From the Desk of Coordinator

From the Desk of Coordinator, Bioinformatics Center

January , 2004

Battle of the Bulge

(Obesity & Metabolic Programming)

In early seventies when I started teaching Biochemistry to medical Students, I proudly used to say that we have well understood what is ideal nutrition to combat malnutrition and importance of proteins, oils, fruits, vegetables in diet as sources of vitamins, fibre etc. One fine morning we ended up in a mess called ‘Obesity’. Due to bulge, belly would appear like a big apple in male and as a pear in female. In America an obesity (Body – Mass index of at least 30-35) rate of nearly 1 in 3 or almost 59 million people has been reported. Childhood obesity is equally alarming, especially in the children belonging to the well-to-do families. Obesity has become a global problem with economic prosperity in developing countries funneled by fast food industry and supermarkets. It has become a matter of great concern to the medical world as nothing much is being done to prevent the scourge. Why is it in epidemic proportions these days? The reasons are – Excessive eating of high calorie, sweets & fat rich foods, processed and chemically polluted junk foods, sedentary life style, lack of physical activity, television, commerce and aggressive advertisement in foods. People have filed Legal suits against McDonald for deceptive advertising and thus causing obesity in children. Health problems associated with obesity include diabetes, heart disease, high blood pressure and arthritis, increasing the health care costs. The American Federal Department of Health and Human Services puts the health care cost of overweight and obese Americans at $117 billion in 2000 and said that being overweight results in 30000 deaths a year.

Extensive epidemiological findings indicate that metabolic programming / adaptation during critical phases of early development occurs in humans emphasizing the importance of adequate maternal nutrition during pregnancy. In animal studies, Patel et. al. have shown that artificial rearing of 4-day-old rat pups on a high carbohydrate milk formula up to Day 24 results in the immediate onset of hyperinsulinemia which persists through out the period of dietary intervention, sustains in the post weaning period and forms the basis of adult-onset obesity.

Nature has a way of tackling obesity though secondary to regulating the metabolic supply of nutrients. Excessive calorie intake is thought to be sensed by the brain, which then activates thermogenesis – converting food directly into heat, a process called diet induced thermogenesis. This seems to be determined by genetic make up of the individual and composition of the diet. Interestingly there are stories of individuals who survive on boiled water, sunlight or blessings of “Mataji”. Prahlad Jani, 76 year old man in Gujrat has baffled the medical fraternity by claiming that he has been blessed by Mataji at the age of ten and living in a cave near the Ambaji Temple without food and water for 65 yrs. When he was observed for 10 days in a hospital, he did not take food or liquid and did not pass urine or stool. DIPAS at Delhi would be conducting research in this case. Another case is of 64 year old mechanical engineer and Jain follower, Mr. Manek, who undertook his record breaking feast of sunlight. For 411 days he survived on just boiled water and sunlight. He was physically active carried out all his normal activities. Perhaps his body is undergoing ‘Chronic adaptation’ learning to survive on few calories, explains a neurophysician observing him. Manek was invited to USA by NASA to study his fasting technique.

Regulated diet and plenty of exercise seem to be the best weapons to fight obesity.

April , 2004

Stress: The Mind – body connection

Outer circumstances and events don’t create stress
It is our response to them which creates stress

- Phil Nuernberger

A degree of stress is necessary in life. A Sitar can not be played unless the strings are stretched tight to an extent. Stress adds zest to life, but too much of it can break us down. Whenever the mind feels uneasy, restless, disturbed, agitated and tense, one is said to be under stress. When the mind is feeling light, easy, cheerful, calm and quiet, one is said to be in relaxed state.

As a response to external stimuli, fight or flight response arouses sympathetic component of autonomous nervous system thus elevating Cortisol to provide sugar for instant energy, faster breathing to provide more oxygen, release of adrenaline and nor-adrenaline to produce a surge of energy in the body, increased heart beat, muscular tension etc. to meet the impending challenge. When one is peaceful and relaxed, parasympathetic nervous system takes over and helps in body chemistry return to normal.

Every sympathetic arousal is not stress. Stress occurs only when there is excessive or prolonged sympathetic arousal (due to worries, concerns, fears etc.) without relaxation thus resulting in autonomic imbalance. Symptoms of stress at earlier and reversible stage are anger, frustration, irritability, depressed mood, fear and anxiety, negative thoughts, lack of confidence, tension, headache, backache, sleep disturbance, reduced activity level, difficulty in concentrating etc. The stress induced disorders are anxiety neurosis, hyper tension and Ischemic heart disease, hyperglycemia & diabetic mellitus, peptic ulcer, irritable bowel syndrome, asthma, arthritis, obesity etc.

Stress is increasing due to competitive, fast moving and modern life style with ever-growing consumerism and ambition. Stress is man made health problem that too self made and individualistic. In other words the same situation may cause stress in one individual but not in the other. Stress is a result of combination of environmental and individual factors and how the individual reacts to them.

Stress can be successfully managed by looking positively, identifying and analyzing the problem with cool mind, being less ambitious, more realistic to one’s capacity and learn to relax with exercise, yoga and meditation. No wonder considerable research is being done on the beneficial effects of life style change, yoga and meditation for stress free life. Transcendental meditation (TM) has shown significant decrease in the levels of nonepinephrine and epinephrine in TM group compared to control subjects (Infante JR et al). Assay of Cortisol, the “Stress hormone” which is released in the body during stressed states has been used for monitoring stress and found beneficial effects of MRT – Music compared to hormone drugs in pregnant women under threat of miscarriage. Relaxation or biofeed back techniques were found to lower elevated blood pressure, playing an important role in the development and course of essential hypertension (Hermann JM). Mind-body therapy (Yoga practice) has been found to be valuable in preventing adverse outcomes of coronary disease (Pandya DP). Nowadays there is considerable interest to study Alternate medicine in particular ‘Yoga and meditation’ for their beneficial effects in Stress management.

July , 2004

The Breath of Life and Beyond

The breath we breathe in and out without respite is termed as Prāna or the bioenergy or life force which endows man with an unlimited spiritual potential. Breath is a wireless connection to transcend the entire field of mind and matter by meditation and experience bliss. According to the yogic view, man is part of cosmic phenomenon and continuously exchanges bioenergy through his breathing with the cosmic power outside of him. Respiratory rate goes up in anger, after physical strain or under mental stress while it goes down when one is in relaxation or sleep. As roses and jasmine flowers spread out fragrance into the environment, it is possible that the regulated breathing by the chemicals produced by positive or negative emotions of man, do influence the environment at subtle level.

Pranayama, the controlled and conscious breathing helps in calming and purifying effects on the body-mind complex. Slow, relaxed and deep (abdominal) breathing reduces stress, deepens insight, expands consciousness and increases intuitive perception. The yogic disciplines such as abdominal breathing, shavasana and meditation admirably bring about a reduction in the sympathetic activity and increases the inner strength of the individual and foster the feeling of connectedness bringing reduction in stress. Constant awareness or concentration on normal breathing or parts of body as in Vipassana meditation or Yognidra, quietens mind and helps in coming over stressful situations. Mindfulness is defined as a non-judgemental moment-to-moment awareness without drifting into thoughts of the past or future. At University of Massachusetts Medical Centre, Mindfulness-Based Stress Reduction (MBSR) program through sitting meditation and body scan (full attention to the parts of the body) has been very helpful in decreasing chronic pain (low back, headache and neck / shoulder pain). Even a short programme of mindfulness meditation produces lasting positive changes in both brain and the functions of the immune system (Davidson et al., 2004).

Asthma, a gift of junk foods, modern life style and polluted environment, is increasing in the recent years. The National Heart, Lung and Blood Institute of USA says that the prevalence of asthma around the world has doubled in the last 15 years. WHO estimates that between 100-150 million people around the globe have asthma with about two lakh deaths each year due to asthma. There are attempts to explore Alternate Systems of Medicine in management of asthma. In a study by Cooper etal. (Thorax, 2003), the Buteyko breathing technique improved symptoms and reduced bronchodilator use to some extent whereas use of Pink City Lung Exerciser (mimics Pranayama) did not show benefit. This is in contrast to the encouraging results observed at Yoga Institutes. The failure with objective prototype studies is possibly due to lack of spiritual element and positive attitude. Emotional involvement of individual along with yoga way of living may give better results.

October , 2004

Business of Spirituality

The fast changing life style, ever increasing competition, growing urge to earn more and acquire more are destroying the peace of mind today making more people turn towards spirituality. Quest for the Divine and peace has resulted in organizing Millennium World Peace summit by religious and spiritual leaders and global alliance for new humanity by Global celebrities, Presidents, film makers and writers to create a compassionate world and instill softer values in business, entertainment and politics. Matters of spirituality and faith are no more personal preferences with usurping of globalization, liberalization and aggressive commercialization. Earlier business and spirituality were looked as different walks of life. Rapid growth in business is not possible with charity and ethics. Nowadays Corporates are opting for spirituality as one of the components of corporate culture with meditation rooms for their staff. However how a really meditated person works with ruthless competition and targets, a company demands, is to be seen. Commercialization of spirituality is making some spiritualists and Gurus earn millions and in the process the non-material and divine aspects of spirituality is suffering. As spirituality is turning into profitable activity, number of ‘Gurus with Palacial Ashrams, Satsangs and Bhajan mandals are coming up with considerable organizing and marketing skills to attract devotees. However some organizations are still working quietly maintaining its spiritual nature with emphasis on simplicity, divinity and service of humanity.

Marketing opportunities have also engulfed spirituality with their beneficial and harmful effects. The market is flooded with books, music, insignia, VCDs and DVDs related to spirituality. Some TV channels in India with spiritual discourses, Bhajans and clips of holy places are enchanting the masses and at the same time flourishing with commercial advertisements on products and services, some spurious and with unproven claims. In America as per the International Association of Yoga Therapists, 2.2 million Americans are practising yoga with 80 percent of commercial health clubs offering yoga classes. It is estimated that people were spending about $20 billions a year on yoga and meditation. Five to six new yoga books are published practically every month. With American marketing touch, yoga is taking various shapes and styles. Yogic exercises are combined with eastern martial arts and conventional exercises, calling it “Fusion” yoga to suit sportspersons including weight lifters, according to a report in “The Washington Post”. Yoga is offered under various names, including yogabutt (squeezing a grapefruit size blue rubber ball between thighs), yoga - pilates - resist - a- ball; yoga bar for weight lifters, combining submerged yoga with tai chi and pilates, hot yoga done in a 105 degree room etc. with availability of Trendy yoga clothing. Twelve hundred modified yoga teachers met in Washington area and demonstrated their techniques, changing ancient discipline of yoga with its divinity for commercial exploitation. As the competition increases Gurus are going for trademarks and copyrights. The Art of Living (AOL) has registered the name ‘Sudarshan Kriya’ based on exercise of breath and its rhythm to ‘reestablish balance on life’. Only licensed instructor can teach it, possibly making it authentic. The founder of ‘Bikram Yoga’ in US plans to copyright Bikram books and Bikram yoga asanas, which are conducted in heated room. (Consumer Voice, Sep-Oct. 2004)

Positive aspect of globalization of spirituality is research using modern scientific tools to assess the beneficial aspects of yoga, meditation etc. in more objective fashion for reduction of suffering in chronic diseases, resulting in the development of discipline Body – Mind Medicine.

Prof. B. C. Harinath

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