The benefits of barefoot walking

The human foot was designed for walking barefoot. The basic design that was born out of a series of evolutions from the ape-foot is an architectural and biomechanical marvel of science. The human foot has remained anatomically, architecturally, and biomechanically modern for a long time and certainly since much, much, before footwear was invented.

Several studies have pointed out the benefits that can accrue from walking barefoot. While it may not be practical or practicable to walk around barefoot all the time particularly with the state of our roads, (in India) there is definitely scope to include bare foot walking into our daily lifestyle.

A study that compared morphological and functional effects of habitual foot wear amongst three groups of individuals is revealing. Group-1 consisted of a population of habitually barefoot Indians (n = 70), Group-2 consisted of habitually shod Indians (n = 137) and a Western population (n = 48). An important note here is that even habitually shod Indians also wore shoes less often and used shoes that were less constrictive compared to their Western counterparts.

Barefoot walkers had wider feet and more equally distributed peak pressures, i.e. the entire load carrying surface of the feet was contributing more uniformly (towards bearing the load) than in habitually shod subjects, in whom regions of very high or very low peak pressures were more apparent. Additionally, western subjects differed strongly from both Indian populations (and most from barefoot Indians), by having relatively short and, especially, slender feet, with more focal and higher peak pressures at the heel, metatarsals (bones of the foot) and hallux (the big toe) [D'Ao K, et al. Footwear Science. 2009;1(2):81-94]

Another study that evaluated the effects of modern shoes on gait and lower extremity joint loads in osteoarthritis (OA) showed that shoes detrimentally increased the load on the lower extremity joints. Results showed that barefoot walking reduced the peak load on the joints and knees by almost 12%. The study goes on to say that since excess loading in OA is associated with increase in pain and worsening of the disease, modern shoes may actually worsen the problem in patients with osteoarthritis.  [Shakoor N, Block JA. Arthritis and Rheumatism. 2006;54(9):2923-2927.]

There is a message here for Indians, traditionally barefoot walkers at home who are increasingly using “chappals” and flip-flops at home - could this perhaps be the reason for the increasing incidence of knee replacement surgeries and complaints of pain in the lower extremities, particularly ankles and knees? While it is true (as stated at the beginning of this post) that it may not be possible to walk around barefoot all the time, it is certainly possible to at least incorporate small changes including:

1. Walking barefoot inside your homes
2. Removing your shoes if you know you are going to be sitting at a desk for a long time - using a slip-on as opposed to one with laces may make it easier for you to slip in and out of your shoes.
3. Choosing shoes that are functional and those that are not constrictive, particularly around the large toe and the heel.
4. Using slippers (when you go out socially or whenever possible) that are more open, less constrictive and allow your feet to breathe
5. Carrying a functional slipper/chappal/footwear with you while going to work - you could wear it while traveling to and from work.

Deodorants, antiperspirants and breast cancer - Is there a link?

Posted by Ramesh Venkatraman

There are several articles floating around in the press and internet that warn people not to use deodorants and antiperspirants. These articles have pointed out that antiperspirants (a preparation that reduces underarm sweat) and deodorants (a preparation that masks body odor) could be potentially carcinogenic (i.e. cause cancer). This article examines the available evidence to see if these claims are genuine.

Most of these articles have focused on two key ingredients - aluminum-based compounds in antiperspirants and Parabens in deodorants. The articles have gone on to suggest that since antiperspirants and deodorants are applied under the arm, close to the breast region these compounds can be absorbed via the skin and/or through small nicks caused by shaving. Aluminum-based compounds and Parabens are thought to mimic the activity of the female hormone estrogen and because estrogen has the ability to promote growth of breast cancer cells some scientists have suggested that perhaps these compounds could cause breast cancer. However the question to be asked is if there is evidence to support this claim?

At the moment the available evidence is circumstantial and not completely conclusive. One study published in the European Journal of Cancer Prevention, 2003 indicated that frequent use of antiperspirants/deodorants combined with underarm shaving was associated with an increased incidence of breast cancer diagnosis at an earlier age. This was a retrospective study in 437 women diagnosed with breast cancer using a written questionnaire. [McGrath K G. Eur J Cancer Prev. 2003; 12:479-485.]. See also, the graph at the end of this article which shows a direct relationship between the incidence of breast cancer and the increase in the sale of antiperspirants/deodorants in the US.

The National Cancer Institute (NCI) of the National Institutes of Health (NIH) however maintains that more research is necessary to determine whether the chemicals used in deodorants/antiperspirants can alter DNA structure or cause any other changes in the structure of breast cells. (http://www.cancer.gov/cancertopics/factsheet/Risk/AP-Deo)

What does all of this mean to you? Should you or should you not use deodorants/antiperspirants? As it is always better to err on the side of caution, it may be useful for you to do the following:

1. Use deodorants/antiperspirants sparingly and when necessary - This means that you restrict their use only when you are going out or if you have to be at a social gathering where you don’t want people scurrying away from you with their noses all screwed up. It also means that you don’t drench yourself in deodorant spray or slather on a thick past using the roll-on - a thin film should suffice.
2. Observe deodorant/antiperspirant holidays: Don’t use deodorants/antiperspirants when you are at home or during weekends when all you are going to do is to laze around the house.
3. Avoid using deodorants containing Parabens: This should be quite easy, look at the ingredients label and look for names like methylparaben, propylparaben, butylparaben, or benzylparaben. 

Antiperspirant/Deodorant Sales Versus Breast Cancer Incidence

Ref: Roush et al., 1987 [34] ; SEER Incidencepublic-Use Database, 2001 [37]. ;US Cosmetic and Toiletries Market, 2001;
Bull Cancer 2008 ; 95 (9) : 871-80.

Monsosdium Glutamate (MSG/Ajinomoto): The hidden poison in food

Post written by: Ramesh Venkatraman

The next time you hear the phrase “No one can eat just one” on TV or radio, advertising a popular brand of potato chips you need not grin sheepishly and nod your head in agreement, ashamed at your own lack of dietary control. It might well be that manufacturers of several popular snacks are adding substances that are literally driving your neurons (nerve cells) into a state of high excitement making it impossible for you to pull your hands away from that pack of snacks - the secret to making you captive and begging for more is MSG (monosodium glutamate) more popularly known by its brand name - Ajinomoto.

Chemically speaking, MSG is the sodium salt of glutamic acid (thus, the name monosodium glutamate). Glutamic acid was first isolated from gluten (wheat). MSG is an “excitotoxin” and as the name suggests quite literally, MSG is a poison that excites your nerve cells. MSG is a chemical additive commonly used by the food industry as a “flavor enhancer” and has been in use for more than 100 years since the time it was first commercialized in 1909 by the AJINOMOTO Company, Japan. First introduced into India in 1963, MSG is now marketed in India by the Ajinomoto India Pvt Ltd.

Is it necessary to add MSG to food? The simple answer is NO, because other than its purported claim of enhancing the taste of food, it has no other role to play - then why use it? Precisely because of its ability to excite your nerve cells and make you addicted to the food substance.

Several scientific, animal toxicity studies have clearly pointed out that MSG has the potential to:

1. cause dose-dependent swelling and death of neurons (nerve cells) - study conducted using mouse neuronal culture. [Xiong JS, et al. Int J Clin Exp Med. 2009 Nov 15;2(4):329-36]
2. increase BP (systolic), increase muscle sensitivity, and cause headaches - study conducted among healthy male human volunteers [Hansen BL, et al. Cephalalgia. 2010 Jan;30(1):68-76.]

Another study conducted among neonatal rats injected with MSG, showed that MSG can cause several neurochemical alterations in the brain as a direct result of the excitotoxic potential of MSG. [Perez-Lopez SJ, et al. Cephalalgia. 2010 Jan;30(1):68-76.]Yet another study showed that MSG can actually cause cell death and damage to your nerve cells. [Brain Res. 2010;1317:246-56.]

Dr. Russel Blaylock in his book “Excitotoxins: the Taste That Kills” goes to the extent of saying that MSG could be the initiator of serious neural diseases like Alzheimer’s, epilepsy, multiple sclerosis, parkinson’s, autism, strokes, and learning disorders.

Even with all this evidence, MSG continues to be classified under the GRAS (“generally recognized as safe”) index by the Food and drug Administration (FDA), USA but the operational word here is “Generally”. Manufacturers themselves realize that MSG is a bad word and therefore they disguise its presence under the garb of harmless sounding names. 

A list of MSGs' various avatars is given below. Watch out for these names when you buy that pack of instant noodles, bag of chips, bottle of sauce/ketchup, sachet of ready-to-make soup:

1. Hydrolyzed vegetable protein
2. Hydrolyzed protein
3. Hydrolyzed plant protein
4. Plant protein extract
5. Sodium caseinate
6. Calcium caseinate
7. Yeast extract
8. Textured protein
9. Autolyzed yeast
10. Hydrolyzed oat flour 

[Jane Grey; MSG: The killer food additive. http://janegrey.hubpages.com/hub/MSG-the-Killer-Food-Additive-Allergy]

The home medicine chest - What YOU MUST HAVE IN IT

You have a splitting headache and you rummage through your bag, pockets, upturn the files on your table but still can’t find that damn pain killer tablet that can provide you with the much needed relief. Worse still you can’t even find that pain balm you bought a couple of years ago - If this sounds all too familiar, it is time you got yourself organized and set up a medicine chest at home. If you have an infant or a little kid at home you will need 2 medical chests - one for the adults at home and another for the kid.

Before we look at what MUST go into that medicine chest a few tips on maintaining the medical chest:

1. Your medicines and medicine chest should not be exposed to direct sunlight
2. Remember that all medicines need not be refrigerated - some people put everything into their refrigerators. Read the storage instructions and store medicines appropriately. If a medicine needs to be refrigerated, then put it there but also add a small note to your medical chest informing anyone who will need to use it that a particular medicine can be found in the refrigerator.
3. Make it a habit to clean you medicine chest regularly - do it at least once a month: throw away damaged and expired medicines, check to see if you need to replenish certain medicines, and rearrange and put things back in order.

Now let us look what YOU MUST HAVE in your medicine chest. We will start with the general one for adults:

1. Pain killers and fever medicines: This is an absolute must. Typically you should have Ibuprofen and paracetamol (acetaminophen) - Buy at least two strips of each. Common paracetamol brands available include Crocin, Calpol, Dolo-650 - You could buy any of these. Internationally a paracetamol brand that is more readily recognized is Tylenol. Ibuprofen brands include Ibugesic, Brufen in India and Advil, Motrin internationally. Also keep a bottle of pain balm - Tiger balm, Amrutanjan are good choices.
2. Antiseptic/Disinfectant: Keep a bottle of Dettol or Savlon to wash cuts, abrasions, and any injury. Always dilute the disinfectant before applying it to the cut or wound.
3. Antibiotic cream/ointment/gel: Keep a tube of antibiotic cream/ointment/gel. Soframycin ointment or Neosporin ointment should do. Apply an antibiotic only after you have washed and cleaned the wound. Additionally keep a tube of Burnol cream in case of mild burns, scalds, and boils.
4. Aspirin: Absolutely essential. Aspirin originally a pain killer is now more often used as an anti-clotting agent. If you see someone gasping for breath or holding his/her chest, complains of chest pain then he/she could well be suffering a heart attack, immediately pop an aspirin into his/her mouth and ask him/her to chew on it.
5. Anti-allergics: Keep a strip of anti-allergic tablets. Buy a strip of cetrizine - cetzine or zyrcet. Take it when you have an allergy (allergic cold/cough, skin allergies, allergies due to insect bites etc.). Although cetrizine is supposed to be non-sedative, exercise caution. Do not take it if you have to drive or need to be involved in some motor action.
6. Betamethasone/Hydrocortisone cream: Keep a tube to provide relief in skin allergies, hives, itching, contact dermatitis (skin allergy due to contact with a substance), bug/insect bites. A tube of Betnovate should suffice.
7. Anti-diarrheals: Keep a strip of loperamide (Lomotil, Lomofen, Immodium) and it can help stop that diarrhea. Always go to a doctor if your stools have a foul smell or if the diarrhea does not stop. Also keep a strip of lactobacillus (the good bacteria) which can help restore the balance of good and bad bacteria in your stomach - Sporlac is a good choice.
8. Rehydration solution/salts: Keep a sachet of ORS - Electral or Electrobion are good choices. They will help restore the electrolyte balance in your body after a bad bout of diarrhea and/or vomiting. The patient should also be given the ORS even during the course of his/her diarrhea. Note: Once reconstituted the ORS should be consumed within 24 hours.
9. Nausea and Vomiting: Domperidone is a readily available OTC medicine for nausea and vomiting. Keep a few tablets (you don’t need an entire strip). The brand Domstal is available across medical shops in India.
10. Cold, Cough, and a stuffy chest: I am not a great fan of cough syrups. I prefer plain steam inhalation to relieve congestion and regular salt water gargle to clear irritation in the throat. In India you also get a medicine called Karvol Plus - This is a caplet that contains tea tree oils, menthol etc. and is a great addition to plain steam. All you have to do is to cut the tip of the caplet with a scissor and pour the liquid into the hot water, then drop the caplet shell as well into the hot water. Inhale deeply for instant relief. You can also apply Vicks Vaporub or Amritanjan on your chest, back and neck to relive the congestion.
11. Heart Burn: Commonly known as acid indigestion is a burning pain/sensation in the chest/neck region particularly after a heavy meal. While preventive steps include making lifestyle changes like stopping smoking, eating low fat diets and maintaining regular eating habits, you can keep antacids like gelusil and also certain medicines like ranitidine that can prevent excess acid release - commonly available brands include Zinetac, Rantac, and Aciloc.
12. Bandaid, bandages, gauze, cotton: Buy a variety of sizes. Also keep plain adhesive tapes which can be used to hold a medicated pad or surgical gauze. Also keep a roll of cotton and gauze bandage to wrap larger wounds and prevent leakage from the injury.
13. Elastic wrap, compression bandage: Keep a roll ready in case of severe sprains, and when you have to support a limb or joint before going to the doctor.
14. An accurate thermometer: If you know how to read a mercury thermometer that is ideal, else a digital thermometer should do. Do not buy the fever strips and ear thermometers - they are useless.
15. Measuring cups/jars/beakers: Keep a couple of measuring cups and/or jars to accurately measure dosage of liquid medicines.
16. Scissors: Keep a pair of scissors permanently in the medical chest. You don’t want to be running around the house looking for one when you have to cut a strip of bandage to dress a wound
17. Tweezers: Keep one in the chest in case you want to remove wood splinters, or any foreign body that has become embedded in the skin.

Let us now look at the baby’s medical chest. Several items would be common but there may be variants:

1. Pain killers and fever medicines: Acetaminophen (paracetamol) syrup and Ibuprofen (Ibugesic Plus)
2. Antiseptic/Disinfectant: Dettol/Savlon liquid,
3. Moisturizing cream/lotion: Keep a good brand of moisturizing lotion and/or cream to prevent skin dryness.
4. Topical calamine lotion or Hydrocortisone/Betamethasone cream: For allergies, insect bites etc. Wycort is a brand of hydrocortisone that is available in India. You can also use betnovate (Betamethasone)
5. Antibiotic Cream/Ointment: Soframycin ointment
6. Antiallergic medicines: Cetzine zyrup
7. Nausea/vomiting: Domstal syrup
8. Stomach pain due to gas, bloating, colici pain: This is very common in children and can cause a lot of discomfort. Babies usually cry and writhe in pain. Gripe water, Omum water, Colicaid can all provide quick and effective relief
9. Digital Thermometer: You can measure the temperature by placing it in the rectum or under the armpit.
10. Bandaid, bandages, gauze, cotton: Buy a variety of sizes. Also keep plain adhesive tapes which can be used to hold a medicated pad or surgical gauze. Also keep a roll of cotton and gauze bandage to wrap larger wounds and prevent leakage from the injury.
11. Chest congestion/Cold/Cough: Vicks Vaporub rubbed into the chest, neck, and back. In case of severe congestion in the chest, you can give steam inhalation but you must exercise extreme caution. Place the baby on your lap, cover the vessel containing hot water with wire mesh or use the sieve from your kitchen. Hold the baby’s head with both your hands and hold her over the steam for a few seconds and then pull away. Do this a few times. Do not hold the baby over the steam for more than a few seconds at a time. A very good ayurvedic medicine for children is Sithophaladi churna which should be available in most ayurvedic shops - a pinch of the powder has to be mixed with honey or ghee and given to the baby.
12. Nose block: Pure saline drops (Available as Rhine drops in India) or Otrivin pediatric drops are good choices to unblock baby’s nostrils.
13. Measuring cups, dropper, and oral syringe: Depending on the age of your baby store one or all of these as most medicines for children are liquid preparations and need to be measured out.
14. Scissors: Keep a pair of scissors permanently in the medicine chest. You don’t want to be running around the house looking for one when you have to cut a strip of bandage to dress a wound
15. Tweezers: Keep one in the chest in case you want to remove wood splinters, or any foreign body that has become embedded in the skin.
16. Torch/Flashlight: Keep a small torch/flashlight for checking your baby’s nose, throat, mouth, and ears.
17. Bandaid, bandages, gauze, cotton: Buy a variety of sizes. Also keep plain adhesive tapes which can be used to hold a medicated pad or surgical gauze. Also keep a roll of cotton and gauze bandage to wrap larger wounds and prevent leakage from the injury.

One puff of Cigarette smoke is enough to cause a lot of harm

One puff and...

1. Your heart rate increases by 10 to 25 beats/minute
2. The carbon monoxide that you inhale, squeezes your blood vessels and then chases out the oxygen from your blood leaving your system starved of precious oxygen - "the fuel of life"
3. The delicate mucus-lined cells and tissues of your nostrils, mouth, throat, and lungs burn and singe as the temperature at the tip of the cigarette soars to anywhere between 400 to 600 degrees centigrade
4. Your lungs retain 90% of the smoke, soot, and tar so that very soon your lungs are no better than the factory chimney that guzzles smoke by the ton
5. Your blood vessels cringe and squeeze themselves tight as they struggle to cope with the massive assault on their sensibilities - in the bargain your heart and brain lose out on life-giving oxygen
6. Your blood pressure rises by 10 to 15 percent making you feel heady giving you that smokers high you crave so desperately, while taking away 5 years of your life in the bargain

These are only some of the changes that happen during the act of smoking. Chronic smoking as a habit is a sure shot way to kill yourself and your chance at living life to the fullest, you can choose from - cancer, heart attack, infertility, shortened life span, chronic bronchitis, asthma, premature aging... 

Think about this the next time you reach out for that cigarette.

Charaka and his observations on the “Signs and Symptoms of approaching death”

Post written by: Ramesh Venkatraman

Today’s healthcare model is all about “evidence-based-medicine” where you will be asked to get a scan done, or subject yourself to a test before the physician even pronounces a verdict on what afflicts you, leave alone start a treatment regimen. Gone are the days when your doctor used to “touch” and “feel” your limbs or forehead, shine a torch into your mouth, or ask you to stick your tongue out before recommending a medicine. It is in this context that Charaka’s observations on the “Signs and Symptoms of approaching death” make for interesting reading. This article only lists the physical signs mentioned in Charaka’s Samhitha. It is the author’s belief that the other signs, symptoms border on the superstitious and may not be appreciated in today’s context.

The physical signs that can be noted through observation of the patient on deathbed or sudden changes that are premonitory in nature include:

1. Sudden loss in physical strength and sensory functions
2. Discoloration of face, nails, eyes, urine, feces, hands, and feet
3. Sudden appearance of malodor in a deteriorating patient
4. Loss of pulsation in body parts that had pulsations earlier, coldness in parts that were earlier warm, harness of what was soft, muscle wasting, instability in the joints
5. Very deep or very shallow breathing
6. Matted eyelids
7. Displaced teeth with white concretions
8. Absence of or very low pulse in the neck
9. Matted eyelashes, glassy, glazed appearance of eyes with eyelids either permanently open or closed
10. Bluish tinge under the nails
11. Absence of cracking sound when the fingers are bent
12. Discoloration of the abdominal wall
13. Severe fatigue, anxiety, confusion, restlessness, severe thirst along with drastic loss in appetite
14. Stiffness in the jaws and neck
15. Back becomes rigid and arched

Reference: The legacy of Charaka by M. S. Valiathan