Antioxidants generation as a normal phenomenon in the body

A free radical is like a naughty atom or molecule because it has an electron that doesn’t have a buddy to hang out with. It tries to find a buddy by stealing an electron from another atom or molecule nearby. This stealing process can cause damage to the other molecule which then, also becomes a free radical, and the cycle repeats. This cycle of stealing electrons can be very troublesome for the body.Though these troublemakers,in low and moderate amounts,serve some important functions in the body like the immune system uses the cell damaging property of free radicals to destroy harmful bacteria and viruses. Free radicals also act like little messengers inside the cells, telling them when to grow and when to die. They help pass along important messages between cells, like telling the blood vessels when to relax or brain cells to send signals.Exposure to chemicals and toxins in the environment can cause abnormally high levels of free radicals which affects the cell functioning by messing up with proteins, fats and DNA in cells causing aging and various diseases.

Antioxidants are like superheroes that catch the naughty free radicals and stop them from causing damage. Our bodies make some of these superheroes on their own and some we get from food. When antioxidants meet free radicals, they give them a hug, basically, by sharing their own energy. This stops them from causing more trouble, thus breaking the chain reaction. Then, the free radicals can’t hurt us anymore. Thus, antioxidants keep our cells healthy and protect against various diseases and aging process.

How to Prevent the Overgeneration of Free Radicals in the Body

When free radicals outweigh the antioxidant supply, the body gets into the condition of oxidative stress. So, using antioxidants from foods can be of help in protecting our bodies. For this a knowledge of their presence and amounts in different foods is essential.

A useful guide has been given below for suitable diet planning.

Antioxidant Content of some foods

Nuts & seeds

All these nuts should be eaten with skin (pellicle) for maximum benefit.

Ways to add nuts and seeds to the diet

• Sprinkle chopped nuts or seeds on top of your oatmeal /yogurt /cereal / salad
• Snack on a combination of your favourite nuts and seeds and add some dried fruit for sweetness.
• Roast nuts and seeds with a pinch of salt or your favourite spices for a quick, crunchy snack.
• Incorporate peanuts into stir-fries and curries for a crunchy texture.
• Add chopped nuts to your baked goods, such as muffins, bread, or cookies.

Fruits

Other fruits rich in antioxidants whose exact values have not been analysed include mango, cherry,lemon, musk melon, water melon, kiwi,guava, jamun, apricot, plums.

Berries – Black currant, blackberries, blueberries, goji berries and cranberries. Processing of berries to jam reduces its antioxidant content.

Dried Fruits

Ways to add dried fruits to the diet

• Make a powder of dried amla. You can have one tsp of this with water after meal. This would help in digestion and improve iron absorption besides the antioxidant benefit.
• Add dried mango powder to green chutney.
• Add a handful of dried fruits to your oatmeal or porridge or salad
• Blend dried fruits into your morning smoothie for added sweetness and nutrients.
• Snack on a combination of your favourite nuts and seeds and add some dried fruit for sweetness.
• Make energy balls by blending dried fruits like dates with nuts, seeds, and a bit of honey or coconut oil.
• Add dried fruits to cookies, muffins, bread, or cakes.

Herbs &Spices

Dark chocolate – dark chocolate with 70-99 % cocoa has 10.9 mmol / 100 gm. Theantioxidant content of chocolate decreases with reduction in cocoa content.

Cereals

Beverages

Vegetables – Black and green olives, broccoli, kale, cabbage, cauliflower, red and green chili, carrot, mustard greens, spinach, coriander leaves, amaranth (chulai), colocasia leaves, drumstick leaves, avocado, sweet potato, bell peppers, pumpkin, karela, red cabbage, red beets, onion, tomato, garlic. Steamed carrots have higher antioxidants than raw carrots.

Steaming is the best method to retain the antioxidants in all vegetables as compared to boiling, frying, and microwaving. Slow cooking of vegetables like spinach, corn and tomato helps to break down the cell wall and release powerful antioxidants.

Sauces – Tomato based sauces, basil pesto, mustard paste, sun dried tomatoes and tomato puree.Tomato peel has the highest antioxidant content and should not be discarded while cooking.

Indian medicinal plants/ Ayurvedic herbs– Triphala, Arjuna, Aloe vera, shatavari, neem, brahmi, curry leaves, kala jeera, tulsi, ratanjyot, ashwagandha.Triphala, additionally acts as detoxifier, immune modulator and prevents cancer. 1 gm triphla can be taken with honey thrice a day.

Case Study

Dr X having cancer of the gums was prescribed immunomodulators. Immunomodulators are generally given during cancer treatment to help regulate and enhance the body’s immune response against cancer cells.  Due to certain adverse side effects of the immunomodulators, the doctor advised to stop these and include antioxidant rich foods in the diet.

Antioxidant rich foods advised were easy to incorporate in the daily diet and made remarkable improvement in the patient. Antioxidant rich food acted more than a medicine.

A person requiring 1400 Kcal should include the following quantities from each food group.

Cereals & Millets (Rice, wheat, millets & other cereals) – 130 gm

Pulses (Lentil, green gram, chickpea, rajma, cowpea etc) – 60 gm

GLV – 100 gm

Other veg – 200 gm

Roots and tubers (Potato, arbi, sweet potato, yam)– 100 gm

Fruits – 200 gm

Seeds & nuts – 30 gm

Milk & curd – 300 ml

Fats & oil – 20 gm

To combat the effect of free radicals, choose a variety of foods rich in antioxidants in the diet on different days to get maximal benefit.

Are Antioxidant Supplements Beneficial

Large-scale observational studies, which track people’s eating habits and supplement use alongside their disease patterns, have found benefits from antioxidant-rich diets, especially the ones having a variety of colourful vegetables and fruits. However, randomized controlled trials of antioxidant supplements have not supported many of these benefits.This is because foods rich in antioxidants usually contain a combination of vitamins, minerals, fibre, and phytochemicals which work together to provide health benefits beyond what individual supplements can offer. The antioxidants in food are also more readily absorbed by the body compared to those in supplements.  In fact, excessive intake of these supplements can be harmful. It is better to obtain antioxidants from a well-balanced diet.

By harnessing the power of antioxidants, we can navigate the challenges posed by the environment,protect our cells from damage, reduce the risk of chronic diseases, support our immune system, and enjoy the benefits of healthy aging. So next time you sit down for a meal, remember to fill your plate with colourful, nutrient& antioxidant dense foods that nourish both your body and soul.

Normally, the body constantly gains fluid through what we eat and drink, and loses fluid through urination, sweating, and other bodily functions. But if we keep losing more fluid than we take in, we can become dehydrated.

Chances of dehydration increase in older adults as there may be

• Reduction in total body water content
• Reduced sensation of thirst
• Impaired kidney function
• Intake of medicines like diuretics and laxatives
• Restriction in fluid intake due to urine incontinence.

Various illnesses, infections and long periods of warm weather and heat waves may also increase the risk of dehydration.

You may be dehydrated if you experience:

• Fatigue
• Drowsiness
• Low attention span
• Dry mouth & lips and/or coated tongue
• Constipation
• Loss of skin elasticity
• Muscle cramps
• Dark colored urine or reduced urine output
• Headache
• Confusion
• Dizziness or lightheadedness after standing up

You may not have all of these symptoms at the same time, but all may be caused by not drinking enough fluids.

The consequences of dehydration

Even mild dehydration can adversely affect mental functions like memory, attention, concentration and reaction time and increase feeling of tiredness. Dehydration in elderly increases the likelihood of urinary tract infections, lung infections, kidney stones, constipation, low blood pressure and increased risk of falls.

Tips to stay hydrated this summer

• Consume between 1.5 and 2 liters of fluids per day.
• Drink small amounts on many occasions throughout the day rather than large amounts on only a few occasions.
• Our body is mildly dehydrated after sleep, so make sure to drink a glass of water as first thing in the morning.
• Keep a water bottle near your bed side or sitting area and carry one wherever you go.
• Add fruit or vegetables, such as lemons, berries, orange/ cucumber slices or mint leaves to enhance the flavour of plain water. You can even add ice cubes made from fresh fruit to a glass of water.

• If you tend to forget, set a schedule or calendar reminder few times throughout the day.
• Hydrate before, during and after exercise.
• Choose a variety of fluids based on what you like.
• Good fluid choices include coconut water, jaljeera (cumin water), aam pana (tangy green mango drink), herbal tea, vegetable juice, buttermilk, clear soup, low fat milk shake, smoothies.
• Eat fruits and vegetables with high water content like watermelon, musk melon, apricot, orange, peach, pineapple, apple, plum, cucumber, lettuce, tomato, zucchini, broccoli, green cabbage, mushroom, cauliflower, eggplant and spinach.

• Limit fruit juices and soft drinks as they are high in sugar.
• Limit tea and coffee. Caffeinated drinks contain water, and can contribute to your daily fluid intake, but they have a mild diuretic effect and cause your body to produce urine, which can lead to dehydration.
• Limit alcohol as it is a diuretic that causes your kidneys to produce large quantities of urine.

Nerve pain / neuralgia / neuropathic pain occurs when a health condition affects the nerves that carry sensation to the brain. It is a particular type of pain that feels different from other kinds of pain – often feels like a shooting, stabbing, or burning sensation.

There are numerous causes attributed to nerve pain. The most common causes are physical injury or infection, degenerative joint or disc disease in the spine, uncontrolled diabetes, varicose veins, long term excessive alcohol intake, gastric surgery, nutrient deficiencies of B complex vitamins, vitamin C and omega 3 fatty acids

In people with diabetes, the body’s nerves can be damaged by decreased blood flow, oxygen and nutrient supply and a high blood sugar level. This condition is more likely when the blood sugar level is not well controlled over time.

Types of Nerves – Let’s know them!

Every nerve in your peripheral system has a specific function, so symptoms depend on the type of nerves affected. Nerves are classified into:

Motor nerves: These nerves send messages from the brain to the muscles so you can control your movements.

Sensory nerves: These nerves send messages from other body parts to the brain and trigger your senses such as temperature, pain, vibration or touch, from the skin.

Autonomic nerves: These nerves control involuntary and semi-voluntary functions including blood pressure, heart rate, digestion, bladder functions and sweating.

 Causes of Nerve Pain

• Damage from physical injury or infection
• Degenerative joint or disc disease in the spine with spinal cord or nerve compression
• Herniated disc
• Body may send pain signals to the brain unprompted due to
  • Diabetes
  • Varicose veins
  • Long term excessive alcohol intake
  • Gastric surgery
• Vitamin B deficiency, Carpel Tunnel syndrome (A numbness and tingling in the hand and arm caused by a pinched nerve in the wrist), Thyroid problems, Facial Nerve problems, Arthritis in the spine
• Cancer, chemotherapy and radiation treatment

 Nutrient deficiencies leading to Nerve Pain

• Vitamin B6
• Vitamin B12
• Vitamin C
• Omega 3 fatty acids

Symptoms of Nerve Pain

Symptoms of neuropathic pain may vary slightly, but few symptoms are generic and common. People with diabetes commonly experience loss of feeling and numbness, followed by pain, burning, and stinging, in their limbs and digits. This is Peripheral Neuropathy, which is a very common condition associated with Diabetes.

 Natural Treatments for Nerve Pain

• Lifestyle Treatment: Physical, relaxation, and massage therapies are all used to relieve symptoms of nerve pain. These forms of treatment can help ease muscles.
• Proper techniques for sitting, stretching, standing, and moving definitely helps to alleviate pain.
• Cure of the underlying disease like Diabetes
• Nutritional intervention: B vitamins, Alpha lipoic acid, Acetyl L carnitine, curcumin, omega 3 fatty acids , vitamin C, Vitamin E, Vitamin B 12 and Niacin.

Peripheral neuropathy, the most common form of diabetic neuropathy, is a result of damage to the nerves outside of the brain and spinal cord (peripheral nerves), which cause weakness, numbness and pain, usually in hands and feet. It can also affect other areas of the body.

In people with diabetes, the body’s nerves can be damaged by decreased blood flow, oxygen and nutrient supply due to high blood sugar levels. This condition is more likely when the blood sugar level is not well controlled over time.

Peripheral neuropathy can also result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins.

 Signs and symptoms

• Gradual onset of numbness, prickling or tingling in your feet or hands, which can spread upward into your legs and arms.
• Sharp, jabbing, throbbing or burning pain.
• Extreme sensitivity to touch.
• Pain during activities that shouldn’t cause pain, such as pain in your feet when putting weight on them or when they’re under a blanket.
• Lack of coordination and falling.
• Muscle weakness.
• Feeling as if you’re wearing gloves or socks when you’re not.
• Paralysis in extreme conditions, if motor nerves are affected.

If autonomic nerves are affected, signs and symptoms might include heat intolerance, excessive sweating or not being able to sweat, bowel, bladder or digestive problems, changes in blood pressure, causing dizziness or lightheadedness.

Peripheral neuropathy can affect one nerve, two or more nerves in different areas or many nerves.

 Risk factors

• Diabetes, especially if your sugar levels are poorly controlled
• Alcohol abuse
• Vitamin deficiencies, particularly B vitamins
• Infections, such as hepatitis B and C etc.
• Autoimmune diseases, such as rheumatoid arthritis and lupus, in which your immune system attacks your own tissues
• Kidney, liver or thyroid disorders
• Exposure to toxins
• Repetitive motion, such as those performed for certain jobs
• Family history of neuropathy

 Complications

• Burns and skin trauma: You might not feel temperature changes or pain on parts of your body that are numb.
• Infection: Your feet and other areas lacking sensation can become injured without your knowing. Check these areas regularly and treat minor injuries before they become infected, especially if you have diabetes.
• Falls: Weakness and loss of sensation may be associated with lack of balance and falling.

 Prevention

• Manage underlying conditions that put you at risk, such as diabetes, alcoholism or rheumatoid arthritis.
• Make healthy lifestyle choices that support your nerve health.
• Eat a diet rich in fruits, vegetables, whole grains and lean protein to keep nerves healthy. Protect against vitamin B-12 deficiency by eating meats, fish, eggs, low-fat dairy foods and fortified cereals. If you’re vegetarian or vegan, fortified cereals are a good source of vitamin B-12, but talk to your Health expert about B-12 supplements. Since B12 is used by the body to boost energy and to stimulate metabolism and nervous system, take it in the morning or early afternoon. Also, vitamin B12 supplement should be taken with food  to avoid digestive upsets.
• Exercise regularly. With your Health expert’s recommendation, try to get at least 30 minutes to one hour of exercise at least three times a week.
• Avoid factors that may cause nerve damage, including repetitive motions, cramped positions that put pressure on nerves, exposure to toxic chemicals, smoking and overindulging in alcohol.

Natural Treatments for Peripheral Neuropathy

Inclusion of Vitamins B12 and Vit D rich food sources.

Cayenne Pepper – Cayenne pepper contains capsaicin, an ingredient in hot peppers that makes them spicy. Capsaicin has been used in topical creams for its pain relief properties. It decreases the intensity of pain signals sent through the body.

Warm Bath – Taking a warm bath with Epsom salt can be soothing and can also alleviate pain symptoms from neuropathy. Warm water increases blood circulation throughout the body, decreasing pain symptoms from numbness. If your sensory nerves are affected from peripheral neuropathy and you’re not as sensitive to temperature, be careful not to make your bath water too hot.

Exercise – Regular exercise can help to combat pain and improve your overall health. Being active can reduce your blood sugar, which, in turn, can reduce or slow down nerve damage. Exercise also increases blood flow to your arms and legs and reduces stress.

Essential Oils – Some essential oils, including chamomile and Roman lavender, help to increase circulation in the body. They also have pain-relieving and anti-inflammatory properties that could boost healing. Dilute essential oils (a few drops) in 1 ounce of a carrier oil such as olive oil. Applying these diluted oils to the affected area can reduce stinging and tingling pains.

Meditation – It can help to lower stress, improve your coping skills, and decrease your pain intensity. Taking a mind-body approach is a non-invasive technique that provides you with more control over your condition.

Acupuncture promotes natural healing by stimulating the body’s pressure points. This technique triggers the nervous system to release chemicals that can change the pain experience or threshold. Acupuncture helps to provide an energy balance to the body that can affect your emotional well-being too.

Appropriate diet and lifestyle changes can help to control and manage the symptoms of peripheral neuropathy and prevent further nerve damage.

Cause & Management

• Overuse, strain or injury to a specific muscle while performing activity
  Over usage or repetitive muscle activity without any variation due to exercise / work can cause pain to a specific muscle. When beginning any physical activity start with proper warm up and progressively increase the intensity to allow the muscles to adapt. End the exercise with cool down and hydrate yourself after workout. If sitting for extended periods, take regular breaks and do stretches. Maintain proper posture at all times.
• Chronic stress & anxiety
  Psychological or physical stress can lead to muscle tension which is the body’s automatic reflex to guard against injury and pain. Sudden stress may cause muscles to tense up but once the stress passes, the tension is released. In chronic stress, muscles may remain in a near constant state of tension, leading to pain. Learning and practicing relaxation techniques, breathing exercises and taking part in adequate physical activity can improve how one deals with stress or chronic pain and in turn reduce its negative effects on muscles.
• Electrolyte Imbalance
  Electrolytes like calcium (Ca), magnesium (Mg), potassium (K) and sodium (Na) are needed for energy production, muscle contraction & relaxation & conduction of nerve impulses. Shortage or imbalance of electrolytes can slow muscle contractions causing cramping, weakness, fatigue and pain.

Differentiating symptoms for deficiency of different electrolytes

Correcting Electrolyte Imbalance

Medical Condition

Hypothyroid

Deficiency of thyroid hormone reduces the ability to produce, store and use glycogen in times of need, causing muscle aches, tenderness and stiffness. Weakness is seen in the muscles that are closest to the centre of the body, such as the thigh or shoulder. This can lead to problems while climbing stairs, combing hair and getting up from cross legged position. In addition to this, there is an elevation in creatinine kinase which is a muscle enzyme that increases with a muscle injury.

Peripheral Arterial Disease 

Fatty blockages in the vessels that carry blood from the heart to the legs can lead to pain in the legs from exertion, such as walking- that is relieved after resting. Symptoms of pain, ache or cramps from walking can occur in the buttocks, hips, thighs or calves. Other symptoms include skin that is cool to the touch, decreased or no pulse in the feet, non-healing sores in the legs or feet and cold or numb toes. People diagnosed with this condition are recommended to walk more frequently, stop smoking and reduce saturated fats in the diet.

Prescription Medication

• Medications used to treat high cholesterol – can cause flu like ache and muscle pain. These medicines reduce coenzyme Q10 which is needed for energy production. Q10 supplement may be considered.
• Medications Used to Treat High Blood Pressure – Diuretics can reduce body’s potassium levels leading to weakness, leg cramps or fatigue. Use of potassium-sparing diuretics is advised.
• Opiates – Long-term use of opiates suppress the body’s natural painkilling functions making the body more sensitive to pain after its effect wears off.

Lifestyle management for muscle pain

• Follow a healthy lifestyle that includes a routine exercise regimen or physical activity to suit your health. Perform gentle stretches in the morning, warm up before exercising and stretch after.
• Maintain regular activity levels and avoid sudden increase in exercise intensity. Any changes should be made slowly. Avoid overusing same set of muscles; adjust work station or furniture and equipment at home to suit your needs. Be aware of your posture and stay aligned when at work. Learn when to stop and take rest, without overusing your muscles.
• Aim to maintain an ideal weight with correct body composition. Make gradual changes in diet and activity levels to remain fit and healthy.
• Try to relax, as stress can add to muscle tension and worsen muscle pain. Take breaks from work, indulge in hobbies, practice stress management techniques, yoga and meditation. Breathing exercises can help to provide relaxation and improved blood circulation.
• Consume a balanced diet according to your health status. Drink plenty of water to keep yourself well hydrated. Consume fresh fruits and vegetables to get a natural boost of minerals and vitamins. Consume whole grain foods & adequate proteins to build strong muscles.

Changes associated with Aging

Aging is associated with following changes.

Body Composition and Fat distribution:

As we age, our body composition changes – fat mass increases and muscle mass decreases, leading to a slower metabolism thus reducing the energy requirements. If the calories are not restricted, it may result in unwanted weight gain. With age, the pattern for body fat accumulation, shifts from peripheral areas to the abdominal area of the body, increasing the waist size. Both these factors increase the risk for diabetes, high blood pressure, heart disease, stroke, sleep apnea and arthritis.

Metabolism:

Our metabolism reduces as we age. The complex processes by which our body uses food, water and nutrients, slows down. Our body is not able to absorb and utilize these resources as efficiently as it once did. The greatest change in gastrointestinal function with advancing age is atrophic gastritis, a condition in which chronic inflammation damages the glands, that produce stomach acid. This results in reduced absorption of folic acid, vitamin B-12, calcium, magnesium and iron.

Bone strength:

Bone is living tissue. It undergoes a lifelong process of remodeling. Mature bone tissue is broken down and new bone tissue is formed. As we age, the rate of bone destruction exceeds the rate of bone formation, resulting in loss of bone tissue. Low bone mass makes the bones weaker and more prone to fractures. Reduced activity and hormonal changes also reduce bone density. The chemistry of cartilage, which provides cushioning between bones, changes. With less water content, the cartilage becomes more susceptible to stress. As cartilage degenerates, arthritis can develop. Ligaments, the connective tissue between bones becomes less elastic, reducing flexibility.

Skin:

With advancing age, the skin becomes thinner. As collagen fibres decrease in number and rupture, their capacity to bind water diminishes and the skin loses its tone & elasticity, sags and becomes wrinkled.

 Hydration:

As you age, your body’s thirst signal diminishes. When your body needs water, you may not even realize it because you don’t feel thirsty like you once did. Your kidneys may not work as effectively with age, leading to a fluid imbalance in your body. Since your body has less water as you age, you become dehydrated much quicker than when you were younger.

Long-term dehydration can reduce the fluid in the cells, reducing the ability to absorb medicine, worsening existing medical conditions and increasing fatigue.

Memory and Thinking:

 Alzheimer’s disease is the most common cause of dementia among older adults. It is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and eventually, the ability to carry out activities of daily living. Elders with normal mental health, with maternal family history, APOE 4 gene and insulin resistance are prone to Alzheimer’s.

Medications:

Medications and antibiotics given for treatment of diseases have numerous side effects and even lower immunity, thus initiating a vicious cycle. Certain medications also affect the way our body absorbs or uses minerals. Metformin, a common medicine for diabetes reduces the level of Vit B-12, which is essential for making red blood cells and healthy brain functioning. In elderly, the absorption of Vit B-12 is already reduced. This double fold impact of vit B-12 deficiency in elderly can result in tiredness, muscle weakness, nerve problems, depression, memory loss etc.

Healthy longevity is a boon for elderly. Knowing the changes and appropriate preventive action can contribute a lot towards healthy aging.