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    Honestly running was never in my genes, I don't remember any stories even of my forefathers about running. I am an amateur runner and my journey of being runner is inspired by many like Mr Rajendra jaiswal from Nagpur, who proudly explain about knee ailments he had to an extent that one of the leading orthopedic surgeon advised knee replacement to him, then he started running at the age of 40’s. Gradual, graded and proper training has made him a full marathon runner. Let me make running more interesting, like any other love story my love for running is two years old which had many breakups. And finally in 2018 beginning i decided to be committed and dedicated when I joined “Couch to 5K” organized by Hyderabad runners club (an non-profit organization with credit of organizing Hyderabad marathon). Truly speaking for last few years I had all possible excuses to join this excellent protocol based training program like professional and lack of time, but this time I made up my mind, reason being reaching 40’s can motivate you a lot. As mentioned love story are usually not easy going, so obviously my running love too had lot of ups and down during my training but consistency and motivation from fellow runners kept me on toes. Are you new to marathon running !!! My Advice 1. First few weeks are going to be difficult (Like any new relationship), when your body tries to deny and resist any change in habit. So listen to your brain and try to convince your body. 2. Obviously there will be few mornings when you don't want to get up because you slept late or yesterday was tiring, It is just a matter of first few minutes after getting out of bed. Also remember first few kilometers would be difficult during beginning but eventually you get accustomed. 3. “Solo running doesn't last more than few days, i have done it several times” at least for me. So go out join some running group and breath fresh air instead of running on treadmill. 4. “Compete with yourself”, as marathons are about running and completing it and not about securing first or second position as every finisher is a winner. 5. “Don’t be paranoid”, first you need to understand your limitations, endurance or fitness level so never compare your performance with any other, instead set goal for yourself about pace and distance. 6. “Breathing is the key” during initial days you may easily get breathless or fatigue. It’s all because of wrong breathing technique. Now the next question would be “how to breath during running” my experience says • Breath from nose (you may even try inhaling from nose and excelling from mouth). • Don't hold your breath while running but have a control on the rate of breathing, because its normal physiological defense mechanism of human body to hold breath during stress conditions. So let be voluntary breathing for initial days until your body adopts to breathing. • Look forward at horizon and keep your arms at side making your chest come forward (that will increase your lung capacity) Happy running, Author (Dr Abhishek katakwar) is an bariatric & metabolic surgeon based at Asian institute of gastroenterology, Hyderabad. abhishekkatakwar@gmail.com +91-8087358725
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    Obesity is a common but often underestimated condition of clinical and public health importance in many countries around the world. Its general acceptance by many societies as a sign of well-being or a symbol of high social status, and the denial by healthcare professionals and the public alike that it is a disease in its own right, have contributed to its improper identification and management and the lack of effective public health strategies to combat its rise to epidemic proportions. In general, obesity is associated with a greater risk of disability or premature death due to type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) such as hypertension, stroke and coronary heart disease as well as gall bladder disease, certain cancers (endometrial, breast, prostate, colon) and non-fatal conditions including gout, respiratory conditions, gastro-esophageal reflux disease, osteoarthritis and infertility. Obesity also carries serious implications for psychosocial health, mainly due to societal prejudice against fatness. The body mass index (BMI) is a simple and commonly used parameter for classifying various degrees of adiposity. It is derived from the weight of the individual in kilograms divided by the square of the height in metres (kg/m2). By the current World Health Organisation (WHO) criteria, a BMI <18.5kg/m2 is considered underweight, 18.5–24.9 kg/m2 ideal weight and 25–29.9kg/m2 overweight or pre-obese. The obese category is sub-divided into obese class I (30–34.9kg/m2), obese class II (35–39.9kg/m2) and obese class III (≥40kg/m2). A BMI greater than 28kg/m2 in adults is associated with a three to four-fold greater risk of morbidity due to T2DM and CVDs than in the general population
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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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    News article by Dr Abhishek Katakwar published in Deccan Chronicle (Date 21 january 2018) Our complete gastrointestinal tract is lined with microbes collectively called the microbiome, which includes bacteria, fungi, and even viruses. Though it sounds weird and even unhealthy, gut bacteria perform many important functions in the body, including aiding the immune system, producing the feel-good brain chemical serotonin, making energy available to the body from the food we eat, and disposing of foreign substances and toxins, though we always have a mixture of good and bad bacteria, sometimes the bad guys get the upper hand, causing an imbalance in gut bacteria, and can cause severe health problems than just stomach pain, gas, bloating, or diarrhea. Because 60-80% of our immune system is located in our gut, gut imbalances have been linked to obesity, hormonal imbalances, autoimmune diseases, diabetes, chronic fatigue, fibromyalgia, anxiety, depression, eczema, and other chronic health problems. You will be surprised to know that human gastrointestinal microbiota is a complex ecosystem of approximately 300 to 500 bacterial species, comprising nearly 2 million genes (the microbiome). Indeed, the number of bacteria within the gut is approximately 10 times that of all of the cells in the human body. At birth, the entire intestinal tract is sterile; the infant’s gut is first colonized by maternal and environmental bacteria during birth and continues to be populated through feeding and other contacts. Factors known to influence colonization include gestational age, mode of delivery (vaginal birth vs assisted delivery), diet (breast milk vs formula), level of sanitation, and exposure to antibiotics. by the age of 2.5 years, the microbiota fully resembles the microbiota of an adult in terms of composition. In humans, the composition of the flora is influenced not only by age but also by diet and socioeconomic conditions. In a study published in 2012 in “Nature” (high indexed journal) the interaction of diet and age was demonstrated, firstly, by a close relationship between diet and microbiota composition in the subjects and, secondly, by interactions between diet, the microbiota, and health status. It also concluded that non-digestible or undigested components (Fibre) of the diet may contribute substantially to bacterial metabolism; for example, much of the increase in stool volume resulting from the ingestion of dietary fibre is based on an augmentation of bacterial mass. Most recently, qualitative changes in the microbiota have been invoked in the pathogenesis of a global epidemic: obesity. It has been postulated that a shift in the composition of the flora toward a population dominated by bacteria that are more avid extractors of absorbable nutrients, which are then available for assimilation by the host could play a major role in obesity. Also there are enough evidence to support the hypothesis that the endogenous intestinal microflora plays a crucial role in the pathogenesis of Inflammatory bowel diseases and its variants and related disorders. Most Western populations over-consume highly refined, omnivorous diets of poor nutritional quality. Those diets are energy dense, high in animal protein, total and saturated fats, and simple sugars but low in fruits, vegetables and other plant-based foods. Consequently, they are typically low in dietary fibre, non starch polysaccharides in general and resistant starch in particular. Cross-sectional studies have shown some evidence that Western-style diets are associated with gut microbial populations that are typified by a Bacteroides enterotype (bad gut bacteria) whereas traditional diets rich in plant polysaccharides are associated with a Prevotella enterotype (good gut bacteria). Obesity is associated with an increased fecal Bacteroidetes:Firmicutes ratio relative to lean subjects. Replacing a habitual Western diet with one high in fiber elicited rapid (within 24 h) and marked alterations in fecal microbiota composition, although the changes were insufficient to produce a broad switch from Bacteroides to Prevotella enterotype.  One mechanism by which fiber promotes and maintains bowel health is through increasing digesta mass. Incompletely fermented fiber (e.g., insoluble non starch polysaccharides such as cellulose), increases digesta mass primarily through its physical presence and ability to adsorb water. An increase in digesta mass dilutes toxins, reduces intracolonic pressure, shortens transit time and increases defecation frequency. Fibers can also increase fecal mass to a lesser degree by stimulating fermentation, which leads to bacterial proliferation and increased biomass. Prebiotics are dietary substrates that selectively promote proliferation and/or activity of “beneficial” bacteria indigenous to the colon. The concept, first published by Gibson and Roberfroid in 1995, has been refined and redefined on several occasions. Prebiotics are defined currently as “selectively fermented ingredients that result in specific changes, in the composition and/or activity in the GI microbiota, thus conferring benefit(s) upon host health”. Dr Abhishek katakwar, Bariatric & amp; Metabolic surgeon from Asian Institute of Gastroenterology quote “Your body is a Temple. You are what you eat. Do not eat processed food, junk foods, filth, or disease carrying food, animals, or rodents. Some people say of these foods, ‘well, it tastes good;. Most of the foods today that statically cause sickness, cancer, and disease all taste good;s well seasoned and prepared poison. This is why so many people are sick; mentally, emotionally, physically, and spiritually; because of being hooked to poison, instead of being hooked on the truth and to real foods that heal and provide you with good health and wellness.
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