HEART ATTACK & ANGINA

( By Dr. Natoobhai J.Shah & Dr. Sailesh N. Shah )

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d-Practical Methods Of Weight Reduction

At first, it is important to understand the following facts :



  1. When we eat and drink, we ultimately consume some proteins, carbohydrates, fats, minerals, vitamins and water.


  2. Fats, carbohydrates and proteins are calorigenic, which means that they are fuel or energy producing which is required for the healthy working of our body organs, but in only adequate amounts.


  3. Minerals, vitamins and water are NOT calorigenic.


  4. For the maintenance of balanced health, all the above mentioned six food components are essential. However, they are all necessary in certain proportions only. When food containing these in the proper amount is consumed, it is called a need " balanced diet ". For example, to maintain a healthy physique, an adult must consume about 40 to 70 grams of proteins daily. This, of course, would differ from constitution to constitution.


  5. When calorigenic foodstuffs (carbohydrates, fats and proteins ) are consumed in more than the desirable amount, extra quantity in the end stage is ultimately converted into fat that can be abnormally stored in the body. This has a harmful effect on the heart, blood vessels as well as other body systems.


  6. An average urban adult requires only 1,500 to 1,800 calories per day. Manual workers or labourers, who use their skeletal muscles more vigorously, would certainly need additional calories.


  7. Do not bother about counting your calories every day. Let your weighing machine do it for you. Weigh yourself twice a week at a fixed time before food. If your machine shows same weight, it means that you have been taking your normal requirement of calories. If it shows an increase, then you have certainly consumed more than that which is required by your system. Again, do not compare your intake of food with someone else’s . You are a different person. Continue optimum intake of proteins as they are required by your tissues for their daily growth and repair.


  8. Mental work do not require any extra calories.


  9. Vitamins do not stimulate the appetite nor do they make you gain weight. In order to bring about reduction of body weight, you have to further reduce your calories.

There are two principles involved in this :



  1. Actual reduction of body weight, and
  2. Maintenance of reduced body weight. Unless vigilance and self -control is observed

(B) is more difficult that (A).

(A) Actual reduction of body weight
Cutting down on calorigenic foodstuffs, particularly fats and carbohydrates, should be the main aim. More of vegetable and fruits and less of everything else. None of the so-called "nature clinics" or "body -beautiful boutiques " can help, unless strict dieting is observed. These "clinics" also prescribe some specific diet which is the main line of action. Ordinary exercise and massages would make you feel better and relaxed, but play only a small role in reducing your weight. Whether you like it or not, the crux is the diet. Your grandmother’s prescription for reducing weight by taking honey and water or lime-juice and water will not work as long as you consume calorigenic food. At times, certain tablets are prescribed for depressing the appetite. Unless self-control is exercised, these tablets will help you as long as you take them. Besides, most of the tablets have some side effects and may harm your system.

Table Of Measures And Calories Of Common Items Of Food:






















































































































































































































































1 OUNCE = 30 ml. or 30 gm. (approximately )
1 teaspoon = 5 ml. of liquid
1 cup = 180 ml. of liquid
1 glass = 240 ml. of liquid
1 tablespoon = 3 teaspoons
1 gm. of fat = 9 calories
1 gm. of protein = 4 calories
1 gm.of carbohydrates = 4 calories
1 average size chapati,prepared in the usual way with only a touch of ghee = 80 calories
100 ml. of cooked semi-watery dal or any other pulse = 100 to 110 calories
75 gm. of cooked rice, i.e. 3/4th of a cup (30 gm. dry weight) = 100 calories
1 precut slice of bread (weight 20 gm) = 50 calories
1 orange = 40 to 50 calories
1 average banana = 80 calories
1 mango = 100 calories
1 teaspoon of sugar = 20 calories
30 ml. of ‘toned’ milk = 20 calories
100 fm(dry weight) of all cereals and pulses (for example wheat, rice, bajra, tur dal, moong dal, chana dal) = 350 calories
30 gm. of mutton = 50 calories
30 gm. of fish = 35 calories
Aerated soft drinks = 80 to 100 calories
2 slices of bread = 100 calories
2 teaspoons of butter = 70 calories
1 cup cow’s milk = 100 calories
2 chapatis ( thin) = 120 calories
1/2 katori dry vegetables = 100 calories
2 puries = 100 calories
1 boiled egg = 75 calories
1 cup corn flakes = 100 calories
1 plain paratha = 250 calories
2 khakhras = 100 calories
2 idlies = 130 calories
1 katori sambar = 100 calories
1 omelette (1 egg) = 150 calories
1 katori undhiyo = 300 calories
1 katori rice = 100 calories
1/2 katori dal = 100 calories
2 pieces of fish = 100 calories
1 piece of roasted chicken = 200 calories
1 piece of masala "dosa" = 380 calories
3/4 katori palak mung dry vegetable = 200 calories
1 stuffed paratha ( mixed vegetable) = 280 calories
2 katoris of rice pulav = 400 calories
1 katori of custard = 140 calories
1 slice ice-cream = 250 calories
1 kulfi = 500 calories
1/2 katori srikhand = 200 calories
1 piece burfi (khoa) = 140 calories
1 piece gulab jamun = 100 calories
2 pieces jilebi = 200 calories
1 piece ladoo (bundi) = 200 calories
1 piece puranpoli = 230 calories
1 piece rasgulla = 140 calories
1 piece sandesh = 170 calories
1 small piece of sponge cake = 100 calories
1 piece Swiss roll = 90 calories
1 piece pastry = 250 to 400 calories
1 tablespoon (30 gms.)jam = 75 calories
30 gms. marmalade = 75 calories
6 pieces bhajiya (onions) = 150 calories
2 tablespoons of chivada roasted white chana dal = 300 calories
1 katori pohe = 170 calories
1 piece potata pattice = 200 calories
1 piece potato wada = 100 calories
1 piece vegetable cutlets = 140 calories
1/2 cup buffalo milk = 100 calories
2 cups skimmed milk = 100 calories
1/2 cup curds (buffalo’s milk) = 100 calories
1 cup curds (cow’s milk) = 100 calories
2 cups curds (skimmed milk) = 100 calories
1 cream cracker biscuit = 50 calories
4 Marie biscuits = 50 calories
2 ginger biscuits = 50 calories
1 Glaxo biscuit = 50 calories
1 glucose biscuit = 50 calories
2 Monaco biscuits = 50 calories
3 walnuts = 100 calories
25 groundnuts (with shells) = 100 calories
6 pieces cashew nuts = 100 calories
15 small badam = 100 calories
15 pista = 100 calories

You notice that as far as calories are concerned,rice, bajra, and wheat have the same amount. It is an inaccurate impression that rice is more fattening. No doubt, as compared to wheat, rice has somewhat more carbohydrates and less of proteins, but rice contains better quality proteins than wheat. In fact, for ideal nutrition, different combinations of cereals and pulses should be consumed. This makes up for the total quality value of proteins as different types of amino acids are available from multiple protein sources. Mixed items of cereals and pulses serve to provide better and balanced nutrition.

Normally, an adult with sedentary habits, would require the following for his daily menu :















Proteins 50 to 70 gm. = 200 to 280 calories
Fats 45 to 50 gm. = 405 to 450 calories
Carbohydrates 200 to 250 gm. = 800 to 1,000 calories
Total = 1,405 to 1,730 calories.

The diet should contain enough quantities of both vitamins and minerals, the main source of which is vegetables and fruits. All items of food contain varying proportions of proteins, fats, carbohydrates, vitamins, minerals and water. For example, butter, ghee, and oils are rich in fats, but poor in proteins and carbohydrates. Wheat and pulses have more proteins and carbohydrates. They are poor in fat content. Rice has relatively less proteins and more carbohydrates, but is also poor in fat. Green vegetables are rich in vitamins and minerals but poor or proteins, carbohydrates and fats, thus accounting for their low caloric value.

The approximate protein values of common foodstuffs are as under :



























30 ml. milk or curds = 1 gm. protein 30 gm. wheat
(an average chapati) 75 gm. cooked rice i.e. 3/4 of a cup = 3.5 gm. proteins
(30 gm. dry weight) = 2.5 gm. proteins
30 gm. egg white = 2.5 gm. proteins
100 ml. semi-watery tur dal (dry weight 30 gm.) = 6 gm. proteins
30 gm. meat = 5.5 gm. proteins
30 gm. fish = 6 gm. proteins
1 slice white bread (20 gm. of wheat flour, mainly prepared from maida) = 1.6 gm. proteins

As stated earlier, your daily diet should contain a combination of proteins derived from cereals and pulses of different varieties. After taking care of the proteins in the above manner, the rest of the calories can be derived by calculating the quantity of carbohydrates and fats present in various food-stuffs.

Methods
For the purpose of reducing body fat, one need not go into the above mathematics. You may only follow your weighing machine and your abdominal girth. Any method that shows a reduction in weight, and at the same time allows you to work with a sense of well-being, is the ideal method for you. Continue with it, and if you lose about one or a half kg. of weight in a week, it is an efficient method.



  1. Cut down on all items of food or drink that are consumed daily by about 25 to 50%. This means, for example, that instead of two chapatis, you should only consume one, and one glass of milk should be reduced to half a glass. The same ratio rule should be applied to dals, bread, biscuits and all other items of food. The only exception is vegetables and the next are fruits that are not very sweet. You may consume plenty of green vegetables prepared in the minimum of oil to appease your hunger. A little oil is permitted because it gives taste and a feeling of satisfaction. Non-vegetarian preparations are better taken as grilled or boiled as they already have natural oils in them. To fill up the stomach, clear soups and they can be consumed in large amounts. A cup of tea, prepared with one level teaspoon of sugar and 30 ml. of milk, goes a long way in curbing an uncontrolled appetite.


  2. In our experience, this method of cutting down on the quantum of cereals and pulses has been found to be more effective. The patient retains his right to have everything but in lesser quantities. The amount for a given person is to be decided ultimately by the weighing machine. Care should be taken to maintain the daily protein intake to about 40 to 50 gm. A mix of cereals and pulses can provide good biological value of proteins.


  3. Milk ( without cream ) and banana diet :


  4. This is also an effective diet method which gives a sense of fullness. While on this regime, the patient should not have anything else except this diet. Milk and bananas make up for all the required proteins and for most of the vitamins. The total amount of calories consumed daily gets automatically restricted because of the desire to have more of same food becomes limited.


  5. To skip one meal, particularly dinner :


  6. This is rather hard and would work if the quantum of remaining meals, that is breakfast and lunch is not increased.


  7. Non-cereal diet :
    Avoid cereals of all kinds, for example bread, chapati, rice, barja, etc. Other items can be taken, but without the vehicle of cereals in any form. This will indirectly limit the intake of other food stuffs. For example, only dals or only mutton with a vegetable cannot be consumed in large amounts, thus rationing the total daily calories.


  8. Non-salt diet :
    Apart from reducing the salt with its accompanying water in the body, this has the added advantage of making food unpalatable, thus making one resign to eating less. However, this regime is considered too difficult on a long term basis.


  9. To follow a standard low caloric diet chart Two specimens of diet charts are given below :

800 Calorie Vegetarian Diet


















Morning 1 cup of tea (no sugar)
Breakfast 1 cup of milk ( no sugar)
Lunch 1 chapati ( with a dash of ghee ). 4 tablespoons of semi-watery dal.
1/2 cup curds.
100 gm. vegetables with a dash of oil.
Afternoon 1 cup of tea ( no sugar)
Dinner 1 chapati ( with a dash of ghee). 4 tablespoons of semi-watery dal.
1/2 cup curds.
100 gm. vegetables with a dash of oil.

1000 Calorie Vegetarian and Non-vegetarian Diet























  VEGETARIAN NON-VEGETARIAN
Breakfast Tea without sugar
1 slice bread no butter.
Tea without sugar
1 slice bread, 1 egg on alternate days,boiled or poached.
Lunch 1 chapati or rice prepared from 2 level tablespoons (45 gm.), 8 tablespoons semi-watery dal cooked vegetables - any amount cooking fat, 1 teaspoon of oil, 90 gm. curds. 1 chapati or rice prepared from 2 level tablespoons (45 gm.), 30 gm. meat, cooking fat-nil.
4 P.M. 120 ml. toned milk without sugar. 120 ml. toned milk without sugar.
Dinner Chapati or rice,as at lunch. Dal as at lunch. cooked vegetables, cooking fat, one teaspoon of oil.90 gm. curds. 1 chapati or rice, 90 gm. meat,cooked vegetables, cooking fat - nil.

(B) Maintenance of reduced body weight

It is most important to recognize, that for the maintenance of reduced body weight, one must observe control and take just enough food so as to control the weight at a steady level. It has been our experience that if a patient observes two semi-fasting days ( for example every Tuesday and Saturday) in a week, it will not be difficult for him to maintain his desired weight.

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