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Weight loss is probably one of the most frustrating things. At some point in our life, we’ve all tried to shed a few extra pounds by doing things like skipping meals, increasing exercise, trying intermittent fasting, eating apples, drinking more apple cider vinegar, and the list goes on. But why is it so hard?
We asked endocrinologist Dr. Sheliza Lalani, who focuses on behavioral therapy, obesity, and nutrition, for her thoughts on weight loss and why it is so challenging.
Firstly, a lot of people believe being obese is due to being lazy and a lack of discipline. What are your thoughts on this?
Obesity is a chronic disease, like heart disease and breast cancer - we should never blame a patient for their medical condition. It is a combination of genetics and the obesogenic environment in which we live. This means that our environment encourages us to eat in an unhealthy way and not exercise enough. But after gaining weight, diet and exercise alone are not a way to treat a medical condition: trying just this is a setup for failure. A diet does not help us change our mindset or how to manage our emotions.
In your opinion why is weight loss so hard?
We evolved from cavemen and are not meant to lose weight. Losing weight is unnatural and our bodies naturally want to retain weight to survive. Often when patients are losing large amounts of weight, we worry about cancer or another disease. Our brains often drive us to re-gain the weight we’ve lost so when we try fad diets to lose weight, they fail.
The first thing a lot of people look for are foods that help with weight loss, like apple cider vinegar, chia seeds, apples - are there any foods or particular diets that can help with weight loss?
There is no diet or food that will lead to weight loss. It is all about a mindset towards a healthy lifestyle. When patients ask me about intermittent fasting or any other diet, my response is simple: ‘if this diet works for your lifestyle - do it. If it’s challenging, don’t.’
Is it possible to lose weight fast?
This is unhealthy and more worrisome.
What is the best advice you can give someone that wants to lose weight?
When I see patients, I often ask them to tell me their values. A change often starts with defining what you value. When you know what you value, you can make more conscious choices and become more aware when you are eating out of boredom versus when you are hungry. It is important to have the right support around you, and behavioral therapy can help. In some instances, talk to your doctor, because there are medications that can help with weight management, but they work alongside changing your mindset towards a healthy lifestyle and managing emotions.
References:
World Tuberculosis (TB) Day is commemorated annually on March 24 to raise awareness about the different social, economic, and health consequences of TB.
This year’s theme is The Clock is Ticking highlights the fact that the world is running out of time to act on commitments to end TB. The COVID-19 pandemic has put even more importance on lung health and protection against various diseases which spread through droplets in the air.
Tuberculosis (TB) Facts:
TB is caused by the bacteria Mycobacterium tuberculosis
The disease mainly affects our lungs and airways, and remains one of the deadliest infectious killers. It is present throughout the globe and can affect anyone, regardless of age.
TB is most common in India, Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh and South Africa. According to the World Health Organization (WHO), in 2019, more than 10 million people fell ill with TB, and 1.4 million lost their lives from the disease.
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TB is mainly spread between humans through droplets in the air Droplets can spread from human to human through coughing, sneezing, singing, and talking closely. You cannot get infected by shaking hands, sitting on toilet seats, or through sex. |
People with compromised immune systems are at a higher risk of falling ill Generally, people that get infected with TB bacteria have a 5-15% chance of becoming ill. Those with compromised immune systems from: HIV, diabetes, kidney disease, and cancer have a higher risk of falling ill. Individuals who do not get enough nutrients from their diet, have high alcohol intake, and are smokers are also at increased risk. |
TB is diagnosed through skin and/or blood tests The skin test involves an injection of a small amount of a TB protein (that does not cause infection) under the skin of your arm. If your skin reacts to this injection, it means a positive result. After a positive test, you may require further medical examinations, including a chest x-ray and blood work. |
90% of people that are infected do not develop the disease – this is called latent tuberculosis. These individuals have no symptoms, do not feel sick, and do not spread germs to other people. |
Dogs and other pet animals can get TB and spread it to humans Breathing infected droplets from the lungs of an animal can get passed to a person and vice versa. If you suspect your pet is infected, they need to see their veterinarian and be treated. |
A bad cough that lasts longer than 2 weeks is a common symptom of TB A TB cough can be severe – some people may also cough up blood or phlegm. Other common symptoms include chest pain, weakness or tiredness, weight loss, loss of appetite, chills, fever, and/or night sweats. |
If you think you, or someone you know has TB, it is important to talk to a doctor and stay home to avoid spreading it. TB treatment requires several different medications, but it is treatable and curable!
References:
Being lactose intolerant means your body has a hard time digesting or breaking down foods containing lactose. Lactose is a type of sugar found in dairy products and is broken down by an enzyme called lactase. Your body may not produce enough of this enzyme for reasons, such as:
Common symptoms of lactose intolerance
Without enough lactase, your body can’t break down lactose into smaller pieces for digestion. Undigested lactose stays in the digestive system and can cause:
How severe the symptoms get depends on how much lactose is in the food you ate, and how much lactase is in your body. Symptoms may be different for everyone.
Common ingredients to look for that contain lactose
These words on ingredient lists will help you determine whether or not a product contains lactose:
What foods can I eat?
Most people with lactose intolerance are usually able to eat small amounts of lactose, but it is helpful to try swapping out foods that you have a negative reaction to.
| If you have a negative reaction to these foods, Try swapping for ----------------> | These Foods |
| Butter | Coconut Oil, Olive Oil |
| Cow’s Milk, Goat Milk, Sheep Milk | Lactose-free milk or plant milks, like almond milk and soy milk |
| Milk Chocolate | Dark/semi-sweet chocolate |
| Milk-based Ice Cream | Sorbet |
| Frozen Yogurt | Yogurt with active bacterial cultures, kefir |
| Soft cheeses, like ricotta | Fermented, hard, or aged cheeses, which have less lactose (swiss, parmesan, blue cheese), cottage cheese, sour cream |
Because many foods containing lactose are important sources of calcium and vitamin D, it is important to make sure you still get enough of these nutrients in your daily diet! If you are unsure about whether your current diet is well balanced, talking to a nutritionist or doctor can help.
Sources:
Vitamin D, also known as the ‘sunshine vitamin’, is an important vitamin that often gets overlooked. Vitamin D deficiency is considered a global health problem that affects almost 50% of the population (more than 1 billion children and adults) worldwide. Even in Southeast Asia, where many countries enjoy sunshine all year round, Vitamin D deficiency is very common.
[Image Alternative Text: A globe with the Southeast Asia region highlighted in Red]
We ask Naturopathic Doctor Julie Hwang (ND), for her thoughts on vitamin D deficiency and the role it plays in mood and mental health. Naturopathic Doctors combine conventional medicine diagnostics with nutrition, lifestyle acupuncture, physical medicine and natural remedies and treatments.
Why are there high levels of Vitamin D deficiency in countries that have year-round sunlight?
The main source of Vitamin D exposure is via sunlight, but many factors can reduce the skin’s ability to produce Vitamin D. Here are some of the trends and risk factors we see:
1) Not getting enough sun exposure
Completely covering-up your body when you are in the sun or wearing sunscreen prevents your body from being able to absorb UVB rays to produce Vitamin D.
2) Not getting enough UVB ray exposure
Not all sunlight rays will convert to Vitamin D; only sunlight with sufficient UVB rays will convert Vitamin D into its active form when it touches the skin. As an example, in Jakarta, the highest intensity of UVB occurs between 11 a.m. to 1 p.m. The sunlight in the early morning and late afternoon contain mostly UVA, which can’t be converted to Vitamin D, not UVB.
[Image Alternative Text: Diagram showing that the ultraviolet rays from the sun that reach the earth come in the form of UVA and UVB]
What role does Vitamin D play in the body, and how is it connected to mental health?
Vitamin D is mostly known for its critical and most clearly researched role of helping the body absorb calcium and phosphorus from the small intestines. This is important for the growth and development of both bones and teeth. In addition to bone health, having low vitamin D levels can negatively impact your immune function.
What is most surprising about Vitamin D is the role it plays in so many other areas like mental health. There is a strong correlation between vitamin D and depression, but whether it can be used as a treatment is not clear yet. As an example, some interesting research shows that there are Vitamin D receptors in the brain that are known to play a key role in mood regulation.
Even though the available studies aren’t robust enough to make specific recommendations to really understand the role of vitamin D plays in mood, it’s clear it plays an important role in the body. Here are some interesting research findings and uses:
 | Depression during Pregnancy & Post-Partum Depression | A few small studies have shown that Vitamin D during pregnancy helped with depressive symptoms during pregnancy and post-partum |
 | Depression in Adults | A few studies have shown benefit in those with clinical depression that take Vitamin D alone or in combination with an antidepressant |
 | Depression and anxiety in women with Type 2 Diabetes | A small study showed that Vitamin D may help improve depression in anxiety in women with Type 2 Diabetes |
 | Depression in Childhood & Adolescents | Vitamin D has shown to have a possible role in some psychiatric conditions such as depression, attention deficit disorder and autism spectrum disorders |
How can people get more vitamin D?
It is important to know your body can’t make Vitamin D by itself, but there are a few options to increase levels in your body:
If you think you may be at risk for low vitamin D, talk to a medical professional to get your levels tested and discuss what the best options may be.
References:
Holick, M.F. (2017). The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord, 18(2):153-165.