How to manage Food Cravings!

Midnight ones? Sugar Cravings or just the need to binge onto something. Let’s figure out where they come from? How do we prevent them?… While trying to find scientifically backed answers to all these questions. I had another wild wild question in my head?

Do we really have any cravings at all?


Or is it our mind playing tricks? Do we really feel the need to eat something urgently? The answer is surprizingly YES & NO both at the same time.

Our mind does play tricks. We definitely do feel hunger, when our blood glucose falls beyond a point which forces us to hunt for food. But can we feel hungry for certain food items even after eating a wholesome meal or when our body doesn’t require that food. Is this kind of hunger driven by our survival instincts? The answer is a big NO. This is simply driven by our brain’s memory of how it felt while eating that food item. For eg: Chocolates: we all know how it feels to have the first bite and not being able to stop.

When we have something that we relish, it releases the feel good hormone: dopamine in the body. We can trick our mind into releasing the feel good hormones even with healthy nutritious food. This happens only if you pay absolute attention and appreciate every bite, chew it properly. This mechanism gets suppressed if you are eating in a hurry or dont relish every particle that goes into your mouth or eat while looking at the TV.

your mind talking to you

Davis, Kaplan, Kennedy & Carter showed that an appetite suppresant that blocked dopamine functioning was not effective in adults who screened positive for food addiction on the YFAS.1

“Wait a second, I am not a food addict ” isn’t that your first thought? ( Thing to note: Many of us who binge eat or can’t stop eating are borderline food addicts: Check it by answering the YFAS questionnaire.)


Ok food addict or no food addict. All of us try really hard to stop all these craving resorting to different methods. One of the famous methods is just having a cheat day in your diet plan. In a certain experiment, rats given a high fat low sucrose (sugar diet) intermittently craved for sugary substances more than the rats who were given low fat low sucrose diet. Surprise Surprise, No doubt you crave more when you limit yourself from eating these things or eat them at intermittent intervals.

This happens mainly because of sugar addiction. Fun Fact: Do you know that sugar activates the same receptors in our brain as drugs. Although the activation is low in intensitycompared to alcohol and drugs, thats where most of our sugar cravings come from. As if the cake or the carb loaded pizza or a sugary drink invites us, compels us to eat it.

As soon as we have that piece of cake, our blood sugar rises rapidly and our receptors, the opiod ones, register that level. Now to engage your body into a similar high, next time you would require a little more of that cake. Thats how the overeating cycle starts.

So do we give up on sugary drinks, Icecreams that we love, our all time favourite pizzas and that piece of cake.Are you already salivating at the mention of these items?

Repeat after me thats your brain- not your gut.

No, we don’t give those things up or make any life altering food choices. The withdrawals symptoms that you get for making the decision of removing sugar completely from your diet will do more damage than help you out. You might be wondering “the withdrawal symptoms ??” Yes the ones that chronic smokers, alcoholics and Drug addicts experience. Remember they stimulate the same pathway after all.

In a certain study using an FMRI to map the brain activation, particiants with three or more food addiction symptoms on YFAS was studied. Gearhardt and colleagues concluded that this pattern of increased activation in areas of the brain related to reward (anticipation of a chocolate milkshake) and decreased activation in areas related to inhibition is similar to that seen in substance dependence.2

The first step to a healthier lifestyle is to recognize the symptoms of drastically reducing your levels of unhealthy food intake. Markus and associates reported that among 1414 participants who reported experiencing at least one YFAS symptom in the past year, 9.5% endorsed “withdrawal-like” physiological effects in response to either high-fat savory foods (3.8%), high-fat sweet foods (2.8%), low-fat sugary foods (1.6%), or low-fat savory foods (1.3%). The self-reported “intensity” of withdrawal symptoms were significantly greater for high-fat savory and high-fat sweet foods compared to low-fat sugary foods (ps < 0.05). 3

Withdrawal symptoms of Sugar, Loaded Carbs, Fatty Food items

So what’s an easy way out. Remember we talked about the blood sugar spike. Let’s try and control that.

  1. Portion Control: Take a smaller plate, a smaller bite. Keep that piece of chocolate longer in your mouth where you can taste it. Instead of gulping it down. Remember the taste sensation that your brain registers is from the taste buds in your mouth. the longer to keep food there, the fuller you will feel. And last enjoy what you are eating without any guilt.
  2. Take your time: Take a tiny weeny bite, go around finish some work and come back 15 minutes later for another one. Your appetite for that food item will diminish because your gut would have signalled the brain by then that its received the required food. Hormones like leptin will take over and stop you from eating more of that item or craving it.

Following these techniques will prevent the blood sugar from rising too high at a given point and will keep your dopamine and opiod receptors in check. Once you continue this for a while, the receptors will become sensitive to minor levels of blood sugar eliminating cravings & the need to binge eat.

Now this method can work only if you recognize all the sources of sugars in your diet. Let me list them for you.

  1. Carbonated drinks
  2. Items that have added sugars- Icecreams, Chocolates, Cakes, Pastries, anything that taste sweet
  3. Items that a processed and have a good shelf life- usually these are high in fats and a lot of salts are used for an improved shelf life, High fat- low sugar combination increases cravings4
  4. Incidences where you combine fats & Sugars together- Having a full Dal, Chawal, Roti, Bhaji meal. Chawal and Rotis ( wheat ones) are broken down easily into sugars in our body. Hence after eating loads of rice, or many rotis we feel sleepy.

Most traditional food combinations have a balanced amount of proteins, fibres, carbs and fat. But most of the time we tend to overeat or selectively eat to satiate our taste buds throwing this balance off.

Once you recognize the sources, the idea is to eliminate the non- essential ones slowly by the above methods and limit the essential ones to the quantity our body needs to function.

Inspite of all this, allow yourself to indulge every once in a while. But Remember Indulge in Bits & Pieces



  1. Davis, C.; Levitan, R.D.; Kaplan, A.S.; Kennedy, J.L.; Carter, J.C. Food cravings, appetite, and snack-food consumption in response to a psychomotor stimulant drug: The moderating effect of ‘food-addiction Frorrt. Psychos. 2014.5.403. [CrossRef] ]PubMed]
  2. Gearhardt, A.N; Yokum, S; Neural correlates of food addiction. Arch. Gen. Psychiatry 2011,68,808-816 [CrossRef] ]PubMed]
  3. Markus, C.R; ROgers,PJ; Eatign Dependence and weight gain: no human evidence for a sugar addiction model of overweight. Appetite 2017,114,64-72 [CrossRef] ]PubMed]
  4. Adams, W.K; Sussman,J.L; LOng term calorie restricted intake of high fat diet in rats reduces impulse control and ventral strital D2 receptor signaling – two markers of addiction vulnerability. Eur. J. Neurosci 205, 42, 3095-3104 [CrossRef] ]PubMed]

Stevia: the Sugar substitute

Its been a dream for most people to eat whatever they want and still not gain weight! Well in that case, Stevia is your dream come true. Double the sweetness minus the calories. Indulge in your sweet tooth all you want.

Have you’ll ever thought about where stevia comes from?

Originally, its from a woody shrub, a plant called Stevia Rebaudiana. There are above 200 species of Stevia, but this one is the sweetest. It is non-nutritive, non-toxic, high potency sweetener which is almost 300 times sweeter than sucrose (aka sugars).

Why is it a low calorie sweetener?

Stevia leaves contain Stevioside and Rebaudioside. It has been shown that human body doesn’t absorb stevioside by the oral route and the digestive enzymes cannot degrade stevioside in its steviol form. Only the colon microbes are able to metabolize it into steviol and glucose. Glucose formed by this process gets used up by the bacteria present in the gut rather than getting absorbed in the blood stream. And most of the steviol gets excreted from the body in urine or feaces.



Inspite of no calories, there is some amount of nutritional value to Stevia. Stevia leaves provide 2.7 kcal/g energy with fat content at 1.9-4.34g/100g , carbohydrate whihc is 52-64.06g /100gms and protein at 10.0-18.0g/100g.

Can Diabetics consume Stevia?

Yes, Absolutely! In stevia leaves, the main source of energy is carbohydrates due to the presence of poly and fructo-oligosaccharides which regulates the metabolism of lipid and reduces the sugar level in blood. Consuming Stevia doesn’t induce a glycaemic response, on the contrary, it promotes glucose uptake by enhancing insulin sensitivity. Enough of the detailed medicinal mumbo jumbo.

The main thing to note here is the consumption of stevia has positive metabolic outcomes for patients with Diabetes Mellitus.


Well the list of Nature’s help to us doesn’t end here. Apart from being a low calorie sweetener, it also acts as an anti-oxidant due to the flavonoids & polyphenols. It can potentially reduce the free radical load which is implicated in diseases like diabetes, cancer, neural disorders, arthritis and aging.

It also Protects the Heart!!

Stevia Rebaudiana helps in decreasing cholesterol and fatty acid synthesis, thus reducing total cholesterol, triglycerides and LDL levels; and by elevating HDL Cholesterol (the good one). Stevia leaves also help the arteries relax and prevents the build-up of calcium on the artery walls thus regulating blood pressure and being cardio-protective.

There are many other properties of Stevia. It has an antitumor effect, protects your kidneys and liver. It also has Antifungal and Antibacterial effects. Are you already thinking of using this as a go to sweetner?

Take a moment. Let’s first figure the most authentic source of this medicinal, non-caloric herb & sweetener.

I wouldn’t use anything other than something that is naturally occuring as a sugar substitute. Recently an interaction with my friend motivated me to check all the zero-calorie sugar substitutes. There are many artificial sweeteners out there. Are they all by-products of Stevia or Stevia compounds? not necessarily.

Many popular zero calorie sweeteners like Sugar free or Splenda have Sucralose which is a highly chemically processed form of sugar, to reduce calories and enhance the sweetness. Sucralose can sometimes be even sweeter than stevia. Easier to manufacture and sell in bulk.

Some of them have additives like maltodextrine, lactose, sucrose along with sucralose. Studies have found that these can cause spikes in blood sugar post consumption. Certain research studies in Mice have assocaited consuming sucralose with cancer. Cooking with Sucralose may create potential carcinogens.

So looks like STEVIA in its pure form is our best bet. How do we find it?

Well, you will find dry stevia leaves or you might find them in the processed form as small pellets, powdered or as liquid. In the processed ones, compounds named Steviol Glycoside, Rebaudioside, FOS & Stevia leaf Extracts are ok. Checking the ingredients will give you a fair idea of what to invest your money and health in.

What is the Recommended Daily Intake?

According to the FDA, the acceptable daily intake for stevia glycosides is 4 milligrams (mg) per kilogram of body weight. Meaning a 50kg person could consume upto 200mg of stevia. Which is way more than what will be actually required. Remember it is almost 300 times sweeter than normal sugar.

Replacing sugars with stevia doesn’t mean you get a rain check. It is still beneficial to limit the intake of stevia to minimal.


Sweetness is a something your taste buds convey to your brain. Everytime you eat something sweet, your brain registers that level of sweetness. Once your brain registers that level, it becomes your new normal; meaning that you will require to add more of it for enhanced taste. The more sweetness you get used to, the more your body will require. And considering stevia is extremely sweet, consuming it in large quantities might alter your taste sensation forcing you to consume more of it. SO KEEP YOUR SWEET TOOTH IN CHECK.




  1. DOI:10.19080/CRDOJ.2020.13.555867
  3. DOI: 10.3390/nu12010029
  4. DOI:10.1186/s13287-020-01753-0

Sugar, Honey, Jaggery & Everything Sweet

All of these add sweetness to our food. And in turn to our life. Sugar in the form of white crystals or brown sugar with a slightly brown tinge is easily available in all markets over the world. Honey : in small Bottles & Jaggery in certain countries or in Indian stores all over the world.

Most of these are highly processed for a greater shelf life. So let’s make a choice of a lesser evil among all these sweeteners.

All sugars come from one source: Sugarcane. Honey from the bees. Depending on how they are processed, they could have a different calorific value. Below is a table which would help you decide which one to choose on basis of calories 1

White Sugar375kcal/100gms
Brown Sugar390kcal/100gms
Calories per 100 gms

While adding it as teaspoon the difference in these calories almost vanish. So one thing to remember “If it sweetens it has the calories”

A lot of us replace white sugar with the ” so called healthier options” like Brown sugar, Honey or Jaggery. When it comes to weight loss, all sweeteners contribute to a similar calorie count.

Don’t be disspointed as yet. Jaggery & Honey are still healthier than the regular sugars. I’ll explain how.

We know that jaggery comes from boiling sugarcane juice until it hardens. Sugar cane juice contains numerous nutrients which are retained in Jaggery that we consume.(P.S. A lot of jaggery is factory processed which might strip it of the essential nutrients. Here we only talk about traditional desi gur)


Iron10-13 mg
Vitamin A3.8mg
Vitamin B10.01mg
Vitamin B20.06mg
Vitamin B50.01mg
Vitamin B60.01mg
Vitamin C7.0mg
Vitamin D26.50mg
Vitamin E111.30mg
Vitamin PP7.0mg
NItritional Value of Jaggery

I had an amazing chance of visiting such a place where they make Desi Gur on the highways of Chandigarh, India. It rejuvenated my tastebuds to eat something so pure and fresh, just made jaggery with peanuts.

Along with 280mg of Protein per 100gm of Jaggery4. Now you know what to replace your vitamin pills with. (Just Joking). Jaggery serves as an amazing addition towards our daily mineral and nutrient intake giving us, about 30% of Magnesium & Potassium and about 61% of Iron of the RDI(Recommended Daily Intake)

Having said this remember, Jaggery still has 70% Sucrose and all the calories. So take in moderation for those aiming towards weight loss or are Diabetic.

JAGGERY IS MORE COMPLEX THAN SUGAR, IS DIGESTED SLOWLY AND RELEASES ENERGY OVER TIME-which causes lower blood sugar spikes as compared to other sweetners like white or brown sugar

Let’s get to Honey!

Honey contains around 56-500mg/kg of total polyphenols mainly flavonoids. These are responsible for the antioxidant properties of honey. Honey contains 0.3-25mg/kg choline and 0.06 to 5mg/kg acetylcholine. Choline is essential for cardiovascular and brain function, and for cellular membrane composition and repair, while acetylcholineacts as a neurotransmitter.5

The honey bees support us in a big way by making honey. which we steal from them. Because it is so delicious and nutritious. Honey may differ slightly in taste and composition depending on areas they are acquired from.


Taken from the Book of Honey 6

Apart from the essential Minerals & Vitamins, it also contains trace elements which are of nutritional value.

Do you know that certain studies have shown that the carbohydrate profile and the GI response of honey was identical to popular sports gel. All you athletes out there, you’ll now have another more natural option as a substitute for your expensive sport gels. 7



Brown sugar is White sugar + Molasses (by product of sugar production). Except for the difference in Color and Taste, white and brown sugar are practically the same thing.

Brown sugar being less refined than white sugar, gives you marginally more minerals than the white sugar. Substituting white for brown and paying more for one versus another is a smart marketing gimmick with minimal added value.

The Important Question

What would you choose?

Now that you know a smarter choice would be Honey and Jaggery. Both these are rich in nutrients, minerals and trace elements. They have antioxidant properties. They taste good and are complex in nature, so they break down slowly, providing energy over longer periods of time.

In spite of all these things, they contribute to a similar calorie intake as white and brown sugar.Hence, Intake should be in moderation.Remember just because they are healthier doesn’t mean you can consume them without any check on the amount.

Anything in excess is poison. Even Honey and Jaggery (P.S. will contribute to weight gain in excess)

Hemali Physio


  1. https://www.resea rc hgate.n et/pu blication/343557962
  2. https://www.resea rc hgate.n et/pu blication/343557962
  3. https://www.resea rc hgate.n et/pu blication/343557962
  4. https://www.resea rc hgate.n et/pu blication/343557962
  5. Bogdanov, Stefan. (2016). Honey as Nutrient and Functional Food. Bee Product Science. 15.
  6. Bogdanov, Stefan. (2016). Honey as Nutrient and Functional Food. Bee Product Science. 15.
  7. Bogdanov, Stefan. (2016). Honey as Nutrient and Functional Food. Bee Product Science. 15.

Water for your Body

More than 70% of the earth is made up of water and so are our bodies. But have you’ll ever wondered where does that 70 percent water come from.

We are born with it? ( NO) We have to drink it . We only get about 20 % from food that is dry and it can go upto 40% if your diet consists of more fruits and vegetables. There is still a deficit in water intake.

The National Academies of Sciences, Engineering, and Medicine determined that an adequate daily fluid intake is:

About 15.5 cups (3.7 liters) of fluids for men

About 11.5 cups (2.7 liters) of fluids a day for women


Having said this, remember it is still a guideline. The daily water intake will differ from person to person depending on various factors like

Body composition- Height, Weight & Total surface area

People with smaller body sizes would require less quantity of water to reach their 70 % versus someone who is tall and broad framed. Women & Obese people display indicators of cellular dehydration, and are more at risk of dehydration1

Exercise levels- Mild, Moderate or Intense

Exercise causes fluid loss which needs to be replaced. Water intake is extremely essential before, during and after exercising. Any Activity or sport that is intense or lasts more than 45 minutes would require electrolyte (Water+Salt) ingestion too.

Osmoregulation & Thermoregulation

Water keeps us cool literally. It helps in regulating temperature. Have you though why large machines having a cooling fan. Water is our cooling fan. One reason why we love showers, fountains mist sprays so much. Every individual differs when it comes to thermo & Osmoregulation. These processes depend heavily on ions, hormones & cellular mechanics of each body.

Environmental Factors

We all have experienced how we sweat heavily in higher temperatures and relatively less in colder climates. Humidity is also one determining factor. Thermoregulatory (temperature regulation) strain increases in the heat when humidity rises, elevating skin temperature causing an increase in skin blood flow and greater circulatory strain.2



Its Simple! The easiest possible way is by looking at our urine.


The results of one study suggest that a “change in urine colour by 2 shades can be achieved with a quantifiable change (1100–1300 mL/day) in daily water intake.”

The change in daily water intake and the change in urine colour shades were supported by corresponding changes in urine volume (1.0 L/d) and specific gravity (0.008 units), respectively.

Now one would wonder how does specific gravity of urine help us. In literature ” maintaining a high urine volume with target urine specific gravity of <1.010 is recommended as a cornerstone in the prevention of recurrent kidney stones” 3

A lot of us, inspite of knowing these basic facts,we forget to drink enough water

This not only effects the Kidneys, but total body function. Decreased water intake would lead to decreased blood volume .Blood volume is necessary to maintain adequate perfusion to all of the tissues in the body. Nearly all cells in the body require replenishment of nutrients and a removal system for waste, both of which the blood provides

Still wonder why you feel achy tired or lethargic at the end of the day or sometimes even in the morning?

We put our body through various tasks throughtout the day. All that wear & tear needs repair, which usually happens at the end of the day. Decreased perfusion to the cells impair the repair process. BINGO!

Joints , muscles, nerves, fascia everthing at its cellular level needs water to function.

De-hydrated individuals are more susceptible to joint wear & tear- arthritis, muscle strains & tears, nerve issues like sciatica or tingling & numbness. Slow Cognition, decreased alertness, lethargy can all happen due to decreased water input.

So monitoring your Urine, slowly and steadily increase your fluid intake upto at least 2.5 litres to 3.5 litres. Feel the change in the way your body functions. You might feel more energetic, lively with softer pliable skin.

Donot start chugging down litres of water as yet. there is a way to do that.

Sipping water at intervals while sitting helps your intestines absorb water efficiently and decreases the load on the kidneys. When we drink a lot of water in one go, it doesn’t get absorbed in the system, the kidneys have to work to eliminate that water. And you have to pee frequently.



Basically you should feel good and soon you’ll find your sweetspot with fluid intake. And if you still are unable to judge the amount of fluid needed for hydration. contact me or get an expert opinion!

Although one thing to take care of in Elderly!!!

Renal function diminishes as you age beyond 75 years, more or less depending on your fitness level & body composition. Hence Urine color or volume might not be a good indicator of hydration in such people. Elderly also tend to have diminished sense of thirst combined with forgetfullness increases their risk of dehydration.

A recent study by Fortes et al. reported that in a sample of patients with a mean age of 79 years, neither urine colour nor specific gravity was able to accurately distinguish euhydrated and dehydrated patients. 3

Stay Aware, Stay Healthy, Stay Hydrated!

P.S. All the conditions mentioned above can also happen due to other reasons like nutritional deficiences, hormonal imbalances. If you have other co-morbidities like High blood pressure, Diabetes or Throid Issues, you would need an individual consult. Increasing the water intake beyond what your body can tolerate can lead to hyponatremia symptoms: lethargy, confusion.


  2. DOI :10.1080/23328940.2016.1182669
  3. DOI: 10.1007/s00394-015-1010-2

My stint with cycling!

Only when you can be young and stupid, can you be old and wise. So this is an online cheers to my stupidity. Also a very big cheers to my friends who accompanied me here. Let me tell you how this all started.

Backing up 5 years, While I was leaving Boston, one of my friends got a folding bike and would travel to and fro work cycling. I was encouraged to do the same, so as soon as I came back to Mumbai, India, I decided to get a similar folding bike. Decathalon was the go to place. The folding bikes were just introduced by the company BTWIN into the Indian Market. Got mine and was super elated to ride to work. I exactly used it for 3-4 months before putting it away as my work demands increased and could no longer cycle to work.

Moving forward in time to 15 days back, me and one of my friends went to cycle upto Worli from Sion. I rode my folding bike which was pretty cool & surprizingly comfortable. Came back in 2 hours with a total of approximately 15 kms covered. That ride seemed like an easy one.

Switching to the present, a day back, with my previous experience of biking/cycling being easy I thought cycling upto Nariman point from Sion wouldn’t be a big deal. How wrong was I! Me and my friends rented our bikes from Do Pahiya at Sion. Yeah! we were all first timers. We had planned starting at 6:30 am but the bike rental was available only after 7am. We were 3 people. All our others friends were meeting us at Nariman point. Another added motivation to ride till there. Using our running belts for water and essentials like Sanitizer, Money, cellphone & food we started off.

Passing along the crowded Shivaji Park with people running, exercising and cycling with wind hitting our faces and our hair flying ( not really- just added a pinch of bollywood drama). Excited and super elated we reached worli in no time. Stopped as soon as we found the car waiting for us. One of my friends exhanged her cycle so that her husband could ride too. We realized our seats were too low. Adjusted them at this point. Point to note: Seat height is extremely important to be able to ride the cycle well. And off we started again taking the Haji Ali route where I met my Dad & Sister who were also keeping a track of whether we reach Nariman Point alive!

After a short discussion one of my friends recommended the breachcandy long roude instead of the kemps corner bridge. We were extremely thankful to him. Although let’s not tell him this! 😉 Slopes are beautiful only when riding downhill. Uphill is a herculean task. Not recommended to anybody riding a bike for the first time.

We reached Nariman Point. Yes we truly did. I have proof ! Although at 8:30am. One and half hour for a 20 kms ride. Not bad considering all the breaks we took. Another 30 minutes of fun, photo session and talks with our squad. And then all set to head back.

By this time, the sun was out and our buttocks were sore but our minds hopeful. Much like we didn’t have any option but to ride back and return our rental cycles.

Pushing and pulling and thinking of my stupidity. Never thought cycling could hurt so much. Our quadriceps (Front thigh muscles) were completely jammed. I would blame the seat height ( read: in my mind the idea of riding 40 kms) We were suppose to head back and not stop in our way. Contrary to our thinking, we took numerous ones, mostly to free our muscles and give our buttocks the much needed rest.

Behind the scenes of our cycling photo shoot!

At this point I was thinking to myself ” The only way we are able to sit on our butts the entire day is because we have soft cushy nice chairs. ” Maybe our buttocks; the strongest muscles in our body were not made for all this sitting, whether on the bike seat or the chair ” Bookmark this thought.

My thought

With the sun shining down on us the distance coming back felt longer than ever. Our heads started to hurt. We thought we didn’t need electrolytes. Didn’t we?(face palm) Dehydrated, with our muscles on fire and buttocks going numb from all the friction we arrived. 20 another kms to the rental place.

No more photos- we were more than happy to return the cycles

It was amazing to get off the buttocks. That moment felt like freedom. Jelly legs or maybe not since I rode my teeny weeny folding cycle back home another kilometer. We did it ! Yes in all the stupidity and madness. But, we knew the worse was yet to come. In the shower when our butts would burn & when our muscles would feel relieved.


Hemali Mehta- AMateur cyclist & SPorts physio

We had discussed our recovery routine with each other. Ice packs, Cold showers, Stretches, Foam rolling and rest.. Defintely rest since we taxed our body with something new. I often say to my clients

Avoid TOO MUCH, TOO FAST, TOO SOON to prevent injuries.

And I did the exact opposite, too much distance- 40kms. Too soon- Riding the first time without prior practice. Too fast- maybe not but the too much & too soon did enough damage. With a good recovery protocol for me- Foam rolling & Cold Shower. Our next day was relatively Painfree.

In those hours, early Sunday Morning, I was young and stupid, inspite of having the knowledge of what could happen. But gladly all that stupidity made me qualified enough to tell you’ll that this wasn’t a good idea. 3 Hour cycling old, 12 years into the physio field old & now a little wise too.

Here are first time cyclers do’s & don’ts

  1. Females wear a cushy pad (sanitary pads also work ) or special cycling shorts with cushions. Males – Cushy SHorts ( Very important to reduce Buttock & Seat Friction
  2. Wear long sleeves to avoid tanning & helmet fitting the size of your head is a must
  3. Always carry water, electrolyte and some food for refueling
  4. Wear good shoes- Sport shoes
  5. Adjust the seat height before you start. Generally once you are on the cycle, your feet should tip toe to the ground.
  6. If you can and have the control with every obstacle- pot holes, speed breakers, Lift your butt off the seat
  7. Keep a doable distance in mind. Last Go Slow & Enjoy the ride

Tada for now, Stay stupid but carefully! 😉

Runner’s Alert: Sudden Cardiac Arrest

Day: 4th Feb, the night before me and my dad were extremely motivated to do an early morning workout instead of our regular evening workouts. In all that excitement, we left our house not realizing that the gym is shut on Monday mornings. Disappointed but not willing to waste our time, we headed to five gardens for a walk-jog not realizing what it had in store for us.

We were at our 4th ( each round being 800mts). My dad was happily surprised to see this area booming with activity contributed by old, young and middle-aged man alike. A few meters down, we saw a person (mostly a runner, let’s call him Mr. Runner) collapsed on the road with 5-10 people surrounding him. One of them was trying to give him chest compressions. I rushed to the spot.

Confusion had ensued. People didn’t know of him, about him. Turns out he was running/walking/jogging alone. Few of them found an ID and a cell phone. And the other few were trying to call an ambulance. While I was trying to find a pulse, radial pulse was very feeble, the person had extremely labored breathing. Without further ado, I continued the compressions. I knew we needed to get him to a hospital soon. So, without waiting for the ambulance, people loaded the person in the taxi. I soon realized I didn’t have any money or cell phone on me. I borrowed some money from the people around and rushed the person to S.R. Mehta Hospital. Sadly, being in the taxi didn’t allow me to give any compressions. Mr. Runner had stopped breathing on our way. I was in desperation trying to call people he has recently called. Thankfully his phone was unlocked and one of his friends picked up the early morning call and passed the message onto his family all of whom resided in Pune.

Reaching the hospital took 5 minutes, taking him up to the emergency another 2 minutes. Meanwhile, his daughter got the news and was calling him on his phone. I talked to the daughter explaining what happened and soon the doctor requested to talk to a relative. He was proclaimed dead.

I, being a Sports Physio, never get into positions where I have to deal with life and death. This was my second. First one was with my father, and he is ok now. This one was an unknown person but that didn’t make it any easier. After consoling his daughter and giving my details to the hospital in case they needed to contact me, I went back to the five gardens where my dad was waiting for me. This experience made me realize a few important things.

If Mr. Runner didn’t have his ID card on him and his phone unlocked, it would have been extremely difficult to identify the person and call his family. In spite of his phone being unlocked, only after dialing 3 recently called people, the third one picked up and that guy knew the family and had his daughter’s number on him. How could this entire process be made easy? Here’s a solution.

Runners often run around in different areas and by lanes. It is important to have something with you that identifies you in case of an emergency. Most of us have those tiny pockets in our shorts or slacks that could fit in a paper with the following details.

  • Name
  • Emergency Contact Details
  • Area of Residence
  • Medical Details like Blood Group and any important condition diagnosed with.

For Eg: Mr. A, Wife: # 123456789, Juhu, A+, Diabetes

For those running with their phones on them, can save these details on their phone screen and feed in emergency dial numbers accessible without unlocking the phone.

With respect to those running with their watches, I wish there was some way to put up all the emergency details that could be easily accessible. It’s extremely important that companies make some provision for this.

And with all due fairness, you might think this won’t happen to you. You probably are someone who gets regular checkups done. And are someone who eats healthy and stays fit.

So was Mr. Runner, he was someone who did yoga and was extremely fit. He worked at a high rank in the Indian Intelligence Bureau. He had his medical checkups done regularly. But, incidences like these happen and more so, they are now on an upward trend.

Sudden cardiac death (SCD) is described as an event that is non-traumatic, non-violent, unexpected and resulting from sudden cardiac arrest within six hours of previously witnessed normal health [1,2,3]. It is a rare but tragic condition usually precipitated by physical activity which occurs not only in athletes but in all people.

The only way to prepare yourself for an incident like this is to be aware of how we can help ourselves first and then learn how to help others.

P.S. The Incidence is reported to my best knowledge. The concerned Mr. Runner was as per sighted by other people. Kindly remember I reached when the person was already subconscious. The family mentioned that he didn’t run but would brisk walk 9 -12 km per day. He didn’t have any prior history of major cardiac abnormality. Although he was diagnosed with some ECG abnormalities, 5-6 years ago, nature unknown and resolved with medications.


1.Cross B J, Estes M, Link M S. Sudden cardiac death in young athletes and nonathletes. Curr opin crit care. 2011;17:328–334. [PubMed]

2.Pugh A, Bourke J P, Kunadian V. Sudden cardiac death among competitive adult athletes: a review. Postgrad Med J. 2012
[Epub ahead of print.] [PubMed]

3.Sharma S, Whyte G, McKenna W J. Sudden death from cardiovascular disease in young athletes: fact or fiction?. BR J Sports Med. 1997;31:269–276. [PMC free article] [PubMed]

Take care: 23 hours for Faster Pain Relief.

Even after trying multitudes of treatment options, many undergo the perpetual cycle of pain. They find chronic pain persisting in spite of the best assessment and  treatment methods  applied.

Why is that ?

The secret to pain relief  doesn’t lie in the one hour of treatment you go through in a day or sometimes in 2-3 days. It depends more on what you do in the next 23 hours that are not monitored by the Physiotherapist.images

For the one hour of treatment to show its effectiveness and cause pain relief over time, it is extremely important to be aware of what we are doing to aggravate or relieve the pain throughout the day.

There are many triggering factors during various movements we perform. Learn and get insight on how to control them to create a better environment for healing. The best person to instruct you regarding this, is your physio. Don’t forget to ask about the  correct ergonomical postures to be maintained during house as well as office work.

I am open to questions on my FB page: Dr Hemali Mehta

Take care of your 24 hours! Signing off..


Bio mechanical or Biochemical?

Back Pain? Knee pain? Shoulder pain? Neck pain or Headaches?
Pop a Pill!  How many of us have done that  and still continue to do it?
But, Pain does come back. And there you are. Again, repeating
the cycle, popping a pill.

Think whether the cause of your re-current pain is a Biochemical Issue or a Bio mechanical one?IMG-20160128-WA0002-c869fa53-1199-4bf6-88e1-3e26abe1fe26.jpg

Many a times wrong postures during sitting, standing, walking, lifting put uneven loads on our bodies causing damage This activities repeated over and over through the days, weeks , months and years cause the tissues to come to a point of tolerance and breakdown.

Popping a pill will numb the pain from the breakdown. It doesn’t stop the breakdown or reverse it, nor does it treat the root cause of the  pain. To achieve a more sustained pain relief, next time don’t pop a pill or inject your back. Book an appointment with  a Physio to get yourself corrected bio mechanically.

Tada for now! Stay Fit..

1 Simple test to determine how fit you are!

Generations back, we used the squatting toilet. In India and some eastern countries, Sitting on the floor in a cross legged position was the norm while eating, reading and watching television. As luxury creeped into our lifestyle, our modes of sitting changed to chair and a sitting toilet. We hardly sit on the floor these days.

Also, Now if I asked you to do that you would probably struggle with it. Sitting on the floor in a cross legged or a full squat position is extremely challenging. It requires enough stability, strength, balance, Power, flexibility and motor control. It also depends on how much you weigh. Increased weight makes it difficult for you to sit on the floor and get up without using support.

A research Study published in European Journal in 2014 Continue reading “1 Simple test to determine how fit you are!”

FootNotes : Are Flat feet, evolution for sedentary?

Guilty I am of posting after a ridiculously long break. Life gets busy and sometimes there is no way out. Well this time off, got me to a few realizations. Few Crazy ones. I am going to talk about my First realization or rather discovery as you might have guessed from the heading. Evoluntion-ary Flat Feet.

After having worked in a Sports Speciality clinic in Boston under a Physio
therapist who specializes in Orthotics. I learnt my bit about foot. Since quite a while, I have been noticing that almost 70% of my patients with Back, Knee, Ankle problems sometimes even Shoulder pain have Flat foot or feet to vary-ing extents.

Continue reading “FootNotes : Are Flat feet, evolution for sedentary?”