APRIL 2016
Khaas Baat : A Publication for Indian Americans in Florida
Health & Wellness


Dr. M. P. Ravindra Nathan

By M. P. Ravindra Nathan,

EAT CHEW LIVE: 4 Revolutionary ideas to prevent Diabetes, Lose Weight and Enjoy Food” by John M. Poothullil, MD, 2015 Published by Over and Above Press, Los Angeles - www.overandabovecreative.com

Addressing the burden of Type 2 Diabetes Mellitus (T2D) has become an important issue as the prevalence of the disease continues to increase around the globe. As per the 2014 National Diabetes Statistics Report, an estimated 29.1 million people or 9.3 percent of the U.S. population have diabetes. Of these, 8.1 million people are still undiagnosed – a whopping 27.8 percent! And it is a common disease among Indians all over the world.

In this context, a new book on diabetes has come out, one that specifically addresses the various theories of T2D and how best to control the disease, if not prevent it. A welcome tool in our battle to fight the epidemic of T2D, the book addresses many burning issues on the topic such as ‘How to lose fat from fat cells and control your weight,’ ‘Ways to lower the consumption of carbs’ and finally, ‘How a complete overhaul on your eating habits – Eating what you enjoy and enjoying what you eat – can lead to better control of the disease.’ The book is the result of the author’s decades’ long personal study and research that guided him to investigate the theory of insulin resistance and the biology behind the development of T2D. To quote John M. Poothullil, “Eat Chew Live presents four revolutionary ideas that can help you change your relationship to food, learn to stop overeating, lose weight, and prevent diabetes. My recommendations are based on a scientific approach.”

EAT CHEW LIVE: 4 Revolutionary ideas to prevent Diabetes, Lose Weight and Enjoy FoodOne of the most intriguing elements is Poothullil’s new theory that insulin resistance is a faulty theory to explain T2D. In its place, he suggests that T2D is caused by the consumption of grains that triggers a “fatty acid burn switch,” which causes muscles to burn excess fatty acids rather than glucose, creating high blood sugar. The author feels that by understanding the new theories and explanations presented in this book and following his recommendations, one can effectively reverse T2D in most cases or at least control it better, so the daily requirements of anti-diabetic medications can be reduced. In addition, those who are prediabetic – in fact one in three adults in the United States are prediabetic! – can gain a lot of insight that will help them to prevent the eventual onset of T2D. This book can also help those who are overweight, as obesity and diabetes are two major causes of illness and disability in the country.

Details in the book about the absorption of glucose after food intake and subsequent transportation into the cells, how the cells detect the presence of insulin, how one becomes pre-diabetic and then diabetic and how obesity contributes to T2D are enlightening. There are specific instructions on how to lose fat from fat cells and control weight. Dr. Poothullil also talks about how our present-day culture is food focused and our eating habits begin in childhood and continue into adulthood, which is why obese kids grow up to be obese adults. “Chew your food slowly and appreciate it while you eat. This helps your brain send signals to regulate the digestive process that in turn alert you to stop eating when you’ve had enough nutrient intake,” he says. The end result is, you eat less and thus decrease the glycemic load. Another caveat: “Exercise is great but not for weight loss.”

The book is visually appealing, illustrated with colorful diagrams that are easy to understand and annotated with many patient testimonials. It is a must-read for everybody who has been diagnosed with T2 D and for all those who are involved with the care of diabetic patients like physicians, nurses and other caregivers. The scientific theories and metabolic details of T2D are presented and explained in a clear jargon-free fashion for non-medical people to easily understand.

The author’s goal is “to help the reader live a healthy life without the fear of developing T2D.” Most definitely, that goal has been achieved. This is one of the best books I have read on the subject and is useful to anybody who wants to prevent, reverse or control his/her diabetes with the least amount of medications. Well, that includes all of us right? I strongly recommend you get yourself a copy and read it to learn the principles that govern the development of T2D and the rationale behind proper treatment and control.

M.P. Ravindra Nathan, M.D., is a cardiologist and Emeritus Editor of AAPI Journal. His book Stories from My Heartwas recently released. (www.amazon.com or www.bn.com).




A condition that affects 1 in 2000 Americans and actually with a higher incidence based on recent diagnostic advances, Keratoconus (Kerato means Cornea and Konus means cone shaped) is a genetically programmed condition where the normally round cornea (clear front window of the eye) thins and begins to bulge into a cone-like shape. This cone shape deflects light irregularly as it enters the eye on its way to the light-sensitive retina, causing distorted vision.

As I have mentioned before, the shape of this cornea determines your nearsightedness, farsightedness and astigmatism. So, as the cornea due to keratoconus becomes more irregular in shape, it causes progressive nearsightedness and irregular astigmatism to develop, creating additional problems with distorted and blurred vision.

A common history among early keratoconus patients is changes in their eyeglass prescription every time they visit their eye care practitioner. This may affect one or both eyes and may affect more than one member in the family tree. Many patients may present with high astigmatism or an unusual refractive error that is just never corrected to perfect vision, i.e. “I just don't see great despite my glasses and contact lenses.”

Additionally, many patients are sent to me because they went to their eye doctors and did not qualify as Lasik candidates. They were told they are “Not a Lasik Candidate.”

High suspicion is an important indicator to suggest further diagnostic testing to determine keratoconus and address the patient's constantly "not so perfect" vision.

Our cornea is normally made up of collagen fibers and research has revealed that there is any imbalance of enzymes in keratoconus cornea, which makes this collagen more susceptible to oxidative damage from free radicals causing them to weaken and bulge forward.

In the early forms of keratoconus, eyeglasses or contact lenses could help but as the disease progresses and the cornea thins and becomes increasingly more irregular in shape, glasses and regular soft contact lens designs no longer provide adequate vision correction.

Recently, a new technology called collagen cross-linking has been approved in the USA and under clinical trials for cases of keratoconus wherein this procedure, often called CXL/CCL/C3R for short, strengthens the corneal collagen to halt bulging of the eye's shape in keratoconus.

I had the privilege to learn from its inventor who was originally from Germany and now in Switzerland. Having met him recently during my lectures abroad, we were nostalgic of how far his invention has come 20 years later.

The procedure is simple and easily executed and basically implies application of a special dye called Riboflavin drops on the eye followed by exposure to a wavelength specific UV light for about 20-30 minutes

Not only are these patients stabilized but they can also seek non-surgical vision improvement with specialty contact lenses and even avail of laser vision surgery (not LASIK but LASIK-like laser vision surgery without making a flap) and then be cross-linked in a staged manner.

Instead of “sentencing” advanced keratoconus patients to a lifetime of “vision imprisonment”, we can now offer them new generation technological advances in laser vision surgery, custom cataract surgery, Intacs surgery, ICL surgery, including combination surgeries to a truly achievable goal of “Vision Freedom.”

I have encouraged eye surgeons to "Thinking outside the CONE" and approach this relentless condition not as a disease but as a refractive error and thereby aspire to make these patients see and, in most cases, even without glasses.

Keratoconus patients, especially those in the early stages, now have hope beyond the usual despair of a corneal transplant. Early detection though is essential.

Arun C. Gulani, M.D., M.S., is director and chief surgeon of Gulani Vision Institute in Jacksonville. He can be reached at gulanivision@gulani.com or visit www.gulanivision.com

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