Dr S Chakraborty
As a doctor we have been parroting what has been taught in medical school all these years specially how much exercise a person must do. Now things have been turned on its head by a pioneering experiment done by Dr Timmons, a sports physiologist.
He basically selected two person say A and B with identical physical fitness measured objectively by plethora of tests specially Vo2 max which is the ability to extract maximum amount of oxygen from blood by our muscles per kg of body weight. For a average person like me with fair amount of fitness, its around 40, where as for athletes like Farah & Bolt, it is around 8o. A high Vo2 max is at present one of the top markers of a persons cardiovascular fitness, used both for short period sports like sprints and for endurance sports like marathon, mountaineering, cycling etc.
So Dr Timmons made both the person to do exercise for a period of 6 months but differently. Subject A was made to do conventional exercise that we routinely recommend like brisk walking for 45 minutes, 5 days a week whereas B was made to do intense exercise only for 5 minutes. He was made to run from one corner of a room( 20 foot long) to another at maximum pace. He did this for 30 seconds and took rest for 30 seconds and then repeated again. So of overall 5 minutes of exercise period , he actually did running only for 2.30 minutes. But the running was so intense that he felt as if his heart will come out of his throat.
After 6 months of training, the level of fitness was checked objectively. Subject A had marginal increase in Vo2 max from 42 to 46 where as subject B, whose initial vo2 max was 42, astonishingly went to 72. He also had significant improvements in other parameters like lactate tolerance, exercising blood pressure and the time needed by heart to bring its rate to near normal post exercise.
So when a 5 minutes of exercise specially in our time starved and excused life , can do more benefits than a leisure walk of 45 minutes, we indeed have got to have paradigm shift in the way we do exercise. In fact after this experiment, many national advisories of different countries are thinking about scrapping the concept of recommending 5 days of exercise for 30 to 45 minutes. This remarkable experiment has again opened up the debate of how much is enough. For sure its not more the merrier. It is also called as HIIT which stands for high intensity interval training. Well there is conditions apply for HIIT regimen and that is you must have average level of fitness before attempting it. You just can’t get out of couch and do HIIT straight away.

Dr Sudip Chakraborty
MD( Medicine)
How often have you found yourself cursing for that fat around your tummy despite following all the dieting tips your friends shell out? Inspite of being regular in walking or some other exercise ,still that desired body weight remaining elusive? And another new year has come but the pending resolutions of previous years are far from being met. So if you belong to those warriors against fat and body weight who is sincere and punctual but still on the loosing side then, read on.
Usually we have two sources of fuel in our body; carbohydrates( I will refer it sugar) and fats. We are primed to use sugar from foods as our day to day energy source despite it giving only 36 ATP ( basic currency of our body) per gram where as fats give 441 ATP per gram. I wonder when we Indians are so much obsessed with mileage ( kitna deteh hai?) why we are not using fats for energy? Yes we can change our metabolism from sugar dependent to fat burning. Of course its not a overnight process but if we understand some facts and bunk some myths, we can do it.
1) Sugar promotes fat : sugar consumption promotes the release of INSULIN, a hormone which increases the utilization of sugar and in that process keeps body fat just like that. Either you are burning sugar or fat for energy but both cannot take place side by side. Your body fat can’t be utilized till there is insulin in your blood. Even half a glass of juice, cola or wine can disrupt your well intentioned fat burning strategy. A small toffee with just 80 calorie can trigger enough insulin in a non diabetic person for nearly 72 hrs, to stop any fat burning for energy.
2) Belly fat is not diet related; it is promoted by cortisol, the principle stress hormone. That explains how stubborn it is. Basically it is deposited as an insurance against starvation by cortisol. So getting rid of stress, good sleep along with core strengthening exercises are needed to remove it.
3) Eating less doesn’t reduce body weight; you might get a initial result of 4-5 kg of weight loss, but you soon hit a set point. Soon your intelligent body reduces your metabolic rate, due to which eating less is not sufficient to produce a calorie deficit state which can call for fat burning. Further weight loss may be due to water loss but not fat loss leading to dehydration.
4) Eating fat increases fat loss; if we eat predominant (60-70%) fat containing diet, it reduces the release of insulin and gradually your body could be coaxed to burn fat for energy. Of course the debate of good and bad fat is still on, right now all the data suggests other than trans fat( greasy fat, hydrogenated oils), remaining are good like virgin coconut oil,olive,peanut, mustard,soyabean oil. Every day liver produces 2000mg of fat/cholesterol equivalent to eating 45 eggs per day, just for the day to day function of our brain, cell wall maintainance,hormone production etc. So if we eat fat, liver will produce less. Eating alone is not sufficient. You have to exercise to the extent that energy provided by the dietary fat is inadequate, so stored fat is called upon to do the job.
5) Increase fat burning hormonal activity; these are glucagon, IGF-1 and Growth hormone. So doing EXHAUSTIVE exercise and not just feel good slow walk, high intensity exercise in bursts like running, jumping,cycling for shorter intervals . Good rest post exercise along with a healthy liver( no alcohol please) helps release above hormones as well. So recovery is a must and not foolish daily work outs.
6) Reduce fat storing hormonal activity. These are insulin, cortisol and oestrodiol. By reducing sugar including the obvious and the masked ones in artificial flavours, insulin release is reduced. Any physical and mental stress will release cortisol, even excessive exercise without adequate recovery period , will undo your goal. Similarly hormonal supplements like pills will augment fat deposit.

Dr SUDIP CHAKRABORTY (MD Medicine)
So what is placebo? It basically means ‘ I shall please’. But it is much more than that. Any doctor worth his salt will tell you the enormous role it plays in getting a patient satisfied after giving whatever treatment .
How it started?
When a American surgeon Henry Beecher was serving in world war2, he ran out of morphine, a terrific pain killer among other things. So much was the rush of wounded soldiers needing surgery and with no morphine to give before operation, he panicked. He started filling empty bottles of morphine with normal saline. With a flair and telling the patients ‘ here I am giving you morphine and your pain will go away in no time’, he went on to perform surgery without a single ouch from patients. He subsequently performed many surgeries that day using only saline but to the soldiers it was the potent morphine. When morphine finally arrived, he did his surgeries on alternate soldiers with morphine and with plain saline. Results of both the group were identical and the soldiers on saline surgery were in no more pain than the morphine group. He subsequently published his findings in Journal of American Medical association, which turned out to be huge leap forward for us to know the role of mind, positive acceptance, faith, suggestibility and so on.
Of course these days no drug is considered effective if it can’t surpass placebo. Typically placebo which could be anything like a peppermint or chalk, which when given under appropriate circumstances and in a manner, can have a effect on a person which can’t be explained by that substance alone. So for placebo to be effective many factors are to be present. I would like to suggest some;
1) Seed and soil concept; A good seed not only needs a appropriate prepared soil but also a right environment. If seed is the medicine, then the soil has to be the mind prepared to the extent that he is convinced without any doubt that this is going to cure me. All this is to be done in a environment where the patient is neither hurried nor short of attention with any distractions.
2) Mass effect: Ever wondered about thousands of people lined up for that gulp of fish to cure asthama? And that fish prepared by select section of people since generations. Of course no scientific reason been found for cure other than thought of thousands of minds with an acceptant attitude strongly believing that they will be cured.
3) Suggestibility: Wondered why a very difficult to reach doctor when treats you, you get cured when hundreds of other equally qualified doctors in your town failed? The whole process of waiting and thus allowing the mind to dwell on the doctor for months, hearing his success stories, prepared the eager mind and bingo a multi vitamin along with the dharshan of the doctor and nice little tap on the hand , just cured you.
4) Engage the mind: Have u ever felt good while telling your problems to your doctor and he meanwhile keeps on answering his phone or somebody barging in and out of the room constantly? So you end up either repeating your symptoms or start thinking about what’s in for lunch? Placebo effect comes only when the mind is engaged and the doctor gives the undivided attention to the patient.
5) Body language: Body languages like showing you complete attention as if he has nothing else to do, listening up without interrupting or judging, non combative and non suspicious stance, eyes wide open without yawning, showing genuine interest in the problem presented, understanding the non verbal cues like the way eyes moves around, frequent eye contact, prosody of the voice etc all goes a long way in establishing a rapport for the placebo to set in.

Of course there is many more things about placebo but due to time constraint I tried an attempt to present some commoner and readily identifiable scenarios.

DR. SUDIP CHAKRABORTY ( MD Medicine)
With increasing awareness about health, people are following various forms of exercise depending upon the prevailing fad. Pilates, zumba, functional exercise etc are all clamouring to get our attention. Of course each type of exercise has its benefits but the problem lies in our expectation. No single exercise can claim to provide the golden triad of strength, flexibility and endurance alone. And there in lies the problem. Recently I came across a patient who developed a heart attack. He was shocked because his years of practicing yoga led him to preume that he was having perfect health. And another patient who was very disciplined to do regular 5km brisk walking, was aghast to find out a trifle thing like missing a step in stairs, led to fracture in his foot.

These examples just highlights that just one discipline of exercise is not enough. So what’s the solution?
1) STRENGTH; We loose more than 1% of muscle mass every year once we age beyond 30. Without muscle strength, imbalance and fall greatly increases. Moreover once we do strength training exercise by lifting weights, the benefits of increasing metabolism like body weight in check, great blood sugar control etc stays beyond 24 hrs of exercise. Ofcourse I am not suggesting to beef up, low weights or free hand exercises like push ups, pull ups, planks, squats and lunges are really helpful in preventing or slowing the muscle mass loss. Muscles just follow the rule; use it or loose it.
2) FLEXIBLITY ; Without good flexibility, injuries are bound to happen. That explains why all those WWE fighters has lower life expectancy. Of the numerous benefits of yoga, one for sure is great flexibility of nearly all possible joints in our body, not to forget the mental well being that it imparts. A flexible and nimble body is easy on the joints and one can have a functional and utilitarian body. So notwithstanding your increasing age, you can easily carry out the activities of daily living and not depend on some one else.
3) ENDURANCE; Cardio respiratory fitness in the form of brisk walking, running, cycling or swimming, imparts benefits that no other exercise can claim. Not only it keeps your blood pressure and host of other biochemical parameters under check, but also releases lots of feel good hormones called endorphins that keeps depression at bay. The value of a good horse could be judged only when it runs. Similarly no claim for heathy heart is passed till one does any exercise which raises the heart rate to the target of 220 – age, and the person still comfortable. For ex, if your age is 50, target heart rate will be 170.
Health is the only thing that you can call truly yours and everything else is just temporary just like your 1000 rupee note. We all know and some dedicated ones do some exercise but many times it doesn’t give us the desired result. Remember to include above three things in your exercise regime to enjoy great health and see what our beautiful life can offer.