Shabnam Das Kar and Michal Ofer
Nutrition Science Meets Medicine

Shabnam Das Kar

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PCOS: Time to ditch your plastic bottles?

Below is a video I recorded recently. What do plastic bottles contain that is so harmful to you?

Endocrine Disrupting Chemicals (EDCs)

EDCs are hormone disruptors. Your body is exposed to a soup of chemicals every day, starting with your skincare products, home cleaning chemicals and right down to the lining of cold drink cans and even store receipts!

Many EDCs are obesogens:

For many of you with PCOS, weight loss challenge is one of the most important problems that you are dealing with. While the underlying problem in PCOS is insulin resistance, it is possible that EDCs are an additional factor as well. Some EDCs are considered to be obesogens. This means that they can make you gain or retain excess weight.

From numerous animal and lab studies as well as human studies, scientists have found that EDCs are associated with obesity, metabolic dysfunction, hypothyroidism, some cancers, PCOS, infertility, diabetes.

Studies in women with PCOS have shown that levels of an EDC called BPA (Bisphenol-A) were higher in women with PCOS than in those without. More importantly, higher levels of BPA were also related to worse metabolism and higher levels of male hormones, both of which are hallmarks of PCOS. 1)Ref

EDCs are a major problem all over the world. This is the reason that the Endocrine Society as well as the World Health Organisation (WHO) have attempted to bring awareness about this. 2)Ref 3)Ref

Beware Of BPA-free!

A few years ago when BPA was banned from being used in infant feeding bottles, manufacturers came up with an alternative product, BPS. It turns out that the alternative may not be a safer option! 4)Ref

Video Slides On Slideshare:

References   [ + ]

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2. ↑ Ref
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4. ↑ Ref

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Major Concerns Of Women With PCOS

What Is PCOS?

Polycystic Ovarian Syndrome or Polycystic Ovarian Disease (PCOD) is a complex genetic, hormonal and metabolic disorder that affects the whole body, not just the ovaries.

Many of you have been frustrated at the insufficient information provided to you by your healthcare provider. PCOS presents differently in different parts of the world. Those of you from India have often struggled with losing weight or maintaining your weight loss. Caucasian women may have struggled with getting an accurate diagnosis because they seemed “normal”.

[Read more…] about Major Concerns Of Women With PCOS

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Obesity, Diabetes And Covid 19

The Coronavirus disease 2019 (COVID-19) caused by the SARS CoV2 virus (Severe Acute Respiratory Syndrome Coronavirus 2 ) was first reported in China in late December, 2019. It has has since evolved into a global pandemic (present all over the world).

Quick Facts About Covid 19:

  • It is highly contagious. It can spread very easily. Unlike previous SARS viruses, the SARS CoV2 settles in the nose and throat. This means it can spread when you talk or laugh or sing, particularly in confined spaces (super-spreader events).
  • Asymptomatic spread. People may have the virus and potentially spread the disease even when they do not have symptoms of Covid 19.
  • It is a new virus. However, in a short span of 6 months, scientists have already found out quite a lot about this virus. By January 12, 2020, the virus was sequenced in China. This means that the genetic signature of the virus is known. This is important from the perspective of testing and treatment. 1)Ref
  • Vaccine: There is no vaccine against the SARS CoV2 available now, but many promising ones are in development.
  • At present, there is no specific treatment available for Covid 19. However, the search is on!
  • The Coronavirus is here to stay. It is not going anywhere. This means that measures of physical distancing will remain even after the lockdown. For how long? We do not know as yet.
  • Wearing face masks help!
  • Young people are not immune to Covid 19, particularly if they are overweight and/or have a chronic disease.
[Read more…] about Obesity, Diabetes And Covid 19

References   [ + ]

1. ↑ Ref

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Webinar Recordings And Show Notes.

Sleep, Eat, Move and Mind.

(This post includes the recordings, references and contact details from the FREE online webinar series co-hosted by Deepak Saini and Shabnam Das Kar April 6 to 9, 2020)

Day 1 (April 6, 2020) Sleep

Speakers: Karim Delgado and Deepak Saini

Day 2 (April 7, 2020) Eat

Speakers Deepak Saini, Shabnam Das Kar and Michal Ofer

Day 3 (April 8, 2020) Move

Speaker: Deepak Saini

Day 4 (April 9, 2020) Mind

Speakers: Deepak Saini and Shabnam Das Kar

Additional Resources

SLEEP

Screening for Obstructive Sleep Apnoea (OSA)

EAT

Michal’s Vegetable Broth Recipe

MIND

Rethink Stress Intervention

Steps To Elicit The Relaxation Response

Free MBSR Resources

[Read more…] about Webinar Recordings And Show Notes.

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Coconut Flour Idli (Steamed Savoury Cake)

Coconut Flour Idli (Steamed Savoury Cake)

Recipe by Lily Kiswani and Mitali Kar
Servings

24

servings

Idlis are a common South Asian food, usually made of fermented rice and lentils. They are usually eaten with chutney or curry.

Ingredients

  • Coconut Flour 200 grams/ 2 cups


  • Isapgol (Psyllium Husk) 8 tablespoons


  • Baking Powder 2 teaspoonful


  • Salt 1 teaspoonful. 

  • Hot water as required

Directions


  • Knead together all the ingredients with hot water to make a somewhat firm dough. Add a little water at a time, do not let the mixture become runny. At a certain stage of adding water, the psyllium husk will expand and the dough will come together.

  • Set aside for 15-20 minutes.

  • Pat into idli moulds and steam them for 10-12 min.

  • Eat with any desired chutney. Coconut green chutney goes very well.

  • If you eat eggs, you can replace the psyllium husk with eggs. In this case, add coconut oil 1 tbsp for every half cup of coconut flour. 

Notes

  • The coconut flour may be completely or partially replaced by nut flour such as almonds or walnuts, or by ground seeds such as flaxseeds, pumpkin, sunflower, sesame, or a combination of these. Go ahead and experiment with them.Find the one you like best and enjoy! 
  • Important: Coconut flour absorbs liquids, a lot more than nut or seed flours.

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Why Can’t I Lose Weight? Part 2 Insulin Resistance.

Insulin resistance is a condition when your cells stop responding to the insulin that is produced in your body. This is a highly simplified explanation.

Insulin is your “fat fertilizer” hormone. This is in the words of Harvard endocrinologist, Dr. David Ludwig. Most of you probably know insulin as the injection that people with diabetes (types 1 and 2) take to manage their blood glucose levels. However, here I am talking about the hormone insulin that is produced by the beta cells in your pancreas.

What Does Insulin Do In Your Body?

Insulin helps

  • In maintaining blood glucose levels in the blood.
  • Glucose to enter into the muscles.
  • Stops breakdown of fat.
  • Stimulates the liver to store glucose as glycogen.

Insulin Resistance or Metabolic Syndrome or Syndrome X?

Metabolic Syndrome has been called by various names, Syndrome X, Insulin Resistance Syndrome. It was originally called Syndrome X by Stanford Professor Dr. Gerald Reaven, who is known as the “Father of Insulin Resistance”. His 1988 Banting Lecture is legendary among those interested in this field. He passed away in February 2018 at the age of 89.

A syndrome is a group of symptoms that together are characteristic of a specific disorder or disease. In the original definition of Syndrome X, Dr. Reaven had included several criteria as shown in the image below. (Fig 1)

Criteria for Metabolic Syndrome or Syndrome X
Fig 1 Syndrome X

The common factor underlying Syndrome X is insulin resistance. The X has been dropped from the description because the relationship of insulin resistance and heart disease is no longer disputed. Now it is called Metabolic Syndrome or MetS.

Your risk for developing diabetes , dementia,stroke or heart disease is very high if you have Metabolic Syndrome.

Criteria for Metabolic Syndrome:

According to guidelines from the National Heart, Lung, and Blood Institute (NHLBI) and the American Heart Association (AHA), metabolic syndrome is diagnosed when you have at least 3 of the following 5 conditions:

  • High Fasting Blood Glucose
  • High Blood Pressure
  • High Triglycerides
  • Low HDL-C
  • Waist circumference ≥102 cm (40 in) in men or ≥88 cm (35 in) in women; if Asian, ≥90 cm (35 in) in men or ≥80 cm (32 in) in women.

Insulin Resistance/Metabolic Syndrome and Other Disease

I am stressing on this again. As you can see in the image here (Fig 2) if you have insulin resistance or MetS, your risk for many diseases increases dramatically.

Fig 2 Diseases Related To Insulin Resistance

The Relation Of Carbohydrates To Insulin Resistance

Your food is a combination of carbohydrates, fat and protein. When you eat food your insulin levels go up.

How much insulin goes up will depend on (besides other factors) the protein, fat and carbohydrate content of your food.

As you can see in the image (Fig 3) here, insulin levels are highest after a high-carbohydrate (HC) diet, followed by a high-protein (HP) diet. A high-fat (HF) diet raises insulin the least. Fasting doesn’t raise insulin levels at all.

In this study, the high-carbohydrate diet included about 60% of carbohydrates.

Fig 3 Insulin Levels after food. dit El Khoury 2006

Glycogen And Triglycerides

Fatty acids are used by fat cells to make triglycerides. Triglycerides consist of 3 fatty acids joined to a glycerol spine. When the liver is full of glycogen, any extra glucose gets diverted into making free fatty acids.

Therefore, high triglycerides in your blood is a problem of insulin resistance and carbohydrate intolerance.

It cannot be corrected by taking a cholesterol-lowering drug or by eating a diet low in good fat and high in carbohydrates. Insulin targets the heart and the lining of the blood vessels that supply the heart and brain. This is why those of you with diabetes or pre-diabetes have a high risk of heart disease, stroke and dementia.

How Will You Manage Insulin Resistance?

  • Low-carbohydrate diet. How low will depend on individual variations.
  • Eat “real food”. This does not include highly processed high carbohydrate food and sugar.
  • Time-Restricted Eating/Intermittent Fasting (TRE-IF)

Benefits Of Low-Carbohydrate Diet

As you can see in Fig 4, the effects of a low-carbohydrate diet are many. The pathways affected are numerous. Does it have to be high-fat? This will be discussed in a separate post.

Effects of Low-Carbohydrate High-Fat Diets
Fig 4 Effects of Low-Carbohydrate High-Fat Diets, Ludwig 2018

Bottom Line

  • If you have insulin resistance a low carbohydrate diet will work better for reducing weight and improving your metabolism.
  • How little carbohydrates you eat will depend on several factors. How much you exercise, sleep, your medications, genes, gut microbiome all impact your carbohydrate tolerance.

Other Articles

Why Can’t I Lose Weight Part 1

Is Intermittent Fasting Just A Low-Calorie Diet?