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3 Obesity and Diabetes surgery

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    Simple Sugars vs. Complex Carbs Many people seeking a positive health and fitness change are very confused about the differences between simple and complex carbohydrates. And to make matters worse, many of the popular weight-loss solutions seem to do all they can to cloud the waters even further. My goal here is to help you understand the difference between the simple and complex carbohydrates, show you how they impact your health and fitness, and provide you with some simple steps you can take – today – to move you closer to becoming your own fitness champion. After reading this information, you will be one critical step closer toward reaching your absolute physical best! Carbohydrates are one of three necessary macro-nutrients that provide calories in our diets. The other two are protein and fat. Carbohydrates provide most of the energy needed in our daily lives, both for normal body functions (such as heartbeat, breathing, digestion, and brain activity) and for exercise (like biking, walking, running up the stairs and all types of resistance training). An ample supply of carbohydrates is absolutely necessary to sustain a healthy existence and a must if your goal is to reduce your body fat and enhance your fitness level. Carbohydrates are considered simple or complex based upon their chemical structure. Both types contain four calories per gram, and both are digested into the bloodstream as glucose, which is then used to fuel our bodies for normal daily activity and exercise. The main difference between simple and complex carbs is: Simple carbohydrates or simple sugars - These carbs are broken down and digested very quickly, but most simple carbs contain refined sugars and very few essential vitamins and minerals. Examples include table sugar, fruit juice, milk, yogurt, honey, molasses, maple syrup and brown sugar. Complex carbohydrates - the complex carbs take longer to digest and are packed with fiber, vitamins and minerals. Examples include vegetables, whole grain breads, oatmeal, legumes, brown rice and wheat pasta. When you eat (or drink) a simple carbohydrate or a simple sugar – whether it is a can of soda, a scoop of fat-free ice cream, or even a glass of orange juice – all of the ingested sugar quickly rushes into your bloodstream. You typically feel a quick rush of energy. Your body then promptly reacts to this sudden spike in blood sugar by calling on the pancreas to produce additional insulin to remove the excess sugar from your blood. And for the moment, you have significantly lower blood sugar as a result of the insulin doing its job, resulting in a sense or feeling of needing more fuel, more energy and more calories. And as you hit that residual low blood sugar, you begin to crave more of the quick-release, simple sugars, and hence you have just initiated the sugar craving cycle. As this downward cycle continues, your pancreas continues to secrete insulin while it simultaneously reduces its production of another hormone called glucagon. Glucagon production, as it relates to improving your body composition, is very important if your fitness goal is to lose excess body fat. Glucagon is the only hormone that allows stored body fat to be released into the bloodstream to be burned by your muscles as energy. And when the pancreas has to elevate its production of insulin while reducing its supply of glucagon, you are basically locking-in your excess body fat. Therefore, too much simple sugar intake dramatically hinders the process of reducing stored body fat. American’s consumption of sugar continues to rise year after year. So too, does obesity in our country. In my opinion, the correlation between increased sugar consumption and obesity is telling. When 16-20 percent of daily calorie intake is coming from sugar, Americans are not only locking in stored body fat, but also squeezing out the healthier, more supportive and nutrient-dense food choices. Sugar is the enemy of body fat reduction; and the enemy of a healthy, high energy lifestyle. So, do your best to begin to understand what’s in the food you are consuming and reduce those that contain more than a few grams of sugar. When searching out the food choices that include simple carbs (i.e., sugars), start by looking for obvious ingredients on food labels that actually use the word “sugar”, like brown sugar, sugar cane, and of course, just simple sugar. Also, reduce your intake of foods that have any form of “syrup” in their ingredients. For example, corn syrup, high-fructose corn syrup, maple syrup and glucose syrup. And finally, look for those ingredients that end in “–ose”, like sucrose, glucose, lactose and fructose. All of these ingredients are sugars and, if ingested, will spike your blood sugar and initiate the pancreas to produce insulin and essentially shut off glucagon production – the fat release hormone. If you find yourself in a situation where you are limited in your food choices (e.g., a breakfast or luncheon business meeting, traveling, dinner parties, etc.), and sugar seems to be the predominant choice, try to eat a protein with the sugar. Protein will help to slow down sugar’s release into the bloodstream, and reduce the insulin/glucagon effect. Complex carbohydrates, on the other hand – and despite all the negative press they receive in some of the popular weight loss books – are actually your body’s preferred source of energy. When you consume the healthy complex carbs – the ones that have not been altered in a food laboratory – they are broken down into glucose molecules and used as fuel or stored in muscle and the liver as glycogen. When the body has an ample supply of glucose fuel and glycogen fuel storage, it can run efficiently. You will then have the energy to function at your best and provided the material that your body needs to reduce body fat and reach your health and fitness goals. When you look for complex carbohydrate food choices to put into your body, seek out two subgroups of carbohydrates…starchy carbohydrates and fibrous carbohydrates. Starchy carbohydrates include food choices such as brown rice, baked and sweet potatoes, oatmeal, brown pastas and whole grains. Fibrous carbohydrates include asparagus, broccoli, cauliflower, onions, mushrooms, spinach and peppers and can also be found in most varieties of dark green leafy vegetables. One more very important nugget of carbohydrate information to remember: Do your best to seek out the complex carbohydrates that have not been processed in a food factory. When shopping at the grocery store, stay away from the carbs that include the following words in their ingredients: bleached, enriched, processed or refined. These processed and altered foods are void of critical nutrient value and will do very little to fuel and energize your body. Bottom line, the goal in consuming carbohydrates should be to reduce or eliminate simple sugars and instead focus on the complex carbohydrates – both the starchy and fibrous complex carbs – those that have not been processed or refined. Do the best you can. At first, it may seem challenging as you begin to uncover the foods that contain sugar, eliminate them and seek out the more supportive carbohydrates. But once you get into the habit of eating the fibrous and starchy carbohydrates, eventually it will become a way of life for you. I can promise you, after an initial effort, the payoff of eliminating sugar from your diet can be dramatic. Your energy level will soar. You will lose stubborn body fat. And your craving for sugar will completely dissipate. To wrap up this extremely important section, let me share the same simple steps with you that I share with my friends who are striving for their absolute physical best: 1.Start to put the good carbs into your body: Complex Starchy and Fibrous Carbs that have not been altered or processed. 2.Eat small meals more frequently – every 3-3½ hours, 5-6 times per day. 3.Begin to gain an awareness of food labels and the “sugar” ingredients. 4, Start to reduce or eliminate the simple sugars and the processed carbohydrates. Remember: If your goal is fat reduction, sugar is your worst enemy! 5.Focus on making progress and forget about being perfect. You’ll mess up every so often. Forgive yourself and just move on! 6.Remember that small changes over time will stack up on themselves…and eventually will bring you to a new destination of physical excellence! #obesity #diabetes #bariatric #Metabolic #surgery
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    Smart eating: Carbohydrate Counting for Indian Foods When a person uses carbohydrate counting, the focus is on the carbohydrate in the food. This is due to the fact that carbohydrate raises your blood glucose much more rapidly than the other two macronutrients that provide calories; protein and fat (excluding alcohol, which is not a macronutrient). Following is a more complete list of the food groups whose calories are mainly from carbohydrate: • Starches: rice, pasta, bread, cereal, crackers • Starchy vegetables: potatoes, corn, green peas, beans and lentils • Fruit and fruit juices • Non Starchy vegetables: spinach, tomatoes, cauliflower • Dairy Foods: yogurt, milk, and other dairy foods • Sweets / Desserts: cakes, cookies, candy • Beverages high in sugar Carbohydrate Counting and Blood Glucose Control? Blood glucose levels are directly related to the amount of carbohydrate one eats. If the amount of carbohydrate is tracked at meals and snacks, and the blood glucose levels are taken before and two hours after the meal; a trend or pattern will emerge. Keeping an eye on the carbohydrate intake daily and eating the same amount each day, will assist in maintaining the blood glucose levels within the target range. How much Carbohydrate should a person eat? For a female, a basic rule of thumb for estimating the carbohydrate servings is approximately 45-60 grams of carbohydrate, or three to four carbohydrate servings per meal. For males, it is four to five carbohydrate servings per meal or 60-75 grams of carbohydrate per meal. Tips for Successful Carbohydrate Counting • Educate Yourself: Attend support group meetings on diabetes and obesity offered at “Obesity and diabetes clinic” of Asian institute of gastroenterology, Hyderabad (Enquire at +91-9866646942 or mail to us aig.bariatric@gmail.com). • Start small: Pay attention to portion size, Learn what average portion sizes look like and avoid large meals when eating out. Share your meal when eating out. • Learn to read the nutrition facts label • Be consistent • Find Technology that works for you and use it: You may use the Lose it i-phone app to look up food’s carbohydrate counts. • Figure out what you can’t eat: Most people with diabetes can eat anything in moderation, but carbohydrate counters sometimes find foods that just aren’t worth the glucose spikes. • Study your body • Plan it out • When you are at a restaurant. Learn how to improvise • Be smart about mindless munching
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    Why you don't lose weight despite best diet and exercise efforts For years you have tried various very low calorie diets and restriction to achieve weight loss, and to no avail.  It seems despite the decrease in intake and several hours in gym, your weight still was not dropping as you would have anticipated. With these severe habits, it's likely that it never really resulted in great weight loss and when it did, you may have found that you gained it back in no time at all. What actually is happening is related to your metabolism regulating hormones.  As you take in less and less, your body's hormones, such as thyroid and leptin, begin to drop in an effort to create homeostasis in the body.  At the same time the muscle tissue begins to break down and be used for energy (which will lead to an even slower, more depressed metabolism).   this slowing of your metabolism can turn into a vicious cycle.   So is it possible to fix this broken metabolism: Let’s start with exercise, taper it to about 3-5 days a week, maximum, with an hour at a time - as a maximum. Really,  30-45 minute workouts are more than enough. Keep in mind that resistance and weight training is the best way to enhance metabolism, while cardio workouts should be considered secondary and can be added in as part of the 3-4 day regimen, but a combination is best.  The next step is to look at your caloric intake, and be prepared to increase this slowly.  It is important to take this slow as to not gain weight back too rapidly, which will discourage you and may lead to another cycle of restricting your intake.  Try to calculate how many calories you are taking in and add about 50-100 calories a week. The goal will be to have added about 500 calories after the course of a few weeks. Author (Dr Abhishek katakwar) is a bariatric & metabolic surgeon based at Asian institute of gastroenterology, Hyderabad. abhishekkatakwar@gmail.com +91-8087358725
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    CHILDHOOD OBESITY: Childhood obesity is a serious medical condition that affects children and adolescents. Children who are obese are above the normal weight for their age and height. Childhood obesity is particularly troubling because the extra pounds often start children on the path to health problems that were once considered adult problems — diabetes, high blood pressure and high cholesterol. Many obese children become obese adults, especially if one or both parents are obese. Childhood obesity can also lead to poor self-esteem and depression. One of the best strategies to reduce childhood obesity is to improve the eating and exercise habits of your entire family. Treating and preventing childhood obesity helps protect your child's health now and in the future. Risk factors: Many factors — usually working in combination — increase your child's risk of becoming overweight: Diet. Regularly eating high-calorie foods, such as fast foods, baked goods and vending machine snacks, can easily cause your child to gain weight. Candy and desserts also can cause weight gain, and more and more evidence points to sugary drinks, including fruit juices, as culprits in obesity in some people. Lack of exercise. Children who don't exercise much are more likely to gain weight because they don't burn as many calories. Too much time spent in sedentary activities, such as watching television or playing video games, also contributes to the problem. Family factors. If your child comes from a family of overweight people, he or she may be more likely to put on weight. This is especially true in an environment where high-calorie foods are always available and physical activity isn't encouraged. Psychological factors. Personal, parental and family stress can increase a child's risk of obesity. Some children overeat to cope with problems or to deal with emotions, such as stress, or to fight boredom. Their parents may have similar tendencies. Socioeconomic factors. People in some communities have limited resources and limited access to supermarkets. As a result, they may opt for convenience foods that don't spoil quickly, such as frozen meals, crackers and cookies. In addition, people who live in lower income neighborhoods might not have access to a safe place to exercise.
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    BMR vs RMR Basal Metabolic Rate (BMR) and Resting Metabolic Rate (RMR) are rates used to estimate the amount of calories a person will burn if he is at rest for 24 hours. Â It is used to determine the minimum amount of energy a person requires to keep his body functioning, his heart beating, his lungs breathing and to keep his body temperature normal. They are conducted the same way but there are very many differences between the two; one is that BMR is measured under more restrictive conditions, while RMR is measured under less restrictive conditions. There are many requirements before a person’s Basal Metabolic Rate can be taken, while taking a person’s Resting Metabolic Rate has no requirements at all. Here are some of the features of the two metabolic rates: *Basal Metabolic Rate* Basal Metabolic Rate is the rate that an organism gives off heat while at complete rest. Â It is measured while the person is awake but at complete rest. Â It is often conducted in a darkened room upon a person’s waking up after at least 8 hours of sleep. To get the correct BMR of a person, it is important that he does not exert any extra energy while doing the test. Â This is why a person who is being subjected to a BMR test is required to stay at the testing facility the night prior to the test. He is made to lie in a reclining position, resting completely. Â He is required to fast for 12 hours before testing to ensure that his digestive system is not working during the procedure. Â During this time the energy released by his body should only be sufficient to let his vital body organs to function. *Resting Metabolic Rate* Also known as Resting Energy Expenditure (REE), Resting Metabolic Rate is measured under less restrictive conditions than Basal Metabolic Rate. Â It does not require the person to spend the night in the testing facility to ensure at least 8 hours of sleep and rest before testing. He is still required to rest in a reclining position while the test is being taken but he does not need to get 8 hours of sleep. Calorie counters and calculators usually use Resting Metabolic Rate rather than Basal Metabolic Rate because the conditions upon which the RMR rates are taken reflect the normal situation in a person’s day to day activities. Â So the results are more realistic. Summary 1. Basal Metabolic Rate is taken under very restrictive conditions, while Resting Metabolic Rate is taken under less restrictive conditions. 2. Before the Basal Metabolic Rate is taken, the person is required to stay at the testing facility, while in taking the Resting Metabolic Rate; the person can stay wherever he wants. 3. Basal Metabolic Rate requires the person to have at least 8 hours of sleep, while Resting Metabolic Rate does not. 4. Twelve hours of fasting is required before the Basal Metabolic Rate can be taken, while no fasting is required before taking the Resting Metabolic Rate.
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