us enough to start taking care of our heart.
The interview below is from PERSONNEL TODAY, a journal of National Institute of Personnel Management.

Q What are the five thumb rules for a layman to take care of his heart?
A. 1. Diet – Less of carbohydrate, more of protein, less oil.
2. Exercise – half an hour’s walk, at least five days a week. Avoid lifts and avoid sitting for a long time.
3. Quit smoking
4. Control weight
5. Control blood pressure and sugar.

Q Is eating non-veg food (fish) good for the heart?
A. No

Q. It’s still a grave shock to hear that some apparently healthy person get a cardiac arrest. How do we understand it in perspective?
A. This is called silent attack. That is why, we recommend everyone past the age of 30 to undergo routine health check-ups.

Q Are heart diseases hereditary?
A. Yes

Q What are the ways in which the heart is stressed? What practices do you suggest to de-stress?
A. Change your attitude towards life. Do not look for perfection in everything in life.

Q Is walking better than jogging or is more intensive exercise required to keep a healthy heart?
A. Walking is better than jogging since jogging leads to early fatigue and injury to joints.

Q You have done so much for the poor and needy. What has inspired you to do so?
A. Mother Theresa, who was my patient.

Q Can people with low blood pressure suffer heart diseases?
A. Extremely rare.

Q Does cholesterol accumulate right from an early age (I’m currently only 22) or do you have to worry about it only after you are above 30 years of age?
A. Cholesterol accumulates from childhood.

Q How do irregular eating habits affect the heart?
A. You tend to eat junk food when the habits are irregular and your body’s enzyme releases for digestion gets confused.

Q Can a healthy person without a medical history have a heart attack due to stress?
A. Extremely rare

Q How can I control cholesterol content without using medicines?
A. Control diet, walk and eat walnut.









Q Can yoga prevent heart ailments?
A. Yoga helps

Q, which is the best and worst food for the heart?
A. Best food is fruits, worst are oils.

Q If a person has undergone angioplasty, what are the chances of the stent getting displaced?
A. Stent doesn’t get displaced. It can get blocked. You could prevent it by controlling sugar, cholesterol and taking medication to prevent clots.

Q Do negative emotions like depression or anger always cause heart disease?
A. Not always. On the other hand, positive emotions help recovery of the heart.

Q I have read about music therapy for the heart and the mind. What is your opinion on this?
A. Guess, it helps.

Q Which oil is better – gingili, groundnut, sunflower, saffola, olive?A. All oils are bad. The so-called best oil company has the largest marketing budget.

Q What is the routine check-up one should go through? Is there any specific test?
A. Routine blood test to ensure sugar, cholesterol is ok. Check BP, Treadmill test after an echo.

Q How different was it in treating Noor Fatima, the little kid from Pakistan?
A. It was extremely difficult because of the media attention. As far as the medical treatment is concerned, she was like any other child with a complex heart problem.

Q What are the first aid steps to be taken on a heart attack ?
A. Help the person into a sleeping position, put an Aspirin tablet under the tongue with a Sorbitrate tablet if available, and rush him to coronary care unit since the maximum casualty takes place within the first hour.

Q How do you differentiate between pain caused by a heart attack and that cause due to gastric trouble ?
A. Extremely difficult without ECG.

Q Can drinking less water lead to heart problems ?
A. No. However, drinking plenty of water in normal people helps preserve good health.

Q Is it true that diabetic women seem to have 3 to 7 times greater risk of developing heart diseases than non-diabetic women? Is it the same with high BP patients as well ?
A. Women are protected by the hormones till the age of 45. After that, their risk increases like men and in general, the result of treatment on heart patients who are women is slightly poorer than men.

Q What are some of the precautions during pregnancy to avoid heart problems in the new born ?
A. German measles, which causes congenital abnormalities in the babies. No smoking.









Q What is the main cause of a steep increase in heart problems amongst youngsters? I see people of about 30-40 years of age having heart attacks and serious heart problems.
A. Increased awareness has increased incidents. Also, sedentary lifestyles, smoking, junk food, lack of exercise in a country where people are genetically three times more vulnerable for heart attacks than Europeans and Americans.

Q What is the right time to check the BP in any person?
A. Past the age of 30 and earlier, if you have symptoms.

Q Is it possible for a person for a person to have BP outside the normal range of 120/80 and yet to be perfectly healthy?
A. Yes

Q Are there any symptoms for heart problems, which we need to be aware of ?
A. Shortness of breath on exertion, and chest pain.

Q If a person has had a heart attack, how frequently is regular heart check-up recommend?
A. Once in 6 months.

Q Marriages within close relatives can lead to heart problems for the child. Is it true?
A. Yes, co-sanguinity leads to congenital abnormalities and you may not have a software engineer as a child.

Q Many of us have an irregular daily routine and many a time we have to stay in office till late nights. Does this affect our heart? What precautions would you recommend?
A. When you are young, nature protects you against all these irregularities. However, as you grow older, respect the biological clock.

Q How can we find out about blockage of arteries, beforehand?
A. Routine cardiac evaluation by blood test, ECGs, TMTs, Stress Thallium Scan, Cardiac CT Scan for Calcium score.

Q Does a recurring pain in the left arm signify any heart related ailment?
A. Usually, you get chest discomfort or shortness of breath, months or years before the heart attack. So, when in doubt, go for a heart check-up, which should not take more than a couple of hours.

Q Will taking anti-hypertensive drugs cause some other complications (short/long term) ?
A. Yes, most drugs have some side effects. However, modern anti-hypertensive drugs are extremely safe.

Q Will consuming more coffee/tea lead to heart attacks?
A. No

Q What are the chances of lean people developing heart complications? Are they at less risk?
A. Obese people are at a higher risk. Lean people also develop heart attacks, but primarily because of genetic predisposition.

Q Is it true that after open-heart surgery, patients lose memory-recall to some extent?
A. No. Especially after bypass grafting on a beating heart, incidence of neurological problems have come down significantly.

Q Are Asthma patients more prone to heart disease?
A. No

Q How would you define junk food?
A. Fried food like Kentucky, McDonalds, Samosas, and even Masala Dosas.

Q You mentioned that Indians are three times more vulnerable. What is the reason for this, as Europeans and Americans also eat a lot of junk food ?
A. Every race is vulnerable to some disease and unfortunately Indians are vulnerable for the most expensive disease.

Q Does consuming bananas help reduce hypertension?
A. No

Q Is there any cure for chronic palpitations?
A. The patient should be investigated and if there is a cause for palpitation like an electrical abnormality of the heart, this can be rectified by a procedure called radio-frequency-ablation.

Q How would you rate the health facilities currently available in India?
A. There are institutions, which are as good or even better than the one in the US and Europe. However, they are exceptions. In general, the qualities of health-care available to the masses are poor.

Q If there is a small hole in the heart, what are the possible ways of curing it? Is operation the only solution?
A. Small holes in children less than 6 months of age usually closes. But the decision not to operate should be taken by the specialists who are experts in treating children with heart problems.

Q Are emotions really controlled by heart?
A. No. The heart is just a slave of the brain and it is the brain, which controls the emotions.

Q If a person does not do any physical exercise, he is bound to have shortness of breath on exertion; say climbing stairs. Is this an indication of heart disease?
A. No. But if one has difficulty in breathing on mild exertion, it is better to go for a heart check-up.

Q Can a person help himself during a heart attack?
A. Yes. Lie down comfortably and put an aspirin tablet of any description under the tongue and ask someone to take you to the nearest coronary-care-unit without any delay and do not wait for the ambulance since most of the time, the ambulance does not turn up.

Q Do, in any way, low white-blood-cells and low hemoglobin-count lead to heart problems?
A. No. But it is ideal to have normal hemoglobin level to increase your exercise capacity.

Q Sometimes, due to the hectic schedule, we are not able to exercise. So, does walking while doing daily chores at home or climbing the stairs in the house, work as a substitute for exercise?
A. Certainly. Avoid sitting continuously for more than half an hour and even the act of getting out of the chair and going to another chair and sitting helps a lot.

Q Is there a relation between heart problems and blood sugar?
A. Yes. A strong relationship is there since diabetics are more vulnerable to heart attacks than non-diabetics.

Q Do bypass surgeries reduce the risk of future heart attacks ?
A. It significantly reduces the risk of heart attack.

Q What are the things one needs to take care of after a heart operation?
A. Diet, exercise, drugs on time. Control Cholesterol, BP and weight.

Q Are people working on night shifts more vulnerable to heart disease when compared to day shift workers?
A. No.

Q Can you brief us about angina attack? How major it is?
A. Angina is the pain, which comes on exertion and goes away with rest and medication. One has to be investigated in detail to plan treatment.

Q What are the modern anti-hypertensive drugs?
A. There are hundreds of drugs and your doctor will chose the right combination for your problem. But my suggestion is to avoid the drugs and go for natural ways of controlling blood pressure by walk, diet to reduce weight and changing attitudes towards lifestyle.

Q Does dispirin or similar headache pills increase the risk of heart attacks?
A. No

Q If there is about 85 percent blockage in the arteries, can the person be treated without surgery? If not, what other remedies and the power of your heart muscles
A. It depends on collateral or natural bypass, the quality of other arteries and the power of your heart muscles. It’s impossible to give an opinion without seeing the angiography film.

Q There is a feeling that bypass is unnecessarily being performed in some cases. When is bypass really needed?
A. When you have blockages affecting major arteries, bypass is the best option. I am sure, conscientious doctors will not perform an operation when it is not required.

Q Is it true that mechanical valves can fail any moment?
A. No. If you take medication to prevent clot formation and maintain the INR at accepted levels, the valve cannot get blocked. However, like any mechanical gadget, it can fail and fortunately, such incidences are extremely low.

Q Can you brief me on pulmonary stenosys problems? What are the complications involved and what care needs to be taken?
A. In this condition, the pulmonary valve is narrower at birth and putting a balloon across the valve and dilating it can easily correct it.

Q Why is it the rate of heart attacks more in men than in women?
A Nature protects women till the age of 45.

Q How can one keep the heart in a good condition?
A Eat a healthy diet, avoid junk food, exercise every day, do not smoke and, go for a health checkup if you are past the age of 30 for at least once in two years. And WORK VERY HARD

Fit Is One Thing; Obsessive Exercise Is Another

Now we know that excessive exercise probably better termed
'obsessive' exercise does more harm than good. Read on.

By JANE E. BRODY
NY Times
Published: August 9, 2005

Many people have asked me why my knees were hobbled by arthritis long before I turned 60. Being born bowlegged gave them a start. But I made things worse by jogging daily for about 10 years and playing singles tennis for an hour nearly every day for more years than I can remember until increasing knee pain forced me to cut back to three or four times a week.

I loved my activities and planned my life around them, scheduling my workouts around family and professional obligations. When I couldn't do my daily activities - typically two or three a day - for reasons of weather, travel or closings of the facilities - I felt out of sorts, even guilty, and worried about gaining weight.

Had I been assessed by a sports medicine specialist at the time, I would have scored high on the scale of exercise addiction. To use a less pejorative and more accurate term, I was an obligatory exerciser, overly committed to an exercise routine probably to the detriment of my body if not to my psychological and social well-being.

While most Americans remain sadly sedentary, there is a small group of active people for whom exercise becomes something of an obsession, pursued despite physical injuries, damaged relationships and time stolen from work, family and social activities.

Do you remember Jim Fixx, author of the best-seller "The Complete Book of Running," which sparked the fitness revolution? Mr. Fixx ignored signs of impending heart trouble and died while running at 52. An estimated 10 percent of runners are obligatory exercisers, according to a 1982 report in The Journal of Sports Psychology.

A classic example was described in the June issue of The Physician and Sportsmedicine by Dr. John H. Draeger and Dr. Alayne Yates, psychiatrists at the University of Hawaii, and Douglas Crowell, a sports scientist in Honolulu. They told of a 38-year-old physician and marathon runner with a busy practice and large family who, after several months of progressive deterioration in his running times, finally visited a sports medicine clinic. He complained of persistent fatigue, muscle soreness, lack of energy and middle-of-the-night awakenings worrying about his physical performance and training routine.

The doctor's wife complained that he was becoming increasingly irritable, and he himself conceded that although running had been a stress reducer that gave him time to think, he now had to force himself to run and was no longer enjoying it as much.

The experts from Hawaii used "obligatory exerciser" to describe someone "who feels obligated or compelled to continue exercising despite the risk of adverse physiologic or psychological" consequences. These may include injuries caused by overtraining and social isolation. "When confronted with a decrease in performance, they will push their bodies harder to succeed," the experts wrote.

For the obligatory exerciser, exercise becomes a top priority, even more important than work, school, friends and family. It is no longer a free choice.

This affliction is by no means limited to runners or to adults. While it can happen to anyone, young females are especially at risk. It is more common among those young women and men involved in sports that focus on weight and appearance like gymnastics, figure skating, dance, cheerleading, swimming, crew, track, wrestling and horseback riding. It is also more common among noncompetitive female college students who worry inordinately about weight.

Common Characteristics

Aerobic activity that burns 2,000 to 3,500 calories a week is considered the amount of exercise to attain and maintain optimal health. This would entail 40 to 60 minutes of cardiovascular exercise four to six times a week. Beyond that, there are no added health benefits, but there is an increased risk of exercise-induced injuries.

Excessive exercise can damage tendons, ligaments, bones, cartilage, joints and muscles and not give minor injuries a chance to heal. Instead of building muscle, too much exercise can lead to muscle breakdown. Girls and young women may stop menstruating and start losing bone, as if they were in menopause. Excessive exercise can also release loads of free radicals, which can cause mutations and may increase cancer risk.

But it is not so much the amount of activity that defines the obligatory exerciser as it is its effects. Some people's bodies can handle more physical stress than others.

While there is no clear definition of obligatory exercise, there are telltale signs that exercise is becoming too important to a person and creating undue physical and psychological stress. These indicators were outlined by Molly Kimball, dietitian at the Ochsner Clinic Foundation:

¶Continuing to train even when ill or injured.

¶Experiencing anxiety when a workout is missed.

¶Constantly talking about their sport, training schedule and diet.

¶Neglecting other important areas of life.

¶Justifying excessive exercise as necessary to their sport.

¶Having friends and family notice a loss of perspective.

Obligatory exercisers often report some of the symptoms seen in athletes who overtrain, the article reported. They include anxiety, apathy, chronic fatigue, decreased appetite, depression, hostility, mental exhaustion, mood changes, changes in values and beliefs, diminished self-image, impaired concentration, emotional isolation, sore muscles and disturbed sleep. People may also become substance abusers, particularly of drugs thought to enhance performance.

Treating the Problem

But, the article said, obligatory exercisers may not readily admit to any of those symptoms and behaviors because of their need to appear healthy and normal. They do not want to be seen as "sick, weak, inadequate or needing help from anyone," the experts wrote.

It may be the task of parents, coaches, friends or other athletes to urge the person to get help to regain a healthier perspective.

The obligatory exerciser must be made to understand that "recovery periods, mandatory days of rest and the body's need to regenerate contribute to peak performance," the experts wrote. In contrast, continuing to pursue a relentlessly punishing course of activity can only lead to diminished performance.

The physician runner they cited was advised to reduce his training schedule. In two weeks, his physical symptoms disappeared and his mood improved. He was encouraged to look closely at his overcommitment to training and to learn relaxation exercises. With a therapist's help, he sought to develop alternatives to "his driven thoughts about training."

Ms. Kimball, the dietitian, suggested that when obligatory exercisers were unable to turn things around on their own, "meeting with a therapist, nutritionist or other health professional" could help them understand and deal with underlying problems that might drive disordered behavior.

Of course, prevention is preferable. For those involved in competitive activities, it is critically important for parents and coaches to avoid overemphasizing winning and pushing players into regimens that can become counterproductive.

Cool cucumber has hidden health benefits

The Star
FOOD SAFETY by CHIA JOO SUAN

What is the right vegetable for decorating dishes
with a touch of green and complement the dish with a pleasing taste of juicy crunchiness? Often the answer is either fresh or pickled cucumber. The complementary appetiser has its unique moist and cooling taste coupled with hidden health benefits unknown to the diners.

More than a thirst quencher

Eating cucumbers is an easy way to increase our water consumption. Under the crunchy thin skin, the pale green flesh contains about 95% water. One cup of diced cubes supplies about 90ml of pure water. Moreover, the dietary fibres regulate cholesterol level and support bowel regularity.

Cucumbers add potassium to our diet. Potassium promotes flexibility in muscles and regulates blood pressure. Together with its natural water, cucumber is the vegetable for sportsmen doing regular intensive exercise.


Eating cucumbers is an easy way to increase our water consumption.
One hundred grams of cucumber has 73mg of potassium. Though in no way comparable to banana (379mg in pisang berangan), it is as good as in watermelon (78mg) and green apple (83mg). Furthermore, cucumber has very little sugar and is low in calories. These features are of advantage to weight watchers and diabetics who prefer low-sugar or low-calorie food.

The manganese in cucumber promotes functions of nutrients, especially those of thiamine, ascorbic acid and choline to improve their absorption. Young people who often feel nauseous and have poor appetite, and those with skin rashes or suffer from loss of hair colour could have manganese deficiency. Including cucumber juice in their diet is a healthful tip.

Worry about preservatives?

Persons who are sensitive to sulphites may experience rapid heartbeats, headache or disorientation. Sulphite is a preservative commonly added to dried foods, dehydrated fruits and vegetables, pickles and wine. Some salad bars may use it to maintain freshness of their salads.

People who react to sulphite may have low levels of molybdenum which is needed to detoxify the sulphite. Other than black beans, cucumber can supply this trace element.

If you eat sausages and burgers regularly, it would be better for you to include cucumber in your diet. These foods may contain the preservatives nitrate and nitrite, which can lead to the formation of carcinogenic N-nitroso compound residues.

Cucumbers contain caffeic acid (3,4-dihydroxycinnaminic acid). It is a phenol antioxidant previously regarded as toxic but is now found to have anti-carcinogenic and anti-inflammatory properties.

A radiant complexion

The combination of ascorbic acid and caffeic acid contributes to cucumber’s cool and soothing properties. They prevent water retention, reduce swelling and help soothe skin irritations.

Cucumber extract is popular among beauticians as part of facial treatment for rejuvenating skin and facial appearance. Ladies like to place cucumber slices on their eyes while resting to prevent puffiness under the eyes. The “coldness” in cucumber also reduces pain from sunburn.

Healthful juice

Potassium in cucumber helps in regulating blood pressure. Cucumber’s diuretic property also helps to rid your body of toxins. Its magnesium content relaxes nerves and muscles and keeps blood circulating smoothly. Cucumber juice is used as a folk remedy for treatment of kidney stones and hypertension.

The juice is also used to treat rheumatic conditions. Mixing it with celery and carrot juice to enrich the cucumber juice with other phytonutrients would result in a concoction that is more effective.

Do not peel off the skin

The thin cucumber skin is rich in fibre and contains a variety of beneficial minerals especially silica, potassium and magnesium. Silica is an important component of healthy connective tissue for stronger muscles, tendons, ligaments, cartilage, intracellular cement and bone.

Do not peel off the skin; serve cucumbers with the skin intact. Soak and wash cucumbers to remove surface contact pesticides, or use those that are organically grown.

Curbing bitterness A common problem found in cucumber is bitterness. You might have heard the belief that cucumber grown on land that was previously planted with bitter gourd would be bitter.

However, the culprit is actually environmental stress. Wide temperature fluctuations, uneven watering (very wet, then very dry) and soil that is too acidic are possible reasons for cucumber to turn bitter.

The bitterness is due to the presence of cucurbitacin, which is more prevalent in the skin and just beneath the skin. Normally, bitterness is more concentrated in the darker green stem end than in the blossom end that is lighter green.

It can be very frustrating to find that the vegetable is too bitter for consumption. To avoid the bitterness you can peel off the skin, but only if you start peeling from the lighter end and stop about one inch from the stem end, then wash the knife and repeat peeling. Unfortunately, this also peels off the bulk of the benefits of cucumber.

Cucumbers are scientifically known as Cucumis sativus, which belongs to the same family as pumpkin, zucchini, watermelon and squash. The skin either ranges in colour from green to white, smooth or ridged depending on the variety.

Gherkins are the small variety best for making pickles. Pick the fruits that are firm for better eating quality.

Chia Joo Suan is a food chemist who advocates safe eating habits. She is the author of What’s in your food? (Pelanduk).