Showing posts with label normal. Show all posts
Showing posts with label normal. Show all posts

Thursday, January 4, 2018

DRINKING WATER FOR A HEALTHY LIVING- All you ever wanted to know


Water forms 60% of our body weight and is essential for life. It should be consumed in adequate amounts for proper functioning of various organs.
Normal water intake
1.     Men: 3.7 liters per day
2.     Women: 2.7 liters per day (Pregnant and breast-feeding women need more water).
20% of this comes from food (fruits, vegetables, beverages, etc) and the remaining should be consumed in the form of plain water.
When do we need more water?
1.     Exercise- Exercise leads to water loss in the form of sweating. So, we should consume water before, during and after exercise. Avoid drinking too much water as it can be harmful; it could dilute the body fluids leading to hyponatremia (low sodium).
2.     In hot climates- Water loss is more via perspiration and sweating, and hence, more water is needed.
3.     During illnesses such as fever, vomiting and diarrhea. All these conditions lead to water loss and this loss needs to be replenished.
When should the water intake be reduced (less than normal intake)?
In some diseases, water intake needs to be reduced (under the supervision of a doctor). These are:
1.     Chronic kidney disease,
2.     Heart failure,
3.     Chronic liver disease,
4.     Hyponatremia (low sodium)- some cases are treated by restricting fluid intake. 
How do we know whether our water intake is normal or not?
If you rarely feel thirsty and if the colour of your urine is light yellow (or colorless), your water intake is probably adequate.
What is the best way of getting our daily water requirement?
·      Plain water is the best (safe, inexpensive, easily available and has zero calories).
·      20% of water can also come from fruits, vegetables, juice, milk, tea/coffee, etc
·      Soft (carbonated drinks), sports drinks, energy drinks and alcohol should not be routinely relied upon to complete the daily quota of water. Sports drinks may be taken if one does rigorous exercise for one hour or more.
Can more water intake help in weight loss?
The answer is yes. This is because many times, thirst is confused with hunger. So, whenever you feel hungry, drink water first. People, who consume more water, end up consuming less salt, less sugar and less saturated fats (this leads to weight loss).
A bottle of water before main meals could aid in weight loss.
Replace soda with water, tea of coffee to fight diabetes
Yes, you heard it right. The habit of having a “soft drink” (carbonated beverage) to quench your thirst can increase your chances of getting diabetes, as it contains high amount of sugar. Replacing soda/soft drinks with water, tea or coffee (without sugar) leads to lesser chance of getting diabetes.
Is drinking water on empty stomach in mornings useful?
Yes, drinking water in morning on empty stomach is helpful. Most of us have not had water for about eight hours prior to getting up, leading to mild dehydration. So, one should consume 2-3 glasses (600-800 ml) of water in mornings. This helps in improving bowel movements & urination (leading to release of toxins). This would also reduce hunger, leading to lesser consumption of carbohydrates and fats (thus promoting weight loss).
Providing water dispensers in schools could also be a cheap method of reducing obesity in children.

Dr Sudhir Kumar MD DM (Neurology)
Consultant Neurologist
Apollo Hospitals, Jubilee Hills, Hyderabad

Friday, March 18, 2016



Today is World Sleep Day (celebrated on Friday of second full week in March).  You must be wondering why should we celebrate World sleep day. This is because about 45% of population suffers from one form of sleep disorder or other or are sleep deprived. Sleep problems are not only associated with un-refreshed feeling, but are also associated with major health hazards. So, the World sleep day is aimed at raising awareness about benefits of good sleep and ways to ensuring a good sleep. This year’s slogan for World sleep day is “Good sleep is a reachable dream”.

Normal Sleep
     1. Normal sleep duration is 7-9 hours in adults (10-11 hours in 6-12 year olds; 9 hours in teenagers)
     2. Natural sleep occurs at nights, as melatonin (sleep hormone) is released during nights (when there is no light)
     3. Adults need to sleep only once (at nights). This is called monophasic sleep. People older than 60 may have biphasic sleep (in addition to nights, they may sleep in afternoons too). Newborn babies and infants may have polyphasic sleep (they sleep and get up multiple times).
     4. The best time to go to bed is between 9 PM to 11 PM and the best time to get up is between 5 AM to 7 AM. It should be made a habit to go to sleep and awaken at the same time everyday to avoid sleep problems.
     5. People who work until late evenings may benefit from a short post-noon sleep, called as siesta or power nap. Typically, it should not last more than 15-20 minutes. Siesta energizes the individual improving their work efficiency.

Functions of Normal Sleep
1. Sleep is restorative in nature and makes us fresh and energised to do the day’s work,
2. Growth hormone (GH) is released at nights during sleep. GH secretion may get affected in nights shift workers (and day sleepers). (Prolactin and testosterone are also maximally secreted at nights)
3. Consolidation of memory occurs during sleep. So, it is a better habit to have a good nights’ sleep for better memory, rather than burning midnight oil! The best long term memory is achieved when learning is followed by sleep within three hours.

Risks and Hazards of Sleeping Less
1. Attention and concentration are impaired the day after less sleep. This could result in driving errors, poor efficiency at school or work, as the case may be,
2. Some people complain of general tiredness or heaviness of head/headache after sleeping less,
3. Memory impairment may occur in people sleeping less,
4. Increased irritability and behavioral problems are seen in sleep deprived people,
5. Less sleep may make you fat and lead to obesity,
6. Increased incidence of diabetes mellitus, hypertension, cancer, stroke and coronary artery disease is seen in people sleeping less,
7. Lack of sleep kills sex drive,
8. Less sleep may lead to depression and anxiety; also, people with depression and anxiety sleep less,
9. Lack of sleep leads to skin ageing, and makes it lackluster. Dark circles may form under the eyes.
10. There is also an association between less sleep and higher death rates. Reducing sleep duration from 7 to 5 hours on a regular basis may double the risk of death, mostly from cardiovascular causes.

Tips for Ensuring Good and Sound Sleep
1. Have a light dinner and avoid heavy meals at nights. Eat at least two to three hours before sleeping time. A full stomach may cause sleep disturbance. Late dinners may cause acid reflux in the stomach,
2. Avoid tea, coffee other stimulant drinks at nights, as it may cause less sleep,
3. Avoid smoking at all times, especially at nights,
4. Maintain a good sleep hygiene (try to sleep and wake up at the same time every day)
5. Avoid night shift duties and doing duties in changing shifts (occasional night duty is alright),
6. Avoid frequent travels to places with different time zones (this can lead to jet lag and impaired sleep),
7. Avoid arguments and heated discussions just before sleep,
8. Avoid watching negative news on TV about various crimes, etc at nights. Instead it may be better to listen to some soothing music or read a relaxing novel.
9. Exercise in the evenings improve night’s sleep quality,
10. A glass of milk would also improve sleep,
11. The bedroom should be used only for sleep (and sex) and office work should not be brought to bedroom.
12. It is better to keep the phones and other gadgets away during sleep, and keep them in silent mode
13. Sleep is better in dark, so, ensuring that would improve sleep quality.
14. Also, maintain a good ambient room temperature. Too hot or too much cold temperature may hamper good sleep.
15. Avoid taking sleeping pills, as they can lead to addiction or dependence on them. After that, you would not get sleep without them and over a period of time, much higher doses of sleeping pills would be needed.

DR SUDHIR KUMAR MD (Internal Medicine) DM (Neurology)
Senior Consultant Neurologist
Apollo Health City, Hyderabad
Phone- 0091-40-23607777/60601066
Online consultation:

Tuesday, June 21, 2011


What, When, Why and How Much of sleep?


Sleep is one of the most important activities that we enjoy a lot. On an average, we spend about one-third of our lives sleeping (assuming one sleeps about 8 hours a day). So, if one's job/profession is important (which also occupies about 8 hours per day), sleep is equally important, if not more!

What is the normal sleep duration?

Normal sleep ranges from 5 to 9 hours per day. Those who sleep less than 5 hours or more than 9 hours per day, have a higher incidence of heart attack, brain stroke, cancer and death.

When is the best time to sleep?

Night is the time meant for normal sleep. This is because the sleep-inducing hormone, melatonin, is secreted only during nights. The secretion of melatonin is inhibited by light, hence, darkness in the bedroom is essential for sound sleep.

Based on the sleep-pattern, there are two types:

1. "Owl" type: Person sleeps late (11 PM-12 midnight) and wakes up late (7AM-8 AM)
2. "Lark" type: Person sleeps early (8 PM-9 PM) and wakes up early (4 AM-5 AM)

These patterns are genetically determined and hence, it is difficult to change them.

Are daytime naps good?

Most of us feel sleepy in the afternoon, especially after a good lunch. However, it is not a good habit to sleep in the afternoon. Between the ages 10 and 60, sleep is monophasic, which means, sleeping only once (at night) is enough. Infants and small children have polyphasic sleep, which means, they wake up and sleep several times in 24 hours. Preschool children and elderly have biphasic sleep, and they require an afternoon nap in addition to night sleep. For others, afternoon nap is not necessary. However, a very short snooze (20 min or so) can be very energizing, especially in those who have to work very hard in the post-lunch session. Sleeping more than 30 minutes in the afternoon may make one very groggy and difficult to concentrate in work.

Why do we need to sleep?

 Sleep serves may important functions, some of them are:

1. Makes us feel fresh, and restores the energy.
2. Consolidation of memory happens during sleep. Brain decides what is important and that gets stored in long-term memory. Whatever is un-importnat is deleted from brain storage. So, lack of night sleep can lead to poor memory functions.
3. Growth hormone secretion occurs at night, so, sleep is important for proper growth.
4. Dreams occur during sleep, which is important for normal human functioning. We shall discuss more about dreams separately.
5. Normal night sleep decreases the risk of cancer. This is because melatonin secreted during sleep is an antioxidant and has anti-cancer properties.

Sleep is therefore one of the most important funcitons of human brain, and those with a good sleep are truly blessed!

Dr Sudhir Kumar MD DM
Consultant Neurologist
Apollo Hospitals, Hyderabad, India
Phone: 0091-40-23607777/60601066