I have tried to make my own little mark in this world. My career as a Medical Educator and Clinician in Gastroenterology (see www.gastroindia.net) and my flirtations with Health Promotion, especially amongst school children (see www.hope.org.in) are shown elsewhere.This blog contains my attempts at creative writing, most being write-ups for Health Adda column of HT City of Hindustan Times (also see www.healthaddaindia.blogspot.com) as well as a few others, and some reflections and thoughts that have struck me from time to time on my life journey.Please leave your footprint on this blog with your comment.


Saturday, January 25, 2014

Wheat Woes and Worries

Wheat, the staple diet of over half the world’s population, could paradoxically be the cause of several of our vexing health problems. A recent study in the journal ‘Nutrients’ points out that proteins in this cereal could be triggering a wide a range of disorders from autistic behaviour in children to liver cirrhosis in adults.

Wheat does not seem to go down well in 5% of its consumers. In its most well recognized form called Celiac Disease, one of its proteins called gluten evokes an immune reaction from the small intestines, typically causing diarrhoea, malabsorption and growth failure in children. Funnily, despite having literally grown up on chappatis all through childhood, Celiac Disease often appears suddenly in adulthood with loose motions, weight loss, weakness, anaemia and fatigue.

Celiac Disease can also masquerade and present in atypical forms such as delayed puberty, weak bones, deficient dental enamel, neuritis, diabetes, itchy skin rash or an abnormal body movement called ataxia. A simple blood test called IgA TTG often leads to the correct diagnosis.

Wheat Allergy (WA) is another form. Many people who complain of gas, bloating, abdominal cramps, urticarial and itching often overlook the all-too-familiar wheat as being the culprit. In fact, food allergy testing, which has come into vogue these days, throws up wheat as one of the commonest allergens.  The IgA TTG is negative in this condition.

A third form of wheat sensitivity that has recently arrived on stage is called Non Celiac Gluten Sensitivity or NCGS, and seems in fact to be the commonest form. The symptoms are usually those of flatulence, abnormal bowel movement and gas and characteristically respond when one goes on a gluten free diet (GFD). In fact 30 % of patients with Irritable Bowel Syndrome, who have often been told that “it is all in the mind”, seem to get an impressive relief of symptoms by shunning wheat.

The effect of wheaton the mind is emerging as a hot topic for research. Few recent studies have linked NCGS with autistic behaviour in children. Autism Spectrum Disorders (ASD) are one of the fastest growing developmental disabilities in which children below 3 years of age demonstrate a range of stereotyped repetitive behaviour, hyperactivity, aggression, anxiety and depression, and often show impaired language and social skills.

What has come up as a surprise is that many of these children improve remarkably as soon as they are taken off wheat! While scientists are still grappling to elucidate the reason, it appears that wheat proteins make the intestines ‘leaky’, allowing large quantities of natural peptides to enter the circulation and then find their way to the brain. In an extended observation on the effect of wheat and our brain, some patients of schizophrenia got better when the cereal was eliminated from their diets.


These fascinating studies are pushing us to re-explore the pivotal role that our diets may be playing in not just shaping our bodies but in nurturing our brains and emotions as well. 

As published in HT City ( Hindustan Times) dated 26th January, 2014.

Saturday, January 18, 2014

Winter Blues

Winter is a season when many find themselves not quite at their best: low on energy and gloomy in mood, resonating with the chill and fog outside the window.

Seasonal depression, or seasonal affective disorder (SAD) as it is now called by mind-scientists, is indeed rather common affecting one of ten people. It often gets passed off as laziness or excess sensitivity to cold, but can also manifest as social withdrawal, oversleeping, appetite changes and weight gain. Many get unduly sluggish during these times. It affects women more often, plunging many into depression.

The insidious entry of winter, with temperatures dropping, days getting shorter and the feeble sun peeping occasionally between fog and cloud, makes it difficult for many of us to notice the link between the weather and our mood. If however we think back on what we did at these times over the last few years, a recognizable pattern often begins to emerge. Patients are often able to link their feelings to this particular time of the year, perhaps around their husband’s birthday or Christmas or MakarSankranti.

Researchers believe that the root of SAD may lie in the conflict of our body clock with the altered day-night cycle that artificial light causes. Many animals hibernate in winters passing several months in a deep sleep, and waking up and being active during summers. Perhaps a similar tendency occurs in higher forms of life as well. But our penchant to defy the natural light-darkness cycle that matches our awake-sleep body clock by the use of artificial light that keeps us up at nights might be playing havoc.

Winter depression can sometimes be severe with feelings of hopelessness and negativity impact professional work output, relationships or life quality, necessitating a visit to your doctor.
There are few simple ways that you can adopt to push back your blues and energize yourself.
Going out on a sunny day and getting as much sunshine as possible is a first simple measure.Don't let colder weather chase you inside; it's what jackets and mittens were made for. Go outdoor (not to a mall! the botanical garden or the zoo are more appropriate places) take a walk around the block, eat lunch at the park or simply sit on a bench and relax.

Staying active is the key. Many notice a definite decrease in their energy levels every December when the days start getting shorter. Pulling yourself out from the bed or the sofa, and take a regular brisk walk or play a game of shuttle to invigorate yourself.

Light therapy also seems to help. Throw open the curtains to let the sunshine stream in as soon as you wake up. Radiation heaters could be more helpful than blowers, as they provide light in addition. Use indoor lights if necessary, but remember not to overuse them into late nights and disrupt your circadian rhythm.

Lastly, keep telling yourself ‘ If winter is here, can spring be far away’.

As published in HT City ( Hindustan Times) dated 19th January, 2014.

Sunday, January 5, 2014

Alcohol’s Lakshman Rekha

Alcohol, once tabooed in Indian society, has gained wide social acceptance today. Parties are no longer always as ‘dry’ as to keep the conversation hovering for hours around the weather, the boss, children’s school or politics. A couple of drinks make guests mingle better, voice their honest opinions about Katrina’s lips or Shakira’s hips, crack jokes and even sing a soulful gazal! Ladies have also started prefering spirits to Sprite as they join their men in the ‘wet’ soiree with equal gusto.

Exposure to alcohol is not really recent; humans and their forefathers (apes) have tasted alcohol through the ages while munching or sucking over-ripe fruits, most of which have fermented cores. The difference is in the concentration; it is a meagre 1-3% in naturally fermented foods as the yeasts die when the alcohol levels rise. And these low levels can’t make one tipsy!  It is through the process of “distillation”, discovered by man a few centuries ago,  that alcohol can be concentrated and beverages such as beer (4-7%), wines (7-15%), and spirits (brandy, whisky, gin, rum, vodka, 35-45%) produced, depending on the source of the substrate.
The line dividing harmless social drinking and “alcoholism” is often so fuzzy that a fun loving party-goer does not often realize when he is trespassing the Lakshman-rekha. A familiar story is how he could stay off drinks during the Navratri days or the holy month till a few years ago, but can’t any more.The CAGE Questionnaire, with 4 simple questions, could help let you know if your drinking is getting dangerous.
  1. Have you ever felt you need to Cut down on your drinking?
  2. Have criticisms by family, friends, colleagues or neighbours over your drinking ever Annoyed you?
  3.  Have you ever felt a sense of Guilt about your drinking?
  4.  Have you ever needed alcohol in the morning as an Eye opener? 

A “yes” to any of them indicates that you are in the trouble zone, and need urgent help from family, well wishers and experts. Other indicators of alcohol dependence are drinking alone, starting to drink in the morning or afternoon, inability to get sleep, trembling of hands or restlessness if a drink is missed or denied.

Kicking the habit is, by no means, easy and often requires both desire and will. A change of place, setting and circle of friends can help break away from the entrapping vicious cycle. It is often helpful to meet an ex-alcoholic and have him share how he conquered the problem. Many cities have groups called Alcoholic Anonymous, a group of ex-drinkers who provide this kind of support to those wanting to quit alcohol. A specialist can make the process smooth and ensure that the withdrawal symptoms are not too painful.


It is pity that an occasional pleasure often turns a trap ruining careers, families, health and life. It is time to wake up and take the call.

As published in HT City ( Hindustan Times) dated 5th January, 2014.