The Paowallahs of amchi Mumbai.

800px-Vada_Pav
CC image by Deepesh

What is Mumbai without its pav?

Vada-pav, pav-bhaji, maska-pav, bhajiya-pav and just plain old chai with pav. The humble pav is Mumbai’s icon, it is uniquely and typically Bombay, it exemplifies the bindaas attitude that defines the City of Dreams.

The word ‘pav’ does not come from the alleged practice of bakers using their feet to knead the dough! No bakery in Bombay is known to do this (at least I hope not). The word ‘pav’ actually comes from the Portugese ‘pao’, which means bread. The technology for pao-making was brought to India by the Portugese in the late 15th century.

After the Portugese took over Goa, that state fell into economic ruin. Many Goans migrated to Bombay, and settled in a place called Cavel, near Dhobi Talao in South Bombay. One such Goan was Vitorino Mudot, an enterprising young man from the village of Assagao. In 1819, he set up the first bakery in Cavel, and started making Portugese-style pao.  Vitorino encouraged his fellow Goans by giving them jobs in his bakery and by helping them set up their own bakeries. Vitorino Mudot became a rich man in the process.

In 1843, one of his own assistants, Salvador Patricio de Souza, forcibly took over the business. He in turn grew rich and powerful, and diversified into banking, real-estate and cotton. Under his reign, Goans monopolised the bread-making business in Bombay. After he died in the late 1890’s, the Goans were undermined by the aggressive Iranis. The pav business in Bombay is now dominated by north Indian muslims, most of whom are in the Grant Road area.

The golden age of the Goan pao-makers is long gone, but the nickname given to them still remains – makapao. It’s not a polite nickname, but the easy-going Goans take it sportingly (usually, but not always!)

So the next time you bite into a spicy vada-pav, don’t forget to pay your respects to Vitorino Mudot, the young baker from Assagao.

Cheers … Srini.

A dose of Dosa.

sks-174245.JPGIt’s a multi-billion dollar industry in India, not to mention the rest of the world. It is breakfast, lunch, dinner, evening snack, fast food and health food, all in one. The dosa is, well, the dosa.

The idli isn’t really Indian in origin, but the dosa is totally desi. Dosa making goes all the way back to 600 AD, somewhere in south India.

The masala dosa on the other hand, was invented in the 1960’s, at Woodlands Hotel, Udupi, by one Kadandale Krishna Bhat. Potato curry was usually served separately with plain dosas. During a potato crisis in the 1960’s, Krishna Bhat served dosas with a layer of pureed potato curry applied inside the dosa, to save on potatoes. Thus was born the masala dosa.

In its classical form, the dosa is made with parboiled rice and urad dal, ground together in a ratio of 3:1, fermented overnight. As with the idli, the process of fermentation increases the dosa’s nutritive value, making it a super-food. There are several dosa versions without rice, like the ragi dosa, adai, pessaratu (made from moong dal), wheat dosa, cabbage dosa, and what not.

The traditional dosa is a powerhouse of nutrition. The normal dosa has about 80 calories only. It has significant amounts of vitamin B, carbohydrates, protein and almost no fat (provided it is not fried in ghee). Instant dosa mixes are simply not as good. And hotel dosas are generally not safe. Instead, make them at home, with parboiled rice and urad dal. Add some home-made potato curry, or better yet, add a lightly spiced paneer or soya curry, and you have one terrific low-cal, high-protein meal.longest dosa.jpg

There are almost as many dosa variants as there are cooks in India. Onion dosa, banana uttappa, pineapple uttappam, set dosa, benne dosa, neer dosa, and some weird ones like Amitabh dosa (six feet long. I’ve eaten one such), Punjabi dosa, and Schezuan dosa and chop suey dosa (of all the things!). They’re all great, of course.

My personal favorite: Kheema dosa – traditional dosa stuffed with chicken kheema. Superb stuff. (My mom would be scandalised!).

Cheers … Srini.

The Great Weight-loss hoax – part 2

obesity-crop-187102.JPGUnderstand this:

Obesity is a medical condition. Like all other medical conditions, obesity needs medical attention. Period.

So, first and foremost, you must consult your primary healthcare provider.

Disregard all promotional hype about supplements or herbals. Remember, this stuff is not made by people who deeply care about your weight or your health. These are people who want your money.

That does not necessarily mean that all nutra-peddlers are dishonest. But it also means that they are not necessarily scrupulously honest.

You have a medical condition. You talk to a medical professional.

So what are my options?

If you’re a few kilos overweight, and below a BMI of 26 or so, then a sensible doctor would advise proper diet and exercise – and nothing more.

Dieting means eating smart, making the correct choices, and still eating well. Exercise does not mean huffing and puffing in a stinking, expensive gym. It means getting off your butt, getting into moderate aerobic and anaerobic workouts, and also workouts that improve your flexibility and balance, like hathayoga.

The first-line treatment for weight management has always been, and will always be, diet and exercise.obesity-crop-1920.JPG

Across the world, every single government agency that regulates public healthcare solidly endorses this line of treatment. Diet and exercise.

What if I’m really obese?

If you’re above BMI 27 and you have a family history of diabetes or coronary disease, you are morbidly obese. Don’t worry. Your doctor has several options:

1) Prescription meds: These are medicines approved by the USFDA or the relevant government agency in your country, and available only on prescription.

Do they work? Yes, they do, within reasonable limits. And when taken under medical supervision.

Are they safe? There is no “safe” drug.

There is no “safe” dietary supplement or nutraceutical either.

In a medical context, “safe” means that the drug has been approved after rigorous testing over several years, and the benefits of the drug outweigh its potential side-effects.

Even so, any responsible doctor will think twice before prescribing a drug for weight-loss.

Six prescription drugs are in common use for obesity management. I won’t mention any names, in case you think I’m promoting any particular medicine. Each of them is useful in treating severe obesity and each has its own benefit-to-risk profile.

How long do I take prescription meds?

This is the difference between scientific obesity management and nutra-quackery.

Prescription meds are taken under medical supervision for limited periods of time. Depending on your response to the drug, your doctor may prescribe it for a few weeks to a few months. The doctor’s objective is to use drugs to bring down your weight to the point where you can take up a diet and exercise program. At this point, the drug will be discontinued.

The nutra-peddler on the other hand, will try to convince you that you should buy his “safe” nutraceutical stuff for the rest of your life. It’s “just” a dietary supplement, you will be told.  You can take his “safe” dietary supplement for the rest of your life and remain slim and sexy for the rest of your life.

Yeah, sure.

If you’re expected to consume a nutraceutical, every single day, for the rest of your life, don’t you think you should be deeply worried about its long-term effects on your body? And don’t you think your nutra-peddler should give you safety data on his weight-loss supplement? By long-term, one means over a period of ten years at least.

In most cases, your nutra-peddler won’t give you this data. Because he doesn’t have it. Because long-term safety studies cost money. Because it’s cheaper to hire a smart lawyer instead.

2) Surgery

For patients whose obesity is potentially life-threatening, and cannot be managed even with prescription drugs, a doctor will consider bariatric surgery. The objective of bariatric surgery is to temporarily or permanently reduce the size of your stomach, and thereby restrict the amount of food you can eat.

Bariatric surgery can result in significant and sustained weight-loss. But remember that any surgical procedure, even a simple tooth cavity filling, has an element of risk. And also remember that bariatric surgery is not a cosmetic procedure, like a liposuction or a facelift. Bariatric surgery is a serious intervention and it does carry some risk. When it is performed by the right surgeon, the procedure can be life-changing.

Any kind of surgical intervention is used as a last resort, and bariatric surgery is no exception.

But then, most obesity patients can be readily treated with diet and exercise, and if really necessary, a short course of prescription drugs.

Obesity can be psychologically devastating. I’ve seen how bad it can get.

In my opinion, nutra-peddlers who exploit your fear to sell you worthless and very expensive nutra-crap, are the lowest forms of human life on this planet.

I have spoken.

Srini.

 

Key references:

The NHLBI’s Obesity Education Intitiative, under the US government’s Dept of Health and Human services provides a wealth of information and booklets that you can download. I would seriously recommend that you read them.

Here’s the link:

https://www.nhlbi.nih.gov/health/resources/heart#obesity

Nutra Tamasha – The great weight-loss hoax – Part 1.

obesity-crop-187102.JPGTamasha: In India it means “farce”.

Obesity: In the world of nutraceuticals, it means “cash-cow”.

Nutra-peddlers can always count on your irrational obsession with your waistline – to improve their bottomline.

Every profit-making nutraceuticals manufacturer (and there are a lot of them, thanks to you), has at least one “guaranteed” product in his arsenal for weight loss. You can safely bet that half their profits come from your paranoia about your bulging belly and your jiggling butt.

Whether any of these weight-loss nutraceuticals or dietary supplements actually work is debatable. Very debatable.

The root cause of the problem is social. We have weird, illogical, physiologically unattainable and medically ridiculous standards of beauty. We judge others by their physical appearance, not by their competence.

In other words, the root cause of the problem is not the nutra-peddlers, but you.

Nutra-peddlers know this very well and they exploit your stupidity to the hilt, as they ply you with one “scientific” dietary supplement after another, each backed by “research”, each guaranteed to make you as sexy as Adonis (or Aphrodite), and each equally worthless.

What’s obesity anyway?

Ah. That’s a good question. Innocent laypeople (that’s you), cannot distinguish between normal weight gain and morbid obesity.

I said, normal weight gain. It is perfectly normal to gain some weight as one ages. Obviously, you cannot expect to be as slim and hard at fifty as you were at twenty. Normal human beings tend to gain some weight, as their metabolic rates decline with age.

The technical term is basal metabolic rate or BMR. Simply put, BMR is an indicator of how much energy you consume at rest. As you age, your BMR will decrease. This is a natural process and not something to be tampered with.

Many nutra-peddlers claim that their products, uniquely, can increase your BMR and make you lose weight dramatically.

Bullshit.

It is exceptionally difficult to raise your basal metabolic rate, partly because it is difficult to accurately measure your BMR in the first place. No nutraceutical or dietary supplement that I know of can increase your BMR to the point where you will lose weight just like that.

If any supplement does increase your BMR, then I would definitely wonder about what that supplement actually contains – because only certain prescription drugs are known to affect BMR, and those drugs have nasty side-effects.

How do I know if I’m just overweight or really obese?

What you need to know is your body-to-mass index, also known as BMI. It’s easy to calculate. Simply divide your weight in kilos by your height in square meters.

For a 6 foot tall man weighing 80 kgs, his BMI would be 80/(1.83)^2 = 23.8.

Another quick calculation is your waist-to-hip ratio. That’s easy. Measure waist, measure hips. Divide.

A BMI of more than 26 is generally considered obese. If your BMR is more than 30, that’s morbid obesity.  If your waist-to-hip is more than 1.2, and your BMR is in the high twenties, it would be a good idea to seek professional help.

Mind you, professional help. Not nutra-crap in a bottle.

Up next: How to properly treat obesity.

Stay tuned.

Srini.

 

Key reference:

Weight control, US Dept of Health and Human Services.

https://nccih.nih.gov/health/weightcontrol

 

Relax … with JPMR.

Stress! The one word that gives nutra-peddlers and alt-meds a real hard-on. It costs companies hundreds of lost man-hours and keeps a lot of quacks in business.

Here’s a time-tested relaxation technique you can try yourself.  It’s called Jacobson’s Progressive Muscular Relaxation or JPMR.  It was originally developed by Dr. Edmund Jacobson.  Various versions of JPMR are peddled by many ‘experts’ as their own invention.  It’s simple, it’s safe and it works.

This is the version that I learnt many years ago, from my friend who is a clinical psychologist.

Choose a quiet place where you can sit or lie down undisturbed.  Relax your entire body. Take a few slow, deep breaths.  Imagine the tension flowing out with each breath.  Now contract your feet as you inhale. Hold for about five seconds, then relax as you breathe out, still imagining the tension flowing out with the breath.  Notice the feel of the muscles as they are contracted or relaxed.

Progressively contract your calves, upper legs, buttocks, abdomen and chest.  Tighten your fists, hold and release.  Same for your forearms. Raise your shoulders, hold and release.  Slowly raise your head, hold and release.  If you’re sitting, try to tighten your chin against your collar bone, hold and release.

Do any neck movements very slowly, or you might strain your neck muscles.

End with your face, tensing and relaxing the muscles of your mouth, jaw, eyes and scalp.  Raise your eyebrows, release.  Screw up your face, hold and release.  Purse your lips tightly, hold, release.

Now lie still for five minutes, just feeling your relaxed muscles.  Turn to one side and get up slowly.  Remember, each ‘hold’ should be for about five seconds and each ‘release’ around five seconds.  Exhale slowly with each release, inhale with each contraction.

Important: With each exhalation, repeat a soothing word like ‘relax’, or ‘calm’.   That particular word, coupled with the muscular relaxation, will eventually become a relaxation cue for your brain. In other words, you are training individual muscle groups to relax on cue.

Dr Jacobson proved that excessive stress and anxiety can increase muscular tension and cause a strong contraction of muscle fibers. Conversely, if the muscles were made to relax, then mental tension would correspondingly reduce.

This is the basic theory behind JPMR.  Something the quacks won’t tell you – when you pay their fancy fees.

Believe it or not, this deceptively simple technique actually does work.  JPMR can be combined with any other relaxation system you’re following. It gels well with yoga and Indian meditation techniques, for instance.

Or, you can practise JPMR as a stand-alone method. It works quite well as a quick relaxation trick, before a stressful event like a business presentation – or a date.

Hang loose and relax.  You have nothing to lose – but your tension.

Cheers … Srini.

Some juicy facts.

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Public domain image

So you thought fruit juices are good for your kids, eh?  So you thought all those “fortified” juices in fancy tetrapaks would make your child bounce and glow, eh?  So you thought a hefty swig of fruit juice four times a day would make you healthy, wealthy and wise, eh?

You’re wrong.

Way back in 2001, The American Association of Pediatrics (AAP) had issued a policy statement on the use of fruit juices [The use and misuse of fruit juice in pediatrics. Pediatrics, Volume 107, pages 1210-1213, 2001.] Here’s an extract:

Fruit juice offers no nutritional benefit for infants younger than 6 months and therefore should not be introduced into their diet.  For older infants and children, fruit juice offers no nutritional benefits over whole fruit.  Fruit drinks are not nutritionally equivalent to fruit juice. Juice is not appropriate for treating dehydration or managing diarrhea. 

Surprised?  You ought to be.  Here are some more juicy facts for you:

Excessive juice consumption may be associated with malnutrition and can cause diarrhea, flatulence, abdominal distention and tooth decay.

Unpasteurized juice may contain pathogens that can cause serious illnesses.  In place of ‘unpasteurized’ read ‘squeezed in a fruit juicer at home’.

Infants should not be given juice from bottles or hi-tech transportable covered cups that allow them to consume juice easily throughout the day. Infants should not be given juice at bedtime. Intake of fruit juice should be limited to one small glass per day for children 1 to 6 years old.  For children 7 to 18 years old, juice intake should be limited to two servings per day.

Children should be encouraged to eat whole fruits to meet their recommended daily fruit intake. Infants, children, and adolescents should not consume unpasteurized juice.

You can download the entire report here.

I could quote several other reports and articles about the perils of juicing, but I’m sure you can do your own research, instead of taking me at my word.

No point in squeezing the life out of all those fruits and raw vegetables. You may actually be doing yourself and your child some harm.

In case you didn’t get it, the message is …

JUICING IS UNSAFE!

Diet gurus would have us believe that juicing is the answer to mankind’s ills.  There are all kinds of ‘organic’ juice concoctions that promise to reverse disease, stop aging and generally bring happiness to one and all.  “Live”, uncooked juices, we are told, flush the body of “toxins”, leaving us in state of eternal bliss.

Bullshit.

When you juice the crap out of a fruit or vegetable, you lose all the other benefits you can get from it, like fiber for instance.

Fruit or vegetable juice is not a substitute for food. Fruits and vegetables are meant to be eaten.  What do you think your teeth are for?

Yes, fruits and vegetables are good for you. That’s the primary message of my blog.

But…eat your fruits and vegetables. Don’t drink them!

Stay healthy. Stay safe. As Nature intended.

Cheers … Srini.

Eating sugar? No Papa!

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CC image attribution: SBHarris

This isn’t about diabetes.  Quite the opposite actually.  This is about an underestimated condition called Hypoglycemia or Low Blood Sugar.  Hypoglycemia frequently goes undiagnosed, with devastating results.

The normal range for blood sugar is about 60 milligrams per deciliter (per ten millilitres of blood ) to 120 mg/dL, depending on when you last ate.  Hypoglycemia occurs when the level drops below 60 mg/dl.

SYMPTOMS:  Characteristic symptoms include weakness, drowsiness, confusion, acute hunger and dizziness.  Paleness, headache, anxiety, trembling, sweating, rapid heartbeat, and cold sweating are frequently seen.  In severe cases, a person can faint and even lapse into a coma.

CAUSES:  Antidiabetic medication is a common cause of hypoglycemia.  However, hypoglycemia can and does occur in non-diabetics too.  There are several reasons for hypoglycemia:

Prolonged fasting in non-diabetic individuals can lower blood sugar to a dangerous point.

Excessive exercise, especially on an empty stomach, can trigger a hypoglycemic episode in an otherwise normal person.

Emotional stress can cause hypoglycemia in susceptible individuals.

A carbohydrate-deficient diet is another common cause.

Overactive pancreas can produce a condition called hyperinsulinism and resultant hypoglycemia.  Hyperinsulinism is frequently seen in patients suffering from disturbed thyroid function.

An insulinoma, a tumor in the pancreas, can cause episodes of severe hypoglycemia.  Although by themselves, insulinomas are regarded as benign tumors, the hypoglycemia they can cause can be life-threatening.

Reactive hypoglycemia or post-prandial hyoglycemia happens to certain people immediately after a heavy meal.

DIAGNOSIS:  A Glucose Tolerance Test is the preferred diagnostic test for hypoglycemia.  In addition, the doctor may order an RBS (random blood sugar) whenever you feel symptomatic.  An insulinoma is usually diagnosed by estimating blood insulin levels over a 24 to 72 hour period.  MRI or CT scans are used to pinpoint the tumor.

TREATMENT:  The best treatment for a hypoglycemia episode is glucose.  A few grams of glucose can quickly reverse hypoglycemia symptoms.  Severe hypoglycemia requires an injection of glucagon which stimulates the liver to release stored glycogen which gets converted to glucose.  Diet and stress-induced hypoglycemia can be treated with proper counseling and dietary modifications.  If the hypoglycemia is caused by a tumor, the only option is surgery.

Hypoglycemia sufferers would do well to recognize the onset of hypoglycemia and act quickly.  Hypoglycemia is far more common in non-diabetics than previously suspected.  If you keep getting characteristic symptoms, especially giddiness and weakness when hungry, it’s time you got your pancreas checked up.  You may be in for a not-so-sweet surprise.

As a general precaution, make it a practice to carry a light snack with you at all times, like a pack of biscuits, or some candy. You never know when hypoglycemia may strike.

Stay healthy. Stay safe. As Nature intended.

Cheers … Srini.

 

Key references:

https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/low-blood-glucose-hypoglycemia

http://www.webmd.com/diabetes/guide/diabetes-hypoglycemia#1