Nutrition And Cognitive Health

A child belonging to the lower socioeconomic status, not only has to struggle with a lack of educational opportunities but also a lack of healthy nutrition. This child will most likely go through their formative years having a poor diet which lacks most essential nutrients. This may lead to a lower academic performance throughout the school years, which in turn may lead to fewer job opportunities resulting in lower socioeconomic status. When the same child grows up and starts own family, the cycle continues to the next generation. On the other side of the socio-economic spectrum, a child belonging to an affluent urban family also deals with poor nutrition but in a very different way. More than one-third of such children and adolescents, aged 6yrs to 19yrs, are considered overweight or obese. This is because these children are overfed but remain undernourished. Studies show that more than 90% of children in urban areas, belonging to affluent families, consume more than the recommended amounts of saturated fats and added sugars. The consumption of fruits and vegetables in these children is also observed to be less than the recommended intake. Thus, even though they may appear to be well nourished, they have many underlying nutritional deficiencies. Some of these deficiencies impact the performance of these children in academics and extracurricular activities.

Relationship Between Breakfast And Academic Performance

There have been many studies that have looked at the relationship between breakfast consumption and academic performance in children, and most have concluded that eating breakfast improves cognitive functions like memory recall. A study was done in Norway which looked at 475 high school children, found that those who ate breakfast regularly had fewer difficulties in learning, especially mathematics, besides improved reading and writing. Another study carried out in China on kindergarten students found that kids who ate breakfast had higher IQs (intelligent quotients). This was independent of the education level of the parents, or the family’s socioeconomic status. Many similar studies carried out over the years have reported that skipping breakfast was associated with decreased cognitive performance (e.g., alertness, attention, memory, processing of complex visual display, problem-solving, etc.) among the students. Children who do not eat an adequate breakfast can also suffer from hunger pangs while in school, headaches, and stomach pains due to excessive acid, etc. This, besides being a source of distraction for children, can also lead to absence from classes, which in turn can affect academic performance in school.

Relationship Between Specific Foods And Academic Performance

Interestingly, studies have not just found a positive association with breakfast consumption but also between the quality of meals and academic performance. A study carried out in Scotland investigated the consumption of sugary drinks, sweets, chocolates, pizza, savory snacks and hot dogs with learning abilities. The study found that children who had a higher consumption of these foods had increased mathematical difficulties as compared to children who had a more nutritious dietary intake. Another study found that children who ate healthier foods with a low glycemic index had better attention span, word recall and reaction time than children who consumed food with a higher glycemic index that leads to high blood glucose levels soon after consumption Sub-optimal intake of foods, such as fruits, vegetables, and dairy products, has also been associated with lower grades among students.

Relationship Between Physical Activity And Academic Performance

Physical activity is another very important factor that affects academic performance. Today, many mothers with children as young as 10 years old, feel that enrolling their children in extracurricular activities will take time away from their studies and result in poorer academic results. On the contrary, studies have shown that students who are physically active, perform better in school, compared to children who are physically inactive. These kids not only have better grades but also better attendance and fewer absenteeism, better memory recall, concentration during lessons and lesser disciplinary problems. Physically inactive children who gradually increased their activity showed improved memory and cognitive function than when they were physically inactive.

Relationship Between Specific Nutrients And Academics Performance

There are specific micro-nutrients that have been associated with better academic performance.

Children with deficiencies of micronutrients like vitamin A, B6, B12, folic acid, iron, zinc, and calcium, have shown to score lower grades and result in higher absenteeism. Two nutrients, known to have the strongest relation to school performance, are iron and zinc. Iron is an integral part of hemoglobin which is the oxygen-carrying molecule in the blood. Deficiency of iron is called anemia. Symptoms of iron deficiency include fatigue or tiredness, lethargy, slowed growth and development, poor appetite, abnormally rapid breathing, behavioral problems or disciplinary issues and susceptibility to frequent infections. All these individually and collectively can lead to increased absenteeism and thereby decreased academic performance. Iron deficiency also directly affects the ability to undertake physical activity, which in turn can further affect performance in school. Zinc is mainly needed for the body’s immune system to work properly. In addition, it is involved in cell growth, wound healing and for the sense of taste and smell. Symptoms of zinc deficiency are depression and psychological disorders, impaired immunity, impaired growth, diarrhea, delayed sexual maturation, alopecia or abnormal hair growth, impaired appetite, altered cognitive functions and altered sense of smell and taste. Zinc deficiency also leads to poorer performance in school. This can be due to the fact that children with zinc deficiency are more prone to catching an infection and falling sick, thereby missing classes, their ability to memorize is affected, there are psychological disorders that can affect learning, etc. So, how can parents ensure that they give their children the best advantage for improving academic performance? Some of the suggestions are as follows:

• Give them a nutritious breakfast.
• Always have healthy snacks stocked in your pantries, so that kids eat the right foods throughout the day.
• Don’t be fooled by “Low Fat” labels. Such products are usually loaded with sugar. Similarly, “natural” does not always mean whole grain or unrefined ingredients. Educate yourself about reading the labels and identifying what they mean.
• Encourage your children to be physically active, it will not only help them improve their academic performance but also help in building their overall personality.
• A good healthy balanced diet will ensure that your children do not suffer from any nutritional deficiencies.

Kanupriya Khanna, a Sr. Consultant Nutritionist & Dietitian specializing in pediatrics, is a private practitioner at Greater Kailash, New Delhi. For over 15 years, she has been working with mothers and children to create more wholesome food habits with the least restrictions and disruptions. She pioneers the science of healthy eating, using fresh ingredients and foods that are easily available and can be integrated easily into daily lives.

Take for instance Life In Control and Wellthy Therapeutics. These digital platforms connect patients with doctors and coaches and provide personalized care in terms of diet and exercise plan. Users can create long-term health goals, follow-up daily tasks and keep tabs on their health profile including HbA1C and glucose levels, track medicines intake and understand how their daily routine affect these measures. These start-ups also give doctors the flexibility of reaching out to patients outside their clinical hours as well as to create and coach them on their personalized care plans. In the language of numbers, Life In Control has over 100 doctors on the platform and appears to have helped over a lakh patient with their app. Wellthy Therapeutics took the approach of a pilot program with diabetic patients and claims to have helped reduce both HbA1C levels by a little over 1% and an average weight reduction of 3.4 kgs over 16 weeks. It also got an endorsement by Asia’s largest diabetes association, Research Society for the Study of Diabetes in India. Both the apps are available for download on Android and iOS platforms.

Adding to the growing list of startups are those that detect blood glucose and connect directly to your smartphone. BioSense SYNC, for instance, is a compact Glucometer with Bluetooth connectivity to a user’s phone. It provides a detailed analysis of blood sugar data collected over a number of days. Similar to other diabetes management apps, a user can map their glucose data with their eating and exercising habits. Taking these interventions a step further, the start-up BeatO not only provides a smartphone Glucometer but also a range of diabetic friendly food products to munch upon. Patients can order medicines, sync their fitness devices and count calories on food items consumed. As of today, BeatO has served more than 25000 customers with a daily user add-on of 75-100. Most of these diabetes management apps can instantly connect a patient to a diabetic coach in case the sugar levels are off, and alert the patient’s family as well on concerning trends.

Complimenting these health management gurus, patients are also likely to benefit if there were devices providing at home diagnosis for diabetic complications, such as neuropathy, kidney malfunction or diabetic retinopathy. Scintiglo by Cutting Edge Medical Devices, Anupath by PathShodh and Sparsha by Yostra Labs have created Point of Care (PoC) tests to detect the first two complications. Scintiglo is a small handheld device that detects urinary proteins (should be trace levels in a healthy individual) at a low cost with remarkable accuracy and connects to a smartphone through a custom app. Anupath uses unique test strips for detection of specific biomarkers of diabetes, while also eliminating the need of usual sample preparation that one sees in clinics. Patients can get a comprehensive reading of their plasma and urine protein levels, HbA1c levels blood glucose and hemoglobin. While Sparsha, as the name suggests, focuses on touch-based tests that can diagnose diabetic peripheral neuropathy and send reports via users’ smartphone. Funded by the Department of Biotechnology grant (BIRAC), these start-ups focus on low-cost solutions, so an average user can save money on constant check-ups. Low costs also allow these start-ups to cater to rural segments of India, where a healthcare worker can refer patients to tertiary hospitals based on initial reports by these devices.

The complication of retinopathy, as mentioned above, relates to the slowly progressive disease of the eye and is one of the leading causes of blindness in diabetic patients. This segment is addressed by start-ups like ChironX and Artelus that use artificial intelligence to detect or monitor diabetic retinopathy risks from retinal image scans. Both the start-ups have achieved high accuracy of detection (over 95%) while the technology of AI confers an easy benefit of scanning retinas at a much faster speed to doctors and hospitals. Artelus also boasts to have saved over 3900 eyes so far from diabetic complications.

Given the burden of diabetes in every aspect of life (behavioral, physiological and financial), being handheld into recovery could be motivating for many patients. For maximum impact, we need to reach the furthest demographic corners of India, as diabetes has a growing prevalence in all sectors of the country. Infact, why wait for diabetes to knock at your door? One can also mitigate pre-diabetic conditions or reduce the chances of developing diabetes later in life. These start-ups aim to provide that ecosystem, where a patient can be led into an improved, healthy lifestyle at minimal costs. And just as it is heartening to see the growing awareness of Indians towards their health, it is equally imperative that these solutions are also as democratic as possible. Importantly in a booming start-up scenario, maintaining data integrity, complete transparency between doctors, patients and companies as well as strict adherence to ethical standards would go a long way in ensuring patient trust in this system.

About the author

Urvashi (Raheja) Bhattacharyya is a Biomedical Science graduate from Delhi University and a Ph.D. from National Centre for Biological Sciences. When not running behind her toddler, she spends time reading stuff about the brain, AI, ML, and latest innovations. Writing keeps her calm.

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InnoHEALTH Magazine | Volume 4 Issue 1 | Innovation in Diabetes – Unmet Needs
Highlights

• Exclusive interview of H.E Klas Molin, Ambassador of Sweden to India on “Sweden-India collaboration in the health sector”
• Digital healthcare
• DISHA: Need of the hour. How crucial is DISHA (Act) for the healthcare industry?

HIGHLIGHTS

• It possible to prevent burnout?
• Burnout can happen to anyone and everyone
• Burnout should not be underestimated

Have you ever heard someone say, “I’m exhausted”, or “I’m dead tired”? This is often how people unknowingly express the sensation of burnout. It is widely known that burnout is closely linked with stress, but it is much more than simply being tired, and it is often the case that the seriousness of burnout is overlooked.

Let us then ask the questions that need to be asked when talking about the subject of burnout. Is it possible to prevent burnout? How do we know when we have been exposed to either too much – positive or negative stress? How can we change our lifestyles accordingly to make the meaningful and sustained change to make ourselves more immune to burnout?

Stress is perception based

It is primarily our perception or evaluation of something that determines whether or not we become stressed. If we perceive an object to be too challenging or potentially dangerous in some way, the “flight” type of emotional and mental reactions surface, eventually influencing the body – this is the route of negative stress. If something is challenging enough and we deem the odds of success leading to a potential opportunity in our favour, the “fight” type of emotional and mental reactions occur, and we experience positive stress.

Regardless of the polarity of stress (positive or negative), biochemically your body reacts in the same way. Whenever our subconscious autopilot system detects a stressor, adrenaline and cortisol are released from our adrenal glands located on top of the kidneys. Our blood pressure rises, our muscles tense, heart rate elevates, and digestion is inhibited, all preparing us to either fight or take flight. We all have experienced this feeling, like a sudden rush. However, being constantly exposed to prolonged episodes of stress impacts the health of our body and reinforces unhealthy patterns mentally as well as emotionally. It can weaken the immune system, cause more regular mood swings, and can manifest as if being ‘on the ashes’, ultimately resulting in burnout.

However, whether it is a one-time major life event (think of a tsunami), or the constant day-to-day sub-threshold sensation of being ‘stressed’ (think minor but regular waves), at one point you’ll reach your breaking point where the stress reaction gives way to exhaustion, resulting in the sensations of feeling burnt out.

I can handle everything – Always! Burnout usually works in either of the two ways, more frequently as a manifestation of chronic stress, or the result of one sudden life-changing event. Because burnout is closely linked with increasing stress, you may already assume that this isn’t a result of one single event but is rather a question of lifestyle choices and skills to handle the inner turmoil that gets triggered by certain events.

Burnout can happen to anyone and everyone, however, there are certain types of people more prone than others. Those who are success or achievement oriented, so-called “career” people, managers and entrepreneurs tend to be more susceptible. They are the people who seem capable of anything. These sorts of people live for their work, strive for success and never switch off.

They are burdened with numerous to-do lists and they check their work emails on a Sunday. They are always on the go and find it difficult taking time out. They validate themselves based on their achievements and getting things done. Even during their vacation, they feel the need to be on the go, filling their days with planned activities and engagements. The bigger picture is very often completely lost; they just don’t seem to be able to stop the lifestyle of ‘busyness’.

When you look at that description you may notice that these people seem invincible, they don’t seem to complain and seem to be able to manage everything. However, their lives are filled with dangerous amounts of positive stress or eustress. Of course, this positive stress feels good in the beginning and is indeed useful because it helps to get things done and achieve goals. However, in positive stress ‘mobilizing us for action’ means the constant release of adrenaline and cortisol from the adrenal glands – the stress hormones.

From the perspective of burnout, it is irrelevant whether the events that lead to the need to mobilize are “positive” or “negative” and if this lifestyle becomes habitual, it can quickly lead to near addiction because one adrenaline rush primes the craving for another. Negative stress is not a problem because everyone already avoids it due to its association with negative feelings. Most of the cases of burnout today are caused by people “riding the wave” of positive stress because people do not expect it to be dangerous – on the contrary, it is almost actively encouraged and often glorified.

Lifestyle Changes – No Easy Way Out

It is very much the common and accepted prevailing attitude of our modern working world that it’s perfectly normal to be “stressed”. It is no wonder then that more and more of us are facing burnout.

In order to prevent or recover from burnout, we must adjust our whole lifestyle. Already the term “lifestyle” suggests that this is not just a minor phenomenon that can be simply fixed with a few good night’s sleep or a vacation. This is not a bacterial infection that can be cured by taking a few pills and then rushing back to our “normal” life where stress reaction is considered inevitable. It is this attitude that is what really needs changing leading to skills that help in handling reactions.

One must consider both the physical and psychological sides, understanding that psychological arousal leads to a stress reaction in the physical body. It’s not just about reassessing values, setting priorities or time management. The most crucial elements to address are the chronic emotional and mental reactions.

What can be done to prevent burnout from taking hold? By educating ourselves on how we function internally will help us further understand the problems associated with burnout. This will help you make better and more informed choices for yourself.

Learning relaxation exercises, in particular stress relieving breathing exercises will also help, but in essence it’s already alleviating a consequence caused by a reaction. It is important to take time out during our busy days to just sit and simply be. It seems obvious, but many of us feel guilty for investing in sufficient leisure time. Make it a point to put aside a certain time each week to do that thing you have been meaning to do, make good on that promise to meet a friend, do something with your loved ones, or do something entirely for yourself. Just make sure you do it. Making sure we are getting 7-9 hours per night of continuous quality sleep can make all the difference in how we think and feel.

Finally, try consulting a competent specialist, psychiatrist, psychologist, nutrition therapist, fitness trainer, or a yoga teacher to guide you in all directions – physical, emotional, mental, conscious and the self. Seek a solution that enables you to release automatic emotional reactions. You have found an effective method when the same situations do not trigger the reaction that was previously the problem.

CONCLUSION

Burnout should not be underestimated or downplayed as a mere side effect of modern day living. In understanding the physiological effects, we see just how dangerous burnout can be in the long-term. By implementing a lifestyle adjustment will ensure that burnout is prevented, however learning to discontinue emotional reactions that lead to stimulation of the adrenal glands is the key. Learning intra-personal skills and training awareness will naturally expand your understanding in many other areas of life, helping to transition from dealing with problematic consequences to skillfully creating your own destiny.

Read all the issues of InnoHEALTH magazine:
InnoHEALTH Volume 1 Issue 1 (July to September 2016) – https://goo.gl/iWAwN2 
InnoHEALTH Volume 1 Issue 2 (October to December 2016) – https://goo.gl/4GGMJz 
InnoHEALTH Volume 2 Issue 1 (January to March 2017) – https://goo.gl/DEyKnw 
InnoHEALTH Volume 2 Issue 2 (April to June 2017) – https://goo.gl/Nv3eev
InnoHEALTH Volume 2 Issue 3 (July to September 2017) – https://goo.gl/MCVjd6

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