Hi all,
Welcome 90 new subscribers from last week. Compiling this from my holidays in Sikkim. A must visit state.
Was just checking statistics of all issues and readership is over 60% consistently. That’s a great motivator for me. A big thanks to each one of you. Few of you have suggested to make it short and I will work on that in near future.
In this issue
  • Toolkit to help overcome Loneliness
  • Menopause – a mystery
  • An inspiring story of transformation
We had some tough challenges during Mrs. Mall’s menopause and I strongly encourage all husbands to also read and understand about it. This needs to be handled together.
If you like the issue, please share with friends and family. Do share your feedback and also any specific topic you would like me to cover. Please keep sharing your feedback with me on Twitter. Which article did you like most? What do you want to read more or less of? Other suggestions? Just send a tweet to @SandeepMall and add #GoodVibesWithSandeepMall at the end so I can find it.
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Happy reading,
Sandeep Mall

“Every man has his secret sorrows which the world knows not; and oftentimes we call a man cold when he is only sad”: Henry Wadsworth Longfellow
Have you ever experienced that someone you once knew well, suddenly hasn’t been keeping in touch? How did you feel? Did you feel rejected by their apparent lack of interest. Did you send them a text or pick up the phone? Or did you think, they can call me! Too often we take another’s silence as personal rejection, instead of pausing to consider what might be going on in his/her life.
Loneliness and happiness are rarely companions; when one appears, the other tends to leave the premises. Humans are by nature social creatures. When we are feeling sad or lonely, other people’s joy and laughter can feel like weapons, sent to mock our own sense of isolation from the world. On the other hand, rediscovering a sense of happiness can make loneliness feel like a thing of the past, almost instantly; our troubles seem more manageable; life feels worth living.
How does one state become the other; and how can a helping hand be offered to those who feel cut off from the world? 
Many people are happy to spend time alone; it can be enriching to spend quiet time thought or contemplation or simply to feel free to enjoy personal space without interruption. Alone time and loneliness are different things. Being alone is a choice, where as loneliness feels more like cut adrift. 
Loneliness can lead to terrible feeling of emptiness and isolation. It is painful. 
At the heart of someone’s loneliness may be lies the inability to share emotions or trust other people; beneath the outer shell may lie a lack of self confidence. It ca be difficult to ask for help when you are feeling so alone. 
  • Take some time to focus on your feelings, to understand what is making you feel this way. Learning how to practice meditation can be immensely helpful.
  • Try not to reject invitations or offers of help. Those who feel lonely will often push people away. They are afraid to let others get too close.
  • Arrange to meet an old friend. You are much more likely to tell someone what is really going on if you spend proper time with them, have eye contact, and know they are listening to you.
  • Trust is the key to building relationships. When you are ready, take a risk, and tell someone what is really going on in your life. This could be a medical practitioner if you want to be 100 percent certain of confidentiality.
  • Taking up walking, running, or any form of mildly aerobic exercise can help to beat the blues. It will help to increase the levels of endorphins in your body, and give you a natural lift.
  • Check if some aspects of your own behaviour is unfavourable to you. Are you adding to your own sense of isolation?
  • Make an effort to look good. Even when you are at home alone, it can make a difference to how you feel about yourself.
  • Check if you need help with overeating, drinking, or other issues.
  • Pay attention to small things in your life that give you pleasure -listening to birds chirping, nature walk, colours around you, a piece of music- and focus on their detail.
  • Don’t let yourself stay indoors all day. Go outside, be in the company of other people.
  • A good laugh works wonders- watch your favourite movie that is guaranteed to make you laugh.
No man is an island. Try not to do everything alone or unsupported.
by Dr. Goonjan Bhola
Menopause is when you stop having periods. It happens when your ovaries have been removed or your ovaries stop releasing eggs and the amount of estrogen hormone in your body falls. Most women have their menopause between the ages of 45 to 55 years, with average age around 51 years.
 Menopause can occur earlier in some women. If it occurs before the age of 40 years, it is known as premature menopause or premature ovarian insufficiency. The time before your last period, when your estrogen levels are falling, is called perimenopause. This can last from a few months to few years.
Around half of the women notice physical and/or emotional symptoms during this time.
The most common symptoms are-
  • Hot flushes
  • Night sweats
  • Vaginal dryness
  • Low mood and/or feeling anxious
  • Joint and muscle pain
  • Loss of interest in having sex
Every woman experiences menopause differently. Some experience one or two symptoms, which may be mild, while others have more severe and distressing symptoms. Some women choose to go through the menopause without treatment, while others prefer some form of treatment to manage their symptoms well, by using either hormone replacement therapy [HRT] or an alternative treatment.
Options for the treatment of Menopausal symptoms:
  1. Lifestyle Changes – Regular aerobic exercises, such as running, swimming may help, as well as low intensity exercises, such as yoga. Reducing your intake of caffeine and alcohol may also help to reduce hot flushes and night sweats.
  2. Non Prescribed treatments – Herbal medicines-plants or plants extract, such as St John’s wort, black cohosh and iso flavones [soya products], can help reduce hot flushes and night sweats for some women. However, their safety is unknown and they can react with other medicines that you may be taking for conditions such as breast cancer, epilepsy, heart disease or asthma.
  3. Alternative therapies– acupuncture and homeopathy may be helpful to some women.
  4. Complementary therapy-aromatherapy -although effects of these therapies specifically on menopausal symptoms are not distinctly known.
  5. Non-Hormonal Medical treatment– Clonidine or Gabapentin for hot flushes.
  6. Physiological Treatment – Cognitive behavioural therapy [CBT] is a type of psychological treatment. CBT maybe offered for low mood or anxiety related to menopause.
  7. Hormone Replacement Theory – HRT is the most common form of prescribed treatment for menopausal symptoms. It helps to replace the hormone estrogen in your body, which decreases around your menopause. But it should be discussed with your doctor. Types of HRT depends on individual situation. If you have uterus then a combination of estrogen & progestrone HRT (COMBINED HRT) would be recommended. Estrogen alone can lead to abnormal thickening of uterine lining which can lead to bleeding. Adding progestone prevents this. Progestogen can be given in form of tablets, patches or a hormone – containing coil. In case of previous hysterectomy then only estrogen is enough in HRT treatment. Women with low sex drive after menopause are offered another hormone called testosterone, a hormone related to sex drive in both women & men. HRT is available as oral tablets, skin patches, injections, body gels, spray, vaginal rings, creams or pessary.
Frequently Asked Questions on HRT
  1. IS HRT SAFE & DOES IT WORK? For most women, HRT works and is safe.
  2. WHAT ARE THE BENEFITS OF HRT? It is an effective treatment for hot flushes and low mood, associated with the menopause. It can improve sexual drive and reduce vaginal dryness. It helps keep bones strong by preventing osteoporosis.
  3.  WHAT ARE THE RISKS OF HRT? HRT with estrogen alone (used for women who have no uterus) is associated with little or no increased risk of breast cancer. HRT with estrogen & progestrone can increase your risk of breast cancer. This risk is higher if you stay on it for long and reduces when you stop it. Your individual risk of developing breast cancer depends on underlying risks factors, such as your body weight and your drinking and smoking habits. HRT taken as a tablet increases your risk of developing a blood clot, which is not the case if HRT is taken as a patch or gel. HRT in tablet form slightly increases your risk of stroke, although the overall risk of stroke is very low if you are under 60 years of age.
  4. CAN I HAVE HRT IF I HAVE DIABETES OR HIGH BLOOD PRESSURE? HRT should not affect your blood sugar control, so one can take after consulting the doctor.
  5.  WOULD TAKING HRT PREVENT DEMENTIA? It is not known whether HRT affects the development of dementia.
  6.  DO I STILL NEED TO USE CONTRACEPTION WHEN TAKING HRT? HRT does not provide contraception. You need to continue using contraception for 1 year after your last period if this happens after the age of 50 years. If your last period happens before 50 years then continue using contraception for 2 years.
  7.  WHEN SHOULD I SEEK ADVICE AFTER STARTING HRT? Review appointment with health professional after 3 months of starting or changing HRT and then yearly. 
  8.  HOW LONG CAN I TAKE HRT FOR? The benefits and risks of taking HRT will depend on individual situation. There are no standard benchmarks.
  9.  HOW DO I STOP HRT? You can stop HRT suddenly or reduce gradually before stopping it. The chances of symptoms coming back is the same either way.
  10. WHICH TREATMENT IS THE BEST FOR HOT FLUSHES & NIGHT SWEATS? Patient should be offered HRT after discussing its benefits and risks with the doctor.
  11. WHICH TREATMENT IS BEST FOR MY LOW MOOD? HRT is an effective treatment for low mood. CBT is also helpful in treating low mood and anxiety related to the menopause. Low mood as a result of the menopause is different from depression. So antidepressants are not helpful unless diagnosed with depression.
  12.  WHICH TREATMENT IS BEST FOR LACK OF INTEREST IN SEX? HRT containing estrogen and/or progestogen may be helpful as a treatment for low sexual desire during menopause. Another hormone called testosterone, is also linked to sex drive in both men & women.
  13.  WHICH TREATMENT IS BEST FOR VAGINAL DRYNESS? Many women use vaginal moisturisers and lubricants for vaginal dryness. Estrogen given vaginally in form of tablet, ring, creams are also used in treating vaginal dryness. These can also reduce bladder infections and help urinary symptoms.
Dr. Gunjan Bhola is an expert in High risk obstetrics, endoscopy and gynaecologist oncology. She provides treatments for conditions related to prenatal care, prolapse of pelvic organs, painful menstrual period management, high risk pregnancy, abnormal delivery, vaginal infections, female reproductive organ cancer management, and hysterectomy. She is associate director, Cloud 9 hospital, Faridabad. You can find her on Twitter @bholachibber

“T-shirt size XXL, waist 42. Back in 2018, that was my identity.”
Read the inspiring story of Abhishek Jain’s transformation.
Imagine entering a clothing store and getting humiliating judgmental stares from the sales folks. They used to run their eyes from top to bottom and then roll them wondering what ‘fashionable’ piece of clothing would embrace my body.
Once, when I was shopping with my mom, the shopkeeper abruptly said “iske size ki nahi milegi” on my face. I didn’t even look at my mom and just left the place. Embarrassed, disgusted, and done with battling such comments.
I was always this HEALTHY kid. Eating mindlessly, drooling over fancy-looking meals, and ignoring healthcare advice.
That junk accumulated. Over my body and my mind. At the age of 24, I weighed 114kg. Walking for 10 minutes used to make me dead on my feet. Climbing a flight of stairs was not possible without puffs and blows. My energy was always down and out and I was like a 40-year-old trapped in a 24-year old’s body. Life was pretty messed up.
But nobody was coming to be my savior. I was the only hero I needed. And I took what felt like the hardest first step then. Joined the gym.
It was intimidating. Watching muscular guys lifting weights, making abs, and clicking their transformation pictures. And here I was. Frightened of my own shadow. There however was no option of backing out. So, I started working on my body.
In this journey, I have failed more times than most people even try. I was still eating everything thoughtlessly because I believed I was burning those calories in the gym. That’s what many beginners think, don’t they?
It took three months of ‘no progress on the weighing scale’ for me to understand where I was going wrong. I started paying attention to nutrition as well.
I studied carbs, protein intake, calorie tracking, the importance of lifting weights, and other details that were the key ingredients of the recipe of creating a healthy life. One straight month of doing things right showed me visible changes and injected me with motivation to keep on track. I had lost my first 3 kgs.
And the rest is history. After 13 months, 400 days later, I was 4 sizes down.
In just over 1 year, I managed to lose close to 44kgs. Let me share some of the lessons I learnt, that will definitely help you in your transformation and will help you avoid that mental burnout.
1.     Nutrition is the foundation of any fitness journey. You are what you eat. Nothing can be achieved physically if your diet is not on point. Make sure you eat to fuel your body and not to fuel your emotions.
2.     Tracking your calories is always a good idea especially when you’re starting out. It will help you to know your portion size and will, in turn, help you understand how much food is too much for you.
3.     Increase your protein intake. Protein is the building block of muscles and it makes sure you don’t lose muscle when you are on a calorie deficit. Aim for at least 1.6gm protein per kg of body weight. Include protein in each of your meals.
4.     Strength training is very important for your overall well-being. It will help you build muscles. Muscles are gold for our bodies and more muscles you’ve, faster will be your fat loss.
5.     Don’t overdo your cardio. The number one mistake people make when they start their fat loss journey is overindulgence in cardio. Excessive cardio can impact your joint health because of the weight you carry and also will lead to muscle loss. In the beginning, limit your cardio to just 10k steps.
6.     Sleep is a very important aspect of your fitness journey. It directly impacts your overall progress. The muscles you break in the gym are recovered in your sleep. 7-8 hours of quality sleep is non-negotiable.
7.     Do not fear carbs, add them to your diet. Carbs are the source of energy, they will help you enhance your overall performance in the gym.
8.     Taking care of your body makes you mentally strong. You will feel like an altogether different person once you start your health journey.
The journey of over 600 days, and counting, has been amazing, with lots of highs and lows. But one thing that kept me moving was that 1 picture of myself that I visualized even before embracing this path. At the moment of writing this, I weigh around 73kgs with good muscle definition and less fat, but more than anything, I feel more alive now. I feel like I can do anything, I can climb any mountain, I can run any race, more than a physical transformation, losing weight and building muscles have mentally transformed me into someone who can take on any hard situation that life throws at me.
Abhishek is a student of nutrition. He has been obese most of his teenage and now after losing over 40kgs he wants to help as many people as possible, who are on the same journey.
He believes nutritious food, some form of strength training, and good deep sleep can solve 99% of your problems. He has written a fat loss guide that has been downloaded by over 7000 people. You can connect with him on Twitter.
Stories of Transformation Journeys & everything about Strength Training – Sandeep Mall in conversation with Coach Nachiketh Shetty and his mentee Vivek Gupta.
Sandeep Mall in conversation with Dr. Rahul Baxi & Ms. Ujjwala Baxi.
Dr. Rahul Baxi is a consulting diabetlogist at Bombay Hospital and Ms. Ujjwala Baxi is a registered dietitian with focus on diabetes cure through diet.
Diabetes, one of the most prevalent and widespread lifestyle diseases across the world, is strengthening its grip world over. Dr. Rahul Baxi explained about Diabetes in simple terms, including different type of diabetes – Pre-diabetes, Type 1 and Type 2 .
Diagnosis of Diabetes parameters is based on numbers. These parameters are based on American guidelines. Dr. Baxi alarmed us of Diabetes being a Silent Killer as it is undiagnosed in a large number of people, due to its asymptotic characteristics.
He reinstated, “If diabetes is not treated at the right time, then the consequences of the same can be life threatening, since diabetes primarily affects the cardio- vascular system in the body”.
The conversation further ventured into on how food/meals is also one of the major factor which causes diabetes. Fad diets, trending diets, irregular meals, junk foods also cause diabetes. Ms. Ujjwala Baxi said, “An ideal diet combined with exercise prevents onset of diabetes in any individual”.
Sustainable diets are the key to prevention and long term cure for diabetes. Ms. Baxi stressed on the the importance of balanced diet, which could be squeezed into the lifestyle. One of the key things that Ms. Baxi stressed upon is keeping a check on your weight and taking prompt action to reduce if you notice weight gain.
Taking balanced diets in all the nutrient components, small frequent meals, are effective in maintaining a healthy lifestyle and prevent diabetes. An individual should not follow any diets blindly.
Dr. Baxi also enlightened the listeners about various types of medical treatments available for diabetics. “During the last few years, many advancements have been made in the field of medicine, to treat patients better and bring them to a remission stage of diabetes”.
Discussing further, an important point was raised on how to introduce sugar to young kids and young adults. Ms. Baxi shared important insights and provided helpful alternatives to sugar, to introduce sugar in the diets of children/kids. Healthy eating habits and laying strong foundation are essential for better health of children.
Ms. Baxi also shared tips on how to consume popular meals like ‘aam ras’, sweet potatoes, etc.
Given the 21st century, stress is also considered to be one of the factors in inducing diabetes in an individual. Acute stress in an individual will have a sugar spike and an increase in diabetes. Dr. Baxi reminded us that stress affects our bodies in more ways than one.
The spaces session ended on a positive note, inviting questions from the audience. After sharing and imparting knowledge, one can rightly say, that diabetes can surely be managed well with a healthy, active lifestyle, which incorporates medicines, nutrient rich meals and an proactive approach to lead a better life, physically and mentally.
Complete audio file of the first Good Vibes Twitter Space by Sandeep Mall, which was attended by 1800 listeners, can be accessed here: https://bit.ly/3FSo9kL
You may connect with Dr. Rahul Baxi and Ms. Ujjwala Baxi on Twitter.
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Curd Rice – Low Carb by Pramila Mundra

Pramila Mundra is a Nutritionist, with a Masters Degree in Food Science and Nutrition. The key aspect of her approach is to handle health issues mostly by correcting the food choices and lifestyle. Her Meal planners and programs are holistic and are customised as per the individual food likings, work routine and limitations. She runs her own Health clinic at Adarsh Palm Retreat, Bangalore. You can find her on Twitter @PramilaMundra