M. P. Ravindra Nathan

Editor's Note: This series is designed to give you heads up on healthy living and graceful aging.

Dr. Sanjay Gupta's passion to keep America healthy is well-known and every broadcast he does on CNN makes me feel that he is on a crusade. Whether it is about the E. coli outbreak in a California farm, tainted products imported from China or the health of presidential candidates, his opinions are considered in higher regard, which is one reason I wanted to meet Dr. Gupta. And it all started after my daughter Sandra sent me an autographed copy of "Chasing Life."

	Dr. Sanjay Gupta

During a recent interview, Dr. Gupta and I discussed many other topics, including the global increase in heart diseases and use of popular drugs such as statins for primary and secondary prevention, the role of genetics on longevity, stem cell therapy to reverse aging, biotechnology revolution to extend life, yoga for relaxation and vitality, etc.

He thinks there is little clinical evidence to support the use of many supplements such as Echinacea for colds but green tea, turmeric (a constant ingredient of Indian curries) and aswagandha may serve as antioxidants preventing damage from free radicals, and garlic may reduce cholesterol and help clean up your coronaries.

"What do you think of the wonder drugs 'statins'? It has been shown to prevent heart disease and also arrest its progression?" I asked. Most of you know by their brand names such as Lipitor, Crestor, etc.

"Statin is a great drug and Steve (Steven Nissen, M.D., past president of American College of Cardiology) thinks it should be in our drinking water. I myself don't take any statin, though my LDL is just a little high, but my HDL is 80 now with daily exercise."

In answer to "Should statins become over the counter to prevent heart disease, as in U.K.?" he answered: "My concern is they would use this as a ruse for not seeing a doctor being lulled into thinking that the statins alone will protect the heart. All patients want to know 'Am I going to live longer?' "

Then our attention turned to genetic influence on survival. "Many people fervently believe it is all in your genes. If you are born with good genes, you have a real chance of living longer; otherwise, whatever you do may not be good enough, so why bother with all these restrictions," I pointed out.

"The idea of longevity genes is very much real," he responded. "Neal Barcalai, who has studied 100-year-olds, has identified at least three longevity genes. Even if they smoked or drank, they still seem to exert protective influence. I don't know if we can manipulate these genes; we are not there yet."

Dr. Gupta also cautions us about the downside of postponing diseases as the clock continues to tick in our cells and the body continues to age. We could wind up like the mythical figure Tithonus in the ancient Greek story who was given eternal but not perpetual youth.

A similar story is told in Hindu mythology as well when Lord Siva, trying to save the life of his ardent devotee Markandeya, had to kill Yamaraja, Lord of death, and for many years thereafter, death was halted in this world. This resulted in a lot of old, debilitated, confused and unhealthy people sitting like stuffed dolls who just lived forever. So, finally Lord Siva had to bring back Yamaraja to restore the order of life.

Obviously, none of us want to live like Tithonus. But we do want to age gracefully with vigor and vitality and live longer. That is the essence in the quest for practical immortality. In the final analysis, what is going to make a difference will be "your ability to make simple changes in your life as you try to overcome the obstacles and challenges which life will deal you," as Gupta says.

With scientists and clinicians from multiple disciplines working together to identify and characterize many common diseases, the future certainly looks good. Who knows, living up to 100 for ordinary folk like us is still possible!

"Chasing Life" by Dr. Gupta, the book (reviewed in a previous issue) about new discoveries in the search for long and healthy living, is an essential read for those aspiring to live long and healthy. Some of the well-known physician authors such as Andrew Weil, the Harvard-trained popular guru of complementary and alternate medicine and Dr. Deepak Chopra, author of the much acclaimed book "Ageless Body, Timeless Mind" have praised the book immensely.

Dr. Gupta was prepared to continue with this discussion, but his secretary interrupted, "You have a broadcast in 10 minutes." So, I had to say goodbye, feeling satisfied that my trip to CNN was a success.

So, is practical immortality - living up to 120 years or more - on the horizon? Says CNN's health guru: "Yes, it is within our reach. The path is not always easy though, but it is worth it."

Cardiologist Dr. M. P. Ravindra Nathan, director of Hernando Heart Clinic in Brooksville, lives in Brooksville.

Most of our leg, knee, ankle and lower back injuries occur because of inappropriate footwear. People work long hours. Several professional and retailer workers have to stand on their feet for at least eight hours. The constant standing and walking creates pressure on knees and ankles. The inappropriate footwear creates the imbalance in the feet pronation process, which is the initial cause of any leg pain.

What is pronation?

Pronation is the normal, natural inward roll of the foot as the arch collapses (like a spring) when walking, between the time the heel contacts the ground and toe-off. Pronation is necessary for the foot to absorb shock. But not all the shock is absorbed.

Some of the shock caused by the feet sticking the ground is transmitted up the legs, through the pelvis, to the lower back. The imbalance pronation (under Proantion and Overpronation) creates pain in the legs, pelvis and lower back.

Underpronation: The foot does not roll inward enough to adequately absorb shock. These people usually have a high and inflexible arch. It leads to pain in feet, knees and lower back. Wearing flexible shoes with extra cushioning can prevent underpronation. Often, it occurs in people with deep shaped feet.

Overpronation: The foot rolls inward excessively, which causes excessive internal rotation of the lower leg and knee and places strain on the entire lower body, including the lower back. These people usually have low arches and straight feet. Overpronation leads to pain in the entire lower body, specifically heel, knee, legs and lower back. It often occurs in people with straight shaped feet.

Let's see how we can prevent Underpronation and Overpronation

" Adequate cushioning and support: Shoes with adequate cushioning in the soles help to absorb the shock of the feet hitting the ground. Everyone walks differently and stands differently. The difference may not appear but body pressure on the area of feet is different for each person. Some people put more pressure on the heel, some on toes and some on sideways of feet. A more pressured area required more cushioning. Also, stability with cushion is necessary. Shoes must provide stable walking and standing surface along with cushion.

" Shape of the shoe: It is generally determined by the shape of the foot. The soles of shoes can be straight, curved or semi-curved. People whose feet are straight should wear the straight shoes. People whose feet are curved should wear curved or semi-curved shoes.

There are many shoe stores that have employees who specialize in fitting shoes. They can look at the shape of your feet, observe your gait to see if you underpronate or overpronate or have a normal gait. Make sure you ask for your fit when you purchase shoes.

There is a difference between running shoes, working and sports shoes. So, please be sure to buy shoes according to your need. Running shoes are not helpful at work. Sport shoes are not good if you intend to walk or run for 2 or more miles.

Many professionals are required to wear professional footwear. There are stores that provide professional leather boots and sandals according to foot shape and with extra cushion. I personally recommend the Rocky Point brand shoes. You can also put the Dr. Scholl's gel for temporary cushion. These cushions are good, yet the built-in shape shoes are more effective and supportive.

I suggest that people should change their working shoes every six months. Also, your lower back heels and knees will remind you that it's the time to get new shoes - please pay attention to leg aches at the end of the day. You may choose to have two pairs of working shoes that you interchangeable. I personally keep two to three pairs of shoes. I wear running shoes when I work out. When I train my client, I wear sport shoes. And when I attend or work in a professional environment, I wear my specially fitted cushion leather shoes. I always pay attention to my lower back signals that tells me to change my shoes.

Achut Mashruwala of Fitness Guru Inc. can be reached at (813) 857-5103 or e-mail [email protected]

	Payal Patel

I get a lot of parents in the office who are proud to say how well their child is learning and focusing because of TV and videogames. Nowadays, kids are plopped in front of a TV even before they can sit up because the caregiver observes that they seem interested in the TV and seem to like it, without realizing the consequences.

Television has a tremendous influence on our kids. It does have positive influence because the kids are smarter and learn a variety of new things, but because of the excessive time spent in front of a TV, computer or playing videogames, it does have a lot of negative affects.

Many children spend more time in front of a TV than in school. Also, these days we don't see a lot of children playing outside or interacting with their peers like before, leading to a lack of communication and social interaction. This also is true for siblings and parents.

Most kids are not reading at grade level nowadays because TV, videogames, etc., are taking away from valuable reading time, which would enhance their vocabulary and thinking capacity. It leads to a decrease in school performance as they are hurried in homework time, and watching TV when they should be going to sleep at an appropriate time.

TV and videogames also lead to a more aggressive behavior because of the numbing effect watching violent cartoons and playing violent videogames has on a child. Because a child is unable to reason the amount or extent of aggression they see, they may think it is normal for them to behave the same way as portrayed on TV, etc.

To prevent such behavior, it is important to encourage other activity. The most important intervention is limiting TV watching and videogame time to 1-2 hours per day depending on the age of the child. A 4- to 5-year-old should have no more than 30 minutes to one hour in front of the TV, while an 8-year-old may watch or play videogames 1-2 hours.

n weekends, you may allow them 30 minutes to an hour more depending on family values and age of the child. Setting a time limit helps your child focus his time elsewhere such as interacting with the family or friends, playing outside, reading, sports, music, etc.

Introducing interest in books early on promotes reading and vocabulary enhancement as they grow up. Parents should read to their child even before they are a year old as valuable time spent together, and to boost interest in books.

TV or videogames should never be used as a distraction or a babysitter because this form of entertainment becomes unsupervised, leading to younger children watching violent or inappropriate shows. TV videogames should never interfere with bedtime. Setting a routine for the child as to when it is a good time to watch shows is a good habit that will last through the years.

A good time is right after school, when they want to relax for an hour before starting their homework. This way it does not interfere with learning, family time at the dinner table, and scheduled bed time.

Talking to your child about what is considered an appropriate show also is important so they realize the reasons mom and dad don't allow certain TV watching. Buy videogames that are age appropriate and do not contain violence.

Also, make sure you set a good example by not watching too much TV yourself or inappropriate shows in front of them. Always enforce that the TV be turned off once their time is over, giving more value to family-based interaction.

Although TV and videogames can teach focus, attention to details, enhance their imagination, etc, excessive and inappropriate TV and videogames has a negative impact on our kids. Therefore, setting and maintaining routines for TV and videogames is important for a child's intellectual development.

Happy holidays and a Happy New Year.

Dr. Payal Patel is a board-certified pediatrician at Sunshine Pediatrics, 18928 N. Dale Mabry Highway, Suite 102, Lutz. For information, call (813) 948-2679.