What oxygen is to the lungs, such is hope to the meaning of life.

(Emil Brunner)

The COVID-19 pandemic is a global emergency that has led to the implementation of unprecedented measures to stop the spread of the infection. Governments of almost every country are enforcing measures to avoid the spread of this virus, including lockdown, travel bans, home quarantine, isolation, and social distancing. These all have resulted in extended periods of time at home, reductions in physical activities and lifestyle, including dietary habits.  

This lifestyle degradation has led to the loss of muscle mass and an increase in body fat. It may also accelerate sarcopenia (decrease in muscle mass, more common in old people).  

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In addition to sarcopenia (muscle loss), these lifestyle changes may also lead to several chronic disorders, including cardiovascular disease (CVD), diabetes, osteoporosis, frailty, cognitive decline, and depression. 

These disorders and increased body fat increase the risk of COVID-19 infection and more severe symptomatology, underscoring the importance of avoiding the development of such morbidities.

Here we will discuss the mechanisms of sarcopenia (muscle loss) and its relation with physical activity, dietary habits, sleep, stress, as well as extended bed rest due to COVID-19 morbidity. 

However, these symptoms can be reduced by the intervention of several home-based strategies, including resistance exercise, higher protein intakes, and supplementation. The intervention of such strategies may also reduce the chances or can also reverse the symptoms of sarcopenia (muscle loss). It can also be beneficial for future periods of isolation. 

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The three main factors leading to lean muscle mass are acute illness or injury leading to prolonged bed rest, incomplete recovery, and increased age. A comparative study between people taking sleep for 5.5 hours and 8.5 hours reported that people sleeping for only 5.5 hours lost a greater amount of weight as fat-free mass (including muscle) and less body fat was lost in comparison to those taking 8.5 hours of sleep.
 

Summary of potential effects of government restriction on lifestyle behavior and the mechanism by which muscle protein synthesis is decreased and muscle protein loss is increased:

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Measures to Prevent Weight Loss and Cachexia in COVID-19 

COVID-19 disease can cause considerable weight loss and clinical cachexia in patients. There are reports of 589 patients of covid-19 showing weight loss and clinical cachexia. The severity of the disease and the timing of assessment were variable for different patients. 11% of the patients (65 patients) were treated in intensive care units at the time of assessment and 31% of patients (183 patients) cared in intermediate care structures. The frequency of weight loss ≥5% (that defines cachexia) was 37% (range 29-52%). Weight loss occurs in correspondence with raised levels of C-reactive protein, impaired renal function, and longer morbidity due to COVID-19. 

According to seven studies on 6661 patients, only 4% of patients were found underweight (BMI < 18.5 kg/m2 ). 

Cachexia is commonly observed in association with many chronic diseases. COVID-19 associated cachexia is understood to affect muscle and fat tissue.  Major factors which contribute to muscle wasting in COVID-19, include loss of appetite and taste, fever and inflammation, immobilization, as well as general malnutrition, catabolic-anabolic imbalance, endocrine dysfunction. Additionally, organ-specific complications of COVID-19 disease such as cardiac and renal dysfunction also cause muscle wasting. Overall, treatment of COVID-19 patients should focus on nutritional support and rehabilitative exercise in addition to medicines. There is no specific treatment for cachexia associated with COVID-19, so, a high medical intervention is needed to prevent long-term disability due to acute COVID-19 disease.

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Importance of Vitamin D Supplementation during COVID-19

COVID-19 is a disease caused by a highly infectious virus known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The disease is characterized by mild-to-severe clinical symptoms such as flu-like symptoms, fever, headache, dry cough, muscle pain, loss of smell and taste, increased shortness of breath, bilateral viral pneumonia, conjunctivitis, acute respiratory distress syndromes, respiratory failure, cytokine release syndrome (CRS), sepsis, etc. Till May 18, 2020, there have been more than 4.7 million cases and over 316,000 deaths worldwide. 

The treatment for infection with this novel coronavirus is yet to be discovered by doctors and scientists. Two main questions should be addressed urgently: 

1.  How to prevent the infection in people with suppressed immunity and  
2. How to treat severe symptoms of COVID-19, including CRS, acute respiratory failure, and the loss of somatosensation.

Previous experience of the 1918 influenza pandemic has suggested that vitamin D may play an important role in reducing lethal pneumonia and fatality rates. According to reports provided by some recent clinical trials, supplementation of vitamin D can reduce the incidence of acute respiratory infection and can also reduce the severity of respiratory tract diseases in adults and children. 

There are no articles on clinical trials till July 1st, 2020, for showing the relation between vitamin D supplementation and prevention and treatment for COVID-19.

Let’s summarize the potential role of vitamin D

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The focus should be on three major topics: 

1. Vitamin D might aid in preventing SARS-CoV-2 infection: 
2. Vitamin D might act as a strong immunosuppressant inhibiting cytokine release syndrome in COVID-19
3. Vitamin D might prevent loss of neural sensation in COVID-19 by stimulating the expression of neurotrophins like Nerve Growth Factor (NGF)

Effect of Quarantine on Older Adults:

Older adults are the most vulnerable population affected by the pandemic COVID-19. An efficient treatment for COVID-19 is not ready yet. Since there is no specific treatment and the virus is very much contagious, a general quarantine has been initiated as a preventive action against the spread of the disease. This intervention on the one hand is protecting against the disease but is reducing the physical activity level on the other hand. 

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There are several negative health effects of sedentariness, especially on older adults, including increased risk of fall, fractures, and disabilities. Most of the studies have reported that implementation of physical exercise (such as walking, low load resistance, or in-bed exercise) during periods of disuse to protect muscle mass and function from the catabolic crisis is beneficial. Overall, physical rehabilitation, in addition to intense resistance training, and proper nutrition is necessary to prevent loss of skeletal muscles and also to regain the lost muscles for older adults.

Impact of Sedentarism on Neuromuscular, Cardiovascular, and Metabolic Health

The COVID-19 pandemic has led the entire population to self-isolate and live-in home confinement for several weeks to months. This in itself gave rise to several significant health risks. Several studies have reported that muscle wasting occurs rapidly, being detectable within two days of inactivity. This muscle mass loss is linked with fiber denervation, neuromuscular junction damage, and upregulation of protein breakdown.  It is mostly due to the suppression of muscle protein synthesis. Sedentarism also has adverse effects on glucose homeostasis. Just a few days of bed rest can lead to reduced insulin sensitivity. The aerobic capacity of the body is also impaired at all levels, from the cardiovascular system including peripheral circulation to the oxidative functions of the skeletal muscles. 

Physical inactivity results in positive energy balance which in turn increases fat deposition. Fat deposition leads to systemic inflammation and activation of antioxidant defenses, exacerbating muscle loss. The adverse effects of inactivity can be overlapped by routine exercise practice, but the exercise dose-response relationship is currently unknown. A reduction in 15-25% of calorie intake combined with low to medium-intensity home-based resistive exercises will have positive effects on health. This combination is ideal for preserving neuromuscular, metabolic, and cardiovascular health.

COVID-19  and Tinnitus

Most people who get infected by coronavirus suffer from mild to moderate symptoms, including respiratory symptoms, neurological symptoms, central nervous system manifestations, peripheral nervous manifestations, and skeletal muscle manifestations. The negative effect of coronavirus on the hearing organs including the inner ear is a new finding and yet to be explored. Currently, there is little evidence published connecting novel coronavirus and tinnitus directly. According to the findings of the American Tinnitus Association, pre-existing behavioral conditions like stress and depression associated with social isolation and infection avoidance increase the risk of tinnitus in patients.

Nutritional Management of Patient with COVID-19 Infection

The respiratory complications associated with COVID-19 are the major cause of morbidity and mortality for the same. Those are most vulnerable whose immune system is compromised, including older adults, polymorbid people, and malnourished people. 

Nutritional management for people at high risk of COVID-19 infection, people suffering from COVID-19, and COVID-19 ICU patients requiring ventilation:

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COVID-19 Infection and Neurological Dysfunction

COVID-19 is linked to several neurological disorders. Most of the people suffering from COVID-19 respiratory disease experience headache, nausea, and vomiting, and up to 40% present also experience dizziness, confusion, cerebrovascular disease, muscle pain, ataxia, and seizures. Defects in visual acuity, loss of smell and taste sensation, and pain are also associated with COVID-19 infection. Such central nervous system (CNS) signs and symptoms linked with COVID-19 infection may be life-threatening. Health care providers currently evaluating patients with neurological symptoms need to consider COVID-19 in any differential diagnosis. This will facilitate testing, isolation, and prevention of the spread of the virus. 

Neurological signs and symptoms associated with COVID-19:

1. Neuroinflammation 

2. Delirium and cognitive impairments

3. Loss of smell and taste

4. Cardiac dysfunction

5. Acute respiratory distress syndrome (ARDS)

6. The brain stem (Cardiac and respiratory dysfunction)

7. Spinal cord injuries

8. Stroke

9. Muscle pain and fatigue

ICU Acquired Weakness

The basic reason for the ICU acquired weakness is the critical illness itself and results in sustained disability long after the ICU stay. This weakness can result in muscle wasting, impaired contractility, neuropathy, and major pathways associated with muscle protein degradation such as the ubiquitin-proteasome system and dysregulated autophagy. 

Most of the risk factors associated with ICU acquired weakness has been identified, there is a need for effective interventions to offset these changes remain elusive. 

Let’s discuss the various proposed pathways involved in the pathophysiology of ICUAW. Also, we will discuss the contribution of inflammation, steroid use, and paralysis to the development of ICUAW and how it pertains to those with the coronavirus disease of 2019 (COVID-19).

Then intervention needed to avoid and overcome these critical illnesses will be discussed. 
 

Changes monitored inpatient with definite critical illness myopathy (CIM):

1. Severe muscle atrophy, affecting both type 1 and type 2 fibers. 

2. Significant loss of thick filament protein myosin.

3. Eventual sarcomere disorganization.

4. Electrical hypoexcitability of the muscle and poor excitation-contraction coupling. 

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Resistance Training During and After COVID-19 Disease

The adverse consequences of isolation are the absence of organized training and competition, lack of communication among athletes and coaches, inability to move freely, lack of adequate sunlight exposure, and inappropriate training conditions. The mobility restriction to stop the spread of the COVID-19 virus led to negative effects on physical conditions, including muscle atrophy, progressive loss of muscle strength, and reductions in neuromuscular and mechanical capacities. Resistance training (RT) might be an effective tool to counteract these adverse consequences. Due to its numerous health benefits, RT is considered an essential part of an exercise program. RT can be adapted to allow its performance with measures adopted to control coronavirus outbreaks such that the benefits would largely overcome the potential risks.
 

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The Childhood Obesity or Obesity in children

When the body mass index (BMI) of a child is at the same level or higher than 95% of his/her peers, he/she can be considered obese.

BMI is used as a tool to determine weight status. Height and weight are used to calculate the BMI. Your BMI percentile is then determined using your gender and age.

Obesity is a serious health problem for children. Overweight and obese children are at a higher risk of developing many chronic health conditions. Obesity and the problems related to it also continue into adulthood.

Childhood obesity not only affects physical health but can also affect the social and mental health of a child. They can become depressed and have a poor self-image and self-esteem. 

"Childhood obesity is a serious issue increasing worldwide. However, children can learn healthier ways to cope with their problems. This can be done with proper education for healthy eating habits and various outdoor activities. In this context, their parents, teachers, and other caregivers help them. Help your children stay healthier for longer by preparing nutritious foods for them and encouraging them to get plenty of exercise."

Childhood Obesity Causes

The main role in childhood obesity is played by family history, psychological factors, and lifestyle.

Children with parents or other family members overweight or obese are more likely to be obese. But the root cause behind the obesity of children is a combination of eating too much and exercising too little.

Foods like fast food, candy, and soft drinks, containing high levels of fat or sugar and low in nutrients, are the common culprits for fast weight gain.

According to a study, 32% of adolescent girls and 52% of adolescent boys in the US drink 24 ounces of soda or more per day. 

Some children gain weight because their parents are unaware of foods that can be harmful to their children. They don’t know how to choose and prepare healthy foods.

Other families may not afford fresh fruits, vegetables, and meats. Convenience foods like frozen dinners, canned pasta, and salty snacks also contribute to unhealthy weight gain.

Less physical activity may be another cause of childhood obesity. Less activeness at any age tends to cause weight gain. Exercise keeps you healthy by burning your calories and maintaining your weight. Children who don’t spend their time in sports and other physical activities are less likely to burn their extra calories and as a result, become overweight or obese.

The third reason for obesity in children is psychological issues. Bored, stressed, or depressed kids eat more, to cope with negative emotions.

Health risks associated with childhood obesity

Obese children are always at a higher risk of developing health problems as compared to their peers having a healthy weight. The most serious risks associated with childhood obesity are diabetes, heart disease, and asthma.

Diabetes

Overweight children and adults are more likely to develop type2 diabetes. Patients having type2 diabetes are not able to metabolize glucose properly present in their bodies. Diabetes can lead to kidney dysfunction, nerve damage, and eye disease. However, the condition may be reversible through diet and lifestyle changes.

Heart Disease

Obese children are also at a higher risk for developing high cholesterol and high blood pressure levels, giving rise to future heart disease. High salt and high-fat foods cause increased cholesterol and increased blood pressure levels. The two major complications of heart disease are heart attack and stroke.

Asthma

Asthma, a chronic disease of the lungs, is caused by inflammation of the lung's airways. Obesity is the most common comorbidity with asthma. According to a recent study, about 38% of adults with asthma in the US are also obese. In the same study, it was found that obesity may be a risk factor for more severe asthma in some, but not all, people with obesity. 

Sleep Disorders

Obese children and teens may also suffer from sleep disorders like excessive snoring and sleep apnea. Their airways can be blocked by the extra weight in the neck area.

Joint Pain

Obese children can also experience joint stiffness, pain, and a limited range of motion from carrying excess weight. In most cases, weight loss can eliminate joint problems.

Impact of Childhood Obesity

In this section we discuss important aspect and their impact on childhood obesity as follows:

1. Determinants of childhood obesity

2. Medical impact

3. Psychological impact

4. Economic impact

Healthy eating for obese children

It’s essential to change the eating habit of obese children. The parental effort is very essential to influence a child's eating patterns. Normally, kids eat what their parents buy. So, it's of utmost importance for the parents to start with themselves.

Restrict the entry of sweets and soft drinks in your home. Replace juice with fruits because drinks made of 100% juice can be high in calories. Serve water or low-fat or non-fat milk with meals. Restrict fast foods and ready-to-eat foods, try to cook more at home. Preparing a meal and eating together is not only a healthy option in a nutritional sense, but it’s also an excellent way to spend some time with your family.

Instead of using processed items, baked goods, or salty snacks, plan your meals and snacks around fresh foods. You may try:

1. low-fat dairy products, i.e. skim milk, low-fat plain yogurt, and low-fat cheese

2. lean proteins like chicken and fish

3. fresh fruits and vegetables, and

4. whole grains, such as brown rice, whole-wheat pasta, and whole wheat bread.

As there will be a transition to a healthier way of eating, your overweight or obese child will most probably lose some weight. If weight loss doesn’t occur, consult your pediatrician. He/ she may recommend a nutritionist or dietician for further weight loss.

Lifestyle modifications to tackle childhood obesity

Increase Physical Activity

Try to increase the physical activity of your children so that they can shed their weight safely. Always encourage your child to do exercise in the form of activity to make workouts interesting for them. Playing football or some other outside game will be more interesting for a child than jogging around the block. Always encourage your child to try a sport for which he /she has an interest.

One study shows that children get at least one hour’s worth of exercise daily to remain healthy.

Increase family activities

Plan some activities in which the whole family can enjoy together. This will not only make a great bond between the family members but also help your child learn by example. Hiking, swimming, or even playing tag can help your child get active and start on the path to a healthier weight. Vary activities to avoid boredom.

Decrease time spent in front of the screen

Restrict the time spent in front of the screen. Children spending their time watching television, playing computer games, or using smartphones or other devices are more likely to be overweight.  

According to a study, there are two big reasons for this. First, screen time cuts the time that could be spent doing physical activities and sports instead. And second, more time in front of the TV means more time for snacking and munching and also more exposure to ads for the high-sugar, high-fat foods that make up most food marketing.

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Infertility  Diet Plan (Due to Obesity)

According to WHO, if the BMI of your body is greater than 25 kg/m2, it is considered as overweight and if the BMI equals or is greater than 30 kg/m2, then it is considered as obesity. It has been found that overweight women have a very high hence of menstrual dysfunction and anovulation. Overweight and obese women are always at a very high risk of reproductive malfunction. Even the risk of subfecundity and infertility, conception rates, miscarriage rates, and pregnancy complications are increased in these women.

In case you are overweight and are planning to build a family then you must get rid of excess fats to avoid any complications and be on the safer side.

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Post-Pregnancy Diet

Losing the stubborn pregnancy fat and becoming slim again is a concern of every new mom. But realistically, it is a little difficult to shed off all the extra pregnancy pounds without following a diet. Now, the question arises which diet to follow to become fit again? Here, the most important thing to notice is that you are a new mom having the responsibility of feeding your child and taking care of him/her. A strict diet plan would do more harm than good to a recent mother.

So, while you are deciding to follow a diet plan, be conscious about what you eat because it is directly going to affect your baby. You can trust dietplusminus to carve out the perfect post-pregnancy diet plan for you which you can follow fearlessly to help yourself become slim once again!

Why should you go for a post-pregnancy diet?

Before you go directly towards the diet plan, let’s take a glimpse of why you should follow a post-pregnancy diet and what are its benefits.

It is common for pregnant women to get extra fat after giving birth. However, it is not necessary to remain continually fat. Some may ignore the extra pounds but to some of you, it is a matter of concern. It may even affect your personality and health indirectly. So, even if you are not willing to become fit, nevertheless from the health point of view, you should definitely follow a good diet plan to improve your and your baby’s overall health.

Which nutrients to include in a post-pregnancy diet?

There should be a balanced ratio of every nutrient in your diet, however, there are some important nutrients which you should definitely include in your post-pregnancy diet.

The first such nutrient is Calcium. It is very important as seen from the breastfeeding point of view, because if your diet lacks calcium, your body may draw it from the bones which are extremely harmful. Iron and Choline are equally important for you and your baby to develop a good memory and a responsive nervous system. Omega 3 fatty acids are essential and always recommended as important constituents of a post-pregnancy diet. So, don’t forget to include these nutrients in your diet.

Post-pregnancy diet plan

Here are some essential food items suggested by dietplusminus which you must include in your diet plan.

1. Salmon- Salmon fish is a powerhouse of nutrients. It is loaded with DHA and nutrients.
2. Dairy products- Low-fat dairy products like milk and cheese are highly recommended for a healthy diet plan.
3. Blueberries- Blueberries are rich in vitamins and minerals and are tasty as well.
4. Oranges- Oranges provide energy and certain essential nutrients along with a great amount of vitamin C.
5. Eggs- Eggs are power boosters as they fulfill the body’s need for protein to a great extent and are highly recommended for the post-pregnancy diet.
6. Brown rice-Brown rice will give you an energy boost without increasing the fat content.

How does it work?

Choose diet packages as per your need or call us to help you in choosing the best suitable package

We recommend you to do some basic blood and urine tests like

Complete Blood Count (CBC)

Liver Function Tests (LFT)

Kidney Function Tests (KFT) (including Uric Acid)

Lipid Profile

Thyroid Profile

Fasting Blood Sugar (FBS)

Glycosylated Hemoglobin (HbA1c)

Fasting Insulin Level

Urine Analysis

USG Abdomen (Optional)

(If you have done tests in last 3 months then please submit, no need to do tests again)

Maintenance Diet

It is simply a maintenance diet that is advised to start after weight loss journey. It is very much similar to a normal diet. You can send a request as per your calorie requirements or you can estimate your calorie requirements using a calculator.

Anybody who wish to maintain their weight may send the request. We do not need any special blood tests before starting a maintenance diet. But if you have basic blood reports then please share with your detail here support@dietplusminus.com

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Weight Loss Diet Plan 

How To Get Enrolled?

Weight loss is definitely a difficult task to accomplish, but sometimes people make it more complicated by counting every calorie. Of course, there’s no magic tip that can do the job instantly, but you definitely don’t need to strip your diet of entire food groups for losing weight.

The fact is that no matter whether you intend to lose 5kg or 15kg, the quantity of weight you lose is determined by the same principles. So, instead of adopting a radical approach, you should try to introduce a series of healthy habits into your daily routine. According to dietplusminus, to lose weight fast you should first understand what might lead to weight gain.

What Leads To Weight Gain?

So, what exactly might cause you to gain that excess weight? Well, there’s only one reason (except for medical conditions) that causes people to gain excessive weight and hinders the weight loss process as well. It’s the bad habits, eating what you shouldn’t, and not eating what you should, having an excess of something unnecessarily, etc.

Say, for example, eating too much processed foods, or sugar can lead to excessive weight gain. Maybe, you are confusing  'fat-free' with 'calorie-free'. Or you just eat without thinking when you had these eating fits out of nowhere.

Simply put, there are two main things that will determine your weight- the number of calories you take in and the number of calories you burn, on a daily basis. Apart from all this, your genetics can also play a role in both weight gain and weight loss.

Why Should You Lose Weight?

It is indeed a valid question as to why should you actually consider losing weight even though you’re perfectly comfortable being chubby. Well, there’s actually just one reason, but it’s pretty serious. If you are overweight or obese, this means you are at a higher risk of some potentially serious health problems like high blood pressure, heart disease, stroke, type 2 diabetes, osteoarthritis, back pain, and even some types of cancer!

So, basically you are a ticking time bomb! Nah, just kidding, you are as fine as anyone else but definitely there are these potential risks to consider. You should know that these risks are directly proportional to the amount of excess weight that you have. More excess pounds mean the deadlier potential risks you face. Therefore, for the best of your health, you should set out on the journey of weight loss to lose those extra pounds.

 

 

 

 

 

 

 

 

 

 

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Some Pro Tips To Lose Weight

 

1. The number one thing, as suggested by dietplusminus, that you need to do is to stick to a proper diet plan to lose weight.

2. To lose weight fast, you should try to burn more calories than you eat in a day. You should consider weight loss exercises for this purpose, so you can join a gym to go the extra mile.

3. Introduce fat burning foods into your daily diet.

4. Also, your diet should be high in protein, but low in carbohydrates. Simply put, say no to sugar or at least eat as much less sugar as possible.

5. You should drink lots of water and other liquids. You should also introduce coffee and green tea in your drinks.

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Dr. Pankaj Kumar after clearing MBBS from Calcutta University and DNB Family Medicine from Sir Ganga Ram Hospital, associated with Practo, DocsApp, Mfine, and many other online consultation platforms to help patients online for their day to day health-related problems. Now you can consult with Dr. Pankaj Kumar (online) for your general problem on the Diet Plus Minus platform also.

You need to pay online, after a successful transaction you will get a call back within 30 minutes to 1 hour. If you have any reports or prescription then please upload it after a successful transaction. 

What you will get in this consultation?

1. One Online Consultation with 3 days online follow up

Why Dr. Pankaj Kumar's Lifestyle Modification Program?

How To Enroll For Dr. Pankaj Kumar's Lifestyle Modification Program?

Share your idea, question and answer with like minded people

Join our weight loss forum and ask questions there. we will be happy to help you.

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High Uric Acid Diet

High uric acid is most commonly detected while undergoing blood tests for any other medical condition. It is usually diagnosed incidentally and therefore, most people don’t know they have it till it worsens. Millions of cases of high uric acid are reported throughout the world every year. But, did you know it can be taken care of just by following a proper diet? Let’s see how!

What Is High Uric Acid?

High uric acid, also known as hyperuricemia, is a condition that is caused when high levels of uric acid are present in the blood. If this high concentration of uric acid is not removed in time, it forms crystals of uric acid. These crystals ultimately settle in the joints of bones, thereby leading to a condition called gout and it can be very painful. Moreover, the crystals of uric acid can also settle in the kidneys and form kidney stones. In such a severe condition, your blood and urine can turn acidic too.

High uric acid levels require immediate action and so dietplusminus urges you to get medical attention as soon as possible, otherwise, it can eventually lead to permanent bone and tissue damage, heart disease, etc. Advanced research has shown also shown that type 2 diabetes, high blood pressure, and fatty liver disease are somehow linked to high uric acid levels. This condition is more commonly seen in men than in women. In the case of men, it usually occurs after 30, and in women, it commonly occurs after menopause (around 50).

What Causes High Uric Acid?

Uric acid is actually a waste product and so your body filters it out through kidneys and in the urine. So, high uric acid levels are most commonly caused when your kidneys malfunction. If your kidneys fail to eliminate uric acid efficiently, then the acid stays in your body. However, there are some things that can slow down the process of elimination of uric acid. These include rich foods, medical conditions like diabetes, obesity, excess alcohol consumption, stress, etc. Genetics can also play a role in this.

Some other less common factors include a purine-rich diet (liver, gamer meat, sardines, gravy, dried peas and beans, mushrooms, etc.), your body producing excess uric acid, certain diuretics, immune-suppressing drugs, vitamin B-3, certain cancers/chemotherapy, etc.

How To Cure High Uric Acid With Diet?

The best way to reduce high uric acid levels is by following a gout-friendly diet. Your diet must be low in purines. So, your diet should compromise of fruits (cherries can help to lower uric acid levels and inflammation), vegetables (potatoes, peas, eggplants, dark and green leafy veggies, etc.), legumes (lentils, beans, etc.), nuts and seeds, whole grains, etc. All dairy products are safe for you, but dietplusminus recommends consuming low-fat dairy products. Further, eggs and beverages (like coffee, tea, green tea) are all recommended.

You also, strictly, need to avoid some foods that contain high levels of purines. These include all organ meats (liver, kidneys, etc.), game meats, fish, yeasts, white bread, cakes, cookies, etc. Additionally, you should also avoid sugary drinks such as soft drinks. Dietplusminus recommends you to maintain a healthy weight and exercise regularly. Plus, drinking plenty of water and cutting down on alcohol can also help.

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Fatty Liver Diet

Fatty liver is a very common disease and can be potentially lethal. Millions of people get affected by it each year. Although treatment can help, this disease can’t be cured with medications. Diet and exercise are the two best ways to get a fatty liver normal. Diet comes first. Therefore, this article will tell you what is a Fatty liver and how to cure it with diet.

What Is A Fatty Liver?

Fatty liver disease is an increase in the build-up fat in the liver. Simply put, having more fat in your liver than normal is referred to as fatty liver. There are usually no apparent symptoms. But, sometimes symptoms like fatigue, weight loss, abdominal pain, etc. may occur. A normal and healthy liver helps in the removal of toxins from the body and also produces bile, which is very important for the digestion of fats. Fatty liver disease is a serious disease that prevents the liver from functioning normally by damaging it.

What Causes Fatty Liver Disease?

Fatty liver disease has two common types- alcoholic and non-alcoholic Fatty liver disease. Although, there is no clarity about the exact causes, yet the former is usually caused by excess alcohol consumption and the common cause of the latter is obesity. It is also commonly diagnosed in people who eat too much-processed food.

It is believed that genetics also plays a role and some specific genes can increase the chances of developing the disease by around 30%. Another known cause includes high levels of cholesterol in the blood. Some health problems can also lead a person to non-alcoholic Fatty liver disease. These include high blood pressure, type 2 diabetes, insulin resistance, hepatitis C, etc.

How To Get Rid Of Fatty Liver Disease?

So, how do you cure, or avoid in the first place, Fatty liver disease? We at dietplusminus say that the best way to treat Fatty liver disease is diet. You need to follow a diet that will help you to reach a healthy weight. Your diet should consist of fruits and vegetables, fish and seafood, whole grains, nuts, legumes, etc. As different people need different diets, dietplusminus recommends you should talk to a nutrition expert for a proper diet plan.

To fight insulin resistance, you should consume the right fats. Omega-3 fatty acids and monounsaturated fats are two types of good fats to avoid insulin resistance. These are present in fish, vegetable oils, walnuts, flaxseeds, olives, nuts, avocados, etc. You should also include antioxidants and supplements in your diet. Coffee, green tea, raw garlic, fruits, vegetables, vitamin E, vitamin D, etc. are some of the best antioxidants and supplements to consider.

You should also exercise daily for a healthy liver. Daily exercise can prevent you from developing Fatty liver disease in the first place. So, try to lose weight and avoid alcohol. You should also lower your cholesterol and if you are diabetic, then you must keep it in control. dietplusminus also recommends you to avoid some foods. Most importantly you should completely avoid the consumption of saturated fats. So, you need to avoid poultry, full-fat cheese, yogurt, red meat, baked and fried foods, sugary candies, soda, etc. 

Want to know more about fatty liver disease?

No worries join our fatty liver forum and ask questions there. we will be happy to help you.

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Why Dr. Pankaj Kumar's Lifestyle Modification Program

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Sexual Wellness Diet

Typically, patients suffering from excess weight and obesity suffer from diabetes, hypertension, cardiovascular diseases, sleep apnea, and high – cholesterol, and so on. But a lot of people don't know that sexual problem to arises due to excess weight, especially obesity, a majority of people suffer from sexual problems due to excess weight and moreover, they even fail to realize that the root of their sexual problem is their overweight.

Henceforth, we study your body profile and your problem thoroughly and then make unique diet plans for you which not only target those excess fats but also your sexual problems.

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Read everything about Intermittent Fasting here

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PCOD/PCOS diet

One in every 10 women suffers from PCOD/PCOS on an average. Some experiences obesity, weight gain,

acne while some experiences abnormal menstruation, irregular or heavy menstruation and depression, loss of

scalp hair are also some significant symptoms of PCOS. All these side-effects-cum-symptoms are threatening

and alarming too. In a world where stress and anxiety are common, there is a high risk for women to suffer

from PCOS/PCOD. But every problem has a solution and this deadly-looking worst situation also has some

specific solutions.

The most significant one is opting for a proper diet. Whether it is diabetes, blood pressure, or any other

disease diet plays a major role because anything we eat has a direct effect on our body so, going for a healthy

and proper diet can help a lot with this problem also. Dietplusminus is here to help.

What is PCOD/PCOS?

PCOD (Polycystic Ovarian Disease) or PCOS (Polycystic Ovarian Syndrome) are names given to the same

ailment. PCOD affects nearly 1 million women per year in India only, mostly striking at an early age. As the

name already suggests, in the disease, the development of multiple cysts (blisters inside the body) in the ovary

takes place. Due to this ovary enlarges and excessive production of androgen and estrogen (female hormones)

happens to lead to multiple disorders in the body. Symptoms of the ailment are already listed above.

Causes of PCOS

The exact causes of PCOS are still unknown but excess production of male hormones (androgen) inside the

body may lead it. High levels of the male hormone inside the body prevent ovaries from producing eggs

normally, leading to many problems. 

PCOS runs in families so, it is related to genes, meaning that if your ancestor had it there are high chances of

you catching it. Insulin resistance and inflammation of tissues also lead to excessive production of a male

hormone which then leads to PCOD.

PCOD diet plan

Diet affects the problem in two major ways first a good diet led to PCOS weight management and second it

maintains the insulin level of the body (One is a significant symptom of the ailment and other being a major

reason behind the disease).

Here dietplusminus has listed some of the diets which will help everyone fight the disease and control the

symptoms to a great extent.

Low Glycemic index (GI) diet- A diet in which less amount of Glycemic is present may help a lot in this case.

A diet with low GI is digested slowly inside the body meaning, that they do not lead to rising the insulin level,

which is necessary to be balanced. Nuts, fruits, starchy vegetables, whole grains all come in a low GI diet.

Less inflammatory diet- Inflammation of tissues is a major cause of the disease so, ingesting an inflammatory

diet can do worse. Berries, fishes, leafy green vegetables can help to reduce symptoms.

Dietary approaches to stop hypertension (DASH Diet)- It includes fruits, vegetables, low-fat dairy products,

etc. DASH diet is highly recommended for PCOS.

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Diabetes Diet Plan

Diabetes has already become the third most common disease on the planet with around 500 million people affected by it. Though the mortality rate is low, dietplusminus urges you to take it extremely seriously. People who ignore it at first, later either succumb to it or it turns out to be their worst nightmare. Diabetes (any type) requires necessary care from the diet and lifestyle point of view. Otherwise, it can lead to other serious complications such as stroke and heart disease. Here you will get to know about everything related to diabetes and its concerning diet.

What Is Diabetes?

Diabetes is a serious medical condition that alters your body’s natural way and ability to process blood glucose (blood sugar). Food that you eat is ultimately converted into a simpler form (glucose). Glucose is then used by your cells to release energy. Insulin is a hormone secreted by your pancreas that promotes the absorption of glucose and thereby helps to regulate your blood sugar level. Depending on what’s happening to insulin in your body, different types of diabetes can occur.

Type I diabetes (juvenile diabetes) occurs if your body completely fails to produce enough insulin or does not produce enough of it. So, type I diabetic patients need to take artificial insulin, daily. On the other hand, Type 2 diabetes occurs when your cells don’t respond to insulin as effectively as normal and therefore it affects the processing of glucose. So, type 2 is actually caused by insulin-resistance of your cells. So, here,  it doesn’t matter if your body is producing enough insulin or not. This is the most common type of diabetes and studies have shown that it is highly linked to obesity.

There's another type of diabetes known as gestational diabetes. As the name suggests, this type occurs in women during their trimesters. Basically, during pregnancy, the body of a woman can become less sensitive to insulin and therefore develop somewhat insulin-resistance. But, this does not occur in all women and mostly it gets resolved naturally after parturition. Also, in some people, borderline diabetes known as pre-diabetes is diagnosed.

The normal fasting blood sugar level ranges between 70 and 110 mg/dL. A level of 126mg/dL and above is considered to be diabetic and a blood sugar level ranging from 111 to 125 mg/dL is pre-diabetic. Such people face the risk of developing type 2 diabetes.

What Causes Diabetes?

Genes may be playing a role in causing type 1 diabetes but the significant cause is hormonal imbalance, immune system unknowingly attacks the insulin-producing beta cells and thus accounts for the high level of sugar in the blood.

Unlike type-1, type 2 diabetes has different causes. Genes still play a role, but lifestyle plays a major role. Being overweight, having high blood pressure issues, high triglycerides, high alcohol intake, all directly or indirectly cause diabetes. Gestational diabetes is caused due to hormonal imbalance during pregnancy.

Diet Plan To Treat Diabetes

Following a proper diet plan is very important in case of diabetes. Dietplusminus strictly recommends you to follow a low-glycemic index diet. For those of you who don’t know what glycemic index means, it is a number assigned to foods indicating their ability to raise blood sugar after consumption. So, you are totally advised to avoid food with a glycemic index of 70 or above. You must make low-glycemic choices to maintain a normal blood sugar level.

Consider the following tips:

• Eat unprocessed foods and not processed ones. Because whole, unprocessed foods have a lower glycemic index than processed foods.
• Eat more high in fiber foods. Fiber takes time to digest and therefore your blood sugar level does not rise quickly.
• Eat fruits like apples, vegetables like sweet potato, and lentils, kidney beans, etc. These have a low glycemic index.
• Apart from these, strawberries, yogurt, chia seeds, and nuts are also very helpful.
• But, most importantly you need to avoid consuming table sugar, in any form. So, avoid all the soft drinks, etc. You can substitute table sugar with honey, but make sure to use it in moderation.

You should look at the total nutritional value in foods, not just glycemic index, to control diabetes. Even some foods that have a high glycemic index (potatoes) contain vitamin C, potassium, fiber, etc. which can be helpful. Also, the norms of a good diet may vary as per your personal liking, so you should visit a qualified medical practitioner for the best suitable diet.

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Weight Gain Diet Plan

Being underweight comes under the category of malnutrition. According to the World Health Organization (WHO), around 462 million people in the world are underweight. Poor dieting habits, skipping meals, etcetera can lead to being underweight.

Underweight people are quite prone to diseases, especially deficiencies. With our scientific diet plans, you can eliminate all such deficiencies and get proper nutrition every day. Within 3 months you will be able to see the result and you will also gain significantly.

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Healthy Diet Plan

A healthy diet is defined as one which contains the various groups of foodstuffs such as energy-yielding foods, body-building foods, and protective foods in the correct proportions so that the individual is assured of obtaining the minimum requirements of all the nutrients. The components of a healthy diet will differ according to age, sex, physical activity, economic status, and physiological state, viz. pregnancy, lactation, and different age groups.
 

Consuming a healthy diet throughout the life-course helps to prevent malnutrition in all its forms as well as a range of noncommunicable diseases (NCDs) and conditions. However, increased production of processed foods, rapid urbanization, and changing lifestyles have led to a shift in dietary patterns. People are now consuming more foods high in energy, fats, free sugars, and salt/sodium, and many people do not eat enough fruit, vegetables, and other dietary fiber such as whole grains.[1]

Healthy Eating for a Healthy Weight

• Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products.

• Includes lean meats, poultry, fish, beans, eggs, and nuts.

• Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.

• Stays within your daily calorie needs.

9 tips for healthy eating:

• Do not skip your breakfast

• Drink plenty of water (6 to 8 glasses)

• Do regular exercise and maintain a healthy weight

• Eat less salt (not more than 6 gms)

• Restrict your sugar intake

• Cut down on saturated fat

• Eat more fish, including a portion of oily fish

• Eat lots of fruits and vegetables

• Base your meal on high fiber starchy carbohydrates

There are seven essential factors for a balanced diet. These are

• carbohydrates

• proteins

• fats 

• fiber

• vitamins

• minerals, and

• water

The percentage requirement of these factors differs from person to person. We are here to weave a diet completely according to your need. We at diet plus minus provide food and nutrition information and support people to improve their health. We provide advice on nutrition-related matters.

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IBS and Functional Dyspepsia

It is assessed that 40% of all gastroenterology center visits are for functional gastrointestinal disorders, and an ongoing study of generalists and gastroenterologists found that about 33% of their patient populace had side effects of Irritable bowel syndrome (IBS). 

Numerous patients with IBS have dyspepsia; similarly, numerous patients with dyspepsia additionally have overlapping symptoms that mimic IBS. These two sets of patients are comparative in that side effects are regularly chronic in nature, may come and go, are irritated by psychosocial stressors, and are frequently troubled by suppers. What's more, the two issues are viewed as hard to analyze by numerous doctors, and without notice signs or "warnings," broad testing is probably not going to be useful. These likenesses raise the issue of whether IBS and dyspepsia are simply different manifestations of a similar issue or whether they speak to unmistakable clinical substances.

Managing patients with IBS and Functional Dyspepsia can be a challenging and frustrating process for clinicians. Currently, these two common Functional Gastrointestinal Disorders are thought of as completely distinct entities. Because many patients have overlapping symptoms of IBS and dyspepsia, maintaining two separate diagnoses leads to separate, but often parallel, processes of evaluation and treatment. Tragically, these outcomes in repetitive lab tests, duplication of demonstrative investigations, visit office visits, and the utilization of numerous meds.

What plays a role in the development of these disorders?

These factors may play a critical role in the development and expression of these chronic disorders

• Prior infection

• Inflammation

• Stress

• History of abuse to the gastrointestinal system - Injury to the enteric nervous system may be the common

Some patients will manifest the abnormal pathophysiology that develops as a result of enteric nervous system injury with primarily upper GI tract symptoms (epigastric fullness and discomfort, bloating, nausea), whereas others will manifest primarily lower GI symptoms (abdominal pain and disordered defecation). Treatment options for IBS and FD should be directed at modulating both peripheral and central pain mechanisms, to improve symptoms, improving quality of life, and minimizing the economic burden to society.

Rome II Criteria for Irritable Bowel Syndrome and Functional Dyspepsia

Functional Dyspepsia

Functional dyspepsia is a common health issue of the digestive system of humans. Around 1.5 billion people around the world face this issue. Although functional dyspepsia is not very lethal, it can surely affect the quality of your life as it can last for long.  It can be managed by taking medication, but diet and lifestyle changes are as important. 

What Is Functional Dyspepsia?

Functional dyspepsia (indigestion) is the name given to some symptoms of indigestion that show up without any obvious cause. 

So basically, your digestive system seems all okay, but there are symptoms of stomach pain, discomfort, bloating, etc. just like that of ulcers. It is also known as non-ulcer stomach pain or non-ulcer dyspepsia. It usually does not lead to any serious consequences, but it should not be neglected. Because, sometimes it can be caused by a bacteria called Helicobacter pylori, which can cause ulcers in the stomach in the long run. 

This is the most common type of dyspepsia. The symptoms can vary, but its prominent symptoms include nausea, bloating and bleaching, stomach upset or pain, vomiting, etc. Other less common symptoms include burping, sour mouth, weight loss, psychological distress, etc. If these symptoms come and go away within a month, then you most probably don’t have functional dyspepsia. 

Further, these symptoms can be suppressed by over-the-counter medication. But, dietplusminus recommends making necessary changes in diet and lifestyle as soon as possible to avoid unpleasant complications.

What Causes Functional Dyspepsia?

Functional dyspepsia does not have one single cause. In fact, it is not known what actually causes it. It is called 'functional' because it does not have a diagnosable cause. Several reasons may lead to this functional disorder. 

Some of the causes include allergens, infection due to bacteria, excess acid secretion in the stomach, unhealthy diet, lifestyle, obesity, etc. Some factors are known to increase the risk of functional dyspepsia. 

Females are known to develop this disorder more than males. Similarly, elders and chain smokers are at a higher risk of developing it. Moreover, studies have also shown that a history of childhood physical or sexual abuse may also be a risk factor. Further, there is an unknown link between irritable bowel syndrome (IBS) and indigestion. Because around one-third of the people affected by this disorder develop IBS.

Functional Dyspepsia Diet Idea

First of all, you need to make some lifestyle changes. Always eat slowly, as eating too fast affects the process of digestion. Also, eating foods that are high in fat can aggravate the symptoms. High alcohol consumption as well as cigarette smoking can also worsen the condition. 

Studies have shown that some foods can effectively alleviate the symptoms. These include:

• Apples

• Dates

• Honey

• Rice

• Yogurt

• Walnuts

While some can aggravate the symptoms:

• Watermelon

• Citrus juice

• Carbonated drinks

• Caffeine (coffee)

• Oily and fatty foods

Read about Irritable Bowel Syndrome

But, as the symptoms vary from person to person, so dietplusminus suggests that it is better to seek help from a medical practitioner to set up a proper diet plan. 

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What is Pre-diabetes? 

When the blood glucose levels are above normal level but below the defined threshold of diabetes, the condition is called pre-diabetes. With high chances of developing diabetes, this condition is considered at risk. There is always the presence of pre-diabetes before the onset of diabetes. The elevation of blood sugar is a continuum and hence pre-diabetes cannot be considered an entirely benign condition.

Diagnosis of prediabetes can be alarming. The condition is mainly due to insulin resistance. Prediabetes is often a precursor of type2 diabetes. According to a study, people with prediabetes are always at a higher risk of developing type2 diabetes. The risk of cardiovascular disease also increases in pre-diabetic people.
 

However, being pre-diabetic doesn’t mean that you will definitely get type2 diabetes. Early intervention, that is diet and physical activity are the two keys to get your blood sugar out of the prediabetes range. Now, this is an alarm for you, to know the right kind of food to eat.

Diagnosis of Pre-diabetes

The criteria for pre-diabetes are different for different organizations. WHO has defined pre-diabetes as a state of intermediate hyperglycemia using two specific parameters, impaired fasting glucose (IFG)  defined as fasting plasma glucose of 6.1-6.9 mmol/L (110 to 125 mg/dL) and impaired glucose tolerance (IGT) defined as 2 h plasma glucose of 7.8-11.0 mmol/L (140-200 mg/dL) after ingestion of 75 g of oral glucose load or a combination of the two based on a 2 h oral glucose tolerance test. On the other hand, the American Diabetes Association (ADA), has the same cut-off value for IGT (140-200 mg/dL) but has a lower cut-off value for IFG (100-125 mg/dL) and has additional hemoglobin A1c (HbA1c) based criteria of a level of 5.7% to 6.4% for the definition of pre-diabetes.

According to American Diabetes Association (ADA), diabetes screening for adults begins at the age of 45 years. If you are overweight and have an additional risk for prediabetes, you are advised to start early screening for diabetes.
 

There are several blood tests available for pre-diabetes. Let's discuss one by one.

Glycated hemoglobin (A1C) test

Your average blood sugar level for the past three months is shown in this test. This test measures the percentage of blood sugar attached to the hemoglobin. (oxygen-carrying protein in red blood cells) 

• An HbA1C level below 5.7% is considered normal.

• An HbA1C level between 5.7% and 6.4% is considered prediabetes.

• An HbA1C level of 6.5% or higher on two separate tests indicates type 2 diabetes.

In some conditions, like if you have an uncommon form of hemoglobin or if you are pregnant- HbA1C results can be inaccurate.
 

Fasting blood sugar test

Blood samples are collected after you fast for at least 8 hours or overnight.

•  A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes.

• A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes.

• A fasting blood sugar level below 100 milligrams per deciliter (mg/dL) — 5.6 millimoles per liter (mmol/L) — is considered normal.

Oral glucose tolerance test

This test is mainly used to diagnose diabetes in pregnant women. An 8-hour fasting blood sample is taken. Then you'll drink a sugary solution, and then again your blood sample will be taken after 2 hours.

• A blood sugar level of 200 mg/dL (11.1 mmol/L) or higher indicates type 2 diabetes.

• A blood sugar level from 140 to 199 mg/dL (7.8 to 11.0 mmol/L) is considered prediabetes.

• A blood sugar level less than 140 mg/dL (7.8 mmol/L) is considered normal.

If you come under the category of pre-diabetic, your doctor will typically check your blood sugar levels at least once a year.

Prevalence of Pre-diabetes 

There have been reports of increased mean FPG and prevalence of diabetes in developed as well as developing countries.

Health risk associated with pre-diabetes
 

Progression to diabetes:

There are two factors associated with conversion from pre-diabetic to diabetic- population characteristics and criteria used to define pre-diabetes. According to a study, in India, among those with pre-diabetes, 58.9% converted to diabetes (52.8% among i-IGT, 47.8% among i-IFG, and 84.1% among those with combined IFG and IGT).

Retinopathy:

According to a study, 8% of participants with prediabetes were found to have evidence of diabetic retinopathy. Although pre-diabetes has been associated with an increased risk of retinopathy in some studies, these findings vary depending on the method used for detection.

Nephropathy and kidney diseases:

Several studies have shown an association of increased risk of chronic kidney disease and early nephropathy with pre-diabetes. The causal nature of this relationship remains unclear as this association may be due to increased incidence of diabetes in this group or the presence of other factors associated with both hyperglycemia and nephropathy rather than the effect of pre-diabetes itself.

Neuropathies:

Prediabetes is also found to be associated with dysfunction of cardiac autonomic activity, reflected by reduced heart rate variability, decreased parasympathetic modulation of the heart, and increased prevalence of male erectile dysfunction in individuals with pre-diabetes. 

Macrovascular disease:

Prediabetes has been associated with an increased risk of developing the macrovascular disease, but whether this elevated risk is due to pre-diabetes itself or due to the development of diabetes remains unclear. Some studies have shown an increased prevalence of coronary heart disease in individuals with pre-diabetes but this relationship may be confounded by the common risk factors present between cardiovascular diseases and pre-diabetes.

Relation between diet and prediabetes:

Many factors increase your risk for prediabetes. Genetics plays a role, especially if diabetes runs in your family. Some other factors play a larger role in the development of pre-diabetes. Overweight and very low physical activity are potential risk factors. 

In the case of pre-diabetes, sugar from food begins to build up in your bloodstream because insulin can’t easily move it into your cells.

The amount and type of carbohydrates consumed in a meal influence blood sugar level and causes pre-diabetes. The sugar level in the blood increases, when your diet is filled with refined and processed carbohydrates that digest quickly.

It is difficult for the body to reduce blood sugar levels after a meal. Avoiding blood sugar spikes by watching your carbohydrate intake can help.

When you eat more calories than your body needs, they get stored as fat. This causes you to gain weight. Body fat, especially around the belly, is linked to insulin resistance. This is why many people with prediabetes are also overweight. 

Healthy eating:

Although you can’t control the risk factors associated with prediabetes, some can be managed. Measures taken to stay within a healthy weight range and to balance blood sugar levels may help you.

Select carbs with a low glycemic index:

You can determine how a particular food could affect your blood sugar by the use of a glycemic index. High GI food will increase your blood sugar faster. Foods ranked lower on the scale have less effect on your blood sugar spike. High fiber foods are low on the GI. Highly processed foods, refined foods, foods low in fiber and nutrients, register high on the GI.

Refined carbohydrates are high in the GI. These are the products that digest quickly in your stomach. Examples are white bread, russet potatoes, and white rice, along with soda and juice. Restrict these foods if you are pre-diabetic.

Although foods that rank medium on GI are fine to eat, still not as good as foods that rank low on the GI. Examples include whole-wheat bread and brown rice.  Foods that rank low on the GI are best for pre-diabetics.

Add the following items to your diet:

• Steel-cut oats

• Whole wheat pasta

• Whole wheat bread

• Corn

• Non-starchy vegetables

• Sweet potatoes

• Beans

GI of food is not mentioned on the labels of food items. Instead, check the fiber content listed on the label to help determine a food’s GI ranking.

Restrict the intake of saturated fat to reduce the risk of developing high cholesterol and heart disease, along with pre-diabetes.

You can lower the GI of a given food item by taking mixed meals. For example, if you plan to eat white rice, add vegetables and chicken to slow down the digestion of the grain and minimize the spikes of blood sugar level.

Control portion size:

You should have good control over the portion size to keep your diet on the low GI. This means you should limit the amount of food you eat on every meal. Often, portions are higher, which creates problems and results in spikes in blood sugar levels.

Food labels can help you much regarding the proper portion size. The label will list calories, fat, carbohydrates, and other nutrition information for a particular serving.

It is important to understand that it will affect the nutritional value if you eat more than 1 serving listed. A portion of food may have 30 grams of carbohydrate and 200 calories per serving. But if you have two servings, you’ve consumed 60 grams of carbohydrate and 400 calories.

Elimination of carbohydrates from the diet is not necessary. Recent research has shown that a diet containing less than 40 percent is associated with the same mortality risk as a diet containing 70 percent carbs.

A minimal risk was reported when the intake of carbohydrates was 50 to 55 percent. For example, on a 1600-calorie diet, you should take 200 grams of carbohydrates. Spreading intake of carbohydrates evenly throughout the day is best.

As recommended by the ‘National Institutes of Health’ and the ‘Mayo Clinic’, 45 to 65 percent of calories should come from carbohydrates per5 day. Individual carbohydrate needs differ based on a person’s stature and activity level. It is recommended to consult with a dietician to know about your specific needs.

Mindful eating is the best way to keep control of your portion size. Eat only when you are hungry, and stop when you feel full. Sit properly and concentrate on the food and flavors while eating.

Include plenty of fiber-rich foods:

Fiber is essential and beneficial for you. It has several benefits. It helps you feel fuller for a long time. It adds bulk to your diet, making bowel movements easier.

Since fiber-rich foods add bulk to your diet, you are less likely to overeat. You are also able to avoid the ‘crush’ which results from eating high sugar food. These types of foods will often give you a big boost of energy, but make you feel tired shortly after.  

Example of some foods high in fiber:

• beans and legumes

• whole wheat pasta

• whole-grain bread

• whole-grain cereals

• whole grains, such as quinoa or barley

• fruits and vegetables that have an edible skin

Restrict sugary drinks:

A single can of soda can give you carbohydrates recommended for a meal. A normal can of soda, 12 ounces, can contain 45 grams of carbohydrates. This number is the recommended carbohydrate serving for a meal for women with diabetes.

Sugary sodas give you only empty calories and are readily digested. Water is always a better choice to quench your thirst.

If alcoholic, drink alcohol in moderate amounts:

In most instances, moderation is a healthy rule and it also goes well in the case of alcohol. Several alcoholic beverages are dehydrating. The sugar level in most of the cocktails is very high, enough to spike your blood sugar level. According to research, women should only have one drink per day, while men should limit themselves to two drinks per day. Portion control is very important in the case of alcohol. Following are the measurements for an average single drink:

• 1 bottle of beer (12 fluid ounces)

• 1 glass of wine (5 fluid ounces)

• 1 shot of distilled spirits, such as whiskey, gin, or vodka (1.5 fluid ounces)
   

Keep your drink simple. Avoid adding sugary juices or liqueurs. Drink plenty of water to avoid dehydration.
 

Include lean meat in your diet:

If you are a pre-diabetic, it is recommended for you to avoid cuts of meat with visible fat or skin. A low saturated and trans fat diet will help you reduce your risk of heart disease.

However, meat doesn’t contain carbohydrates but can be a significant source of saturated fat in your diet. Eating fatty meat in moderation can lead to high cholesterol levels.

Choose your protein sources from here:

• low-fat Greek yogurt

• chicken without skin

• egg substitute or egg whites

• turkey without skin

• lean beef cuts, such as flank steak, ground round, tenderloin, and roast with fat trimmed

• shellfish, such as crab, lobster, shrimp, or scallops

• fish, such as cod, flounder, haddock, halibut, tuna, or trout

• beans and legumes

• soybean products, such as tofu and tempeh

Very lean cuts of meat have about 0 to 1 gram of fat and give you 35 calories per ounce. High-fat meat, such as spareribs, can have more than 7 grams of fat and will provide 100 calories per ounce.
 

Drink plenty of water:

Water is an essential part of any healthy diet. Drink plenty of water to avoid dehydration. For pre-diabetics, water is a healthier option in place of sugary sodas, juices, and energy drinks.

Average daily intake of water should depend upon your body size, activity level, and the climate you live in.
You can determine if you are taking enough water or not, by monitoring your urine volume and color. The color of your urine should be pale yellow.

Read article Pre-diabetes - The Younger Brother of Silent Killer Diabetes

Ketogenic Diet (Keto Diet)

The ketogenic diet is a very low-carb, high-fat the moderate-protein diet. Low carbohydrate generates ketones and puts you in a ketosis state. It is efficient at burning fat for energy. A ketogenic diet normalizes blood sugar and insulin levels. The keto diet is very beneficial for overweight or obese, diabetic, and for people who want to improve their metabolic health. It may be less useful for people desiring muscle or weight gain, like for elite athletes. It may not be suitable for some people’s lifestyles and preferences. Must consult your doctor about your eating plan and goals. Let him decide if a keto eating plan right for you.

Read complete about the ketogenic diet here

Buy Our  Keto Plan - Supervised by Dr. Pankaj Kumar

Frequently asked questions on the keto diet

Here are answers to some of the most common questions about the ketogenic diet.
 

1.    Can I eat carbs in near future?

Yes, you can. Initially, it’s very important to reduce your carbs significantly. After 2 to 3 months, have controlled amounts of carbs on special occasions and return to your diet immediately.

2. Will there be muscle loss during the keto diet?
 

Yes, there is always a risk of muscle loss during any diet. But protein intake in appropriate amounts and high ketone levels minimizes muscle loss, especially if you lift weights.

3. Can muscle build if I am on a keto diet?

Yes, but not as well as on a moderate carbs diet.

4. What will be the proportion of protein in my diet?
 

Always take protein in a moderate amount during the keto diet, as very high protein will liberate glucose and will spike insulin levels and lower ketones. Your protein intake must not increase more than 35% of your total calorie intake.

5. I am constantly tired, weak, or fatigued. How to come out of this?
 

Your body may not be utilizing fats and ketones efficiently, i.e. not in full ketosis. Lower your carb intake. You may take MCT oil or ketones supplement to reveal these problems.
 

6. Why my urine smells fruity?
 

The fruity smell of urine is just due to the excretion of by-products created during ketosis. There is nothing to worry about as such.

7. What may I do to stop breath smells?
 

Breath smell is a common side effect of the keto diet. You may try some naturally flavored water or sugar-free gum to get rid of this.
 

8. Is ketosis extremely dangerous?
 

No, but ketoacidosis is dangerous. Ketosis on a ketogenic diet is usually fine for healthy people. People often confuse ketosis with ketoacidosis. Consult your doctor before starting any new diet.
 

9. I am suffering from diarrhea and digestion issues. What to do in such a situation?
 

This is a common side effect of the keto diet, usually starts post 3 to 4 weeks starting diet. If the symptoms persist, take more high-fiber vegetables. 
 

10. What is the maximum dose of MCT oil per day?

MCT oil doesn’t have a defined tolerable upper intake level till now, but a maximum daily dose of 4–7 tablespoons (60–100 mL) has been suggested.

                             

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High Blood Pressure Diet Plan

High blood pressure is a seriously common medical condition. It has already been estimated that more than 1.20 billion people have this disease. It accounts for about 13% of the total deaths worldwide. In this article, you will learn how to control your blood pressure with diet.

What Is High Blood Pressure?

High blood pressure is also known as hypertension. It is basically of two types- primary and secondary hypertension. It occurs when your blood pressure increases to abnormal levels. In this, your blood forces itself against your blood vessels too much forcibly than normal. Usually, blood pressure above 140/90 is considered High blood pressure. Primary hypertension develops takes time to develop and is not too lethal. On the other hand, secondary hypertension occurs quickly and is more serious. But, dietplusminus urges to take both of them seriously. Though slight changes in the blood pressure do not matter, if the pressure is around or above 180/120 then it is a serious problem.

Hypertension is a chronic condition and can last up to several years and even lifelong. It does not have any typical symptoms, but if left unattended it can lead to health conditions such as stroke and heart disease. It can also damage your blood vessels and vital organs like heart, brain, kidneys, etc. It is treatable by a medication, diet changes and does not require any lab tests of imaging. 

What Causes High Blood Pressure?

The exact causes of hypertension are not known yet. But, some researches have clarified that primary hypertension or essential hypertension can be caused due to physical or environmental changes, and genes can also play a role. Secondary hypertension, real high blood pressure, can be caused by smoking, obesity, excess salt consumption, stress, sleep apnea, chronic kidney disease, etc. 

Food, medicine (some birth control medicine), age, genetics, etc. can also cause High blood pressure. A diet that is high in cholesterol can also lead to this condition. Other causes include hormonal imbalance, diabetes, lack of physical activity, drinking too much alcohol, etc. 

Older people are at higher risk of developing high blood pressure. Further, people who have a family history of High blood pressure are also at a greater risk. 

How To Cure High Blood Pressure? 

High blood pressure can be controlled by both medication and dietary changes. But, we at dietplusminus prefer dietary changes. Anyway, early detection is extremely important if you want to get rid of it completely. Therefore, dietplusminus recommends you to regularly take your blood pressure readings. Your diet should consist of garlic, fruits especially berries, bananas, watermelon, oats, leafy vegetables, avocados, mushrooms, tomatoes, etc. 

Dark chocolate, pistachios, olive oil, and pomegranates are also known to lower blood pressure. Plus, making necessary lifestyle changes is also recommended. Exercising daily and losing some pounds are very important factors that will determine if your blood pressure problem will go. You also need to avoid consuming too much salt, caffeine, and alcohol. These can significantly raise your blood pressure and therefore highly increase the risk of developing cardiovascular diseases in the long-term. So, you should be able to track what you and how much you eat. 

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What do you mean by "nutrition"?

The word nutrition itself means "the process of nourishing or being nourished, especially the process by which we assimilate food and use it for growth and replacement of tissues". 

Nutrients are substances that are essential to life, must be supplied by food. A majority of the population is deficient in one nutrient or the other but the amazing fact is that most of them aren't even aware of it! At Diet Plus Minus, we take your blood test to do your nutritional assessment and study your body profile. After a detailed study of your body profile and tests thoroughly, we prepare scientific diet charts and exercise plans just for you!

Today more than ever, obtaining nutritional knowledge can make a big difference in lives. Air, soil and water pollution in addition to modern farming techniques have depleted soils of vital minerals. The widespread use of food additives, chemicals, sugar, and unhealthy fats in diets contributes to many of the degenerative diseases of the day such as cancer, heart disease, arthritis, and osteoporosis. 

The nutritional care process begins with nutritional assessment. Nutrition assessment is the evaluation of an individual’s nutritional status and nutrient requirements. It is a systematic process of obtaining, verifying, and interpreting data to make decisions about the nature and cause of nutrition-related problems. The purpose of nutrition assessment is to:

1.    Obtain adequate information to identify nutrition-related problems. 
2.    Define accurately an individual’s nutritional status
3.    Determine the level of nutritional support that individuals need, and 
4.    Monitor changes in the nutritional status and the effect of nutritional intervention

At Diet Plus Minus, our goal of nutrition assessment is achieved by “ABCD” analysis:

A stands for Anthropometric measures: It measures growth in children and shows changes in weight in all populations that can reflect diseases and help to monitor progress in fat loss or gain.

B stands for Biochemical investigations: These help to reveal nutrients and metabolites in blood and/ or urine, and /or feces that indicate an infection or a disease.

C stands for Clinical analysis: This analysis includes a complete physical examination and a medical history. The physical examination begins with the patient’s general appearance. Nutrition oriented aspects of the physical examination focus on the skin, hair, head, eyes, mouth, nails, extremities, abdomen, skeletal muscle, and fat stores.

D stands for Diet history and nutrient intake: This is used to evaluate diet for nutrient or food intake. Common methods used include the 24-hour diet recall, diet history, food frequency questionnaire, weighment method, etc.

Once you’ve reached your goal weight and are looking towards transitioning towards a normal way of eating after weight loss, it is more difficult to navigate food choices. The most successful way to maintain your weight loss is by making lifestyle changes that work for you. The transition from dieting to regular eating need some precautions as most of the time it is a difficult task.

Normally after achieving desired weight or getting revealed from a painful symptom, people return to their pre-packaged diet and also lifestyle. It can make the situation even more drastic. So, at Diet Plus Minus, we have a maintenance diet plan for you.

Arthritis Disease Diet Plan

Arthritis can attack people of all ages, genders, and lifestyles and it is one of the leading causes of disabilities in India. Almost 50 million adults and 300,000 children have some kind of arthritis. It is generally more popular among the ladies as compared to men.

Overweight and aged people are more likely to develop this medical condition. However, diet can influence it positively to a great extent.

What Is Arthritis?

Arthritis is quite common condition yet it isn't understood correctly in most cases. As a matter of fact, arthritis is not just joint pain. There are in excess of 100 kinds of arthritis and related conditions known to date. 

Arthritis is not only painful but it also causes structural and functional joint changes for life. These progressions might be noticeable, for example, bumpy finger joints. However, the diagnosis can only be confirmed by X-ray. 

The three common kinds of arthritis are: 

Degenerative Arthritis or Osteoarthritis

• Primary Osteoarthritis

• Secondary Osteoarthritis

Inflammatory Arthritis

• Rheumatoid Arthritis

• Psoriatic Arthritis

• Crystal-Induced Arthritis - 1.  Gout  2. Pseudogout

Infectious Arthritis or Septic Arthritis

What Causes Arthritis?

The two principle sorts of arthritis— osteoarthritis and rheumatoid arthritis— harm joints in various manners. 

Osteoarthritis

The most well-known sort of joint pain, osteoarthritis mainly affects your joint cartilages— the flexible and smooth covering on the articulating bone surfaces. This covering permits frictionless joint movement. In osteoarthritis, the joint cartilages degenerate and consequently, significant harm is sustained as one bone grinds legitimately on other bone during any movement.

Osteoarthritis is seen most commonly in the back region, knees, hip, or fingers.

Rheumatoid Arthritis

In rheumatoid arthritis, the body's immune system attacks the covering of the joints, which is the synovial layer. Consequently, the joint area is inflamed and swollen. If left untreated, this ultimately destroys the bones in the joint.

Risk factors 

Risk factors for arthritis can be summed up as below: 

• Family ancestry: A few kinds of joint inflammations run in families, so you might be at additional risk if your ancestors have/had arthritis.

• Age: The danger of the numerous kinds of arthritis, specifically osteoarthritis, rheumatoid arthritis -- increases with increasing age.

• Your sex: Ladies are more prone to arthritis than men.

• Past joint injury: Individuals, who have harmed a joint, maybe while playing a game, are more likely to develop arthritis than others.

• Weight: Putting excess weight on joints, especially your knees, hips, and spine can increase the chances of arthritis.

Arthritis Diet Plan Idea

Just like with numerous other ailments, a proper diet can go a long way in not only preventing the disease but also in keeping it under check. That’s why at dietplusminus, a proper diet is always recommended.

Luckily, there are numerous foods that can ease the pain of arthritis and may help mitigate a portion of the joint pain altogether.

Below are some foods recommended by deitplusminus that can help you lower the pain in arthritis. 

• Spinach

• Walnuts 

• Grapes

• Ginger

• Olive Oil

• Broccoli

Be sure to avoid the following as much as is possible:

• Sugar containing foods

• Fatty foods

• Alcohol

• Fried meat

• Packaged foods

If you’re still confused, please reach out to us so that we can create the perfect diet plan for you!
 

How To Get Enrolled for Arthritis Management by Diet?

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Thyroid Disease Diet Management

The thyroid is a gland in your neck area that controls some hormones in your body. These hormones are necessary for the proper metabolism of proteins, fats, and carbohydrates. 

But, two common disorders (hyperthyroidism and hypothyroidism) of this gland lead to certain health issues. In this dietplusminus page, you will learn about the thyroid disease and its management with a proper diet.

What Is Thyroid Disease?

Thyroid disease actually doesn’t refer to a single disorder, because there are many disorders related to the thyroid gland. But, the two most common types are hyperthyroidism and hypothyroidism. Hyperthyroidism is referred to as overactive thyroid. As the word 'hyper', which means 'more' or 'over' suggests, it is the condition in which the thyroid gland releases more amount of the hormone thyroxine than normal. On the other hand, hypothyroidism is the condition in which enough hormone is not produced by the gland.

Hypothyroidism is the more common one of the two and therefore sometimes it is directly referred to as the thyroid disease. Both of them have different symptoms, but some also share some common symptoms such as enlargement of the gland (goiter). But, both have different causes and are treated very differently. 

The Symptoms of hypothyroidism include

• Constipation

• Fatigue

• Unexplained weight gain

• Dry skin

• Cold sensitivity, etc. 

The symptoms of hyperthyroidism include

• Weight loss

• Elevated and/or irregular heart rate

• Brittle skin

• Irritability, etc. But, the old usually don’t experience any symptoms.

What Causes Thyroid Disease?

As already mentioned, there are different causes of the two different thyroid diseases.  Hypothyroidism can be caused if your thyroid is not working as normal or if it has been removed (in cases of medical conditions like cancer). But, its most common cause is another autoimmune disorder (the body’s immune system fails to recognize their own cells and attacks them) known as Hashimoto's thyroiditis. Other causes include surgical treatment of some conditions like hyperthyroidism, thyroid cancer, etc. Some medications can also trigger hypothyroidism.

The most common cause of hyperthyroidism is another autoimmune disease called Graves' disease. Basically, this autoimmune disorder makes the thyroid gland grow abnormally large and release more hormone than required. Hyperthyroidism can also be caused due to- inflammation of the thyroid gland (thyroiditis), postpartum thyroiditis, consuming too much thyroid hormone, toxic nodular goiter, etc. 

Women are more prone to develop thyroid disease than men. Further, old age, as well as family history, can also make one more prone. 

Thyroid Disease Diet Idea

In this disease, a proper diet is as important as the medication itself. So both should go hand in hand. According to Dietplusminus, foods that are okay for people with hypothyroidism include:

• Eggs (rich in iodine and selenium)

• Meat, all types.

• Fish, all seafood.

• Vegetables, all vegetables. In fact, your diet should be based around vegetables.

• Fruits like berries, bananas, tomatoes, etc.

• All dairy products and yogurt.

Also, you should avoid some foods strictly in order to keep your weight under check:

• Avoid eating processed foods.

• All varieties of millets.

• Avoid taking too many supplements (iodine and selenium)

• Avoid tofu, tempeh, soy milk, etc.

• Broccoli, spinach, cabbage, etc.

• Fruits like pears and strawberries.

• All caffeinated beverages as well as alcohol.

The recommended foods in case of hyperthyroidism include:

• Low iodine foods like egg whites, fresh fruits, oats, honey, potatoes, etc.

• Cruciferous vegetables.

• Iron-rich foods like dried beans, vegetables, nuts, lentils, whole grains, etc.

• Healthy fats present in flaxseeds, olive oil, etc.

• Spices like turmeric, green chilies, black pepper, etc. 

• Also, take vitamin D supplements.

Some foods to avoid in hyperthyroidism include:

• Nitrates present in parsley, cabbage, turnip, carrots, cucumber, pumpkin, etc. 
• Gluten present in wheat, barley, malt, etc.
• Soy-foods.
• Caffeinated beverages.

Reach out to us, so that we can create the perfect diet plan for you according to your lifestyle and requirements!
 

How to Get Thyroid Diet Plan?

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Snoring (Due to Obesity) Diet Plan

Staying fit and healthy is the best sort of lifestyle, one can have and we are always there to help you! At Diet +/-, we thoroughly study your body profile and conduct tests like blood tests to prepare scientific diet plans and exercises for you.

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High Cholesterol/Triglycerides Diet

Millions of people are diagnosed with high cholesterol levels and high triglycerides levels each year. These two may not be too lethal themselves but can give rise to other deadly medical conditions. These include heart attack, stroke, etc. Therefore, it is important to keep the levels of cholesterol and triglycerides in check. And we at dietplusminus strongly believe that the best way to lower high-cholesterol/triglycerides levels is to follow a healthy diet.

What are High Cholesterol/Triglyceride levels?

These are two types of fat (lipid) in your blood and therefore are related. They are important for your body. Cholesterol is present in every cell of your body and has structural importance as well as is required to make hormones, vitamin D, etc. Triglycerides are actually the extra calories that your body stores for energy between meals. But, high quantities of cholesterol/triglycerides in the blood limits blood flow and thus give rise to other serious medical problems.

There are no symptoms and therefore it becomes difficult to know if you have high cholesterol/triglycerides. But, high cholesterol/triglycerides can be detected by blood tests. So, dietplusminus recommends you to check your cholesterol and triglycerides levels periodically for early detection.

High triglycerides can also harden your arteries, increasing the risk of arteriosclerosis and atherosclerosis. If it goes untreated, you can also develop pancreatitis (inflammation of the pancreas). High cholesterol/triglycerides are often related to other health conditions like obesity, metabolic syndrome, etc.

What Causes High Cholesterol/Triglycerides?

High cholesterol can be caused by a lot of risk factors. First, poor/wrong diet is the number one to be discussed. Eating too much-saturated fats and trans fats (present in animal products, commercial cookies, crackers, microwave popcorn, etc.) can highly raise the risk. Other foods such as red meat and full-fat dairy products also increase the risk. Further, obesity and lack of exercise, smoking, etc. like bad habits can also increase cholesterol. Diabetes and your age also play a role in this. 

On the other hand, high triglycerides are usually caused by other conditions such as obesity, untreated diabetes, thyroid, kidney disease, high alcohol consumption, etc. Eating too many calories than you burn on a regular basis can also lead to this condition. Some medications can also raise triglycerides. These include steroids, diuretics, birth control pills, etc.  Moreover, your genetics may also play a role.

How To Cure High Cholesterol/Triglycerides With Diet?

High cholesterol/triglycerides can be treated with a healthy diet. Firstly, you need to avoid consuming saturated and trans fats. Also, dietplusminus recommends you to lower your sugar intake and limit foods with cholesterol. Avoid eating animal organs such as liver, egg yolks, shrimp, etc. Rather you should eat lots of fruits and vegetables, all kinds. You should also consume plenty of soluble fiber (whole-grain cereals, apples, bananas, legumes, lentils, kidney beans, etc.)

Omega-3 fatty acids are your friends, so eat fish. But, make sure to limit salt and alcohol consumption. Lose some weight and maintain a healthy weight. Be more active and quit smoking. Dietplusminus recommends you to visit a nutrition expert for a proper diet. If you follow the diet, you can control your cholesterol and triglycerides levels without any medications.

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