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In Short Skipping breakfast can be deadly in the long run Studies shows that every ‘1 in 4 urban Indian’ claim to skip breakfast A healthy Breakfast not only kick-starts the metabolic processes but supports overall health “I was in a hurry.” “It’s okay, I will have lunch directly.” “I had a fruit.” “I had a heavy dinner.” These are some of the excuses that we tell ourselves when we skip breakfast. However, often, skipping breakfast, which initially starts due to time constraints or just pure laziness, soon turns into a habit (not a good one, btw). This habit of skipping breakfast not only leads to heart problems, but can also be deadly in the long run. The most skipped meal: Breakfast We Indians, are, of course, known for their good food. However, when it comes to breakfast, we often tend to skip it, thinking we can compensate for it with a fruit, a cup of coffee or, even worse, at lunch. There are a few studies on breakfast patterns in India, and the number does not look good. For instance: A study by Kellogg’s states that every ‘1 in 4 urban Indians’ claims to skip breakfast, and it was seen across all age groups. The study also found that around 72% skimp by having a nutritionally inadequate breakfast meal. Most important meal of the day? Suvarna Sawant, chief dietician at Nanavati Max Super Speciality Hospital in Mumbai, shares that as a nutritionist, she always stresses the significance of a nutritious breakfast. Eating breakfast kickstarts your metabolism, helping your body burn calories throughout the day. Photo: Getty Images “Being the most important meal of the day, breakfast induces metabolism and improves gut health,” she says. Now, there are various reasons why breakfast is considered as an important meal of the day. Kickstarts metabolism Eating breakfast kickstarts your metabolism, helping your body burn calories throughout the day. This can aid in weight management and energy levels. Fuel for the brain After a night of fasting, breakfast provides essential nutrients and energy to the brain, improving concentration, focus, and cognitive function. Maintains nutrient intake A nutritious breakfast can provide vital nutrients such as vitamins, minerals, protein, and fibre, which are important for overall health and well-being. Regulates blood sugar Eating breakfast helps stabilise our blood sugar levels, preventing spikes and crashes that can lead to cravings and overeating later in the day. Prevents overeating Starting the day with a balanced meal can help control hunger and prevent overeating at subsequent meals, promoting better portion control and weight management. “A regular healthy breakfast also helps in weight management, especially in urban areas, where sedentary lifestyles and consumption of processed foods is high,” says Suvarna. What skipping breakfast does Suvarna says skipping breakfast can lead to low energy levels and causes a lack of essential nutrients, affecting our productivity and well-being. “For individuals involved in physically demanding activities, missing a breakfast can result in undernutrition and compromise the ability to perform labour-intensive tasks,” she adds. Ruins your digestive health Dr Chetan Kalal, program director of Nanavati Max Institute of Gastroenterology, Hepatology & Therapeutic Endoscopy, Mumbai, explains that as a gastroenterologist, he always emphasises the importance of breakfast for maintaining gastrointestinal health. Skipping breakfast can disrupt the release of digestive enzymes. Photo: Getty Images “Missing this important meal of the day can harm the digestive system,” he says. How? Dr Kalan explains that if we skip our breakfast, it can cause a disruption in the release of digestive enzymes and lead to disruption of the circadian rhythm of the digestive tract. This can lead to issues such as: Indigestion Bloating Altered bowel habits According to him, it can also potentially contribute to the development of gastroesophageal reflux disease (a chronic, usually lifelong disease that develops in your gut) and other functional gastrointestinal disorders. Impact your heart We know that heart-related diseases are on the rise. But do heart-related problems have a connection with skipping breakfast? Apparently, yes. Dr Vivudh Pratap Singh, senior consultant, interventional cardiology, Fortis Escorts Heart Institute, Okhla Road, New Delhi, explains that skipping breakfast occasionally might not necessarily lead directly to heart-related issues, but consistently skipping breakfast over time “could potentially contribute to certain risk factors associated with heart health”. He refers to a 2019 study that suggests regularly skipping breakfast may be linked to an increased risk of developing conditions such as obesity, high blood pressure, high cholesterol levels, and Type 2 diabetes, all of which are risk factors for heart disease. “Skipping breakfast could affect insulin sensitivity and glucose metabolism, which are also factors in heart health,” he says. Consistently skipping breakfast over time could potentially contribute to certain risk factors associated with heart health. Photo: Getty Images However, please also remember that skipping breakfast may contribute to certain risk factors for your heart, but it’s not the sole reason for heart-related issues. Cause weight gain Since the beginning of time, we’ve been told that eating less can lead to weight loss. But here’s the deal, skipping breakfast will not make you skinny, rather it may contribute to your weight gain. Here’s why: Regularly skipping breakfast can lead to overeating throughout the day, as we may compensate by grazing or consuming larger portions later on. This behaviour can increase hunger and prompt choices of foods high in fats and carbohydrates, which may seem more filling. Moreover, skipping breakfast can disrupt blood sugar levels, potentially complicating the body’s ability to metabolise food and contributing to obesity. Various research, including a study published in The American Journal of Clinical Nutrition, says eating breakfast can lead to the benefits of eating breakfast daily, such as reducing dietary fat intake and curbing impulsive snacking, which can aid in weight reduction efforts. Quick healthy breakfast ideas If you’re in a hurry in the morning to go to school or work, remember, you can always prepare your breakfast in the night or beforehand. Here are some ideas: Upma A savoury breakfast made from semolina (sooji) cooked with vegetables like peas,

As a hepatologist with a keen interest in holistic well-being, it’s imperative to recognize the profound impact mindful eating can have on liver health and overall vitality. Mindful eating is more than a trend; it’s a transformative approach to nourishing the body and fostering a positive relationship with food. *Understanding Mindful Eating:*Mindful eating is the practice of bringing full attention to the present moment while consuming food. It involves being aware of the sensory experience, acknowledging hunger and satiety cues, and appreciating the flavors, textures, and nutritional value of each bite. *Listen to Your Body:*One of the fundamental aspects of mindful eating is tuning in to your body’s signals. Distinguish between physical hunger and emotional cues. Eat when genuinely hungry, and stop when comfortably satisfied. This awareness promotes healthier food choices and prevents overeating, which is crucial for liver health. *Savor the Flavors:*Take the time to savor each mouthful. Engage your senses by appreciating the colors, aromas, and tastes of your food. This not only enhances the eating experience but also allows for a deeper connection with the nutritional benefits each meal provides.4. *Slow Down and Chew:*In our fast-paced lives, we often rush through meals. Mindful eating encourages slowing down and thoroughly chewing each bite. This aids digestion, promotes satiety, and allows the body to absorb nutrients more effectively, supporting liver function. *Eliminate Distractions:*Turn off electronic devices, step away from work, and create a dedicated eating environment. By eliminating distractions, you can focus on the act of eating, leading to increased awareness and satisfaction from your meals. *Gratitude and Mindful Choices:*Express gratitude for the nourishment your food provides. Make conscious choices about the food on your plate, opting for a variety of nutrient-rich options that benefit your liver and overall health. *Portion Awareness:*Mindful eating involves being mindful of portion sizes. Listen to your body’s cues to determine when you’ve had enough, preventing overconsumption and promoting a balanced intake of nutrients. In conclusion, incorporating mindful eating practices into your daily life can profoundly impact your relationship with food and contribute to overall well-being, including liver health. By savoring each bite, listening to your body, and making conscious food choices, you embark on a journey towards a healthier, more mindful approach to nourishment.

In the modern era, sedentary lifestyles have become increasingly prevalent, contributing to various health issues. However, breaking free from these habits doesn’t necessarily require a radical fitness overhaul. Instead, incorporating movement into your daily life can make a significant impact on your overall well-being. The Perils of Sedentary Living Sitting for extended periods has been linked to numerous health concerns, including obesity, cardiovascular disease, and musculoskeletal problems. Our bodies are designed for movement, and a sedentary lifestyle disrupts the natural balance our systems crave.  Small Changes, Big Impact *Deskercise:*Simple exercises at your desk, like leg lifts, seated marches, or neck stretches, can be done throughout the day to counteract the effects of prolonged sitting. *Take the Stairs:* Opting for stairs instead of elevators whenever possible provides a quick and effective way to inject movement into your routine. *Walking Meetings:*Consider holding meetings on the move. Walking not only promotes physical activity but also enhances creativity and focus. *Regular Breaks:* Set a timer to remind yourself to stand up and stretch every hour. These short breaks can refresh both your body and mind. *Active Commuting:*If feasible, consider biking or walking to work. It’s an excellent way to incorporate exercise into your daily routine. ### Embracing Technology for Motivation *Fitness Apps:*Numerous apps offer quick, effective workouts suitable for various fitness levels. Incorporate these into your day, even if it’s just for a few minutes. *Activity Trackers:*Wearable devices can be powerful motivators. Set daily step goals and gradually increase them to make steady progress. ### Family and Social Integration *Family Workouts:*Encourage family members to join in, turning physical activity into a shared experience. This not only promotes health but also strengthens relationships. *Social Events:*Plan activities with friends that involve movement, such as hiking, dancing, or playing sports. This way, you can socialize while staying active. ### Mindful Movement Practices *Yoga or Pilates:* These practices not only improve flexibility and strength but also promote mindfulness, reducing stress and enhancing overall well-being. *Mindful Walking:*Whether in a park or around your neighborhood, walking mindfully, paying attention to each step, can turn a simple activity into a meditative practice. ### Consistency is Key The key to breaking free from sedentary habits lies in consistency. Start small, gradually increasing the intensity and duration of your activities. Remember, any movement is better than none. By incorporating these strategies into your daily life, you can cultivate a more active and health-conscious lifestyle. Small changes today can lead to significant improvements in your overall well-being tomorrow. So, let’s break free from the shackles of sedentary living and embrace a more movement-oriented, healthier life.

Staying away from aerated drinks and adopting an active lifestyle are among the top tips to keep your liver hale and healthy Written by Ayush Arya With quotes from Dr. Neelamekam Thoppa Kapali (gastroenterologist), Dr. Chetan Kalal (Hepatologist), Eshita (nutritionist) The liver is one of the most vital organs associated with multiple physiological functions such as cholesterol secretion, detoxification, hormone secretion, and even glucose metabolism. Liver disease has been on the rise during the recent years and it has been attributed to unhealthy diet, excess alcohol consumption, and sedentary lifestyle along with other co-morbid conditions like diabetes. Hepatologists point out that most liver conditions start showing visible signs and symptoms quite late after their onset. As a result, in the absence of early intervention, recovery from most of these conditions becomes a bit tricky and difficult. They however point out some simple and practical tips for healthy liver that could be adopted as your resolution for 2024. Tips to have better liver health in 2024 1. Drink in moderation for healthy liver Excess alcohol consumption is one of the main reasons for liver damage including liver cirrhosis, says Prof Dr Neelamekan Thoppa Kapali, HOD gastroenterology and liver transplant surgeon, Fortis Malar, Chennai. Avoid alcohol or make sure you have it in moderation to avoid the accumulation of fat in the liver causing alcoholic fatty liver disease. Dr Chetan Kalal, program director of liver, pancreas, and intestine transplantation at Nanavati Max Super Speciality Hospital Mumbai says a definitive no to binge drinking. Alcohol drinkers, especially binge drinkers are at a higher risk of alcoholic hepatitis, cirrhosis, and liver failure. 2. Live clean and eat clean Dr Kalal says that practicing good personal hygiene is extremely important for maintaining liver health. Simple tasks like washing your hands thoroughly would help prevent liver diseases. He adds that washing your hands before and after using the restroom could help prevent viral infections like hepatitis which could infect your liver. Washing fruits and vegetables before using them is also recommended to wash off the toxins from pesticides and insecticides used which is used to keep them safe till harvest. The residue of these toxins on their outer surface could damage your liver. 3. Go easy on carbs and eat home-cooked food Excess intake of refined carbs mainly from ultra-processed food and refined grains and cereals get deposited on the liver which could lead to fatty liver. Delhi-based nutritionist Eshita also says that a balanced healthy diet with fruits like papaya and berries with antioxidants could prevent liver inflammation. Consumption of chemical-laced ultra-processed food with preservatives could also adversely affect your liver health since it has to deal with toxins. 4. Drink more water and no aerated drinks Drinking enough water is recommended to avoid dehydration and to support liver function. “Water helps remove toxins and the liver relies on sufficient fluids to perform its functions effectively,” says Dr Kalal. Experts also point out that aerated sugary beverages lead to the early onset of fatty liver disease. 5.  Adopt an active lifestyle for healthy liver “Engaging in regular physical activity can help support liver function,” says Dr Kapali. One of the other crucial factors is sleep. Therefore, try to get seven hours of good sleep each night along with routine health checkups. 6.  Don’t miss your hepatitis vaccination Dr Kalal suggests vaccinations as a preventive measure against potentially harmful viruses like Hepatitis B, which can help prevent liver disease. Being vaccinated can significantly reduce the risk of contracting an infection and reduce the severity of illness caused by certain viruses, such as Hepatitis A and B. 7. Do not self-medicate Dr Kapali cautions against taking medications and supplements without medical supervision to protect your liver — be it for any specific health condition. The liver is at higher risk in such instances since it is responsible for removing excess toxins and chemicals from your body. 8. Do not stress Dr Kapali points out that there is a direct link between stress and liver health. He points out that high levels of stress negatively impact liver health since it triggers excess cortisol secretion. Cortisol in excess levels could lead to inflammation in the liver that could lead to multiple liver conditions like fatty liver which could be a precursor to liver failure if left unaddressed.

Introduction Ganesh Utsav, also known as Ganesh Chaturthi, is an auspicious Hindu festival celebrated with great fervor across India and in various parts of the world. While it holds immense religious significance, it’s fascinating to explore the subtle yet profound connection between this revered deity and the vital organ, the liver. The Symbolism of Lord Ganesha Lord Ganesha, the elephant-headed god, is revered as the remover of obstacles and the harbinger of good fortune. He symbolizes wisdom, intellect, and the power to overcome challenges. Interestingly, this symbolism finds resonance in the realm of liver health. The Liver: Nature’s Ultimate Problem Solver Much like Lord Ganesha, the liver is a remarkable problem-solver within the human body. It’s the largest internal organ and plays a pivotal role in various physiological functions. Here’s how the symbolism aligns: 1. *Removing Toxins:* – Lord Ganesha’s role as a remover of obstacles mirrors the liver’s function of detoxification. It filters toxins and harmful substances from the bloodstream, ensuring the body remains free from potential hindrances to optimal health. 2. *Metabolic Wisdom:* – Lord Ganesha is hailed for his intellect and wisdom. Similarly, the liver is a metabolic powerhouse, orchestrating a myriad of complex biochemical processes. It regulates blood sugar levels, processes nutrients, and produces essential proteins crucial for bodily functions. 3. *Overcoming Challenges:* – Just as Lord Ganesha is venerated for his ability to overcome challenges, the liver exhibits remarkable resilience. It has the extraordinary capacity to regenerate, enabling it to recover from various insults and continue functioning effectively. Ganesh Chaturthi: A Lesson in Moderation While the connection between Lord Ganesha and the liver is symbolic, there’s a practical lesson to be learned. The celebrations of Ganesh Chaturthi often involve feasting on a variety of delectable sweets and rich foods. This provides an opportunity to reflect on the importance of moderation in our dietary habits. Excessive indulgence, particularly in foods high in sugar and unhealthy fats, can strain the liver. Over time, this can lead to conditions like fatty liver disease and other liver-related disorders. It’s a reminder that while celebrations are meant to be enjoyed, they should also be balanced with mindful choices for our health. Practical Tips for Liver Health during Festivities 1. *Stay Hydrated:* Adequate water intake supports liver function and helps flush out toxins. 2. *Include Liver-Friendly Foods:* Incorporate fruits, vegetables, whole grains, and lean proteins in your festive meals. 3. *Limit Sugary Treats:* Enjoy sweets in moderation and opt for healthier dessert alternatives when possible. 4. *Monitor Alcohol Intake:* If you consume alcoholic beverages, do so in moderation and consider liver-friendly options. 5. *Practice Portion Control:* Be mindful of portion sizes to prevent overindulgence. Conclusion As we celebrate Ganesh Utsav and Ganesh Chaturthi, let us not only honor Lord Ganesha’s spiritual significance but also draw inspiration from the symbolism that resonates with our physical well-being. Just as Lord Ganesha navigates obstacles with wisdom, let us approach our health with mindfulness and balance, cherishing the precious gift of a healthy liver. May this festival bring blessings of good health, prosperity, and spiritual growth to all. Dr Chetan Kalal

Dr Chetan Kalal Hepatologist & Transplant Physician E very year, on the 13th of August, the world unites to celebrate a remarkable day that embodies the spirit of selflessness and compassion- World Organ Donation Day. This day serves as a poignant reminder of the crit- ical role organ donation plays in saving lives and offering hope to those in need. Organ transplantation has revolution- ized modern medicine, allowing individ- uals with failing organs a second chance at life. For those suffering from end-stage liver disease, like cirrhosis or hepatocel- lular carcinoma, a liver transplant can be the ultimate lifesaving intervention. As a hepatologist, I am deeply aware of the challenges faced by patients awaiting a suitable organ match, and World Organ Donation Day is a crucial platform to raise awareness about these challenges and the power each individual holds to make a difference. The demand for organs far outweighs the supply, leading to long waiting lists and unfortunate outcomes for many pa- tients. A single organ donor can potentially save multiple lives by providing organs such as the heart, lungs, kidneys, liver, and more. The liver, being a complex and regenerative organ, can also be divided for transplantation, enabling a single liver to benefit multiple recipients. One of the misconceptions is the fear of compromised medical care for donors. However, it’s im- portant to emphasize that medical pro- fessionals prioritize saving lives, and organ donation only becomes a consideration after all efforts to save a patient’s life have been exhausted. Rigorous protocols and ethical guidelines are in place to ensure the safety of both donors and recipients

*Introduction:* Janmashtami, also known as Krishna Jayanti, is a vibrant and joyous festival celebrated by millions of people worldwide. It marks the birth of Lord Krishna, who is not only a divine figure but also a symbol of wisdom, compassion, and holistic living. As a hepatologist, I find it fascinating to explore the intriguing connection between Janmashtami and liver health. Let’s delve into this unique perspective on this auspicious occasion. *Balancing Act:* Lord Krishna, in his childhood, was known for his mischievous and adventurous nature. He would often engage in activities that required boundless energy and vitality. This boundless energy resonates with the importance of a healthy liver in our lives. The liver, after all, is our body’s energetic powerhouse, performing an array of vital functions that keep us going. *Digestion and Detoxification:* One of the liver’s key roles is in digestion. It produces bile, a digestive juice that breaks down fats and helps absorb essential nutrients. Similarly, Lord Krishna’s love for butter and dairy products underscores the significance of good digestion and nutrient absorption. Moreover, the liver serves as our body’s detoxification center, eliminating harmful toxins and waste products. Just as Lord Krishna is revered for vanquishing evil forces, the liver protects our body from harmful invaders, ensuring our well-being. *Healthy Lifestyle Lessons:* Lord Krishna’s life offers valuable lessons for a balanced and healthy lifestyle. His teachings emphasize the importance of moderation, physical activity, and a diet rich in fruits, vegetables, and dairy products. These principles align remarkably well with modern notions of maintaining liver health. *Moderation:* In Krishna’s teachings, moderation is key. Excessive consumption of alcohol, fried foods, and rich, fatty meals can strain the liver. Emphasizing moderation, like Lord Krishna did, is a step towards liver well-being. *Physical Activity:* Lord Krishna’s youthful enthusiasm for sports, including the iconic game of “Dahi Handi,” highlights the importance of physical activity. Regular exercise not only promotes overall health but also supports liver function. *Nutrient-Rich Diet:* Lord Krishna’s preference for fresh dairy products, fruits, and vegetables is a testament to the significance of a balanced diet. These foods provide essential nutrients that nourish the liver and enhance its functionality. *Stress Management:* Krishna’s teachings on inner peace and stress management resonate with our understanding of stress’s impact on liver health. Chronic stress can harm the liver, making relaxation and mindfulness essential. *Conclusion:* As we celebrate Janmashtami, let us not only embrace the spiritual significance of this festival but also reflect on the wisdom it imparts regarding liver health and holistic living. Just as Lord Krishna’s life exemplifies balance, moderation, and vitality, let us endeavor to maintain our liver’s well-being by adopting a healthy lifestyle. #HappyJanmashtami! May your liver and your spirit both thrive in perfect harmony.

Dear all, As we come together to honor and celebrate our educators on this Teachers’ Day, I’d like to reflect on the profound influence teachers have on our lives, including a less-discussed aspect: our liver health. Teachers are the first influencers on our educational journey, shaping not only our minds but also our choices and behaviors. Here’s how their impact extends to our liver health: 📌 *Foundations of Health Education:* Teachers lay the groundwork for understanding the importance of balanced diets, the risks of excessive alcohol consumption, and the hazards of unhealthy behaviors, all of which are pivotal for liver well-being. 📌 *Fostering Healthy Habits:* They inspire healthy habits such as physical activity, stress management, and adequate sleep—cornerstones of a healthy liver and overall well-being. 📌 *Stress Reduction and Mental Health:* Educators often become confidants, helping us manage stress and maintain good mental health. Chronic stress can impact liver health, making their role invaluable. 📌 *Substance Abuse Education:* Teachers educate us about the perils of substance abuse, including alcohol and drugs, helping deter behaviors that can lead to liver diseases. 📌 *Lifelong Learning:* Teachers ignite a passion for learning, including staying informed about health, including liver health. Informed individuals make healthier choices. 📌 *Empowering Advocates:* They empower us to advocate for our own health, enabling informed decisions about lifestyle, nutrition, and when to seek medical care. On this Teachers’ Day, let’s express heartfelt gratitude to the educators who have positively influenced our lives, including our health. As a Hepatologist, I’ve witnessed the profound impact of education on liver health. Teachers are instrumental in promoting liver-friendly choices and a healthier future. The lessons we learn from teachers extend far beyond the classroom, shaping our health, happiness, and the world we live in. Let’s celebrate and appreciate their dedication to nurturing minds and health. Wishing all educators a Happy Teachers’ Day and a lifetime of well-being! Warm regards, #TeachersDay #EducationMatters #LiverHealth #Gratitude #liver #liverhealth #livertransplant #LiverCirrhosis #livercancer #chetankalal