Madeeha Syed

How we eat and how we sleep go hand-in-hand. Read on to find out how those late-night tikkas have been robbing you of qualitative rest.

The Connection Between Food & Sleep

This article or video has been vetted and verified by Meri Sehat’s specialists. It contains citations and research from validated sources.

Uncover the fascinating connection between food and sleep and how it affects your overall well-being. Food and sleep, impact on health, relationship, benefits, tips, and more. Don't miss out on understanding this crucial link for a better lifestyle.

The Connection Between Food And Sleep

Can't Go To Sleep? Here’s Why And How To Fix It

Overview

You&rsquo;re lying in bed, trying to fall asleep. You&rsquo;ve tried everything: reading a book, taking a bath, meditating, nothing seems to work. If this sounds like you, don&rsquo;t worry, I&rsquo;m here to help. In this article, we&rsquo;ll explore some of the most common reasons why people can&rsquo;t fall asleep and what you can do about them. 
&nbsp;

trick your body into sleeping

It&rsquo;s hard to shut down the mind, but if you can allow yourself to be free of all thoughts, worries and overthinking, it&rsquo;s easier to get a good night&rsquo;s sleep. This is why meditation has become so popular as a way to relax and clear your mind.

If you are having trouble going to sleep at night because you have too much on your mind, try focusing on relaxing exercises, such as taking deep breaths for 10 minutes or listening to calming music before bedtime.

If you feel like there is simply too much for your mind to process before bedtime, try not to think about anything at all until after midnight (or whenever you plan on falling asleep). That means no worrying about things that happened earlier in the day or what needs doing tomorrow morning&mdash;just let everything go until it&#39;s time for bed!

&nbsp;

Your environment can also influence the quality of your sleep. If you are sharing a bed with a partner who snores, or have pets that are noisy at night, this can affect your ability to get into REM and deep sleep stages of sleep. If you suffer from these problems, try to keep your pets out during night time.

&nbsp;

If you nap during the day, this can make it harder to fall asleep at night. This is because napping reduces your total sleep time and delays your internal circadian rhythm. In other words, it makes for a long period of time with reduced sleep quality and quantity, which makes falling asleep at night even more difficult.

Napping during the day also makes you feel groggy when it&rsquo;s time to go to bed. It&rsquo;s like drinking coffee in the morning. Once the caffeine has worn off, you may find yourself struggling to stay awake until lunchtime, instead of the usual 3pm!

If you want an afternoon nap but don&rsquo;t want these side effects on your nighttime slumber, consider power naps (naps lasting between 15 minutes and 1 hour), instead of full-on snoozing sessions (which can last longer than 90 minutes). Naps are great if they help improve alertness or performance, however, they shouldn&#39;t be used as a substitute for nighttime sleep if that&rsquo;s what you need most!

&nbsp;

You may have heard that it&#39;s important to go to bed at the same time every night and wake up at the same time every morning. This is true, but even more important is your schedule on weekends and weekdays. If you get enough sleep every night, then it doesn&rsquo;t matter if you sleep in on Saturdays or stay up late on Sundays, your body will adjust to these changes when they happen.&nbsp;

However, if you&rsquo;re not getting enough sleep overall, especially if it&rsquo;s because of inconsistent nighttime habits, then your body might have trouble adjusting to irregular schedules.

&nbsp;

Imagine this scenario: you go to bed at 10pm as usual, but you&rsquo;re not tired. You try and get comfortable, but you can&rsquo;t stop thinking about all of the things that happened during the day &mdash; the conversations you had with colleagues, how much work is left to do tomorrow, or what your friends are doing right now. You start worrying about them and then feel guilty because they don&rsquo;t have time for a phone call when they could be sleeping.&nbsp;

Then another thought pops into your head: did I switch off my iron? Should I check? Now we all know that checking whether an appliance is turned off isn&rsquo;t going to help us sleep any better than worrying if our friends are safe (unless there&rsquo;s a fire nearby somewhere), but this process repeats itself over and over again until suddenly, it&rsquo;s 2am, and there&rsquo;s no hope for rest tonight either!

So how can we avoid these situations? The key is finding something else, anything else, to occupy our minds instead of keeping track of every single little thing that crosses our minds throughout the day.

&nbsp;

Pillow size is another important consideration. Your pillow should be firm enough to support your head and neck, but soft enough to mold around your head and neck as you sleep. A proper pillow will also allow you to keep your spine in alignment while sleeping on either side or on your back, which helps with good posture.

If you have been using the same old pillows for years, it may be time for an upgrade. If a new pillow doesn&rsquo;t work right away, try adjusting its height (keep adding or removing stuffing) until you find one that works for you 
&nbsp;

Don&rsquo;t forget about the other side of the bed - do not share a bed with someone if that person snores heavily. Snoring can really affect quality of life. If a partner snores loudly enough at night that it keeps other people awake or keeps them from getting enough sleep themselves, then this could lead to fights between couples over who gets up earlier so they don&rsquo;t disturb their spouse&#39;s slumber. This problem can be resolved by setting up separate bedrooms for each person or getting rid of noisy beds altogether by buying two twin mattresses instead!

&nbsp;

If you can&rsquo;t get to sleep, it could be for any number of reasons. There are a lot of things that can keep you from drifting off into blissful slumber.

<ul>
	<li>You have too much going on. If there&rsquo;s something weighing on your mind, or if you&rsquo;re in an environment that&rsquo;s too stimulating (like a loud restaurant or party), try taking a moment to reflect on everything that&rsquo;s stressing you out and how it might affect your sleep quality. Try jotting down some notes and setting aside time tomorrow to talk over those issues with someone else so they&rsquo;re not still bothering you when it&rsquo;s bedtime.</li>
	<li>You napped during the day or had too much caffeine/food/alcohol before bedtime. When we nap during the day, we tend to wake up feeling more alert than usual, and while this can be helpful if we have somewhere important to go after work and need the extra boost, it can also hinder our ability to fall asleep at night when all we want is rest.</li>
	<li>Your sleep schedule is off-kilter or irregularly shifted throughout the week due to travel changes etcetera. This will make it harder for us humans whose bodies are programmed over thousands of years by evolution just like all animals&rsquo; bodies, except ours has evolved way faster so now sometimes ours needs work done on them sometimes too. Thus, needing proper rest does matter, so here are some tips. 
	&nbsp;</li>
</ul>

If you are listening to music, watching TV, or playing video games, shut it off! Your brain may be losing focus and this makes it hard for you to sleep.

If you can&rsquo;t sleep, get up and do something else before going back to bed. The more time spent lying awake in bed the more difficult it becomes to fall asleep again.

&nbsp;

On a personal note, I have always <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle" target="_blank">struggled with sleeping</a>. When I was younger, I had to have my mom read me bedtime stories to help me fall asleep and would still be up way past midnight reading under my covers. These days, it&rsquo;s not as bad but there are still nights where my mind won&rsquo;t shut off and I find myself lying awake for hours. Sometimes it&rsquo;s because of something that happened earlier in the day or week; other times it&#39;s just a matter of getting enough rest.

As you can imagine, this can be frustrating when you want nothing more than to turn off your brain and go to sleep! But there are ways you can get better at falling asleep faster, and even staying asleep all night long if you want.

&nbsp;

Bottom Line

If you have tried all of these tricks and still can&rsquo;t sleep, there&rsquo;s nothing left to do but wait it out! Just remember, sometimes things happen in life that are out of our control. If you are lying there tossing and turning, just try to breathe deeply and stay calm. It may take some time for us humans to get back into a <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle">regular sleeping cycle</a> again, so don&rsquo;t be discouraged if you&rsquo;re stuck in bed all day without any hope of going anywhere else anytime soon!

Umna Salah

Are You Sleeping On Your Sleep Cycle?

The circadian rhythm is the internal biological clock that regulates the sleeping-and-waking time of every person. This rhythm is controlled based on the sleep-wake cycle, which is also called the light-dark cycle, and it&rsquo;s present in almost all life forms.&nbsp;

Additionally, the circadian rhythm is related to many physiological processes like mood, metabolism, body temperature, hormone secretion and more. Therefore, having a good sleep and waking up at the right time has many health benefits for all people.

The circadian rhythm refers to the physical and mental changes that occur within an organism throughout an approximately 24-hour cycle. This cycle is controlled by signals sent from various parts of the brain to control functions like body temperature, hormone secretion and more. 
&nbsp;

Circadian Rhythm

When you don&rsquo;t sleep enough or at appropriate times during the day (for example: staying up late on weekdays), this can throw off your circadian rhythm&nbsp; and affect your energy levels during waking hours too!

You may be asking yourself, why is sleeping on time so important? Well, there are many reasons for this. First of all, sleeping has a lot of benefits for the body and mind.

<ul>
	<li>Sleep As A&nbsp;Time For The Body To Rejuvenate: When you sleep your brain stops sending signals to your muscles and organs telling them what to do. This allows them to rest and recover from the day&rsquo;s activities. 
	&nbsp;</li>
	<li>Sleep As A&nbsp;Time For The Mind To Relax: While you&rsquo;re asleep, you don&rsquo;t think about anything or anyone else but yourself and your own needs. This can help reduce stress levels when done consistently with other relaxation methods (such as meditation). 
	&nbsp;</li>
	<li>Importance Of Sleep In Children: Children need at least 10 hours of sleep each night because they still have developing brains which require proper rest in order to grow properly into young adults who will eventually be able to function independently without assistance from parents or guardians. 
	&nbsp;</li>
</ul>

The first sleep is probably the most important part of the entire sleep cycle because it helps people fall asleep faster and have a longer rest throughout the night.&nbsp;

If a person doesn&rsquo;t get enough sleep during the first part of the night, that can have consequences during daytime as well. Some people may be more prone to falling asleep faster with two separate sleeps instead of one long one. This phenomenon is called &ldquo;first sleep&rdquo; or &ldquo;second wind&rdquo; and it occurs in humans as well as other organisms including fruit flies, rats and mice. 
&nbsp;

Lack of sleep can lead to a variety of health problems. The following are some common ailments that have been linked to a lack of sleep:

<ul>
	<li>Headaches</li>
	<li><a href="https://merisehat.pk/disease/depression">Depression</a> and <a href="https://merisehat.pk/disease/anxiety">anxiety</a></li>
	<li>Weight gain and obesity (insulin resistance)</li>
	<li>Memory loss and cognitive impairment</li>
	<li><a href="https://merisehat.pk/disease/diabetes-type-1-and-2">Diabetes type II (pre-diabetes</a>)</li>
	<li>Heart disease 
	&nbsp;</li>
</ul>

The Circadian Rhythm is an internal clock that tells your body when to sleep and when to wake up. Disrupting this clock may not seem to cause a lot of damage right now but overtime, the damage accumulates and starts showing up when it is too late.&nbsp;

The concept of beauty sleep is somewhat related to maintaining a good circadian rhythm. While you are sleep, your body takes this time to undo the daily damage done to your cells. In this case, the blood flow supplies the key nutrient to your exhausted cells. The same is the case with your other organs, they take the time to reset and repair.&nbsp; 
&nbsp;

Our body gets used to when we sleep so much that we immediately start feeling tired regardless of our hectic or slow day. Ignoring this signal causes your brain and body to work overtime during their off hours. Think of your own productivity levels when you have to work overtime in your office, you are just pushing yourself without energy to somehow get the work done and go back home as early as possible. Our bodies are no less than a machine that needs their time off in a timely manner.&nbsp;

Circadian rhythm is an important part of our life as it regulates our sleeping and waking time. If you want better health and well-being, make sure you have enough sleep at night and wake up on time in the morning. This will help your body recover from stress caused by work or school during daytime so that you can function better throughout the day.

Online Consultation

Iqra Mazhar

This article or video has been recorded by a subject / domain specialists with a proven track record of excellence in their area. 

The Do’s And Don’ts Of Typhoid Prevention

Introduction

<a href="https://www.merisehat.pk/disease/typhoid-fever">Typhoid fever</a> is a systemic illness caused by S. Typhi infections. It is responsible for causing 200,000 to 600,000 fatalities globally each year, resulting from an estimated 21 million new infections<a href="#accordion">[1]</a>. Typhoid fever is a significant health issue in areas with few resources. However, its increasing prevalence among foreign visitors has made it a more well-known condition on a global scale. Moreover, the Indian subcontinent accounts for 90% of typhoid fever cases across the world<a href="#accordion">[1]</a>.&nbsp; 
&nbsp;

Licensed vaccines only protect against some S. Typhi variants. Further research is required to develop advanced and broad-spectrum vaccines for some resistant variants. 
&nbsp;

Typhoid is caused by the bacteria part of the Salmonella enterica serotype Typhi family. It can grow in the 
&nbsp;

<ul>
	<li>Blood</li>
	<li>Spleen</li>
	<li>Liver</li>
	<li>Gallbladder</li>
	<li>Intestines</li>
	<li>Peyer&#39;s patches (lymphoid follicles of the intestine)</li>
	<li>Some lymph nodes 
	&nbsp;</li>
</ul>

Typhoid is simply transmitted by consuming food or water contaminated with an infected person&#39;s feces.

&nbsp;

Salmonella Typhi is a bacterium that causes the illness typhoid fever. Whereas paratyphoid fever results from the bacterium Salmonella Paratyphi. These diseases bring on identical symptoms. While typhoid infections are more common, paratyphoid infections are typically less severe. 
&nbsp;

Fever is not the only symptom of typhoid. It can become life-threatening if it is not treated appropriately under the supervision of healthcare professionals. If you suspect you may have typhoid fever, consult a doctor as soon as possible.&nbsp;

Let&#39;s have a look at the behavior of S. Typhi in the human body. 
&nbsp;

<h5>Transmission And Role Of The Human Stomach</h5>

<ul>
	<li>After entering the body via the mouth, S. Typhi travels to the acidic stomach where it can survive in pH levels as low as 1.5. Normally, a healthy person&#39;s stomach will start producing enough gastric acid for killing S. Typhi, but it only happens when there is an excessive amount of acid.</li>
</ul>

<ul>
	<li>The bacteria will remain active if the stomach cannot yield sufficient acid. This typically occurs in children, as they produce less acid than adults.</li>
</ul>

<ul>
	<li>As a result, S. Typhi passes through the stomach and enters the ileum in the small intestines. 
	&nbsp;</li>
</ul>

<h5>Incubation Period Of Typhi&nbsp; 
&nbsp;</h5>

<ul>
	<li>
	As the S. Typhi begins attacking intestinal epithelial cells, this causes an inflammatory reaction and the production of intestinal mononuclear phagocytes.&nbsp;
	</li>
	<li>They are responsible for recognising and killing invading pathogens by engulfing S. Typhi, but sadly they only engulf and do not kill it.&nbsp;</li>
</ul>

<ul>
	<li>The incubation period for typhoid fever is between 7 and 14 days. During this time S. Typhi survives in monocytes and reproduces inside them. 
	&nbsp;</li>
</ul>

<h5>Onset Of Symptoms 
&nbsp;</h5>

<ul>
	<li>The phagocytes finally rupture as a sufficient number of S. Typhi fill them up.</li>
</ul>

<ul>
	<li>Then they invade the Peyer&#39;s patches, a lymphoid tissue beneath the enterocytes, resulting in abdominal pain and ulceration (open sores).&nbsp;</li>
</ul>

<ul>
	<li>Later, S. Typhi enters the bloodstream and spreads to numerous organs, particularly the liver, spleen (which enlarges), and bone marrow. The symptoms typically manifest around this time. 
	&nbsp;</li>
</ul>

<h5>Diagnosis Procedures Of Typhoid 
&nbsp;</h5>

Any of the following methods can help to make a diagnosis of typhoid.

<ul>
	<li>Blood test</li>
	<li>Bone marrow</li>
	<li>Stool cultures</li>
	<li>The Widal test (antibodies against Salmonella)&nbsp; 
	&nbsp;</li>
</ul>

In epidemics, and in less developed nations, a therapeutic trial period with chloramphenicol is typically started while awaiting the results of the various laboratory tests. 
&nbsp;

Understanding Dos And Don'ts Of  Typhoid Prevention

Yes, there is no debate that typhoid is a communicable illness. It typically results from the consumption of food or water. Interaction with a freshly infected relative, inadequate sanitation and hygiene infrastructure, especially geographical linkages with polluted public water sources, have all been linked to increased risk of infections. 
&nbsp;

&nbsp;

<h5>Lack Of Well-Equipped Healthcare Systems</h5>

Diagnostic tools in typhoid-prevalent regions are quite limited for test accuracy and specificity. The time required for a proper diagnosis, the increasing spread of antibiotic resistance, and the cost of testing are some of the challenges faced by under-resourced healthcare systems. 
&nbsp;

<h5>Lack Of Hygiene Awareness</h5>

Unhygienic food, contaminated water, and poor sanitation are the main causes of typhoid. Due to poor hygiene habits, poverty, water scarcity, fecal pollution of water sources, and overcrowding, salmonella typhi infection has become more common in South Asian countries. According to current reports, typhoid annually affects 21 million people and kills approximately 161,000 people every year<a href="#accordion">[3]</a>. 
&nbsp;

Untreated typhoid fever often progresses in three separate stages, each lasting a week or so. In contrast to normal fever, typhoid fever starts in the late afternoon, or evening, and typically peaks in the morning. Typhoid fever is correlated to the symptoms listed below. 
&nbsp;

<h5>In the First Week</h5>

1. A gradual increase in body temperature

2. Relative bradycardia&nbsp;

3. Headache and cough

4. General discomfort

5. Abdominal pain

6. Sweating 
&nbsp;

<h5>In the Second Week</h5>

1. Feeling of tiredness

2. High fever (approx. 104 degrees Fahrenheit)

3. Bradycardia

4. Difficulty in focus

5. Diarrhea&nbsp; 
&nbsp;

<h5>In The Third Week &ndash; Complicated Week</h5>

1. Relatively high fever with minimal 24-hour fluctuation

2. Bleeding in GIT

3. Pneumonia and inflammation of the lungs

4. Inflammation of brain

5. Inflammation of bone

6. Low platelet count

&nbsp;

Despite our long-standing knowledge and fear of typhoid fever, there are still numerous obstacles to overcome. When trying to control enteric fever in susceptible human populations, one should focus on all possible ways the infection can spread further.&nbsp; 
&nbsp;

<h5>Financial Instability</h5>

A deteriorating economic growth, low-quality public services, inadequate infrastructure, corruption, fiscal traps, and among other problems, a lack of innovation have inevitably contributed to the emergence of diseases like typhoid fever.&nbsp; 
&nbsp;

<h5>Hygiene Awareness</h5>

Typhoid fever cases tend to cluster in less affluent, densely populated areas with inadequate sanitation and a scarcity of clean water. People who have typhoid are frequently unaware of their condition and continue to conduct various unsanitary habits which helps the infamous disease thrive and spread even more quickly.&nbsp; &nbsp; 
&nbsp;

<h5>Healthy Water Resources</h5>

In the 1950s, Pakistan had an annual water supply of about 5000 cubic meters per person.&nbsp; Owing to population increase, inadequate water policies, inadequate infrastructures, as well as water pollution, the water availability level has substantially decreased below 1000 cubic meters. A clean drinking water system for everyone is a crucial step in eradicating typhoid. 
&nbsp;

<h5>Appropriate Sanitation</h5>

Currently, 22 million people in low-income countries still defecate in the open, and 79 million lack access to toilets. Open defecation exposes a large population, particularly vulnerable children, to diseases like typhoid by polluting the environment and contaminating water sources like streams. 
&nbsp;

<h5>Self-treatment Control&nbsp;</h5>

Due to a lack of awareness, many locals frequently self-medicate, which leads to excessive antibiotic use. Thus, increasing the likelihood of antibiotic resistance. This raises the emergence of multi-drug resistant typhoid strains. Moreover, treatment options are becoming more limited in many endemic regions due to rising antimicrobial resistance and the emergence of multi-drug resistant pathogens. 
&nbsp;

<h5>Vaccine Availability</h5>

The use of vaccines is an efficient way to stop the spread of the illness, but many children, particularly those living in rural areas, lack the necessary protection. This is partially brought on by the negative cultural and religious perceptions of vaccines that prevent universal immunization. Moreover, inadequate infrastructure, low-income levels, and a lack of healthcare services in remote areas also contribute to the low vaccination rates. 
&nbsp;

Although the price of the TCV typhoid vaccine ($1.4- 1.5 USD per dose) is comparatively low, mass immunization is not cost-effective. The typhoid vaccine must be maintained at a temperature of 2-8 degrees Celsius. Therefore, it is difficult to distribute the vaccine to remote and rural areas, while keeping the doses at the required temperatures.&nbsp;

&nbsp;

The ongoing global epidemic has added to the strain on the already failing hospital sector; the resources are being diverted to stop the spread of COVID-19. Blood cultures, the most accurate test for typhoid, are rarely utilized because so many laboratories have become COVID-19 testing facilities.&nbsp; 
&nbsp;

Furthermore, a number of symptoms, such as fever and headache, are shared by COVID-19 and typhoid, along with other illnesses, such as dengue and measles. Thus, making a conclusive diagnosis difficult. Moreover, using azithromycin for COVID-19 and typhoid might raise the possibility of resistance over time.&nbsp;

&nbsp;

The majority of cases of typhoid and paratyphoid fever occur in places with low hygienic control. Such areas include:&nbsp;<ul><li>Africa</li><li>The Caribbean</li><li>Central and South America</li><li>The Middle East</li><li>Some sections of Asia (particularly Pakistan, India, and Bangladesh)</li></ul>People who are visiting friends or family have a higher probability than other tourists of catching typhoid fever. Since they could remain in the country, they may be less careful with the food and drinks they consume because they eat local cuisine cooked in the homes of people. Moreover, they may not believe in getting vaccinated prior to travelling.

The best defense against typhoid is vaccination, caution for food, and hand washing.

Verify whether the typhoid vaccination is advised for the area where you want to travel.&nbsp;

There are two typhoid vaccinations available: 
&nbsp;

<h5>1. Oral Vaccine In The Form Of Tablets</h5>

The tablet vaccine is suitable for individuals above the age of six. Complete the four pills (one daily) a minimum of one week before your trip. 
&nbsp;

<h5>2. Injectable Vaccines</h5>

Anyone above the age of two can receive the vaccine shot. At least two weeks before your trip, get one shot (or a booster shot).

The tablet and the shot for typhoid do not provide 100% protection against infection (50-80%), and both become less effective with time. Additionally, there is no vaccine to prevent paratyphoid fever. Because of these factors, it&#39;s crucial that you also follow the recommendations below to prevent typhoid. 
&nbsp;

<h5>Pick Your Foods And Beverages Wisely</h5>

<ul>
	<li>Consume only hot, freshly prepared dishes.</li>
	<li>Eliminate food that has been on a buffet for some time.</li>
	<li>Only consume unpeeled or raw vegetables and fruits rinsed in drinkable water.</li>
	<li>Drink only from bottles that have been factory sealed.</li>
	<li>Avoid ice as it may have been made with contaminated water.</li>
	<li>Drink only pasteurized milk. 
	&nbsp;</li>
</ul>

<h5>Clean Your Hands</h5>

<ul>
	<li>Wash your hands frequently for approximately 20-25 seconds with medicated soap and clean water, particularly after going to the toilet and prior to eating.</li>
	<li>If hand-washing&nbsp;is not an option, apply an alcohol-based antibacterial hand sanitizer&nbsp;with at least 60% alcohol.</li>
	<li>Avoid putting your hands near your face or mouth.</li>
</ul>

&nbsp;

S. Typhi should be confirmed with a blood test before starting treatment. Following antibiotics are used to treat typhoid: 
&nbsp;

<ul>
	<li>Ceftriaxone</li>
	<li>Azithromycin</li>
	<li>Fluoroquinolone 
	&nbsp;</li>
</ul>

Even if you feel better, it&#39;s crucial to take all recommended antibiotics exactly as prescribed. If you want to confirm whether you still have S. Typhi or not, get a stool culture done to identify it accurately. 
&nbsp;

People who have received typhoid treatment may still carry the bacterium. They are classified as &quot;chronic carriers&quot; of typhoid. The bacteria from typhoid can be excreted by a chronic carrier in their feces or urine, as well as from wounds or tissues. They are mostly asymptomatic. 
&nbsp;

Some typhoid-causing strains are becoming more resistant to antibiotics. One newly-emerging strain in Pakistan, known as XDR, is now resistant to all but two of the antibiotic classes typically used to treat drug-resistant typhoid. Healthcare professionals may request tests to identify the strain of bacteria causing typhoid due to the rising rates of antibiotic resistance. As a result, the type of antibiotics may change.

&nbsp;

1. Typhoid should be taken seriously, and proper treatment methods should be used to reduce its effect on public health worldwide. 2. Standardized laboratory testing guidelines are required for S.Typhi azithromycin and ciprofloxacin susceptibility testing. Most of this argues that the antibiotic stewardship program (ASP) must be strictly implemented nationwide in low and middle-income countries. The implementation of such a program has faced many challenges, particularly in India. These barriers include:<ul><li>A limited number of highly trained pharmacists</li><li>Few physicians and specialist&nbsp;</li><li>Improper electronic medical data</li><li>Physically hidden stewardship practices</li><li>Few microbiological professionals</li><li>High rates of antibiotic use among people</li></ul>Therefore, the use of antibiotics in hospitals and physician prescribing practices are crucial areas of focus for antibiotic stewardship programs. Furthermore, low-income countries need to introduce antibiotic limitations as a crucial element of ASP. 3. The public health burden of multi drug-resistant (MDR) and extensive drug-resistant (XDR) typhoid must be reduced through:&nbsp;<ul><li>Antibiotics culture sensitivity test&nbsp;</li><li>Proper sanitary procedures</li><li>Community hygiene</li><li>Carrier surveillance and treatment</li><li>Immunization </li><li>Effective oral antibiotics for disease prevention</li></ul>Furthermore, healthcare organizations must anticipate the extent of the epidemics in order to implement appropriate countermeasures. It is crucial to identify an efficient oral antibiotic against XDR typhoid. In order to decrease the financial and health burden of the disease, particularly in low-income countries like India where the condition is endemic, adopting preventative measures should be our first line of action.

Conclusion

The germs of typhoid fever can be transferred by infected individuals. This frequently occurs when a sick person uses the restroom and, without washing their hands, touches everything, including food and beverages. As they may still carry the bacteria on their hands, they ultimately contaminate everything they touch. 
&nbsp;

These bacteria can also be found in the water used to cook meals and beverages. Moreover, in places where dishes are rinsed with inadequate hygiene, this can also lead to the transmission of typhoid bacteria.&nbsp; 
&nbsp;

Typhoid fever has more occurrence probability in travellers and children. Travellers may become ill if they consume food or drinks tainted with certain microorganisms. Therefore, the World Health Organization (WHO) advises vaccination for all visitors to nations where enteric fever is prevalent, irrespective of the scheduled duration of the visit.&nbsp;

Further research is required on the mechanism of action of S. Typhi and the biomechanics of host-pathogen interactions. 
&nbsp;

&nbsp;

Key Points

<ul>
	<li>Salmonella Typhi is a bacterium that causes the deadly illness typhoid.</li>
	<li>Typically, fever in typhoid might reach up to 103&ndash;104&deg;F (39&ndash;40&deg;C).</li>
	<li>People might also have weakness, headaches, stomach aches, constipation or diarrhoea, coughing, and appetite loss.</li>
	<li>Typhoid is spread by consuming food or liquids contaminated with an infected person&#39;s faeces.</li>
	<li>Typhoid fever can be prevented with highly effective immunisations.</li>
	<li>Travellers are at high risk of contracting typhoid fever, especially when travelling to endemic regions.&nbsp;</li>
</ul>

[1].John A. Crump, E. D. M., 2010. oxford academic --clinical infectious disease.

[2].J.Swansoncd, B.-P., 2011. SCIENCE DIRECT.

[3].Rasheed, M. K., 2019. THE LANCET infectious diseases.

Neelam Asad

Back Pain And Sleep Problems - What’s The Connection?

Back pain and <a href="https://merisehat.pk/article/are-you-sleeping-on-your-sleep-cycle">sleep</a> problems can be a vicious cycle. However, there are ways to alleviate both issues and promote better overall health.

&nbsp;

Understanding the link between Back Pain and Sleep Issues

Back pain and sleep problems are two of the most common health issues that affect millions of people worldwide.

In particular, low back pain, which is considered a primary cause of disability worldwide, is a widespread condition and it affects individuals of all ages<a href="#accordion">[3]</a>. Based on the 2015 Global Burden of Disease Study, the global prevalence of activity-limiting low back pain was 7.3%, which means approximately 540 million individuals were affected at any given time<a href="#accordion">[3]</a>.

Low back pain is more likely to occur in individuals who have certain lifestyle habits, such as engaging in physically demanding occupations, smoking, and having low levels of physical activity.

Back pain and sleep issues are often interconnected, with one affecting the other. When a person suffers from back pain, it can be challenging to get a good night&#39;s sleep. The lack of sleep can then exacerbate the pain, leading to a vicious cycle of pain and sleeplessness. Lack of sleep can also affect mood and energy levels, making it harder to cope with pain. 
&nbsp;

<h5>Understanding Back Pain</h5>

Back pain is a common problem that can be caused by a variety of factors, including injury, poor posture, and aging. The pain can range from mild discomfort to severe. Moreover, it can be localized or radiating to other areas of the body.

Some common symptoms of back pain include stiffness, muscle spasms, and difficulty moving or standing.

A study conducted on 9,611 participants using cross-sectional methodology has shown that inadequate sleep duration and poor sleep quality are linked to low back pain<a href="#accordion">[1]</a>. 
&nbsp;

<h5>Understanding Sleep Problems</h5>

Sleep problems can be caused by a variety of factors, including stress, anxiety, depression, and physical pain.

When a person experiences back pain, falling asleep and staying asleep can be difficult. Certain sleep disorders like sleep apnea can also cause back pain due to abnormal sleeping positions. 
&nbsp;

Fortunately, several strategies can improve both back pain and sleep problems. Here are some tips: 
&nbsp;

<ol>
	<li>
	<h5>Exercise</h5>
	</li>
</ol>

Regular exercise, especially low-impact activities, like walking, swimming, or yoga, can help strengthen the muscles supporting the spine and improve overall fitness. This can help reduce back pain and improve sleep quality. 
&nbsp;

<ol start="2">
	<li>
	<h5>Improve The Sleep Environment</h5>
	</li>
</ol>

Make sure the mattress, pillows, and bedding are comfortable and supportive. Keep the bedroom dark, quiet, and cool, and limit screen exposure before bedtime. Here are some additional tips for better sleep patterns with back aches. 
&nbsp;

Choosing The Right Mattress And Pillow

<ul>
	<li>Use a supportive mattress</li>
	<li>Use a cervical or ergonomic pillow to support and align the neck and spine 
	&nbsp;</li>
</ul>

Sleep Position

<ul>
	<li>Avoid sleeping on the stomach</li>
	<li>Place a pillow between the knees when sleeping on the side</li>
	<li>Use a pillow to support the spine when sleeping on the back 
	&nbsp;</li>
</ul>

Practice Good Sleep Hygiene

<ul>
	<li>Develop a consistent sleep routine, i.e., going to bed and waking up at approximately the same time every day.</li>
	<li>Avoid caffeine and nicotine in the hours leading up to bedtime</li>
	<li>Avoid large meals close to bedtime 
	&nbsp;</li>
</ul>

<ol start="3">
	<li>
	<h5>Try Relaxation Techniques</h5>
	</li>
</ol>

Meditation, deep breathing, or progressive muscle relaxation can help reduce stress and promote relaxation, which can help improve sleep quality and reduce back pain. 
&nbsp;

<ol start="4">
	<li>
	<h5>Consider Physical Therapy</h5>
	</li>
</ol>

A physical therapist can help develop an exercise program tailored to the individual needs of the person to help reduce pain and improve flexibility. 
&nbsp;

<ol start="5">
	<li>
	<h5>Consider Alternative Therapies</h5>
	</li>
</ol>

Acupuncture, chiropractic care, or massage therapy may also help reduce back pain and improve sleep quality. However, it&rsquo;s important to consult a healthcare professional before trying any alternative therapies. 
&nbsp;

<ol start="6">
	<li>
	<h5>Manage Stress</h5>
	</li>
</ol>

Stress can exacerbate back pain and disrupt sleep, so find ways to manage stress. This includes scheduling a specific time of the day to worry about everything going on in life.

Another technique is to form a habit of journaling. Writing down worries, especially anything that triggers anxiety before sleep, helps them get out in the open so that it can be addressed.

Moreover, a to-do list for the following day can help instill a sense of achievement as well as deal with all the worries before bedtime. 
&nbsp;

Back pain and sleep problems are two of the most common health issues that affect people worldwide. These issues are often interconnected, with one affecting the other. Practicing good sleep hygiene, using proper sleeping positions, engaging in regular exercise, stretching before bed, and seeking professional help can improve both back pain and sleep problems. Remember, caring for the body is essential for a healthy and fulfilling life. 
&nbsp;

Key Takeaways

<ul>
	<li>Back pain can make it difficult to get comfortable in bed, leading to sleep problems.</li>
	<li>Poor sleep can worsen back pain by causing muscle tension and reducing the body&#39;s ability to heal and repair itself.</li>
	<li>Common causes of back pain and sleep problems include poor sleeping posture, an uncomfortable mattress, a sedentary lifestyle, stress, and medical conditions.</li>
	<li>To improve sleep and reduce back pain, it&#39;s important to prioritize healthy sleep habits and address any underlying issues.</li>
</ul>

[1] Murase K, Tabara Y, Ito H, et al. Knee Pain and Low Back Pain Additively Disturb Sleep in the General Population: A Cross-Sectional Analysis of the Nagahama Study. PLoS One. 2015;10(10):e0140058. Published 2015 Oct 7. doi:10.1371/journal.pone.0140058.

[2] Vos T, Allen C, Arora M, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: A systematic analysis for the global burden of disease study 2015. The Lancet. 2016;388(10053):1545-1602. doi:10.1016/s0140-6736(16)31678-6.

[3] Hartvigsen J, Hancock MJ, Kongsted A, et al. What low back pain is and why we need to pay attention. The Lancet. 2018;391(10137):2356-2367. doi:10.1016/s0140-6736(18)30480-x.

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Shame: The Most Toxic Emotion

Shame is an unpleasant emotion in which you feel inadequate, powerless, worthless and have negative thoughts about yourself. Our personal insecurities, secrets, mistakes and judgement can all lead to it. It’s more common in women and adolescents since they are burdened by so many expectations, rules and judgments.&nbsp;In her book, Atlas of Heart, Brené Brown describes shame as, “The intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love, belonging, and connection.”It is such a universal emotion and experienced across all cultures and social backgrounds that our first reaction is to side step the discussion as the mention of shame alone can make us feel uncomfortable in our skin.&nbsp;Shame is not as openly talked about as it should be, given its prevalence and negative impact. This is how it simmers and becomes bigger than it needs to be.&nbsp;Brené Brown, the American author who dedicated much of her career to studying shame, much to her peers’ and mentors’ chagrin, also says that it needs three things to fester: secrecy, silence and judgement.&nbsp;It then tends to hide behind other behaviours that are adapted to compensate for persistent feelings of inadequacy. Some people become perpetually rude and defensive in order to hide their shame.&nbsp;

Where does Shame Come from?

&nbsp;Every society has a certain set of rules for how to behave and even though they might not be right, they get ingrained into us from our childhood.&nbsp;

This means we associate certain behaviours and ways of being with intense feelings of guilt and shame simply because they aren&rsquo;t the norm.&nbsp;

People can and will publicly lash out at you for not sticking by these rules. However, most of the time, only perceived or imagined judgement is enough to make us feel this terrible emotion.&nbsp;

People who experience chronic and persistent feelings of shame might benefit from revisiting their childhood and how they were raised. The origins of this emotion can almost always be tied back to past experiences of feeling criticised and rejected by those around us.&nbsp; 
&nbsp;

If, while growing up, you were constantly criticised and told that your behaviour is wrong and harmful to others, no matter how true or false it was, chances are that you internalised it.&nbsp;

This leads to shame associated with the self where the individual starts viewing themselves in a negative light and as someone who is prone to doing the wrong thing hence incurring the judgement and wrath of the people around them.&nbsp;

Children also tend to internalise anything negative that happens to them as their own fault. They believe it&rsquo;s something about them that needs to be changed or that there is something wrong with them. This can also lead to immense shame where it becomes a part of their core identity.&nbsp;

Why is this an issue? Shame can have an everlasting negative impact and can ruin your life in all kinds of ways.&nbsp;

 
It can be toxic and destructive to you in the following ways:&nbsp;

<ul>
	<li>Leads to a pessimistic view of the world and your own future.&nbsp;</li>
	<li>You end up suffering from self-critical thinking where nothing is ever good enough.&nbsp;</li>
	<li>You might get caught up ruminating constantly about past mistakes and slights.&nbsp;</li>
	<li>You&rsquo;d be prone to underestimating yourself and your abilities.</li>
	<li>A lack of empathy, as all of the focus is shifted inwards instead of engaging fully with other people.&nbsp;</li>
	<li>Leaning towards social withdrawal to reduce the number of incidents that might lead to shame.&nbsp;</li>
	<li>You start suffering from feelings of powerlessness and helplessness.</li>
	<li>You might have physical symptoms such as upset stomachs and nausea.&nbsp;</li>
	<li>It can lead to feelings of numbness and a lack of connection with others.&nbsp;</li>
	<li>You are prone to hypervigilance and excessive self-consciousness.</li>
	<li>Irritability, impulsivity and moodiness.</li>
	<li>Much more likely to indulge in self-destructive behaviours such as substance abuse.&nbsp;</li>
	<li>Leads to excessive defensiveness.</li>
	<li>Risk avoidance and hence lack of growth opportunities. There is a feeling of being overwhelmed by the challenges of life.</li>
	<li>Self-sabotaging relationships and opportunities.</li>
	<li>Settling for the bare minimum since asking for more makes one feel uncomfortable.&nbsp;</li>
	<li>Misrepresentation of oneself to others in order to hide the underlying feelings of inadequacy.&nbsp;</li>
	<li>Not standing up for yourself when wronged.&nbsp;</li>
	<li>Constantly comparing oneself with others.</li>
	<li>Highly dependent on external validation. 
	&nbsp;</li>
</ul>

The problem with shame is that it turns our entire focus inwards and we end up painting ourselves in a negative light. When you are engrossed in these feelings of self-pity you are less inclined to make any changes in your behaviour or form meaningful connections.&nbsp;

Research has shown that shame is highly correlated with addiction, depression, bullying, aggression, suicide, <a href="https://merisehat.pk/disease/binge-eating-disorder">eating disorders</a>, social anxiety, personality disorders and low self-esteem.&nbsp;

On the other hand, people with better self-esteem tend to experience less shame. It can also lead to developing a defeatist attitude about life. Instead of viewing mistakes as natural mishaps that can be corrected they view their entire self negatively. This can be quite debilitating and attack one&rsquo;s sense of self.&nbsp; 
&nbsp;

Even though it has been found to serve an evolutionary purpose as well where individuals tightly adhering to the pre-set norms of the group (or the pack) ensured increased chances of survival.&nbsp;

However, in the modern world we don&rsquo;t need to adhere to every single tradition and convention. Most of these expectations are unrealistic and contrary to each other and you can never please everyone across the board.&nbsp;

If you have been told to &lsquo;be yourself&rsquo; and then criticised for it in the same breath then you know how it feels.&nbsp; 
&nbsp;

How to Deal with it?

Brené Brown’s Shame Resilience Theory (SRT) can help you deal with this toxic emotion:&nbsp; <ul><li>Acknowledge and recognise the feeling of shame no matter how tiny or big.&nbsp;</li><li>Work through it constructively, avoiding self-criticism and learn from the experience.&nbsp;</li><li>Build more meaningful connections.&nbsp; </li></ul>It’s not a switch you can flip off, but rather, it’s a whole process where you are expected to move through your feelings of shame and work with resilience, empathy, self-compassion and mindfulness to come out on the other side unscathed.&nbsp;However, if it’s still overwhelming and affecting your daily life to the point of paralysis then it might be time to seek professional help.&nbsp;

Dr. Safia Mehmood

Why Do You Feel Sleepy All Day Long?

Sleep is a part of our human design that gives our body that much-needed rest from the hustle bustle of everyday life. It’s supposed to be restorative and re-energizes you for a new day. Unfortunately, however, some of us struggle with this exact thing.&nbsp;Instead of reaping the benefits sleep is supposed to provide us, we wake up tired and exhausted, wanting to either hit the snooze button or just go right back to bed again.&nbsp;Occasionally waking up tired is not a cause for concern, but if it’s been like this for as long as you can remember and now it feels like you’re running on fumes, it might be wise to take a look at why this is happening.&nbsp;

Sleep Inertia

One common reason for feeling tired right after waking up could be sleep inertia. This means that you continue to feel groggy after you have gotten up as it takes your body a little while to adjust to the waking state. It can last for over 15 to 60 minutes, but can last longer for some people.&nbsp;

Having sleep inertia leads to having slower motor and cognitive skills and can be annoying for those who need to be on high alert as soon as they wake up such as a security guard or an on-call doctor. We don&rsquo;t really understand why this happens but it&rsquo;s postulated that our prefrontal cortex, part of the brain that controls higher mental functions, takes a while to come back online after waking up.&nbsp;

Our bodies also ensure we wake up naturally by slowly releasing cortisol into the system at the end of the sleep cycle. This allows all your organs to get acclimated to the waking state and <a href="https://merisehat.pk/page/sehat-scan/">your blood pressure</a> and breathing get to slowly adjust as well.&nbsp;

However, when a loud alarm wakes us up, it can happen when you are in deep sleep. This means you never get enough time to adjust and are thrust into consciousness all of a sudden. This is another reason why it feels like you didn&rsquo;t catch a wink all night even after you have gotten enough sleep.&nbsp; 
&nbsp;

Gastric Reflux

It’s entirely possible that you simply didn’t get enough sleep. This could be due to reflux that gets exacerbated upon lying down flat and is the reason behind a whole night of tossing and turning. Other than visiting your GI specialist you can tackle this issue by sleeping with more than one pillow under your head, by sleeping on your side and also by avoiding heavy meals right before bed.&nbsp;

Bad Sleep Hygiene

Bad sleep hygiene is common and is the leading cause behind why some folks don’t ever feel fully rested no matter how much sleep they get. Sleep hygiene refers to healthy practices associated with bedtime such as turning down bright lights, avoiding tea, coffee and bright screens and not taking any naps throughout the day. This ensures your body naturally shuts off at bedtime instead of a whole night of disrupted sleep.&nbsp;

Other Medical Causes

Other reasons for waking up tired can include medical causes such as anemia, chronic fatigue syndrome, depression, diabetes or hypothyroidism. All of these conditions can make you feel fatigued and lead to sleep related issues.

The Bottom Line

According to the American Academy of Sleep Medicine, adults should be getting at least seven hours of sleep each night.&nbsp; Our circadian rhythms or internal body clocks decide whether we are night owls or morning people. Yes, you’re naturally predisposed to be either one or the other and unfortunately we don’t get to choose which one we are thanks to thousands of years of evolution.&nbsp; However, you can still do certain things to train your body to go to bed early and wake up on time. Practice better sleep hygiene by ensuring you sleep in a cool and comfortable room, avoid stimulants or heavy meals right before bed, incorporate some form of exercise in your daily routine or some light stretches right before bed and start going to bed at the same time every night.&nbsp;These are some of the things that can help you have better sleep hygiene. Things like using your phone before sleeping can also disturb the production of melatonin, a hormone that controls sleep. So, stop using any screens an hour or two before bed.Also, having a good filling breakfast consisting of whole grains, nuts, and proteins like eggs or oatmeal can help you get rid of the early morning fatigue and charge you up for the day. At the end of the day most of these measures can fix your problem of waking up already tired.&nbsp;

Understanding And Managing Common Sleep Disorders Such As Insomnia And Sleep Apnea

<a href="https://merisehat.pk/article/how-you-sleep">Sleep </a>is a fundamental aspect of our well-being, providing us with the necessary rest and rejuvenation to function optimally. Unfortunately, many individuals experience sleep disorders that disrupt their ability to obtain quality sleep. Two of the most common sleep disorders are <a href="https://merisehat.pk/disease/insomnia">insomnia and sleep</a> apnea. In this article, we will delve into the causes, symptoms, diagnosis, and management strategies for these conditions. 
&nbsp;

Insomnia

Insomnia refers to a persistent difficulty in falling asleep, staying asleep, or experiencing restful sleep. It can have various causes, including stress, anxiety, depression, medications, medical conditions, or poor sleep hygiene. Insomnia can be classified into two types: acute insomnia, which lasts for a short duration, typically triggered by a stressful event, and chronic insomnia, which persists for at least three nights a week for three months or longer.

Symptoms of insomnia may include difficulty falling asleep, waking up frequently during the night, waking up too early in the morning, feeling tired upon waking, daytime sleepiness, irritability, and difficulty concentrating. 
&nbsp;

<h5>Diagnosis</h5>

To diagnose insomnia, healthcare professionals typically rely on a thorough evaluation of the patient&#39;s medical history, sleep patterns, and symptoms. They may also employ sleep logs or actigraphy, a method of monitoring sleep-wake patterns using a wristwatch-like device. In some cases, a sleep study, known as a polysomnography, may be recommended to rule out other underlying sleep disorders. 
&nbsp;

<h5>Management</h5>

The management of insomnia involves both non-pharmacological and pharmacological approaches. Non-pharmacological interventions include improving sleep hygiene practices, such as establishing a regular sleep schedule, creating a comfortable sleep environment, avoiding stimulating activities before bedtime, and managing stress through relaxation techniques or therapy. Cognitive-behavioral therapy for insomnia (CBT-I) is a highly effective psychological intervention that helps individuals address the underlying thoughts and behaviors that contribute to sleep difficulties.

In some cases, short-term use of prescription sleep aids or over-the-counter sleep aids may be recommended, but their long-term use should be avoided due to the risk of dependence. It&#39;s important to consult with a healthcare professional to determine the most appropriate treatment plan based on individual circumstances. 
&nbsp;

Sleep Apnea

Sleep apnea is a sleep disorder characterized by interruptions in breathing during sleep. The most common type of sleep apnea is obstructive sleep apnea (OSA), where the airway becomes partially or completely blocked, leading to reduced airflow and repeated episodes of shallow breathing or complete cessation of breathing. <a href="https://merisehat.pk/disease/sleep-apnea-91">Central sleep apnea (CSA)</a> is less common and occurs when the brain fails to send proper signals to the muscles responsible for breathing.

Symptoms of sleep apnea may include loud snoring, gasping or choking during sleep, daytime sleepiness, <a href="https://merisehat.pk/disease/cluster-headaches">morning headaches</a>, difficulty concentrating, irritability, and restless sleep. 
&nbsp;

<h5>Diagnosis</h5>

If sleep apnea is suspected, a sleep study is usually conducted to confirm the diagnosis. A polysomnography is the gold standard for diagnosing sleep apnea and involves monitoring various physiological parameters during sleep, including brain waves, eye movements, muscle activity, heart rate, and breathing patterns. 
&nbsp;

<h5>Management</h5>

The management of sleep apnea can vary depending on the severity and underlying causes. Lifestyle modifications such as weight loss, regular exercise, avoiding alcohol and sedatives, and sleeping on the side instead of the back can help alleviate symptoms in some cases.

Continuous positive airway pressure (CPAP) therapy is the most common and effective treatment for moderate to severe obstructive sleep apnea. It involves wearing a mask over the nose or nose and mouth during sleep, which delivers a continuous flow of air to keep the airway open. Other treatment options include oral appliances that reposition the jaw and tongue, and in some cases, surgery may be recommended to remove obstructions in the airway.

For central sleep apnea, addressing the underlying medical conditions, such as heart failure or neurological disorders, is crucial. Treatment options may include medications to stabilize breathing patterns or the use of adaptive servo-ventilation devices that provide positive pressure to support breathing.

It&#39;s important to consult with a sleep specialist or healthcare professional to determine the most appropriate treatment plan based on the individual&#39;s specific needs and circumstances. 
&nbsp;

Insomnia and sleep apnea are common sleep disorders that can significantly impact an individual&#39;s quality of life and overall health. Understanding the causes, symptoms, diagnosis, and management strategies for these conditions is essential in ensuring effective treatment and improved sleep.

Non-pharmacological interventions, such as improving sleep hygiene, implementing relaxation techniques, and adopting cognitive-behavioral therapy, are crucial for managing insomnia. In the case of sleep apnea, lifestyle modifications, CPAP therapy, oral appliances, and, in severe cases, surgery may be necessary.

Seeking professional help from sleep specialists, such as sleep medicine physicians or pulmonologists, can provide a comprehensive evaluation and personalized treatment plan. By addressing these sleep disorders effectively, individuals can regain control over their sleep patterns, enhance their overall well-being, and improve their daily functioning.

&nbsp;

Food Cravings – And How To Manage Them

&nbsp;Food cravings can be powerful, often driving you to indulge in unhealthy choices that sabotage your <a href="https://merisehat.pk/article/weight-loss-supplements-exposed">weight loss</a> goals. But understanding the science behind these cravings can help you manage them effectively and make healthier choices. 
&nbsp;

Understanding Food Cravings And Strategies For Weight Loss

Food cravings are sudden and intense desires for specific foods.

One explanation is that your body may be craving certain foods to satisfy nutritional deficiencies, hormonal imbalances, or blood sugar fluctuations. For example, craving chocolate may indicate a need for magnesium, while craving salty snacks could be a sign of dehydration or low electrolyte levels.

Underlying conditions like menstruation or pregnancy can also cause strong cravings. Some people experience pica, or a craving for nonfood items like dirt, ice chips, chalk, or coins.

On a psychological level, food cravings are often tied to emotions and memories. Stress, boredom, sadness, and even happiness can trigger cravings for comfort foods that provide temporary relief or pleasure. You may crave the exact food that you&#39;re allergic to, or you may crave pasta for comfort and warmth.

Additionally, environmental cues such as advertisements, social gatherings, and even the sight or smell of food can trigger cravings and influence our eating behaviors. For instance, a chocolate ad may trigger a craving for it. 
&nbsp;

Studies suggest that more than 90% of individuals experience food cravings at some point in their lives, with men likely to crave savory items and women likely to crave sweet or high-fat items.<a href="#accordion">[2]</a>.Cravings are also reportedly more common in people with a high BMI.<a href="#accordion">[3]</a> 
&nbsp;

There&rsquo;s a myth that all food cravings are bad, particularly for weight loss. This is not true. It&rsquo;s perfectly normal to indulge in occasional cravings in moderation without spoiling your weight-loss progress. It does not mean you&rsquo;re weak, have poor willpower, or cannot achieve your goals. The trick is to not let occasional indulgences spiral into unhealthy habits.

Moreover, suppressing food cravings without addressing the underlying causes can sometimes lead to intensified cravings and potential binge eating episodes later. 
&nbsp;

Cognitive behavioral treatment addresses how you think about food, replacing self-defeating thoughts with positive self-statements.

Don&rsquo;t think: &ldquo;This is too hard. I can&rsquo;t do it.&rdquo;

Change it to: &ldquo;Am I genuinely hungry, or is this just a craving? I should wait to see if this passes.&rdquo; 
&nbsp;

<ul>
	<li>
	<h5>Restrictive Diet Vs Intuitive Eating</h5>
	</li>
</ul>

There&rsquo;s no need to feel scared of your craving. Compared to restrictive dieting that may leave you feeling down, it&rsquo;s recommended to try intuitive eating.<a href="#accordion">[4]</a>

It allows for greater self-esteem, positive body image, and overall well-being. Moreover, it decreases disordered eating behaviors, such as taking diet pills. 
&nbsp;

<ul>
	<li>
	<h5>Instant Gratification Vs Delayed Gratification</h5>
	</li>
</ul>

Cravings, in a way, are expectations. For instance, when you begin to enjoy a particular food in a specific situation, like popcorn while watching Netflix, your mind begins to develop this expectation subconsciously, such that every time you sit down to watch Netflix, your body will send messages to your mouth, stomach, and even the &#39;reward center&rsquo; in your brain to get ready.<a href="#accordion">[3]</a>

Hyperpalatable foods, i.e., foods that are rich or have enjoyable qualities of salt and sweet, can stimulate the release of appetite, metabolic, and stress hormones including insulin, cortisol, dopamine, leptin, and ghrelin, all of which contribute to cravings.<a href="#accordion">[5]</a>

Once you realize this pattern, you can unlearn it and subsequently reduce the frequency and intensity of your cravings. For instance, you watch movies and shows without eating &lsquo;the usual food.&rsquo; Or you replace eating with healthier alternatives. 
&nbsp;

While food cravings can feel overwhelming, it&#39;s important to acknowledge and address cravings in a healthy and balanced way:

<ul>
	<li>Mindful Eating: Pay attention to hunger cues and practice mindful eating so you can become more attuned to your body&#39;s signals and differentiate between true hunger and emotional cravings.</li>
	<li>Identify Triggers: Keep a food diary and note what you eat, when you eat, how you feel while eating, and if you&rsquo;re doing something while eating. 
	&nbsp;</li>
</ul>

By recognizing the situations, emotions, or environments that trigger cravings, you can address them proactively, like getting enough sleep if late night shifts are causing you to overeat and gain weight.

<ul>
	<li>Choose Nutrient-Dense Foods: Eat nutrient-dense foods like fruits, vegetables, whole grains, and lean proteins to satisfy your appetite and reduce cravings. These foods provide essential nutrients and fiber, promoting satiety and stabilizing blood sugar levels.</li>
	<li>Stay Hydrated: Dehydration can mimic hunger or cravings. Drink an adequate amount of water throughout the day to prevent dehydration and reduce the likelihood of mistaken cravings.</li>
	<li>Practice Stress Management: According to research, chronic stress and emotional eating lead to higher BMI.[2] Finding healthy ways to cope with stress, such as exercise, meditation, deep breathing, or engaging in hobbies, can help reduce emotional eating and cravings triggered by stress.</li>
	<li>Plan Ahead: This is one of the most underrated solutions. Stocking up on healthy snacks and planning your meals in advance can prevent impulsive decisions and make healthier choices more accessible. A handful of nuts, for instance, can leave you feeling energized and full for the day.</li>
	<li>Seek Support: Building a support system of friends, family, or a support group can provide encouragement and accountability for managing cravings.</li>
	<li>Nutritional Supplementation: Vitamin B complex, fish oil, and magnesium are some supplements that help reduce cravings. Always consult a doctor before taking any supplements.<a href="#accordion">[1]</a> 
	&nbsp;</li>
</ul>

Remember, it&#39;s okay to indulge in moderation occasionally, but by understanding and addressing triggers, you can develop a healthier relationship with food and achieve sustainable weight loss success. 
&nbsp;

<ul>
	<li>Food cravings are complex and can be influenced by physiological, psychological, and environmental factors.</li>
	<li>Physiologically, our bodies may crave certain foods to satisfy nutritional deficiencies or hormonal imbalances.</li>
	<li>Psychologically, food cravings are often tied to emotions and memories, with stress, boredom, sadness, and happiness triggering cravings for comfort foods.</li>
	<li>Strategies for managing food cravings include mindful eating, choosing nutrient-dense foods, staying hydrated, practicing stress management, and seeking support from friends, family, or support groups.</li>
	<li>Indulging in occasional cravings in moderation is normal and shouldn&#39;t derail weight loss efforts.</li>
	<li>Addressing the underlying causes of food cravings, such as emotional triggers, listening to hunger cues, and incorporating healthy lifestyle habits like regular physical activity and adequate sleep, can contribute to better overall well-being.</li>
	<li>Understanding the psychology behind food cravings helps you develop healthier eating habits, achieve your weight loss goals, and maintain long-term success in maintaining a balanced and fulfilling lifestyle.</li>
</ul>

[1] The psychology behind cravings and how to deal with them. Psychology Today. Accessed February 27, 2024

[2] Food cravings: Causes and how to reduce and replace cravings. Medical News Today. Accessed February 27, 2024.

[3] Schnieber A. Psychological strategies can reduce your cravings. ScienceNordic. April 27, 2020. Accessed February 27, 2024.

[4] Hoshaw C. How to find the Wisdom in food cravings and make peace with food. Healthline. December 23, 2022. Accessed February 27, 2024.

[5] Cravings. The Nutrition Source. October 26, 2023. Accessed February 27, 2024.

Shermeen Zuberi

Hold On To That Haldi: The Desi Super Food Going Global

Turmeric, or haldi as it is called locally, is the spice that add a pop of mustard-yellow colour and a slightly peppery flavour and aromatic fragrance to Pakistani curries. The active ingredient in turmeric is curcumin. It is an antioxidant, anti-inflammatory and antibacterial compound. Turmeric also increases the flow of bile, which is key to digesting fats. Research also shows that turmeric may alleviate <a href="https://merisehat.pk/disease/alzheimers-disease">symptoms of Alzheimer&rsquo;s</a> disease.

It&rsquo;s extensively used in South Asian cuisine. It&rsquo;s used in pretty much everything from aaloo ki bhujiya (potato curry) to the various forms of daal (lentils) made locally to popular favourites such as the biryani (spicy rice with a protein such as chicken, beef or mutton).&nbsp; 
&nbsp;

Turmeric is a member of the ginger family, with a distinct flavour similar to saffron or mustard seeds. It can be purchased as a ground powder &mdash; which gives off more of its aroma than unground turmeric &mdash; or in fresh form (the latter being preferable if you&rsquo;re using it often, but it&rsquo;s only available in the right season).

The humble haldi is undergoing a resurgence of popularity around the world. Turmeric also been used medicinally for thousands of years. Ayurvedic medicine considers turmeric an anti-inflammatory that can help reduce inflammation throughout the body. Additionally, turmeric has been known to have antioxidant properties (and therefore may help prevent cell damage), as well as being able to inhibit cancer cell growth through its ability to induce apoptosis (a process by which cells die). 
&nbsp;

Proven Benefits of Haldi

<h5>Turmeric Also Has Cosmetic Uses</h5>

It can be used externally on the skin for its antibacterial properties. It&rsquo;s also believed that applying turmeric topically can protect against sun damage and reverse signs of ageing by reducing wrinkles and age spots. 
&nbsp;

<h5>Mythic Mentions</h5>

Curcumin, the active ingredient in turmeric, has been used for thousands of years in South Asia, where it&rsquo;s even found a place in mythology.

A legendary Hindu sage named Nandi used turmeric and milk to cure his wounded body after he was attacked by demons. The milk helped him heal and regain his strength while the turmeric soothed his wounds and prevented infection. 
&nbsp;

<h5>There Are Scientific Studies To Back Up Turmeric&rsquo;s Healing Properties</h5>

The most comprehensive study on turmeric and its anti-inflammatory properties was done in India by researchers at the National Institute of Nutrition, Hyderabad and published in the Journal of Medicinal Food. The study looked at 1,300 people over a period of six months and found that those who took a daily dose of curcumin (the active ingredient in turmeric) had significantly lower levels of inflammation than those who didn&rsquo;t take curcumin supplements.

Another study from 2018 found that taking a supplement containing both curcumin and piperine increased absorption by 2,000 percent. This shows how important it is to consume turmeric with black pepper, ginger or another pungent flavouring agent as these will increase bioavailability &mdash; your body&rsquo;s ability to absorb nutrients.&nbsp;&nbsp;

According to a study published in the American Journal of Clinical Nutrition, taking turmeric capsules daily for three months may be just as effective at reducing cholesterol levels as taking statin drugs. 
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<h5>Reduces Inflammation And Regulates Blood Sugar</h5>

For the longest time, we all have been fed haldi doodh [turmeric milk] whenever we have gotten sick or injured. The current generation has been quick to disregard the cultural and traditional remedies that our grandparents practised upon us. However, it is fascinating to know how right they have been. Every spice in our kitchen has some sort of healing properties and haldi just took the cake with its fame in the western world.

Curcumin has also been shown to help reduce blood sugar levels by reducing the amount of glucose absorbed by body cells. It may also improve insulin sensitivity so that more glucose can be taken up by cells, leading to lower blood sugar levels overall.

Turmeric has also been found to help prevent inflammation caused by rheumatoid arthritis or inflammatory bowel disease.

Also increases the flow of bile, the key to digesting fats. In Ayurveda (an ancient form of holistic medicine practised in South Asia), turmeric is considered a detoxifying agent that helps cleanse the liver by stimulating bile production and improving digestion. 
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<h5>Haldi Vs Alzheimer&rsquo;s</h5>

Turmeric has been long believed to have health benefits, but there are now more scientific studies that show it can help treat a number of conditions. Research published in the Journal of Alzheimer&rsquo;s Disease shows that curcumin may help manage symptoms of Alzheimer&rsquo;s disease. The study showed that curcumin can cross the blood-brain barrier and reduce amyloid plaque build-up, which is a hallmark sign of Alzheimer&rsquo;s disease. 
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In conclusion, turmeric is a spice with a long history of use in the sub-continent. It&rsquo;s one of the most popular spices in the world and it&rsquo;s not just used for cooking but also has various health benefits.&nbsp;

Food For Thought: Exploring 8 Foods That Impact Depression Symptoms

The connection between diet and mental health has gained significant attention in recent years, with research suggesting that certain foods can influence<a href="https://merisehat.pk/disease/depression"> depression</a> symptoms positively or negatively. In this engaging article, we delve into the fascinating realm of nutritional psychology, exploring eight foods that may worsen depression and others that can help ease its symptoms. By understanding the impact of these dietary choices, we can take charge of our mental well-being and nourish our minds alongside our bodies. 
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dietary choices on depression symptoms

<h5>Sugar: The Sweet Trap</h5>

Sugar may provide a temporary burst of energy, but its excessive consumption can lead to a rollercoaster of blood sugar spikes and crashes. These fluctuations can exacerbate mood swings, irritability, and feelings of fatigue, potentially worsening depression symptoms.

Satisfy sweet cravings with natural alternatives like fruits, dark chocolate, or honey, which offer additional nutritional benefits and help stabilize blood sugar levels. 
&nbsp;

<h5>Processed Foods: A Recipe For Discontent</h5>

Processed foods, laden with unhealthy fats, refined sugars, and additives, have been linked to inflammation and oxidative stress in the body. These factors can negatively impact brain health, potentially contributing to depression.

Opt for whole, nutrient-dense foods like fresh fruits, vegetables, whole grains, and lean proteins, which provide essential nutrients to support overall well-being. 
&nbsp;

<h5>Trans Fats: The Hidden Culprits</h5>

Trans fats, commonly found in fried and processed foods, have been associated with an increased risk of depression. These harmful fats interfere with neurotransmitter function and contribute to inflammation, potentially worsening depressive symptoms.

Choose healthier fats such as those found in avocados, nuts, seeds, and olive oil, which support brain health and reduce inflammation.

&nbsp;

<h5>Caffeine: The Jittery Effect</h5>

While moderate caffeine consumption can offer a temporary mood boost, excessive intake can lead to increased anxiety and sleep disturbances. These effects can exacerbate depression symptoms in vulnerable individuals.

Opt for decaffeinated beverages or herbal teas to enjoy a comforting drink without the jittery side effects. 
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<h5>Alcohol: The Temporary Escape</h5>

Alcohol may provide temporary relief from negative emotions, but its depressant effects can worsen mood disorders in the long run. Excessive alcohol consumption can disrupt neurotransmitter balance and interfere with REM sleep, crucial for emotional regulation.

Practice moderation and consider alternative ways to cope with stress and emotions, such as exercise, meditation, or spending time with loved ones. 
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<h5>Omega-6 Fatty Acids: Balancing The Scales</h5>

An imbalance between omega-6 and omega-3 fatty acids in the diet has been linked to increased inflammation and depressive symptoms. Diets high in processed vegetable oils often contribute to this imbalance.

Increase your intake of omega-3 fatty acids by incorporating fatty fish, flaxseeds, chia seeds, and walnuts into your diet, which can help restore the balance and support brain health. 
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<h5>Magnesium: The Calming Mineral</h5>

Magnesium deficiency has been associated with an increased risk of depression. This essential mineral plays a role in nerve function, neurotransmitter regulation, and stress management.

Include magnesium-rich foods such as leafy greens, nuts, seeds, and whole grains in your diet to support emotional well-being. 
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<h5>Serotonin-Boosting Foods: Nourishing The Mind</h5>

Certain foods can enhance serotonin production in the brain, supporting mood and emotional balance. Foods rich in tryptophan, an amino acid precursor to serotonin, can be particularly beneficial.

Incorporate foods like turkey, eggs, nuts, seeds, and bananas into your diet to boost serotonin levels naturally. 
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As research on the link between diet and mental health continues to grow, it becomes evident that the foods we consume can influence our emotional well-being significantly. By being mindful of our dietary choices and focusing on whole, nutrient-dense foods, we can support our mental health and alleviate depression symptoms. While making dietary changes alone may not replace professional treatment, adopting a balanced and nutritious diet can be a valuable step towards nurturing our minds and bodies in the pursuit of a healthier, happier life.

Have you ever twisted and turned in bed after a spicy dinner, unable to sleep no matter what you do, and wondered where and why? It&#39;s that dinner you had. The spices most likely are working their way to giving you a form of indigestion and/or given you, ahem, gas.&nbsp;

We don&rsquo;t think about it often, but what we eat has a direct impact on how we sleep.&nbsp;

Two crucial factors for general health and well-being are nutrition and sleep. Sleep has a direct impact on how we behave, work, and live. A nutritious diet and enough sleep each night immediately contribute to a healthy lifestyle and less incidence of chronic diseases. Proper nourishment and sleep go hand-in-hand in bolstering our health.&nbsp;

Here, we&rsquo;ll discuss the connection between nutrition and sleep as well as how to create a diet that will assist get qualitative sleep. 
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connection between nutrition and sleep

<h5>The Connection Between Your Diet And Sleep</h5>

How does nutrition come into play when we talk about sleep? The answer is not that simple because both nutrition and sleep include numerous other aspects and bodily systems, making it challenging to draw a clear connection between the two.

However, it appears there is evidence that certain foods, drinks, and dietary habits may contribute to people not getting enough sleep.&nbsp;

They in turn affect your circadian rhythm &mdash; our body&rsquo;s internal clock that drives a 24-hour rhythm but is reset every day by the sun&rsquo;s light/dark cycle.&nbsp; 
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<h5>How Diet Affects Your Circadian Rhythm</h5>

Your eating and sleeping habits together can affect circadian rhythm (the body&rsquo;s internal clock). These habits can either disrupt your rhythm or support it. While research is ongoing regarding the extent of this, it appears that following a regular eating schedule may help to improve and restore circadian rhythm and improve health and sleep.

The quality of your nighttime sleep may be impacted by eating late at night or skipping meals during the day. Improved energy levels during the day and improved sleep are both benefits of a healthy, balanced diet. Eating a meal late at night or skipping your breakfast can impact your nighttime sleep. A balanced and <a href="https://merisehat.pk/article/what-are-the-common-components-that-constitute-a-healthy-diet">healthy diet</a> can keep our energy levels regulated which will contribute to a good night&rsquo;s sleep. 
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<h5>What Foods Are Good For Your Sleep</h5>

Foods packed with vitamins and minerals will help your body in one way or another. But some foods have been beneficial in promoting better sleep. This is due to combinations of certain nutritious elements in that food that promotes good quality of sleep. However, the identification of specific food that can enhance your sleep, is the subject of ongoing research.&nbsp;

Serotonin, a hormone that stabilizes mood, Vitamin D, melatonin, and tryptophan, which the body uses to make serotonin, are all known to support sound sleep. These meals, which may also enhance sleep, are high in these nutrients. 
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<h5>Here is a list of the foods that may help your body regulate your sleep:</h5>

<ol>
	<li>Cherries: They contain anti-inflammatory agents and melatonin.</li>
	<li>Kiwi: Kiwi consumption has been known to improve the overall quality of sleep.</li>
	<li>Bananas: Nutrients like potassium and magnesium, found in abundance in bananas, are known to contribute to sound sleep.</li>
	<li>Oily Fish, nuts, and other dairy products can also help with sleep.&nbsp;</li>
	<li>Dairy Products seem to contain tryptophan, which is an amino acid used in treating sleep disorders. 
	&nbsp;</li>
</ol>

Better sleep and general health and well being have been related to eating a balanced diet that is high in a range of fruits, vegetables, whole grains, lean meats and healthy fats. For a more restful night&rsquo;s sleep, concentrate on eating a Mediterranean-style diet and stay away from heavily processed foods, big meals, caffeine and alcohol. Both nutrition and sleep are crucial components of healthy living because they influence how our bodies function and repair.