Ginseng extract: An ancient immunity booster

By: Nutrition expert- Vidula Kozarekar, Mumbai.

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Ginseng is a medicinal plant widely used for the treatment of various conditions. The pharmacological effects of ginseng have been demonstrated in cancer, diabetes, cardiovascular diseases and have been used for promoting immune function, central nervous system (CNS) function, relieving stress, and for its antioxidant activities.

Among eleven different species of ginseng commonly called as ginseng, three species of ginseng, i.e., Panax ginseng (Korean ginseng), P. quinquefolius (American ginseng) and P. notoginseng (Chinese notoginseng or Sanchi) are the three most commonly used ginseng herbs at present (1).

Natural-dried ginseng is known as white ginseng, and red ginseng is prepared by steaming fresh ginseng root prior to drying on the purpose of enhancing efficacy, safety, and preservation (2).

How Ginseng improves immunity?

Red ginseng, which results from the special preparation of ginseng, has an unusual saponin profile; which is of higher pharmacological and medicinal functions than white ginseng (3).

Ginseng has been well known as an immune modulator. Roots (mostly), stems, leaves of ginseng and their extracts have been used for maintaining immune homeostasis and enhancing resistance to illness or microbial attacks through effects on immune system. Immune system is composed of diverse types of cells with their own specialized functions and each type of the immune cells differently responds to ginseng treatment (4), (5).

Efficacy of Ginseng extract:

  • Improving cerebral functions

A 24-week randomized open-label study with Korean red ginseng (KRG) showed cognitive benefits in patients with Alzheimer’s disease. The effect of KRG on cognitive functions was sustained for 2 yrs. follow-up, indicating feasible efficacies of long-term follow-up for Alzheimer’s disease (6).

  • Preventing cancer

In a literature review author XinJin et al. found that; ginseng consumption is associated with a significantly decreased risk of cancer (7). Othman A AL Shabanah et al revealed in a study that; ginseng may inhibit breast cancer cell growth by activation of the apoptotic pathway (8).

  • Anti-oxidation and anti-aging activity

A study conducted by Eunson Hwang et al found in a study that; Panax ginseng and Crataegus pinnatifida together can prevent aging by inhibiting wrinkle formation and increasing moisture in the human skin (9).

  • Treating metabolic syndrome

Dong-Hyuk Junga et al found evidence that Red Ginseng had a favorable effect on mitochondrial function and hormones in men with metabolic syndrome. There was a Significant improvement in mitochondrial function and an increase in total testosterone levels were observed in the RG group when compared with the placebo group. Diastolic blood pressure and serum cortisol significantly decreased in the RG group (10).

  • Improving male reproductive function

Ginseng is a vital constituent of traditional Chinese medicine and has been used to treat sexual dysfunction as well as to enhance sexual behavior and gonadal functions in men. Oral administration of the Korean Ginseng Berry extract improved all domains of sexual function. It can be used as an alternative medicine to improve sexual life in men with sexual dysfunction (11).


While ginseng appears to be safe, people taking certain medications should pay attention to possible drug interactions. Ginseng can be consumed raw or lightly steamed or in the form of tea. It can also easily be added to your diet via its extract, capsule or powder form. Whether you want to improve a certain condition or simply give your health a boost, ginseng is definitely worth a try.



Biotin – Vitamin Necessary for Beauty &Immunity

By-Nutrition Expert:Meena Ganagani,Practicing Clinical Nutritionist,Mumbai.

Biotin is an essential nutrient that is naturally present in some foods and available as a dietary supplement

  • Immunity

The immune system protects the body against disease or other potentially damaging foreign bodies. When functioning properly, the immune system identifies and attacks a variety of threats, including viruses, bacteria and parasites, while distinguishing them from the body’s own healthy tissue.(1)

  • Micro-nutrients

Micro-nutrients often referred to as vitamins and minerals, are vital to healthy development, disease prevention, and well being. Although only required in small amounts, micro-nutrients are not produced in the body and must be derived from the diet. (2)

An adequate amount of all micro-nutrients is required for optimal immune function in adolescents and adults (and throughout life), but in higher amounts compared with infants and children. It is especially important to ensure that antioxidant levels and micro-nutrients that are components of antioxidant enzymes are sufficient to combat the oxidative stress that is induced by many lifestyle factors common in this group, and which has great impact on immune function.(3)

  • Role of Biotin

Biotin, a member of the family of water-soluble vitamins (also known as vitamin B7), is an indispensable micro nutrient for normal human health due to its essentiality for cellular metabolism, proliferation, and survival. Marginal and severe degrees of biotin deficiency lead to a variety of clinical abnormalities that include neurological disorders and dermal abnormalities. Such deficiency/sub optimal levels occur in a variety of conditions including inflammatory bowel disease (IBD), inborn errors in biotin metabolism (multiple carboxylase deficiency), and chronic alcoholism among others. At the metabolic level, biotin acts as a co factor for five carboxylases that are critical for fatty acid, glucose, and amino acid metabolism. Important roles for this vitamin in cellular energy metabolism (i.e., ATP production) and in regulation of cellular oxidative stress, as well as in gene expression have also been reported recently. Emerging evidence has also been accumulating showing a role for biotin in the functions of immune cells. In reference to the latter, biotin was shown to be important for the activity of human natural killer (NK) lymphocytes, for the generation of cytotoxic T lymphocytes (CTLs), and for the maturation and responsiveness of immune cells. Defects in T-cell and B-cell immunity have been reported in patients with multiple carboxylase deficiency, a condition associated with biotin deficiency. An increase in the levels of pro-inflammatory cytokines TNF-α and interleukin-1β (IL-1β) has also been observed in biotin deficiency. (4)

Signs and symptoms of Biotin deficiency

Signs of overt biotin deficiency include hair loss and a scaly red rash around the eyes, nose, mouth, and genital area. Neurologic symptoms in adults have included depression, lethargy hallucinations, numbness and tingling of the extremities, ataxia, and seizures. The characteristic facial rash, together with unusual facial fat distribution, has been termed the “biotin deficient facies” by some investigators. Individuals with hereditary disorders of biotin metabolism (see Inborn metabolic disorders) resulting in functional biotin deficiency often have similar physical findings, as well as seizures and evidence of impaired immune system function and increased susceptibility to bacterial and fungal infections.(5)

  • Sources of Biotin

Many foods contain some biotin. Foods that contain the most biotin include organ meats, eggs, fish, meat, seeds, nuts, and certain vegetables (such as sweet potatoes). The biotin content of food can vary; for example, plant variety and season can affect the biotin content of cereal grains, and certain processing techniques (e.g., canning) can reduce the biotin content of foods.(6)

Nutrient Requirements and Recommended Dietary Allowances for Indians (ICMR 2010)

  • Biotin (mcg/d) is 30 mcg



Lycopene- The powerful antioxidant we all need

By: Nutrition expert- Vidula Kozarekar, Mumbai.

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Lycopene is a naturally occurring chemical that gives tomatoes, watermelons, red oranges, pink grapefruits, apricots, rose hips, guavas and other delicious fruits and vegetables their vibrant colour. It is one of the colour pigments called Carotenoids.

More than 80% of dietary lycopene intake in the U.S. is derived from processed tomato products such as ketchup, tomato juice, spaghetti sauce and pizza sauce. The amount of lycopene present in processed foods is often much higher than that found in fresh foods given that processing often involves concentration via water loss. For example, ketchup contains 9.9–13.44 mg lycopene/100 g, whereas fresh tomatoes contain anywhere from 0.88–7.74 mg lycopene/100 g wet weight (1), (2), (3).

Health benefits of Lycopene:

Over the past decade, lycopene-containing foods (primarily tomato products) and lycopene supplements have been reported to affect diseases ranging from cancer to heart disease to asthma. The consumption of tomatoes and tomato products has been associated with a reduced incidence of a number of different types of cancers, most notably prostate, lung, and stomach. Experimental and clinical studies have also confirmed lycopene’s positive effects on the skeletal system and on neuro-degenerative diseases, including Alzheimer’s and Parkinson’s. Of the diseases studied in relation to lycopene, prostate cancer is one of the well-researched. Various observational studies suggest that the consumption of lycopene or lycopene containing foods reduces the risk for developing prostate cancer (4).

Oxidative stress is considered to be one of the main causes of the diseases of civilization. However, antioxidants, including lycopene, are assumed to be able to limit or prevent the development of various conditions caused by ROS (Reactive Oxygen Species). Lycopene is about 2 times greater than B-carotene and 10 times greater than vitamin E in its potency to quench singlet oxygen and is one of the most potent antioxidants in food (5).

Lycopene may also lower your risk of developing heart disease. Its anti-oxidant properties help reduce total and LDL cholesterol and help increase good HDL cholesterol. It has been shown to increase life expectancy of people with metabolic syndrome (6).

A study found that; Lycopene protects against cataract development by virtue of its antioxidant properties, and it may be useful for prophylaxis or therapy against cataracts (7).


Lycopene is a powerful antioxidant with many health benefits like improved heart health and a lower risk of certain types of cancer. It can be obtained from supplements and it may be most effective when consumed from lycopene-rich foods like tomatoes and other red or pink fruits.



Iron: The immunity booster

Nutrition Expert: Sana Saiyed, Practicing clinical nutritionist, Mumbai

A robust and properly functioning immune system helps you in daily life as you come into contact with germs.

Why should we have robust immune system?

Protecting your body from viruses and bacteria is the sole purpose of the immune system. Without the immune system, your body would be easily available for foreign substances i.e. virus and bacteria to get inside your system and make you ill. Your immune system works by recognizing the difference between foreign substances and its own body cells, allowing it to destroy any of it that could cause harm.


 How can we improve our immunity?

Minerals have always played a very essential role in immunity-boosting for decades, although they are recognized better in today’s time considering the external conditions. One scientific review concluded that almost every effector of the immune response is limited in number or action by experimental iron deficiency. (1) In other words, every aspect of your immune system will be impaired by inadequate iron levels in your body.

It’s vital that your immune system is in good working order if you want to stay as protected as possible. Iron is one of the minerals that contributes to building a robust immune system. 

 Iron plays an essential role in both primary and secondary immune responses. Having too little iron degrades nonspecific immunity which is your body’s first line of defense against pathogens.

Importance of iron in hemoglobin synthesis:

One of the most important functions of iron is in heme synthesis, which forms hemoglobin, a protein found in red blood cells. Hemoglobin is the protein in red blood cells responsible for carrying oxygen to the tissues from the lungs. Myoglobin is a protein found in muscles that are used for the storage of oxygen.

Hemoglobin is the oxygen transport system found in the red blood cells of all vertebrates and some invertebrates. In humans, hemoglobin is made up of four globular protein subunits. The four subunits form a pocket that binds a heme group. Oxygen binds to the iron atom within the hemoglobin molecule in the lungs to form oxyhemoglobin. This occurs in the capillaries of the lung alveoli. It is released at its destination in the cells. Hemoglobin carries CO2 back to the lungs to be exhaled as waste instead, CO2 binds to the protein portion of the hemoglobin molecule and not to the bound iron in the heme group.

The overall utilization of iron in the body is regulated by ferritin and transferrin mRNAs which contain iron-responsive elements (IREs). Always remember iron requires vitamin-s (Ascorbic acid) for its absorption and transport in the blood.

Functions of Hemoglobin:

1.Oxygenation of the blood: 

Heme synthesis is the most important function of iron, which produces hemoglobin, a protein found in red blood cells. Hemoglobin’s primary role is to transport oxygen from the lungs to body tissues to maintain basic life functions. Without healthy red blood cells, your body cannot get enough oxygen, and this can result in you feeling increasingly tired or exhausted. (2)

2. Removal of carbon dioxide and Carbon Monoxide from the body: 

Hemoglobin transports carbon dioxide from different tissues to lungs. 80% of the carbon dioxide is transported via blood plasma. Carbon Dioxide does not compete with the oxygen binding site of hemoglobin. It rather binds to the protein structure other than the iron-binding position. The carbon dioxide bound hemoglobin is referred to as carbaminohemoglobin.

Recommended daily allowance: (RDA)

The below table shows the Recommended daily allowance of iron for Indians as per ICMR. (3)

7-12 months5 mg/day
1-3 years9 mg/day
4-6 years13 mg/day
9-13 years29 mg/day
13-15 years27 mg/day
16-17 years26 mg/day
18 and above21 mg/day
Pregnant35 mg/day
Breastfeeding21 mg/day
10-15 years27 mg/dl
16-17 years28 mg/day
18 years and above17 mg/day



“keeping your immune system intact is important”

Riboflavin (RF) and Immunity

Nutrition Expert- Saba Shaikh, Clinical Nutritionist, Mumbai.

  • Immunity

The immune system is constantly working to protect the body from infection, injury, and disease. It relies on an adequate supply of nutrients for its baseline functions as well as for ramping up its activity when necessary. It is well established that malnutrition (protein-energy malnutrition and obesity) and deficiencies in one or more micronutrients (vitamins and nutritionally essential minerals) diminish immune function. (1)

  • Riboflavin

Riboflavin (RF) is known as an essential vitamin B2, a water-soluble vitamin, is heat stable. Cooking does not lower levels of RF; however exposure to light could destroy it.

RF is poorly stored by vertebrates because of its limited absorption in humans. Therefore, orally supplied RF by a healthy diet is required to avoid ariboflavinosis which causes cheilitis, sore tongue, and a scaly rash on the scrotum or vulva. RF causes no known toxicity, since at higher intakes it is excreted in the urine and not stored. (2)

The two flavorprotein coenzymes derived from riboflavin, Flavin Mononucleotide (FMN) and Flavin Adenine Dinucleotide (FAD) are crucial rate limiting factors in most cellular enzymatic processes. The flavoproteins are also co-factors in the metabolism of essential fatty acids in brain lipids, the absorption and utilization of iron, and the regulation of thyroid hormones.

Riboflavin derivatives also have direct antioxidant properties and increase endogenous antioxidant status as essential cofactors in the glutathione redox cycle. (3)

  • Role of Vitamin b2

Vitamin B2 helps break down proteins, fats, and carbohydrates. It plays a vital role in maintaining the body’s energy supply.

Riboflavin helps convert carbohydrates into adenosine triphosphate (ATP). The human body produces ATP from food, and ATP produces energy as the body requires it. The compound ATP is vital for storing energy in muscles. (4)

  • Riboflavin and Immunity

RF activates phagocytic activity of neutrophils and macrophages, and stimulates the multiplication of neutrophils and monocytes. The reduction in RF concentration resulted in a decreased rate of cell proliferation. A combined supplementation consisting of RF, delta-tocotrienol and quercetin improved the inhibition of serum tumor necrosis factor alpha (TNF-α) and nitric oxide (NO) levels.

RF administration affects neutrophil migration, inhibiting the infiltration and accumulation of activated granulocytes into peripheral sites, which may lead to a decreased inflammatory influx and, thereby, a decrease in inflammatory symptoms. RF is a potential substance for use in virus inactivation, or as an adjuvant in chemo radiotherapy for cancer treatment because of its toxicological and photosensitizing attributes. RF suppressed T-cells infiltration and donor-reactive alloantibody formation during the early period after allotransplantation. (2)

  • Metabolism

The pro-inflammatory transcription nuclear factor kappa B (NF-κB) is normally activated by degradation of inhibitory kappa B (IκB). When this occurs, NF-κB translocates to the nucleus and binds to specific promoter regions of genes encoding pro-inflammatory proteins. Proteasomes are key regulators of lipopolysaccharide (LPS)-stimulated inflammatory signaling pathways. RF, as proteasome inhibitor, possibly down-regulates the NF-κB activation initiated by ROS, which are the potent activators of a plethora of general pro-inflammatory cytokines such as interleukin-6 (IL-6), TNF-α, etc. Therefore, ultimately, as proteasome inhibitor RF suppresses the production of TNF-α and NO, and exerts anti-inflammatory effects by inhibiting NF-κB, activation. As was recently reported, RF may protect against multitude of age-associated diseases by inhibition levels of secretion of TNF-α, NO production, activation of NF-κB, and degradation.(2)

  • Vitamin B2 Deficiency

Vitamin B2 deficiency is at significant risk when diet is poor, because the human body excretes the vitamin continuously, so it is not stored. A person who has a B2 deficiency normally lacks other vitamins too. (4)


Alcoholics are at increased risk of vitamin B2 (riboflavin) deficiency due to decreased intake, decreased absorption, and impaired utilization of riboflavin.

Additionally, anorexic individuals rarely consume adequate riboflavin, and lactose intolerant individuals may not consume milk or other dairy products which are good sources of riboflavin. (5)


Symptoms of vitamin B2 (riboflavin) deficiency include sore throat, redness and swelling of the lining of the mouth and throat, cracks or sores on the outsides of the lips and at the corners of the mouth, inflammation and redness of the tongue, and a moist, scaly skin inflammation. (5)

Ariboflavinosis is the medical name for clinical riboflavin deficiency. Riboflavin deficiency is rarely found in isolation; it occurs frequently in combination with deficiencies of other water-soluble vitamins. Other symptoms may involve the formation of blood vessels in the clear covering of the eye (vascularization of the cornea) and decreased red blood cell count in which the existing red blood cells contain normal levels of hemoglobin and are of normal size (normochromic normocytic anemia). Severe riboflavin deficiency may result in decreased conversion of vitamin B6 to its coenzyme form (PLP) and decreased conversion of tryptophan to niacin.(6)

Recommended Dietary Allowances (RDAs) for Riboflavin

Age groupRiboflavin (mg/d)
Infants (0-6 months)0.3
Infants(6-12 months)0.4
Children’s(1-3 years)0.6
Children’s(4-6 years)0.8
Children’s(7-9 years)1.0
Boys(10–12 years)1.3
Girls(10-12 years)1.2
Boys(13-15 years)1.6
Girls(13-17 years)1.4
Boys(16-17 years)1.8
Girls(16-17 years)1.2
Men (sedentary work)1.4
Men (Moderate work)1.6
Men (Heavy Work)2.1
Women (sedentary work)1.1
Women (Moderate work)1.3
Women (Heavy Work)1.7
Pregnant Women+0.3
Lactating Women(0-6 months)+0.4
Lactating Women(6-12 months)+0.3

Source: Nutrient Requirements and Recommended Dietary Allowances for Indians (ICMR 2010)

What Foods Provide Riboflavin:

Riboflavin is found naturally in some foods and is added to many fortified foods. You can get recommended amounts of riboflavin by eating a variety of foods, including the following:

  • Eggs, organ meats (such as kidneys and liver), lean meats, and low-fat milk
  • Green vegetables (such as asparagus, broccoli, and spinach)
  • Fortified cereals, bread, and grain products(7)



Selenium_ An Essential Trace-element

By: Pallavi Vathiar. Practicing Clinical Nutritionist, Mumbai.


Dietary selenium (Se) is an essential micro-nutrient that affects various aspects of human health, including optimal immune responses.

Why should we have robust Immunity?

When your immune system is in tip-top condition, you probably do not even notice it working away to protect you around the clock.

As immunity and the immune system are an overly complex collection of processes that act together to protect organisms against attacks by pathogens and malignancy. You will know when there is something wrong as your immune system is your body’s in-built defence system against illness and infection. If you feel good today, thank your immune system.

How Selenium comes into the picture when we talk about Immunity?

The public perception of selenium has changed significantly over the last decades. Originally known for its high toxicity, it was later recognized as an essential trace element and is now almost being marketed as a lifestyle drug.

Through selenium’s incorporation into selenoproteins, Se is involved in regulating oxidative stress, redox, and other crucial cellular processes in nearly all tissues and cell types, including those involved in innate and adaptive immune responses (1-3).

Few studies on Selenium

Recent studies have highlighted the benefits of milk enriched with Se as a unique source of Se that is more bioavailable and bioactive, compared with inorganic forms such as sodium selenite, or organic forms such as Se‐enriched yeast.(4,5) In addition, milk is also a rich source of macro‐ and micronutrients with immunomodulatory and antibacterial and antiviral properties (6). As a result, there is increasing interest in the use of dairy as a source of Se in human diets

Data from studies in humans suggest that Selenium supplementation enhance immunity, including both humoral and cell-mediated responses (7).

Another study shows that Selenium-supplemented subjects also showed more rapid clearance of the poliovirus, and the poliovirus reverse transcriptase–polymerase chain reaction (8).

Selenium Deficiency

Selenium deficiency produces biochemical changes that might predispose people who experience additional stresses to develop certain illnesses.

Selenium deficiency could exacerbate iodine deficiency, potentially increasing the risk of cretinism in infants (9,10).

Groups at Risk of Selenium Inadequacy

Selenium deficiency is exceedingly rare but selenium deficiency in isolation rarely causes overt illness the following groups are among those most likely to have inadequate intakes of selenium.

  • People living in selenium-deficient regions
  • People undergoing kidney dialysis
  • People living with HIV
  • People with Cancer
  • Facing Cardiovascular disease
  • Suffering from Cognitive decline
  • People with Thyroid disease

How much selenium do I need?

While too little selenium can cause serious health problems, too much can also be toxic.

According to ICMR (Indian Council of Medical Research), the nutrient requirements and Recommended Dietary allowance for Indians is 40 micrograms of Selenium per day.

Are Sodium Selenate and Selenium different?

Sodium Selenate is the sodium salt of selenium. As a trace mineral that is toxic in high doses, selenium is a cofactor for glutathione peroxidase, an antioxidant enzyme that neutralizes hydrogen peroxide.

Selenium may be chemoprotective for certain cancers, particularly prostate cancer. High dietary supplementation with sodium Selenate may inhibit the progression of hormone-refractory prostate cancer due, in part, to an antiangiogenetic effect (10).

Its molecular formula is Na2SeO4.

From where Do I get selenium?

It is easy to get enough selenium by making healthy choices.

Choosing a variety of antioxidant-rich vegetables and fruit, whole grains, lean meat and dairy, fish, legumes, nuts, and seeds will meet your selenium needs.

Sources of Selenium:

ChickenBrazil Nuts
FishSunflower seeds
Enriched foodsMushrooms
TurkeyMilk and Yogurt
Cottage CheeseCashews
Brown riceBananas


  1. Behne D, Wolters W. Distribution of selenium and glutathione peroxidase in the rat. J Nutr. 1983;113:456-461.
  2. Bainbridge DR. Use of (75Se)L-Selenomethionine as a label for lymphoid cells. Immunology. 1976;30:135–144.
  3. Gromer S, Eubel JK, Lee BL, Jacob J. Human selenoproteins at a glance. Cell Mol Life Sci. 2005;62:2414–2437.
  4. Uglietta R, Doyle PT, Walker GP et al. Tatura‐Bio® Se increases plasma and muscle selenium, plasma glutathione peroxidase and expression of selenoprotein P in the colon of artificially‐reared neonatal pigs. Asia Pac J Clin Nut 2007; 16 (Suppl. 3): S51.
  5. McIntosh GH, Royle PJ. Supplementation of cows with organic selenium and the identification of selenium‐rich protein fractions in milk. In: TP Lyons, KA Jacques, eds. ‘Nutritional Biotechnology in the Feed and Food Industries’. Proceedings of Alltech 18th Annual Symposium. Cambridge, UK; Woodhead Publishing Ltd. 2002; 233– 8.
  6. Iran J Pharm Res. 2016 Summer; 15(3): 573–591. PMCID: PMC5149046PMID: 27980594. Health-Related Aspects of Milk Proteins.
  7. Hawkes WC, Kelley DS, Taylor PC. The effects of dietary selenium on the immune system in healthy men. Biol Trace Elem Res. 2001;81:189–213.
  8. Broome CS, McArdle F, Kyle JA, Andrews F, et al. An increase in selenium intake improves immune function and poliovirus handling in adults with marginal selenium status. Am J Clin Nutr. 2004;80:154–162.
  9. Sunde RA. Selenium. In: Bowman B, Russell R, eds. Present Knowledge in Nutrition. 9th ed. Washington, DC: International Life Sciences Institute; 2006:480-97.

Green Tea- All there is to know

Nutrition Expert- Sana Shaikh, Dietitian at healthine clinic, Mumbai

Tea is one of the most popular beverages consumed worldwide. Tea, from the plant Camellia sinensis, is consumed in different parts of the world as green, black, or Oolong tea. Among all of these, however, the most significant effects on human health have been observed with the consumption of green tea.

To produce green tea, freshly harvested leaves are immediately steamed to prevent fermentation, yielding a dry, stable product. This steaming process destroys the enzymes responsible for breaking down the color pigments in the leaves and allows the tea to maintain its green color during the subsequent rolling and drying processes. These processes preserve natural polyphenols with respect to the health-promoting properties.

The major flavonoids of green tea are various catechins, which are found in greater amounts in green tea than in black or Oolong tea. There are four kinds of catechins mainly find in green tea: epicatechin, epigallocatechin, epicatechin-3-gallate, and EGCG

Health benefits of green tea

Studies have shown that green tea catechins provide some protection against degenerative diseases. Some studies indicated that green tea has an anti-proliferative activity on hepatoma cells and a hypolipidemic activity in hepatoma, as well as the prevention of hepatoxicity  and as a preventive agent against mammary cancer post-initiation . Green tea catechins could also act as anti-tumorigenic agents and as immune modulators in immunodysfunction caused by transplanted tumors or by carcinogen treatment. Moreover, green tea, its extract, and its isolated constituents were also found to be effective in preventing oxidative stress and neurological problems.

Green tea consumption has also been linked to the prevention of many types of cancer, including lung, colon, esophagus, mouth, stomach, small intestine, kidney, pancreas, and mammary glands . Several epidemiological studies and clinical trials showed that green tea (and black and Oolong teas to a lesser extent) may reduce the risk of many chronic diseases. This beneficial effect has been attributed to the presence of high amounts of polyphenols, which are potent antioxidants.

Green tea extract (GTE) has many naturally occurring biological components of which polyphenolic epicatechins (ECs) are predominantly active.

Epigallocatechin gallate (EGCG), the most abundant form of catechin in green tea, has been known to be the main attributable factor of beneficial effects of green tea.

In particular, green tea catechins are involved in many biological activities such as antioxidation and modulation of various cellular lipid and proteins. Thus, they are beneficial against degenerative diseases, including obesity, cancer, cardiovascular diseases, and various inflammatory diseases.

Tip: Consume one cup of green tea everyday

Lifestyle changes in cardio-vascular diseases

By: Pallavi Vathiar. Practicing Clinical Nutritionist, Mumbai.


Lifestyle and dietary modifications are the cornerstone in CVD prevention. Given below are different lifestyle and dietary approaches which are recommended to manage the major modifiable CVD risk factors and hence CVR risk:

  • Saturated fat should be replaced with MUFA or PUFA to reduce LDL-cholesterol.
  • Foods with added plant sterols/stanols are effective in reducing LDL-cholesterol when consumed in recommended amounts (1.5-3 g/day)
  • Consume 25-45 g of dietary fiber per day of which 5-15 g of soluble fibers from foods rich in these fibers for a cholesterol-lowering effect
  • Salt intake should be reduced below 5 g/day by avoiding table salt and limiting salt in cooking and by choosing foods low in added salt.
  • The intake of beverages and foods with added sugars, particularly soft drinks, should be limited, particularly for patients with hypertriglyceridemia. Sugar intake should not exceed 10% of total energy.
  • Physical activity should be encouraged, aiming at regular physical exercise for at least 30 minutes a day.
  • A BMI of < 25 kg/m2 is associated with favorable effects on BP and dyslipidemia
  • For those who drink alcoholic beverages, moderation should be advised (no more than 1drink/day for women and 1-2 drinks/day for men) and patients with hypertriglyceridemia should abstain.
  • Use and exposure to tobacco and even passive smoking has to be avoided.

Weight loss- What really works!

By: Nutrition expert- Vidula Kozarekar, Mumbai.

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Obesity is an excess of body fat, resulting in adverse health effects. Obesity has emerged as a major public health problem. The prevalence of obesity is increasing in almost all parts of the world.The prevalence of overweight and obesity among population aged 30 years and above was 42% and 12% globally, respectively. Obesity is much more than cosmetic problems, as its associated health problems are increasing. According to some estimates, it is responsible for greater health-care costs than is either smoking or drinking. The development of overweight and obesity is extremely complex and multi factorial. Ultimately, it is the imbalance of energy intake being greater than the energy expenditure that contributes to weight gain.

Research studies over the last decade showed that regular activity and appropriate energy intake can play critical roles in preventing and managing the negative health consequences of obesity, diabetes and other cardiovascular diseases. Weight loss programs focused on restricting energy intake, but sharp reductions in energy intake have been shown to result in fat-free mass reductions and negatively impact metabolic rate. In addition, a growing body of evidence demonstrates that in comparison with a dietary restriction intervention alone, exercise, accompanied with or without weight loss, can lead to favorable changes in body composition including a reduction in abdominal adiposity.

Exercise has been found to be associated with better results in dieting subject. Furthermore, improvement of diet as well as regular physical activity of at least 60 min/d may also protect obese individuals of cardiovascular disease.

  • Diet and exercise in obesity: A case report
  • Patient Info: A rural mother aged 58 years at the time of appointment, with complaints of breathlessness while doing normal day-to-day activities. Excessive sleepiness was observed during the day hours as she dosed off performing normal daily chores. Her sleeping behavior included loud snoring. The breathlessness was not associated with postural variation, nor did it disturb her sleep.

She was morbidly obese as she weighed around 150.9 kg against a height of 157 cm [body mass index (BMI) 61.2 kg/m2]. She was diagnosed with morbid obesity, chronic type II respiratory failure, and obstructive sleep apnea. Her clinical history and examination along with lab investigations ruled out the possibility of hypothyroidism and Cushing’s syndrome. She was not on any steroids nor was she on any antidepressants. She was a nonalcoholic and a nonsmoker.

  • Goal setting: The goal setting was planned on a weekly basis. The first week was planned for behavioral modification, followed by minor changes in diet and mild physical activity. As the weeks progressed, her diet was gradually changed to a low carbohydrate, low fat and low protein diet. Similarly, increased the physical activity from indoor activity to outdoor physical activity. The goals were specific, measurable, and achievable.
  • Physical activity: Increased energy expenditure is the other half of the energy balance equation that affects body weight, the other being food intake. Daily activities were planned and modified. Motivational counseling on following a healthy lifestyle was given at least twice on a daily basis.

    The goal from the point of view of physical activity was to achieve a minimum 3 h of moderately vigorous physical activity on most days of the week. Initially, started with hand cycling for 10 min at four occasions on a single day. Along with this, she was asked to walk 150 steps indoors. The frequency as well as duration of hand cycling was also increased to 3-4 times/day, and the duration from 15 min to 20 min. Breathing exercises were also started from the third day. The patient did it regularly at an interval of 2 h during the day hours. The duration of breathing exercises varied from 5 min to 15 min. By the middle of second week, she was able to walk outdoors. Initially, she was able to cover 500 m in 90 min. But by the end, she was able to cover 1.5 km in 60 min on two occasions (morning and evening). This activity was undertaken along with hand cycling and breathing exercises.
  • Dietary modifications: Includes decreasing calorie intake and promoting low-calorie diet. Limiting the consumption of high-calorie foods by limiting the portion size and the number of servings was the principle followed in all her meals. Included more of fruits, vegetables, legumes, and whole grain cereals in her diet. Between the servings, there would be a minimum of 4 h, which was the time given for the food to be digested. In between, no supplementary meals were given. Only fruit or vegetable juices and drinking water were provided between meals. Lemon juice with honey was the first drink that she had soon after waking up. Breakfast would be sumptuous, followed by a lighter lunch, then an even lighter dinner. Milk was replaced with curd, which was gradually reduced and stopped during the subsequent weeks. She was asked to move from rice-based meal to wheat-based meals with more of fresh vegetable salads, fresh fruits, legumes, peas, nuts, and fruit and vegetable juices. Fruit juices and vegetable juices were provided at an interval of 2 hour. Gradually, reduced the amount of rice served. The final goal was to make her diet free of rice and make it a plant-based, whole-food diet over the period of 7 days.
  • Discussion

Sedentary lifestyle is a type of lifestyle with no or irregular physical activity. A person who lives a sedentary lifestyle may colloquially be known as a couch potato. A similar study done in rural South India showed that leisure-time physical activity had a significant negative relation to waist circumference. Because of the impact on energy balance, physical activity contributes to the prevention and control of weight gain. Hagan et al. reported reductions in weight losses of 7.5%, 5.5%, and 0.6% in women participating in 12 weeks of diet plus exercise, diet alone, or exercise alone, respectively. The solution to losing weight is a whole food, plant-based diet, coupled with a reasonable amount of exercise. Studies from across the world have shown that vegans are anywhere from 1.8 kg to 13.59 kg slimmer than their meat-eating counterparts. By feeding on a plant-based diet along with exercise, several intervention studies have shown to decrease the weight by 4-7% of their body weight over 3 weeks. All of these results show that consuming a whole-food, plant-based diet will reduce weight quickly over a period of 3-4 weeks. Losing body weight while on a plant-based diet is much less likely to occur if the diet includes too many refined carbohydrates. Sweets, cakes, pastries, and pastas also do not help. As long as one eats the right type of food, one will be able to achieve the desired weight.

  • Outcome
  • Weight reduction: Over a period of 1 week, with gradual modification of diet and exercise, she lost only 1.8 kg. During the course of the intervention, after 9 days she weighed 146.2 kg (lost 4.7 kg) while fully on diet modification but still picking up on physical activities.
  • Breathlessness: Her breathlessness gradually reduced from breathlessness even while doing normal activities to only during the performance of strenuous activities
  • Snoring: By the end of the second week, the patient’s relatives observed that her loud snoring behavior had reduced.
  • Blood pressure: She presented with a blood pressure of 150/100 mmHg. End of the program her reading was 130/90 mmHg.
  • Conclusion

Obesity is the most ominous harbinger of poor health. With necessary lifestyle modifications, the trend can be reversed. Weight control has been the subject of extensive study and writing. The simple conclusion of weight control research is the need for dietary modification and increased physical activity. Treating professionals should devote time to counsel the patient and bring him/her back to a diet-and-physical activity regime that will solve this issue.

Bone boosting minerals

Nutrition expert-Trupti, at Sushruta clinic, Baroda

Calcium, the most abundant mineral in the body, is found in some foods, added to others, available as a dietary supplement, and present in some medicines (such as antacids). Calcium is required for vascular contraction and vasodilation, muscle function, nerve transmission, intracellular signaling and hormonal secretion, though less than 1% of total body calcium is needed to support these critical metabolic functions. Serum calcium is very tightly regulated and does not fluctuate with changes in dietary intakes; the body uses bone tissue as a reservoir for, and source of calcium, to maintain constant concentrations of calcium in blood, muscle, and intercellular fluid

At particular risk are female adolescents when bone formation and growth is most crucial. Later in the life cycle, women continue to be at highest risk and this risk is elevated if early baseline bone is not strong during adolescence. Women who have diagnosed eating disorders or exhibit physical hyperactivity with female athlete triad syndrome have been shown to be at high risk for calcium deficiency. Postmenopausal women, due to hormonal changes that may affect bone mineralization processes, have also been widely studied for calcium deficiency risk. Calcium is essential to maintaining total body health.  Your body  needs  it  every day  not just  to keep  your  bones  and  teeth  strong  over  your  life time  but to  ensure  proper functioning  of  muscles and  nerves.  It even helps your blood clot. Ca deficiency is

usually  due  to  an  inadequate  intake  of  Ca  when blood Ca levels  drop too low,  the vital mineral is borrowed  from  the  bones. It  is  returned  to  the bones  from  Ca  supplied  through  the  diet.  If an individual’s diet is low in  Ca, there  may  not  be sufficient amount of Ca available in the blood to be returned to the bones to maintain strong bones and total body health. Taking Ca regularly everyday is key to preventing and treating Ca deficiency.

Maximum-calcium-retention studies, which examine the maximum amount of calcium that can be forced into bones, suggest a fairly high requirement. To ensure that 95% of the population gets this much calcium, the National Academy of Sciences established the following recommended intake levels:

  • 1,000 milligrams/day for those ages 19 to 50
  • 1,200 milligrams/day for those ages 50 or over
  • 1,000 milligrams/day for pregnant or lactating adult women.

Phosphorus is an essential structural component of cell membranes and nucleic acids but is also involved in several biological processes, including bone mineralization, energy production, cell signaling through phosphorylation reactions, and regulation of acid-base homeostasis.

Some investigators are concerned about the increasing amounts of phosphates in the diet, which they largely attribute to phosphoric acid in some soft drinks and the increasing use of phosphate additives in processed foods. High serum phosphorus has been shown to impair synthesis of the active form of vitamin D (1,25-dihydroxyvitamin D) in the kidneys, reduce blood calcium, and lead to increased PTH release by the parathyroid glands . PTH stimulation then results in decreased urinary calcium excretion and increased bone resorption; both contribute to serum calcium concentrations returning to normal. If sustained, elevated PTH levels could have an adverse effect on bone mineral content, but this effect appears to be observed with diets that are high in phosphorus and low in calcium, underscoring the importance of a balanced dietary calcium-to-phosphorus ratio. In a small cross-sectional study, which enrolled 147 premenopausal women with adequate calcium intakes, participants with lower calcium-to-phosphorus (Ca:P) intakes (ratios ≤0.5) had significantly higher serum PTH levels and urinary calcium excretion than those with higher Ca:P ratios (ratios >0.5). A controlled trial in 10 young women found no adverse effects of a phosphorus-rich diet (3,000 mg/day) on bone-related hormones and biochemical markers of bone resorption when dietary calcium intakes were maintained at almost 2,000 mg/day (Ca:P = 0.66), again demonstrating the importance of the balance between dietary calcium and phosphorus.         

The Recommended Dietary Allowance (RDA), 700 mg/day of phosphorus for healthy adults, is meant to sustain serum phosphorus concentrations within the physiologic range of 2.5 to 4.5 mg/Dl.