iPill usage, iPill’s benefits and issues related to Ipill’s misuse

What is iPill ?
i-Pill consists of one 1.5 mg levonorgestrel pill. The pill is indicated for the prevention of pregnancy *after* an act of unprotected sexual intercourse. You take the pill as soon as possible after the unprotected intercourse, up to 5 days (the sooner, the better).

Ipill, an emergency contraceptive pill. Unfortunately it is gaining popularity amongst teenagers, despite repeated warning from doctors / gynecologists against its careless use. Since ipill is an over the counter product, one doesn’t need a prescription and even teenagers are able to purchase the same from medical shops. The trend is more prevalent amongst the affluent classes of major cities in India like Gurgaon, Delhi, Mumbai, Bangalore etc. We receive many a cases where in young girls in their teens have taken iPill and call up RxOcean doctor to understand what could be the possible consequences of the same. In one such absurd case a girl’s boy friend made her have iPill twice within a span of 7 days without knowing what could be the possible consequences of doing this.

Infact dos and donts of the same are not clearly advertised even on Piramal Healthcare’s website which says
“i-pill has no long-term or serious side effects, and is safe to use for almost every woman. Nausea, vomiting, lower abdominal pain, a feeling of breast tenderness and headache are some common side effects after taking i-pill. All this should stop within a day or two. There are chances of unexpected vaginal bleeding, but this is not dangerous and should clear up by the time of the next period. i-pill might also cause the next period to come early or later than normal. But if the periods are delayed by more than a week, it is recommended to go in for a pregnancy test. i-pill will have no lasting effect that may complicate future (and wanted) pregnancies. i-pill is not recommended if you are allergic to levonorgestrel – the medicine used in i-pill.”

On one hand iPill’s Opponents claim that “It is only proved for women aged from 25-45. Ipill can be potentially harmful since it is a hormonal pill. Some Doctors have also suggested that frequent use can cause ovarian damage and menstrual problems, especially among younger girls. Certain side effects of ipill as mentioned by ISARC researchers include, reduced sex interest, skin allergies and loss of vigor. Long time effects of a hormonal pill cant be predicted. Continuous use may reduce the chances of future pregnancy too.”

Based on the logic that this medicine is supposed to be used sparingly and occasionally and hence is completely safe. But most of the people dont understand this logic and just go by the advertisement they see in the TV which doesnt clearly mention that it should be used sparingly and is not an alternative to contraceptive pills and hence use it without knowing the effects of its usage. Based on this background, proponents of iPill argue that  ” It is wrong to say that it was designed for women over 25 and is completely safe. According to these advocates of iPill there is no age restriction for the emergency contraceptive pill like the i-Pill. If you are of reproductive age (past menarche = the first period), are sexually active, and do not plan a pregnancy you can use the i-Pill. Other than allergy or pregnancy, there are no contraindications to i-Pill use.The i-Pill is safe to use even for women who cannot use the regular birth control pill. The i-Pill does not cause ovarian damage, nor does it reduce the chance of future pregnancy, etc. Briefly, the hormone in the i-Pill is a progesterone-like hormone; progesterone is a hormone secreted by the body and it has a regulatory function in the reproductive system.” Thus claiming that iPill is completely safe medicine

Although there are no clear winners to this debate but all said and done it is always safe to avoid any type of drug. Why cant we use other precautions to prevent pregnancy rather than depend on iPill post unprotected Sex. In case you still have queries and would like to discuss with a professional doctor , please call Family Physician ( Doctor / Gyanecologist ) available at www.RxOcean.com and discuss your case in detail.

One of the other question that people ask is do women gain weight when they take contraceptive pills?

Although there doesnt exist any scientific research to prove this but our experience from our clients suggest that a minority of women do experience weight gain. They get a feeling of bloating, probably due to fluid retention, and their weight goes up. These problems are temporary in nature and are resolved when they stop taking it.

Ideal BMI, Body Water, Lean Mass, Body Fat %

Many a times people have lots of misconceptions about ideal body mass, body water %, lean mass and body fat %. It is ok when people who are not aware about these things and how they work technically but the main problem arises when some of the gym instructors and fitness trainers tell wrong things to their clients.

Recently a client of mine who had lost almost 20 kilos of weight in 5 months and was very satisfied with the results called me frantically asking for an appointment. When we finally sat down he told the entire story that a friend of his who is a fitness trainer told that his body fat % is 20% over the normal and he needs to lose that fat. Now that he had already lost 20 kilos and was very much near his ideal body weight he wondered what else can he do ? Although I was a bit bemused at whatever he told me about the fitness trainer but then I realized that a number of people dont understand these things in detail hence am publishing the following tables which can be used as a benchmark for checking if your ratios are near to normal or above / below normal.

Just a note of caution although these numbers can be used as a benchmark but they mightnt be applicable on each and everyone.  A lot depends upon the individual’s current medical conditions etc. Hence it is always advisable to consult a dietitian / dietician to ensure that you know the right parameters for your self.

 

BMI (Body Mass Index) Categories:

 

BMI Standards
19 – 23 Normal
23 – 25 Over weight
25- 28 Obese
28 – 30 Obesity Grade -1
30 – 32 Obesity Grade -2
32 – 34 Obesity Grade -3

Total Body Water Percentage:

  • Males- 60 -70 %
  • Females- 40 %


Average Lean Mass:
Women- 40 -43
Male- 45 – 48

Body Fat % Analyser:

 

Age % Standards
Female:
20-39 23 %
40-59 25 %
60-79 27 %
Male :
20-39 18 %
40-59 20 %
60-79 22 %

Wheat Grass and its Benefits ( A Fad or substance)

Recently I visited a neighbourhood store and when paying for the groceries, our friendly grocery store owner who is aware that I am a dietitian said Madam Have a look at this product . How come everyone is asking for it and you are not ? You are a dietitian so you should be the first one to ask for . At that stage I realized what a rage / fad wheat grass has become nowadays. everyone is just raving about its benefits as if it is the best product for health of an individual.

For the people who dont know what Wheatgrass is. It is the young grass of the wheat plant. Many people (Indians during Navratras) grow their own wheatgrass by putting wheat seeds in water and then harvest the leaves. It is a natural source of vitamins and antioxidants, including Vitamins A, E, and B-12, Calcium, Selenium, Magnesium, Iron. On its own, it is tough to digest and mostly people crush and squeeze to make its juice. Wheatgrass leaves are also dried and made into tablets or capsules.

To list the benefits that are claimed in various health magazines or TV shows – wheat grass is claimed to strengthen the immune system, detoxify the body, and ward off diseases.Wheatgrass is also claimed to help treat constipation and pain of rheumatism. People also believe that it can help combat a number of everyday health conditions, including colds, coughs, fevers, digestive ailments, and skin conditions. Some people even claim that a wheatgrass diet can shrink cancerous tumors and improve survival.

People reason it on chlorophyll, the pigment that gives plants their green color. Claims also go to an extent that chlorophyll acts like hemoglobin and increases oxygen levels in the body. Despite all the above listed claims, there is very little evidence or any scientific evidence on the benefits of wheatgrass. Some studies in ISRAEL showed that Wheatgrass is helpful in ulcerative colitis and some studies have shown that it helps reduce side effects of Chemotherapy on women of breast cancer. But like I said earlier all these studies havent been done at large scale and we cant conclude anything from these whereas the risk of contracting diseases from Wheatgrass also exist which every one has been ignoring . It is known to have side effects like nausea , headaches and allergic reactions like swelling of throats etc hence people suffering from any sort of ailment or compromised immune system should completely avoid it. Like I have been advocating everything in LIMITS is ok – so for people who want to try it can do so but that doesnt mean that they can go gung ho over it and have it all the time and expect miracles from Wheatgrass.

A healthy and balanced nutritious diet is what one needs to take instead of believing in these fads which come and go :-).

PCOS / PCOD and Obesity, Infertility and Heart Diseases amongst Women

Research shows that women with PCOS (polycystic ovarian syndrome), are at higher risk of heart diseases, obesity, diabetes and infertility. This research can be substantiated the moment you talk to any dietitian / dietician regarding the profile of female clients they have. At RxOcean we get a number of females who are obese and are suffering from PCOS. Most of these cases are recommended by our panel of doctors and  gynecologists. Reason of involvement of a dietitian in cases of PCOS is that an optimum diet helps in effective management of PCOS and its complications. Proper Diet Planning also gets emphasis because it can help fight insulin resistance, which happens amongst females suffering from PCOS .

Insulin’s primary function is converting  foods (especially carbohydrates) in to energy. It helps transport glucose to muscles, fat and liver cells through blood. But in case of a patient suffering from PCOS, this function tends to get impaired, due to which the process of getting glucose out of the blood into the cells gets affected. To counter that body over compensates and secretes more and more insulin to get excess glucose out of the blood. This vicious cycle creates havoc with hormonal levels, ability to lose weight, LDL and triglycerides levels. Hence, the best way to treat PCOS and its symptoms is to correct underlying insulin resistance problem with diet, exercise and if needed and weight loss. Research shows that losing ~10% of body weight can lead to substantial improvement in skin health, menstrual cycle irregularity, response to insulin and even fertility issues. Effectiveness of the diet plan may be determined by factors such as improvement in menstrual cycle regularity, weight loss or decreased insulin levels.

Diet for PCOS
Diet that works for normal weight loss clients doesnt work for PCOS clients i.e. low fat and high carbohydrate. Carbohydrates in our diet get quickly converted in to glucose and cause elevated blood glucose levels, which in turn will increase the insulin production and its related problems. Hence Diet for PCOS should be a low glycemic index diet. This diet would help maintain steady blood glucose levels and help reduce weight.

What to Eat when Suffering from PCOS – diet Composition ?
Even though suffering from PCOS, Diet for Obese women and non – obese women is completely different. In case of non Obese Women suffering from PCOS problem who get regular periods a balanced diet with approx. 50% of calories from complex carbohydrates (whole grains, fruits and vegetables) and 20-30% from lean proteins( egg whites, whole pulses and low fat dairy products) is recommended. Whereas in case of an obese patient with insulin resistance carbohydrate intake is restricted to 40% and carbohydrates are replaced with healthy mono unsaturated fats like omega 3 fatty acids (flax seeds, olive oil and fish). The diet plan is tailored as per individual requirement and degree of insulin resistance.

Healthy Tiffin / Lunch Options for Kids

Yesterday I visited my Kid’s Parent teacher meeting. (For readers to be able to correlate – my kid is 4.5 yrs old, studies in a chain of reputed schools in Gurgaon / Delhi / Bangalore etc and has recently entered “Prep” Class ). It was an open session wherein parents of at least 20 kids were sitting together in the same class listening to what all teacher had to say about the kids and how to teach them. But after 5 minutes Teacher stopped educating on how to teach kids instead started telling parents as to what a dietitian / dietician should be telling them i.e. my job. I was surprised to hear the horror stories (of what kids eat in school) that the teacher narrated in the class.

Teacher educated parents on what to send in tiffin to school and what should not be sent. What are healthy food items and what is considered to be junk food. Teacher had strict NO for some of the food items that kids carry to school in their tiffin. It was a strange thing to note that people send maggie, Pizzas, chips, cold drinks etc in tiffins of school kids. Apart from being a difficult thing to eat, during short lunch break, these food items are unhealthy for young kids who are still in nursery and prep. Although most of the kids crave for these things when they see advertisements in TV or see their elder siblings eating the same but parents shouldn’t give into demands of their kids. As a dietician / dietitian I always suggest to parents that a complete Ban on these things wouldnt work but parents should try not to make it a daily routine and ensure that their kids get these things once in a while and not on a regular basis. Although my kid now teaches me what he has been taught in school i.e. too much of noodles can cause stone :-).

Although teacher had a very valid point that these food items draw too much attention in the class and most kids start fighting for the food and end up eating nothing. On top of that they get spilled easily in the class and create a mess for kids as well as teacher to manage. But looking at these things from a nutritionist’s / dietician’s perspective I end up asking parents in counseling sessions – Do these things provide enough nutrition to the kids – who we want to grow up as healthy adults and not as obese and unhealthy adults ?

I think at times it is to do with our kids demands or their tantrums to not eat anything and sometimes it is we ourselves who get convinced by marketing campaigns to end up believing that junk food is healthy or an alternative for our wholesome meal as it contains a lot of fortified minerals and vitamins. At the end onus lies on parents to ensure that their kids eat healthy. For few things we have to explain that they are not good for health and also ensure that we give them wholesome meals which they like. For this we need to experiment with things to not only make food attractive / innovative but delicious for kids.

Kids love variety in their food so the effort has to be put in from parents to ensure that their food is palatable. One of the examples that the teacher gave in the class was that of Pizza Parantha. Although there are a number of healthy food options and best and wholesome one is Chapati / parantha with subzi but many a times kids atleast the young ones cant handle it on their own. May be the same can be given to kids in the form of Parantha Roll.

After the eye opening session at the school I as a dietician / dietitian feel obliged to let people know about some of the healthy food options that I give to my kid for his lunch which are easy to make at the same time ensure that kids get enough nutrition in their lunch. Following are some of the things that I include in my son’s tiffin:
1) Paneer Pakoda
2) Paneer Sandwich
3) Cheese Sandwich
4) Chenna murgi
5) Milkmaid Coconut Laddu
6) Home Made Cake
7) Bread Rolls / Pakoda
8) lemon water can easily replace packed juices and cold drinks
9) Soya Aaloo tikki
10) Paneer Tikki
11) Peanut Tikki
12) Bread & Peanut Butter
13) Vegetable Sandwich
14) Besan Pancake
15) Poha
16) Suji Upma
17) Sweet / Salty French Toast
18) Idlis
19) Home made dhoklas
20) Fruit Serving / Fruit Chat / Fruit Cream

Recipes for some of the above food items are provided on Rxocean. i.e. http://www.rxocean.com/Healthy-Recipes.php and we would try to ensure that we add recipes that are missing from the list above on our website.