The first week of September is observed as the National Nutrition Week to spread awareness about the pitfalls of nutritional deficiencies and how to address them. To spread awareness about this silent and unnoticed epidemic, National Nutrition Week is observed between 1st and 7th September.
Nutritional deficiency is a silent killer, especially in the present-day setting where several cannot afford a balanced meal, and many are giving into fad diet trends. This combined with the increasingly common sedentary lifestyle choices and lack of awareness about nutritional requirements paint a rather bleak picture of the prevalence of nutritional deficiencies. Combatting nutritional deficiency requires awareness. To achieve objectives of controlling rampant nutritional deficiencies, the first week of September is observed as the National Nutrition Week. To protect yourself from the common nutritional deficiencies, here is a list of simple things you can do.
Find out more about the common nutritional deficiencies - Common nutritional deficiencies arise out of diets that are not balanced in the major food groups. These food groups include carbohydrates, proteins, fats, vitamins, and minerals. A little research into the common deficiencies shows a deficiency of either vitamins or minerals. Include lots of fruits, vegetables, and supplements if absolutely necessary in your daily diet. Talk to a dietician about your daily diet and ensure you are on the right path. After all, knowledge is power.
Don’t miss out on the essential fats - Speaking of food groups, fats are the one is the single most avoided food group. However, it is important to know that not all fats are bad. In fact, it is vital for the proper functioning of the brain. Include more polyunsaturated fatty acids and Omega3 fatty acids in your diet. Fish and fish oil are the best source. Other options include avocadoes, almonds, coconut oil, etc.
Include fibres - Another overlooked food group contains fibres or the indigestible part of fruits and vegetable, mostly consisting of cellulose. They are incredibly important for the health of the intestine. Other than this, they can reduce the risk of Type 2 diabetes and protect the body from jumps in the insulin level after consuming sugary food.
Antioxidants are essential - Antioxidants found richly in bright and colourful fruits and berries and dark green vegetables. Among their several benefits, they protect the cells from oxidative damages caused by disease-causing germs and blocks cancer cells.
Organic over processed - Natural and organic food is superior in its nutrition content but also free from toxic pesticides and fertilizers. Additionally, they are rich in vitamins, minerals and fibres often lost in the processing and packaging of the food.
Chose unpolished over polished - The kernel found in unpolished and unprocessed food grains is a rich source of protein and fibre. Brown rice, oats, barley, unprocessed wheat or atta, and bulgur contain the nutrient-rich part of the staples that are otherwise discarded by all the processing.
Your body is your temple and it requires proper care and attention to what you put in it. Adopting these simple habits can ensure a healthy and balanced long life without the burden of diseases.
Cholesterol is a building block of animals. We have only one type of cholesterol, just as we have one type of water. Animals can walk, swim or fly because their cells have cholesterol. Plants have cellulose instead of cholesterol. It makes them immobile. Everything of every animal, including hair, nails, bone, blood, eggs, meat, skin, wing, milk, etc. always contains cholesterol; and everything obtained from plants is always ‘zero cholesterol’.
Most of our cholesterol is manufactured by our cells. We can get some from food. Our livers can easily excrete excess in bile. Food cholesterol does not raise the blood levels just as buying shirts does not lead to wearing two together.
Cholesterol does not dissolve in water, so it is called a lipid or fat. Triglyceride is another important lipid. Oil, ghee and meat-fat are mostly triglycerides. Body uses them as fuel. Triglycerides from food enter blood directly as chylomicrons. Other foods go first to liver, and are converted to triglycerides for circulation.
Since lipids are insoluble in blood, they are transported with proteins as ‘lipo-proteins’. We have LDL, HDL, and chylomicrons. All lipoproteins contain a mixture of various proteins, fats, and other insoluble substances.
LDL and HDL are made in the liver. Fresh LDL and HDL keep entering the blood, and old lipoproteins are continuously removed. Lipoproteins trap all insoluble dirt, including broken cells and bacterial toxins, and keep our blood vessels clean and healthy. LDL and HDL work together, like mop and bucket. The liver has Kuppfer cells for safely disposing of the toxins they collect and bring.
Our blood has more toxins during illnesses, and more lipoproteins get consumed; blood levels, therefore, drop in every illness. High levels, therefore, predict good health and longer lifespan, but there are exceptions to this rule. Sometimes, there is accumulation of old toxin-filled lipoproteins in blood. Egs: In familial hypercholesterolemia clearance of old LDL by liver is slow. Similarly, alcohol slows removal of HDL; torcetrapib prevents HDL-LDL cooperation. In such situations, high levels of LDL or HDL increase blockages.
Statin medicines help by clearing old LDL from blood, but most lipid medicines just change the blood report without improving health.
Cholesterol and Blockages
Food cholesterol has virtually nothing to do with blockages. Blockages occur because of modern lifestyle. Unlike pre-modern hunter-gatherers who fed on forest foods, we eat a high glucose agricultural diet. Thankfully, our liver does not allow too much glucose into the blood, otherwise, our blood glucose would shoot up to over one thousand after every meal! The liver converts sugars into triglycerides and circulates them as VLDL.
Modern diets keep the liver busy manufacturing triglycerides from glucose; this predisposes us to diabetes and fatty liver. Fasting triglycerides should be less than 150. Higher values suggest that the diet contains too much glucose or alcohol.
Glucose damages artery endothelium, and also changes our LDL to small dense LDL. The cholesterol inside blockages comes from harmful, small dense LDL.
Lipid Profiles ‘tests’ are quite popular, but not very helpful. Lipid Profiles have poor predictive value.
The lipids we measure are mostly from liver, not food. Cholesterol, triglycerides and HDL are measured. All the other numbers are usually arithmetic. E.g.: VLDL is triglycerides divided by 5. Additional measurements like apo A, B, Lp(a) etc. do not help much.
Cholesterol levels below 300 are normal. Levels persistently above 300 (or LDL levels above 220) suggest familial hypercholesterolemia. Much lower levels of cholesterol and LDL are presently advocated. The dangerous cholesterol levels have been changed from 350 to 270, 250, 220, 200, 170, 150 etc.; and safe level of LDL is being continuously reduced. These recommendations are motivated. In 1945, a heart disease scare was started in the USA. Large research programs were rolled out to ‘find the cause’ of the ‘number 1 killer’, and they promoted the cholesterol theory the whole world now believes.
High Triglycerides and low HDL is called atherogenic dyslipidemia (blockage causing lipid abnormality). Focus on these for protecting health. They usually stay perfect with a diet low in sugar, starch and alcohol.
Cholesterol is present in animal bodies for the same reason that wood is present in plants. LDL and HDL are two types of blood cleaning lipoproteins; they are not two types of cholesterol. Both these are good and essential for health. High triglycerides and low HDL are the commonest abnormalities in people prone to heart attacks. These improve with low glucose/fructose diet or exercise. Cholesterol found in blockages is not food cholesterol, it is small dense LDL. Blockages are caused by glucose-rich diets.
Diabetes is a state of persistent high blood sugar either due to lack of the hormone called insulin or resistance to the action of insulin even if it is somewhat adequate. Few basic points for the readers before we delve into how the medicines act in controlling blood sugar.
1. Type 1 Diabetes occurs in children or adults aged less than 30 years. It is due to the complete destruction of the insulin-producing cells of the pancreas. (these patients will need external insulin for survival as there is NO insulin in the body)
2. Type 2 Diabetes occurs in adults usually over the age of 30 years and it appears after 80% of the insulin-producing cells of the pancreas are destroyed. (Since there is some amount of insulin in the body, these patients respond to medicines)
3. Insulin helps the glucose in the blood to be pushed inside the cells of different organs especially liver and muscles and thus decrease the blood glucose levels.
4. Type 2 Diabetes patients often suffer insulin resistance, which means, whatever insulin they have in them, is unable to perform to its best due to obesity , extra fats in the tissues and other hormonal dysregulation. Drugs that help to overcome insulin resistance can help in the control of blood sugar without external insulin.
Now let's discuss the medications in brief.
6. Glifosins : (empraglifosin/ dapaglifosin/ empaglifosin)-
This is just a summary of the oral medications available for the management of Type 2 Diabetes Mellitus. Few points for the readers.
1. Usually, treatment is started with metformin and the dose is gradually increased up to the maximum dose or up to the level of tolerance.
2. The next medicine that is added in case the blood sugar is just out of the range is Pioglitazone, however, in case the blood sugar is significantly high, doctors prefer to add the Sulfonylureas (Glimiperide /Glicazide, etc).
3. Ideal treatment should address insulin resistance first and then target insulin release.
4. Gliptins are the third line drugs or can be used just after metformin is maximized depending on the patients' profile and doctors evaluation.
6. Caution regarding Hypoglycemia should always be observed when a patient is on the Sulfonylurea group of medications. Keep 2 to 3 packs of sugar along with.
7. Use of gliosis is often restricted due to its cost else, it is a fantastic medicine to lose weight.
Govt bans 344 drugs, including phensedyl, corex
Sr. No. Product name (irrational fdc)
1 aceclofenac + paracetamol + rabeprazole
2 nimesulide + diclofenac
3 nimesulide + cetirizine + caffeine
4 nimesulide + tizanidine
5 paracetamol + cetirizine + caffeine
6 diclofenac + tramadol + chlorzoxazone
7 dicyclomine + paracetamol + domperidone
8 nimesulide + paracetamol
9 paracetamol + phenylephrine + caffeine
10 diclofenac+ tramadol + paracetamol
11 diclofenac + paracetamol + chlorzoxazone + famotidine
12 naproxen + paracetamol
13 nimesulide + serratiopeptidase
14 paracetamol + diclofenac + famotidine
15 nimesulide + pifofenone + fenpiverinium + benzyl alcohol
16 omeprazole + paracetamol + diclofenac
17 nimesulide + paracetamol injection
18 tamsulosin + diclofenac
19 paracetamol + phenylephrine + chlorpheniramine + dextromethorphan + caffeine
20 diclofenac + zinc carnosine
21 diclofenac + paracetamol + chlorpheniramine maleate + magnesium trisillicate
22 paracetamol + pseudoephedrine + cetrizine
23 phenylbutazone + sodium salicylate
24 lornoxicam + paracetamol + trypsin
25 paracetamol + mefenamic acid + ranitidine + dicylomine
26 nimesulide + dicyclomine
27 heparin + diclofenac
28 glucosamine + methyl sulfonyl methane + vitamini d3 + maganese + boron + copper + zinc
29 paracetamol + tapentadol
30 tranexamic acid + proanthocyanidin
31 benzoxonium chloride + lidocaine
32 lornoxicam + paracetamol + tramadol
33 lornoxicam + paracetamol + serratiopeptidase
34 diclofenac + paracetamol + magnesium trisilicate
35 paracetamol + domperidone + caffeine
36 ammonium chloride + sodium citrate + chlorpheniramine maleate + menthol
37 paracetamol + prochlorperazine maleate
38 serratiopeptidase (enteric coated 20000 units) + diclofenac potassium & 2 tablets of doxycycline
39 nimesulide + paracetamol suspension
40 aceclofenac + paracetamol + famotidine
41 aceclofenac + zinc carnosine
42 paracetamol + disodium hydrogen citrate + caffeine
43 paracetamol + dl methionine
44 disodium hydrogen citrate + paracetamol
45 paracetamol + caffeine + codeine
46 aceclofenac (sr) + paracetamol
47 diclofenac + paracetamol injection
48 azithromycin + cefixime
49 amoxicillin + dicloxacillin
50 amoxicillin 250 mg + potassium clavulanate diluted 62.5 mg
51 azithromycin + levofloxacin
52 cefixime + linezolid
53 amoxicillin + cefixime + potassium clavulanic acid
54 ofloxacin + nitazoxanide
55 cefpodoxime proxetil + levofloxacin
56 azithromycin, secnidazole and fluconazole kit
57 levofloxacin + ornidazole + alpha tocopherol acetate
58 nimorazole + ofloxacin
59 azithromycin + ofloxacin
60 amoxycillin + tinidazole
61 doxycycline + serratiopeptidase
62 cefixime + levofloxacin
63 ofloxacin + metronidazole + zinc acetate
64 diphenoxylate + atropine + furazolidonee
65 fluconazole tablet, azithromycin tablet and ornidazole tablets
66 ciprofloxacin + phenazopyridine
67 amoxycillin + dicloxacillin + serratiopeptidase
68 azithromycin + cefpodoxime
69 lignocaine + clotrimazole + ofloxacin + beclomethasone
70 cefuroxime + linezolid
71 ofloxacin + ornidazole + zinc bisglycinate
72 metronidazole + norfloxacin
73 amoxicillin + bromhexine
74 ciprofloxacin + fluticasone + clotrimazole + neomycin is
75 metronidazole + tetracycline
76 cephalexin + neomycin + prednisolone
77 azithromycin + ambroxol
78 cilnidipine + metoprolol succinate + metoprolol tartrate
79 l-arginine + sildenafil
80 atorvastatin + vitamin d3 + folic acid + vitamin b12 + pyridoxine
81 metformin + atorvastatin
82 clindamycin + telmisartan
83 olmesartan + hydrochlorothiazide + chlorthalidone
84 l-5-methyltetrahydrofolate calcium + escitalopram
85 pholcodine + promethazine
86 paracetamol + promethazine
87 betahistine + ginkgo biloba extract + vinpocetine + piracetam
88 cetirizine + diethyl carbamazine
89 doxylamine + pyridoxine + mefenamic acid + paracetamol
90 drotaverine + clidinium + chlordiazepoxide
91 imipramine + diazepam
92 flupentixol + escitalopram
93 paracetamol + prochloperazine
94 gabapentin + mecobalamin + pyridoxine + thiamine
95 imipramine + chlordiazepoxide + trifluoperazine + trihexyphenidyl
96 chlorpromazine + trihexyphenidyl
97 ursodeoxycholic acid + silymarin
98 metformin 1000/1000/500/500mg + pioglitazone 7.5/7.5/7.5/7.5mg + glimepiride
99 gliclazide 80 mg + metformin 325 mg
100 voglibose+ metformin + chromium picolinate
101 pioglitazone 7.5/7.5mg + metformin 500/1000mg
102 glimepiride 1mg/2mg/3mg + pioglitazone 15mg/15mg/15mg + metformin 1000mg/1000mg/1000mg
103 glimepiride 1mg/2mg+ pioglitazone 15mg/15mg + metformin 850mg/850mg
104 metformin 850mg + pioglitazone 7.5 mg + glimepiride 2mg
105 metformin 850mg + pioglitazone 7.5 mg + glimepiride 1mg
106 metformin 500mg/500mg+gliclazide sr 30mg/60mg + pioglitazone 7.5mg/7.5mg
107 voglibose + pioglitazone + metformin
108 metformin + bromocriptine
109 metformin + glimepiride + methylcobalamin
110 pioglitazone 30 mg + metformin 500 mg
111 glimepiride + pioglitazone + metformin
112 glipizide 2.5mg + metformin 400 mg
113 pioglitazone 15mg + metformin 850 mg
114 metformin er + gliclazide Mr. + voglibose
115 chromium polynicotinate + metformin
116 metformin + gliclazide + piogllitazone + chromium polynicotinate
117 metformin + gliclazide + chromium polynicotinate
118 glibenclamide + metformin (sr)+ pioglitazone
119 metformin (sustainded release) 500mg + pioglitazone 15 mg + glimepiride 3mg
120 metformin (sr) 500mg + pioglitazone 5mg
121 chloramphenicol + beclomethasone + clomitrimazole + lignocaine
122 of clotrimazole + ofloxaxin + lignocaine + glycerine and propylene glycol
123 chloramphennicol + lignocaine + betamethasone + clotrimazole + ofloxacin + antipyrine
124 ofloxacin + clotrimazole + betamethasone + lignocaine
125 gentamicin sulphate + clotrimazole + betamethasone + lignocaine
126 clotrimazole + beclomethasone + ofloxacin + lignocaine
127 becloemthasone + clotrimazole + chloramphenicol + gentamycin + lignocaine ear
128 flunarizine + paracetamole + domperidone
129 rabeprazole + zinc carnosine
130 magaldrate + famotidine + simethicone
131 cyproheptadine + thiamine
132 magaldrate + ranitidine + pancreatin + domperidone
133 ranitidine + magaldrate + simethicone
134 magaldrate + papain + fungul diastase + simethicone
135 rabeprazole + zinc + domperidone
136 famotidine + oxytacaine + magaldrate
137 ranitidine + domperidone + simethicone
138 alginic acid + sodium bicarbonate + dried aluminium hydroxide + magnesium hydroxide
139 clidinium + paracetamol + dicyclomine + activated dimethicone
140 furazolidone + metronidazole + loperamide
141 rabeprazole + diclofenac + paracetamol
142 ranitidine + magaldrate
143 norfloxacin+ metronidazole + zinc acetate
144 zinc carnosine + oxetacaine
145 oxetacaine + magaldrate + famotidine
146 pantoprazole (as enteric coated tablet) + zinc carnosine (as film coated tablets)
147 zinc carnosine + magnesium hydroxide + dried aluminium hydroxide + simethicone
148 zinc carnosine + sucralfate
149 mebeverine & inner hpmc capsule (streptococcus faecalis + clostridium butyricum + bacillus
Mesentricus + lactic acid bacillus)
150 clindamycin + clotrimazole + lactic acid bacillus
151 sildenafil + estradiol valerate
Avoid this combinations and be safe.