Stop flirting with your enemies by eating smarter and healthier.

Cruise ship in St. Martin. (Dr. Noorali Bharwani)
Cruise ship in St. Martin. (Dr. Noorali Bharwani)

Let us start with a question – What is the best way to lose weight? Is it intense exercise or less eating? Or both?

You cannot lose weight just by exercising. Regular exercise will make your heart and muscles strong. To lose weight you have to eat less and eat healthy. This has to be a lifelong strategy. Scientific evidence shows most people (who lose weight) will regain their weight over a period of time as they revert to their old eating habits.

There are many challenges faced by people who try to lose weight and maintain the loss. The challenges are to avoid foods containing sugar, salt and fat.

When you start cooking or sit down to eat, ask yourself – am I flirting with my enemies? How grave are the consequences? Let us look at the answers in more detail.

Your enemy number one – sugar.

Today, our diet is packed with huge amounts of added sugars.

Sugar is used as an ingredient in many packaged foods. Statistics from the National Health and Nutrition Examination Survey shows Americans eat about 17 teaspoons of added sugars per day. That’s significantly more than the American Heart Association’s recommendation of not to consume more than nine teaspoons a day. We are consuming twice the amount of sugar than recommended.

We know added sugars are bad for us. It is associated with an increased risk of overweight and obesity. That is directly linked to the development of type 2 diabetes. Studies have shown odds of being overweight or obese were 54 percent greater among individuals with the highest intake of sugars compared with those with the lowest intake.

Those who like to eat sweet stuff also increase the risk of heart disease. Several studies have shown a higher sugar intake also meant higher levels of total cholesterol, LDL (bad) cholesterol, and triglycerides irrespective of your weight.

Your enemy number two – salt.

We know too much sodium (salt) is bad for your heart. And yet, most North Americans consume about 50 per cent more than the maximum of 2,300 mg per day of salt. Reducing salt intake reduces the risk of heart disease.

Sodium is present in all types of food as a preservative or to improve the taste. It is lurking in some foods you wouldn’t necessarily suspect.

According to the Centers for Disease Control and Prevention, 10 categories of food (breads, pizza, sandwiches, cold cuts and cured meats, soups, burritos and tacos, savory snacks, chicken, cheese, eggs and omelets) account for 44 per cent of our overall sodium intake.

Best thing is to cook at home. Restaurant foods are heavily loaded with salt. Eating at home is always healthier and safer.

Your enemy number three – fat.

If you eat the right kind of fat then fat is good for you. Studies show different types of fats -monounsaturated, polyunsaturated, and saturated – had varied effects on health.

Saturated fat is the bad one. Instead of consuming saturated fat, eat unsaturated fats (fish, nuts, olive oil) or healthy carbs (grains, legumes). This way you can protect your heart. You want your heart to pump forever!

Avoid trans fats. American Heart Association says, “Doughnuts, cookies, crackers, muffins, pies and cakes are examples of foods that may contain trans fat. Limit how frequently you eat them. Limit commercially fried foods and baked goods made with shortening or partially hydrogenated vegetable oils.” Trans fat is really bad fat.

Eat more foods that contain unsaturated fat. Avocados, nuts, olive oil, and fatty fish should all appear regularly on your plate. Keep an eye on the calorie intake. Otherwise these foods are good.

My favourite diet: heart-healthy Mediterranean diet with a four-point plan.

According to Mayo Clinic website, if you’re looking for a heart-healthy eating plan, the Mediterranean diet might be right for you.

The main components of Mediterranean diet include:

  1. Daily consumption of vegetables, fruits, whole grains and healthy fats
  2. Weekly intake of fish, poultry, beans and eggs
  3. Moderate portions of dairy products
  4. Limited intake of red meat

Sounds pretty simple! Enjoy!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Here are some reasons for eating the heart-healthy Mediterranean diet.

Kananaskis Country (Dr. Noorali Bharwani)
Kananaskis Country (Dr. Noorali Bharwani)

In a 2012 study, 52 per cent of Americans (that were polled) believed doing their taxes was easier than figuring out how to eat healthy.

When you are hungry it is so easy to find unhealthy fast junk food. Junk food easily satisfies your hunger and craving for sweet, salty and oily food. But junk food can cause lot of damage to your heart, liver, brain, bones and other vital organs.

Heart and Stroke Foundation of Canada encourages Canadians to eat a healthy diet, control salt intake, and be physically active to lower blood pressure. The latest result from the DASH study (Dietary Approaches to Stopping Hypertension) has confirmed these recommendations, providing more encouragement for people to choose a healthier diet.

My favourite is Mediterranean diet – a traditional cooking style of countries bordering the Mediterranean Sea. The Mediterranean diet incorporates the basics of healthy eating – plus a splash of flavorful olive oil and perhaps a glass of red wine.

Mediterranean and DASH diets are considered to be the most effective diets for good health.

In Mediterranean diet you are encouraged to eat fresh fruit and vegetables, wholegrain cereals, nuts, the odd glass of red wine, fish and dairy, and olive oil as the main source of fat. Mediterranean diet is well known as one of the world’s healthiest. DASH diet also recommends a higher level of vegetable and fruit intake.

The DASH diet had the greatest effect on blood pressure, lowering levels within two weeks of starting the plan. Not only was blood pressure reduced, but total cholesterol and low-density lipoprotein (LDL) or “bad cholesterol” was lower, too.

What is important to note is blood pressure was lower for everyone on the DASH diet. Less salt people consumed, the greater the decrease in blood pressure. People who already had high blood pressure had the largest decrease in blood pressure.

Five things to remember about Mediterranean diet:

  1. Eat fruits and vegetables, whole grains, legumes and nuts.
  2. Replace butter with healthy fats such as olive oil and canola oil.
  3. Use herbs and spices instead of salt to flavor foods.
  4. Limit red meat to no more than a few times a month.
  5. A glass of red wine per day – if you are confortable with that.

The health effects of alcohol have been debated for many years, and some doctors are reluctant to encourage alcohol consumption because of the health consequences of excessive drinking.

There are other benefits of Mediterranean diet. It is associated with a reduced incidence of cancer, and Parkinson’s and Alzheimer’s diseases. Women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts may have a reduced risk of breast cancer.

The focus of the Mediterranean diet isn’t on limiting total fat consumption, but rather to make wise choices about the types of fat you eat. The Mediterranean diet discourages saturated fats and hydrogenated oils (trans fats), both of which contribute to heart disease.

In 1999, the Lyon Diet Heart Study compared the effects of a Mediterranean-style diet with one that the American Heart Association recommended for patients who had survived a first heart attack. The study found that within four years, the Mediterranean approach reduced the rates of heart disease recurrence and cardiac death by 50 to 70 percent when compared with the heart association diet. That is remarkable.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

Eating the Right Kind of Protein

A rock formation in Barbuda! (Dr. Noorali Bharwani)
A rock formation in Barbuda! (Dr. Noorali Bharwani)

A balanced diet consists of carbohydrates, proteins, fats and fruits and vegetables to provide you with vitamins, minerals and other nutrients.

Proteins are considered essential nutrients for the human body. They are one of the building blocks of body tissue, and can also serve as a fuel source. The body needs protein for growth and maintenance. Aside from water, proteins are the most abundant kind of molecules in the body.

There are many sources of protein: grains, legumes, nuts, seeds as well as animal sources such as meats, dairy products, fish and eggs. Vegetarians and vegans can get enough essential proteins (amino acids) by eating a variety of plant proteins.

A recent study from Harvard University and Massachusetts General Hospital in Boston (published in JAMA Internal Medicine) shows people who eat more protein from plants and less from animals may live longer even when they have unhealthy habits like heavy drinking or smoking.

If you like to eat animal protein then you should avoid processed red meat and choose fish or chicken instead.

The Harvard researchers followed more than 130,000 nurses and other health professionals over several decades. Half of the participants were getting at least 14 per cent of their calories from animal protein such as meat, eggs and dairy and at least four per cent from plant protein sources such as pasta, grains, nuts, beans and legumes.

The researchers noted that previous studies have indicated eating fewer starchy foods and more protein can help people manage their weight, blood pressure, sugar and blood lipids. But the Harvard study shows animal protein is deadlier for individuals who were obese or heavy drinkers.

The researchers found that meat eaters with an unhealthy lifestyle and higher mortality risk tended to eat more red meat, eggs and high-fat dairy than the fish and poultry eaters favoured by those with a healthy lifestyle.

The new study also found that meat eaters with a healthy lifestyle tended to consume more fish and poultry, while those with an unhealthy lifestyle and higher mortality risk – such as those who were overweight and drank at least one alcoholic beverage per day – tended to eat more red meat, eggs and high-fat dairy.

The authors say the study cannot prove that the type of protein people eat directly influences how long they may live. It’s also possible that the eating and lifestyle habits of health-care workers (participants in this study) might not be representative of the broader population of adults.

The real risk of mortality from animal protein also appears largely tied to processed meat, such as bacon, salami and hot dogs.

The take-home message here is to eat specific healthier plant-based foods such as fruits, nuts, seeds, beans, and non-starchy veggies. Avoid dangerous plant-based foods such as French fries to soda to white bread and white rice. And pursue a healthier life-style.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

How Schools Teach our Children to be Fat

A beautiful view of the mountains in Canmore, Alberta. (Dr. Noorali Bharwani)
A beautiful view of the mountains in Canmore, Alberta. (Dr. Noorali Bharwani)

“Our children are getting fatter. They eat more and move less,” says Diane Kelsall, MD, deputy editor, Canadian Medical Association Journal (CMAJ April 7, 2015), in an editorial titled, “How schools teach our children to be fat.”

The editorial goes on to say that nearly 85 per cent of children aged three to four years meet activity levels recommended in Canadian guidelines, but this falls to only four per cent in teens.

Unfortunately, most of our overweight or obese children will not outgrow their weight problem. That means they develop adult diseases like hypertension and diabetes. And our schools hinder the fight against obesity in our youth, says the editorial.

If you look at a typical day for our children when they are at school then you will understand why Dr. Kelsall feels our schools are doing a poor job of preventing obesity. She makes the following points:

  • Our children’s school day starts early, often well before 9 am.
  • They are likely driven or take the bus to school.
  • They are tired when they arrive and sit for most of the day.
  • Physical education classes are usually not required after grade nine.
  • Lunch may be rushed, and food options available in the school may be high in fat or sugar.
  • At lunch or after classes, some students may participate in sports, but most don’t.
  • Students have hours of homework resulting in extended screen time.
  • They go to bed late, and the cycle starts all over again.

No wonder nearly one-third of our school-aged children are overweight or obese. Our schools should be helping our children to be healthy and that should lead to healthy adulthood. How can schools do that? Dr. Kelsall suggests the following:

  • Daily exercise should be mandatory for all school children. It should become part of daily life. Classes should include enough sustained, vigorous exercise to help students meet recommended activity levels, rather than the 20-minute requirement in some jurisdictions.
  • Walking or cycling to school is a good start.
  • Taking public transportation affords more opportunity for exercise than being driven by parents.

Lengthy sitting time has been shown to be a risk factor for early death in adults. The editorial says that a peek into most high school classrooms will show rows of students sitting for classes that are often 75 minutes in length, among the longest in the world. This sends the message that being sedentary is acceptable. Beyond physical education classes, getting students moving during school hours takes creativity.

We should do what Japan does. Make food education a part of the compulsory curriculum. We should encourage our kids to sleep early and get up early. Like adults, tired adolescents are at increased risk of obesity.

“Obesity is a complex disease and prevention requires multilevel intervention,” says Dr. Kelsall. It starts with the individual and family making good choices around exercise and food intake, but broader societal support is necessary. Our battle against smoking is slowly winning and message to people is clear – if you smoke then you kill yourself and hurt others. The message for obesity and overeating is the same – stop hurting yourself and the people you love.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!