The summary of book "Own Your Body” by Dr S.K. Sarin is prepared in the memory to my loving wife Shaminder Kaur who died at tender age of 48 years, suffering from Hepatitis C induced Liver Cirrhosis, due to complications arisen after Liver Transplant. Her last wish was to spread awareness about the liver diseases to everyone who is suffering from this and help them in best possible manner so that they could fight bravely.
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It will be incomplete without the
mention of S. Amrinder Singh, Sunaina Madam (who daily prayed for her), S.Gurmeet Singh along with his spouse Pal Didi and their Children Jashan and Inderjot. Special thanks of Shri Atul
Parmar, and Fagun, Shri Rajeev Mahajan, and his wife Namita, Mr. and Mrs. D.K.
Tripathy during those difficult times. I must appreciate the courage and
calmness shown by my daughter Gulsanjan Kaur and Son Palkeerat Singh, who stood
like a rock during the tragic incident.
My sister Gurmeet Kaur and Brother Manjit Singh along with his spouse for putting in untiring efforts for arranging everything during those difficult days. I am also thankful to the support of relatives S. Gurpreet Singh, S. Surinder Singh along with their spouses, her army of friends and unknown people who supported me during those difficult times. I must mention support of many college friends Shri Nand Kishore Ratnoo, Shri Manoj Songara, Shri Neeraj Gupta and many more who kept supporting me during those difficult periods.
This book summary is
equally dedicated to her following army(Term coined by Rachna Madam of Parth Public School Gharounda) of friends.
(i) Army of class Xth
(ii) Army of Class XIIth
(iii) Army of Khalsa College Women Ludhiana
(iv) Army of Akal Academy Mander, Punjab
(v) Army of Parth Public School, Gharounda,
Haryana
(vI) Army of IOCL Friends.
This summary is not
complete without mentioning the Eminent Hepatologist and Author of the book Dr
S.K. Sarin who is warehouse of knowledge on Liver and associated organs. I
interacted with him during treatment of my wife, an excellent human being and
wonderful person. This is just a summary of the book, for complete details
kindly refer to the book.
If
you find summary lengthy, read Critical Parameters and Values, Exercise, Life
saving tips, Easy checks and Drugs causing liver Injury.
|
S. No |
Parameter |
Unit |
Normal Value |
Used for |
Test to be Carried out |
|
01 |
Liver
Stiffness |
KPa |
<
6 |
Measures
stiffness in Liver |
Fibro
scan |
|
02 |
ALT |
IU/L |
5-40 |
Measures
amount of Enzyme in Liver |
Blood
test |
|
03 |
AST(SGOT) |
IU/L |
<40 |
Released
in case of Injuries in Liver |
Blood
test |
|
04 |
GGT |
IU/L |
<30 |
Indicative
of Liver Injuries |
Blood
test |
1.Information:- Information
above various medical terms, procedures and critical things pertaining to liver
as well as other body organs.
2.Exercise :-How important
is the exercise for liver patients, healthy life and various terms/tests
associated with exercise
3. Risk: - Risk involved
with various metabolic conditions of the body and measured values of it
wherever available in the book.
4. Study: - Synopsis of
various studies carried all over world pertaining to liver and other medical
conditions.
5.Parameters: - Critical
values of some important parameters pertaining to health.
6.Facts :- Some facts
gathered by the Author pertaining to liver and other medical conditions
7.Life saving tips: -
Summary of Life saving tips curated by the author.
8.Easy Checks: - Some easy checks suggested by doctor in the book for early diagnosis of liver disease.
9.Drugs causing damage to Liver
Information: -
●
Albumin is a
protein synthesized by the liver. Low levels indicate reduced amount of liver
cells or weak liver. Albumin levels in the blood crudely correlate with the
amount of liver-cell mass. Normal range of Albumin levels in
the blood is 3.4–5.4 grams per deciliter p38
●
Auto-immune injury:
-
o It
is generally caused by antibiotic drugs that we normally take on day to day
daily basis.
o By-products of these drugs bind to
some body cells. These altered body cells are considered as foreign by own body
defense cells. Due to above, body defense cells attack these altered body cells
and kill them.
●
Children with
genetic history of diseases needs to be cautious about their health.
●
A donor can
donate up to 60-65 percent of his/her liver safely. The remaining liver grows
back to almost its original size in eight to twelve weeks.
●
In nearly, half
of the patients with cancer due to fatty liver, the tumour develops with
cirrhosis.
●
Fatty liver can
remain silent for long time without any symptoms.
●
The velvety lines
on neck and small polyp like skin tags are indicators of metabolic ill health
and genetic traits. These lines are known as Acanthosis Nigricans, are
manifestation of metabolic syndrome comprising of Obesity, Impaired glucose
tolerance, hypertension, high serum triglyceride and Low high-density
lipoprotein. Susceptible for development of diabetes and cancer. It is an
indicator for Liver disease.
●
Fatty liver index
is calculated on basis of four variables: Waist circumference, body mass index,
serum triglycerides and liver enzyme, gamma-glutamyl transferase. The score ranges from 0 to 100. Anything above
60 indicates the presence of liver diseaease.
●
People with
hypertension, even if lean, should get themselves tested for liver and
metabolic health.
●
Red wine has
flavonoids and antioxidants that reduce inflammation in the body. It can
increase some protective proteins and reduce the risk of blood clotting.
●
Alcohol has been
classified as class 1 carcinogen for liver by international agency for research
on cancer.
●
Alcohol is known
to be direct toxin for pancreatic cells and damages the organ over time. The
capacity to produce insulin from the pancreas can gradually decrease in regular alcohol drinkers, predisposing them to the risk of
developing diabetes.
●
Operation of
patient with underlying liver disease carried additional risks as anesthesia
and surgery can out extra load on the liver.
●
The level of
serum albumin (the most abundant
protein of the body produced by the liver) and prothrombin time ( a
blood clotting indicator) reflect the capacity of the liver to synthesize
proteins.
●
GGT Enzyme is an
important antioxidant in the body and breaks down and recycles the glutathione,
the proteins that detoxify harmful products in the body. Elevated blood levels
of GGT indicate high glutathione use and a state of oxidative stress in the body.
High GGT also reveals regular alcohol consumption.
●
The molecules
called cytokines, takes the message of the injured pancreas far and wide to
other organs and slowly affect the functioning of the lungs and the kidneys.
●
Bile produced by
the liver is a vital body secretion which helps in the digestion and absorption
of fats. The body removes nearly 500 milligrams of cholesterol every day
through the bile. Bile acid keeps the cholesterol in a soluble liquid form. The
liver secrets about half a litre of bile a day. If bile acids are low in volume
or cholesterol is high in bile (as in a fatty liver
patient or after fatty diets or in some cases of genetic traits), then the
cholesterol precipitates, which could lead to the formation of stones.
●
Gallbladder removal: - After removal of gall bladder, within days the body
adjusts to working without a gallbladder and bile flow and circulation through
the gut readjusted without any harmful side effects. In absence of the
gallbladder, the bile is directly released into the intestine. The intestine
takes over sump pumping functions of the gallbladder, and the
Bile starts recycle fast between the
liver and intestines.
●
Snoring could be
a warning for metabolic ill health.
●
Reduction of size
of stomach: - Balloon is placed in the stomach
and filled with about 600ml of saline. It is then left in the stomach for few
months. The gastric balloon is a flexible, small device made of silicon, which
is placed in the stomach under endoscopic vision. It remains stationed in the
upper part of the stomach. Since the space in the stomach is now occupied by
the inflated balloon, the space for the food gets reduced. With this the person
feels full most of the time.
●
Bariatric
surgery: - A Part of the stomach is stapled or an adjustable band is placed
around it to reduce the capacity.
●
There is a strong
association between liver fibrosis and sleep apnea (Snoring while sleeping).
●
High GGT level
reflects increasing breakdown of bad fat and low-density lipoprotein and release of injurious metabolites in
blood. A liver dysfunction due to a fatty liver can contribute to thrombosis of
the vessels by producing blood clotting and inflammation related proteins.
●
A liver
dysfunction due to a fatty liver can contribute to thrombosis of the vessels by
producing blood clotting and inflammation related proteins.
●
Every extra
kilogram added to your weight decreases your age by a year.
●
GERD :-
Gastroesophageal reflux disease is
mainly lifestyle dependent.
●
Genes and Acid Reflux: - At least one gene, ABAT was identified by Swedish scientists that makes one susceptible to developing reflux disease.
●
Frequent bouts of
diarrhea are common in the obese people.
●
The Janampatri
could be supplemted if not replaced by ‘Gene Patri’ or ‘Genome Patri’.
●
Average longevity
of the cyclists was 175 times higher than that of the general population.
●
Genes: - The presence of one mutation in FTO
gene(rs9939609) can be associated with obesity, weigh three kilograms more and
are 1.7 times more likely to be obese compared with those who have a lower risk
level.
●
Green and colored
fruits and vegetables provide a plenty of anti-oxidants.
●
Corn syrup in
soft drinks has 55 percent fructose, 41 percent glucose and 4 percent complex
carbohydrates. Colas, Tonic waters and sodas often carry high fructose.
●
Fructose and
Liver fat: - Even with norm caloric diet, 3g/kg fructose per day can
increase the liver fate content and serum triglyceride levels. Compared to
glucose, fructose intake increases liver fat synthesis and reduces its
clearance. The result is more fat in the liver and high triglycerides in the
blood. Fructose changes the composition of gut bacteria, favoring the development of fatty liver.
●
Fructose is the dominant ingredient of sugary beverages. If these beverages are ingested for
six months, the liver fat increases. Its long-term intake reduces the production of Adenosine triphosphate
(ATP), the energy currency in the liver as well as the energy expenditure.
●
As per WHO Guideline, the free sugar intake should not be more than 10 percent of
the total energy intake.
●
The level of uric
acid rises in the blood minutes after eating fructose rich food.
●
High salt diet
causes more fructose production and thereby high uric acid levels.
●
High fructose
related fatty liver can be prevented by taking Omega-3 fatty acids such as
those found in fish oils, walnut and Mediterranean diets.
●
Glycemic- Index
reflects the potential of a food item to raise blood sugar. Choose foods with
low GI.
●
Walnuts, pumpkin
seeds, chia seeds, soya oil, seaweeds, kidney beans etc. are good source of
Omega-3 fatty acids which reduce the liver fat and inflammation as measure by
ALT levels.
●
Habitual snoring
may be taken as a useful low-cost non-invasive predictor of fatty liver disease.
Exercise
:-
●
How much exercise?- Try to achieve
a heart rate of 50-70 percent of your maximum heart rate
●
Maximum heart
rate is subtracting your age from 220.
●
Try to achieve 60
percent of
maximum heart rate in moderate exercise which is low end target
●
Try to achieve 80
percent of
maximum heart rate in moderate exercise which is high end target
●
Try to maintain
this for at least 30 minutes to get optimal benefits.
●
For Healthy
people, moderate to vigorous physical training is required for thirty to forty
minutes every day, and at least six days a week.
●
Talk test: - It is a measure of level of Physical exercise. While
exercising
o If you can talk but not sing, you are at moderate
intensity
o If You are unable to speak beyond few words without a
pause, you are at a vigorous physical activity level.
●
Students must use
at least 20 percent of their school and college time to maintain good health
and to adopt a healthy lifestyle.
●
The main function
of bones is to support muscles and allow movement in space without a breakdown.
Exercises keep your bones young. Repeated and dynamic loads on the skeleton
during the exercise prevent age- associated bone decay.
●
Resistance
exercises have been shown to reduce high lipids and fat around the heart in
twelve weeks. These exercises also reduced HbAIc by 0.48 percent and BP by
about 6 mm Hg in patients with metabolic syndrome.
●
High intensity
interval training ( a minute warm up followed by five intervals of cycling at
high intensity, interspersed with a three minute recovery period and then a
three-minute cool down period) has been
shown to achieve 2 kilograms of loss of body fat, 2.8 percent of reduction of
hepatic lipids and a reduction of ALT levels to 10IU/L.
●
Add resistance
training to aerobics for maximum benefit.
●
Adding three
weekly aerobic and resistance training sessions to the dieting programme
delivers good results.
●
Resistance
training is used in management of type 2 diabetes, improvement in bone density
by 1 to 3 percent, help low back pain and arthritis and can even reverse
specific ageing factors in skeletal muscle.
●
Resistance
training guidelines from American college of sports Medicine
o Training exercises: - Perform 8 to 10
multijoint exercises that address the major muscle groups(Chest, Shoulders, back, abdomen, arms, hips, legs )
o Training frequency: - Train each
muscle groups two or three non-consecutive days per week
o Training sets: - Perform two to
four sets of resistance training for each major muscle group
o Training resistance and repetition: - Use a resistance that can be performed for 8 to 12
repetitions.
o Training technique: - Perform each
repetition in a controlled manner through a full range of motion. Exhale during
lifting actions and inhale during lowering actions.
●
Regular Exercise
can raise healthy HDL cholesterol levels, reduce triglyceride levels and
decrease the risk of heart disease.
Risk:-
●
Both Antibiotics
and pain killers can become toxic to the liver in case of some subjects and
more in case of unhealthy liver
●
Having fatty liver in a person increases the
risk of diabetes and cancer in people.
●
Diabetes in
adults is a form of liver disease.
●
High Calorie sweets, Oil rich food and Lack of
exercise lead to weight gain and contribute to fatty liver
●
If a person is
obese and drinks heavily, the risk of liver disease increases manyfold: - P47
●
Drinking alcohol
can lead to development of cirrhosis in half time as compared to normal person.
●
In obese
individuals, the relative risk of liver cancer is two to four-fold higher than
in individuals with normal weight.
●
The risk of liver
cancer increases about 1.5 times in smokers.
●
Breakdown product
of alcohol, acetaldehyde, increases the risk of cancer in the liver, oral
cavity, food pipe, stomach, pancreas, prostate and the female breast.
●
The risk of
having breast cancer is nearly two times in patients with fatty liver diseases.
●
Increase in BMI
and waist circumference are sure to increase the risk of gallstones in you and
your children.
●
The risk of developing
gallstones is sevenfold higher in subjects who are obese, have constipation and
raised liver enzymes and inflammation markers such as C-reactive protein.
●
A thick neck may
indicate a greater risk of high blood sugar and lipids.
●
In an analysis of
nine studies, the presence of fatty liver was associated with 2.3 times more risk of getting ischemic stroke even when there is no other risk factor like diabetes or high lipids.
●
A new tool often
used in west is to measure the difference in the noise produced by protons
bound to water or fat in the liver, called proton
density fat fraction.
●
Patients with
fatty liver showed a higher risk of developing dementia and nearly two times if
the person had any heart disease.
Study:-
●
Lean people do
have fatty liver disease as study conducted on Japanese people (25 % in1
258,531 people)
●
Patient with
fatty liver had about 2.2 times higher risk of developing diabetes than those
without fatty liver. Risk becomes 4.7 times with grade 3 fatty liver.
●
Weigh loss of
around 4 kg shows the significant reduction of liver enzymes.
●
ALT increases a
marker of liver inflammation increases 9 times more in obese people drinking alcohol.
●
The risk of
developing of cirrhosis was 4.73 times and that of liver cancer 3.51 times
higher in NAFLD as compared to non-NAFLD.
●
Diabetic people
born with three specific genes PNPLA3, SUGP1-TM6SR2 AND HSD17B13 have up to ten
times higher risk of development of cirrhosis with moderate drinking.
●
People who
consumed at least 16 gallons of alcohol per year and maintained a BMI of <23
kg/m2 over ten years still had a 1.8 times greater risk of diabetes.
●
Patients who have
got significant fatty liver disease have nearly 80 percent changes of having
stomach cancer and 60 percent more chance of gynecological cancers.
●
Subjects with a
fatty liver had a 64 percent higher risk of cardiovascular events.
●
Weight Loss,
Exercise and dietary modifications were able to reverse ALT Levels and fatty
liver diseases in children.
●
Mothers who had
high BMI and waist circumference are more likely to pass on some extra health
risks to their offspring's.
●
Breast feeding
for at least six months reduces the chance of fatty liver in the baby.
●
Globally, fatty
liver diseases is found in half the girls with PCOS compared with only 29
percent in those without PCOS. Women with PCOS may have more severe liver
diseases and get it 5 years earlier compared with their counterparts with PCOS.
●
Parents of young
children with gallstones had five times more gallstones than parents of young
children without gallstones.
●
In a French study
involving 2120 patients with sleep apnea, 75 percent patients had fatty liver
and 18 percent
had liver fibrosis.
●
As per one study
conducted Patients with a fatty liver had a 16 percent higher risk of
developing stroke than those without a fatty liver.
●
High GGT of the
liver could be associated with stroke.
●
The people who
gained 5 to 10 kilograms after the age of twenty were found to be many times more likely to develop heart disease, high BP, Type 2 diabetes and gallstones than those who
gained 2.5 kilograms or less.
●
Odds of getting
fatty liver were reduced by 7,11 and 26 percent with light. Moderate and vigorous physical activities respectively,
per ten minutes per day of exercise.
●
Acidity could be
due to metabolic ill health.
●
Misnomer: -Acidity is not due to
excessive acid production. In fact, acid is required
for break down the food one eats and is crucial for proper
digestion. It is an important ingredient of the gastric juices meant for
digesting food. Acid also kills organisms ingested with food. It also helps to
limit growth of bacteria in the stomach and prevents intestinal infections.
●
Acidity is when
the acid that should stay in the stomach goes up in food pipe.
●
Acid regurgitates
more often from the stomach into the food pipe in obese people. It is because
of the acid reflux from the stomach to the food pipe.
●
Persons who
reduced more than 3.5 units in BMI showed nearly a 36 percent
reduction in the acid reflux symptoms.
●
For patients with
existing fatty liver diseases or NASH (Nonalcoholic steatohepatitis), a weight
loss of 5 percent of body weight can reduce liver fat, 7 percent can help in
the resolution of NASH and 10 percent can even show a reduction or stabilization of liver scarring or fibrosis.
●
Air pollution and
Fatty liver diseases:
- Long term ambient air pollution is found to be
associated with fatty liver diseases. The effects are more pronounced in
smokers, obese subjects and those who drink moderate alcohol. The odds
increased with every 10mcg/m3 increase in PM1, PM2.5 or PM 10 co-exposure to phthalates and metals.
●
Exercise and
fatty liver: - 45 minutes of aerobic or resistance exercises help in
cleaning fate from the liver even if the overall weight loss is not much.
●
Six months of
exercise led to a reduction in BMI, cholesterol, triglyceride and ALT levels as well as reduced liver inflammation.
●
Ten-week resistance training may increase lean
weight by 1.4 kgs and resting metabolic rate by 7 percent with a reduction in
fat by 1.8 kilograms.
●
The duration of
soft drink consumption
had a positive correlation with the presence of NAFLD.
●
Patients with
fatty liver diseases have two to three times higher intake of fructose.
●
1 mg/dL rise in
uric acid increases the incidence of fatty liver by 3 percent.
● Subjects who slept for less than five hours had an increased risk of developing the disease (19 percent).
● Increased ALAN (Artificial light at night) and reduced Melatonin (Hormone which induces sleep) also increases the risk of several cancers in the body.
Parameter:-
●
Normal BP of the
liver is less than 5mm Hg.
●
If liver pressure
goes from 5 mm Hg to 12 mm Hg, the bypass channels, the veins in the food pipe
and the stomach, may give way resulting in blood vomit or black tarry stools.
●
Upper limit of
Normal BP is 120/80 mm Hg.
●
Albumin below 35
grams per liter in blood and prothrombin time increase by more than 5 seconds
above a healthy person, an indicator of liver’s capacity to clot blood are
considered indicators of compromised liver.
●
When a obese
subjects with hypothyroidism lose weight, their thyroid functions improve, even
leading to a reduction in the dose of thyroid supplements.
●
Any value of
liver stiffness of above 14 Kpa, suggests a fibrotic liver with a high
probability of cirrhosis.
●
Dexa scan is used
to measure the bone mineral density.
T-Score +1.0 to -1.0 is normal range. -T-score of -1 to -2.5 SD
indicates low bone mass. A T-score less than -2.5 indicates the presence of osteoporosis.
●
Genes play an
important role in obesity of a person. Persons who
carry FTO Gene are known to be on average 3 kilograms heavier and 70 percent
more likely to be obese.
●
Normal range of
serum testosterone in males is 270-1070 ng/dL, with an average level of 679
ng/dL. There is a strong association between obesity and Low testosterone
levels.
●
20 percent of
adults during their lives are likely to develop gallstones and 20 percent of
them will have symptoms.
●
In a study
conducted in Sweden, familial gallstones accounted for 36 percent of the all
the patients considered in study. Of these familial cases, about half had a
parental history. Increased activity of one ABCG5/8 plays major role in formation of gallstone.
Fact
:-
●
In 2020, about 38.8 percent of Indian males drank on average 5.4 liters of alcohol.
●
Siblings and offspring are especially vulnerable to the long-term ill effects of alcohol.
●
Sometimes the
effect of alcohol may be quick and severe, it may lead to an insulin shock in
diabetes.
●
Moderate drinking
is generally limited to one drink a for women of all ages and men older than 60.
●
Besides direct
injury, alcohol intake adds nearly 7calories per gram of alcohol imbibed whereas sugar gives only 4 calories per gram.
●
Chronic
irritation of an organ can lead to the development of cancers.
●
Fatty liver
disease reduced the life expectancy of a person by four years.
●
Fatty liver
diseases could indeed be a precursor to many metabolic events, including heart
attacks and strokes.
●
Heart of an obese
10-year-old child has worked as much as that of a lean forty-year-old man.
●
Dairy products such as milk, cheese and
yoghurt and green vegetables such as spinach, broccoli and tofu are good source
of calcium, Custard apple or sitaphal is a good source of calcium. About 500
grams of custard apple may give you about 250 milligrams of calcium.
●
Osteocalcin is a
protein hormone secreted by bones. It helps in changing body’s rest and digest
function into fight or flight functions during emergencies. This hormone also
helps in brain development.
●
250 ml Milk, a
cup of yoghurt, a cube and half of cheese (42.5 grams) can provide
approximately 300 milligrams of calcium.
●
A person sleeping
and eating late misguides the core brain clock regulated by daylight. This
disrupts the clocks of different body organs. This is harmful to the body.
●
By losing weight,
a mother can reverse a fatty liver and early liver Fibrosis. The
benefits will be passed down to her child.
●
Each one-point increase in BMI is associated with a 2 percent decrease
in testosterone levels.
●
Four-inch increase in waist size increases a
man’s odds of having a low testosterone level by 75 percent.
●
Generally, a
liver that produces bile with extra cholesterol or fat can initiate the
formation of stones in the liver. This is a common problem in people with fatty
liver.
●
Gallstone is
predominantly a disease of liver.
●
For a woman of 5 feet, ideal weight is 40 kilograms. One should add
2.25 kilogram for every additional inch.
●
Low-fat diet and
losing weight will help only in reducing gall bladder pain but also in reducing
the risk of heart disease.
●
90 percent of
gallstones are made of cholesterol. So do at least 30 minutes of moderate to severe endurance type exercises every day. By following it, the chance of development of gallstones can be
decrease by third.
●
For Every 05
kilograms extra weight per square meter, the body needs
50 kilopascals more before feeding full or satisfied.
- Know your Weight and BMI. Work to correct them.
- If you are overweight or obese, get your liver fat tested. Now
- Resolve not to take any medicine unless it is essential.
- If you are overweight or diabetic, or are born in a family with
metabolic disorders, avoid alcohol.
- I know you want to protect your children from alcoholism and liver
disease. Remember, you may transmit the alcohol addiction and liver
disease genes, along with the habits, to them. Give up drinking or at
least never drink before them and never in excess.
- Get your preventative health checkup done
on regular basis.
- Get your BP Measured. Remember the numbers and keep within healthy
limits.
- Get your blood lipids tested. If they are high, don’t ignore them.
Consult. High lipids are generally associated with fatty liver. Get your
liver fat and metabolic health record.
- Get your right genetic tests done. However, abstain or minimize
your drinking till these tests become more sound scientifically.
- If you are born into a family with diabetic parents, include in
vigorous physical activity and avoid drinking to prevent diabetes.
- Try to keep a family tree of illness to protect current and future
generations.
- If there is a history of any cancer in your family, get all the
members to undergo liver and metabolic health check-ups. If possible,
genetic testing for cancers.
- If you have hypothyroidism, get tests for liver and metabolic
health. Know your numbers, BMI, BP, LFT and Lipids.
- If you have hypothyroidism and are overweight, lose 10 percent of
your body weight and check the likelihood of reducing the thyroxine dose.
- Take stock of health of every family member on weekly basis.
- Get your bone strength checked. Get a Dexa scan done at your next
health checkup.
- Take the advice of your gynecologist and
physician seriously before planning a child. The health of parents
determines the health of the baby.
- If you are planning on having a healthy baby, try to reach your
ideal weight and maintain it for at least
for a year.
- If your young daughter
has excessive hair on her face and is unable to lose weight, do get her
tested for polycystic ovary syndrome and fatty liver. If detected, work to
mitigate the ill effects.
- If you have PCOS, face it and win over it. Aim to get trim and
charming by exercise and healthy diet.
- If your child or relative has voice issues or delayed development
of secondary sexual characteristics, do consult a specialist.
- Sit up and shed excess weight to regain fertility and manliness.
- If your children are obese, they have a high risk of developing
gallbladder sludge, stones and even pancreatitis. Get them tested.
- If you are suffering from obesity, diabetes or metabolic syndrome,
your children should be forewarned and made to understand the need to remain
lean. Protect them. Without causing
any panic, your children should join health check-ups and have low-fat and
low-calorie food.
- Take gallstones seriously. Their occurrence
portends metabolic diseases. All family members of patients with
gallstones should be screened for liver health.
- Reduce the capacity of your stomach by avoiding to pack it to
full. Also, try to consume low calorie food.
- Ask your spouse or your friend to measure your neck circumference
at the mid-point of the neck
with a simple measuring
tape. Get to safe limits.
- Look for the GGT Level in your last blood report, if it is high, then do get a
check-up.
- Get up, if you have ill health or inherited unhealthy genes, make a proper restructuring plan to restore
good health. Know your GGT Level.
- If you have trouble standing or walking, try using a half bicycle or ceiling ropes.
- Recall your weight in college or at the time of marriage. If you
were healthy then, remember to add more than 2 kilograms
extra weight in your life after twenty.
- If you have acid reflux, get your routine health checkup done for reversible actions
- If you want to get rid of acidity change your lifestyle. Anti-acidity drugs
can only help you for a short time. More than inheritance, it is the way
you live your life that will determine your health. Improve it.
- Teachers, parents and students do change the mindset. Make
measurable changes in our way of schooling, from advice
and nudge, may be mandates are needed for the good health of our children.
- Get your body fat content checked. Maintain body fat content lower than 20 percent if you’re a male and 28 percent if
you are female.
- Use stairs to remain healthy and fit and delay exit from life.
Develop a habit of parking your car 500-1000 meters away from your
workplace. It will give you mandatory walk.
- Learn about the fructose content of Carbohydrates that you take.
Choose the ones with low fructose content. Make these choices today.
- If you have high uric acid, get your liver and metabolic health checkup. Calculate your sugar intake and reduce
fructose intake. Try to keep uric acid normal through diet.
- Start practicing fasting in any form. Short spells of starvation
may rejuvenate you.
Easy checks: -
- Find a measuring tape and put it around your waist. Find your WH
Ratio, if its beyond the healthy limit, work to correct it. WH Ration more
than 0.9 in men and 0.8 in women is a good indicator of Central obesity
and Fatty liver
- Get up and see the front, sides and back of your neck in the
mirror. Look for skin tags, moles and black velvety lines and remember
them as well.
- Snoring could be a warning for metabolic ill health
- Neck circumference >35 centimeters for men and >31 cm for women reflects the presence of metabolic syndrome in Asia.
Common drugs which can cause liver injury: -
1
Amoxicillin- clavulanate
2.Isoniazid
3.
Nitrofurantoin
4.TMP-SMZ
5.Minocycline
6.Cefazolin
7.Azithromycin
8.Ciprofloxacin
9.Levofloxacin
10.Diclofenac
11.Phenytoin
12.Methyldopa
13.Azathioprine
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Thank You for the sharing the book. Much appreciated 🙏
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