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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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    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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    Q1. How are work stress and food eating habits related? What happens in the body due to stress, which makes a person eat more food?  While short-term stress can cause a person to lose their appetite, chronic stress can have the opposite effect. Ever notice that when you're really stressed, you tend to crave comfort foods that are high in fat or sugar? Researchers have found that specific hormones may play a role in this process. When you eat carbohydrates, it raises the body's serotonin’s level, “Serotonin” is the body's feel-good chemical. Chronic stress can cause the body to release excess “cortisol”, a hormone critical in managing fat storage and energy use in the human body. Cortisol is known to increase appetite and may encourage cravings for sugary or fatty foods. More recent studies also suggest hormone called “Neuropeptide-Y” that is released from nerve cells during stress and encourages fat accumulation. A diet high in fat and sugar appears to further promote the release of neuropeptide Y. q2. What are the kind of foods that people are found to eat and why? Is it out of necessity, taste buds or habit?  Not surprisingly, people under stress don't tend to make smart food choices. Very often the carbohydrates that people go for are laden with fat, like muffins, pastries, doughnuts, and cookies, which are easily available at workplace. When individuals get stressed, they often act in impulsive ways because they do not know how to transform the stress into something productive. For people diagnosed with an eating disorder, these impulses from environmental and social stressors can cause individuals to not eat enough food, purge after a meal, or engage in a binge-eating episode. Sometimes It's a very high-pressure environment at workplace says Dr Abhishek katakwar. "For a lot of new software or IT recruits, it's their first time being away from home, so that can contribute to stress, and also the work performance and social pressures. All those things compound to lead to some unhealthy behaviours, whether it's full-blown eating disorders or disordered eating." q3. Is there evidence suggesting that overweight and obesity is due to work related stress. If so, what are the changes that the management needs to opt for and what does the employee need to do - do destress and bring their life on track.  According to a new study from the Montreal, office-workers have become less active over the last three decades and this decreased activity may partly explain the rise in obesity. "People eat better and exercise more today than they did in the 1970's, yet obesity rates continue to rise, " "My hypothesis is that our professional life is linked to this seemingly contradictory phenomenon." Also nightshift work is associated with a 29% increased risk of becoming obese or overweight. The findings, which are published in Obesity Reviews, suggest that modifying working schedules to avoid prolonged exposure to long-term night shift work might help reduce the risk of obesity. q4. What are the behavioural changes that they must opt for? And how do deadline based, emergency based jobs make a person opt for these changes?  Effective programs take a multidisciplinary approach that focuses on providing workers with the knowledge, skills, and support to eat a healthier diet and be more active. This can include nutrition classes, onsite exercise facilities and changing rooms, access to nutritionists and other counsellors, and worksite or company-wide policies that provide healthier food options and reimburse exercise-related expenses. q5. What are best methods to opt for during these conditions? What can be done in terms of behaviour change and also change in eating habit.?  In the movie Die Hard, Bruce Willis once said: “If you’re not a part of the solution than you’re part of the problem”. Unless you are currently underemployed, retired, or too young to be employed, you typically will spend at least a third of your time at your workplace. That means your workplace governs a large part of what you eat and drink and how much physical activity you have. For example, you may have heard the saying that “sitting is the new smoking”. Answer to this stress is practicing relaxation techniques like yoga or tai chi, meditation, muscle relaxation to help relieve stress, enjoy nature, get out of the cocoon and connect with world. Dr Abhishek Katakwar Bariatric and Metabolic surgeon Lifestyle expert and motivational speaker Asian Institute of Gastroenterology, Hyderabad abhishekkatakwar@gmail.com Cell: +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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